|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$182.41 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna American Axle |
$320.45
|
| Rate for Payer: Aetna Commercial |
$419.05
|
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$905.59
|
| Rate for Payer: BCN Commercial |
$905.59
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Advantage |
$345.10
|
| Rate for Payer: Cofinity Commercial |
$423.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$443.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.75
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.05
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$419.05
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health SBD |
$310.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: UMR Bronson Commercial |
$182.41
|
| Rate for Payer: VA VA |
$736.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.75
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$216.92 |
| Max. Negotiated Rate |
$443.70 |
| Rate for Payer: Aetna American Axle |
$320.45
|
| Rate for Payer: Aetna Commercial |
$419.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.45
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Advantage |
$345.10
|
| Rate for Payer: Cofinity Commercial |
$423.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.40
|
| Rate for Payer: Healthscope Commercial |
$443.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PHP Commercial |
$419.05
|
| Rate for Payer: Priority Health SBD |
$310.59
|
| Rate for Payer: UMR Bronson Commercial |
$216.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.75
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
HCPCS 11043
|
| Hospital Charge Code |
11043
|
| Min. Negotiated Rate |
$88.18 |
| Max. Negotiated Rate |
$369.75 |
| Rate for Payer: Aetna Commercial |
$183.47
|
| Rate for Payer: Aetna Medicare |
$142.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.16
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$136.92
|
| Rate for Payer: BCN Commercial |
$230.07
|
| Rate for Payer: BCN Medicare Advantage |
$136.92
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$183.47
|
| Rate for Payer: Cofinity Commercial |
$197.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.77
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.61
|
| Rate for Payer: Nomi Health Commercial |
$164.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PACE SWMI |
$136.92
|
| Rate for Payer: PHP Commercial |
$191.69
|
| Rate for Payer: PHP Medicare Advantage |
$136.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$210.57
|
| Rate for Payer: Priority Health Medicare |
$136.92
|
| Rate for Payer: Priority Health SBD |
$210.57
|
| Rate for Payer: Priority Health Tiered Network |
$210.57
|
| Rate for Payer: Railroad Medicare Medicare |
$136.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.46
|
| Rate for Payer: UHC Core |
$273.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.92
|
| Rate for Payer: UHC Exchange |
$273.46
|
| Rate for Payer: UHC Medicaid |
$88.18
|
| Rate for Payer: UHCCP Medicaid |
$88.18
|
| Rate for Payer: UMR Bronson Commercial |
$226.78
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 11046
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$99.58 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna Medicare |
$49.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.95
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$47.88
|
| Rate for Payer: BCN Commercial |
$80.67
|
| Rate for Payer: BCN Medicare Advantage |
$47.88
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$64.16
|
| Rate for Payer: Cofinity Commercial |
$68.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.27
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.67
|
| Rate for Payer: Nomi Health Commercial |
$57.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.00
|
| Rate for Payer: PACE SWMI |
$47.88
|
| Rate for Payer: PHP Commercial |
$67.03
|
| Rate for Payer: PHP Medicare Advantage |
$47.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.83
|
| Rate for Payer: Priority Health Medicare |
$47.88
|
| Rate for Payer: Priority Health SBD |
$73.83
|
| Rate for Payer: Priority Health Tiered Network |
$73.83
|
| Rate for Payer: Railroad Medicare Medicare |
$47.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.58
|
| Rate for Payer: UHC Core |
$99.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.88
|
| Rate for Payer: UHC Exchange |
$99.58
|
| Rate for Payer: UHC Medicaid |
$30.46
|
| Rate for Payer: UHCCP Medicaid |
$30.46
|
| Rate for Payer: UMR Bronson Commercial |
$47.84
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 1-5
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 11720
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$42.75 |
| Rate for Payer: Aetna Commercial |
$17.03
|
| Rate for Payer: Aetna Medicare |
$13.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.30
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$12.71
|
| Rate for Payer: BCN Commercial |
$16.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.71
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Commercial |
$18.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.35
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.98
|
| Rate for Payer: Nomi Health Commercial |
$15.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: PACE SWMI |
$12.71
|
| Rate for Payer: PHP Commercial |
$17.79
|
| Rate for Payer: PHP Medicare Advantage |
$12.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.60
|
| Rate for Payer: Priority Health Medicare |
$12.71
|
| Rate for Payer: Priority Health SBD |
$19.60
|
| Rate for Payer: Priority Health Tiered Network |
$19.60
|
| Rate for Payer: Railroad Medicare Medicare |
$12.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.00
|
| Rate for Payer: UHC Core |
$26.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.71
|
| Rate for Payer: UHC Exchange |
$26.00
|
| Rate for Payer: UHC Medicaid |
$8.09
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 6/>
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 11721
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$28.70
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.84
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Commercial |
$27.88
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Nomi Health Commercial |
$25.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$29.99
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32.37
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$32.37
|
| Rate for Payer: Priority Health Tiered Network |
$32.37
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.51
|
| Rate for Payer: UHC Core |
$44.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$44.51
|
| Rate for Payer: UHC Medicaid |
$13.63
|
| Rate for Payer: UHCCP Medicaid |
$13.63
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
|
|
PR DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM/<
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 97597
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: Aetna Medicare |
$32.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.50
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$30.90
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$30.90
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$44.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.45
|
| Rate for Payer: Meridian Medicaid |
$20.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.99
|
| Rate for Payer: Nomi Health Commercial |
$37.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$30.90
|
| Rate for Payer: PHP Commercial |
$43.26
|
| Rate for Payer: PHP Medicare Advantage |
$30.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48.95
|
| Rate for Payer: Priority Health Medicare |
$30.90
|
| Rate for Payer: Priority Health SBD |
$48.95
|
| Rate for Payer: Priority Health Tiered Network |
$48.95
|
| Rate for Payer: Railroad Medicare Medicare |
$30.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.50
|
| Rate for Payer: UHC Core |
$33.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.90
|
| Rate for Payer: UHC Exchange |
$33.50
|
| Rate for Payer: UHC Medicaid |
$19.81
|
| Rate for Payer: UHCCP Medicaid |
$19.81
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
|
|
PR DEBRIDEMENT OPN WND EA ADDL 20 SQ CM/PRT THEREOF
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 97598
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Aetna Commercial |
$29.05
|
| Rate for Payer: Aetna Medicare |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.22
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS MAPPO |
$21.68
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: BCN Medicare Advantage |
$21.68
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$29.05
|
| Rate for Payer: Cofinity Commercial |
$31.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.76
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.85
|
| Rate for Payer: Nomi Health Commercial |
$26.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.25
|
| Rate for Payer: PACE SWMI |
$21.68
|
| Rate for Payer: PHP Commercial |
$30.35
|
| Rate for Payer: PHP Medicare Advantage |
$21.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$21.68
|
| Rate for Payer: Priority Health SBD |
$34.51
|
| Rate for Payer: Priority Health Tiered Network |
$34.51
|
| Rate for Payer: Railroad Medicare Medicare |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.54
|
| Rate for Payer: UHC Core |
$23.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.68
|
| Rate for Payer: UHC Exchange |
$23.54
|
| Rate for Payer: UHC Medicaid |
$13.85
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
PR DEBRIDEMENT, SKIN, PARTIAL THICKNESS
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 11040
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Medicare |
$40.00
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 11042
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$260.25 |
| Rate for Payer: Aetna Commercial |
$73.31
|
| Rate for Payer: Aetna Medicare |
$56.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.78
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$54.71
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$54.71
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Commercial |
$78.78
|
| Rate for Payer: Cofinity Commercial |
$73.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.45
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.18
|
| Rate for Payer: Nomi Health Commercial |
$65.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PACE SWMI |
$54.71
|
| Rate for Payer: PHP Commercial |
$76.59
|
| Rate for Payer: PHP Medicare Advantage |
$54.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.95
|
| Rate for Payer: Priority Health Medicare |
$54.71
|
| Rate for Payer: Priority Health SBD |
$82.95
|
| Rate for Payer: Priority Health Tiered Network |
$82.95
|
| Rate for Payer: Railroad Medicare Medicare |
$54.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.58
|
| Rate for Payer: UHC Core |
$106.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.71
|
| Rate for Payer: UHC Exchange |
$106.58
|
| Rate for Payer: UHC Medicaid |
$35.57
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
| Rate for Payer: UMR Bronson Commercial |
$159.62
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Facility
|
OP
|
$347.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
11042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$128.39 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$225.55
|
| Rate for Payer: Aetna Commercial |
$294.95
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$388.22
|
| Rate for Payer: BCN Commercial |
$388.22
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Advantage |
$242.90
|
| Rate for Payer: Cofinity Commercial |
$298.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$312.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.25
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.95
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$294.95
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$218.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$128.39
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.25
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
11042
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$260.25 |
| Rate for Payer: Aetna Commercial |
$73.31
|
| Rate for Payer: Aetna Medicare |
$56.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.78
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$54.71
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$54.71
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Commercial |
$73.31
|
| Rate for Payer: Cofinity Commercial |
$78.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.45
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.18
|
| Rate for Payer: Nomi Health Commercial |
$65.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PACE SWMI |
$54.71
|
| Rate for Payer: PHP Commercial |
$76.59
|
| Rate for Payer: PHP Medicare Advantage |
$54.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.95
|
| Rate for Payer: Priority Health Medicare |
$54.71
|
| Rate for Payer: Priority Health SBD |
$82.95
|
| Rate for Payer: Priority Health Tiered Network |
$82.95
|
| Rate for Payer: Railroad Medicare Medicare |
$54.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.58
|
| Rate for Payer: UHC Core |
$106.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.71
|
| Rate for Payer: UHC Exchange |
$106.58
|
| Rate for Payer: UHC Medicaid |
$35.57
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
| Rate for Payer: UMR Bronson Commercial |
$159.62
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Facility
|
IP
|
$347.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
11042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$152.68 |
| Max. Negotiated Rate |
$312.30 |
| Rate for Payer: Aetna American Axle |
$225.55
|
| Rate for Payer: Aetna Commercial |
$294.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.55
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Advantage |
$242.90
|
| Rate for Payer: Cofinity Commercial |
$298.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.60
|
| Rate for Payer: Healthscope Commercial |
$312.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PHP Commercial |
$294.95
|
| Rate for Payer: Priority Health SBD |
$218.61
|
| Rate for Payer: UMR Bronson Commercial |
$152.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.25
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 11045
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$29.56
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.77
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$22.06
|
| Rate for Payer: BCN Commercial |
$36.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.06
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$29.56
|
| Rate for Payer: Cofinity Commercial |
$31.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.16
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.27
|
| Rate for Payer: Nomi Health Commercial |
$26.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.00
|
| Rate for Payer: PACE SWMI |
$22.06
|
| Rate for Payer: PHP Commercial |
$30.88
|
| Rate for Payer: PHP Medicare Advantage |
$22.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.73
|
| Rate for Payer: Priority Health Medicare |
$22.06
|
| Rate for Payer: Priority Health SBD |
$33.73
|
| Rate for Payer: Priority Health Tiered Network |
$33.73
|
| Rate for Payer: Railroad Medicare Medicare |
$22.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.38
|
| Rate for Payer: UHC Core |
$47.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.06
|
| Rate for Payer: UHC Exchange |
$47.38
|
| Rate for Payer: UHC Medicaid |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
|
|
PR DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 36593
|
| Min. Negotiated Rate |
$28.52 |
| Max. Negotiated Rate |
$55.69 |
| Rate for Payer: Aetna Commercial |
$46.78
|
| Rate for Payer: Aetna Medicare |
$36.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.27
|
| Rate for Payer: BCBS MAPPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Medicare Advantage |
$34.91
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$46.78
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.40
|
| Rate for Payer: Nomi Health Commercial |
$41.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.50
|
| Rate for Payer: PACE SWMI |
$34.91
|
| Rate for Payer: PHP Commercial |
$48.87
|
| Rate for Payer: PHP Medicare Advantage |
$34.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$34.91
|
| Rate for Payer: Priority Health SBD |
$55.69
|
| Rate for Payer: Priority Health Tiered Network |
$55.69
|
| Rate for Payer: Railroad Medicare Medicare |
$34.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.24
|
| Rate for Payer: UHC Core |
$51.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.91
|
| Rate for Payer: UHC Exchange |
$51.24
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
PR DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI
|
Professional
|
Both
|
$1,889.00
|
|
|
Service Code
|
HCPCS 27027
|
| Min. Negotiated Rate |
$516.31 |
| Max. Negotiated Rate |
$1,565.95 |
| Rate for Payer: Aetna Commercial |
$1,065.45
|
| Rate for Payer: Aetna Medicare |
$826.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,065.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,144.96
|
| Rate for Payer: BCBS Complete |
$542.13
|
| Rate for Payer: BCBS MAPPO |
$795.11
|
| Rate for Payer: BCN Commercial |
$1,340.57
|
| Rate for Payer: BCN Medicare Advantage |
$795.11
|
| Rate for Payer: Cash Price |
$1,511.20
|
| Rate for Payer: Cash Price |
$1,511.20
|
| Rate for Payer: Cofinity Commercial |
$1,144.96
|
| Rate for Payer: Cofinity Commercial |
$1,065.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$834.87
|
| Rate for Payer: Meridian Medicaid |
$542.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$874.62
|
| Rate for Payer: Nomi Health Commercial |
$954.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,416.75
|
| Rate for Payer: PACE SWMI |
$795.11
|
| Rate for Payer: PHP Commercial |
$1,113.15
|
| Rate for Payer: PHP Medicare Advantage |
$795.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,433.03
|
| Rate for Payer: Priority Health Medicare |
$795.11
|
| Rate for Payer: Priority Health SBD |
$1,433.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,433.03
|
| Rate for Payer: Railroad Medicare Medicare |
$795.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,565.95
|
| Rate for Payer: UHC Core |
$1,565.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$795.11
|
| Rate for Payer: UHC Exchange |
$1,565.95
|
| Rate for Payer: UHC Medicaid |
$516.31
|
| Rate for Payer: UHCCP Medicaid |
$516.31
|
| Rate for Payer: UMR Bronson Commercial |
$868.94
|
|
|
PR DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 27496
|
| Min. Negotiated Rate |
$338.67 |
| Max. Negotiated Rate |
$945.88 |
| Rate for Payer: Aetna Commercial |
$689.00
|
| Rate for Payer: Aetna Medicare |
$534.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.42
|
| Rate for Payer: BCBS Complete |
$355.60
|
| Rate for Payer: BCBS MAPPO |
$514.18
|
| Rate for Payer: BCN Commercial |
$846.07
|
| Rate for Payer: BCN Medicare Advantage |
$514.18
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cofinity Commercial |
$689.00
|
| Rate for Payer: Cofinity Commercial |
$740.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$514.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.89
|
| Rate for Payer: Meridian Medicaid |
$355.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$565.60
|
| Rate for Payer: Nomi Health Commercial |
$617.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.00
|
| Rate for Payer: PACE SWMI |
$514.18
|
| Rate for Payer: PHP Commercial |
$719.85
|
| Rate for Payer: PHP Medicare Advantage |
$514.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$904.43
|
| Rate for Payer: Priority Health Medicare |
$514.18
|
| Rate for Payer: Priority Health SBD |
$904.43
|
| Rate for Payer: Priority Health Tiered Network |
$904.43
|
| Rate for Payer: Railroad Medicare Medicare |
$514.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.88
|
| Rate for Payer: UHC Core |
$945.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$514.18
|
| Rate for Payer: UHC Exchange |
$945.88
|
| Rate for Payer: UHC Medicaid |
$338.67
|
| Rate for Payer: UHCCP Medicaid |
$338.67
|
| Rate for Payer: UMR Bronson Commercial |
$448.96
|
|
|
PR DECOMPRESSION FASCT FOREARM W/BRACH ARTERY EXPL
|
Professional
|
Both
|
$1,743.00
|
|
|
Service Code
|
HCPCS 24495
|
| Min. Negotiated Rate |
$578.08 |
| Max. Negotiated Rate |
$1,474.55 |
| Rate for Payer: Aetna Commercial |
$1,157.79
|
| Rate for Payer: Aetna Medicare |
$898.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.19
|
| Rate for Payer: BCBS Complete |
$606.98
|
| Rate for Payer: BCBS MAPPO |
$864.02
|
| Rate for Payer: BCN Commercial |
$1,379.41
|
| Rate for Payer: BCN Medicare Advantage |
$864.02
|
| Rate for Payer: Cash Price |
$1,394.40
|
| Rate for Payer: Cash Price |
$1,394.40
|
| Rate for Payer: Cofinity Commercial |
$1,157.79
|
| Rate for Payer: Cofinity Commercial |
$1,244.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.22
|
| Rate for Payer: Meridian Medicaid |
$606.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$950.42
|
| Rate for Payer: Nomi Health Commercial |
$1,036.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,307.25
|
| Rate for Payer: PACE SWMI |
$864.02
|
| Rate for Payer: PHP Commercial |
$1,209.63
|
| Rate for Payer: PHP Medicare Advantage |
$864.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,474.55
|
| Rate for Payer: Priority Health Medicare |
$864.02
|
| Rate for Payer: Priority Health SBD |
$1,474.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,474.55
|
| Rate for Payer: Railroad Medicare Medicare |
$864.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.38
|
| Rate for Payer: UHC Core |
$1,399.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$864.02
|
| Rate for Payer: UHC Exchange |
$1,399.38
|
| Rate for Payer: UHC Medicaid |
$578.08
|
| Rate for Payer: UHCCP Medicaid |
$578.08
|
| Rate for Payer: UMR Bronson Commercial |
$801.78
|
|
|
PR DECOMPRESSION FINGERS&/HAND INJECTION INJURY
|
Professional
|
Both
|
$2,252.00
|
|
|
Service Code
|
HCPCS 26035
|
| Min. Negotiated Rate |
$519.93 |
| Max. Negotiated Rate |
$1,689.00 |
| Rate for Payer: Aetna Commercial |
$1,063.48
|
| Rate for Payer: Aetna Medicare |
$825.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.84
|
| Rate for Payer: BCBS Complete |
$545.93
|
| Rate for Payer: BCBS MAPPO |
$793.64
|
| Rate for Payer: BCN Commercial |
$1,316.16
|
| Rate for Payer: BCN Medicare Advantage |
$793.64
|
| Rate for Payer: Cash Price |
$1,801.60
|
| Rate for Payer: Cash Price |
$1,801.60
|
| Rate for Payer: Cofinity Commercial |
$1,063.48
|
| Rate for Payer: Cofinity Commercial |
$1,142.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$833.32
|
| Rate for Payer: Meridian Medicaid |
$545.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$873.00
|
| Rate for Payer: Nomi Health Commercial |
$952.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,689.00
|
| Rate for Payer: PACE SWMI |
$793.64
|
| Rate for Payer: PHP Commercial |
$1,111.10
|
| Rate for Payer: PHP Medicare Advantage |
$793.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,406.95
|
| Rate for Payer: Priority Health Medicare |
$793.64
|
| Rate for Payer: Priority Health SBD |
$1,406.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,406.95
|
| Rate for Payer: Railroad Medicare Medicare |
$793.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,494.64
|
| Rate for Payer: UHC Core |
$1,494.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$793.64
|
| Rate for Payer: UHC Exchange |
$1,494.64
|
| Rate for Payer: UHC Medicaid |
$519.93
|
| Rate for Payer: UHCCP Medicaid |
$519.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,035.92
|
|
|
PR DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH
|
Professional
|
Both
|
$5,918.00
|
|
|
Service Code
|
HCPCS 61330
|
| Min. Negotiated Rate |
$1,124.64 |
| Max. Negotiated Rate |
$4,438.50 |
| Rate for Payer: Aetna Commercial |
$2,354.47
|
| Rate for Payer: Aetna Medicare |
$1,827.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,354.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,530.18
|
| Rate for Payer: BCBS Complete |
$1,180.87
|
| Rate for Payer: BCBS MAPPO |
$1,757.07
|
| Rate for Payer: BCN Commercial |
$2,736.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,757.07
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cofinity Commercial |
$2,354.47
|
| Rate for Payer: Cofinity Commercial |
$2,530.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,757.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,844.92
|
| Rate for Payer: Meridian Medicaid |
$1,180.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,932.78
|
| Rate for Payer: Nomi Health Commercial |
$2,108.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,438.50
|
| Rate for Payer: PACE SWMI |
$1,757.07
|
| Rate for Payer: PHP Commercial |
$2,459.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,757.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,124.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,178.86
|
| Rate for Payer: Priority Health Medicare |
$1,757.07
|
| Rate for Payer: Priority Health SBD |
$3,178.86
|
| Rate for Payer: Priority Health Tiered Network |
$3,178.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,757.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,158.29
|
| Rate for Payer: UHC Core |
$3,158.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,757.07
|
| Rate for Payer: UHC Exchange |
$3,158.29
|
| Rate for Payer: UHC Medicaid |
$1,124.64
|
| Rate for Payer: UHCCP Medicaid |
$1,124.64
|
| Rate for Payer: UMR Bronson Commercial |
$2,722.28
|
|
|
PR DECOMPRESSION PLANTAR DIGITAL NERVE
|
Professional
|
Both
|
$1,620.00
|
|
|
Service Code
|
HCPCS 64726
|
| Min. Negotiated Rate |
$164.65 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Aetna Commercial |
$336.23
|
| Rate for Payer: Aetna Medicare |
$260.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.32
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS MAPPO |
$250.92
|
| Rate for Payer: BCN Commercial |
$410.84
|
| Rate for Payer: BCN Medicare Advantage |
$250.92
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cofinity Commercial |
$336.23
|
| Rate for Payer: Cofinity Commercial |
$361.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.47
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$276.01
|
| Rate for Payer: Nomi Health Commercial |
$301.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,215.00
|
| Rate for Payer: PACE SWMI |
$250.92
|
| Rate for Payer: PHP Commercial |
$351.29
|
| Rate for Payer: PHP Medicare Advantage |
$250.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$477.18
|
| Rate for Payer: Priority Health Medicare |
$250.92
|
| Rate for Payer: Priority Health SBD |
$477.18
|
| Rate for Payer: Priority Health Tiered Network |
$477.18
|
| Rate for Payer: Railroad Medicare Medicare |
$250.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.95
|
| Rate for Payer: UHC Core |
$468.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$250.92
|
| Rate for Payer: UHC Exchange |
$468.95
|
| Rate for Payer: UHC Medicaid |
$164.65
|
| Rate for Payer: UHCCP Medicaid |
$164.65
|
| Rate for Payer: UMR Bronson Commercial |
$745.20
|
|
|
PR DECOMPRESSION UNSPECIFIED NERVE
|
Professional
|
Both
|
$1,836.00
|
|
|
Service Code
|
HCPCS 64722
|
| Min. Negotiated Rate |
$237.92 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$485.48
|
| Rate for Payer: Aetna Medicare |
$376.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.71
|
| Rate for Payer: BCBS Complete |
$249.82
|
| Rate for Payer: BCBS MAPPO |
$362.30
|
| Rate for Payer: BCN Commercial |
$567.69
|
| Rate for Payer: BCN Medicare Advantage |
$362.30
|
| Rate for Payer: Cash Price |
$1,468.80
|
| Rate for Payer: Cash Price |
$1,468.80
|
| Rate for Payer: Cofinity Commercial |
$485.48
|
| Rate for Payer: Cofinity Commercial |
$521.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.42
|
| Rate for Payer: Meridian Medicaid |
$249.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.53
|
| Rate for Payer: Nomi Health Commercial |
$434.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,377.00
|
| Rate for Payer: PACE SWMI |
$362.30
|
| Rate for Payer: PHP Commercial |
$507.22
|
| Rate for Payer: PHP Medicare Advantage |
$362.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$659.37
|
| Rate for Payer: Priority Health Medicare |
$362.30
|
| Rate for Payer: Priority Health SBD |
$659.37
|
| Rate for Payer: Priority Health Tiered Network |
$659.37
|
| Rate for Payer: Railroad Medicare Medicare |
$362.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.90
|
| Rate for Payer: UHC Core |
$624.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.30
|
| Rate for Payer: UHC Exchange |
$624.90
|
| Rate for Payer: UHC Medicaid |
$237.92
|
| Rate for Payer: UHCCP Medicaid |
$237.92
|
| Rate for Payer: UMR Bronson Commercial |
$844.56
|
|
|
PR DECOMPRESSIVE FASCIOTOMY HAND
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS 26037
|
| Min. Negotiated Rate |
$336.11 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$687.49
|
| Rate for Payer: Aetna Medicare |
$533.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.79
|
| Rate for Payer: BCBS Complete |
$352.92
|
| Rate for Payer: BCBS MAPPO |
$513.05
|
| Rate for Payer: BCN Commercial |
$863.50
|
| Rate for Payer: BCN Medicare Advantage |
$513.05
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cofinity Commercial |
$687.49
|
| Rate for Payer: Cofinity Commercial |
$738.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.70
|
| Rate for Payer: Meridian Medicaid |
$352.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$564.36
|
| Rate for Payer: Nomi Health Commercial |
$615.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: PACE SWMI |
$513.05
|
| Rate for Payer: PHP Commercial |
$718.27
|
| Rate for Payer: PHP Medicare Advantage |
$513.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$923.06
|
| Rate for Payer: Priority Health Medicare |
$513.05
|
| Rate for Payer: Priority Health SBD |
$923.06
|
| Rate for Payer: Priority Health Tiered Network |
$923.06
|
| Rate for Payer: Railroad Medicare Medicare |
$513.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$985.45
|
| Rate for Payer: UHC Core |
$985.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$513.05
|
| Rate for Payer: UHC Exchange |
$985.45
|
| Rate for Payer: UHC Medicaid |
$336.11
|
| Rate for Payer: UHCCP Medicaid |
$336.11
|
| Rate for Payer: UMR Bronson Commercial |
$645.84
|
|
|
PR DECORTICATION & PARIETAL PLEURECTOMY
|
Professional
|
Both
|
$4,133.00
|
|
|
Service Code
|
HCPCS 32320
|
| Min. Negotiated Rate |
$977.46 |
| Max. Negotiated Rate |
$3,099.75 |
| Rate for Payer: Aetna Commercial |
$2,042.48
|
| Rate for Payer: Aetna Medicare |
$1,585.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,042.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,194.91
|
| Rate for Payer: BCBS Complete |
$1,026.33
|
| Rate for Payer: BCBS MAPPO |
$1,524.24
|
| Rate for Payer: BCN Commercial |
$2,377.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,524.24
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cofinity Commercial |
$2,042.48
|
| Rate for Payer: Cofinity Commercial |
$2,194.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,524.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,600.45
|
| Rate for Payer: Meridian Medicaid |
$1,026.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,676.66
|
| Rate for Payer: Nomi Health Commercial |
$1,829.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,099.75
|
| Rate for Payer: PACE SWMI |
$1,524.24
|
| Rate for Payer: PHP Commercial |
$2,133.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,524.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,239.25
|
| Rate for Payer: Priority Health Medicare |
$1,524.24
|
| Rate for Payer: Priority Health SBD |
$2,239.25
|
| Rate for Payer: Priority Health Tiered Network |
$2,239.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,524.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,829.90
|
| Rate for Payer: UHC Core |
$2,829.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,524.24
|
| Rate for Payer: UHC Exchange |
$2,829.90
|
| Rate for Payer: UHC Medicaid |
$977.46
|
| Rate for Payer: UHCCP Medicaid |
$977.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,901.18
|
|
|
PR DECORTICATION PULMONARY PARTIAL SEPARATE PROC
|
Professional
|
Both
|
$2,124.00
|
|
|
Service Code
|
HCPCS 32225
|
| Min. Negotiated Rate |
$610.67 |
| Max. Negotiated Rate |
$1,759.64 |
| Rate for Payer: Aetna Commercial |
$1,274.49
|
| Rate for Payer: Aetna Medicare |
$989.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,274.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,369.60
|
| Rate for Payer: BCBS Complete |
$641.20
|
| Rate for Payer: BCBS MAPPO |
$951.11
|
| Rate for Payer: BCN Commercial |
$1,478.01
|
| Rate for Payer: BCN Medicare Advantage |
$951.11
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cofinity Commercial |
$1,274.49
|
| Rate for Payer: Cofinity Commercial |
$1,369.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$951.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$998.67
|
| Rate for Payer: Meridian Medicaid |
$641.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,046.22
|
| Rate for Payer: Nomi Health Commercial |
$1,141.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.00
|
| Rate for Payer: PACE SWMI |
$951.11
|
| Rate for Payer: PHP Commercial |
$1,331.55
|
| Rate for Payer: PHP Medicare Advantage |
$951.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,391.84
|
| Rate for Payer: Priority Health Medicare |
$951.11
|
| Rate for Payer: Priority Health SBD |
$1,391.84
|
| Rate for Payer: Priority Health Tiered Network |
$1,391.84
|
| Rate for Payer: Railroad Medicare Medicare |
$951.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.64
|
| Rate for Payer: UHC Core |
$1,759.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$951.11
|
| Rate for Payer: UHC Exchange |
$1,759.64
|
| Rate for Payer: UHC Medicaid |
$610.67
|
| Rate for Payer: UHCCP Medicaid |
$610.67
|
| Rate for Payer: UMR Bronson Commercial |
$977.04
|
|
