|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28605
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$2,031.31 |
| Rate for Payer: Aetna Commercial |
$398.61
|
| Rate for Payer: Aetna Medicare |
$309.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.36
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$297.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.31
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$297.47
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$398.61
|
| Rate for Payer: Cofinity Commercial |
$428.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.34
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Nomi Health Commercial |
$356.96
|
| Rate for Payer: PACE SWMI |
$297.47
|
| Rate for Payer: PHP Commercial |
$416.46
|
| Rate for Payer: PHP Medicare Advantage |
$297.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$297.47
|
| Rate for Payer: Priority Health Narrow Network |
$483.42
|
| Rate for Payer: Priority Health SBD |
$483.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.47
|
| Rate for Payer: UHC Medicare Advantage |
$297.47
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$371.68
|
|
|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 28600
|
| Min. Negotiated Rate |
$124.39 |
| Max. Negotiated Rate |
$1,628.75 |
| Rate for Payer: Aetna Commercial |
$241.45
|
| Rate for Payer: Aetna Medicare |
$187.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.47
|
| Rate for Payer: BCBS Complete |
$130.61
|
| Rate for Payer: BCBS MAPPO |
$180.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.75
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$180.19
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$241.45
|
| Rate for Payer: Cofinity Commercial |
$259.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.20
|
| Rate for Payer: Meridian Medicaid |
$130.61
|
| Rate for Payer: Nomi Health Commercial |
$216.23
|
| Rate for Payer: PACE SWMI |
$180.19
|
| Rate for Payer: PHP Commercial |
$252.27
|
| Rate for Payer: PHP Medicare Advantage |
$180.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.88
|
| Rate for Payer: Priority Health Medicare |
$180.19
|
| Rate for Payer: Priority Health Narrow Network |
$251.88
|
| Rate for Payer: Priority Health SBD |
$251.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.19
|
| Rate for Payer: UHC Medicare Advantage |
$180.19
|
| Rate for Payer: UHCCP Medicaid |
$124.39
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ
|
Professional
|
Both
|
$1,088.00
|
|
|
Service Code
|
HCPCS 21485
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,428.40 |
| Rate for Payer: Aetna Commercial |
$937.80
|
| Rate for Payer: Aetna Medicare |
$727.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.80
|
| Rate for Payer: BCBS Complete |
$517.52
|
| Rate for Payer: BCBS MAPPO |
$699.85
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,428.40
|
| Rate for Payer: BCN Medicare Advantage |
$699.85
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$1,007.78
|
| Rate for Payer: Cofinity Commercial |
$937.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.84
|
| Rate for Payer: Meridian Medicaid |
$517.52
|
| Rate for Payer: Nomi Health Commercial |
$839.82
|
| Rate for Payer: PACE SWMI |
$699.85
|
| Rate for Payer: PHP Commercial |
$979.79
|
| Rate for Payer: PHP Medicare Advantage |
$699.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,194.30
|
| Rate for Payer: Priority Health Medicare |
$699.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,194.30
|
| Rate for Payer: Priority Health SBD |
$1,194.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.85
|
| Rate for Payer: UHC Medicare Advantage |
$699.85
|
| Rate for Payer: UHCCP Medicaid |
$492.88
|
| Rate for Payer: UMR Bronson Commercial |
$500.48
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 21480
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$32.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.42
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$30.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$30.85
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$41.34
|
| Rate for Payer: Cofinity Commercial |
$44.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.39
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$37.02
|
| Rate for Payer: PACE SWMI |
$30.85
|
| Rate for Payer: PHP Commercial |
$43.19
|
| Rate for Payer: PHP Medicare Advantage |
$30.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.33
|
| Rate for Payer: Priority Health Medicare |
$30.85
|
| Rate for Payer: Priority Health Narrow Network |
$47.33
|
| Rate for Payer: Priority Health SBD |
$47.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.85
|
| Rate for Payer: UHC Medicare Advantage |
$30.85
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
| Rate for Payer: UMR Bronson Commercial |
$65.32
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 24675
|
| Min. Negotiated Rate |
$277.97 |
| Max. Negotiated Rate |
$1,365.66 |
| Rate for Payer: Aetna Commercial |
$545.37
|
| Rate for Payer: Aetna Medicare |
$423.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.07
|
| Rate for Payer: BCBS Complete |
$291.87
|
| Rate for Payer: BCBS MAPPO |
$406.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: BCN Commercial |
$690.01
|
| Rate for Payer: BCN Medicare Advantage |
$406.99
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cofinity Commercial |
$545.37
|
| Rate for Payer: Cofinity Commercial |
$586.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.34
|
| Rate for Payer: Meridian Medicaid |
$291.87
|
| Rate for Payer: Nomi Health Commercial |
$488.39
|
| Rate for Payer: PACE SWMI |
$406.99
|
| Rate for Payer: PHP Commercial |
$569.79
|
| Rate for Payer: PHP Medicare Advantage |
$406.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.99
|
| Rate for Payer: Priority Health Medicare |
$406.99
|
| Rate for Payer: Priority Health Narrow Network |
$659.99
|
| Rate for Payer: Priority Health SBD |
$659.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.99
|
| Rate for Payer: UHC Medicare Advantage |
$406.99
|
| Rate for Payer: UHCCP Medicaid |
$277.97
|
| Rate for Payer: UMR Bronson Commercial |
$577.30
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ
|
Professional
|
Both
|
$797.00
|
|
|
Service Code
|
HCPCS 24670
|
| Min. Negotiated Rate |
$181.05 |
| Max. Negotiated Rate |
$1,283.24 |
| Rate for Payer: Aetna Commercial |
$352.03
|
| Rate for Payer: Aetna Medicare |
$273.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.30
|
| Rate for Payer: BCBS Complete |
$190.10
|
| Rate for Payer: BCBS MAPPO |
$262.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.24
|
| Rate for Payer: BCN Commercial |
$441.27
|
| Rate for Payer: BCN Medicare Advantage |
$262.71
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cofinity Commercial |
$352.03
|
| Rate for Payer: Cofinity Commercial |
$378.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.85
|
| Rate for Payer: Meridian Medicaid |
$190.10
|
| Rate for Payer: Nomi Health Commercial |
$315.25
|
| Rate for Payer: PACE SWMI |
$262.71
|
| Rate for Payer: PHP Commercial |
$367.79
|
| Rate for Payer: PHP Medicare Advantage |
$262.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.45
|
| Rate for Payer: Priority Health Medicare |
$262.71
|
| Rate for Payer: Priority Health Narrow Network |
$427.45
|
| Rate for Payer: Priority Health SBD |
$427.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.71
|
| Rate for Payer: UHC Medicare Advantage |
$262.71
|
| Rate for Payer: UHCCP Medicaid |
$181.05
|
| Rate for Payer: UMR Bronson Commercial |
$366.62
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 25535
|
| Min. Negotiated Rate |
$304.38 |
| Max. Negotiated Rate |
$1,028.60 |
| Rate for Payer: Aetna Commercial |
$596.76
|
| Rate for Payer: Aetna Medicare |
$463.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.29
|
| Rate for Payer: BCBS Complete |
$319.60
|
| Rate for Payer: BCBS MAPPO |
$445.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$445.34
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$596.76
|
| Rate for Payer: Cofinity Commercial |
$641.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.61
|
| Rate for Payer: Meridian Medicaid |
$319.60
|
| Rate for Payer: Nomi Health Commercial |
$534.41
|
| Rate for Payer: PACE SWMI |
$445.34
|
| Rate for Payer: PHP Commercial |
$623.48
|
| Rate for Payer: PHP Medicare Advantage |
$445.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$722.58
|
| Rate for Payer: Priority Health Medicare |
$445.34
|
| Rate for Payer: Priority Health Narrow Network |
$722.58
|
| Rate for Payer: Priority Health SBD |
$722.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.34
|
| Rate for Payer: UHC Medicare Advantage |
$445.34
|
| Rate for Payer: UHCCP Medicaid |
$304.38
|
| Rate for Payer: UMR Bronson Commercial |
$547.40
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$655.00
|
|
|
Service Code
|
HCPCS 25530
|
| Min. Negotiated Rate |
$165.71 |
| Max. Negotiated Rate |
$1,133.73 |
| Rate for Payer: Aetna Commercial |
$320.85
|
| Rate for Payer: Aetna Medicare |
$249.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.79
|
| Rate for Payer: BCBS Complete |
$174.00
|
| Rate for Payer: BCBS MAPPO |
$239.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.73
|
| Rate for Payer: BCN Commercial |
$398.76
|
| Rate for Payer: BCN Medicare Advantage |
$239.44
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cofinity Commercial |
$320.85
|
| Rate for Payer: Cofinity Commercial |
$344.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.41
|
| Rate for Payer: Meridian Medicaid |
$174.00
|
| Rate for Payer: Nomi Health Commercial |
$287.33
|
| Rate for Payer: PACE SWMI |
$239.44
|
| Rate for Payer: PHP Commercial |
$335.22
|
| Rate for Payer: PHP Medicare Advantage |
$239.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.28
|
| Rate for Payer: Priority Health Medicare |
$239.44
|
| Rate for Payer: Priority Health Narrow Network |
$389.28
|
| Rate for Payer: Priority Health SBD |
$389.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.44
|
| Rate for Payer: UHC Medicare Advantage |
$239.44
|
| Rate for Payer: UHCCP Medicaid |
$165.71
|
| Rate for Payer: UMR Bronson Commercial |
$301.30
|
|
|
PR CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 21750
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,388.14 |
| Rate for Payer: Aetna Commercial |
$875.98
|
| Rate for Payer: Aetna Medicare |
$679.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.36
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$653.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$653.72
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cofinity Commercial |
$875.98
|
| Rate for Payer: Cofinity Commercial |
$941.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.41
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Nomi Health Commercial |
$784.46
|
| Rate for Payer: PACE SWMI |
$653.72
|
| Rate for Payer: PHP Commercial |
$915.21
|
| Rate for Payer: PHP Medicare Advantage |
$653.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,027.38
|
| Rate for Payer: Priority Health Medicare |
$653.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,027.38
|
| Rate for Payer: Priority Health SBD |
$1,027.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.72
|
| Rate for Payer: UHC Medicare Advantage |
$653.72
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
| Rate for Payer: UMR Bronson Commercial |
$963.24
|
|
|
PR CLOSURE CYSTOSTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 51880
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,691.09 |
| Rate for Payer: Aetna Commercial |
$596.06
|
| Rate for Payer: Aetna Medicare |
$462.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.54
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$444.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.09
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$444.82
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cofinity Commercial |
$596.06
|
| Rate for Payer: Cofinity Commercial |
$640.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.06
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Nomi Health Commercial |
$533.78
|
| Rate for Payer: PACE SWMI |
$444.82
|
| Rate for Payer: PHP Commercial |
$622.75
|
| Rate for Payer: PHP Medicare Advantage |
$444.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$745.65
|
| Rate for Payer: Priority Health Medicare |
$444.82
|
| Rate for Payer: Priority Health Narrow Network |
$745.65
|
| Rate for Payer: Priority Health SBD |
$745.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$444.82
|
| Rate for Payer: UHC Medicare Advantage |
$444.82
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
| Rate for Payer: UMR Bronson Commercial |
$653.20
|
|
|
PR CLOSURE ENTEROSTOMY LG/SMALL INTESTINE
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 44620
|
| Min. Negotiated Rate |
$210.79 |
| Max. Negotiated Rate |
$1,542.78 |
| Rate for Payer: Aetna Commercial |
$1,115.83
|
| Rate for Payer: Aetna Medicare |
$866.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.10
|
| Rate for Payer: BCBS Complete |
$581.04
|
| Rate for Payer: BCBS MAPPO |
$832.71
|
| Rate for Payer: BCBS Trust/PPO |
$210.79
|
| Rate for Payer: BCN Commercial |
$1,258.83
|
| Rate for Payer: BCN Medicare Advantage |
$832.71
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,115.83
|
| Rate for Payer: Cofinity Commercial |
$1,199.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.35
|
| Rate for Payer: Meridian Medicaid |
$581.04
|
| Rate for Payer: Nomi Health Commercial |
$999.25
|
| Rate for Payer: PACE SWMI |
$832.71
|
| Rate for Payer: PHP Commercial |
$1,165.79
|
| Rate for Payer: PHP Medicare Advantage |
$832.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.78
|
| Rate for Payer: Priority Health Medicare |
$832.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,542.78
|
| Rate for Payer: Priority Health SBD |
$1,542.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.71
|
| Rate for Payer: UHC Medicare Advantage |
$832.71
|
| Rate for Payer: UHCCP Medicaid |
$553.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,040.06
|
|
|
PR CLOSURE GASTROCOLIC FISTULA
|
Professional
|
Both
|
$3,893.00
|
|
|
Service Code
|
HCPCS 43880
|
| Min. Negotiated Rate |
$198.11 |
| Max. Negotiated Rate |
$2,873.80 |
| Rate for Payer: Aetna Commercial |
$2,095.77
|
| Rate for Payer: Aetna Medicare |
$1,626.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,095.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,252.17
|
| Rate for Payer: BCBS Complete |
$1,083.14
|
| Rate for Payer: BCBS MAPPO |
$1,564.01
|
| Rate for Payer: BCBS Trust/PPO |
$198.11
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,564.01
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cofinity Commercial |
$2,095.77
|
| Rate for Payer: Cofinity Commercial |
$2,252.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,564.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,642.21
|
| Rate for Payer: Meridian Medicaid |
$1,083.14
|
| Rate for Payer: Nomi Health Commercial |
$1,876.81
|
| Rate for Payer: PACE SWMI |
$1,564.01
|
| Rate for Payer: PHP Commercial |
$2,189.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,564.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,031.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,530.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,873.80
|
| Rate for Payer: Priority Health Medicare |
$1,564.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,873.80
|
| Rate for Payer: Priority Health SBD |
$2,873.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,564.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,564.01
|
| Rate for Payer: UHCCP Medicaid |
$1,031.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,790.78
|
|
|
PR CLOSURE GASTROSTOMY SURG
|
Professional
|
Both
|
$1,955.00
|
|
|
Service Code
|
HCPCS 43870
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$1,273.14 |
| Rate for Payer: Aetna Commercial |
$921.16
|
| Rate for Payer: Aetna Medicare |
$714.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.90
|
| Rate for Payer: BCBS Complete |
$479.50
|
| Rate for Payer: BCBS MAPPO |
$687.43
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$687.43
|
| Rate for Payer: Cash Price |
$1,564.00
|
| Rate for Payer: Cash Price |
$1,564.00
|
| Rate for Payer: Cofinity Commercial |
$921.16
|
| Rate for Payer: Cofinity Commercial |
$989.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.80
|
| Rate for Payer: Meridian Medicaid |
$479.50
|
| Rate for Payer: Nomi Health Commercial |
$824.92
|
| Rate for Payer: PACE SWMI |
$687.43
|
| Rate for Payer: PHP Commercial |
$962.40
|
| Rate for Payer: PHP Medicare Advantage |
$687.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,270.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.14
|
| Rate for Payer: Priority Health Medicare |
$687.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.14
|
| Rate for Payer: Priority Health SBD |
$1,273.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.43
|
| Rate for Payer: UHC Medicare Advantage |
$687.43
|
| Rate for Payer: UHCCP Medicaid |
$456.67
|
| Rate for Payer: UMR Bronson Commercial |
$899.30
|
|
|
PR CLOSURE INTESTINAL CUTANEOUS FISTULA
|
Professional
|
Both
|
$2,546.00
|
|
|
Service Code
|
HCPCS 44640
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$2,484.81 |
| Rate for Payer: Aetna Commercial |
$1,805.96
|
| Rate for Payer: Aetna Medicare |
$1,401.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,940.73
|
| Rate for Payer: BCBS Complete |
$935.53
|
| Rate for Payer: BCBS MAPPO |
$1,347.73
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$2,026.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,347.73
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cofinity Commercial |
$1,805.96
|
| Rate for Payer: Cofinity Commercial |
$1,940.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,347.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,415.12
|
| Rate for Payer: Meridian Medicaid |
$935.53
|
| Rate for Payer: Nomi Health Commercial |
$1,617.28
|
| Rate for Payer: PACE SWMI |
$1,347.73
|
| Rate for Payer: PHP Commercial |
$1,886.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,347.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,484.81
|
| Rate for Payer: Priority Health Medicare |
$1,347.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,484.81
|
| Rate for Payer: Priority Health SBD |
$2,484.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,347.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,347.73
|
| Rate for Payer: UHCCP Medicaid |
$890.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,171.16
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 40830
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$805.66 |
| Rate for Payer: Aetna Commercial |
$185.12
|
| Rate for Payer: Aetna Medicare |
$143.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.94
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$138.15
|
| Rate for Payer: BCBS Trust/PPO |
$805.66
|
| Rate for Payer: BCN Commercial |
$332.79
|
| Rate for Payer: BCN Medicare Advantage |
$138.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$185.12
|
| Rate for Payer: Cofinity Commercial |
$198.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.06
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Nomi Health Commercial |
$165.78
|
| Rate for Payer: PACE SWMI |
$138.15
|
| Rate for Payer: PHP Commercial |
$193.41
|
| Rate for Payer: PHP Medicare Advantage |
$138.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.72
|
| Rate for Payer: Priority Health Medicare |
$138.15
|
| Rate for Payer: Priority Health Narrow Network |
$260.72
|
| Rate for Payer: Priority Health SBD |
$260.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.15
|
| Rate for Payer: UHC Medicare Advantage |
$138.15
|
| Rate for Payer: UHCCP Medicaid |
$94.79
|
| Rate for Payer: UMR Bronson Commercial |
$247.02
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 40831
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$949.88 |
| Rate for Payer: Aetna Commercial |
$256.05
|
| Rate for Payer: Aetna Medicare |
$198.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.16
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$191.08
|
| Rate for Payer: BCBS Trust/PPO |
$949.88
|
| Rate for Payer: BCN Commercial |
$436.39
|
| Rate for Payer: BCN Medicare Advantage |
$191.08
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$256.05
|
| Rate for Payer: Cofinity Commercial |
$275.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.63
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$229.30
|
| Rate for Payer: PACE SWMI |
$191.08
|
| Rate for Payer: PHP Commercial |
$267.51
|
| Rate for Payer: PHP Medicare Advantage |
$191.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.74
|
| Rate for Payer: Priority Health Medicare |
$191.08
|
| Rate for Payer: Priority Health Narrow Network |
$359.74
|
| Rate for Payer: Priority Health SBD |
$359.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.08
|
| Rate for Payer: UHC Medicare Advantage |
$191.08
|
| Rate for Payer: UHCCP Medicaid |
$131.00
|
| Rate for Payer: UMR Bronson Commercial |
$317.86
|
|
|
PR CLOSURE RECTOURETHRAL FISTULA
|
Professional
|
Both
|
$3,283.00
|
|
|
Service Code
|
HCPCS 45820
|
| Min. Negotiated Rate |
$527.24 |
| Max. Negotiated Rate |
$2,281.98 |
| Rate for Payer: Aetna Commercial |
$1,658.04
|
| Rate for Payer: Aetna Medicare |
$1,286.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,658.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.77
|
| Rate for Payer: BCBS Complete |
$861.27
|
| Rate for Payer: BCBS MAPPO |
$1,237.34
|
| Rate for Payer: BCBS Trust/PPO |
$527.24
|
| Rate for Payer: BCN Commercial |
$1,862.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.34
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cofinity Commercial |
$1,658.04
|
| Rate for Payer: Cofinity Commercial |
$1,781.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.21
|
| Rate for Payer: Meridian Medicaid |
$861.27
|
| Rate for Payer: Nomi Health Commercial |
$1,484.81
|
| Rate for Payer: PACE SWMI |
$1,237.34
|
| Rate for Payer: PHP Commercial |
$1,732.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,133.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,281.98
|
| Rate for Payer: Priority Health Medicare |
$1,237.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,281.98
|
| Rate for Payer: Priority Health SBD |
$2,281.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,237.34
|
| Rate for Payer: UHCCP Medicaid |
$820.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,510.18
|
|
|
PR CLOSURE RECTOVESICAL FISTULA
|
Professional
|
Both
|
$2,859.00
|
|
|
Service Code
|
HCPCS 45800
|
| Min. Negotiated Rate |
$818.35 |
| Max. Negotiated Rate |
$2,276.01 |
| Rate for Payer: Aetna Commercial |
$1,654.14
|
| Rate for Payer: Aetna Medicare |
$1,283.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,777.58
|
| Rate for Payer: BCBS Complete |
$859.27
|
| Rate for Payer: BCBS MAPPO |
$1,234.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.43
|
| Rate for Payer: BCN Commercial |
$1,857.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,234.43
|
| Rate for Payer: Cash Price |
$2,287.20
|
| Rate for Payer: Cash Price |
$2,287.20
|
| Rate for Payer: Cofinity Commercial |
$1,654.14
|
| Rate for Payer: Cofinity Commercial |
$1,777.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,234.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.15
|
| Rate for Payer: Meridian Medicaid |
$859.27
|
| Rate for Payer: Nomi Health Commercial |
$1,481.32
|
| Rate for Payer: PACE SWMI |
$1,234.43
|
| Rate for Payer: PHP Commercial |
$1,728.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,234.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,858.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,276.01
|
| Rate for Payer: Priority Health Medicare |
$1,234.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,276.01
|
| Rate for Payer: Priority Health SBD |
$2,276.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,234.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,234.43
|
| Rate for Payer: UHCCP Medicaid |
$818.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,315.14
|
|
|
PR CLOSURE SALIVARY FISTULA
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 42600
|
| Min. Negotiated Rate |
$231.11 |
| Max. Negotiated Rate |
$808.27 |
| Rate for Payer: Aetna Commercial |
$455.55
|
| Rate for Payer: Aetna Medicare |
$353.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.54
|
| Rate for Payer: BCBS Complete |
$242.67
|
| Rate for Payer: BCBS MAPPO |
$339.96
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$339.96
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$455.55
|
| Rate for Payer: Cofinity Commercial |
$489.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.96
|
| Rate for Payer: Meridian Medicaid |
$242.67
|
| Rate for Payer: Nomi Health Commercial |
$407.95
|
| Rate for Payer: PACE SWMI |
$339.96
|
| Rate for Payer: PHP Commercial |
$475.94
|
| Rate for Payer: PHP Medicare Advantage |
$339.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$645.51
|
| Rate for Payer: Priority Health Medicare |
$339.96
|
| Rate for Payer: Priority Health Narrow Network |
$645.51
|
| Rate for Payer: Priority Health SBD |
$645.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.96
|
| Rate for Payer: UHC Medicare Advantage |
$339.96
|
| Rate for Payer: UHCCP Medicaid |
$231.11
|
| Rate for Payer: UMR Bronson Commercial |
$376.28
|
|
|
PR CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 57320
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,656.75 |
| Rate for Payer: Aetna Commercial |
$722.62
|
| Rate for Payer: Aetna Medicare |
$560.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.55
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$539.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.75
|
| Rate for Payer: BCN Commercial |
$831.73
|
| Rate for Payer: BCN Medicare Advantage |
$539.27
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cofinity Commercial |
$722.62
|
| Rate for Payer: Cofinity Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.23
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Nomi Health Commercial |
$647.12
|
| Rate for Payer: PACE SWMI |
$539.27
|
| Rate for Payer: PHP Commercial |
$754.98
|
| Rate for Payer: PHP Medicare Advantage |
$539.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$847.74
|
| Rate for Payer: Priority Health Medicare |
$539.27
|
| Rate for Payer: Priority Health Narrow Network |
$847.74
|
| Rate for Payer: Priority Health SBD |
$847.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.27
|
| Rate for Payer: UHC Medicare Advantage |
$539.27
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
| Rate for Payer: UMR Bronson Commercial |
$442.98
|
|
|
PR CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 23540
|
| Min. Negotiated Rate |
$159.54 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna Commercial |
$310.42
|
| Rate for Payer: Aetna Medicare |
$240.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.59
|
| Rate for Payer: BCBS Complete |
$167.52
|
| Rate for Payer: BCBS MAPPO |
$231.66
|
| Rate for Payer: BCBS Trust/PPO |
$393.06
|
| Rate for Payer: BCN Commercial |
$361.13
|
| Rate for Payer: BCN Medicare Advantage |
$231.66
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$310.42
|
| Rate for Payer: Cofinity Commercial |
$333.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.24
|
| Rate for Payer: Meridian Medicaid |
$167.52
|
| Rate for Payer: Nomi Health Commercial |
$277.99
|
| Rate for Payer: PACE SWMI |
$231.66
|
| Rate for Payer: PHP Commercial |
$324.32
|
| Rate for Payer: PHP Medicare Advantage |
$231.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$378.09
|
| Rate for Payer: Priority Health Medicare |
$231.66
|
| Rate for Payer: Priority Health Narrow Network |
$378.09
|
| Rate for Payer: Priority Health SBD |
$378.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.66
|
| Rate for Payer: UHC Medicare Advantage |
$231.66
|
| Rate for Payer: UHCCP Medicaid |
$159.54
|
| Rate for Payer: UMR Bronson Commercial |
$275.08
|
|
|
PR CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 23500
|
| Min. Negotiated Rate |
$155.49 |
| Max. Negotiated Rate |
$365.36 |
| Rate for Payer: Aetna Commercial |
$302.12
|
| Rate for Payer: Aetna Medicare |
$234.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.66
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$225.46
|
| Rate for Payer: BCBS Trust/PPO |
$226.26
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$225.46
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cofinity Commercial |
$302.12
|
| Rate for Payer: Cofinity Commercial |
$324.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.73
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Nomi Health Commercial |
$270.55
|
| Rate for Payer: PACE SWMI |
$225.46
|
| Rate for Payer: PHP Commercial |
$315.64
|
| Rate for Payer: PHP Medicare Advantage |
$225.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.36
|
| Rate for Payer: Priority Health Medicare |
$225.46
|
| Rate for Payer: Priority Health Narrow Network |
$365.36
|
| Rate for Payer: Priority Health SBD |
$365.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.46
|
| Rate for Payer: UHC Medicare Advantage |
$225.46
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
| Rate for Payer: UMR Bronson Commercial |
$237.36
|
|
|
PR CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 24500
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$548.60 |
| Rate for Payer: Aetna Commercial |
$438.14
|
| Rate for Payer: Aetna Medicare |
$340.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.84
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$326.97
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$544.87
|
| Rate for Payer: BCN Medicare Advantage |
$326.97
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cofinity Commercial |
$438.14
|
| Rate for Payer: Cofinity Commercial |
$470.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.32
|
| Rate for Payer: Meridian Medicaid |
$236.40
|
| Rate for Payer: Nomi Health Commercial |
$392.36
|
| Rate for Payer: PACE SWMI |
$326.97
|
| Rate for Payer: PHP Commercial |
$457.76
|
| Rate for Payer: PHP Medicare Advantage |
$326.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.28
|
| Rate for Payer: Priority Health Medicare |
$326.97
|
| Rate for Payer: Priority Health Narrow Network |
$533.28
|
| Rate for Payer: Priority Health SBD |
$533.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.97
|
| Rate for Payer: UHC Medicare Advantage |
$326.97
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: UMR Bronson Commercial |
$388.24
|
|
|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$2,080.97 |
| Rate for Payer: Aetna Commercial |
$408.41
|
| Rate for Payer: Aetna Medicare |
$316.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.88
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$304.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,080.97
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: BCN Medicare Advantage |
$304.78
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$408.41
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.02
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Nomi Health Commercial |
$365.74
|
| Rate for Payer: PACE SWMI |
$304.78
|
| Rate for Payer: PHP Commercial |
$426.69
|
| Rate for Payer: PHP Medicare Advantage |
$304.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$304.78
|
| Rate for Payer: Priority Health Narrow Network |
$483.42
|
| Rate for Payer: Priority Health SBD |
$483.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$304.78
|
| Rate for Payer: UHC Medicare Advantage |
$304.78
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
| Rate for Payer: UMR Bronson Commercial |
$211.14
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,831.62 |
| Rate for Payer: Aetna Commercial |
$168.33
|
| Rate for Payer: Aetna Medicare |
$130.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.89
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$125.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.62
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$125.62
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$168.33
|
| Rate for Payer: Cofinity Commercial |
$180.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.90
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: PACE SWMI |
$125.62
|
| Rate for Payer: PHP Commercial |
$175.87
|
| Rate for Payer: PHP Medicare Advantage |
$125.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.58
|
| Rate for Payer: Priority Health Medicare |
$125.62
|
| Rate for Payer: Priority Health Narrow Network |
$205.58
|
| Rate for Payer: Priority Health SBD |
$205.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.62
|
| Rate for Payer: UHC Medicare Advantage |
$125.62
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
| Rate for Payer: UMR Bronson Commercial |
$108.56
|
|
