|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$37.37 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna American Axle |
$65.65
|
| Rate for Payer: Aetna Commercial |
$85.85
|
| Rate for Payer: Aetna Medicare |
$50.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.65
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$70.70
|
| Rate for Payer: Cofinity Commercial |
$86.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Healthscope Commercial |
$90.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.85
|
| Rate for Payer: PHP Commercial |
$85.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health SBD |
$63.63
|
| Rate for Payer: UMR Bronson Commercial |
$37.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.75
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 1-5
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 11720
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$35.75 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$14.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.56
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$13.85
|
| Rate for Payer: BCN Medicare Advantage |
$13.85
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$19.94
|
| Rate for Payer: Cofinity Commercial |
$18.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.54
|
| Rate for Payer: Nomi Health Commercial |
$16.62
|
| Rate for Payer: PACE SWMI |
$13.85
|
| Rate for Payer: PHP Commercial |
$19.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$13.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.85
|
| Rate for Payer: UHC Medicare Advantage |
$13.85
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 6/>
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 11721
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Aetna Commercial |
$30.58
|
| Rate for Payer: Aetna Medicare |
$23.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.58
|
| Rate for Payer: BCBS Complete |
$31.20
|
| Rate for Payer: BCBS MAPPO |
$22.82
|
| Rate for Payer: BCN Medicare Advantage |
$22.82
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$32.86
|
| Rate for Payer: Cofinity Commercial |
$30.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.96
|
| Rate for Payer: Nomi Health Commercial |
$27.38
|
| Rate for Payer: PACE SWMI |
$22.82
|
| Rate for Payer: PHP Commercial |
$31.95
|
| Rate for Payer: PHP Medicare Advantage |
$22.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health Medicare |
$22.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.82
|
| Rate for Payer: UHC Medicare Advantage |
$22.82
|
| Rate for Payer: UMR Bronson Commercial |
$35.88
|
|
|
PR DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM/<
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 97597
|
| Min. Negotiated Rate |
$33.58 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Medicare |
$34.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.00
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$48.36
|
| Rate for Payer: Cofinity Commercial |
$45.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: Nomi Health Commercial |
$40.30
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$47.01
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$33.58
|
| Rate for Payer: UMR Bronson Commercial |
$55.20
|
|
|
PR DEBRIDEMENT OPN WND EA ADDL 20 SQ CM/PRT THEREOF
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 97598
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$90.35 |
| Rate for Payer: Aetna Commercial |
$30.93
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.93
|
| Rate for Payer: BCBS Complete |
$55.60
|
| Rate for Payer: BCBS MAPPO |
$23.08
|
| Rate for Payer: BCN Medicare Advantage |
$23.08
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$33.24
|
| Rate for Payer: Cofinity Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$27.70
|
| Rate for Payer: PACE SWMI |
$23.08
|
| Rate for Payer: PHP Commercial |
$32.31
|
| Rate for Payer: PHP Medicare Advantage |
$23.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.35
|
| Rate for Payer: Priority Health Medicare |
$23.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.08
|
| Rate for Payer: UHC Medicare Advantage |
$23.08
|
| Rate for Payer: UMR Bronson Commercial |
$63.94
|
|
|
PR DEBRIDEMENT, SKIN, PARTIAL THICKNESS
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 11040
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: BCBS Complete |
$31.20
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: UMR Bronson Commercial |
$35.88
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
11042
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$219.05 |
| Rate for Payer: Aetna Commercial |
$77.24
|
| Rate for Payer: Aetna Medicare |
$59.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.00
|
| Rate for Payer: BCBS Complete |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$57.64
|
| Rate for Payer: BCN Medicare Advantage |
$57.64
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$83.00
|
| Rate for Payer: Cofinity Commercial |
$77.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.52
|
| Rate for Payer: Nomi Health Commercial |
$69.17
|
| Rate for Payer: PACE SWMI |
$57.64
|
| Rate for Payer: PHP Commercial |
$80.70
|
| Rate for Payer: PHP Medicare Advantage |
$57.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.05
|
| Rate for Payer: Priority Health Medicare |
$57.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.64
|
| Rate for Payer: UHC Medicare Advantage |
$57.64
|
| Rate for Payer: UMR Bronson Commercial |
$155.02
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 11042
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$219.05 |
| Rate for Payer: Aetna Commercial |
$77.24
|
| Rate for Payer: Aetna Medicare |
$59.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.00
|
| Rate for Payer: BCBS Complete |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$57.64
|
| Rate for Payer: BCN Medicare Advantage |
$57.64
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$77.24
|
| Rate for Payer: Cofinity Commercial |
$83.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.52
|
| Rate for Payer: Nomi Health Commercial |
$69.17
|
| Rate for Payer: PACE SWMI |
$57.64
|
| Rate for Payer: PHP Commercial |
$80.70
|
| Rate for Payer: PHP Medicare Advantage |
$57.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.05
|
| Rate for Payer: Priority Health Medicare |
$57.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.64
|
| Rate for Payer: UHC Medicare Advantage |
$57.64
|
| Rate for Payer: UMR Bronson Commercial |
$155.02
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Facility
|
IP
|
$337.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
11042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$148.28 |
| Max. Negotiated Rate |
$303.30 |
| Rate for Payer: Aetna American Axle |
$219.05
|
| Rate for Payer: Aetna Commercial |
$286.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.05
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$235.90
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.60
|
| Rate for Payer: Healthscope Commercial |
$303.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.45
|
| Rate for Payer: PHP Commercial |
$286.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.05
|
| Rate for Payer: Priority Health SBD |
$212.31
|
| Rate for Payer: UMR Bronson Commercial |
$148.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.75
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Facility
|
OP
|
$337.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
11042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$124.69 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$219.05
|
| Rate for Payer: Aetna Commercial |
$286.45
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Cofinity Commercial |
$235.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$303.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.75
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.45
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$286.45
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.05
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$212.31
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$124.69
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.75
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
11045
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna American Axle |
$45.50
|
| Rate for Payer: Aetna Commercial |
$59.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.50
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$63.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.50
|
| Rate for Payer: PHP Commercial |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health SBD |
$44.10
|
| Rate for Payer: UMR Bronson Commercial |
$30.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
11045
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna American Axle |
$45.50
|
| Rate for Payer: Aetna Commercial |
$59.50
|
| Rate for Payer: Aetna Medicare |
$35.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.50
|
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$63.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.50
|
| Rate for Payer: PHP Commercial |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health SBD |
$44.10
|
| Rate for Payer: UMR Bronson Commercial |
$25.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 11045
|
| Min. Negotiated Rate |
$23.84 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Aetna Commercial |
$31.95
|
| Rate for Payer: Aetna Medicare |
$24.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.95
|
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: BCBS MAPPO |
$23.84
|
| Rate for Payer: BCN Medicare Advantage |
$23.84
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$34.33
|
| Rate for Payer: Cofinity Commercial |
$31.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.03
|
| Rate for Payer: Nomi Health Commercial |
$28.61
|
| Rate for Payer: PACE SWMI |
$23.84
|
| Rate for Payer: PHP Commercial |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health Medicare |
$23.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.84
|
| Rate for Payer: UHC Medicare Advantage |
$23.84
|
| Rate for Payer: UMR Bronson Commercial |
$32.20
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 11045
|
| Hospital Charge Code |
11045
|
| Min. Negotiated Rate |
$23.84 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Aetna Commercial |
$31.95
|
| Rate for Payer: Aetna Medicare |
$24.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.95
|
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: BCBS MAPPO |
$23.84
|
| Rate for Payer: BCN Medicare Advantage |
$23.84
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$31.95
|
| Rate for Payer: Cofinity Commercial |
$34.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.03
|
| Rate for Payer: Nomi Health Commercial |
$28.61
|
| Rate for Payer: PACE SWMI |
$23.84
|
| Rate for Payer: PHP Commercial |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health Medicare |
$23.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.84
|
| Rate for Payer: UHC Medicare Advantage |
$23.84
|
| Rate for Payer: UMR Bronson Commercial |
$32.20
|
|
|
PR DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 36593
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$44.38 |
| Rate for Payer: Aetna Commercial |
$41.30
|
| Rate for Payer: Aetna Medicare |
$32.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.30
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS MAPPO |
$30.82
|
| Rate for Payer: BCN Medicare Advantage |
$30.82
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$44.38
|
| Rate for Payer: Cofinity Commercial |
$41.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.36
|
| Rate for Payer: Nomi Health Commercial |
$36.98
|
| Rate for Payer: PACE SWMI |
$30.82
|
| Rate for Payer: PHP Commercial |
$43.15
|
| Rate for Payer: PHP Medicare Advantage |
$30.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.00
|
| Rate for Payer: Priority Health Medicare |
$30.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.82
|
| Rate for Payer: UHC Medicare Advantage |
$30.82
|
| Rate for Payer: UMR Bronson Commercial |
$27.60
|
|
|
PR DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI
|
Professional
|
Both
|
$1,834.00
|
|
|
Service Code
|
HCPCS 27027
|
| Min. Negotiated Rate |
$733.60 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna Commercial |
$1,143.49
|
| Rate for Payer: Aetna Medicare |
$887.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,228.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.49
|
| Rate for Payer: BCBS Complete |
$733.60
|
| Rate for Payer: BCBS MAPPO |
$853.35
|
| Rate for Payer: BCN Medicare Advantage |
$853.35
|
| Rate for Payer: Cash Price |
$1,467.20
|
| Rate for Payer: Cash Price |
$1,467.20
|
| Rate for Payer: Cofinity Commercial |
$1,228.82
|
| Rate for Payer: Cofinity Commercial |
$1,143.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$896.02
|
| Rate for Payer: Nomi Health Commercial |
$1,024.02
|
| Rate for Payer: PACE SWMI |
$853.35
|
| Rate for Payer: PHP Commercial |
$1,194.69
|
| Rate for Payer: PHP Medicare Advantage |
$853.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,192.10
|
| Rate for Payer: Priority Health Medicare |
$853.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.35
|
| Rate for Payer: UHC Medicare Advantage |
$853.35
|
| Rate for Payer: UMR Bronson Commercial |
$843.64
|
|
|
PR DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 27496
|
| Min. Negotiated Rate |
$379.20 |
| Max. Negotiated Rate |
$766.01 |
| Rate for Payer: Aetna Commercial |
$712.81
|
| Rate for Payer: Aetna Medicare |
$553.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$766.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.81
|
| Rate for Payer: BCBS Complete |
$379.20
|
| Rate for Payer: BCBS MAPPO |
$531.95
|
| Rate for Payer: BCN Medicare Advantage |
$531.95
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$766.01
|
| Rate for Payer: Cofinity Commercial |
$712.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.55
|
| Rate for Payer: Nomi Health Commercial |
$638.34
|
| Rate for Payer: PACE SWMI |
$531.95
|
| Rate for Payer: PHP Commercial |
$744.73
|
| Rate for Payer: PHP Medicare Advantage |
$531.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.20
|
| Rate for Payer: Priority Health Medicare |
$531.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.95
|
| Rate for Payer: UHC Medicare Advantage |
$531.95
|
| Rate for Payer: UMR Bronson Commercial |
$436.08
|
|
|
PR DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL
|
Professional
|
Both
|
$1,692.00
|
|
|
Service Code
|
HCPCS 24495
|
| Min. Negotiated Rate |
$676.80 |
| Max. Negotiated Rate |
$1,231.26 |
| Rate for Payer: Aetna Commercial |
$1,145.75
|
| Rate for Payer: Aetna Medicare |
$889.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.75
|
| Rate for Payer: BCBS Complete |
$676.80
|
| Rate for Payer: BCBS MAPPO |
$855.04
|
| Rate for Payer: BCN Medicare Advantage |
$855.04
|
| Rate for Payer: Cash Price |
$1,353.60
|
| Rate for Payer: Cash Price |
$1,353.60
|
| Rate for Payer: Cofinity Commercial |
$1,231.26
|
| Rate for Payer: Cofinity Commercial |
$1,145.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.79
|
| Rate for Payer: Nomi Health Commercial |
$1,026.05
|
| Rate for Payer: PACE SWMI |
$855.04
|
| Rate for Payer: PHP Commercial |
$1,197.06
|
| Rate for Payer: PHP Medicare Advantage |
$855.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,099.80
|
| Rate for Payer: Priority Health Medicare |
$855.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$855.04
|
| Rate for Payer: UHC Medicare Advantage |
$855.04
|
| Rate for Payer: UMR Bronson Commercial |
$778.32
|
|
|
PR DECOMPRESSION FINGERS&/HAND INJECTION INJURY
|
Professional
|
Both
|
$2,186.00
|
|
|
Service Code
|
HCPCS 26035
|
| Min. Negotiated Rate |
$831.14 |
| Max. Negotiated Rate |
$1,420.90 |
| Rate for Payer: Aetna Commercial |
$1,113.73
|
| Rate for Payer: Aetna Medicare |
$864.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.73
|
| Rate for Payer: BCBS Complete |
$874.40
|
| Rate for Payer: BCBS MAPPO |
$831.14
|
| Rate for Payer: BCN Medicare Advantage |
$831.14
|
| Rate for Payer: Cash Price |
$1,748.80
|
| Rate for Payer: Cash Price |
$1,748.80
|
| Rate for Payer: Cofinity Commercial |
$1,196.84
|
| Rate for Payer: Cofinity Commercial |
$1,113.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$831.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.70
|
| Rate for Payer: Nomi Health Commercial |
$997.37
|
| Rate for Payer: PACE SWMI |
$831.14
|
| Rate for Payer: PHP Commercial |
$1,163.60
|
| Rate for Payer: PHP Medicare Advantage |
$831.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.90
|
| Rate for Payer: Priority Health Medicare |
$831.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$831.14
|
| Rate for Payer: UHC Medicare Advantage |
$831.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,005.56
|
|
|
PR DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH
|
Professional
|
Both
|
$5,746.00
|
|
|
Service Code
|
HCPCS 61330
|
| Min. Negotiated Rate |
$1,780.68 |
| Max. Negotiated Rate |
$3,734.90 |
| Rate for Payer: Aetna Commercial |
$2,386.11
|
| Rate for Payer: Aetna Medicare |
$1,851.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,564.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,386.11
|
| Rate for Payer: BCBS Complete |
$2,298.40
|
| Rate for Payer: BCBS MAPPO |
$1,780.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,780.68
|
| Rate for Payer: Cash Price |
$4,596.80
|
| Rate for Payer: Cash Price |
$4,596.80
|
| Rate for Payer: Cofinity Commercial |
$2,564.18
|
| Rate for Payer: Cofinity Commercial |
$2,386.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,780.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,869.71
|
| Rate for Payer: Nomi Health Commercial |
$2,136.82
|
| Rate for Payer: PACE SWMI |
$1,780.68
|
| Rate for Payer: PHP Commercial |
$2,492.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,780.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,734.90
|
| Rate for Payer: Priority Health Medicare |
$1,780.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,780.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,780.68
|
| Rate for Payer: UMR Bronson Commercial |
$2,643.16
|
|
|
PR DECOMPRESSION PLANTAR DIGITAL NERVE
|
Professional
|
Both
|
$1,573.00
|
|
|
Service Code
|
HCPCS 64726
|
| Min. Negotiated Rate |
$258.79 |
| Max. Negotiated Rate |
$1,022.45 |
| Rate for Payer: Aetna Commercial |
$346.78
|
| Rate for Payer: Aetna Medicare |
$269.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.78
|
| Rate for Payer: BCBS Complete |
$629.20
|
| Rate for Payer: BCBS MAPPO |
$258.79
|
| Rate for Payer: BCN Medicare Advantage |
$258.79
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Cofinity Commercial |
$372.66
|
| Rate for Payer: Cofinity Commercial |
$346.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.73
|
| Rate for Payer: Nomi Health Commercial |
$310.55
|
| Rate for Payer: PACE SWMI |
$258.79
|
| Rate for Payer: PHP Commercial |
$362.31
|
| Rate for Payer: PHP Medicare Advantage |
$258.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,022.45
|
| Rate for Payer: Priority Health Medicare |
$258.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.79
|
| Rate for Payer: UHC Medicare Advantage |
$258.79
|
| Rate for Payer: UMR Bronson Commercial |
$723.58
|
|
|
PR DECOMPRESSION UNSPECIFIED NERVE
|
Professional
|
Both
|
$1,783.00
|
|
|
Service Code
|
HCPCS 64722
|
| Min. Negotiated Rate |
$358.88 |
| Max. Negotiated Rate |
$1,158.95 |
| Rate for Payer: Aetna Commercial |
$480.90
|
| Rate for Payer: Aetna Medicare |
$373.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.90
|
| Rate for Payer: BCBS Complete |
$713.20
|
| Rate for Payer: BCBS MAPPO |
$358.88
|
| Rate for Payer: BCN Medicare Advantage |
$358.88
|
| Rate for Payer: Cash Price |
$1,426.40
|
| Rate for Payer: Cash Price |
$1,426.40
|
| Rate for Payer: Cofinity Commercial |
$516.79
|
| Rate for Payer: Cofinity Commercial |
$480.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.82
|
| Rate for Payer: Nomi Health Commercial |
$430.66
|
| Rate for Payer: PACE SWMI |
$358.88
|
| Rate for Payer: PHP Commercial |
$502.43
|
| Rate for Payer: PHP Medicare Advantage |
$358.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,158.95
|
| Rate for Payer: Priority Health Medicare |
$358.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.88
|
| Rate for Payer: UHC Medicare Advantage |
$358.88
|
| Rate for Payer: UMR Bronson Commercial |
$820.18
|
|
|
PR DECOMPRESSIVE FASCIOTOMY HAND
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26037
|
| Min. Negotiated Rate |
$545.14 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$730.49
|
| Rate for Payer: Aetna Medicare |
$566.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$730.49
|
| Rate for Payer: BCBS Complete |
$545.20
|
| Rate for Payer: BCBS MAPPO |
$545.14
|
| Rate for Payer: BCN Medicare Advantage |
$545.14
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$785.00
|
| Rate for Payer: Cofinity Commercial |
$730.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.40
|
| Rate for Payer: Nomi Health Commercial |
$654.17
|
| Rate for Payer: PACE SWMI |
$545.14
|
| Rate for Payer: PHP Commercial |
$763.20
|
| Rate for Payer: PHP Medicare Advantage |
$545.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health Medicare |
$545.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$545.14
|
| Rate for Payer: UHC Medicare Advantage |
$545.14
|
| Rate for Payer: UMR Bronson Commercial |
$626.98
|
|
|
PR DECORTICATION & PARIETAL PLEURECTOMY
|
Professional
|
Both
|
$4,013.00
|
|
|
Service Code
|
HCPCS 32320
|
| Min. Negotiated Rate |
$1,541.21 |
| Max. Negotiated Rate |
$2,608.45 |
| Rate for Payer: Aetna Commercial |
$2,065.22
|
| Rate for Payer: Aetna Medicare |
$1,602.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,219.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,065.22
|
| Rate for Payer: BCBS Complete |
$1,605.20
|
| Rate for Payer: BCBS MAPPO |
$1,541.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,541.21
|
| Rate for Payer: Cash Price |
$3,210.40
|
| Rate for Payer: Cash Price |
$3,210.40
|
| Rate for Payer: Cofinity Commercial |
$2,219.34
|
| Rate for Payer: Cofinity Commercial |
$2,065.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,541.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,618.27
|
| Rate for Payer: Nomi Health Commercial |
$1,849.45
|
| Rate for Payer: PACE SWMI |
$1,541.21
|
| Rate for Payer: PHP Commercial |
$2,157.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,541.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,608.45
|
| Rate for Payer: Priority Health Medicare |
$1,541.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,541.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,541.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,845.98
|
|
|
PR DECORTICATION PULMONARY PARTIAL SEPARATE PROC
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 32225
|
| Min. Negotiated Rate |
$824.80 |
| Max. Negotiated Rate |
$1,377.79 |
| Rate for Payer: Aetna Commercial |
$1,282.11
|
| Rate for Payer: Aetna Medicare |
$995.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,282.11
|
| Rate for Payer: BCBS Complete |
$824.80
|
| Rate for Payer: BCBS MAPPO |
$956.80
|
| Rate for Payer: BCN Medicare Advantage |
$956.80
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,377.79
|
| Rate for Payer: Cofinity Commercial |
$1,282.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.64
|
| Rate for Payer: Nomi Health Commercial |
$1,148.16
|
| Rate for Payer: PACE SWMI |
$956.80
|
| Rate for Payer: PHP Commercial |
$1,339.52
|
| Rate for Payer: PHP Medicare Advantage |
$956.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.30
|
| Rate for Payer: Priority Health Medicare |
$956.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.80
|
| Rate for Payer: UHC Medicare Advantage |
$956.80
|
| Rate for Payer: UMR Bronson Commercial |
$948.52
|
|
