|
PR EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ
|
Professional
|
Both
|
$4,331.00
|
|
|
Service Code
|
HCPCS 38555
|
| Min. Negotiated Rate |
$627.07 |
| Max. Negotiated Rate |
$3,248.25 |
| Rate for Payer: Aetna Commercial |
$1,301.45
|
| Rate for Payer: Aetna Medicare |
$1,010.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,398.57
|
| Rate for Payer: BCBS Complete |
$658.42
|
| Rate for Payer: BCBS MAPPO |
$971.23
|
| Rate for Payer: BCN Commercial |
$1,549.22
|
| Rate for Payer: BCN Medicare Advantage |
$971.23
|
| Rate for Payer: Cash Price |
$3,464.80
|
| Rate for Payer: Cash Price |
$3,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,301.45
|
| Rate for Payer: Cofinity Commercial |
$1,398.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,019.79
|
| Rate for Payer: Meridian Medicaid |
$658.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,068.35
|
| Rate for Payer: Nomi Health Commercial |
$1,165.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,248.25
|
| Rate for Payer: PACE SWMI |
$971.23
|
| Rate for Payer: PHP Commercial |
$1,359.72
|
| Rate for Payer: PHP Medicare Advantage |
$971.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,061.36
|
| Rate for Payer: Priority Health Medicare |
$971.23
|
| Rate for Payer: Priority Health SBD |
$2,061.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,061.36
|
| Rate for Payer: Railroad Medicare Medicare |
$971.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,801.14
|
| Rate for Payer: UHC Core |
$1,801.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$971.23
|
| Rate for Payer: UHC Exchange |
$1,801.14
|
| Rate for Payer: UHC Medicaid |
$627.07
|
| Rate for Payer: UHCCP Medicaid |
$627.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,992.26
|
|
|
PR EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ
|
Professional
|
Both
|
$1,624.00
|
|
|
Service Code
|
HCPCS 38550
|
| Min. Negotiated Rate |
$330.15 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$678.25
|
| Rate for Payer: Aetna Medicare |
$526.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.87
|
| Rate for Payer: BCBS Complete |
$346.66
|
| Rate for Payer: BCBS MAPPO |
$506.16
|
| Rate for Payer: BCN Commercial |
$794.78
|
| Rate for Payer: BCN Medicare Advantage |
$506.16
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$678.25
|
| Rate for Payer: Cofinity Commercial |
$728.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.47
|
| Rate for Payer: Meridian Medicaid |
$346.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$556.78
|
| Rate for Payer: Nomi Health Commercial |
$607.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE SWMI |
$506.16
|
| Rate for Payer: PHP Commercial |
$708.62
|
| Rate for Payer: PHP Medicare Advantage |
$506.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,057.52
|
| Rate for Payer: Priority Health Medicare |
$506.16
|
| Rate for Payer: Priority Health SBD |
$1,057.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,057.52
|
| Rate for Payer: Railroad Medicare Medicare |
$506.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.72
|
| Rate for Payer: UHC Core |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.16
|
| Rate for Payer: UHC Exchange |
$903.72
|
| Rate for Payer: UHC Medicaid |
$330.15
|
| Rate for Payer: UHCCP Medicaid |
$330.15
|
| Rate for Payer: UMR Bronson Commercial |
$747.04
|
|
|
PR EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
HCPCS 26205
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$1,824.00 |
| Rate for Payer: Aetna Commercial |
$750.84
|
| Rate for Payer: Aetna Medicare |
$582.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.88
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS MAPPO |
$560.33
|
| Rate for Payer: BCN Commercial |
$929.23
|
| Rate for Payer: BCN Medicare Advantage |
$560.33
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cofinity Commercial |
$750.84
|
| Rate for Payer: Cofinity Commercial |
$806.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.35
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$616.36
|
| Rate for Payer: Nomi Health Commercial |
$672.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.00
|
| Rate for Payer: PACE SWMI |
$560.33
|
| Rate for Payer: PHP Commercial |
$784.46
|
| Rate for Payer: PHP Medicare Advantage |
$560.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$993.33
|
| Rate for Payer: Priority Health Medicare |
$560.33
|
| Rate for Payer: Priority Health SBD |
$993.33
|
| Rate for Payer: Priority Health Tiered Network |
$993.33
|
| Rate for Payer: Railroad Medicare Medicare |
$560.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,052.16
|
| Rate for Payer: UHC Core |
$1,052.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$560.33
|
| Rate for Payer: UHC Exchange |
$1,052.16
|
| Rate for Payer: UHC Medicaid |
$367.43
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.72
|
|
|
PR EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT
|
Professional
|
Both
|
$1,835.00
|
|
|
Service Code
|
HCPCS 26215
|
| Min. Negotiated Rate |
$346.34 |
| Max. Negotiated Rate |
$1,376.25 |
| Rate for Payer: Aetna Commercial |
$706.54
|
| Rate for Payer: Aetna Medicare |
$548.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.27
|
| Rate for Payer: BCBS Complete |
$363.66
|
| Rate for Payer: BCBS MAPPO |
$527.27
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.27
|
| Rate for Payer: Cash Price |
$1,468.00
|
| Rate for Payer: Cash Price |
$1,468.00
|
| Rate for Payer: Cofinity Commercial |
$706.54
|
| Rate for Payer: Cofinity Commercial |
$759.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.63
|
| Rate for Payer: Meridian Medicaid |
$363.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.00
|
| Rate for Payer: Nomi Health Commercial |
$632.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,376.25
|
| Rate for Payer: PACE SWMI |
$527.27
|
| Rate for Payer: PHP Commercial |
$738.18
|
| Rate for Payer: PHP Medicare Advantage |
$527.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$931.04
|
| Rate for Payer: Priority Health Medicare |
$527.27
|
| Rate for Payer: Priority Health SBD |
$931.04
|
| Rate for Payer: Priority Health Tiered Network |
$931.04
|
| Rate for Payer: Railroad Medicare Medicare |
$527.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$982.33
|
| Rate for Payer: UHC Core |
$982.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.27
|
| Rate for Payer: UHC Exchange |
$982.33
|
| Rate for Payer: UHC Medicaid |
$346.34
|
| Rate for Payer: UHCCP Medicaid |
$346.34
|
| Rate for Payer: UMR Bronson Commercial |
$844.10
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 27637
|
| Min. Negotiated Rate |
$451.35 |
| Max. Negotiated Rate |
$2,143.50 |
| Rate for Payer: Aetna Commercial |
$924.36
|
| Rate for Payer: Aetna Medicare |
$717.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$993.34
|
| Rate for Payer: BCBS Complete |
$473.92
|
| Rate for Payer: BCBS MAPPO |
$689.82
|
| Rate for Payer: BCN Commercial |
$1,143.36
|
| Rate for Payer: BCN Medicare Advantage |
$689.82
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cofinity Commercial |
$924.36
|
| Rate for Payer: Cofinity Commercial |
$993.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$724.31
|
| Rate for Payer: Meridian Medicaid |
$473.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$758.80
|
| Rate for Payer: Nomi Health Commercial |
$827.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,143.50
|
| Rate for Payer: PACE SWMI |
$689.82
|
| Rate for Payer: PHP Commercial |
$965.75
|
| Rate for Payer: PHP Medicare Advantage |
$689.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,222.23
|
| Rate for Payer: Priority Health Medicare |
$689.82
|
| Rate for Payer: Priority Health SBD |
$1,222.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,222.23
|
| Rate for Payer: Railroad Medicare Medicare |
$689.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.57
|
| Rate for Payer: UHC Core |
$1,305.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$689.82
|
| Rate for Payer: UHC Exchange |
$1,305.57
|
| Rate for Payer: UHC Medicaid |
$451.35
|
| Rate for Payer: UHCCP Medicaid |
$451.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,314.68
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT
|
Professional
|
Both
|
$2,279.00
|
|
|
Service Code
|
HCPCS 27638
|
| Min. Negotiated Rate |
$445.60 |
| Max. Negotiated Rate |
$1,709.25 |
| Rate for Payer: Aetna Commercial |
$915.35
|
| Rate for Payer: Aetna Medicare |
$710.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$983.66
|
| Rate for Payer: BCBS Complete |
$467.88
|
| Rate for Payer: BCBS MAPPO |
$683.10
|
| Rate for Payer: BCN Commercial |
$1,133.90
|
| Rate for Payer: BCN Medicare Advantage |
$683.10
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cofinity Commercial |
$915.35
|
| Rate for Payer: Cofinity Commercial |
$983.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$717.25
|
| Rate for Payer: Meridian Medicaid |
$467.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$751.41
|
| Rate for Payer: Nomi Health Commercial |
$819.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,709.25
|
| Rate for Payer: PACE SWMI |
$683.10
|
| Rate for Payer: PHP Commercial |
$956.34
|
| Rate for Payer: PHP Medicare Advantage |
$683.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,212.11
|
| Rate for Payer: Priority Health Medicare |
$683.10
|
| Rate for Payer: Priority Health SBD |
$1,212.11
|
| Rate for Payer: Priority Health Tiered Network |
$1,212.11
|
| Rate for Payer: Railroad Medicare Medicare |
$683.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.93
|
| Rate for Payer: UHC Core |
$1,338.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.10
|
| Rate for Payer: UHC Exchange |
$1,338.93
|
| Rate for Payer: UHC Medicaid |
$445.60
|
| Rate for Payer: UHCCP Medicaid |
$445.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,048.34
|
|
|
PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 28104
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$748.50 |
| Rate for Payer: Aetna Commercial |
$441.33
|
| Rate for Payer: Aetna Medicare |
$342.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.26
|
| Rate for Payer: BCBS Complete |
$227.23
|
| Rate for Payer: BCBS MAPPO |
$329.35
|
| Rate for Payer: BCN Commercial |
$542.80
|
| Rate for Payer: BCN Medicare Advantage |
$329.35
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$441.33
|
| Rate for Payer: Cofinity Commercial |
$474.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.82
|
| Rate for Payer: Meridian Medicaid |
$227.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$362.29
|
| Rate for Payer: Nomi Health Commercial |
$395.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: PACE SWMI |
$329.35
|
| Rate for Payer: PHP Commercial |
$461.09
|
| Rate for Payer: PHP Medicare Advantage |
$329.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$580.24
|
| Rate for Payer: Priority Health Medicare |
$329.35
|
| Rate for Payer: Priority Health SBD |
$580.24
|
| Rate for Payer: Priority Health Tiered Network |
$580.24
|
| Rate for Payer: Railroad Medicare Medicare |
$329.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.32
|
| Rate for Payer: UHC Core |
$617.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$329.35
|
| Rate for Payer: UHC Exchange |
$617.32
|
| Rate for Payer: UHC Medicaid |
$216.41
|
| Rate for Payer: UHCCP Medicaid |
$216.41
|
| Rate for Payer: UMR Bronson Commercial |
$459.08
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 24116
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,507.03 |
| Rate for Payer: Aetna Commercial |
$1,047.20
|
| Rate for Payer: Aetna Medicare |
$812.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,047.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.35
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$781.49
|
| Rate for Payer: BCN Commercial |
$1,308.69
|
| Rate for Payer: BCN Medicare Advantage |
$781.49
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,047.20
|
| Rate for Payer: Cofinity Commercial |
$1,125.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.56
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.64
|
| Rate for Payer: Nomi Health Commercial |
$937.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$781.49
|
| Rate for Payer: PHP Commercial |
$1,094.09
|
| Rate for Payer: PHP Medicare Advantage |
$781.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,398.96
|
| Rate for Payer: Priority Health Medicare |
$781.49
|
| Rate for Payer: Priority Health SBD |
$1,398.96
|
| Rate for Payer: Priority Health Tiered Network |
$1,398.96
|
| Rate for Payer: Railroad Medicare Medicare |
$781.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,507.03
|
| Rate for Payer: UHC Core |
$1,507.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.49
|
| Rate for Payer: UHC Exchange |
$1,507.03
|
| Rate for Payer: UHC Medicaid |
$508.86
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
| Rate for Payer: UMR Bronson Commercial |
$821.56
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 23140
|
| Min. Negotiated Rate |
$338.88 |
| Max. Negotiated Rate |
$962.53 |
| Rate for Payer: Aetna Commercial |
$691.37
|
| Rate for Payer: Aetna Medicare |
$536.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.97
|
| Rate for Payer: BCBS Complete |
$355.82
|
| Rate for Payer: BCBS MAPPO |
$515.95
|
| Rate for Payer: BCN Commercial |
$854.04
|
| Rate for Payer: BCN Medicare Advantage |
$515.95
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$691.37
|
| Rate for Payer: Cofinity Commercial |
$742.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.75
|
| Rate for Payer: Meridian Medicaid |
$355.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$567.54
|
| Rate for Payer: Nomi Health Commercial |
$619.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$726.75
|
| Rate for Payer: PACE SWMI |
$515.95
|
| Rate for Payer: PHP Commercial |
$722.33
|
| Rate for Payer: PHP Medicare Advantage |
$515.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$912.94
|
| Rate for Payer: Priority Health Medicare |
$515.95
|
| Rate for Payer: Priority Health SBD |
$912.94
|
| Rate for Payer: Priority Health Tiered Network |
$912.94
|
| Rate for Payer: Railroad Medicare Medicare |
$515.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$962.53
|
| Rate for Payer: UHC Core |
$962.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$515.95
|
| Rate for Payer: UHC Exchange |
$962.53
|
| Rate for Payer: UHC Medicaid |
$338.88
|
| Rate for Payer: UHCCP Medicaid |
$338.88
|
| Rate for Payer: UMR Bronson Commercial |
$445.74
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 24120
|
| Min. Negotiated Rate |
$323.55 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$659.56
|
| Rate for Payer: Aetna Medicare |
$511.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.78
|
| Rate for Payer: BCBS Complete |
$339.73
|
| Rate for Payer: BCBS MAPPO |
$492.21
|
| Rate for Payer: BCN Commercial |
$822.16
|
| Rate for Payer: BCN Medicare Advantage |
$492.21
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cofinity Commercial |
$659.56
|
| Rate for Payer: Cofinity Commercial |
$708.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.82
|
| Rate for Payer: Meridian Medicaid |
$339.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.43
|
| Rate for Payer: Nomi Health Commercial |
$590.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: PACE SWMI |
$492.21
|
| Rate for Payer: PHP Commercial |
$689.09
|
| Rate for Payer: PHP Medicare Advantage |
$492.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$878.87
|
| Rate for Payer: Priority Health Medicare |
$492.21
|
| Rate for Payer: Priority Health SBD |
$878.87
|
| Rate for Payer: Priority Health Tiered Network |
$878.87
|
| Rate for Payer: Railroad Medicare Medicare |
$492.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$924.67
|
| Rate for Payer: UHC Core |
$924.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.21
|
| Rate for Payer: UHC Exchange |
$924.67
|
| Rate for Payer: UHC Medicaid |
$323.55
|
| Rate for Payer: UHCCP Medicaid |
$323.55
|
| Rate for Payer: UMR Bronson Commercial |
$593.86
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 23150
|
| Min. Negotiated Rate |
$403.42 |
| Max. Negotiated Rate |
$1,162.39 |
| Rate for Payer: Aetna Commercial |
$825.67
|
| Rate for Payer: Aetna Medicare |
$640.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.28
|
| Rate for Payer: BCBS Complete |
$423.59
|
| Rate for Payer: BCBS MAPPO |
$616.17
|
| Rate for Payer: BCN Commercial |
$1,022.36
|
| Rate for Payer: BCN Medicare Advantage |
$616.17
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cofinity Commercial |
$825.67
|
| Rate for Payer: Cofinity Commercial |
$887.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.98
|
| Rate for Payer: Meridian Medicaid |
$423.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.79
|
| Rate for Payer: Nomi Health Commercial |
$739.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.00
|
| Rate for Payer: PACE SWMI |
$616.17
|
| Rate for Payer: PHP Commercial |
$862.64
|
| Rate for Payer: PHP Medicare Advantage |
$616.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,092.86
|
| Rate for Payer: Priority Health Medicare |
$616.17
|
| Rate for Payer: Priority Health SBD |
$1,092.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,092.86
|
| Rate for Payer: Railroad Medicare Medicare |
$616.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,162.39
|
| Rate for Payer: UHC Core |
$1,162.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$616.17
|
| Rate for Payer: UHC Exchange |
$1,162.39
|
| Rate for Payer: UHC Medicaid |
$403.42
|
| Rate for Payer: UHCCP Medicaid |
$403.42
|
| Rate for Payer: UMR Bronson Commercial |
$667.92
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 23155
|
| Min. Negotiated Rate |
$477.33 |
| Max. Negotiated Rate |
$1,389.18 |
| Rate for Payer: Aetna Commercial |
$978.74
|
| Rate for Payer: Aetna Medicare |
$759.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$978.74
|
| Rate for Payer: BCBS Complete |
$501.20
|
| Rate for Payer: BCBS MAPPO |
$730.40
|
| Rate for Payer: BCN Commercial |
$1,219.05
|
| Rate for Payer: BCN Medicare Advantage |
$730.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,051.78
|
| Rate for Payer: Cofinity Commercial |
$978.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$766.92
|
| Rate for Payer: Meridian Medicaid |
$501.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$803.44
|
| Rate for Payer: Nomi Health Commercial |
$876.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.75
|
| Rate for Payer: PACE SWMI |
$730.40
|
| Rate for Payer: PHP Commercial |
$1,022.56
|
| Rate for Payer: PHP Medicare Advantage |
$730.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,303.13
|
| Rate for Payer: Priority Health Medicare |
$730.40
|
| Rate for Payer: Priority Health SBD |
$1,303.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,303.13
|
| Rate for Payer: Railroad Medicare Medicare |
$730.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,389.18
|
| Rate for Payer: UHC Core |
$1,389.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$730.40
|
| Rate for Payer: UHC Exchange |
$1,389.18
|
| Rate for Payer: UHC Medicaid |
$477.33
|
| Rate for Payer: UHCCP Medicaid |
$477.33
|
| Rate for Payer: UMR Bronson Commercial |
$668.38
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
HCPCS 23156
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,182.57 |
| Rate for Payer: Aetna Commercial |
$839.16
|
| Rate for Payer: Aetna Medicare |
$651.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.79
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$626.24
|
| Rate for Payer: BCN Commercial |
$1,041.78
|
| Rate for Payer: BCN Medicare Advantage |
$626.24
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cofinity Commercial |
$839.16
|
| Rate for Payer: Cofinity Commercial |
$901.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.55
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.86
|
| Rate for Payer: Nomi Health Commercial |
$751.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,003.50
|
| Rate for Payer: PACE SWMI |
$626.24
|
| Rate for Payer: PHP Commercial |
$876.74
|
| Rate for Payer: PHP Medicare Advantage |
$626.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,113.63
|
| Rate for Payer: Priority Health Medicare |
$626.24
|
| Rate for Payer: Priority Health SBD |
$1,113.63
|
| Rate for Payer: Priority Health Tiered Network |
$1,113.63
|
| Rate for Payer: Railroad Medicare Medicare |
$626.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,182.57
|
| Rate for Payer: UHC Core |
$1,182.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$626.24
|
| Rate for Payer: UHC Exchange |
$1,182.57
|
| Rate for Payer: UHC Medicaid |
$409.81
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
| Rate for Payer: UMR Bronson Commercial |
$615.48
|
|
|
PR EXC/CURTG CST/B9 TUM PHALANGES FOOT
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 28108
|
| Min. Negotiated Rate |
$174.87 |
| Max. Negotiated Rate |
$501.40 |
| Rate for Payer: Aetna Commercial |
$355.86
|
| Rate for Payer: Aetna Medicare |
$276.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.42
|
| Rate for Payer: BCBS Complete |
$183.61
|
| Rate for Payer: BCBS MAPPO |
$265.57
|
| Rate for Payer: BCN Commercial |
$440.71
|
| Rate for Payer: BCN Medicare Advantage |
$265.57
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cofinity Commercial |
$355.86
|
| Rate for Payer: Cofinity Commercial |
$382.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.85
|
| Rate for Payer: Meridian Medicaid |
$183.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$292.13
|
| Rate for Payer: Nomi Health Commercial |
$318.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: PACE SWMI |
$265.57
|
| Rate for Payer: PHP Commercial |
$371.80
|
| Rate for Payer: PHP Medicare Advantage |
$265.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$471.12
|
| Rate for Payer: Priority Health Medicare |
$265.57
|
| Rate for Payer: Priority Health SBD |
$471.12
|
| Rate for Payer: Priority Health Tiered Network |
$471.12
|
| Rate for Payer: Railroad Medicare Medicare |
$265.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$501.40
|
| Rate for Payer: UHC Core |
$501.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$265.57
|
| Rate for Payer: UHC Exchange |
$501.40
|
| Rate for Payer: UHC Medicaid |
$174.87
|
| Rate for Payer: UHCCP Medicaid |
$174.87
|
| Rate for Payer: UMR Bronson Commercial |
$252.08
|
|
|
PR EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT
|
Professional
|
Both
|
$990.00
|
|
|
Service Code
|
HCPCS 28106
|
| Min. Negotiated Rate |
$253.04 |
| Max. Negotiated Rate |
$751.23 |
| Rate for Payer: Aetna Commercial |
$519.17
|
| Rate for Payer: Aetna Medicare |
$402.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.91
|
| Rate for Payer: BCBS Complete |
$265.69
|
| Rate for Payer: BCBS MAPPO |
$387.44
|
| Rate for Payer: BCN Commercial |
$645.38
|
| Rate for Payer: BCN Medicare Advantage |
$387.44
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Cofinity Commercial |
$519.17
|
| Rate for Payer: Cofinity Commercial |
$557.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.81
|
| Rate for Payer: Meridian Medicaid |
$265.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$426.18
|
| Rate for Payer: Nomi Health Commercial |
$464.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.50
|
| Rate for Payer: PACE SWMI |
$387.44
|
| Rate for Payer: PHP Commercial |
$542.42
|
| Rate for Payer: PHP Medicare Advantage |
$387.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$689.90
|
| Rate for Payer: Priority Health Medicare |
$387.44
|
| Rate for Payer: Priority Health SBD |
$689.90
|
| Rate for Payer: Priority Health Tiered Network |
$689.90
|
| Rate for Payer: Railroad Medicare Medicare |
$387.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.23
|
| Rate for Payer: UHC Core |
$751.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.44
|
| Rate for Payer: UHC Exchange |
$751.23
|
| Rate for Payer: UHC Medicaid |
$253.04
|
| Rate for Payer: UHCCP Medicaid |
$253.04
|
| Rate for Payer: UMR Bronson Commercial |
$455.40
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 25136
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$860.97 |
| Rate for Payer: Aetna Commercial |
$626.99
|
| Rate for Payer: Aetna Medicare |
$486.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.78
|
| Rate for Payer: BCBS Complete |
$323.62
|
| Rate for Payer: BCBS MAPPO |
$467.90
|
| Rate for Payer: BCN Commercial |
$768.38
|
| Rate for Payer: BCN Medicare Advantage |
$467.90
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$626.99
|
| Rate for Payer: Cofinity Commercial |
$673.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.30
|
| Rate for Payer: Meridian Medicaid |
$323.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$514.69
|
| Rate for Payer: Nomi Health Commercial |
$561.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$774.75
|
| Rate for Payer: PACE SWMI |
$467.90
|
| Rate for Payer: PHP Commercial |
$655.06
|
| Rate for Payer: PHP Medicare Advantage |
$467.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$821.39
|
| Rate for Payer: Priority Health Medicare |
$467.90
|
| Rate for Payer: Priority Health SBD |
$821.39
|
| Rate for Payer: Priority Health Tiered Network |
$821.39
|
| Rate for Payer: Railroad Medicare Medicare |
$467.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$860.97
|
| Rate for Payer: UHC Core |
$860.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$467.90
|
| Rate for Payer: UHC Exchange |
$860.97
|
| Rate for Payer: UHC Medicaid |
$308.21
|
| Rate for Payer: UHCCP Medicaid |
$308.21
|
| Rate for Payer: UMR Bronson Commercial |
$475.18
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT
|
Professional
|
Both
|
$1,041.00
|
|
|
Service Code
|
HCPCS 25135
|
| Min. Negotiated Rate |
$345.06 |
| Max. Negotiated Rate |
$971.46 |
| Rate for Payer: Aetna Commercial |
$703.07
|
| Rate for Payer: Aetna Medicare |
$545.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.54
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS MAPPO |
$524.68
|
| Rate for Payer: BCN Commercial |
$865.49
|
| Rate for Payer: BCN Medicare Advantage |
$524.68
|
| Rate for Payer: Cash Price |
$832.80
|
| Rate for Payer: Cash Price |
$832.80
|
| Rate for Payer: Cofinity Commercial |
$703.07
|
| Rate for Payer: Cofinity Commercial |
$755.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$550.91
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$577.15
|
| Rate for Payer: Nomi Health Commercial |
$629.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.75
|
| Rate for Payer: PACE SWMI |
$524.68
|
| Rate for Payer: PHP Commercial |
$734.55
|
| Rate for Payer: PHP Medicare Advantage |
$524.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$925.18
|
| Rate for Payer: Priority Health Medicare |
$524.68
|
| Rate for Payer: Priority Health SBD |
$925.18
|
| Rate for Payer: Priority Health Tiered Network |
$925.18
|
| Rate for Payer: Railroad Medicare Medicare |
$524.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$971.46
|
| Rate for Payer: UHC Core |
$971.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$524.68
|
| Rate for Payer: UHC Exchange |
$971.46
|
| Rate for Payer: UHC Medicaid |
$345.06
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
| Rate for Payer: UMR Bronson Commercial |
$478.86
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT
|
Professional
|
Both
|
$1,252.00
|
|
|
Service Code
|
HCPCS 25126
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$1,039.96 |
| Rate for Payer: Aetna Commercial |
$747.81
|
| Rate for Payer: Aetna Medicare |
$580.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.62
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$558.07
|
| Rate for Payer: BCN Commercial |
$922.27
|
| Rate for Payer: BCN Medicare Advantage |
$558.07
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cofinity Commercial |
$747.81
|
| Rate for Payer: Cofinity Commercial |
$803.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.97
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$613.88
|
| Rate for Payer: Nomi Health Commercial |
$669.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$939.00
|
| Rate for Payer: PACE SWMI |
$558.07
|
| Rate for Payer: PHP Commercial |
$781.30
|
| Rate for Payer: PHP Medicare Advantage |
$558.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$985.88
|
| Rate for Payer: Priority Health Medicare |
$558.07
|
| Rate for Payer: Priority Health SBD |
$985.88
|
| Rate for Payer: Priority Health Tiered Network |
$985.88
|
| Rate for Payer: Railroad Medicare Medicare |
$558.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.96
|
| Rate for Payer: UHC Core |
$1,039.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.07
|
| Rate for Payer: UHC Exchange |
$1,039.96
|
| Rate for Payer: UHC Medicaid |
$366.36
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
| Rate for Payer: UMR Bronson Commercial |
$575.92
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$2,389.00
|
|
|
Service Code
|
HCPCS 25125
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$1,791.75 |
| Rate for Payer: Aetna Commercial |
$742.86
|
| Rate for Payer: Aetna Medicare |
$576.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.29
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS MAPPO |
$554.37
|
| Rate for Payer: BCN Commercial |
$916.28
|
| Rate for Payer: BCN Medicare Advantage |
$554.37
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cofinity Commercial |
$742.86
|
| Rate for Payer: Cofinity Commercial |
$798.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.09
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$609.81
|
| Rate for Payer: Nomi Health Commercial |
$665.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,791.75
|
| Rate for Payer: PACE SWMI |
$554.37
|
| Rate for Payer: PHP Commercial |
$776.12
|
| Rate for Payer: PHP Medicare Advantage |
$554.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$979.49
|
| Rate for Payer: Priority Health Medicare |
$554.37
|
| Rate for Payer: Priority Health SBD |
$979.49
|
| Rate for Payer: Priority Health Tiered Network |
$979.49
|
| Rate for Payer: Railroad Medicare Medicare |
$554.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,032.01
|
| Rate for Payer: UHC Core |
$1,032.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$554.37
|
| Rate for Payer: UHC Exchange |
$1,032.01
|
| Rate for Payer: UHC Medicaid |
$364.02
|
| Rate for Payer: UHCCP Medicaid |
$364.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.94
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna Commercial |
$535.42
|
| Rate for Payer: Aetna Medicare |
$415.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$535.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.38
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$399.57
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: BCN Medicare Advantage |
$399.57
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$535.42
|
| Rate for Payer: Cofinity Commercial |
$575.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.55
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.53
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE SWMI |
$399.57
|
| Rate for Payer: PHP Commercial |
$559.40
|
| Rate for Payer: PHP Medicare Advantage |
$399.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$581.58
|
| Rate for Payer: Priority Health Medicare |
$399.57
|
| Rate for Payer: Priority Health SBD |
$581.58
|
| Rate for Payer: Priority Health Tiered Network |
$581.58
|
| Rate for Payer: Railroad Medicare Medicare |
$399.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.43
|
| Rate for Payer: UHC Core |
$728.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.57
|
| Rate for Payer: UHC Exchange |
$728.43
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
| Rate for Payer: UMR Bronson Commercial |
$498.64
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$401.08 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna American Axle |
$704.60
|
| Rate for Payer: Aetna Commercial |
$921.40
|
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,367.78
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$3,367.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Advantage |
$758.80
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$975.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$758.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.00
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$921.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health SBD |
$682.92
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: UMR Bronson Commercial |
$401.08
|
| Rate for Payer: VA VA |
$3,901.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
19120
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna Commercial |
$535.42
|
| Rate for Payer: Aetna Medicare |
$415.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$535.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.38
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$399.57
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: BCN Medicare Advantage |
$399.57
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$535.42
|
| Rate for Payer: Cofinity Commercial |
$575.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.55
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.53
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE SWMI |
$399.57
|
| Rate for Payer: PHP Commercial |
$559.40
|
| Rate for Payer: PHP Medicare Advantage |
$399.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$581.58
|
| Rate for Payer: Priority Health Medicare |
$399.57
|
| Rate for Payer: Priority Health SBD |
$581.58
|
| Rate for Payer: Priority Health Tiered Network |
$581.58
|
| Rate for Payer: Railroad Medicare Medicare |
$399.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.43
|
| Rate for Payer: UHC Core |
$728.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.57
|
| Rate for Payer: UHC Exchange |
$728.43
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
| Rate for Payer: UMR Bronson Commercial |
$498.64
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,084.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$476.96 |
| Max. Negotiated Rate |
$975.60 |
| Rate for Payer: Aetna American Axle |
$704.60
|
| Rate for Payer: Aetna Commercial |
$921.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.60
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Advantage |
$758.80
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Healthscope Commercial |
$975.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$758.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PHP Commercial |
$921.40
|
| Rate for Payer: Priority Health SBD |
$682.92
|
| Rate for Payer: UMR Bronson Commercial |
$476.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.00
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$396.39 |
| Max. Negotiated Rate |
$1,163.26 |
| Rate for Payer: Aetna Commercial |
$818.23
|
| Rate for Payer: Aetna Medicare |
$635.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.29
|
| Rate for Payer: BCBS Complete |
$416.21
|
| Rate for Payer: BCBS MAPPO |
$610.62
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: BCN Medicare Advantage |
$610.62
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$818.23
|
| Rate for Payer: Cofinity Commercial |
$879.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.15
|
| Rate for Payer: Meridian Medicaid |
$416.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$671.68
|
| Rate for Payer: Nomi Health Commercial |
$732.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.75
|
| Rate for Payer: PACE SWMI |
$610.62
|
| Rate for Payer: PHP Commercial |
$854.87
|
| Rate for Payer: PHP Medicare Advantage |
$610.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,095.09
|
| Rate for Payer: Priority Health Medicare |
$610.62
|
| Rate for Payer: Priority Health SBD |
$1,095.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,095.09
|
| Rate for Payer: Railroad Medicare Medicare |
$610.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.26
|
| Rate for Payer: UHC Core |
$1,163.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$610.62
|
| Rate for Payer: UHC Exchange |
$1,163.26
|
| Rate for Payer: UHC Medicaid |
$396.39
|
| Rate for Payer: UHCCP Medicaid |
$396.39
|
| Rate for Payer: UMR Bronson Commercial |
$668.38
|
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$4,089.00
|
|
|
Service Code
|
HCPCS 49204
|
| Min. Negotiated Rate |
$1,635.60 |
| Max. Negotiated Rate |
$3,066.75 |
| Rate for Payer: Aetna Commercial |
$2,046.13
|
| Rate for Payer: Aetna Medicare |
$2,044.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,046.13
|
| Rate for Payer: BCBS Complete |
$1,635.60
|
| Rate for Payer: BCN Commercial |
$2,249.95
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,066.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,880.94
|
|
