|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$107.49 |
| Max. Negotiated Rate |
$198.25 |
| Rate for Payer: Aetna Commercial |
$144.04
|
| Rate for Payer: Aetna Medicare |
$111.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.04
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: BCBS MAPPO |
$107.49
|
| Rate for Payer: BCN Medicare Advantage |
$107.49
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$154.79
|
| Rate for Payer: Cofinity Commercial |
$144.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.86
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: PACE SWMI |
$107.49
|
| Rate for Payer: PHP Commercial |
$150.49
|
| Rate for Payer: PHP Medicare Advantage |
$107.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health Medicare |
$107.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.49
|
| Rate for Payer: UHC Medicare Advantage |
$107.49
|
| Rate for Payer: UMR Bronson Commercial |
$140.30
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT
|
Professional
|
Both
|
$2,913.00
|
|
|
Service Code
|
HCPCS 44625
|
| Min. Negotiated Rate |
$971.22 |
| Max. Negotiated Rate |
$1,893.45 |
| Rate for Payer: Aetna Commercial |
$1,301.43
|
| Rate for Payer: Aetna Medicare |
$1,010.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,398.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.43
|
| Rate for Payer: BCBS Complete |
$1,165.20
|
| Rate for Payer: BCBS MAPPO |
$971.22
|
| Rate for Payer: BCN Medicare Advantage |
$971.22
|
| Rate for Payer: Cash Price |
$2,330.40
|
| Rate for Payer: Cash Price |
$2,330.40
|
| Rate for Payer: Cofinity Commercial |
$1,398.56
|
| Rate for Payer: Cofinity Commercial |
$1,301.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,019.78
|
| Rate for Payer: Nomi Health Commercial |
$1,165.46
|
| Rate for Payer: PACE SWMI |
$971.22
|
| Rate for Payer: PHP Commercial |
$1,359.71
|
| Rate for Payer: PHP Medicare Advantage |
$971.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,893.45
|
| Rate for Payer: Priority Health Medicare |
$971.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$971.22
|
| Rate for Payer: UHC Medicare Advantage |
$971.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,339.98
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS
|
Professional
|
Both
|
$2,972.00
|
|
|
Service Code
|
HCPCS 44626
|
| Min. Negotiated Rate |
$1,188.80 |
| Max. Negotiated Rate |
$2,209.20 |
| Rate for Payer: Aetna Commercial |
$2,055.79
|
| Rate for Payer: Aetna Medicare |
$1,595.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,209.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,055.79
|
| Rate for Payer: BCBS Complete |
$1,188.80
|
| Rate for Payer: BCBS MAPPO |
$1,534.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,534.17
|
| Rate for Payer: Cash Price |
$2,377.60
|
| Rate for Payer: Cash Price |
$2,377.60
|
| Rate for Payer: Cofinity Commercial |
$2,209.20
|
| Rate for Payer: Cofinity Commercial |
$2,055.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,534.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,610.88
|
| Rate for Payer: Nomi Health Commercial |
$1,841.00
|
| Rate for Payer: PACE SWMI |
$1,534.17
|
| Rate for Payer: PHP Commercial |
$2,147.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,534.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,931.80
|
| Rate for Payer: Priority Health Medicare |
$1,534.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,534.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,534.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,367.12
|
|
|
PR CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 57308
|
| Min. Negotiated Rate |
$588.40 |
| Max. Negotiated Rate |
$956.15 |
| Rate for Payer: Aetna Commercial |
$849.59
|
| Rate for Payer: Aetna Medicare |
$659.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.59
|
| Rate for Payer: BCBS Complete |
$588.40
|
| Rate for Payer: BCBS MAPPO |
$634.02
|
| Rate for Payer: BCN Medicare Advantage |
$634.02
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cofinity Commercial |
$912.99
|
| Rate for Payer: Cofinity Commercial |
$849.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.72
|
| Rate for Payer: Nomi Health Commercial |
$760.82
|
| Rate for Payer: PACE SWMI |
$634.02
|
| Rate for Payer: PHP Commercial |
$887.63
|
| Rate for Payer: PHP Medicare Advantage |
$634.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.15
|
| Rate for Payer: Priority Health Medicare |
$634.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.02
|
| Rate for Payer: UHC Medicare Advantage |
$634.02
|
| Rate for Payer: UMR Bronson Commercial |
$676.66
|
|
|
PR CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 57305
|
| Min. Negotiated Rate |
$790.40 |
| Max. Negotiated Rate |
$1,340.93 |
| Rate for Payer: Aetna Commercial |
$1,247.81
|
| Rate for Payer: Aetna Medicare |
$968.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.81
|
| Rate for Payer: BCBS Complete |
$790.40
|
| Rate for Payer: BCBS MAPPO |
$931.20
|
| Rate for Payer: BCN Medicare Advantage |
$931.20
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$1,340.93
|
| Rate for Payer: Cofinity Commercial |
$1,247.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.76
|
| Rate for Payer: Nomi Health Commercial |
$1,117.44
|
| Rate for Payer: PACE SWMI |
$931.20
|
| Rate for Payer: PHP Commercial |
$1,303.68
|
| Rate for Payer: PHP Medicare Advantage |
$931.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health Medicare |
$931.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.20
|
| Rate for Payer: UHC Medicare Advantage |
$931.20
|
| Rate for Payer: UMR Bronson Commercial |
$908.96
|
|
|
PR CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR
|
Professional
|
Both
|
$1,321.00
|
|
|
Service Code
|
HCPCS 57300
|
| Min. Negotiated Rate |
$528.40 |
| Max. Negotiated Rate |
$858.65 |
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: Aetna Medicare |
$605.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.89
|
| Rate for Payer: BCBS Complete |
$528.40
|
| Rate for Payer: BCBS MAPPO |
$582.01
|
| Rate for Payer: BCN Medicare Advantage |
$582.01
|
| Rate for Payer: Cash Price |
$1,056.80
|
| Rate for Payer: Cash Price |
$1,056.80
|
| Rate for Payer: Cofinity Commercial |
$838.09
|
| Rate for Payer: Cofinity Commercial |
$779.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.11
|
| Rate for Payer: Nomi Health Commercial |
$698.41
|
| Rate for Payer: PACE SWMI |
$582.01
|
| Rate for Payer: PHP Commercial |
$814.81
|
| Rate for Payer: PHP Medicare Advantage |
$582.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.65
|
| Rate for Payer: Priority Health Medicare |
$582.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.01
|
| Rate for Payer: UHC Medicare Advantage |
$582.01
|
| Rate for Payer: UMR Bronson Commercial |
$607.66
|
|
|
PR CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 53520
|
| Min. Negotiated Rate |
$461.20 |
| Max. Negotiated Rate |
$770.04 |
| Rate for Payer: Aetna Commercial |
$716.57
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$716.57
|
| Rate for Payer: BCBS Complete |
$461.20
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$770.04
|
| Rate for Payer: Cofinity Commercial |
$716.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Nomi Health Commercial |
$641.70
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$748.65
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UMR Bronson Commercial |
$530.38
|
|
|
PR CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 57311
|
| Min. Negotiated Rate |
$441.20 |
| Max. Negotiated Rate |
$762.03 |
| Rate for Payer: Aetna Commercial |
$709.11
|
| Rate for Payer: Aetna Medicare |
$550.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.11
|
| Rate for Payer: BCBS Complete |
$441.20
|
| Rate for Payer: BCBS MAPPO |
$529.19
|
| Rate for Payer: BCN Medicare Advantage |
$529.19
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$762.03
|
| Rate for Payer: Cofinity Commercial |
$709.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.65
|
| Rate for Payer: Nomi Health Commercial |
$635.03
|
| Rate for Payer: PACE SWMI |
$529.19
|
| Rate for Payer: PHP Commercial |
$740.87
|
| Rate for Payer: PHP Medicare Advantage |
$529.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.95
|
| Rate for Payer: Priority Health Medicare |
$529.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.19
|
| Rate for Payer: UHC Medicare Advantage |
$529.19
|
| Rate for Payer: UMR Bronson Commercial |
$507.38
|
|
|
PR CLSR VESICOVAGINAL FISTUL AABDL APPROACH
|
Professional
|
Both
|
$3,916.00
|
|
|
Service Code
|
HCPCS 51900
|
| Min. Negotiated Rate |
$788.00 |
| Max. Negotiated Rate |
$2,545.40 |
| Rate for Payer: Aetna Commercial |
$1,055.92
|
| Rate for Payer: Aetna Medicare |
$819.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.92
|
| Rate for Payer: BCBS Complete |
$1,566.40
|
| Rate for Payer: BCBS MAPPO |
$788.00
|
| Rate for Payer: BCN Medicare Advantage |
$788.00
|
| Rate for Payer: Cash Price |
$3,132.80
|
| Rate for Payer: Cash Price |
$3,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,134.72
|
| Rate for Payer: Cofinity Commercial |
$1,055.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.40
|
| Rate for Payer: Nomi Health Commercial |
$945.60
|
| Rate for Payer: PACE SWMI |
$788.00
|
| Rate for Payer: PHP Commercial |
$1,103.20
|
| Rate for Payer: PHP Medicare Advantage |
$788.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.40
|
| Rate for Payer: Priority Health Medicare |
$788.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$788.00
|
| Rate for Payer: UHC Medicare Advantage |
$788.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,801.36
|
|
|
PR CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$2,274.00
|
|
|
Service Code
|
HCPCS 27222
|
| Min. Negotiated Rate |
$909.60 |
| Max. Negotiated Rate |
$1,478.10 |
| Rate for Payer: Aetna Commercial |
$1,267.84
|
| Rate for Payer: Aetna Medicare |
$984.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.84
|
| Rate for Payer: BCBS Complete |
$909.60
|
| Rate for Payer: BCBS MAPPO |
$946.15
|
| Rate for Payer: BCN Medicare Advantage |
$946.15
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.46
|
| Rate for Payer: Cofinity Commercial |
$1,267.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.46
|
| Rate for Payer: Nomi Health Commercial |
$1,135.38
|
| Rate for Payer: PACE SWMI |
$946.15
|
| Rate for Payer: PHP Commercial |
$1,324.61
|
| Rate for Payer: PHP Medicare Advantage |
$946.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.10
|
| Rate for Payer: Priority Health Medicare |
$946.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$946.15
|
| Rate for Payer: UHC Medicare Advantage |
$946.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,046.04
|
|
|
PR CLTX ACETABULUM HIP/SOCKT FX W/O MANJ
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 27220
|
| Min. Negotiated Rate |
$400.45 |
| Max. Negotiated Rate |
$1,091.35 |
| Rate for Payer: Aetna Commercial |
$536.60
|
| Rate for Payer: Aetna Medicare |
$416.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.60
|
| Rate for Payer: BCBS Complete |
$671.60
|
| Rate for Payer: BCBS MAPPO |
$400.45
|
| Rate for Payer: BCN Medicare Advantage |
$400.45
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cofinity Commercial |
$576.65
|
| Rate for Payer: Cofinity Commercial |
$536.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.47
|
| Rate for Payer: Nomi Health Commercial |
$480.54
|
| Rate for Payer: PACE SWMI |
$400.45
|
| Rate for Payer: PHP Commercial |
$560.63
|
| Rate for Payer: PHP Medicare Advantage |
$400.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.35
|
| Rate for Payer: Priority Health Medicare |
$400.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.45
|
| Rate for Payer: UHC Medicare Advantage |
$400.45
|
| Rate for Payer: UMR Bronson Commercial |
$772.34
|
|
|
PR CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 27842
|
| Min. Negotiated Rate |
$477.98 |
| Max. Negotiated Rate |
$919.10 |
| Rate for Payer: Aetna Commercial |
$640.49
|
| Rate for Payer: Aetna Medicare |
$497.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.49
|
| Rate for Payer: BCBS Complete |
$565.60
|
| Rate for Payer: BCBS MAPPO |
$477.98
|
| Rate for Payer: BCN Medicare Advantage |
$477.98
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cofinity Commercial |
$688.29
|
| Rate for Payer: Cofinity Commercial |
$640.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.88
|
| Rate for Payer: Nomi Health Commercial |
$573.58
|
| Rate for Payer: PACE SWMI |
$477.98
|
| Rate for Payer: PHP Commercial |
$669.17
|
| Rate for Payer: PHP Medicare Advantage |
$477.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.10
|
| Rate for Payer: Priority Health Medicare |
$477.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.98
|
| Rate for Payer: UHC Medicare Advantage |
$477.98
|
| Rate for Payer: UMR Bronson Commercial |
$650.44
|
|
|
PR CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 26742
|
| Min. Negotiated Rate |
$328.81 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: Aetna Commercial |
$440.61
|
| Rate for Payer: Aetna Medicare |
$341.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.61
|
| Rate for Payer: BCBS Complete |
$374.00
|
| Rate for Payer: BCBS MAPPO |
$328.81
|
| Rate for Payer: BCN Medicare Advantage |
$328.81
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$473.49
|
| Rate for Payer: Cofinity Commercial |
$440.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.25
|
| Rate for Payer: Nomi Health Commercial |
$394.57
|
| Rate for Payer: PACE SWMI |
$328.81
|
| Rate for Payer: PHP Commercial |
$460.33
|
| Rate for Payer: PHP Medicare Advantage |
$328.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.75
|
| Rate for Payer: Priority Health Medicare |
$328.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.81
|
| Rate for Payer: UHC Medicare Advantage |
$328.81
|
| Rate for Payer: UMR Bronson Commercial |
$430.10
|
|
|
PR CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 26740
|
| Min. Negotiated Rate |
$217.01 |
| Max. Negotiated Rate |
$410.80 |
| Rate for Payer: Aetna Commercial |
$290.79
|
| Rate for Payer: Aetna Medicare |
$225.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.79
|
| Rate for Payer: BCBS Complete |
$252.80
|
| Rate for Payer: BCBS MAPPO |
$217.01
|
| Rate for Payer: BCN Medicare Advantage |
$217.01
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$312.49
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.86
|
| Rate for Payer: Nomi Health Commercial |
$260.41
|
| Rate for Payer: PACE SWMI |
$217.01
|
| Rate for Payer: PHP Commercial |
$303.81
|
| Rate for Payer: PHP Medicare Advantage |
$217.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health Medicare |
$217.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.01
|
| Rate for Payer: UHC Medicare Advantage |
$217.01
|
| Rate for Payer: UMR Bronson Commercial |
$290.72
|
|
|
PR CLTX CARPAL BONE FX W/MNPJ EACH BONE
|
Professional
|
Both
|
$1,123.00
|
|
|
Service Code
|
HCPCS 25635
|
| Min. Negotiated Rate |
$413.75 |
| Max. Negotiated Rate |
$729.95 |
| Rate for Payer: Aetna Commercial |
$554.42
|
| Rate for Payer: Aetna Medicare |
$430.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.42
|
| Rate for Payer: BCBS Complete |
$449.20
|
| Rate for Payer: BCBS MAPPO |
$413.75
|
| Rate for Payer: BCN Medicare Advantage |
$413.75
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cofinity Commercial |
$595.80
|
| Rate for Payer: Cofinity Commercial |
$554.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.44
|
| Rate for Payer: Nomi Health Commercial |
$496.50
|
| Rate for Payer: PACE SWMI |
$413.75
|
| Rate for Payer: PHP Commercial |
$579.25
|
| Rate for Payer: PHP Medicare Advantage |
$413.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.95
|
| Rate for Payer: Priority Health Medicare |
$413.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.75
|
| Rate for Payer: UHC Medicare Advantage |
$413.75
|
| Rate for Payer: UMR Bronson Commercial |
$516.58
|
|
|
PR CLTX CARPAL BONE FX W/O MNPJ EACH BONE
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 25630
|
| Min. Negotiated Rate |
$280.11 |
| Max. Negotiated Rate |
$464.10 |
| Rate for Payer: Aetna Commercial |
$375.35
|
| Rate for Payer: Aetna Medicare |
$291.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.35
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCBS MAPPO |
$280.11
|
| Rate for Payer: BCN Medicare Advantage |
$280.11
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$403.36
|
| Rate for Payer: Cofinity Commercial |
$375.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.12
|
| Rate for Payer: Nomi Health Commercial |
$336.13
|
| Rate for Payer: PACE SWMI |
$280.11
|
| Rate for Payer: PHP Commercial |
$392.15
|
| Rate for Payer: PHP Medicare Advantage |
$280.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$280.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.11
|
| Rate for Payer: UHC Medicare Advantage |
$280.11
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 26641
|
| Min. Negotiated Rate |
$300.40 |
| Max. Negotiated Rate |
$538.69 |
| Rate for Payer: Aetna Commercial |
$501.28
|
| Rate for Payer: Aetna Medicare |
$389.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.28
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$374.09
|
| Rate for Payer: BCN Medicare Advantage |
$374.09
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$538.69
|
| Rate for Payer: Cofinity Commercial |
$501.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.79
|
| Rate for Payer: Nomi Health Commercial |
$448.91
|
| Rate for Payer: PACE SWMI |
$374.09
|
| Rate for Payer: PHP Commercial |
$523.73
|
| Rate for Payer: PHP Medicare Advantage |
$374.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$374.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.09
|
| Rate for Payer: UHC Medicare Advantage |
$374.09
|
| Rate for Payer: UMR Bronson Commercial |
$345.46
|
|
|
PR CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 26645
|
| Min. Negotiated Rate |
$386.68 |
| Max. Negotiated Rate |
$661.70 |
| Rate for Payer: Aetna Commercial |
$518.15
|
| Rate for Payer: Aetna Medicare |
$402.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.15
|
| Rate for Payer: BCBS Complete |
$407.20
|
| Rate for Payer: BCBS MAPPO |
$386.68
|
| Rate for Payer: BCN Medicare Advantage |
$386.68
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cofinity Commercial |
$556.82
|
| Rate for Payer: Cofinity Commercial |
$518.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.01
|
| Rate for Payer: Nomi Health Commercial |
$464.02
|
| Rate for Payer: PACE SWMI |
$386.68
|
| Rate for Payer: PHP Commercial |
$541.35
|
| Rate for Payer: PHP Medicare Advantage |
$386.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$661.70
|
| Rate for Payer: Priority Health Medicare |
$386.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.68
|
| Rate for Payer: UHC Medicare Advantage |
$386.68
|
| Rate for Payer: UMR Bronson Commercial |
$468.28
|
|
|
PR CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 26670
|
| Min. Negotiated Rate |
$242.00 |
| Max. Negotiated Rate |
$449.01 |
| Rate for Payer: Aetna Commercial |
$417.83
|
| Rate for Payer: Aetna Medicare |
$324.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.83
|
| Rate for Payer: BCBS Complete |
$242.00
|
| Rate for Payer: BCBS MAPPO |
$311.81
|
| Rate for Payer: BCN Medicare Advantage |
$311.81
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cofinity Commercial |
$449.01
|
| Rate for Payer: Cofinity Commercial |
$417.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.40
|
| Rate for Payer: Nomi Health Commercial |
$374.17
|
| Rate for Payer: PACE SWMI |
$311.81
|
| Rate for Payer: PHP Commercial |
$436.53
|
| Rate for Payer: PHP Medicare Advantage |
$311.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.25
|
| Rate for Payer: Priority Health Medicare |
$311.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.81
|
| Rate for Payer: UHC Medicare Advantage |
$311.81
|
| Rate for Payer: UMR Bronson Commercial |
$278.30
|
|
|
PR CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 26675
|
| Min. Negotiated Rate |
$413.33 |
| Max. Negotiated Rate |
$822.25 |
| Rate for Payer: Aetna Commercial |
$553.86
|
| Rate for Payer: Aetna Medicare |
$429.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.86
|
| Rate for Payer: BCBS Complete |
$506.00
|
| Rate for Payer: BCBS MAPPO |
$413.33
|
| Rate for Payer: BCN Medicare Advantage |
$413.33
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$595.20
|
| Rate for Payer: Cofinity Commercial |
$553.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.00
|
| Rate for Payer: Nomi Health Commercial |
$496.00
|
| Rate for Payer: PACE SWMI |
$413.33
|
| Rate for Payer: PHP Commercial |
$578.66
|
| Rate for Payer: PHP Medicare Advantage |
$413.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.25
|
| Rate for Payer: Priority Health Medicare |
$413.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.33
|
| Rate for Payer: UHC Medicare Advantage |
$413.33
|
| Rate for Payer: UMR Bronson Commercial |
$581.90
|
|
|
PR CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ
|
Professional
|
Both
|
$1,306.00
|
|
|
Service Code
|
HCPCS 27516
|
| Min. Negotiated Rate |
$472.57 |
| Max. Negotiated Rate |
$848.90 |
| Rate for Payer: Aetna Commercial |
$633.24
|
| Rate for Payer: Aetna Medicare |
$491.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.24
|
| Rate for Payer: BCBS Complete |
$522.40
|
| Rate for Payer: BCBS MAPPO |
$472.57
|
| Rate for Payer: BCN Medicare Advantage |
$472.57
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Cofinity Commercial |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$633.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.20
|
| Rate for Payer: Nomi Health Commercial |
$567.08
|
| Rate for Payer: PACE SWMI |
$472.57
|
| Rate for Payer: PHP Commercial |
$661.60
|
| Rate for Payer: PHP Medicare Advantage |
$472.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.90
|
| Rate for Payer: Priority Health Medicare |
$472.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.57
|
| Rate for Payer: UHC Medicare Advantage |
$472.57
|
| Rate for Payer: UMR Bronson Commercial |
$600.76
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/MANJ
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 27788
|
| Min. Negotiated Rate |
$375.69 |
| Max. Negotiated Rate |
$882.05 |
| Rate for Payer: Aetna Commercial |
$503.42
|
| Rate for Payer: Aetna Medicare |
$390.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.42
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$375.69
|
| Rate for Payer: BCN Medicare Advantage |
$375.69
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$540.99
|
| Rate for Payer: Cofinity Commercial |
$503.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.47
|
| Rate for Payer: Nomi Health Commercial |
$450.83
|
| Rate for Payer: PACE SWMI |
$375.69
|
| Rate for Payer: PHP Commercial |
$525.97
|
| Rate for Payer: PHP Medicare Advantage |
$375.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.05
|
| Rate for Payer: Priority Health Medicare |
$375.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.69
|
| Rate for Payer: UHC Medicare Advantage |
$375.69
|
| Rate for Payer: UMR Bronson Commercial |
$624.22
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ
|
Professional
|
Both
|
$775.00
|
|
|
Service Code
|
HCPCS 27786
|
| Min. Negotiated Rate |
$279.28 |
| Max. Negotiated Rate |
$503.75 |
| Rate for Payer: Aetna Commercial |
$374.24
|
| Rate for Payer: Aetna Medicare |
$290.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.24
|
| Rate for Payer: BCBS Complete |
$310.00
|
| Rate for Payer: BCBS MAPPO |
$279.28
|
| Rate for Payer: BCN Medicare Advantage |
$279.28
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cofinity Commercial |
$402.16
|
| Rate for Payer: Cofinity Commercial |
$374.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.24
|
| Rate for Payer: Nomi Health Commercial |
$335.14
|
| Rate for Payer: PACE SWMI |
$279.28
|
| Rate for Payer: PHP Commercial |
$390.99
|
| Rate for Payer: PHP Medicare Advantage |
$279.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$503.75
|
| Rate for Payer: Priority Health Medicare |
$279.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.28
|
| Rate for Payer: UHC Medicare Advantage |
$279.28
|
| Rate for Payer: UMR Bronson Commercial |
$356.50
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 26755
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$391.65 |
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna Medicare |
$282.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.45
|
| Rate for Payer: BCBS Complete |
$220.00
|
| Rate for Payer: BCBS MAPPO |
$271.98
|
| Rate for Payer: BCN Medicare Advantage |
$271.98
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cofinity Commercial |
$391.65
|
| Rate for Payer: Cofinity Commercial |
$364.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.58
|
| Rate for Payer: Nomi Health Commercial |
$326.38
|
| Rate for Payer: PACE SWMI |
$271.98
|
| Rate for Payer: PHP Commercial |
$380.77
|
| Rate for Payer: PHP Medicare Advantage |
$271.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health Medicare |
$271.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.98
|
| Rate for Payer: UHC Medicare Advantage |
$271.98
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$164.80 |
| Max. Negotiated Rate |
$270.71 |
| Rate for Payer: Aetna Commercial |
$251.91
|
| Rate for Payer: Aetna Medicare |
$195.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.91
|
| Rate for Payer: BCBS Complete |
$164.80
|
| Rate for Payer: BCBS MAPPO |
$187.99
|
| Rate for Payer: BCN Medicare Advantage |
$187.99
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$270.71
|
| Rate for Payer: Cofinity Commercial |
$251.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.39
|
| Rate for Payer: Nomi Health Commercial |
$225.59
|
| Rate for Payer: PACE SWMI |
$187.99
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: PHP Medicare Advantage |
$187.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health Medicare |
$187.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.99
|
| Rate for Payer: UHC Medicare Advantage |
$187.99
|
| Rate for Payer: UMR Bronson Commercial |
$189.52
|
|
