|
PR TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
|
Professional
|
Both
|
$4,641.00
|
|
|
Service Code
|
HCPCS 35331
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$3,248.70 |
| Rate for Payer: Aetna Commercial |
$1,949.74
|
| Rate for Payer: BCBS Complete |
$952.75
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: Cash Price |
$3,712.80
|
| Rate for Payer: Cash Price |
$3,712.80
|
| Rate for Payer: Meridian Medicaid |
$952.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$907.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,248.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,269.33
|
| Rate for Payer: Priority Health Narrow Network |
$2,269.33
|
| Rate for Payer: Priority Health SBD |
$2,269.33
|
| Rate for Payer: UMR Bronson Commercial |
$2,134.86
|
|
|
PR TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL
|
Professional
|
Both
|
$3,275.00
|
|
|
Service Code
|
HCPCS 35363
|
| Min. Negotiated Rate |
$1,012.60 |
| Max. Negotiated Rate |
$2,517.22 |
| Rate for Payer: Aetna Commercial |
$2,184.46
|
| Rate for Payer: BCBS Complete |
$1,063.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.79
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Meridian Medicaid |
$1,063.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,012.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,517.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,517.22
|
| Rate for Payer: Priority Health SBD |
$2,517.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,506.50
|
|
|
PR TEAEC W/WO PATCH GRAFT COMMON FEMORAL
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 35371
|
| Min. Negotiated Rate |
$508.43 |
| Max. Negotiated Rate |
$1,266.58 |
| Rate for Payer: Aetna Commercial |
$1,096.85
|
| Rate for Payer: BCBS Complete |
$533.85
|
| Rate for Payer: BCBS Trust/PPO |
$666.19
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Meridian Medicaid |
$533.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,266.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,266.58
|
| Rate for Payer: Priority Health SBD |
$1,266.58
|
| Rate for Payer: UMR Bronson Commercial |
$789.82
|
|
|
PR TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL
|
Professional
|
Both
|
$3,699.00
|
|
|
Service Code
|
HCPCS 35372
|
| Min. Negotiated Rate |
$609.18 |
| Max. Negotiated Rate |
$2,589.30 |
| Rate for Payer: Aetna Commercial |
$1,311.71
|
| Rate for Payer: BCBS Complete |
$639.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.49
|
| Rate for Payer: Cash Price |
$2,959.20
|
| Rate for Payer: Cash Price |
$2,959.20
|
| Rate for Payer: Meridian Medicaid |
$639.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,589.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,515.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,515.55
|
| Rate for Payer: Priority Health SBD |
$1,515.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,701.54
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIAC
|
Professional
|
Both
|
$2,478.00
|
|
|
Service Code
|
HCPCS 35351
|
| Min. Negotiated Rate |
$801.73 |
| Max. Negotiated Rate |
$1,993.77 |
| Rate for Payer: Aetna Commercial |
$1,728.25
|
| Rate for Payer: BCBS Complete |
$841.82
|
| Rate for Payer: BCBS Trust/PPO |
$942.49
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Meridian Medicaid |
$841.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,993.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,993.77
|
| Rate for Payer: Priority Health SBD |
$1,993.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,139.88
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIOFEMORAL
|
Professional
|
Both
|
$2,013.00
|
|
|
Service Code
|
HCPCS 35355
|
| Min. Negotiated Rate |
$641.34 |
| Max. Negotiated Rate |
$1,596.40 |
| Rate for Payer: Aetna Commercial |
$1,386.40
|
| Rate for Payer: BCBS Complete |
$673.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.22
|
| Rate for Payer: Cash Price |
$1,610.40
|
| Rate for Payer: Cash Price |
$1,610.40
|
| Rate for Payer: Meridian Medicaid |
$673.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,596.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,596.40
|
| Rate for Payer: Priority Health SBD |
$1,596.40
|
| Rate for Payer: UMR Bronson Commercial |
$925.98
|
|
|
PR TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL
|
Professional
|
Both
|
$4,420.00
|
|
|
Service Code
|
HCPCS 35341
|
| Min. Negotiated Rate |
$865.42 |
| Max. Negotiated Rate |
$3,094.00 |
| Rate for Payer: Aetna Commercial |
$1,840.86
|
| Rate for Payer: BCBS Complete |
$908.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.71
|
| Rate for Payer: Cash Price |
$3,536.00
|
| Rate for Payer: Cash Price |
$3,536.00
|
| Rate for Payer: Meridian Medicaid |
$908.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$865.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,094.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,146.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,146.98
|
| Rate for Payer: Priority Health SBD |
$2,146.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,033.20
|
|
|
PR TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL
|
Professional
|
Both
|
$3,779.00
|
|
|
Service Code
|
HCPCS 35321
|
| Min. Negotiated Rate |
$561.89 |
| Max. Negotiated Rate |
$2,645.30 |
| Rate for Payer: Aetna Commercial |
$1,199.86
|
| Rate for Payer: BCBS Complete |
$589.98
|
| Rate for Payer: BCBS Trust/PPO |
$677.28
|
| Rate for Payer: Cash Price |
$3,023.20
|
| Rate for Payer: Cash Price |
$3,023.20
|
| Rate for Payer: Meridian Medicaid |
$589.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,645.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,393.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,393.72
|
| Rate for Payer: Priority Health SBD |
$1,393.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,738.34
|
|
|
PR TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC
|
Professional
|
Both
|
$2,790.00
|
|
|
Service Code
|
HCPCS 35311
|
| Min. Negotiated Rate |
$970.00 |
| Max. Negotiated Rate |
$2,421.48 |
| Rate for Payer: Aetna Commercial |
$2,093.18
|
| Rate for Payer: BCBS Complete |
$1,018.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Meridian Medicaid |
$1,018.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,421.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,421.48
|
| Rate for Payer: Priority Health SBD |
$2,421.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,283.40
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 99368
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$852.68 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS Trust/PPO |
$852.68
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.54
|
| Rate for Payer: Priority Health Narrow Network |
$44.54
|
| Rate for Payer: Priority Health SBD |
$44.54
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 99367
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$232.98 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS Trust/PPO |
$232.98
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.53
|
| Rate for Payer: Priority Health Narrow Network |
$68.53
|
| Rate for Payer: Priority Health SBD |
$68.53
|
| Rate for Payer: UMR Bronson Commercial |
$69.00
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$326.32 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$672.54
|
| Rate for Payer: BCBS Complete |
$342.64
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: Cash Price |
$872.80
|
| Rate for Payer: Cash Price |
$872.80
|
| Rate for Payer: Meridian Medicaid |
$342.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$775.17
|
| Rate for Payer: Priority Health Narrow Network |
$775.17
|
| Rate for Payer: Priority Health SBD |
$775.17
|
| Rate for Payer: UMR Bronson Commercial |
$501.86
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,009.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$148.45 |
| Max. Negotiated Rate |
$894.65 |
| Rate for Payer: Aetna Commercial |
$772.36
|
| Rate for Payer: BCBS Complete |
$396.31
|
| Rate for Payer: BCBS Trust/PPO |
$148.45
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Meridian Medicaid |
$396.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$706.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.65
|
| Rate for Payer: Priority Health Narrow Network |
$894.65
|
| Rate for Payer: Priority Health SBD |
$894.65
|
| Rate for Payer: UMR Bronson Commercial |
$464.14
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,157.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$809.90 |
| Rate for Payer: Aetna Commercial |
$384.81
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.43
|
| Rate for Payer: Priority Health Narrow Network |
$452.43
|
| Rate for Payer: Priority Health SBD |
$452.43
|
| Rate for Payer: UMR Bronson Commercial |
$532.22
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,157.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$509.08 |
| Max. Negotiated Rate |
$1,041.30 |
| Rate for Payer: Aetna American Axle |
$752.05
|
| Rate for Payer: Aetna Commercial |
$983.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.05
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cofinity Commercial |
$809.90
|
| Rate for Payer: Cofinity Commercial |
$995.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.60
|
| Rate for Payer: Healthscope Commercial |
$1,041.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$809.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$983.45
|
| Rate for Payer: PHP Commercial |
$983.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health SBD |
$728.91
|
| Rate for Payer: UMR Bronson Commercial |
$509.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.75
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,157.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$294.04 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$752.05
|
| Rate for Payer: Aetna Commercial |
$983.45
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cofinity Commercial |
$809.90
|
| Rate for Payer: Cofinity Commercial |
$995.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$1,041.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$809.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.75
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$983.45
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$983.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Priority Health SBD |
$728.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$294.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$428.09
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.75
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,157.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$809.90 |
| Rate for Payer: Aetna Commercial |
$384.81
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.43
|
| Rate for Payer: Priority Health Narrow Network |
$452.43
|
| Rate for Payer: Priority Health SBD |
$452.43
|
| Rate for Payer: UMR Bronson Commercial |
$532.22
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,391.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$563.60 |
| Max. Negotiated Rate |
$1,351.68 |
| Rate for Payer: Aetna Commercial |
$1,159.57
|
| Rate for Payer: BCBS Complete |
$591.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.41
|
| Rate for Payer: Cash Price |
$1,112.80
|
| Rate for Payer: Cash Price |
$1,112.80
|
| Rate for Payer: Meridian Medicaid |
$591.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,351.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,351.68
|
| Rate for Payer: Priority Health SBD |
$1,351.68
|
| Rate for Payer: UMR Bronson Commercial |
$639.86
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$86.64 |
| Max. Negotiated Rate |
$926.31 |
| Rate for Payer: Aetna Commercial |
$824.71
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS Trust/PPO |
$86.64
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$926.31
|
| Rate for Payer: Priority Health Narrow Network |
$926.31
|
| Rate for Payer: Priority Health SBD |
$926.31
|
| Rate for Payer: UMR Bronson Commercial |
$492.66
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$995.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$857.34
|
| Rate for Payer: BCBS Complete |
$444.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Meridian Medicaid |
$444.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.20
|
| Rate for Payer: Priority Health SBD |
$1,016.20
|
| Rate for Payer: UMR Bronson Commercial |
$457.70
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,311.00
|
|
|
Service Code
|
HCPCS 23430
|
| Min. Negotiated Rate |
$106.55 |
| Max. Negotiated Rate |
$1,617.70 |
| Rate for Payer: Aetna Commercial |
$992.48
|
| Rate for Payer: BCBS Complete |
$506.12
|
| Rate for Payer: BCBS Trust/PPO |
$106.55
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Meridian Medicaid |
$506.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,145.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,145.39
|
| Rate for Payer: Priority Health SBD |
$1,145.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.06
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,311.00
|
|
|
Service Code
|
HCPCS 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$106.55 |
| Max. Negotiated Rate |
$1,617.70 |
| Rate for Payer: Aetna Commercial |
$992.48
|
| Rate for Payer: BCBS Complete |
$506.12
|
| Rate for Payer: BCBS Trust/PPO |
$106.55
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Meridian Medicaid |
$506.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,145.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,145.39
|
| Rate for Payer: Priority Health SBD |
$1,145.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.06
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
OP
|
$2,311.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$741.00 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna American Axle |
$1,502.15
|
| Rate for Payer: Aetna Commercial |
$1,964.35
|
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,976.83
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,617.70
|
| Rate for Payer: Cofinity Commercial |
$1,987.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,848.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$2,079.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,617.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,733.25
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,964.35
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$1,964.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Priority Health SBD |
$1,455.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$815.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$741.00
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: UMR Bronson Commercial |
$855.07
|
| Rate for Payer: VA VA |
$6,359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,733.25
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
IP
|
$2,311.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$1,016.84 |
| Max. Negotiated Rate |
$2,079.90 |
| Rate for Payer: Aetna American Axle |
$1,502.15
|
| Rate for Payer: Aetna Commercial |
$1,964.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.15
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,617.70
|
| Rate for Payer: Cofinity Commercial |
$1,987.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,848.80
|
| Rate for Payer: Healthscope Commercial |
$2,079.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,617.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,733.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,964.35
|
| Rate for Payer: PHP Commercial |
$1,964.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.70
|
| Rate for Payer: Priority Health SBD |
$1,455.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,016.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,733.25
|
|
|
PR TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 26471
|
| Min. Negotiated Rate |
$428.13 |
| Max. Negotiated Rate |
$1,867.54 |
| Rate for Payer: Aetna Commercial |
$869.56
|
| Rate for Payer: BCBS Complete |
$449.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.54
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Meridian Medicaid |
$449.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,027.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,027.43
|
| Rate for Payer: Priority Health SBD |
$1,027.43
|
| Rate for Payer: UMR Bronson Commercial |
$894.24
|
|
