|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$670.15 |
| Rate for Payer: Aetna Commercial |
$530.47
|
| Rate for Payer: Aetna Medicare |
$411.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.05
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS MAPPO |
$395.87
|
| Rate for Payer: BCBS Trust/PPO |
$372.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$395.87
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$530.47
|
| Rate for Payer: Cofinity Commercial |
$570.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.66
|
| Rate for Payer: Meridian Medicaid |
$283.82
|
| Rate for Payer: Nomi Health Commercial |
$475.04
|
| Rate for Payer: PACE SWMI |
$395.87
|
| Rate for Payer: PHP Commercial |
$554.22
|
| Rate for Payer: PHP Medicare Advantage |
$395.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.16
|
| Rate for Payer: Priority Health Medicare |
$395.87
|
| Rate for Payer: Priority Health Narrow Network |
$641.16
|
| Rate for Payer: Priority Health SBD |
$641.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.87
|
| Rate for Payer: UHC Medicare Advantage |
$395.87
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
| Rate for Payer: UMR Bronson Commercial |
$474.26
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$397.31
|
| Rate for Payer: Aetna Medicare |
$308.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.96
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$296.50
|
| Rate for Payer: BCBS Trust/PPO |
$328.60
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: BCN Medicare Advantage |
$296.50
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$397.31
|
| Rate for Payer: Cofinity Commercial |
$426.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.32
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Nomi Health Commercial |
$355.80
|
| Rate for Payer: PACE SWMI |
$296.50
|
| Rate for Payer: PHP Commercial |
$415.10
|
| Rate for Payer: PHP Medicare Advantage |
$296.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.33
|
| Rate for Payer: Priority Health Medicare |
$296.50
|
| Rate for Payer: Priority Health Narrow Network |
$478.33
|
| Rate for Payer: Priority Health SBD |
$478.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.50
|
| Rate for Payer: UHC Medicare Advantage |
$296.50
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
| Rate for Payer: UMR Bronson Commercial |
$319.24
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$362.53 |
| Max. Negotiated Rate |
$2,458.18 |
| Rate for Payer: Aetna Commercial |
$717.74
|
| Rate for Payer: Aetna Medicare |
$557.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.31
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS MAPPO |
$535.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$818.53
|
| Rate for Payer: BCN Medicare Advantage |
$535.63
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$717.74
|
| Rate for Payer: Cofinity Commercial |
$771.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.41
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Nomi Health Commercial |
$642.76
|
| Rate for Payer: PACE SWMI |
$535.63
|
| Rate for Payer: PHP Commercial |
$749.88
|
| Rate for Payer: PHP Medicare Advantage |
$535.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.05
|
| Rate for Payer: Priority Health Medicare |
$535.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.05
|
| Rate for Payer: Priority Health SBD |
$1,007.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.63
|
| Rate for Payer: UHC Medicare Advantage |
$535.63
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
| Rate for Payer: UMR Bronson Commercial |
$771.88
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$573.18 |
| Max. Negotiated Rate |
$1,299.88 |
| Rate for Payer: Aetna Commercial |
$1,161.71
|
| Rate for Payer: Aetna Medicare |
$901.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,161.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.41
|
| Rate for Payer: BCBS Complete |
$601.84
|
| Rate for Payer: BCBS MAPPO |
$866.95
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,299.88
|
| Rate for Payer: BCN Medicare Advantage |
$866.95
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cofinity Commercial |
$1,161.71
|
| Rate for Payer: Cofinity Commercial |
$1,248.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.30
|
| Rate for Payer: Meridian Medicaid |
$601.84
|
| Rate for Payer: Nomi Health Commercial |
$1,040.34
|
| Rate for Payer: PACE SWMI |
$866.95
|
| Rate for Payer: PHP Commercial |
$1,213.73
|
| Rate for Payer: PHP Medicare Advantage |
$866.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,242.10
|
| Rate for Payer: Priority Health Medicare |
$866.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.10
|
| Rate for Payer: Priority Health SBD |
$1,242.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$866.95
|
| Rate for Payer: UHC Medicare Advantage |
$866.95
|
| Rate for Payer: UHCCP Medicaid |
$573.18
|
| Rate for Payer: UMR Bronson Commercial |
$861.12
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,579.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$245.13 |
| Max. Negotiated Rate |
$2,561.78 |
| Rate for Payer: Aetna Commercial |
$1,856.82
|
| Rate for Payer: Aetna Medicare |
$1,441.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,856.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,995.39
|
| Rate for Payer: BCBS Complete |
$962.59
|
| Rate for Payer: BCBS MAPPO |
$1,385.69
|
| Rate for Payer: BCBS Trust/PPO |
$245.13
|
| Rate for Payer: BCN Commercial |
$2,089.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,385.69
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cofinity Commercial |
$1,856.82
|
| Rate for Payer: Cofinity Commercial |
$1,995.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,385.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,454.97
|
| Rate for Payer: Meridian Medicaid |
$962.59
|
| Rate for Payer: Nomi Health Commercial |
$1,662.83
|
| Rate for Payer: PACE SWMI |
$1,385.69
|
| Rate for Payer: PHP Commercial |
$1,939.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,385.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,561.78
|
| Rate for Payer: Priority Health Medicare |
$1,385.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,561.78
|
| Rate for Payer: Priority Health SBD |
$2,561.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,385.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,385.69
|
| Rate for Payer: UHCCP Medicaid |
$916.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,186.34
|
|
|
PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 44661
|
| Min. Negotiated Rate |
$246.19 |
| Max. Negotiated Rate |
$2,739.56 |
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Aetna Commercial |
$1,995.19
|
| Rate for Payer: Aetna Medicare |
$1,548.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,995.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,144.09
|
| Rate for Payer: BCBS Complete |
$1,034.16
|
| Rate for Payer: BCBS MAPPO |
$1,488.95
|
| Rate for Payer: BCBS Trust/PPO |
$246.19
|
| Rate for Payer: BCN Commercial |
$2,239.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,488.95
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Cofinity Commercial |
$1,995.19
|
| Rate for Payer: Cofinity Commercial |
$2,144.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,488.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,563.40
|
| Rate for Payer: Meridian Medicaid |
$1,034.16
|
| Rate for Payer: Nomi Health Commercial |
$1,786.74
|
| Rate for Payer: PACE SWMI |
$1,488.95
|
| Rate for Payer: PHP Commercial |
$2,084.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,488.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$984.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.56
|
| Rate for Payer: Priority Health Medicare |
$1,488.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.56
|
| Rate for Payer: Priority Health SBD |
$2,739.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,488.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,488.95
|
| Rate for Payer: UHCCP Medicaid |
$984.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,644.96
|
|
|
PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ
|
Professional
|
Both
|
$2,662.00
|
|
|
Service Code
|
HCPCS 44660
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,387.58 |
| Rate for Payer: Aetna Commercial |
$1,727.31
|
| Rate for Payer: Aetna Medicare |
$1,340.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,727.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,856.22
|
| Rate for Payer: BCBS Complete |
$897.73
|
| Rate for Payer: BCBS MAPPO |
$1,289.04
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,934.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,289.04
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cofinity Commercial |
$1,727.31
|
| Rate for Payer: Cofinity Commercial |
$1,856.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,289.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,353.49
|
| Rate for Payer: Meridian Medicaid |
$897.73
|
| Rate for Payer: Nomi Health Commercial |
$1,546.85
|
| Rate for Payer: PACE SWMI |
$1,289.04
|
| Rate for Payer: PHP Commercial |
$1,804.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,289.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,730.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,387.58
|
| Rate for Payer: Priority Health Medicare |
$1,289.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,387.58
|
| Rate for Payer: Priority Health SBD |
$2,387.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,289.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,289.04
|
| Rate for Payer: UHCCP Medicaid |
$854.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,224.52
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 43420
|
| Min. Negotiated Rate |
$654.12 |
| Max. Negotiated Rate |
$1,826.76 |
| Rate for Payer: Aetna Commercial |
$1,304.85
|
| Rate for Payer: Aetna Medicare |
$1,012.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,304.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.23
|
| Rate for Payer: BCBS Complete |
$686.83
|
| Rate for Payer: BCBS MAPPO |
$973.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,490.95
|
| Rate for Payer: BCN Medicare Advantage |
$973.77
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cofinity Commercial |
$1,304.85
|
| Rate for Payer: Cofinity Commercial |
$1,402.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.46
|
| Rate for Payer: Meridian Medicaid |
$686.83
|
| Rate for Payer: Nomi Health Commercial |
$1,168.52
|
| Rate for Payer: PACE SWMI |
$973.77
|
| Rate for Payer: PHP Commercial |
$1,363.28
|
| Rate for Payer: PHP Medicare Advantage |
$973.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,826.76
|
| Rate for Payer: Priority Health Medicare |
$973.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,826.76
|
| Rate for Payer: Priority Health SBD |
$1,826.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.77
|
| Rate for Payer: UHC Medicare Advantage |
$973.77
|
| Rate for Payer: UHCCP Medicaid |
$654.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,238.78
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,177.00
|
|
|
Service Code
|
HCPCS 43425
|
| Min. Negotiated Rate |
$914.84 |
| Max. Negotiated Rate |
$2,715.05 |
| Rate for Payer: Aetna Commercial |
$1,862.05
|
| Rate for Payer: Aetna Medicare |
$1,445.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,862.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,001.01
|
| Rate for Payer: BCBS Complete |
$960.58
|
| Rate for Payer: BCBS MAPPO |
$1,389.59
|
| Rate for Payer: BCBS Trust/PPO |
$986.34
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.59
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,862.05
|
| Rate for Payer: Cofinity Commercial |
$2,001.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,459.07
|
| Rate for Payer: Meridian Medicaid |
$960.58
|
| Rate for Payer: Nomi Health Commercial |
$1,667.51
|
| Rate for Payer: PACE SWMI |
$1,389.59
|
| Rate for Payer: PHP Commercial |
$1,945.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,715.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,552.82
|
| Rate for Payer: Priority Health Medicare |
$1,389.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.82
|
| Rate for Payer: Priority Health SBD |
$2,552.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.59
|
| Rate for Payer: UHCCP Medicaid |
$914.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,921.42
|
|
|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,031.77 |
| Rate for Payer: Aetna Commercial |
$144.04
|
| Rate for Payer: Aetna Medicare |
$111.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.79
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$107.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.77
|
| Rate for Payer: BCN Commercial |
$170.81
|
| 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 |
$144.04
|
| Rate for Payer: Cofinity Commercial |
$154.79
|
| 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: Meridian Medicaid |
$78.06
|
| 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 Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.13
|
| Rate for Payer: Priority Health Medicare |
$107.49
|
| Rate for Payer: Priority Health Narrow Network |
$204.13
|
| Rate for Payer: Priority Health SBD |
$204.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.49
|
| Rate for Payer: UHC Medicare Advantage |
$107.49
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
| 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 |
$203.40 |
| 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) |
$1,301.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,398.56
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS MAPPO |
$971.22
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,467.49
|
| 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 |
$1,301.43
|
| Rate for Payer: Cofinity Commercial |
$1,398.56
|
| 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: Meridian Medicaid |
$677.44
|
| 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 Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,893.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.53
|
| Rate for Payer: Priority Health Medicare |
$971.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.53
|
| Rate for Payer: Priority Health SBD |
$1,800.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$971.22
|
| Rate for Payer: UHC Medicare Advantage |
$971.22
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
| 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 |
$205.51 |
| Max. Negotiated Rate |
$2,827.86 |
| Rate for Payer: Aetna Commercial |
$2,055.79
|
| Rate for Payer: Aetna Medicare |
$1,595.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,055.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,209.20
|
| Rate for Payer: BCBS Complete |
$1,064.12
|
| Rate for Payer: BCBS MAPPO |
$1,534.17
|
| Rate for Payer: BCBS Trust/PPO |
$205.51
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| 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 |
$2,055.79
|
| Rate for Payer: Cofinity Commercial |
$2,209.20
|
| 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: Meridian Medicaid |
$1,064.12
|
| 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 Choice Medicaid |
$1,013.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,931.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,827.86
|
| Rate for Payer: Priority Health Medicare |
$1,534.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,827.86
|
| Rate for Payer: Priority Health SBD |
$2,827.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,534.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,534.17
|
| Rate for Payer: UHCCP Medicaid |
$1,013.45
|
| 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 |
$427.49 |
| Max. Negotiated Rate |
$1,574.86 |
| Rate for Payer: Aetna Commercial |
$849.59
|
| Rate for Payer: Aetna Medicare |
$659.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.99
|
| Rate for Payer: BCBS Complete |
$448.86
|
| Rate for Payer: BCBS MAPPO |
$634.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,574.86
|
| Rate for Payer: BCN Commercial |
$970.51
|
| 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 |
$849.59
|
| Rate for Payer: Cofinity Commercial |
$912.99
|
| 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: Meridian Medicaid |
$448.86
|
| 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 Choice Medicaid |
$427.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.59
|
| Rate for Payer: Priority Health Medicare |
$634.02
|
| Rate for Payer: Priority Health Narrow Network |
$992.59
|
| Rate for Payer: Priority Health SBD |
$992.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.02
|
| Rate for Payer: UHC Medicare Advantage |
$634.02
|
| Rate for Payer: UHCCP Medicaid |
$427.49
|
| 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 |
$623.88 |
| Max. Negotiated Rate |
$2,391.09 |
| Rate for Payer: Aetna Commercial |
$1,247.81
|
| Rate for Payer: Aetna Medicare |
$968.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.93
|
| Rate for Payer: BCBS Complete |
$655.07
|
| Rate for Payer: BCBS MAPPO |
$931.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.09
|
| Rate for Payer: BCN Commercial |
$1,444.05
|
| 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 |
$1,247.81
|
| Rate for Payer: Cofinity Commercial |
$1,340.93
|
| 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: Meridian Medicaid |
$655.07
|
| 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 Choice Medicaid |
$623.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,461.35
|
| Rate for Payer: Priority Health Medicare |
$931.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,461.35
|
| Rate for Payer: Priority Health SBD |
$1,461.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.20
|
| Rate for Payer: UHC Medicare Advantage |
$931.20
|
| Rate for Payer: UHCCP Medicaid |
$623.88
|
| 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 |
$393.20 |
| Max. Negotiated Rate |
$2,627.76 |
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: Aetna Medicare |
$605.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.09
|
| Rate for Payer: BCBS Complete |
$412.86
|
| Rate for Payer: BCBS MAPPO |
$582.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,627.76
|
| Rate for Payer: BCN Commercial |
$898.67
|
| 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 |
$779.89
|
| Rate for Payer: Cofinity Commercial |
$838.09
|
| 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: Meridian Medicaid |
$412.86
|
| 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 Choice Medicaid |
$393.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$920.16
|
| Rate for Payer: Priority Health Medicare |
$582.01
|
| Rate for Payer: Priority Health Narrow Network |
$920.16
|
| Rate for Payer: Priority Health SBD |
$920.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.01
|
| Rate for Payer: UHC Medicare Advantage |
$582.01
|
| Rate for Payer: UHCCP Medicaid |
$393.20
|
| 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 |
$256.23 |
| Max. Negotiated Rate |
$894.24 |
| Rate for Payer: Aetna Commercial |
$716.56
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$716.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.04
|
| Rate for Payer: BCBS Complete |
$377.75
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: BCN Commercial |
$808.27
|
| 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 |
$716.56
|
| Rate for Payer: Cofinity Commercial |
$770.04
|
| 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: Meridian Medicaid |
$377.75
|
| 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 Choice Medicaid |
$359.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.24
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health Narrow Network |
$894.24
|
| Rate for Payer: Priority Health SBD |
$894.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$359.76
|
| 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 |
$357.41 |
| Max. Negotiated Rate |
$2,101.05 |
| Rate for Payer: Aetna Commercial |
$709.11
|
| Rate for Payer: Aetna Medicare |
$550.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.03
|
| Rate for Payer: BCBS Complete |
$375.28
|
| Rate for Payer: BCBS MAPPO |
$529.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.05
|
| Rate for Payer: BCN Commercial |
$808.27
|
| 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 |
$709.11
|
| Rate for Payer: Cofinity Commercial |
$762.03
|
| 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: Meridian Medicaid |
$375.28
|
| 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 Choice Medicaid |
$357.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.88
|
| Rate for Payer: Priority Health Medicare |
$529.19
|
| Rate for Payer: Priority Health Narrow Network |
$830.88
|
| Rate for Payer: Priority Health SBD |
$830.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.19
|
| Rate for Payer: UHC Medicare Advantage |
$529.19
|
| Rate for Payer: UHCCP Medicaid |
$357.41
|
| 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 |
$528.24 |
| 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) |
$1,055.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.72
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS MAPPO |
$788.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,187.98
|
| 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 |
$1,055.92
|
| Rate for Payer: Cofinity Commercial |
$1,134.72
|
| 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: Meridian Medicaid |
$554.65
|
| 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 Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,310.74
|
| Rate for Payer: Priority Health Medicare |
$788.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,310.74
|
| Rate for Payer: Priority Health SBD |
$1,310.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$788.00
|
| Rate for Payer: UHC Medicare Advantage |
$788.00
|
| Rate for Payer: UHCCP Medicaid |
$528.24
|
| 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 |
$637.08 |
| Max. Negotiated Rate |
$2,011.24 |
| Rate for Payer: Aetna Commercial |
$1,267.84
|
| Rate for Payer: Aetna Medicare |
$984.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.46
|
| Rate for Payer: BCBS Complete |
$668.93
|
| Rate for Payer: BCBS MAPPO |
$946.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$1,446.98
|
| 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 |
$1,267.84
|
| Rate for Payer: Cofinity Commercial |
$1,362.46
|
| 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: Meridian Medicaid |
$668.93
|
| 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 Choice Medicaid |
$637.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,508.26
|
| Rate for Payer: Priority Health Medicare |
$946.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.26
|
| Rate for Payer: Priority Health SBD |
$1,508.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$946.15
|
| Rate for Payer: UHC Medicare Advantage |
$946.15
|
| Rate for Payer: UHCCP Medicaid |
$637.08
|
| 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 |
$271.15 |
| Max. Negotiated Rate |
$2,011.24 |
| Rate for Payer: Aetna Commercial |
$536.60
|
| Rate for Payer: Aetna Medicare |
$416.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.65
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS MAPPO |
$400.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$620.13
|
| 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 |
$536.60
|
| Rate for Payer: Cofinity Commercial |
$576.65
|
| 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: Meridian Medicaid |
$284.71
|
| 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 Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.69
|
| Rate for Payer: Priority Health Medicare |
$400.45
|
| Rate for Payer: Priority Health Narrow Network |
$642.69
|
| Rate for Payer: Priority Health SBD |
$642.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.45
|
| Rate for Payer: UHC Medicare Advantage |
$400.45
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
| 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 |
$324.40 |
| Max. Negotiated Rate |
$1,704.38 |
| Rate for Payer: Aetna Commercial |
$640.49
|
| Rate for Payer: Aetna Medicare |
$497.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.29
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS MAPPO |
$477.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.38
|
| Rate for Payer: BCN Commercial |
$727.64
|
| 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 |
$640.49
|
| Rate for Payer: Cofinity Commercial |
$688.29
|
| 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: Meridian Medicaid |
$340.62
|
| 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 Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.88
|
| Rate for Payer: Priority Health Medicare |
$477.98
|
| Rate for Payer: Priority Health Narrow Network |
$768.88
|
| Rate for Payer: Priority Health SBD |
$768.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.98
|
| Rate for Payer: UHC Medicare Advantage |
$477.98
|
| Rate for Payer: UHCCP Medicaid |
$324.40
|
| 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 |
$183.81 |
| 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) |
$440.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.49
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS MAPPO |
$328.81
|
| Rate for Payer: BCBS Trust/PPO |
$183.81
|
| Rate for Payer: BCN Commercial |
$562.96
|
| 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 |
$440.61
|
| Rate for Payer: Cofinity Commercial |
$473.49
|
| 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: Meridian Medicaid |
$235.96
|
| 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 Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.25
|
| Rate for Payer: Priority Health Medicare |
$328.81
|
| Rate for Payer: Priority Health Narrow Network |
$531.25
|
| Rate for Payer: Priority Health SBD |
$531.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.81
|
| Rate for Payer: UHC Medicare Advantage |
$328.81
|
| Rate for Payer: UHCCP Medicaid |
$224.72
|
| 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 |
$150.17 |
| 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) |
$290.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.49
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS MAPPO |
$217.01
|
| Rate for Payer: BCBS Trust/PPO |
$153.74
|
| Rate for Payer: BCN Commercial |
$350.87
|
| 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 |
$290.79
|
| Rate for Payer: Cofinity Commercial |
$312.49
|
| 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: Meridian Medicaid |
$157.68
|
| 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 Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.16
|
| Rate for Payer: Priority Health Medicare |
$217.01
|
| Rate for Payer: Priority Health Narrow Network |
$353.16
|
| Rate for Payer: Priority Health SBD |
$353.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.01
|
| Rate for Payer: UHC Medicare Advantage |
$217.01
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
| 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 |
$283.72 |
| Max. Negotiated Rate |
$1,016.45 |
| Rate for Payer: Aetna Commercial |
$554.42
|
| Rate for Payer: Aetna Medicare |
$430.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.80
|
| Rate for Payer: BCBS Complete |
$297.91
|
| Rate for Payer: BCBS MAPPO |
$413.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,016.45
|
| Rate for Payer: BCN Commercial |
$697.83
|
| 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 |
$554.42
|
| Rate for Payer: Cofinity Commercial |
$595.80
|
| 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: Meridian Medicaid |
$297.91
|
| 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 Choice Medicaid |
$283.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$670.68
|
| Rate for Payer: Priority Health Medicare |
$413.75
|
| Rate for Payer: Priority Health Narrow Network |
$670.68
|
| Rate for Payer: Priority Health SBD |
$670.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.75
|
| Rate for Payer: UHC Medicare Advantage |
$413.75
|
| Rate for Payer: UHCCP Medicaid |
$283.72
|
| 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 |
$192.55 |
| Max. Negotiated Rate |
$962.74 |
| Rate for Payer: Aetna Commercial |
$375.35
|
| Rate for Payer: Aetna Medicare |
$291.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.36
|
| Rate for Payer: BCBS Complete |
$202.18
|
| Rate for Payer: BCBS MAPPO |
$280.11
|
| Rate for Payer: BCBS Trust/PPO |
$962.74
|
| Rate for Payer: BCN Commercial |
$461.32
|
| 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 |
$375.35
|
| Rate for Payer: Cofinity Commercial |
$403.36
|
| 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: Meridian Medicaid |
$202.18
|
| 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 Choice Medicaid |
$192.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.39
|
| Rate for Payer: Priority Health Medicare |
$280.11
|
| Rate for Payer: Priority Health Narrow Network |
$453.39
|
| Rate for Payer: Priority Health SBD |
$453.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.11
|
| Rate for Payer: UHC Medicare Advantage |
$280.11
|
| Rate for Payer: UHCCP Medicaid |
$192.55
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
