|
PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,136.00
|
|
|
Service Code
|
HCPCS 33535
|
| Min. Negotiated Rate |
$2,054.40 |
| Max. Negotiated Rate |
$3,376.31 |
| Rate for Payer: Aetna Commercial |
$3,141.84
|
| Rate for Payer: Aetna Medicare |
$2,438.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,376.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,141.84
|
| Rate for Payer: BCBS Complete |
$2,054.40
|
| Rate for Payer: BCBS MAPPO |
$2,344.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,344.66
|
| Rate for Payer: Cash Price |
$4,108.80
|
| Rate for Payer: Cash Price |
$4,108.80
|
| Rate for Payer: Cofinity Commercial |
$3,376.31
|
| Rate for Payer: Cofinity Commercial |
$3,141.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,344.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,461.89
|
| Rate for Payer: Nomi Health Commercial |
$2,813.59
|
| Rate for Payer: PACE SWMI |
$2,344.66
|
| Rate for Payer: PHP Commercial |
$3,282.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,344.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,338.40
|
| Rate for Payer: Priority Health Medicare |
$2,344.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,344.66
|
| Rate for Payer: UHC Medicare Advantage |
$2,344.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,362.56
|
|
|
PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS
|
Professional
|
Both
|
$4,602.00
|
|
|
Service Code
|
HCPCS 33534
|
| Min. Negotiated Rate |
$1,840.80 |
| Max. Negotiated Rate |
$3,037.80 |
| Rate for Payer: Aetna Commercial |
$2,826.84
|
| Rate for Payer: Aetna Medicare |
$2,193.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,037.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,826.84
|
| Rate for Payer: BCBS Complete |
$1,840.80
|
| Rate for Payer: BCBS MAPPO |
$2,109.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,109.58
|
| Rate for Payer: Cash Price |
$3,681.60
|
| Rate for Payer: Cash Price |
$3,681.60
|
| Rate for Payer: Cofinity Commercial |
$3,037.80
|
| Rate for Payer: Cofinity Commercial |
$2,826.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,109.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,215.06
|
| Rate for Payer: Nomi Health Commercial |
$2,531.50
|
| Rate for Payer: PACE SWMI |
$2,109.58
|
| Rate for Payer: PHP Commercial |
$2,953.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,109.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,991.30
|
| Rate for Payer: Priority Health Medicare |
$2,109.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,109.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,109.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,116.92
|
|
|
PR CALIBRATED MICROCAP TUBE
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS A4651
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$50.05 |
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
PR CALORIC VESTIBULAR TEST, EACH IRRIGATION, WITH RECORDING
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 92543
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$12.35 |
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
|
|
PR CANALITH REPOSITIONING PROCEDURE
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 95992
|
| Min. Negotiated Rate |
$33.65 |
| Max. Negotiated Rate |
$85.15 |
| Rate for Payer: Aetna Commercial |
$45.09
|
| Rate for Payer: Aetna Medicare |
$35.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.09
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS MAPPO |
$33.65
|
| Rate for Payer: BCN Medicare Advantage |
$33.65
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$45.09
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.33
|
| Rate for Payer: Nomi Health Commercial |
$40.38
|
| Rate for Payer: PACE SWMI |
$33.65
|
| Rate for Payer: PHP Commercial |
$47.11
|
| Rate for Payer: PHP Medicare Advantage |
$33.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Medicare |
$33.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.65
|
| Rate for Payer: UHC Medicare Advantage |
$33.65
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
PR CANTHOPLASTY
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
HCPCS 67950
|
| Min. Negotiated Rate |
$427.13 |
| Max. Negotiated Rate |
$744.90 |
| Rate for Payer: Aetna Commercial |
$572.35
|
| Rate for Payer: Aetna Medicare |
$444.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.35
|
| Rate for Payer: BCBS Complete |
$458.40
|
| Rate for Payer: BCBS MAPPO |
$427.13
|
| Rate for Payer: BCN Medicare Advantage |
$427.13
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cofinity Commercial |
$615.07
|
| Rate for Payer: Cofinity Commercial |
$572.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.49
|
| Rate for Payer: Nomi Health Commercial |
$512.56
|
| Rate for Payer: PACE SWMI |
$427.13
|
| Rate for Payer: PHP Commercial |
$597.98
|
| Rate for Payer: PHP Medicare Advantage |
$427.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.90
|
| Rate for Payer: Priority Health Medicare |
$427.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.13
|
| Rate for Payer: UHC Medicare Advantage |
$427.13
|
| Rate for Payer: UMR Bronson Commercial |
$527.16
|
|
|
PR CANTHOTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 67715
|
| Min. Negotiated Rate |
$100.57 |
| Max. Negotiated Rate |
$243.10 |
| Rate for Payer: Aetna Commercial |
$134.76
|
| Rate for Payer: Aetna Medicare |
$104.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.76
|
| Rate for Payer: BCBS Complete |
$149.60
|
| Rate for Payer: BCBS MAPPO |
$100.57
|
| Rate for Payer: BCN Medicare Advantage |
$100.57
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$144.82
|
| Rate for Payer: Cofinity Commercial |
$134.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.60
|
| Rate for Payer: Nomi Health Commercial |
$120.68
|
| Rate for Payer: PACE SWMI |
$100.57
|
| Rate for Payer: PHP Commercial |
$140.80
|
| Rate for Payer: PHP Medicare Advantage |
$100.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.10
|
| Rate for Payer: Priority Health Medicare |
$100.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.57
|
| Rate for Payer: UHC Medicare Advantage |
$100.57
|
| Rate for Payer: UMR Bronson Commercial |
$172.04
|
|
|
PR CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC
|
Professional
|
Both
|
$4,799.00
|
|
|
Service Code
|
HCPCS 27036
|
| Min. Negotiated Rate |
$981.53 |
| Max. Negotiated Rate |
$3,119.35 |
| Rate for Payer: Aetna Commercial |
$1,315.25
|
| Rate for Payer: Aetna Medicare |
$1,020.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.25
|
| Rate for Payer: BCBS Complete |
$1,919.60
|
| Rate for Payer: BCBS MAPPO |
$981.53
|
| Rate for Payer: BCN Medicare Advantage |
$981.53
|
| Rate for Payer: Cash Price |
$3,839.20
|
| Rate for Payer: Cash Price |
$3,839.20
|
| Rate for Payer: Cofinity Commercial |
$1,413.40
|
| Rate for Payer: Cofinity Commercial |
$1,315.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$1,177.84
|
| Rate for Payer: PACE SWMI |
$981.53
|
| Rate for Payer: PHP Commercial |
$1,374.14
|
| Rate for Payer: PHP Medicare Advantage |
$981.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,119.35
|
| Rate for Payer: Priority Health Medicare |
$981.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.53
|
| Rate for Payer: UHC Medicare Advantage |
$981.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,207.54
|
|
|
PR CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS
|
Professional
|
Both
|
$1,755.00
|
|
|
Service Code
|
HCPCS 25320
|
| Min. Negotiated Rate |
$702.00 |
| Max. Negotiated Rate |
$1,374.54 |
| Rate for Payer: Aetna Commercial |
$1,279.08
|
| Rate for Payer: Aetna Medicare |
$992.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,279.08
|
| Rate for Payer: BCBS Complete |
$702.00
|
| Rate for Payer: BCBS MAPPO |
$954.54
|
| Rate for Payer: BCN Medicare Advantage |
$954.54
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cofinity Commercial |
$1,374.54
|
| Rate for Payer: Cofinity Commercial |
$1,279.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.27
|
| Rate for Payer: Nomi Health Commercial |
$1,145.45
|
| Rate for Payer: PACE SWMI |
$954.54
|
| Rate for Payer: PHP Commercial |
$1,336.36
|
| Rate for Payer: PHP Medicare Advantage |
$954.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,140.75
|
| Rate for Payer: Priority Health Medicare |
$954.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$954.54
|
| Rate for Payer: UHC Medicare Advantage |
$954.54
|
| Rate for Payer: UMR Bronson Commercial |
$807.30
|
|
|
PR CAPSULAR CONTRACTURE RELEASE
|
Professional
|
Both
|
$2,010.00
|
|
|
Service Code
|
HCPCS 23020
|
| Min. Negotiated Rate |
$668.27 |
| Max. Negotiated Rate |
$1,306.50 |
| Rate for Payer: Aetna Commercial |
$895.48
|
| Rate for Payer: Aetna Medicare |
$695.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.48
|
| Rate for Payer: BCBS Complete |
$804.00
|
| Rate for Payer: BCBS MAPPO |
$668.27
|
| Rate for Payer: BCN Medicare Advantage |
$668.27
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cofinity Commercial |
$962.31
|
| Rate for Payer: Cofinity Commercial |
$895.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.68
|
| Rate for Payer: Nomi Health Commercial |
$801.92
|
| Rate for Payer: PACE SWMI |
$668.27
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: PHP Medicare Advantage |
$668.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.50
|
| Rate for Payer: Priority Health Medicare |
$668.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.27
|
| Rate for Payer: UHC Medicare Advantage |
$668.27
|
| Rate for Payer: UMR Bronson Commercial |
$924.60
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26525
|
| Min. Negotiated Rate |
$634.25 |
| Max. Negotiated Rate |
$1,030.90 |
| Rate for Payer: Aetna Commercial |
$849.89
|
| Rate for Payer: Aetna Medicare |
$659.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.89
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$634.25
|
| Rate for Payer: BCN Medicare Advantage |
$634.25
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$913.32
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.96
|
| Rate for Payer: Nomi Health Commercial |
$761.10
|
| Rate for Payer: PACE SWMI |
$634.25
|
| Rate for Payer: PHP Commercial |
$887.95
|
| Rate for Payer: PHP Medicare Advantage |
$634.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$634.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.25
|
| Rate for Payer: UHC Medicare Advantage |
$634.25
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26520
|
| Min. Negotiated Rate |
$629.66 |
| Max. Negotiated Rate |
$1,030.90 |
| Rate for Payer: Aetna Commercial |
$843.74
|
| Rate for Payer: Aetna Medicare |
$654.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.74
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$629.66
|
| Rate for Payer: BCN Medicare Advantage |
$629.66
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$906.71
|
| Rate for Payer: Cofinity Commercial |
$843.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.14
|
| Rate for Payer: Nomi Health Commercial |
$755.59
|
| Rate for Payer: PACE SWMI |
$629.66
|
| Rate for Payer: PHP Commercial |
$881.52
|
| Rate for Payer: PHP Medicare Advantage |
$629.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$629.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.66
|
| Rate for Payer: UHC Medicare Advantage |
$629.66
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 28270
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$521.30 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.04
|
| Rate for Payer: BCBS Complete |
$320.80
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Commercial |
$448.25
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.30
|
| Rate for Payer: Priority Health Medicare |
$320.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
| Rate for Payer: UMR Bronson Commercial |
$368.92
|
|
|
PR CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 26516
|
| Min. Negotiated Rate |
$698.15 |
| Max. Negotiated Rate |
$1,301.95 |
| Rate for Payer: Aetna Commercial |
$935.52
|
| Rate for Payer: Aetna Medicare |
$726.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,005.34
|
| Rate for Payer: BCBS Complete |
$801.20
|
| Rate for Payer: BCBS MAPPO |
$698.15
|
| Rate for Payer: BCN Medicare Advantage |
$698.15
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$935.52
|
| Rate for Payer: Cofinity Commercial |
$1,005.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.06
|
| Rate for Payer: Nomi Health Commercial |
$837.78
|
| Rate for Payer: PACE SWMI |
$698.15
|
| Rate for Payer: PHP Commercial |
$977.41
|
| Rate for Payer: PHP Medicare Advantage |
$698.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.95
|
| Rate for Payer: Priority Health Medicare |
$698.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.15
|
| Rate for Payer: UHC Medicare Advantage |
$698.15
|
| Rate for Payer: UMR Bronson Commercial |
$921.38
|
|
|
PR CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON
|
Professional
|
Both
|
$2,867.00
|
|
|
Service Code
|
HCPCS 23450
|
| Min. Negotiated Rate |
$912.93 |
| Max. Negotiated Rate |
$1,863.55 |
| Rate for Payer: Aetna Commercial |
$1,223.33
|
| Rate for Payer: Aetna Medicare |
$949.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.33
|
| Rate for Payer: BCBS Complete |
$1,146.80
|
| Rate for Payer: BCBS MAPPO |
$912.93
|
| Rate for Payer: BCN Medicare Advantage |
$912.93
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,314.62
|
| Rate for Payer: Cofinity Commercial |
$1,223.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$958.58
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: PACE SWMI |
$912.93
|
| Rate for Payer: PHP Commercial |
$1,278.10
|
| Rate for Payer: PHP Medicare Advantage |
$912.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.55
|
| Rate for Payer: Priority Health Medicare |
$912.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$912.93
|
| Rate for Payer: UHC Medicare Advantage |
$912.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,318.82
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 23462
|
| Min. Negotiated Rate |
$1,029.48 |
| Max. Negotiated Rate |
$2,219.10 |
| Rate for Payer: Aetna Commercial |
$1,379.50
|
| Rate for Payer: Aetna Medicare |
$1,070.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.50
|
| Rate for Payer: BCBS Complete |
$1,365.60
|
| Rate for Payer: BCBS MAPPO |
$1,029.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.48
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,482.45
|
| Rate for Payer: Cofinity Commercial |
$1,379.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,080.95
|
| Rate for Payer: Nomi Health Commercial |
$1,235.38
|
| Rate for Payer: PACE SWMI |
$1,029.48
|
| Rate for Payer: PHP Commercial |
$1,441.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,219.10
|
| Rate for Payer: Priority Health Medicare |
$1,029.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,029.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,029.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.44
|
|
|
PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK
|
Professional
|
Both
|
$2,793.00
|
|
|
Service Code
|
HCPCS 23460
|
| Min. Negotiated Rate |
$1,051.24 |
| Max. Negotiated Rate |
$1,815.45 |
| Rate for Payer: Aetna Commercial |
$1,408.66
|
| Rate for Payer: Aetna Medicare |
$1,093.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.66
|
| Rate for Payer: BCBS Complete |
$1,117.20
|
| Rate for Payer: BCBS MAPPO |
$1,051.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,051.24
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,513.79
|
| Rate for Payer: Cofinity Commercial |
$1,408.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,051.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,103.80
|
| Rate for Payer: Nomi Health Commercial |
$1,261.49
|
| Rate for Payer: PACE SWMI |
$1,051.24
|
| Rate for Payer: PHP Commercial |
$1,471.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,051.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,815.45
|
| Rate for Payer: Priority Health Medicare |
$1,051.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,051.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,051.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,284.78
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR
|
Professional
|
Both
|
$3,203.00
|
|
|
Service Code
|
HCPCS 23455
|
| Min. Negotiated Rate |
$937.19 |
| Max. Negotiated Rate |
$2,081.95 |
| Rate for Payer: Aetna Commercial |
$1,255.83
|
| Rate for Payer: Aetna Medicare |
$974.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,255.83
|
| Rate for Payer: BCBS Complete |
$1,281.20
|
| Rate for Payer: BCBS MAPPO |
$937.19
|
| Rate for Payer: BCN Medicare Advantage |
$937.19
|
| Rate for Payer: Cash Price |
$2,562.40
|
| Rate for Payer: Cash Price |
$2,562.40
|
| Rate for Payer: Cofinity Commercial |
$1,349.55
|
| Rate for Payer: Cofinity Commercial |
$1,255.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.05
|
| Rate for Payer: Nomi Health Commercial |
$1,124.63
|
| Rate for Payer: PACE SWMI |
$937.19
|
| Rate for Payer: PHP Commercial |
$1,312.07
|
| Rate for Payer: PHP Medicare Advantage |
$937.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,081.95
|
| Rate for Payer: Priority Health Medicare |
$937.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.19
|
| Rate for Payer: UHC Medicare Advantage |
$937.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,473.38
|
|
|
PR CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK
|
Professional
|
Both
|
$3,500.00
|
|
|
Service Code
|
HCPCS 23465
|
| Min. Negotiated Rate |
$1,077.85 |
| Max. Negotiated Rate |
$2,275.00 |
| Rate for Payer: Aetna Commercial |
$1,444.32
|
| Rate for Payer: Aetna Medicare |
$1,120.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.32
|
| Rate for Payer: BCBS Complete |
$1,400.00
|
| Rate for Payer: BCBS MAPPO |
$1,077.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.85
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cofinity Commercial |
$1,552.10
|
| Rate for Payer: Cofinity Commercial |
$1,444.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.74
|
| Rate for Payer: Nomi Health Commercial |
$1,293.42
|
| Rate for Payer: PACE SWMI |
$1,077.85
|
| Rate for Payer: PHP Commercial |
$1,508.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,275.00
|
| Rate for Payer: Priority Health Medicare |
$1,077.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,610.00
|
|
|
PR CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS
|
Professional
|
Both
|
$2,008.00
|
|
|
Service Code
|
HCPCS 23466
|
| Min. Negotiated Rate |
$803.20 |
| Max. Negotiated Rate |
$1,551.23 |
| Rate for Payer: Aetna Commercial |
$1,443.50
|
| Rate for Payer: Aetna Medicare |
$1,120.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,551.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.50
|
| Rate for Payer: BCBS Complete |
$803.20
|
| Rate for Payer: BCBS MAPPO |
$1,077.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.24
|
| Rate for Payer: Cash Price |
$1,606.40
|
| Rate for Payer: Cash Price |
$1,606.40
|
| Rate for Payer: Cofinity Commercial |
$1,551.23
|
| Rate for Payer: Cofinity Commercial |
$1,443.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.10
|
| Rate for Payer: Nomi Health Commercial |
$1,292.69
|
| Rate for Payer: PACE SWMI |
$1,077.24
|
| Rate for Payer: PHP Commercial |
$1,508.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.20
|
| Rate for Payer: Priority Health Medicare |
$1,077.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.24
|
| Rate for Payer: UMR Bronson Commercial |
$923.68
|
|
|
PR CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 28260
|
| Min. Negotiated Rate |
$515.71 |
| Max. Negotiated Rate |
$1,011.40 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: Aetna Medicare |
$536.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.05
|
| Rate for Payer: BCBS Complete |
$622.40
|
| Rate for Payer: BCBS MAPPO |
$515.71
|
| Rate for Payer: BCN Medicare Advantage |
$515.71
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$742.62
|
| Rate for Payer: Cofinity Commercial |
$691.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.50
|
| Rate for Payer: Nomi Health Commercial |
$618.85
|
| Rate for Payer: PACE SWMI |
$515.71
|
| Rate for Payer: PHP Commercial |
$721.99
|
| Rate for Payer: PHP Medicare Advantage |
$515.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.40
|
| Rate for Payer: Priority Health Medicare |
$515.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.71
|
| Rate for Payer: UHC Medicare Advantage |
$515.71
|
| Rate for Payer: UMR Bronson Commercial |
$715.76
|
|
|
PR CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE
|
Professional
|
Both
|
$2,715.00
|
|
|
Service Code
|
HCPCS 27435
|
| Min. Negotiated Rate |
$779.12 |
| Max. Negotiated Rate |
$1,764.75 |
| Rate for Payer: Aetna Commercial |
$1,044.02
|
| Rate for Payer: Aetna Medicare |
$810.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.02
|
| Rate for Payer: BCBS Complete |
$1,086.00
|
| Rate for Payer: BCBS MAPPO |
$779.12
|
| Rate for Payer: BCN Medicare Advantage |
$779.12
|
| Rate for Payer: Cash Price |
$2,172.00
|
| Rate for Payer: Cash Price |
$2,172.00
|
| Rate for Payer: Cofinity Commercial |
$1,121.93
|
| Rate for Payer: Cofinity Commercial |
$1,044.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.08
|
| Rate for Payer: Nomi Health Commercial |
$934.94
|
| Rate for Payer: PACE SWMI |
$779.12
|
| Rate for Payer: PHP Commercial |
$1,090.77
|
| Rate for Payer: PHP Medicare Advantage |
$779.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.75
|
| Rate for Payer: Priority Health Medicare |
$779.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.12
|
| Rate for Payer: UHC Medicare Advantage |
$779.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,248.90
|
|
|
PR CAPSULOTOMY WRIST
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 25085
|
| Min. Negotiated Rate |
$435.03 |
| Max. Negotiated Rate |
$1,066.00 |
| Rate for Payer: Aetna Commercial |
$582.94
|
| Rate for Payer: Aetna Medicare |
$452.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.94
|
| Rate for Payer: BCBS Complete |
$656.00
|
| Rate for Payer: BCBS MAPPO |
$435.03
|
| Rate for Payer: BCN Medicare Advantage |
$435.03
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cofinity Commercial |
$626.44
|
| Rate for Payer: Cofinity Commercial |
$582.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.78
|
| Rate for Payer: Nomi Health Commercial |
$522.04
|
| Rate for Payer: PACE SWMI |
$435.03
|
| Rate for Payer: PHP Commercial |
$609.04
|
| Rate for Payer: PHP Medicare Advantage |
$435.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.00
|
| Rate for Payer: Priority Health Medicare |
$435.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.03
|
| Rate for Payer: UHC Medicare Advantage |
$435.03
|
| Rate for Payer: UMR Bronson Commercial |
$754.40
|
|
|
PR CARDIOPULMONARY EXERCISE TESTING
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 94621
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$204.97 |
| Rate for Payer: Aetna Commercial |
$190.74
|
| Rate for Payer: Aetna Medicare |
$148.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.74
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: BCBS MAPPO |
$142.34
|
| Rate for Payer: BCN Medicare Advantage |
$142.34
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$204.97
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.46
|
| Rate for Payer: Nomi Health Commercial |
$170.81
|
| Rate for Payer: PACE SWMI |
$142.34
|
| Rate for Payer: PHP Commercial |
$199.28
|
| Rate for Payer: PHP Medicare Advantage |
$142.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health Medicare |
$142.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.34
|
| Rate for Payer: UHC Medicare Advantage |
$142.34
|
| Rate for Payer: UMR Bronson Commercial |
$130.18
|
|
|
PR CARDIOPULMONARY RESUSCITATION
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 92950
|
| Min. Negotiated Rate |
$174.91 |
| Max. Negotiated Rate |
$363.35 |
| Rate for Payer: Aetna Commercial |
$234.38
|
| Rate for Payer: Aetna Medicare |
$181.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.38
|
| Rate for Payer: BCBS Complete |
$223.60
|
| Rate for Payer: BCBS MAPPO |
$174.91
|
| Rate for Payer: BCN Medicare Advantage |
$174.91
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$251.87
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.66
|
| Rate for Payer: Nomi Health Commercial |
$209.89
|
| Rate for Payer: PACE SWMI |
$174.91
|
| Rate for Payer: PHP Commercial |
$244.87
|
| Rate for Payer: PHP Medicare Advantage |
$174.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health Medicare |
$174.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.91
|
| Rate for Payer: UHC Medicare Advantage |
$174.91
|
| Rate for Payer: UMR Bronson Commercial |
$257.14
|
|
