|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,892.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$833.68 |
| Max. Negotiated Rate |
$2,590.63 |
| Rate for Payer: Aetna Commercial |
$1,734.27
|
| Rate for Payer: Aetna Medicare |
$1,346.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,734.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,863.69
|
| Rate for Payer: BCBS Complete |
$875.36
|
| Rate for Payer: BCBS MAPPO |
$1,294.23
|
| Rate for Payer: BCN Commercial |
$2,176.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,294.23
|
| Rate for Payer: Cash Price |
$2,313.60
|
| Rate for Payer: Cash Price |
$2,313.60
|
| Rate for Payer: Cofinity Commercial |
$1,734.27
|
| Rate for Payer: Cofinity Commercial |
$1,863.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,294.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,358.94
|
| Rate for Payer: Meridian Medicaid |
$875.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,423.65
|
| Rate for Payer: Nomi Health Commercial |
$1,553.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,169.00
|
| Rate for Payer: PACE SWMI |
$1,294.23
|
| Rate for Payer: PHP Commercial |
$1,811.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,294.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,371.11
|
| Rate for Payer: Priority Health Medicare |
$1,294.23
|
| Rate for Payer: Priority Health SBD |
$2,371.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,371.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,294.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,590.63
|
| Rate for Payer: UHC Core |
$2,590.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,294.23
|
| Rate for Payer: UHC Exchange |
$2,590.63
|
| Rate for Payer: UHC Medicaid |
$833.68
|
| Rate for Payer: UHCCP Medicaid |
$833.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,330.32
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,816.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$614.29 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Aetna Commercial |
$1,278.79
|
| Rate for Payer: Aetna Medicare |
$992.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.22
|
| Rate for Payer: BCBS Complete |
$645.00
|
| Rate for Payer: BCBS MAPPO |
$954.32
|
| Rate for Payer: BCN Commercial |
$1,581.09
|
| Rate for Payer: BCN Medicare Advantage |
$954.32
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,278.79
|
| Rate for Payer: Cofinity Commercial |
$1,374.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.04
|
| Rate for Payer: Meridian Medicaid |
$645.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,049.75
|
| Rate for Payer: Nomi Health Commercial |
$1,145.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,862.00
|
| Rate for Payer: PACE SWMI |
$954.32
|
| Rate for Payer: PHP Commercial |
$1,336.05
|
| Rate for Payer: PHP Medicare Advantage |
$954.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,722.32
|
| Rate for Payer: Priority Health Medicare |
$954.32
|
| Rate for Payer: Priority Health SBD |
$1,722.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,722.32
|
| Rate for Payer: Railroad Medicare Medicare |
$954.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,855.19
|
| Rate for Payer: UHC Core |
$1,855.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$954.32
|
| Rate for Payer: UHC Exchange |
$1,855.19
|
| Rate for Payer: UHC Medicaid |
$614.29
|
| Rate for Payer: UHCCP Medicaid |
$614.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,755.36
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,516.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$728.67 |
| Max. Negotiated Rate |
$3,387.00 |
| Rate for Payer: Aetna Commercial |
$1,519.92
|
| Rate for Payer: Aetna Medicare |
$1,179.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,519.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.35
|
| Rate for Payer: BCBS Complete |
$765.10
|
| Rate for Payer: BCBS MAPPO |
$1,134.27
|
| Rate for Payer: BCN Commercial |
$1,904.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,134.27
|
| Rate for Payer: Cash Price |
$3,612.80
|
| Rate for Payer: Cash Price |
$3,612.80
|
| Rate for Payer: Cofinity Commercial |
$1,519.92
|
| Rate for Payer: Cofinity Commercial |
$1,633.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,134.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,190.98
|
| Rate for Payer: Meridian Medicaid |
$765.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,247.70
|
| Rate for Payer: Nomi Health Commercial |
$1,361.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,387.00
|
| Rate for Payer: PACE SWMI |
$1,134.27
|
| Rate for Payer: PHP Commercial |
$1,587.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,134.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,074.38
|
| Rate for Payer: Priority Health Medicare |
$1,134.27
|
| Rate for Payer: Priority Health SBD |
$2,074.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,074.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,134.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,270.91
|
| Rate for Payer: UHC Core |
$2,270.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,134.27
|
| Rate for Payer: UHC Exchange |
$2,270.91
|
| Rate for Payer: UHC Medicaid |
$728.67
|
| Rate for Payer: UHCCP Medicaid |
$728.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,077.36
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,558.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$675.64 |
| Max. Negotiated Rate |
$2,668.50 |
| Rate for Payer: Aetna Commercial |
$1,405.82
|
| Rate for Payer: Aetna Medicare |
$1,091.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,405.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,510.73
|
| Rate for Payer: BCBS Complete |
$709.42
|
| Rate for Payer: BCBS MAPPO |
$1,049.12
|
| Rate for Payer: BCN Commercial |
$1,766.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,049.12
|
| Rate for Payer: Cash Price |
$2,846.40
|
| Rate for Payer: Cash Price |
$2,846.40
|
| Rate for Payer: Cofinity Commercial |
$1,405.82
|
| Rate for Payer: Cofinity Commercial |
$1,510.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,049.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,101.58
|
| Rate for Payer: Meridian Medicaid |
$709.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,154.03
|
| Rate for Payer: Nomi Health Commercial |
$1,258.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,668.50
|
| Rate for Payer: PACE SWMI |
$1,049.12
|
| Rate for Payer: PHP Commercial |
$1,468.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,049.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,924.65
|
| Rate for Payer: Priority Health Medicare |
$1,049.12
|
| Rate for Payer: Priority Health SBD |
$1,924.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,924.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,049.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,127.45
|
| Rate for Payer: UHC Core |
$2,127.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,049.12
|
| Rate for Payer: UHC Exchange |
$2,127.45
|
| Rate for Payer: UHC Medicaid |
$675.64
|
| Rate for Payer: UHCCP Medicaid |
$675.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,636.68
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,563.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$740.18 |
| Max. Negotiated Rate |
$2,305.41 |
| Rate for Payer: Aetna Commercial |
$1,541.86
|
| Rate for Payer: Aetna Medicare |
$1,196.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,656.92
|
| Rate for Payer: BCBS Complete |
$777.19
|
| Rate for Payer: BCBS MAPPO |
$1,150.64
|
| Rate for Payer: BCN Commercial |
$1,937.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,150.64
|
| Rate for Payer: Cash Price |
$2,050.40
|
| Rate for Payer: Cash Price |
$2,050.40
|
| Rate for Payer: Cofinity Commercial |
$1,541.86
|
| Rate for Payer: Cofinity Commercial |
$1,656.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,150.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,208.17
|
| Rate for Payer: Meridian Medicaid |
$777.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,265.70
|
| Rate for Payer: Nomi Health Commercial |
$1,380.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,922.25
|
| Rate for Payer: PACE SWMI |
$1,150.64
|
| Rate for Payer: PHP Commercial |
$1,610.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,150.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,110.72
|
| Rate for Payer: Priority Health Medicare |
$1,150.64
|
| Rate for Payer: Priority Health SBD |
$2,110.72
|
| Rate for Payer: Priority Health Tiered Network |
$2,110.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,150.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,305.41
|
| Rate for Payer: UHC Core |
$2,305.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,150.64
|
| Rate for Payer: UHC Exchange |
$2,305.41
|
| Rate for Payer: UHC Medicaid |
$740.18
|
| Rate for Payer: UHCCP Medicaid |
$740.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,178.98
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$2,126.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$649.86 |
| Max. Negotiated Rate |
$2,016.02 |
| Rate for Payer: Aetna Commercial |
$1,351.62
|
| Rate for Payer: Aetna Medicare |
$1,049.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,452.48
|
| Rate for Payer: BCBS Complete |
$682.35
|
| Rate for Payer: BCBS MAPPO |
$1,008.67
|
| Rate for Payer: BCN Commercial |
$1,696.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.67
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cofinity Commercial |
$1,351.62
|
| Rate for Payer: Cofinity Commercial |
$1,452.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,059.10
|
| Rate for Payer: Meridian Medicaid |
$682.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,109.54
|
| Rate for Payer: Nomi Health Commercial |
$1,210.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,594.50
|
| Rate for Payer: PACE SWMI |
$1,008.67
|
| Rate for Payer: PHP Commercial |
$1,412.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,848.18
|
| Rate for Payer: Priority Health Medicare |
$1,008.67
|
| Rate for Payer: Priority Health SBD |
$1,848.18
|
| Rate for Payer: Priority Health Tiered Network |
$1,848.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,008.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,016.02
|
| Rate for Payer: UHC Core |
$2,016.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,008.67
|
| Rate for Payer: UHC Exchange |
$2,016.02
|
| Rate for Payer: UHC Medicaid |
$649.86
|
| Rate for Payer: UHCCP Medicaid |
$649.86
|
| Rate for Payer: UMR Bronson Commercial |
$977.96
|
|
|
PR NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS
|
Professional
|
Both
|
$3,516.00
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$826.87 |
| Max. Negotiated Rate |
$2,637.00 |
| Rate for Payer: Aetna Commercial |
$1,721.93
|
| Rate for Payer: Aetna Medicare |
$1,336.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,721.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,850.43
|
| Rate for Payer: BCBS Complete |
$868.21
|
| Rate for Payer: BCBS MAPPO |
$1,285.02
|
| Rate for Payer: BCN Commercial |
$2,166.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,285.02
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cofinity Commercial |
$1,721.93
|
| Rate for Payer: Cofinity Commercial |
$1,850.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,285.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,349.27
|
| Rate for Payer: Meridian Medicaid |
$868.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,413.52
|
| Rate for Payer: Nomi Health Commercial |
$1,542.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,637.00
|
| Rate for Payer: PACE SWMI |
$1,285.02
|
| Rate for Payer: PHP Commercial |
$1,799.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,285.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$826.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,359.71
|
| Rate for Payer: Priority Health Medicare |
$1,285.02
|
| Rate for Payer: Priority Health SBD |
$2,359.71
|
| Rate for Payer: Priority Health Tiered Network |
$2,359.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,285.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,579.93
|
| Rate for Payer: UHC Core |
$2,579.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,285.02
|
| Rate for Payer: UHC Exchange |
$2,579.93
|
| Rate for Payer: UHC Medicaid |
$826.87
|
| Rate for Payer: UHCCP Medicaid |
$826.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,617.36
|
|
|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$2,374.00
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$771.91 |
| Max. Negotiated Rate |
$2,198.49 |
| Rate for Payer: Aetna Commercial |
$1,614.91
|
| Rate for Payer: Aetna Medicare |
$1,253.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,614.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,735.43
|
| Rate for Payer: BCBS Complete |
$810.51
|
| Rate for Payer: BCBS MAPPO |
$1,205.16
|
| Rate for Payer: BCN Commercial |
$1,937.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,205.16
|
| Rate for Payer: Cash Price |
$1,899.20
|
| Rate for Payer: Cash Price |
$1,899.20
|
| Rate for Payer: Cofinity Commercial |
$1,614.91
|
| Rate for Payer: Cofinity Commercial |
$1,735.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,205.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,265.42
|
| Rate for Payer: Meridian Medicaid |
$810.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,325.68
|
| Rate for Payer: Nomi Health Commercial |
$1,446.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,780.50
|
| Rate for Payer: PACE SWMI |
$1,205.16
|
| Rate for Payer: PHP Commercial |
$1,687.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,205.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$771.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,110.18
|
| Rate for Payer: Priority Health Medicare |
$1,205.16
|
| Rate for Payer: Priority Health SBD |
$2,110.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,110.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,205.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,198.49
|
| Rate for Payer: UHC Core |
$2,198.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,205.16
|
| Rate for Payer: UHC Exchange |
$2,198.49
|
| Rate for Payer: UHC Medicaid |
$771.91
|
| Rate for Payer: UHCCP Medicaid |
$771.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,092.04
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,818.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$531.22 |
| Max. Negotiated Rate |
$1,629.27 |
| Rate for Payer: Aetna Commercial |
$1,102.65
|
| Rate for Payer: Aetna Medicare |
$855.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.93
|
| Rate for Payer: BCBS Complete |
$557.78
|
| Rate for Payer: BCBS MAPPO |
$822.87
|
| Rate for Payer: BCN Commercial |
$1,383.39
|
| Rate for Payer: BCN Medicare Advantage |
$822.87
|
| Rate for Payer: Cash Price |
$1,454.40
|
| Rate for Payer: Cash Price |
$1,454.40
|
| Rate for Payer: Cofinity Commercial |
$1,102.65
|
| Rate for Payer: Cofinity Commercial |
$1,184.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$864.01
|
| Rate for Payer: Meridian Medicaid |
$557.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$905.16
|
| Rate for Payer: Nomi Health Commercial |
$987.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,363.50
|
| Rate for Payer: PACE SWMI |
$822.87
|
| Rate for Payer: PHP Commercial |
$1,152.02
|
| Rate for Payer: PHP Medicare Advantage |
$822.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,506.97
|
| Rate for Payer: Priority Health Medicare |
$822.87
|
| Rate for Payer: Priority Health SBD |
$1,506.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,506.97
|
| Rate for Payer: Railroad Medicare Medicare |
$822.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,629.27
|
| Rate for Payer: UHC Core |
$1,629.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$822.87
|
| Rate for Payer: UHC Exchange |
$1,629.27
|
| Rate for Payer: UHC Medicaid |
$531.22
|
| Rate for Payer: UHCCP Medicaid |
$531.22
|
| Rate for Payer: UMR Bronson Commercial |
$836.28
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$242.20 |
| Max. Negotiated Rate |
$411.00 |
| Rate for Payer: Aetna Commercial |
$324.55
|
| Rate for Payer: Aetna Commercial |
$324.55
|
| Rate for Payer: Aetna Medicare |
$251.89
|
| Rate for Payer: Aetna Medicare |
$251.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.55
|
| Rate for Payer: BCBS MAPPO |
$242.20
|
| Rate for Payer: BCBS MAPPO |
$242.20
|
| Rate for Payer: BCN Commercial |
$361.54
|
| Rate for Payer: BCN Commercial |
$361.54
|
| Rate for Payer: BCN Medicare Advantage |
$242.20
|
| Rate for Payer: BCN Medicare Advantage |
$242.20
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cofinity Commercial |
$348.77
|
| Rate for Payer: Cofinity Commercial |
$348.77
|
| Rate for Payer: Cofinity Commercial |
$324.55
|
| Rate for Payer: Cofinity Commercial |
$324.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$266.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$266.42
|
| Rate for Payer: Nomi Health Commercial |
$290.64
|
| Rate for Payer: Nomi Health Commercial |
$290.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.75
|
| Rate for Payer: PACE SWMI |
$242.20
|
| Rate for Payer: PACE SWMI |
$242.20
|
| Rate for Payer: PHP Commercial |
$339.08
|
| Rate for Payer: PHP Commercial |
$339.08
|
| Rate for Payer: PHP Medicare Advantage |
$242.20
|
| Rate for Payer: PHP Medicare Advantage |
$242.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$333.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$333.42
|
| Rate for Payer: Priority Health Medicare |
$242.20
|
| Rate for Payer: Priority Health Medicare |
$242.20
|
| Rate for Payer: Priority Health SBD |
$333.42
|
| Rate for Payer: Priority Health SBD |
$333.42
|
| Rate for Payer: Priority Health Tiered Network |
$333.42
|
| Rate for Payer: Priority Health Tiered Network |
$333.42
|
| Rate for Payer: Railroad Medicare Medicare |
$242.20
|
| Rate for Payer: Railroad Medicare Medicare |
$242.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.47
|
| Rate for Payer: UHC Core |
$410.47
|
| Rate for Payer: UHC Core |
$410.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$242.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$242.20
|
| Rate for Payer: UHC Exchange |
$410.47
|
| Rate for Payer: UHC Exchange |
$410.47
|
| Rate for Payer: UMR Bronson Commercial |
$151.34
|
| Rate for Payer: UMR Bronson Commercial |
$252.08
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 95907
|
| Min. Negotiated Rate |
$43.24 |
| Max. Negotiated Rate |
$149.31 |
| Rate for Payer: Aetna Commercial |
$119.53
|
| Rate for Payer: Aetna Commercial |
$119.53
|
| Rate for Payer: Aetna Medicare |
$92.77
|
| Rate for Payer: Aetna Medicare |
$92.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.53
|
| Rate for Payer: BCBS MAPPO |
$89.20
|
| Rate for Payer: BCBS MAPPO |
$89.20
|
| Rate for Payer: BCN Commercial |
$131.97
|
| Rate for Payer: BCN Commercial |
$131.97
|
| Rate for Payer: BCN Medicare Advantage |
$89.20
|
| Rate for Payer: BCN Medicare Advantage |
$89.20
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$128.45
|
| Rate for Payer: Cofinity Commercial |
$128.45
|
| Rate for Payer: Cofinity Commercial |
$119.53
|
| Rate for Payer: Cofinity Commercial |
$119.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.12
|
| Rate for Payer: Nomi Health Commercial |
$107.04
|
| Rate for Payer: Nomi Health Commercial |
$107.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: PACE SWMI |
$89.20
|
| Rate for Payer: PACE SWMI |
$89.20
|
| Rate for Payer: PHP Commercial |
$124.88
|
| Rate for Payer: PHP Commercial |
$124.88
|
| Rate for Payer: PHP Medicare Advantage |
$89.20
|
| Rate for Payer: PHP Medicare Advantage |
$89.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$121.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$121.70
|
| Rate for Payer: Priority Health Medicare |
$89.20
|
| Rate for Payer: Priority Health Medicare |
$89.20
|
| Rate for Payer: Priority Health SBD |
$121.70
|
| Rate for Payer: Priority Health SBD |
$121.70
|
| Rate for Payer: Priority Health Tiered Network |
$121.70
|
| Rate for Payer: Priority Health Tiered Network |
$121.70
|
| Rate for Payer: Railroad Medicare Medicare |
$89.20
|
| Rate for Payer: Railroad Medicare Medicare |
$89.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.31
|
| Rate for Payer: UHC Core |
$149.31
|
| Rate for Payer: UHC Core |
$149.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.20
|
| Rate for Payer: UHC Exchange |
$149.31
|
| Rate for Payer: UHC Exchange |
$149.31
|
| Rate for Payer: UMR Bronson Commercial |
$80.50
|
| Rate for Payer: UMR Bronson Commercial |
$43.24
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 95913
|
| Min. Negotiated Rate |
$285.08 |
| Max. Negotiated Rate |
$677.25 |
| Rate for Payer: Aetna Commercial |
$382.01
|
| Rate for Payer: Aetna Commercial |
$382.01
|
| Rate for Payer: Aetna Medicare |
$296.48
|
| Rate for Payer: Aetna Medicare |
$296.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.01
|
| Rate for Payer: BCBS MAPPO |
$285.08
|
| Rate for Payer: BCBS MAPPO |
$285.08
|
| Rate for Payer: BCN Commercial |
$423.28
|
| Rate for Payer: BCN Commercial |
$423.28
|
| Rate for Payer: BCN Medicare Advantage |
$285.08
|
| Rate for Payer: BCN Medicare Advantage |
$285.08
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$410.52
|
| Rate for Payer: Cofinity Commercial |
$410.52
|
| Rate for Payer: Cofinity Commercial |
$382.01
|
| Rate for Payer: Cofinity Commercial |
$382.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.59
|
| Rate for Payer: Nomi Health Commercial |
$342.10
|
| Rate for Payer: Nomi Health Commercial |
$342.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$677.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$412.50
|
| Rate for Payer: PACE SWMI |
$285.08
|
| Rate for Payer: PACE SWMI |
$285.08
|
| Rate for Payer: PHP Commercial |
$399.11
|
| Rate for Payer: PHP Commercial |
$399.11
|
| Rate for Payer: PHP Medicare Advantage |
$285.08
|
| Rate for Payer: PHP Medicare Advantage |
$285.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$390.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$390.36
|
| Rate for Payer: Priority Health Medicare |
$285.08
|
| Rate for Payer: Priority Health Medicare |
$285.08
|
| Rate for Payer: Priority Health SBD |
$390.36
|
| Rate for Payer: Priority Health SBD |
$390.36
|
| Rate for Payer: Priority Health Tiered Network |
$390.36
|
| Rate for Payer: Priority Health Tiered Network |
$390.36
|
| Rate for Payer: Railroad Medicare Medicare |
$285.08
|
| Rate for Payer: Railroad Medicare Medicare |
$285.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.53
|
| Rate for Payer: UHC Core |
$475.53
|
| Rate for Payer: UHC Core |
$475.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.08
|
| Rate for Payer: UHC Exchange |
$475.53
|
| Rate for Payer: UHC Exchange |
$475.53
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
| Rate for Payer: UMR Bronson Commercial |
$415.38
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$111.93 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna Medicare |
$116.41
|
| Rate for Payer: Aetna Medicare |
$116.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.99
|
| Rate for Payer: BCBS MAPPO |
$111.93
|
| Rate for Payer: BCBS MAPPO |
$111.93
|
| Rate for Payer: BCN Commercial |
$164.34
|
| Rate for Payer: BCN Commercial |
$164.34
|
| Rate for Payer: BCN Medicare Advantage |
$111.93
|
| Rate for Payer: BCN Medicare Advantage |
$111.93
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$161.18
|
| Rate for Payer: Cofinity Commercial |
$161.18
|
| Rate for Payer: Cofinity Commercial |
$149.99
|
| Rate for Payer: Cofinity Commercial |
$149.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.12
|
| Rate for Payer: Nomi Health Commercial |
$134.32
|
| Rate for Payer: Nomi Health Commercial |
$134.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE SWMI |
$111.93
|
| Rate for Payer: PACE SWMI |
$111.93
|
| Rate for Payer: PHP Commercial |
$156.70
|
| Rate for Payer: PHP Commercial |
$156.70
|
| Rate for Payer: PHP Medicare Advantage |
$111.93
|
| Rate for Payer: PHP Medicare Advantage |
$111.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$151.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$151.55
|
| Rate for Payer: Priority Health Medicare |
$111.93
|
| Rate for Payer: Priority Health Medicare |
$111.93
|
| Rate for Payer: Priority Health SBD |
$151.55
|
| Rate for Payer: Priority Health SBD |
$151.55
|
| Rate for Payer: Priority Health Tiered Network |
$151.55
|
| Rate for Payer: Priority Health Tiered Network |
$151.55
|
| Rate for Payer: Railroad Medicare Medicare |
$111.93
|
| Rate for Payer: Railroad Medicare Medicare |
$111.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.35
|
| Rate for Payer: UHC Core |
$189.35
|
| Rate for Payer: UHC Core |
$189.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.93
|
| Rate for Payer: UHC Exchange |
$189.35
|
| Rate for Payer: UHC Exchange |
$189.35
|
| Rate for Payer: UMR Bronson Commercial |
$103.50
|
| Rate for Payer: UMR Bronson Commercial |
$160.54
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$418.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$134.35 |
| Max. Negotiated Rate |
$313.50 |
| Rate for Payer: Aetna Commercial |
$180.03
|
| Rate for Payer: Aetna Commercial |
$180.03
|
| Rate for Payer: Aetna Medicare |
$139.72
|
| Rate for Payer: Aetna Medicare |
$139.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.03
|
| Rate for Payer: BCBS MAPPO |
$134.35
|
| Rate for Payer: BCBS MAPPO |
$134.35
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Medicare Advantage |
$134.35
|
| Rate for Payer: BCN Medicare Advantage |
$134.35
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cofinity Commercial |
$193.46
|
| Rate for Payer: Cofinity Commercial |
$193.46
|
| Rate for Payer: Cofinity Commercial |
$180.03
|
| Rate for Payer: Cofinity Commercial |
$180.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.78
|
| Rate for Payer: Nomi Health Commercial |
$161.22
|
| Rate for Payer: Nomi Health Commercial |
$161.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$313.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.75
|
| Rate for Payer: PACE SWMI |
$134.35
|
| Rate for Payer: PACE SWMI |
$134.35
|
| Rate for Payer: PHP Commercial |
$188.09
|
| Rate for Payer: PHP Commercial |
$188.09
|
| Rate for Payer: PHP Medicare Advantage |
$134.35
|
| Rate for Payer: PHP Medicare Advantage |
$134.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$182.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$182.33
|
| Rate for Payer: Priority Health Medicare |
$134.35
|
| Rate for Payer: Priority Health Medicare |
$134.35
|
| Rate for Payer: Priority Health SBD |
$182.33
|
| Rate for Payer: Priority Health SBD |
$182.33
|
| Rate for Payer: Priority Health Tiered Network |
$182.33
|
| Rate for Payer: Priority Health Tiered Network |
$182.33
|
| Rate for Payer: Railroad Medicare Medicare |
$134.35
|
| Rate for Payer: Railroad Medicare Medicare |
$134.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.78
|
| Rate for Payer: UHC Core |
$226.78
|
| Rate for Payer: UHC Core |
$226.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.35
|
| Rate for Payer: UHC Exchange |
$226.78
|
| Rate for Payer: UHC Exchange |
$226.78
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: UMR Bronson Commercial |
$192.28
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$174.88 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Aetna Commercial |
$234.34
|
| Rate for Payer: Aetna Commercial |
$234.34
|
| Rate for Payer: Aetna Medicare |
$181.88
|
| Rate for Payer: Aetna Medicare |
$181.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.34
|
| Rate for Payer: BCBS MAPPO |
$174.88
|
| Rate for Payer: BCBS MAPPO |
$174.88
|
| Rate for Payer: BCN Commercial |
$258.45
|
| Rate for Payer: BCN Commercial |
$258.45
|
| Rate for Payer: BCN Medicare Advantage |
$174.88
|
| Rate for Payer: BCN Medicare Advantage |
$174.88
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cofinity Commercial |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.37
|
| Rate for Payer: Nomi Health Commercial |
$209.86
|
| Rate for Payer: Nomi Health Commercial |
$209.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$412.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$174.88
|
| Rate for Payer: PACE SWMI |
$174.88
|
| Rate for Payer: PHP Commercial |
$244.83
|
| Rate for Payer: PHP Commercial |
$244.83
|
| Rate for Payer: PHP Medicare Advantage |
$174.88
|
| Rate for Payer: PHP Medicare Advantage |
$174.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$238.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$238.35
|
| Rate for Payer: Priority Health Medicare |
$174.88
|
| Rate for Payer: Priority Health Medicare |
$174.88
|
| Rate for Payer: Priority Health SBD |
$238.35
|
| Rate for Payer: Priority Health SBD |
$238.35
|
| Rate for Payer: Priority Health Tiered Network |
$238.35
|
| Rate for Payer: Priority Health Tiered Network |
$238.35
|
| Rate for Payer: Railroad Medicare Medicare |
$174.88
|
| Rate for Payer: Railroad Medicare Medicare |
$174.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.53
|
| Rate for Payer: UHC Core |
$298.53
|
| Rate for Payer: UHC Core |
$298.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.88
|
| Rate for Payer: UHC Exchange |
$298.53
|
| Rate for Payer: UHC Exchange |
$298.53
|
| Rate for Payer: UMR Bronson Commercial |
$180.32
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$666.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$208.77 |
| Max. Negotiated Rate |
$499.50 |
| Rate for Payer: Aetna Commercial |
$279.75
|
| Rate for Payer: Aetna Commercial |
$279.75
|
| Rate for Payer: Aetna Medicare |
$217.12
|
| Rate for Payer: Aetna Medicare |
$217.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.75
|
| Rate for Payer: BCBS MAPPO |
$208.77
|
| Rate for Payer: BCBS MAPPO |
$208.77
|
| Rate for Payer: BCN Commercial |
$310.24
|
| Rate for Payer: BCN Commercial |
$310.24
|
| Rate for Payer: BCN Medicare Advantage |
$208.77
|
| Rate for Payer: BCN Medicare Advantage |
$208.77
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cofinity Commercial |
$300.63
|
| Rate for Payer: Cofinity Commercial |
$300.63
|
| Rate for Payer: Cofinity Commercial |
$279.75
|
| Rate for Payer: Cofinity Commercial |
$279.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.65
|
| Rate for Payer: Nomi Health Commercial |
$250.52
|
| Rate for Payer: Nomi Health Commercial |
$250.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$499.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$350.25
|
| Rate for Payer: PACE SWMI |
$208.77
|
| Rate for Payer: PACE SWMI |
$208.77
|
| Rate for Payer: PHP Commercial |
$292.28
|
| Rate for Payer: PHP Commercial |
$292.28
|
| Rate for Payer: PHP Medicare Advantage |
$208.77
|
| Rate for Payer: PHP Medicare Advantage |
$208.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$286.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$286.11
|
| Rate for Payer: Priority Health Medicare |
$208.77
|
| Rate for Payer: Priority Health Medicare |
$208.77
|
| Rate for Payer: Priority Health SBD |
$286.11
|
| Rate for Payer: Priority Health SBD |
$286.11
|
| Rate for Payer: Priority Health Tiered Network |
$286.11
|
| Rate for Payer: Priority Health Tiered Network |
$286.11
|
| Rate for Payer: Railroad Medicare Medicare |
$208.77
|
| Rate for Payer: Railroad Medicare Medicare |
$208.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.87
|
| Rate for Payer: UHC Core |
$357.87
|
| Rate for Payer: UHC Core |
$357.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$208.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$208.77
|
| Rate for Payer: UHC Exchange |
$357.87
|
| Rate for Payer: UHC Exchange |
$357.87
|
| Rate for Payer: UMR Bronson Commercial |
$214.82
|
| Rate for Payer: UMR Bronson Commercial |
$306.36
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$1,845.37 |
| Rate for Payer: Aetna Commercial |
$1,259.57
|
| Rate for Payer: Aetna Medicare |
$977.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,353.57
|
| Rate for Payer: BCBS Complete |
$639.42
|
| Rate for Payer: BCBS MAPPO |
$939.98
|
| Rate for Payer: BCN Commercial |
$1,585.08
|
| Rate for Payer: BCN Medicare Advantage |
$939.98
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cofinity Commercial |
$1,259.57
|
| Rate for Payer: Cofinity Commercial |
$1,353.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$939.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$986.98
|
| Rate for Payer: Meridian Medicaid |
$639.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,127.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.25
|
| Rate for Payer: PACE SWMI |
$939.98
|
| Rate for Payer: PHP Commercial |
$1,315.97
|
| Rate for Payer: PHP Medicare Advantage |
$939.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,841.03
|
| Rate for Payer: Priority Health Medicare |
$939.98
|
| Rate for Payer: Priority Health SBD |
$1,841.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,841.03
|
| Rate for Payer: Railroad Medicare Medicare |
$939.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,845.37
|
| Rate for Payer: UHC Core |
$1,845.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$939.98
|
| Rate for Payer: UHC Exchange |
$1,845.37
|
| Rate for Payer: UHC Medicaid |
$608.97
|
| Rate for Payer: UHCCP Medicaid |
$608.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.06
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG >4 CM
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 64893
|
| Min. Negotiated Rate |
$648.16 |
| Max. Negotiated Rate |
$1,969.89 |
| Rate for Payer: Aetna Commercial |
$1,341.37
|
| Rate for Payer: Aetna Medicare |
$1,041.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,441.47
|
| Rate for Payer: BCBS Complete |
$680.57
|
| Rate for Payer: BCBS MAPPO |
$1,001.02
|
| Rate for Payer: BCN Commercial |
$1,690.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,001.02
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,341.37
|
| Rate for Payer: Cofinity Commercial |
$1,441.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,051.07
|
| Rate for Payer: Meridian Medicaid |
$680.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,101.12
|
| Rate for Payer: Nomi Health Commercial |
$1,201.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$1,001.02
|
| Rate for Payer: PHP Commercial |
$1,401.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,001.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,963.07
|
| Rate for Payer: Priority Health Medicare |
$1,001.02
|
| Rate for Payer: Priority Health SBD |
$1,963.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,963.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,001.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,969.89
|
| Rate for Payer: UHC Core |
$1,969.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,001.02
|
| Rate for Payer: UHC Exchange |
$1,969.89
|
| Rate for Payer: UHC Medicaid |
$648.16
|
| Rate for Payer: UHCCP Medicaid |
$648.16
|
| Rate for Payer: UMR Bronson Commercial |
$821.56
|
|
|
PR NERVE GRAFT 1 STRAND HAND/FOOT <4 CM
|
Professional
|
Both
|
$3,822.00
|
|
|
Service Code
|
HCPCS 64890
|
| Min. Negotiated Rate |
$624.73 |
| Max. Negotiated Rate |
$2,866.50 |
| Rate for Payer: Aetna Commercial |
$1,292.74
|
| Rate for Payer: Aetna Medicare |
$1,003.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.21
|
| Rate for Payer: BCBS Complete |
$655.97
|
| Rate for Payer: BCBS MAPPO |
$964.73
|
| Rate for Payer: BCN Commercial |
$1,628.89
|
| Rate for Payer: BCN Medicare Advantage |
$964.73
|
| Rate for Payer: Cash Price |
$3,057.60
|
| Rate for Payer: Cash Price |
$3,057.60
|
| Rate for Payer: Cofinity Commercial |
$1,292.74
|
| Rate for Payer: Cofinity Commercial |
$1,389.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.97
|
| Rate for Payer: Meridian Medicaid |
$655.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,061.20
|
| Rate for Payer: Nomi Health Commercial |
$1,157.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,866.50
|
| Rate for Payer: PACE SWMI |
$964.73
|
| Rate for Payer: PHP Commercial |
$1,350.62
|
| Rate for Payer: PHP Medicare Advantage |
$964.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,891.92
|
| Rate for Payer: Priority Health Medicare |
$964.73
|
| Rate for Payer: Priority Health SBD |
$1,891.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,891.92
|
| Rate for Payer: Railroad Medicare Medicare |
$964.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.67
|
| Rate for Payer: UHC Core |
$1,898.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$964.73
|
| Rate for Payer: UHC Exchange |
$1,898.67
|
| Rate for Payer: UHC Medicaid |
$624.73
|
| Rate for Payer: UHCCP Medicaid |
$624.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,758.12
|
|
|
PR NERVE GRAFT EACH NERVE MULTIPLE STRANDS
|
Professional
|
Both
|
$3,032.00
|
|
|
Service Code
|
HCPCS 64902
|
| Min. Negotiated Rate |
$375.73 |
| Max. Negotiated Rate |
$2,274.00 |
| Rate for Payer: Aetna Commercial |
$789.43
|
| Rate for Payer: Aetna Medicare |
$612.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.35
|
| Rate for Payer: BCBS Complete |
$394.52
|
| Rate for Payer: BCBS MAPPO |
$589.13
|
| Rate for Payer: BCN Commercial |
$1,019.86
|
| Rate for Payer: BCN Medicare Advantage |
$589.13
|
| Rate for Payer: Cash Price |
$2,425.60
|
| Rate for Payer: Cash Price |
$2,425.60
|
| Rate for Payer: Cofinity Commercial |
$789.43
|
| Rate for Payer: Cofinity Commercial |
$848.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.59
|
| Rate for Payer: Meridian Medicaid |
$394.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$648.04
|
| Rate for Payer: Nomi Health Commercial |
$706.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,274.00
|
| Rate for Payer: PACE SWMI |
$589.13
|
| Rate for Payer: PHP Commercial |
$824.78
|
| Rate for Payer: PHP Medicare Advantage |
$589.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,184.56
|
| Rate for Payer: Priority Health Medicare |
$589.13
|
| Rate for Payer: Priority Health SBD |
$1,184.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,184.56
|
| Rate for Payer: Railroad Medicare Medicare |
$589.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,229.19
|
| Rate for Payer: UHC Core |
$1,229.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$589.13
|
| Rate for Payer: UHC Exchange |
$1,229.19
|
| Rate for Payer: UHC Medicaid |
$375.73
|
| Rate for Payer: UHCCP Medicaid |
$375.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,394.72
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG <4 CM
|
Professional
|
Both
|
$2,701.00
|
|
|
Service Code
|
HCPCS 64897
|
| Min. Negotiated Rate |
$728.03 |
| Max. Negotiated Rate |
$2,231.27 |
| Rate for Payer: Aetna Commercial |
$1,509.16
|
| Rate for Payer: Aetna Medicare |
$1,171.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.79
|
| Rate for Payer: BCBS Complete |
$764.43
|
| Rate for Payer: BCBS MAPPO |
$1,126.24
|
| Rate for Payer: BCN Commercial |
$1,907.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,126.24
|
| Rate for Payer: Cash Price |
$2,160.80
|
| Rate for Payer: Cash Price |
$2,160.80
|
| Rate for Payer: Cofinity Commercial |
$1,509.16
|
| Rate for Payer: Cofinity Commercial |
$1,621.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,126.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,182.55
|
| Rate for Payer: Meridian Medicaid |
$764.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,238.86
|
| Rate for Payer: Nomi Health Commercial |
$1,351.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,025.75
|
| Rate for Payer: PACE SWMI |
$1,126.24
|
| Rate for Payer: PHP Commercial |
$1,576.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,126.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,215.83
|
| Rate for Payer: Priority Health Medicare |
$1,126.24
|
| Rate for Payer: Priority Health SBD |
$2,215.83
|
| Rate for Payer: Priority Health Tiered Network |
$2,215.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,126.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,231.27
|
| Rate for Payer: UHC Core |
$2,231.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,126.24
|
| Rate for Payer: UHC Exchange |
$2,231.27
|
| Rate for Payer: UHC Medicaid |
$728.03
|
| Rate for Payer: UHCCP Medicaid |
$728.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,242.46
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG >4 CM
|
Professional
|
Both
|
$3,287.00
|
|
|
Service Code
|
HCPCS 64898
|
| Min. Negotiated Rate |
$788.53 |
| Max. Negotiated Rate |
$2,465.25 |
| Rate for Payer: Aetna Commercial |
$1,634.34
|
| Rate for Payer: Aetna Medicare |
$1,268.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,756.31
|
| Rate for Payer: BCBS Complete |
$827.96
|
| Rate for Payer: BCBS MAPPO |
$1,219.66
|
| Rate for Payer: BCN Commercial |
$2,066.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,219.66
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Cofinity Commercial |
$1,634.34
|
| Rate for Payer: Cofinity Commercial |
$1,756.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,219.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,280.64
|
| Rate for Payer: Meridian Medicaid |
$827.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,341.63
|
| Rate for Payer: Nomi Health Commercial |
$1,463.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,465.25
|
| Rate for Payer: PACE SWMI |
$1,219.66
|
| Rate for Payer: PHP Commercial |
$1,707.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,219.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,399.77
|
| Rate for Payer: Priority Health Medicare |
$1,219.66
|
| Rate for Payer: Priority Health SBD |
$2,399.77
|
| Rate for Payer: Priority Health Tiered Network |
$2,399.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,219.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,416.11
|
| Rate for Payer: UHC Core |
$2,416.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,219.66
|
| Rate for Payer: UHC Exchange |
$2,416.11
|
| Rate for Payer: UHC Medicaid |
$788.53
|
| Rate for Payer: UHCCP Medicaid |
$788.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,512.02
|
|
|
PR NERVE GRAFT MLT STRANDS HAND/FOOT <4 CM
|
Professional
|
Both
|
$3,311.00
|
|
|
Service Code
|
HCPCS 64895
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$2,483.25 |
| Rate for Payer: Aetna Commercial |
$1,576.71
|
| Rate for Payer: Aetna Medicare |
$1,223.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.38
|
| Rate for Payer: BCBS Complete |
$798.21
|
| Rate for Payer: BCBS MAPPO |
$1,176.65
|
| Rate for Payer: BCN Commercial |
$1,994.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,176.65
|
| Rate for Payer: Cash Price |
$2,648.80
|
| Rate for Payer: Cash Price |
$2,648.80
|
| Rate for Payer: Cofinity Commercial |
$1,576.71
|
| Rate for Payer: Cofinity Commercial |
$1,694.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,176.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,235.48
|
| Rate for Payer: Meridian Medicaid |
$798.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,294.32
|
| Rate for Payer: Nomi Health Commercial |
$1,411.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,483.25
|
| Rate for Payer: PACE SWMI |
$1,176.65
|
| Rate for Payer: PHP Commercial |
$1,647.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,176.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$760.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,316.48
|
| Rate for Payer: Priority Health Medicare |
$1,176.65
|
| Rate for Payer: Priority Health SBD |
$2,316.48
|
| Rate for Payer: Priority Health Tiered Network |
$2,316.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,176.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,336.54
|
| Rate for Payer: UHC Core |
$2,336.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,176.65
|
| Rate for Payer: UHC Exchange |
$2,336.54
|
| Rate for Payer: UHC Medicaid |
$760.20
|
| Rate for Payer: UHCCP Medicaid |
$760.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,523.06
|
|
|
PR NERVE PEDICLE TRANSFER FIRST STAGE
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 64905
|
| Min. Negotiated Rate |
$568.50 |
| Max. Negotiated Rate |
$1,791.43 |
| Rate for Payer: Aetna Commercial |
$1,177.48
|
| Rate for Payer: Aetna Medicare |
$913.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.36
|
| Rate for Payer: BCBS Complete |
$596.92
|
| Rate for Payer: BCBS MAPPO |
$878.72
|
| Rate for Payer: BCN Commercial |
$1,499.42
|
| Rate for Payer: BCN Medicare Advantage |
$878.72
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cofinity Commercial |
$1,177.48
|
| Rate for Payer: Cofinity Commercial |
$1,265.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.66
|
| Rate for Payer: Meridian Medicaid |
$596.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.59
|
| Rate for Payer: Nomi Health Commercial |
$1,054.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,720.50
|
| Rate for Payer: PACE SWMI |
$878.72
|
| Rate for Payer: PHP Commercial |
$1,230.21
|
| Rate for Payer: PHP Medicare Advantage |
$878.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,741.54
|
| Rate for Payer: Priority Health Medicare |
$878.72
|
| Rate for Payer: Priority Health SBD |
$1,741.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,741.54
|
| Rate for Payer: Railroad Medicare Medicare |
$878.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,791.43
|
| Rate for Payer: UHC Core |
$1,791.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$878.72
|
| Rate for Payer: UHC Exchange |
$1,791.43
|
| Rate for Payer: UHC Medicaid |
$568.50
|
| Rate for Payer: UHCCP Medicaid |
$568.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.24
|
|
|
PR NERVE REPAIR W/CONDUIT EACH NERVE
|
Professional
|
Both
|
$2,700.00
|
|
|
Service Code
|
HCPCS 64910
|
| Min. Negotiated Rate |
$444.53 |
| Max. Negotiated Rate |
$2,025.00 |
| Rate for Payer: Aetna Commercial |
$909.78
|
| Rate for Payer: Aetna Medicare |
$706.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.67
|
| Rate for Payer: BCBS Complete |
$466.76
|
| Rate for Payer: BCBS MAPPO |
$678.94
|
| Rate for Payer: BCN Commercial |
$1,152.33
|
| Rate for Payer: BCN Medicare Advantage |
$678.94
|
| Rate for Payer: Cash Price |
$2,160.00
|
| Rate for Payer: Cash Price |
$2,160.00
|
| Rate for Payer: Cofinity Commercial |
$909.78
|
| Rate for Payer: Cofinity Commercial |
$977.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.89
|
| Rate for Payer: Meridian Medicaid |
$466.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.83
|
| Rate for Payer: Nomi Health Commercial |
$814.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,025.00
|
| Rate for Payer: PACE SWMI |
$678.94
|
| Rate for Payer: PHP Commercial |
$950.52
|
| Rate for Payer: PHP Medicare Advantage |
$678.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,338.41
|
| Rate for Payer: Priority Health Medicare |
$678.94
|
| Rate for Payer: Priority Health SBD |
$1,338.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,338.41
|
| Rate for Payer: Railroad Medicare Medicare |
$678.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,371.57
|
| Rate for Payer: UHC Core |
$1,371.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$678.94
|
| Rate for Payer: UHC Exchange |
$1,371.57
|
| Rate for Payer: UHC Medicaid |
$444.53
|
| Rate for Payer: UHCCP Medicaid |
$444.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,242.00
|
|
