|
PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK
|
Professional
|
Both
|
$2,793.00
|
|
|
Service Code
|
HCPCS 23460
|
| Min. Negotiated Rate |
$208.43 |
| 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) |
$1,408.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.79
|
| Rate for Payer: BCBS Complete |
$742.52
|
| Rate for Payer: BCBS MAPPO |
$1,051.24
|
| Rate for Payer: BCBS Trust/PPO |
$208.43
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| 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 |
$1,408.66
|
| Rate for Payer: Cofinity Commercial |
$1,513.79
|
| 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: Meridian Medicaid |
$742.52
|
| 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 Choice Medicaid |
$707.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,815.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,676.69
|
| Rate for Payer: Priority Health Medicare |
$1,051.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,676.69
|
| Rate for Payer: Priority Health SBD |
$1,676.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,051.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,051.24
|
| Rate for Payer: UHCCP Medicaid |
$707.16
|
| 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 |
$188.90 |
| 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) |
$1,255.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.55
|
| Rate for Payer: BCBS Complete |
$661.55
|
| Rate for Payer: BCBS MAPPO |
$937.19
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| 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 |
$1,255.83
|
| Rate for Payer: Cofinity Commercial |
$1,349.55
|
| 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: Meridian Medicaid |
$661.55
|
| 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 Choice Medicaid |
$630.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,081.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,516.41
|
| Rate for Payer: Priority Health Medicare |
$937.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.41
|
| Rate for Payer: Priority Health SBD |
$1,516.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.19
|
| Rate for Payer: UHC Medicare Advantage |
$937.19
|
| Rate for Payer: UHCCP Medicaid |
$630.05
|
| 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 |
$104.00 |
| 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) |
$1,444.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.10
|
| Rate for Payer: BCBS Complete |
$761.08
|
| Rate for Payer: BCBS MAPPO |
$1,077.85
|
| Rate for Payer: BCBS Trust/PPO |
$104.00
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| 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 |
$1,444.32
|
| Rate for Payer: Cofinity Commercial |
$1,552.10
|
| 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: Meridian Medicaid |
$761.08
|
| 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 Choice Medicaid |
$724.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,275.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.93
|
| Rate for Payer: Priority Health Medicare |
$1,077.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.93
|
| Rate for Payer: Priority Health SBD |
$1,718.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.85
|
| Rate for Payer: UHCCP Medicaid |
$724.84
|
| 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 |
$138.81 |
| Max. Negotiated Rate |
$1,728.61 |
| Rate for Payer: Aetna Commercial |
$1,443.50
|
| Rate for Payer: Aetna Medicare |
$1,120.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,551.23
|
| Rate for Payer: BCBS Complete |
$762.87
|
| Rate for Payer: BCBS MAPPO |
$1,077.24
|
| Rate for Payer: BCBS Trust/PPO |
$138.81
|
| Rate for Payer: BCN Commercial |
$1,644.40
|
| 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: Meridian Medicaid |
$762.87
|
| 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 Choice Medicaid |
$726.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,728.61
|
| Rate for Payer: Priority Health Medicare |
$1,077.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,728.61
|
| Rate for Payer: Priority Health SBD |
$1,728.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.24
|
| Rate for Payer: UHCCP Medicaid |
$726.54
|
| 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 |
$348.68 |
| Max. Negotiated Rate |
$1,049.19 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: Aetna Medicare |
$536.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.62
|
| Rate for Payer: BCBS Complete |
$366.11
|
| Rate for Payer: BCBS MAPPO |
$515.71
|
| Rate for Payer: BCN Commercial |
$1,049.19
|
| 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 |
$691.05
|
| Rate for Payer: Cofinity Commercial |
$742.62
|
| 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: Meridian Medicaid |
$366.11
|
| 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 Choice Medicaid |
$348.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.01
|
| Rate for Payer: Priority Health Medicare |
$515.71
|
| Rate for Payer: Priority Health Narrow Network |
$833.01
|
| Rate for Payer: Priority Health SBD |
$833.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.71
|
| Rate for Payer: UHC Medicare Advantage |
$515.71
|
| Rate for Payer: UHCCP Medicaid |
$348.68
|
| 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 |
$527.18 |
| 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) |
$1,044.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.93
|
| Rate for Payer: BCBS Complete |
$553.54
|
| Rate for Payer: BCBS MAPPO |
$779.12
|
| Rate for Payer: BCN Commercial |
$1,193.35
|
| 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 |
$1,044.02
|
| Rate for Payer: Cofinity Commercial |
$1,121.93
|
| 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: Meridian Medicaid |
$553.54
|
| 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 Choice Medicaid |
$527.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,248.75
|
| Rate for Payer: Priority Health Medicare |
$779.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,248.75
|
| Rate for Payer: Priority Health SBD |
$1,248.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.12
|
| Rate for Payer: UHC Medicare Advantage |
$779.12
|
| Rate for Payer: UHCCP Medicaid |
$527.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,248.90
|
|
|
PR CAPSULOTOMY WRIST
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 25085
|
| Min. Negotiated Rate |
$119.92 |
| 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) |
$582.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.44
|
| Rate for Payer: BCBS Complete |
$311.09
|
| Rate for Payer: BCBS MAPPO |
$435.03
|
| Rate for Payer: BCBS Trust/PPO |
$119.92
|
| Rate for Payer: BCN Commercial |
$664.60
|
| 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 |
$582.94
|
| Rate for Payer: Cofinity Commercial |
$626.44
|
| 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: Meridian Medicaid |
$311.09
|
| 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 Choice Medicaid |
$296.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.21
|
| Rate for Payer: Priority Health Medicare |
$435.03
|
| Rate for Payer: Priority Health Narrow Network |
$701.21
|
| Rate for Payer: Priority Health SBD |
$701.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.03
|
| Rate for Payer: UHC Medicare Advantage |
$435.03
|
| Rate for Payer: UHCCP Medicaid |
$296.28
|
| Rate for Payer: UMR Bronson Commercial |
$754.40
|
|
|
PR CARDIOPULMONARY EXERCISE TESTING
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 94621
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$256.23 |
| Rate for Payer: Aetna Commercial |
$190.74
|
| Rate for Payer: Aetna Medicare |
$148.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.97
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$142.34
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: BCN Commercial |
$222.83
|
| 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 |
$190.74
|
| Rate for Payer: Cofinity Commercial |
$204.97
|
| 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: Meridian Medicaid |
$44.73
|
| 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 Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.87
|
| Rate for Payer: Priority Health Medicare |
$142.34
|
| Rate for Payer: Priority Health Narrow Network |
$209.87
|
| Rate for Payer: Priority Health SBD |
$90.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.34
|
| Rate for Payer: UHC Medicare Advantage |
$142.34
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
| Rate for Payer: UMR Bronson Commercial |
$130.18
|
|
|
PR CARDIOPULMONARY RESUSCITATION
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 92950
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$2,166.03 |
| Rate for Payer: Aetna Commercial |
$234.38
|
| Rate for Payer: Aetna Medicare |
$181.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.87
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$174.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.03
|
| Rate for Payer: BCN Commercial |
$475.97
|
| 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 |
$234.38
|
| Rate for Payer: Cofinity Commercial |
$251.87
|
| 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: Meridian Medicaid |
$121.44
|
| 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 Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.73
|
| Rate for Payer: Priority Health Medicare |
$174.91
|
| Rate for Payer: Priority Health Narrow Network |
$254.73
|
| Rate for Payer: Priority Health SBD |
$254.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.91
|
| Rate for Payer: UHC Medicare Advantage |
$174.91
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
| Rate for Payer: UMR Bronson Commercial |
$257.14
|
|
|
PR CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP
|
Professional
|
Both
|
$6,846.00
|
|
|
Service Code
|
HCPCS 33315
|
| Min. Negotiated Rate |
$1,200.89 |
| Max. Negotiated Rate |
$4,449.90 |
| Rate for Payer: Aetna Commercial |
$2,454.50
|
| Rate for Payer: Aetna Medicare |
$1,904.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,454.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.68
|
| Rate for Payer: BCBS Complete |
$1,260.93
|
| Rate for Payer: BCBS MAPPO |
$1,831.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.77
|
| Rate for Payer: BCN Commercial |
$2,745.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,831.72
|
| Rate for Payer: Cash Price |
$5,476.80
|
| Rate for Payer: Cash Price |
$5,476.80
|
| Rate for Payer: Cofinity Commercial |
$2,454.50
|
| Rate for Payer: Cofinity Commercial |
$2,637.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,831.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,923.31
|
| Rate for Payer: Meridian Medicaid |
$1,260.93
|
| Rate for Payer: Nomi Health Commercial |
$2,198.06
|
| Rate for Payer: PACE SWMI |
$1,831.72
|
| Rate for Payer: PHP Commercial |
$2,564.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,831.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,200.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,449.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,999.50
|
| Rate for Payer: Priority Health Medicare |
$1,831.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,999.50
|
| Rate for Payer: Priority Health SBD |
$2,999.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,831.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,831.72
|
| Rate for Payer: UHCCP Medicaid |
$1,200.89
|
| Rate for Payer: UMR Bronson Commercial |
$3,149.16
|
|
|
PR CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP
|
Professional
|
Both
|
$4,619.00
|
|
|
Service Code
|
HCPCS 33310
|
| Min. Negotiated Rate |
$738.05 |
| Max. Negotiated Rate |
$3,002.35 |
| Rate for Payer: Aetna Commercial |
$1,499.49
|
| Rate for Payer: Aetna Medicare |
$1,163.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,611.39
|
| Rate for Payer: BCBS Complete |
$774.95
|
| Rate for Payer: BCBS MAPPO |
$1,119.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.64
|
| Rate for Payer: BCN Commercial |
$1,678.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.02
|
| Rate for Payer: Cash Price |
$3,695.20
|
| Rate for Payer: Cash Price |
$3,695.20
|
| Rate for Payer: Cofinity Commercial |
$1,499.49
|
| Rate for Payer: Cofinity Commercial |
$1,611.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,174.97
|
| Rate for Payer: Meridian Medicaid |
$774.95
|
| Rate for Payer: Nomi Health Commercial |
$1,342.82
|
| Rate for Payer: PACE SWMI |
$1,119.02
|
| Rate for Payer: PHP Commercial |
$1,566.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,002.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.55
|
| Rate for Payer: Priority Health Medicare |
$1,119.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,830.55
|
| Rate for Payer: Priority Health SBD |
$1,830.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,119.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.02
|
| Rate for Payer: UHCCP Medicaid |
$738.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,124.74
|
|
|
PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 93660
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$3,564.97 |
| Rate for Payer: Aetna Commercial |
$202.47
|
| Rate for Payer: Aetna Medicare |
$157.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.58
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS MAPPO |
$151.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,564.97
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$151.10
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$202.47
|
| Rate for Payer: Cofinity Commercial |
$217.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.66
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Nomi Health Commercial |
$181.32
|
| Rate for Payer: PACE SWMI |
$151.10
|
| Rate for Payer: PHP Commercial |
$211.54
|
| Rate for Payer: PHP Medicare Advantage |
$151.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.83
|
| Rate for Payer: Priority Health Medicare |
$151.10
|
| Rate for Payer: Priority Health Narrow Network |
$228.83
|
| Rate for Payer: Priority Health SBD |
$125.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.10
|
| Rate for Payer: UHC Medicare Advantage |
$151.10
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
| Rate for Payer: UMR Bronson Commercial |
$263.58
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
OP
|
$501.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$101.97 |
| Max. Negotiated Rate |
$2,015.13 |
| Rate for Payer: Aetna American Axle |
$325.65
|
| Rate for Payer: Aetna Commercial |
$425.85
|
| Rate for Payer: Aetna Medicare |
$666.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.44
|
| Rate for Payer: BCBS Complete |
$360.84
|
| Rate for Payer: BCBS MAPPO |
$641.15
|
| Rate for Payer: BCBS Trust/PPO |
$626.86
|
| Rate for Payer: BCN Commercial |
$626.86
|
| Rate for Payer: BCN Medicare Advantage |
$641.15
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$350.70
|
| Rate for Payer: Cofinity Commercial |
$430.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.15
|
| Rate for Payer: Healthscope Commercial |
$450.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.75
|
| Rate for Payer: Mclaren Medicaid |
$343.66
|
| Rate for Payer: Mclaren Medicare |
$641.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.21
|
| Rate for Payer: Meridian Medicaid |
$360.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.85
|
| Rate for Payer: Nomi Health Commercial |
$1,923.45
|
| Rate for Payer: PACE Medicare |
$609.09
|
| Rate for Payer: PACE SWMI |
$641.15
|
| Rate for Payer: PHP Commercial |
$425.85
|
| Rate for Payer: PHP Medicare Advantage |
$641.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,015.13
|
| Rate for Payer: Priority Health Medicare |
$641.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,612.10
|
| Rate for Payer: Priority Health SBD |
$315.63
|
| Rate for Payer: Railroad Medicare Medicare |
$641.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.17
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.15
|
| Rate for Payer: UHC Exchange |
$101.97
|
| Rate for Payer: UHC Medicare Advantage |
$641.15
|
| Rate for Payer: UHCCP Medicaid |
$343.66
|
| Rate for Payer: UMR Bronson Commercial |
$185.37
|
| Rate for Payer: VA VA |
$641.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.75
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
IP
|
$501.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$220.44 |
| Max. Negotiated Rate |
$450.90 |
| Rate for Payer: Aetna American Axle |
$325.65
|
| Rate for Payer: Aetna Commercial |
$425.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.65
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$350.70
|
| Rate for Payer: Cofinity Commercial |
$430.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.80
|
| Rate for Payer: Healthscope Commercial |
$450.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.85
|
| Rate for Payer: PHP Commercial |
$425.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health SBD |
$315.63
|
| Rate for Payer: UMR Bronson Commercial |
$220.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.75
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92960
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$325.65 |
| Rate for Payer: Aetna Commercial |
$136.28
|
| Rate for Payer: Aetna Medicare |
$105.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.45
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$248.59
|
| Rate for Payer: BCN Medicare Advantage |
$101.70
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$136.28
|
| Rate for Payer: Cofinity Commercial |
$146.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.78
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$122.04
|
| Rate for Payer: PACE SWMI |
$101.70
|
| Rate for Payer: PHP Commercial |
$142.38
|
| Rate for Payer: PHP Medicare Advantage |
$101.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.72
|
| Rate for Payer: Priority Health Medicare |
$101.70
|
| Rate for Payer: Priority Health Narrow Network |
$149.72
|
| Rate for Payer: Priority Health SBD |
$149.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.70
|
| Rate for Payer: UHC Medicare Advantage |
$101.70
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UMR Bronson Commercial |
$230.46
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
92960
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$325.65 |
| Rate for Payer: Aetna Commercial |
$136.28
|
| Rate for Payer: Aetna Medicare |
$105.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.45
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$248.59
|
| Rate for Payer: BCN Medicare Advantage |
$101.70
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$146.45
|
| Rate for Payer: Cofinity Commercial |
$136.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.78
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$122.04
|
| Rate for Payer: PACE SWMI |
$101.70
|
| Rate for Payer: PHP Commercial |
$142.38
|
| Rate for Payer: PHP Medicare Advantage |
$101.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.72
|
| Rate for Payer: Priority Health Medicare |
$101.70
|
| Rate for Payer: Priority Health Narrow Network |
$149.72
|
| Rate for Payer: Priority Health SBD |
$149.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.70
|
| Rate for Payer: UHC Medicare Advantage |
$101.70
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UMR Bronson Commercial |
$230.46
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 92961
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$349.89 |
| Rate for Payer: Aetna Commercial |
$310.25
|
| Rate for Payer: Aetna Medicare |
$240.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.40
|
| Rate for Payer: BCBS Complete |
$160.14
|
| Rate for Payer: BCBS MAPPO |
$231.53
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$349.89
|
| Rate for Payer: BCN Medicare Advantage |
$231.53
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$333.40
|
| Rate for Payer: Cofinity Commercial |
$310.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.11
|
| Rate for Payer: Meridian Medicaid |
$160.14
|
| Rate for Payer: Nomi Health Commercial |
$277.84
|
| Rate for Payer: PACE SWMI |
$231.53
|
| Rate for Payer: PHP Commercial |
$324.14
|
| Rate for Payer: PHP Medicare Advantage |
$231.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.12
|
| Rate for Payer: Priority Health Medicare |
$231.53
|
| Rate for Payer: Priority Health Narrow Network |
$337.12
|
| Rate for Payer: Priority Health SBD |
$337.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.53
|
| Rate for Payer: UHC Medicare Advantage |
$231.53
|
| Rate for Payer: UHCCP Medicaid |
$152.51
|
| Rate for Payer: UMR Bronson Commercial |
$230.92
|
|
|
PR CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 96161
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$179.62 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$179.62
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$3.82
|
| Rate for Payer: Cofinity Commercial |
$3.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.78
|
| Rate for Payer: Nomi Health Commercial |
$3.18
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Commercial |
$3.71
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.65
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: Priority Health SBD |
$5.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
| Rate for Payer: UMR Bronson Commercial |
$3.22
|
|
|
PR CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 99484
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$594.87 |
| Rate for Payer: Aetna Commercial |
$54.70
|
| Rate for Payer: Aetna Medicare |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.78
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$40.82
|
| Rate for Payer: BCBS Trust/PPO |
$594.87
|
| Rate for Payer: BCN Commercial |
$58.04
|
| Rate for Payer: BCN Medicare Advantage |
$40.82
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Cofinity Commercial |
$58.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.86
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Nomi Health Commercial |
$48.98
|
| Rate for Payer: PACE SWMI |
$40.82
|
| Rate for Payer: PHP Commercial |
$57.15
|
| Rate for Payer: PHP Medicare Advantage |
$40.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.79
|
| Rate for Payer: Priority Health Medicare |
$40.82
|
| Rate for Payer: Priority Health Narrow Network |
$58.79
|
| Rate for Payer: Priority Health SBD |
$58.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.82
|
| Rate for Payer: UHC Medicare Advantage |
$40.82
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
| Rate for Payer: UMR Bronson Commercial |
$41.86
|
|
|
PR CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25210
|
| Hospital Charge Code |
25210
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$640.43
|
| Rate for Payer: Aetna Medicare |
$497.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.22
|
| Rate for Payer: BCBS Complete |
$341.96
|
| Rate for Payer: BCBS MAPPO |
$477.93
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: BCN Commercial |
$731.55
|
| Rate for Payer: BCN Medicare Advantage |
$477.93
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$688.22
|
| Rate for Payer: Cofinity Commercial |
$640.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.83
|
| Rate for Payer: Meridian Medicaid |
$341.96
|
| Rate for Payer: Nomi Health Commercial |
$573.52
|
| Rate for Payer: PACE SWMI |
$477.93
|
| Rate for Payer: PHP Commercial |
$669.10
|
| Rate for Payer: PHP Medicare Advantage |
$477.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.41
|
| Rate for Payer: Priority Health Medicare |
$477.93
|
| Rate for Payer: Priority Health Narrow Network |
$770.41
|
| Rate for Payer: Priority Health SBD |
$770.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.93
|
| Rate for Payer: UHC Medicare Advantage |
$477.93
|
| Rate for Payer: UHCCP Medicaid |
$325.68
|
| Rate for Payer: UMR Bronson Commercial |
$782.46
|
|
|
PR CARPECTOMY 1 BONE
|
Facility
|
IP
|
$1,701.00
|
|
|
Service Code
|
CPT 25210
|
| Hospital Charge Code |
25210
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$748.44 |
| Max. Negotiated Rate |
$1,530.90 |
| Rate for Payer: Aetna American Axle |
$1,105.65
|
| Rate for Payer: Aetna Commercial |
$1,445.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.65
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,190.70
|
| Rate for Payer: Cofinity Commercial |
$1,462.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,190.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.80
|
| Rate for Payer: Healthscope Commercial |
$1,530.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,190.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,445.85
|
| Rate for Payer: PHP Commercial |
$1,445.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health SBD |
$1,071.63
|
| Rate for Payer: UMR Bronson Commercial |
$748.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.75
|
|
|
PR CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25210
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$640.43
|
| Rate for Payer: Aetna Medicare |
$497.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.22
|
| Rate for Payer: BCBS Complete |
$341.96
|
| Rate for Payer: BCBS MAPPO |
$477.93
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: BCN Commercial |
$731.55
|
| Rate for Payer: BCN Medicare Advantage |
$477.93
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$640.43
|
| Rate for Payer: Cofinity Commercial |
$688.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.83
|
| Rate for Payer: Meridian Medicaid |
$341.96
|
| Rate for Payer: Nomi Health Commercial |
$573.52
|
| Rate for Payer: PACE SWMI |
$477.93
|
| Rate for Payer: PHP Commercial |
$669.10
|
| Rate for Payer: PHP Medicare Advantage |
$477.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.41
|
| Rate for Payer: Priority Health Medicare |
$477.93
|
| Rate for Payer: Priority Health Narrow Network |
$770.41
|
| Rate for Payer: Priority Health SBD |
$770.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.93
|
| Rate for Payer: UHC Medicare Advantage |
$477.93
|
| Rate for Payer: UHCCP Medicaid |
$325.68
|
| Rate for Payer: UMR Bronson Commercial |
$782.46
|
|
|
PR CARPECTOMY 1 BONE
|
Facility
|
OP
|
$1,701.00
|
|
|
Service Code
|
CPT 25210
|
| Hospital Charge Code |
25210
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$479.50 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$1,105.65
|
| Rate for Payer: Aetna Commercial |
$1,445.85
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.78
|
| Rate for Payer: BCN Commercial |
$2,214.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,190.70
|
| Rate for Payer: Cofinity Commercial |
$1,462.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,190.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,190.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.75
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,445.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,445.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,071.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.45
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$479.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$629.37
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.75
|
|
|
PR CARPECTOMY ALL BONES PROXIMAL ROW
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 25215
|
| Min. Negotiated Rate |
$407.47 |
| Max. Negotiated Rate |
$1,487.85 |
| Rate for Payer: Aetna Commercial |
$804.16
|
| Rate for Payer: Aetna Medicare |
$624.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.17
|
| Rate for Payer: BCBS Complete |
$427.84
|
| Rate for Payer: BCBS MAPPO |
$600.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: BCN Commercial |
$916.27
|
| Rate for Payer: BCN Medicare Advantage |
$600.12
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$804.16
|
| Rate for Payer: Cofinity Commercial |
$864.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.13
|
| Rate for Payer: Meridian Medicaid |
$427.84
|
| Rate for Payer: Nomi Health Commercial |
$720.14
|
| Rate for Payer: PACE SWMI |
$600.12
|
| Rate for Payer: PHP Commercial |
$840.17
|
| Rate for Payer: PHP Medicare Advantage |
$600.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$963.27
|
| Rate for Payer: Priority Health Medicare |
$600.12
|
| Rate for Payer: Priority Health Narrow Network |
$963.27
|
| Rate for Payer: Priority Health SBD |
$963.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.12
|
| Rate for Payer: UHC Medicare Advantage |
$600.12
|
| Rate for Payer: UHCCP Medicaid |
$407.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.94
|
|
|
PR CARTILAGE GRAFT COSTOCHONDRAL
|
Professional
|
Both
|
$939.00
|
|
|
Service Code
|
HCPCS 20910
|
| Min. Negotiated Rate |
$312.90 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$614.46
|
| Rate for Payer: Aetna Medicare |
$476.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$614.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.31
|
| Rate for Payer: BCBS Complete |
$328.54
|
| Rate for Payer: BCBS MAPPO |
$458.55
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCN Commercial |
$701.25
|
| Rate for Payer: BCN Medicare Advantage |
$458.55
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cofinity Commercial |
$614.46
|
| Rate for Payer: Cofinity Commercial |
$660.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.48
|
| Rate for Payer: Meridian Medicaid |
$328.54
|
| Rate for Payer: Nomi Health Commercial |
$550.26
|
| Rate for Payer: PACE SWMI |
$458.55
|
| Rate for Payer: PHP Commercial |
$641.97
|
| Rate for Payer: PHP Medicare Advantage |
$458.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.39
|
| Rate for Payer: Priority Health Medicare |
$458.55
|
| Rate for Payer: Priority Health Narrow Network |
$740.39
|
| Rate for Payer: Priority Health SBD |
$740.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$458.55
|
| Rate for Payer: UHC Medicare Advantage |
$458.55
|
| Rate for Payer: UHCCP Medicaid |
$312.90
|
| Rate for Payer: UMR Bronson Commercial |
$431.94
|
|
