|
PR EXTENDED ABDOMINOPLASTY
|
Professional
|
Both
|
$5,304.00
|
|
|
Service Code
|
HCPCS 00366
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,121.60 |
| Max. Negotiated Rate |
$3,447.60 |
| Rate for Payer: Aetna Medicare |
$2,652.00
|
| Rate for Payer: BCBS Complete |
$2,121.60
|
| Rate for Payer: Cash Price |
$4,243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,447.60
|
| Rate for Payer: UMR Bronson Commercial |
$2,439.84
|
|
|
PR EXTENDED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 92083
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,352.98 |
| Rate for Payer: Aetna Commercial |
$76.78
|
| Rate for Payer: Aetna Medicare |
$59.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.51
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$57.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.98
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$57.30
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$82.51
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.16
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$68.76
|
| Rate for Payer: PACE SWMI |
$57.30
|
| Rate for Payer: PHP Commercial |
$80.22
|
| Rate for Payer: PHP Medicare Advantage |
$57.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.34
|
| Rate for Payer: Priority Health Medicare |
$57.30
|
| Rate for Payer: Priority Health Narrow Network |
$91.34
|
| Rate for Payer: Priority Health SBD |
$45.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.30
|
| Rate for Payer: UHC Medicare Advantage |
$57.30
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
PR EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 59412
|
| Min. Negotiated Rate |
$95.36 |
| Max. Negotiated Rate |
$279.47 |
| Rate for Payer: Aetna Commercial |
$134.51
|
| Rate for Payer: Aetna Medicare |
$104.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.55
|
| Rate for Payer: BCBS Complete |
$100.13
|
| Rate for Payer: BCBS MAPPO |
$100.38
|
| Rate for Payer: BCBS Trust/PPO |
$279.47
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: BCN Medicare Advantage |
$100.38
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$134.51
|
| Rate for Payer: Cofinity Commercial |
$144.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.40
|
| Rate for Payer: Meridian Medicaid |
$100.13
|
| Rate for Payer: Nomi Health Commercial |
$120.46
|
| Rate for Payer: PACE SWMI |
$100.38
|
| Rate for Payer: PHP Commercial |
$140.53
|
| Rate for Payer: PHP Medicare Advantage |
$100.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.92
|
| Rate for Payer: Priority Health Medicare |
$100.38
|
| Rate for Payer: Priority Health Narrow Network |
$143.92
|
| Rate for Payer: Priority Health SBD |
$143.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.38
|
| Rate for Payer: UHC Medicare Advantage |
$100.38
|
| Rate for Payer: UHCCP Medicaid |
$95.36
|
| Rate for Payer: UMR Bronson Commercial |
$133.40
|
|
|
PR EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 48510
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,002.65 |
| Rate for Payer: Aetna Commercial |
$1,425.14
|
| Rate for Payer: Aetna Medicare |
$1,106.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,425.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,531.50
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS MAPPO |
$1,063.54
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,605.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.54
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.14
|
| Rate for Payer: Cofinity Commercial |
$1,531.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,116.72
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Nomi Health Commercial |
$1,276.25
|
| Rate for Payer: PACE SWMI |
$1,063.54
|
| Rate for Payer: PHP Commercial |
$1,488.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,967.56
|
| Rate for Payer: Priority Health Medicare |
$1,063.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,967.56
|
| Rate for Payer: Priority Health SBD |
$1,967.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,063.54
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,417.26
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93242
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$526.19 |
| Rate for Payer: Aetna Commercial |
$13.94
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.98
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.92
|
| Rate for Payer: Nomi Health Commercial |
$12.48
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.95
|
| Rate for Payer: Priority Health Medicare |
$10.40
|
| Rate for Payer: Priority Health Narrow Network |
$16.95
|
| Rate for Payer: Priority Health SBD |
$16.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 93244
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$533.05 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare |
$22.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.01
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$27.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.65
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.73
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$25.98
|
| Rate for Payer: PACE SWMI |
$21.65
|
| Rate for Payer: PHP Commercial |
$30.31
|
| Rate for Payer: PHP Medicare Advantage |
$21.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.02
|
| Rate for Payer: Priority Health Medicare |
$21.65
|
| Rate for Payer: Priority Health Narrow Network |
$32.02
|
| Rate for Payer: Priority Health SBD |
$32.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.65
|
| Rate for Payer: UHC Medicare Advantage |
$21.65
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93246
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$607.55 |
| Rate for Payer: Aetna Commercial |
$13.94
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.98
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$607.55
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.92
|
| Rate for Payer: Nomi Health Commercial |
$12.48
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.95
|
| Rate for Payer: Priority Health Medicare |
$10.40
|
| Rate for Payer: Priority Health Narrow Network |
$16.95
|
| Rate for Payer: Priority Health SBD |
$16.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93248
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$892.83 |
| Rate for Payer: Aetna Commercial |
$31.96
|
| Rate for Payer: Aetna Medicare |
$24.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.96
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$23.85
|
| Rate for Payer: BCBS Trust/PPO |
$892.83
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$23.85
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$34.34
|
| Rate for Payer: Cofinity Commercial |
$31.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.04
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: PACE SWMI |
$23.85
|
| Rate for Payer: PHP Commercial |
$33.39
|
| Rate for Payer: PHP Medicare Advantage |
$23.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.32
|
| Rate for Payer: Priority Health Medicare |
$23.85
|
| Rate for Payer: Priority Health Narrow Network |
$35.32
|
| Rate for Payer: Priority Health SBD |
$35.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$23.85
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 32540
|
| Min. Negotiated Rate |
$1,090.77 |
| Max. Negotiated Rate |
$2,481.51 |
| Rate for Payer: Aetna Commercial |
$2,223.23
|
| Rate for Payer: Aetna Medicare |
$1,725.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,223.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,389.15
|
| Rate for Payer: BCBS Complete |
$1,145.31
|
| Rate for Payer: BCBS MAPPO |
$1,659.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.07
|
| Rate for Payer: BCN Commercial |
$2,481.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,659.13
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cofinity Commercial |
$2,223.23
|
| Rate for Payer: Cofinity Commercial |
$2,389.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,659.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,742.09
|
| Rate for Payer: Meridian Medicaid |
$1,145.31
|
| Rate for Payer: Nomi Health Commercial |
$1,990.96
|
| Rate for Payer: PACE SWMI |
$1,659.13
|
| Rate for Payer: PHP Commercial |
$2,322.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,659.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,090.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,367.39
|
| Rate for Payer: Priority Health Medicare |
$1,659.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,367.39
|
| Rate for Payer: Priority Health SBD |
$2,367.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,659.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,659.13
|
| Rate for Payer: UHCCP Medicaid |
$1,090.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,479.36
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 26111
|
| Min. Negotiated Rate |
$210.98 |
| Max. Negotiated Rate |
$782.60 |
| Rate for Payer: Aetna Commercial |
$540.01
|
| Rate for Payer: Aetna Medicare |
$419.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.31
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$402.99
|
| Rate for Payer: BCBS Trust/PPO |
$210.98
|
| Rate for Payer: BCN Commercial |
$613.77
|
| Rate for Payer: BCN Medicare Advantage |
$402.99
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$540.01
|
| Rate for Payer: Cofinity Commercial |
$580.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.14
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Nomi Health Commercial |
$483.59
|
| Rate for Payer: PACE SWMI |
$402.99
|
| Rate for Payer: PHP Commercial |
$564.19
|
| Rate for Payer: PHP Medicare Advantage |
$402.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.76
|
| Rate for Payer: Priority Health Medicare |
$402.99
|
| Rate for Payer: Priority Health Narrow Network |
$646.76
|
| Rate for Payer: Priority Health SBD |
$646.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.99
|
| Rate for Payer: UHC Medicare Advantage |
$402.99
|
| Rate for Payer: UHCCP Medicaid |
$273.71
|
| Rate for Payer: UMR Bronson Commercial |
$553.84
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$1,839.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$254.28 |
| Max. Negotiated Rate |
$1,195.35 |
| Rate for Payer: Aetna Commercial |
$710.44
|
| Rate for Payer: Aetna Medicare |
$551.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.46
|
| Rate for Payer: BCBS Complete |
$378.19
|
| Rate for Payer: BCBS MAPPO |
$530.18
|
| Rate for Payer: BCBS Trust/PPO |
$254.28
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: BCN Medicare Advantage |
$530.18
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cofinity Commercial |
$710.44
|
| Rate for Payer: Cofinity Commercial |
$763.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.69
|
| Rate for Payer: Meridian Medicaid |
$378.19
|
| Rate for Payer: Nomi Health Commercial |
$636.22
|
| Rate for Payer: PACE SWMI |
$530.18
|
| Rate for Payer: PHP Commercial |
$742.25
|
| Rate for Payer: PHP Medicare Advantage |
$530.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.30
|
| Rate for Payer: Priority Health Medicare |
$530.18
|
| Rate for Payer: Priority Health Narrow Network |
$850.30
|
| Rate for Payer: Priority Health SBD |
$850.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$530.18
|
| Rate for Payer: UHC Medicare Advantage |
$530.18
|
| Rate for Payer: UHCCP Medicaid |
$360.18
|
| Rate for Payer: UMR Bronson Commercial |
$845.94
|
|
|
PR FAA PHYSICAL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 00180
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$86.45 |
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: UMR Bronson Commercial |
$61.18
|
|
|
PR FACIAL NERVE FUNCTION STUDIES
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 92516
|
| Min. Negotiated Rate |
$21.24 |
| Max. Negotiated Rate |
$2,145.40 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$22.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.59
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$21.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,145.40
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: BCN Medicare Advantage |
$21.24
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.30
|
| Rate for Payer: Nomi Health Commercial |
$25.49
|
| Rate for Payer: PACE SWMI |
$21.24
|
| Rate for Payer: PHP Commercial |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$21.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.30
|
| Rate for Payer: Priority Health Medicare |
$21.24
|
| Rate for Payer: Priority Health Narrow Network |
$30.30
|
| Rate for Payer: Priority Health SBD |
$30.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.24
|
| Rate for Payer: UHC Medicare Advantage |
$21.24
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 97156
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$1,096.22 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.79
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.22
|
| Rate for Payer: BCN Commercial |
$37.50
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.04
|
| Rate for Payer: Priority Health Narrow Network |
$47.04
|
| Rate for Payer: Priority Health SBD |
$47.04
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 90846
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$346.04 |
| Rate for Payer: Aetna Commercial |
$130.86
|
| Rate for Payer: Aetna Medicare |
$101.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.63
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$97.66
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: BCN Medicare Advantage |
$97.66
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$140.63
|
| Rate for Payer: Cofinity Commercial |
$130.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.54
|
| Rate for Payer: Nomi Health Commercial |
$117.19
|
| Rate for Payer: PACE SWMI |
$97.66
|
| Rate for Payer: PHP Commercial |
$136.72
|
| Rate for Payer: PHP Medicare Advantage |
$97.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.43
|
| Rate for Payer: Priority Health Medicare |
$97.66
|
| Rate for Payer: Priority Health Narrow Network |
$107.43
|
| Rate for Payer: Priority Health SBD |
$107.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.66
|
| Rate for Payer: UHC Medicare Advantage |
$97.66
|
| Rate for Payer: UMR Bronson Commercial |
$74.06
|
|
|
PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 90847
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$146.61 |
| Rate for Payer: Aetna Commercial |
$136.43
|
| Rate for Payer: Aetna Medicare |
$105.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.43
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$101.81
|
| Rate for Payer: BCBS Trust/PPO |
$109.89
|
| Rate for Payer: BCN Commercial |
$115.44
|
| Rate for Payer: BCN Medicare Advantage |
$101.81
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$146.61
|
| Rate for Payer: Cofinity Commercial |
$136.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.90
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Nomi Health Commercial |
$122.17
|
| Rate for Payer: PACE SWMI |
$101.81
|
| Rate for Payer: PHP Commercial |
$142.53
|
| Rate for Payer: PHP Medicare Advantage |
$101.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.88
|
| Rate for Payer: Priority Health Medicare |
$101.81
|
| Rate for Payer: Priority Health Narrow Network |
$127.88
|
| Rate for Payer: Priority Health SBD |
$127.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.81
|
| Rate for Payer: UHC Medicare Advantage |
$101.81
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR FASCIA LATA GRAFT INCISION & AREA EXPOSURE
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 20922
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$55,000.50 |
| Rate for Payer: Priority Health Medicare |
$481.75
|
| Rate for Payer: Aetna Commercial |
$645.54
|
| Rate for Payer: Aetna Medicare |
$501.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$645.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.72
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$481.75
|
| Rate for Payer: BCBS Trust/PPO |
$55,000.50
|
| Rate for Payer: BCN Commercial |
$892.81
|
| Rate for Payer: BCN Medicare Advantage |
$481.75
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$645.54
|
| Rate for Payer: Cofinity Commercial |
$693.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.84
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Nomi Health Commercial |
$578.10
|
| Rate for Payer: PACE SWMI |
$481.75
|
| Rate for Payer: PHP Commercial |
$674.45
|
| Rate for Payer: PHP Medicare Advantage |
$481.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.88
|
| Rate for Payer: Priority Health Narrow Network |
$768.88
|
| Rate for Payer: Priority Health SBD |
$768.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.75
|
| Rate for Payer: UHC Medicare Advantage |
$481.75
|
| Rate for Payer: UHCCP Medicaid |
$324.19
|
| Rate for Payer: UMR Bronson Commercial |
$495.42
|
|
|
PR FASCIECTOMY PLANTAR FASCIA PARTIAL SPX
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 28060
|
| Min. Negotiated Rate |
$234.09 |
| Max. Negotiated Rate |
$2,093.12 |
| Rate for Payer: Aetna Commercial |
$461.50
|
| Rate for Payer: Aetna Medicare |
$358.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.94
|
| Rate for Payer: BCBS Complete |
$245.79
|
| Rate for Payer: BCBS MAPPO |
$344.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: BCN Medicare Advantage |
$344.40
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cofinity Commercial |
$461.50
|
| Rate for Payer: Cofinity Commercial |
$495.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.62
|
| Rate for Payer: Meridian Medicaid |
$245.79
|
| Rate for Payer: Nomi Health Commercial |
$413.28
|
| Rate for Payer: PACE SWMI |
$344.40
|
| Rate for Payer: PHP Commercial |
$482.16
|
| Rate for Payer: PHP Medicare Advantage |
$344.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.68
|
| Rate for Payer: Priority Health Medicare |
$344.40
|
| Rate for Payer: Priority Health Narrow Network |
$555.68
|
| Rate for Payer: Priority Health SBD |
$555.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.40
|
| Rate for Payer: UHC Medicare Advantage |
$344.40
|
| Rate for Payer: UHCCP Medicaid |
$234.09
|
| Rate for Payer: UMR Bronson Commercial |
$448.50
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$266.03 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$467.35
|
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,306.91
|
| Rate for Payer: BCN Commercial |
$2,306.91
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Cofinity Commercial |
$503.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$503.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$452.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.95
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$282.68
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$266.03
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 28008
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$3,296.59 |
| Rate for Payer: Aetna Commercial |
$377.85
|
| Rate for Payer: Aetna Medicare |
$293.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.05
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCBS MAPPO |
$281.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.59
|
| Rate for Payer: BCN Commercial |
$623.06
|
| Rate for Payer: BCN Medicare Advantage |
$281.98
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$406.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.08
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Nomi Health Commercial |
$338.38
|
| Rate for Payer: PACE SWMI |
$281.98
|
| Rate for Payer: PHP Commercial |
$394.77
|
| Rate for Payer: PHP Medicare Advantage |
$281.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.39
|
| Rate for Payer: Priority Health Medicare |
$281.98
|
| Rate for Payer: Priority Health Narrow Network |
$453.39
|
| Rate for Payer: Priority Health SBD |
$453.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.98
|
| Rate for Payer: UHC Medicare Advantage |
$281.98
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
| Rate for Payer: UMR Bronson Commercial |
$330.74
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$3,296.59 |
| Rate for Payer: Aetna Commercial |
$377.85
|
| Rate for Payer: Aetna Medicare |
$293.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.05
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCBS MAPPO |
$281.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.59
|
| Rate for Payer: BCN Commercial |
$623.06
|
| Rate for Payer: BCN Medicare Advantage |
$281.98
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$406.05
|
| Rate for Payer: Cofinity Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.08
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Nomi Health Commercial |
$338.38
|
| Rate for Payer: PACE SWMI |
$281.98
|
| Rate for Payer: PHP Commercial |
$394.77
|
| Rate for Payer: PHP Medicare Advantage |
$281.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.39
|
| Rate for Payer: Priority Health Medicare |
$281.98
|
| Rate for Payer: Priority Health Narrow Network |
$453.39
|
| Rate for Payer: Priority Health SBD |
$453.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.98
|
| Rate for Payer: UHC Medicare Advantage |
$281.98
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
| Rate for Payer: UMR Bronson Commercial |
$330.74
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$316.36 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna American Axle |
$467.35
|
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.35
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$503.30
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$503.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health SBD |
$452.97
|
| Rate for Payer: UMR Bronson Commercial |
$316.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
PR FASCIOTOMY HIP/THIGH ANY TYPE
|
Professional
|
Both
|
$3,485.00
|
|
|
Service Code
|
HCPCS 27025
|
| Min. Negotiated Rate |
$191.38 |
| Max. Negotiated Rate |
$2,265.25 |
| Rate for Payer: Aetna Commercial |
$1,209.47
|
| Rate for Payer: Aetna Medicare |
$938.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.73
|
| Rate for Payer: BCBS Complete |
$640.09
|
| Rate for Payer: BCBS MAPPO |
$902.59
|
| Rate for Payer: BCBS Trust/PPO |
$191.38
|
| Rate for Payer: BCN Commercial |
$1,352.66
|
| Rate for Payer: BCN Medicare Advantage |
$902.59
|
| Rate for Payer: Cash Price |
$2,788.00
|
| Rate for Payer: Cash Price |
$2,788.00
|
| Rate for Payer: Cofinity Commercial |
$1,209.47
|
| Rate for Payer: Cofinity Commercial |
$1,299.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.72
|
| Rate for Payer: Meridian Medicaid |
$640.09
|
| Rate for Payer: Nomi Health Commercial |
$1,083.11
|
| Rate for Payer: PACE SWMI |
$902.59
|
| Rate for Payer: PHP Commercial |
$1,263.63
|
| Rate for Payer: PHP Medicare Advantage |
$902.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,430.91
|
| Rate for Payer: Priority Health Medicare |
$902.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,430.91
|
| Rate for Payer: Priority Health SBD |
$1,430.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.59
|
| Rate for Payer: UHC Medicare Advantage |
$902.59
|
| Rate for Payer: UHCCP Medicaid |
$609.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,603.10
|
|
|
PR FASCIOTOMY ILIOTIBIAL OPEN
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 27305
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$1,940.97 |
| Rate for Payer: Aetna Commercial |
$627.58
|
| Rate for Payer: Aetna Medicare |
$487.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.41
|
| Rate for Payer: BCBS Complete |
$333.91
|
| Rate for Payer: BCBS MAPPO |
$468.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.97
|
| Rate for Payer: BCN Commercial |
$715.91
|
| Rate for Payer: BCN Medicare Advantage |
$468.34
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$627.58
|
| Rate for Payer: Cofinity Commercial |
$674.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.76
|
| Rate for Payer: Meridian Medicaid |
$333.91
|
| Rate for Payer: Nomi Health Commercial |
$562.01
|
| Rate for Payer: PACE SWMI |
$468.34
|
| Rate for Payer: PHP Commercial |
$655.68
|
| Rate for Payer: PHP Medicare Advantage |
$468.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.10
|
| Rate for Payer: Priority Health Medicare |
$468.34
|
| Rate for Payer: Priority Health Narrow Network |
$752.10
|
| Rate for Payer: Priority Health SBD |
$752.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$468.34
|
| Rate for Payer: UHC Medicare Advantage |
$468.34
|
| Rate for Payer: UHCCP Medicaid |
$318.01
|
| Rate for Payer: UMR Bronson Commercial |
$608.58
|
|
|
PR FASCIOTOMY PALMAR OPEN PARTIAL
|
Professional
|
Both
|
$1,368.00
|
|
|
Service Code
|
HCPCS 26045
|
| Min. Negotiated Rate |
$153.67 |
| Max. Negotiated Rate |
$889.20 |
| Rate for Payer: Aetna Commercial |
$613.97
|
| Rate for Payer: Aetna Medicare |
$476.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.79
|
| Rate for Payer: BCBS Complete |
$328.09
|
| Rate for Payer: BCBS MAPPO |
$458.19
|
| Rate for Payer: BCBS Trust/PPO |
$153.67
|
| Rate for Payer: BCN Commercial |
$701.25
|
| Rate for Payer: BCN Medicare Advantage |
$458.19
|
| Rate for Payer: Cash Price |
$1,094.40
|
| Rate for Payer: Cash Price |
$1,094.40
|
| Rate for Payer: Cofinity Commercial |
$613.97
|
| Rate for Payer: Cofinity Commercial |
$659.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.10
|
| Rate for Payer: Meridian Medicaid |
$328.09
|
| Rate for Payer: Nomi Health Commercial |
$549.83
|
| Rate for Payer: PACE SWMI |
$458.19
|
| Rate for Payer: PHP Commercial |
$641.47
|
| Rate for Payer: PHP Medicare Advantage |
$458.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.35
|
| Rate for Payer: Priority Health Medicare |
$458.19
|
| Rate for Payer: Priority Health Narrow Network |
$738.35
|
| Rate for Payer: Priority Health SBD |
$738.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$458.19
|
| Rate for Payer: UHC Medicare Advantage |
$458.19
|
| Rate for Payer: UHCCP Medicaid |
$312.47
|
| Rate for Payer: UMR Bronson Commercial |
$629.28
|
|
