|
PR ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$1,544.00
|
|
|
Service Code
|
HCPCS 54650
|
| Min. Negotiated Rate |
$413.22 |
| Max. Negotiated Rate |
$1,254.38 |
| Rate for Payer: Aetna Commercial |
$854.68
|
| Rate for Payer: Aetna Medicare |
$663.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$854.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.46
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$637.82
|
| Rate for Payer: BCN Commercial |
$1,069.16
|
| Rate for Payer: BCN Medicare Advantage |
$637.82
|
| Rate for Payer: Cash Price |
$1,235.20
|
| Rate for Payer: Cash Price |
$1,235.20
|
| Rate for Payer: Cofinity Commercial |
$854.68
|
| Rate for Payer: Cofinity Commercial |
$918.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.71
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$701.60
|
| Rate for Payer: Nomi Health Commercial |
$765.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.00
|
| Rate for Payer: PACE SWMI |
$637.82
|
| Rate for Payer: PHP Commercial |
$892.95
|
| Rate for Payer: PHP Medicare Advantage |
$637.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,164.67
|
| Rate for Payer: Priority Health Medicare |
$637.82
|
| Rate for Payer: Priority Health SBD |
$1,164.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,164.67
|
| Rate for Payer: Railroad Medicare Medicare |
$637.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,254.38
|
| Rate for Payer: UHC Core |
$1,254.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$637.82
|
| Rate for Payer: UHC Exchange |
$1,254.38
|
| Rate for Payer: UHC Medicaid |
$413.22
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
| Rate for Payer: UMR Bronson Commercial |
$710.24
|
|
|
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH
|
Professional
|
Both
|
$1,809.00
|
|
|
Service Code
|
HCPCS 54640
|
| Min. Negotiated Rate |
$251.13 |
| Max. Negotiated Rate |
$1,356.75 |
| Rate for Payer: Aetna Commercial |
$521.29
|
| Rate for Payer: Aetna Medicare |
$404.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.19
|
| Rate for Payer: BCBS Complete |
$263.69
|
| Rate for Payer: BCBS MAPPO |
$389.02
|
| Rate for Payer: BCN Commercial |
$650.37
|
| Rate for Payer: BCN Medicare Advantage |
$389.02
|
| Rate for Payer: Cash Price |
$1,447.20
|
| Rate for Payer: Cash Price |
$1,447.20
|
| Rate for Payer: Cofinity Commercial |
$521.29
|
| Rate for Payer: Cofinity Commercial |
$560.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.47
|
| Rate for Payer: Meridian Medicaid |
$263.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$427.92
|
| Rate for Payer: Nomi Health Commercial |
$466.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,356.75
|
| Rate for Payer: PACE SWMI |
$389.02
|
| Rate for Payer: PHP Commercial |
$544.63
|
| Rate for Payer: PHP Medicare Advantage |
$389.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$708.46
|
| Rate for Payer: Priority Health Medicare |
$389.02
|
| Rate for Payer: Priority Health SBD |
$708.46
|
| Rate for Payer: Priority Health Tiered Network |
$708.46
|
| Rate for Payer: Railroad Medicare Medicare |
$389.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$767.43
|
| Rate for Payer: UHC Core |
$767.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$389.02
|
| Rate for Payer: UHC Exchange |
$767.43
|
| Rate for Payer: UHC Medicaid |
$251.13
|
| Rate for Payer: UHCCP Medicaid |
$251.13
|
| Rate for Payer: UMR Bronson Commercial |
$832.14
|
|
|
PR ORPHENADRINE INJECTION
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS J2360
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$23.25 |
| Rate for Payer: Aetna Commercial |
$11.01
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.84
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.31
|
| Rate for Payer: BCN Commercial |
$10.25
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$11.01
|
| Rate for Payer: Cofinity Commercial |
$11.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.04
|
| Rate for Payer: Nomi Health Commercial |
$9.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$11.51
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Medicare |
$8.22
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.39
|
| Rate for Payer: UHC Core |
$6.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.22
|
| Rate for Payer: UHC Exchange |
$6.39
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 97760
|
| Min. Negotiated Rate |
$34.04 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$58.44
|
| Rate for Payer: Aetna Medicare |
$45.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.44
|
| Rate for Payer: BCBS MAPPO |
$43.61
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$43.61
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$62.80
|
| Rate for Payer: Cofinity Commercial |
$58.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.97
|
| Rate for Payer: Nomi Health Commercial |
$52.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.50
|
| Rate for Payer: PACE SWMI |
$43.61
|
| Rate for Payer: PHP Commercial |
$61.05
|
| Rate for Payer: PHP Medicare Advantage |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$43.61
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$43.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.05
|
| Rate for Payer: UHC Core |
$43.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.61
|
| Rate for Payer: UHC Exchange |
$43.05
|
| Rate for Payer: UMR Bronson Commercial |
$34.04
|
|
|
PR ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 97763
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$63.26
|
| Rate for Payer: Aetna Medicare |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.26
|
| Rate for Payer: BCBS MAPPO |
$47.21
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$47.21
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$67.98
|
| Rate for Payer: Cofinity Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.93
|
| Rate for Payer: Nomi Health Commercial |
$56.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.75
|
| Rate for Payer: PACE SWMI |
$47.21
|
| Rate for Payer: PHP Commercial |
$66.09
|
| Rate for Payer: PHP Medicare Advantage |
$47.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$47.21
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$47.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.96
|
| Rate for Payer: UHC Core |
$45.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.21
|
| Rate for Payer: UHC Exchange |
$45.96
|
| Rate for Payer: UMR Bronson Commercial |
$50.14
|
|
|
PR ORTHOVISC INJ PER DOSE
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS J7324
|
| Min. Negotiated Rate |
$89.70 |
| Max. Negotiated Rate |
$157.09 |
| Rate for Payer: Aetna Commercial |
$146.18
|
| Rate for Payer: Aetna Medicare |
$113.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.09
|
| Rate for Payer: BCBS MAPPO |
$109.09
|
| Rate for Payer: BCBS Trust/PPO |
$113.35
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: BCN Medicare Advantage |
$109.09
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$146.18
|
| Rate for Payer: Cofinity Commercial |
$157.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.00
|
| Rate for Payer: Nomi Health Commercial |
$130.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.25
|
| Rate for Payer: PACE SWMI |
$109.09
|
| Rate for Payer: PHP Commercial |
$152.73
|
| Rate for Payer: PHP Medicare Advantage |
$109.09
|
| Rate for Payer: Priority Health Medicare |
$109.09
|
| Rate for Payer: Railroad Medicare Medicare |
$109.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.26
|
| Rate for Payer: UHC Core |
$111.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.09
|
| Rate for Payer: UHC Exchange |
$111.26
|
| Rate for Payer: UMR Bronson Commercial |
$89.70
|
|
|
PROSTATECTOMY PROCEDURES
|
Facility
|
IP
|
$7,552.64
|
|
|
Service Code
|
APR-DRG 4851
|
| Min. Negotiated Rate |
$7,192.99 |
| Max. Negotiated Rate |
$7,552.64 |
| Rate for Payer: BCBS Complete |
$7,552.64
|
| Rate for Payer: Mclaren Medicaid |
$7,192.99
|
| Rate for Payer: Meridian Medicaid |
$7,552.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,192.99
|
| Rate for Payer: UHC Medicaid |
$7,192.99
|
| Rate for Payer: UHCCP Medicaid |
$7,192.99
|
|
|
PROSTATECTOMY PROCEDURES
|
Facility
|
IP
|
$8,833.51
|
|
|
Service Code
|
APR-DRG 4852
|
| Min. Negotiated Rate |
$8,412.86 |
| Max. Negotiated Rate |
$8,833.51 |
| Rate for Payer: BCBS Complete |
$8,833.51
|
| Rate for Payer: Mclaren Medicaid |
$8,412.86
|
| Rate for Payer: Meridian Medicaid |
$8,833.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,412.86
|
| Rate for Payer: UHC Medicaid |
$8,412.86
|
| Rate for Payer: UHCCP Medicaid |
$8,412.86
|
|
|
PROSTATECTOMY PROCEDURES
|
Facility
|
IP
|
$14,033.25
|
|
|
Service Code
|
APR-DRG 4853
|
| Min. Negotiated Rate |
$13,365.00 |
| Max. Negotiated Rate |
$14,033.25 |
| Rate for Payer: BCBS Complete |
$14,033.25
|
| Rate for Payer: Mclaren Medicaid |
$13,365.00
|
| Rate for Payer: Meridian Medicaid |
$14,033.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,365.00
|
| Rate for Payer: UHC Medicaid |
$13,365.00
|
| Rate for Payer: UHCCP Medicaid |
$13,365.00
|
|
|
PROSTATECTOMY PROCEDURES
|
Facility
|
IP
|
$19,760.23
|
|
|
Service Code
|
APR-DRG 4854
|
| Min. Negotiated Rate |
$18,819.27 |
| Max. Negotiated Rate |
$19,760.23 |
| Rate for Payer: BCBS Complete |
$19,760.23
|
| Rate for Payer: Mclaren Medicaid |
$18,819.27
|
| Rate for Payer: Meridian Medicaid |
$19,760.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,819.27
|
| Rate for Payer: UHC Medicaid |
$18,819.27
|
| Rate for Payer: UHCCP Medicaid |
$18,819.27
|
|
|
PROSTATECTOMY WITH CC
|
Facility
|
IP
|
$31,373.75
|
|
|
Service Code
|
MSDRG 666
|
| Min. Negotiated Rate |
$14,460.74 |
| Max. Negotiated Rate |
$31,373.75 |
| Rate for Payer: Aetna Medicare |
$15,830.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,027.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,027.29
|
| Rate for Payer: BCBS MAPPO |
$15,221.83
|
| Rate for Payer: BCBS Trust/PPO |
$31,373.75
|
| Rate for Payer: BCN Commercial |
$31,373.75
|
| Rate for Payer: BCN Medicare Advantage |
$15,221.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,221.83
|
| Rate for Payer: Mclaren Medicare |
$15,221.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,982.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,505.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,744.01
|
| Rate for Payer: Nomi Health Commercial |
$22,565.97
|
| Rate for Payer: PACE Medicare |
$14,460.74
|
| Rate for Payer: PACE SWMI |
$15,221.83
|
| Rate for Payer: PHP Medicare Advantage |
$15,221.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,202.46
|
| Rate for Payer: Priority Health Medicare |
$15,221.83
|
| Rate for Payer: Priority Health Tiered Network |
$22,561.96
|
| Rate for Payer: Railroad Medicare Medicare |
$15,221.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,513.59
|
| Rate for Payer: UHC Core |
$23,855.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,221.83
|
| Rate for Payer: UHC Exchange |
$19,481.95
|
| Rate for Payer: VA VA |
$15,221.83
|
|
|
PROSTATECTOMY WITH MCC
|
Facility
|
IP
|
$59,950.24
|
|
|
Service Code
|
MSDRG 665
|
| Min. Negotiated Rate |
$25,359.87 |
| Max. Negotiated Rate |
$59,950.24 |
| Rate for Payer: Aetna Medicare |
$27,762.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,368.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,368.25
|
| Rate for Payer: BCBS MAPPO |
$26,694.60
|
| Rate for Payer: BCBS Trust/PPO |
$59,950.24
|
| Rate for Payer: BCN Commercial |
$59,950.24
|
| Rate for Payer: BCN Medicare Advantage |
$26,694.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,694.60
|
| Rate for Payer: Mclaren Medicare |
$26,694.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,029.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,698.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$29,364.06
|
| Rate for Payer: Nomi Health Commercial |
$40,263.48
|
| Rate for Payer: PACE Medicare |
$25,359.87
|
| Rate for Payer: PACE SWMI |
$26,694.60
|
| Rate for Payer: PHP Medicare Advantage |
$26,694.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50,320.42
|
| Rate for Payer: Priority Health Medicare |
$26,694.60
|
| Rate for Payer: Priority Health Tiered Network |
$40,256.33
|
| Rate for Payer: Railroad Medicare Medicare |
$26,694.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,875.56
|
| Rate for Payer: UHC Core |
$42,563.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,694.60
|
| Rate for Payer: UHC Exchange |
$34,760.80
|
| Rate for Payer: VA VA |
$26,694.60
|
|
|
PROSTATECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$19,174.52
|
|
|
Service Code
|
MSDRG 667
|
| Min. Negotiated Rate |
$9,351.58 |
| Max. Negotiated Rate |
$19,174.52 |
| Rate for Payer: Aetna Medicare |
$10,237.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,304.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,304.71
|
| Rate for Payer: BCBS MAPPO |
$9,843.77
|
| Rate for Payer: BCBS Trust/PPO |
$19,174.52
|
| Rate for Payer: BCN Commercial |
$19,174.52
|
| Rate for Payer: BCN Medicare Advantage |
$9,843.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,843.77
|
| Rate for Payer: Mclaren Medicare |
$9,843.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,335.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,320.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,828.15
|
| Rate for Payer: Nomi Health Commercial |
$14,269.98
|
| Rate for Payer: PACE Medicare |
$9,351.58
|
| Rate for Payer: PACE SWMI |
$9,843.77
|
| Rate for Payer: PHP Medicare Advantage |
$9,843.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,834.31
|
| Rate for Payer: Priority Health Medicare |
$9,843.77
|
| Rate for Payer: Priority Health Tiered Network |
$14,267.45
|
| Rate for Payer: Railroad Medicare Medicare |
$9,843.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,031.06
|
| Rate for Payer: UHC Core |
$15,085.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,843.77
|
| Rate for Payer: UHC Exchange |
$12,319.75
|
| Rate for Payer: VA VA |
$9,843.77
|
|
|
PR OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 28114
|
| Min. Negotiated Rate |
$508.64 |
| Max. Negotiated Rate |
$1,497.00 |
| Rate for Payer: Aetna Commercial |
$1,037.71
|
| Rate for Payer: Aetna Medicare |
$805.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,037.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.15
|
| Rate for Payer: BCBS Complete |
$534.07
|
| Rate for Payer: BCBS MAPPO |
$774.41
|
| Rate for Payer: BCN Commercial |
$1,274.84
|
| Rate for Payer: BCN Medicare Advantage |
$774.41
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$1,037.71
|
| Rate for Payer: Cofinity Commercial |
$1,115.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$813.13
|
| Rate for Payer: Meridian Medicaid |
$534.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$851.85
|
| Rate for Payer: Nomi Health Commercial |
$929.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$774.41
|
| Rate for Payer: PHP Commercial |
$1,084.17
|
| Rate for Payer: PHP Medicare Advantage |
$774.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,362.76
|
| Rate for Payer: Priority Health Medicare |
$774.41
|
| Rate for Payer: Priority Health SBD |
$1,362.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,362.76
|
| Rate for Payer: Railroad Medicare Medicare |
$774.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,441.50
|
| Rate for Payer: UHC Core |
$1,441.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$774.41
|
| Rate for Payer: UHC Exchange |
$1,441.50
|
| Rate for Payer: UHC Medicaid |
$508.64
|
| Rate for Payer: UHCCP Medicaid |
$508.64
|
| Rate for Payer: UMR Bronson Commercial |
$918.16
|
|
|
PR OSTC PRTL EXOSTC/CONDYLC METAR HEAD
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 28288
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$763.50 |
| Rate for Payer: Aetna Commercial |
$539.00
|
| Rate for Payer: Aetna Medicare |
$418.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.23
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$402.24
|
| Rate for Payer: BCN Commercial |
$661.82
|
| Rate for Payer: BCN Medicare Advantage |
$402.24
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cofinity Commercial |
$539.00
|
| Rate for Payer: Cofinity Commercial |
$579.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.35
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$442.46
|
| Rate for Payer: Nomi Health Commercial |
$482.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$763.50
|
| Rate for Payer: PACE SWMI |
$402.24
|
| Rate for Payer: PHP Commercial |
$563.14
|
| Rate for Payer: PHP Medicare Advantage |
$402.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$707.46
|
| Rate for Payer: Priority Health Medicare |
$402.24
|
| Rate for Payer: Priority Health SBD |
$707.46
|
| Rate for Payer: Priority Health Tiered Network |
$707.46
|
| Rate for Payer: Railroad Medicare Medicare |
$402.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.44
|
| Rate for Payer: UHC Core |
$751.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$402.24
|
| Rate for Payer: UHC Exchange |
$751.44
|
| Rate for Payer: UHC Medicaid |
$265.61
|
| Rate for Payer: UHCCP Medicaid |
$265.61
|
| Rate for Payer: UMR Bronson Commercial |
$468.28
|
|
|
PR OSTECTOMY CALCANEUS
|
Professional
|
Both
|
$1,060.00
|
|
|
Service Code
|
HCPCS 28118
|
| Min. Negotiated Rate |
$258.80 |
| Max. Negotiated Rate |
$795.00 |
| Rate for Payer: Aetna Commercial |
$528.09
|
| Rate for Payer: Aetna Medicare |
$409.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.50
|
| Rate for Payer: BCBS Complete |
$271.74
|
| Rate for Payer: BCBS MAPPO |
$394.10
|
| Rate for Payer: BCN Commercial |
$646.37
|
| Rate for Payer: BCN Medicare Advantage |
$394.10
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cofinity Commercial |
$528.09
|
| Rate for Payer: Cofinity Commercial |
$567.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.81
|
| Rate for Payer: Meridian Medicaid |
$271.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.51
|
| Rate for Payer: Nomi Health Commercial |
$472.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$795.00
|
| Rate for Payer: PACE SWMI |
$394.10
|
| Rate for Payer: PHP Commercial |
$551.74
|
| Rate for Payer: PHP Medicare Advantage |
$394.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$690.97
|
| Rate for Payer: Priority Health Medicare |
$394.10
|
| Rate for Payer: Priority Health SBD |
$690.97
|
| Rate for Payer: Priority Health Tiered Network |
$690.97
|
| Rate for Payer: Railroad Medicare Medicare |
$394.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.68
|
| Rate for Payer: UHC Core |
$728.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$394.10
|
| Rate for Payer: UHC Exchange |
$728.68
|
| Rate for Payer: UHC Medicaid |
$258.80
|
| Rate for Payer: UHCCP Medicaid |
$258.80
|
| Rate for Payer: UMR Bronson Commercial |
$487.60
|
|
|
PR OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 28119
|
| Min. Negotiated Rate |
$220.67 |
| Max. Negotiated Rate |
$944.25 |
| Rate for Payer: Aetna Commercial |
$450.15
|
| Rate for Payer: Aetna Medicare |
$349.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.74
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS MAPPO |
$335.93
|
| Rate for Payer: BCN Commercial |
$554.25
|
| Rate for Payer: BCN Medicare Advantage |
$335.93
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cofinity Commercial |
$450.15
|
| Rate for Payer: Cofinity Commercial |
$483.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.73
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$369.52
|
| Rate for Payer: Nomi Health Commercial |
$403.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.25
|
| Rate for Payer: PACE SWMI |
$335.93
|
| Rate for Payer: PHP Commercial |
$470.30
|
| Rate for Payer: PHP Medicare Advantage |
$335.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$592.49
|
| Rate for Payer: Priority Health Medicare |
$335.93
|
| Rate for Payer: Priority Health SBD |
$592.49
|
| Rate for Payer: Priority Health Tiered Network |
$592.49
|
| Rate for Payer: Railroad Medicare Medicare |
$335.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.51
|
| Rate for Payer: UHC Core |
$629.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$335.93
|
| Rate for Payer: UHC Exchange |
$629.51
|
| Rate for Payer: UHC Medicaid |
$220.67
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
| Rate for Payer: UMR Bronson Commercial |
$579.14
|
|
|
PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Professional
|
Both
|
$856.00
|
|
|
Service Code
|
HCPCS 28111
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$642.00 |
| Rate for Payer: Aetna Commercial |
$394.68
|
| Rate for Payer: Aetna Medicare |
$306.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.14
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$294.54
|
| Rate for Payer: BCN Commercial |
$483.54
|
| Rate for Payer: BCN Medicare Advantage |
$294.54
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$394.68
|
| Rate for Payer: Cofinity Commercial |
$424.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.27
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$323.99
|
| Rate for Payer: Nomi Health Commercial |
$353.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$642.00
|
| Rate for Payer: PACE SWMI |
$294.54
|
| Rate for Payer: PHP Commercial |
$412.36
|
| Rate for Payer: PHP Medicare Advantage |
$294.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$516.88
|
| Rate for Payer: Priority Health Medicare |
$294.54
|
| Rate for Payer: Priority Health SBD |
$516.88
|
| Rate for Payer: Priority Health Tiered Network |
$516.88
|
| Rate for Payer: Railroad Medicare Medicare |
$294.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.53
|
| Rate for Payer: UHC Core |
$566.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$294.54
|
| Rate for Payer: UHC Exchange |
$566.53
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
| Rate for Payer: UMR Bronson Commercial |
$393.76
|
|
|
PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Professional
|
Both
|
$1,065.00
|
|
|
Service Code
|
HCPCS 28113
|
| Min. Negotiated Rate |
$259.22 |
| Max. Negotiated Rate |
$798.75 |
| Rate for Payer: Aetna Commercial |
$526.31
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.59
|
| Rate for Payer: BCBS Complete |
$272.18
|
| Rate for Payer: BCBS MAPPO |
$392.77
|
| Rate for Payer: BCN Commercial |
$651.85
|
| Rate for Payer: BCN Medicare Advantage |
$392.77
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Cofinity Commercial |
$565.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.41
|
| Rate for Payer: Meridian Medicaid |
$272.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$432.05
|
| Rate for Payer: Nomi Health Commercial |
$471.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$798.75
|
| Rate for Payer: PACE SWMI |
$392.77
|
| Rate for Payer: PHP Commercial |
$549.88
|
| Rate for Payer: PHP Medicare Advantage |
$392.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$696.82
|
| Rate for Payer: Priority Health Medicare |
$392.77
|
| Rate for Payer: Priority Health SBD |
$696.82
|
| Rate for Payer: Priority Health Tiered Network |
$696.82
|
| Rate for Payer: Railroad Medicare Medicare |
$392.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.62
|
| Rate for Payer: UHC Core |
$735.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$392.77
|
| Rate for Payer: UHC Exchange |
$735.62
|
| Rate for Payer: UHC Medicaid |
$259.22
|
| Rate for Payer: UHCCP Medicaid |
$259.22
|
| Rate for Payer: UMR Bronson Commercial |
$489.90
|
|
|
PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
HCPCS 28112
|
| Min. Negotiated Rate |
$189.36 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$385.57
|
| Rate for Payer: Aetna Medicare |
$299.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.35
|
| Rate for Payer: BCBS Complete |
$198.83
|
| Rate for Payer: BCBS MAPPO |
$287.74
|
| Rate for Payer: BCN Commercial |
$477.56
|
| Rate for Payer: BCN Medicare Advantage |
$287.74
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$385.57
|
| Rate for Payer: Cofinity Commercial |
$414.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.13
|
| Rate for Payer: Meridian Medicaid |
$198.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$316.51
|
| Rate for Payer: Nomi Health Commercial |
$345.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$750.00
|
| Rate for Payer: PACE SWMI |
$287.74
|
| Rate for Payer: PHP Commercial |
$402.84
|
| Rate for Payer: PHP Medicare Advantage |
$287.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$510.50
|
| Rate for Payer: Priority Health Medicare |
$287.74
|
| Rate for Payer: Priority Health SBD |
$510.50
|
| Rate for Payer: Priority Health Tiered Network |
$510.50
|
| Rate for Payer: Railroad Medicare Medicare |
$287.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$544.53
|
| Rate for Payer: UHC Core |
$544.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$287.74
|
| Rate for Payer: UHC Exchange |
$544.53
|
| Rate for Payer: UHC Medicaid |
$189.36
|
| Rate for Payer: UHCCP Medicaid |
$189.36
|
| Rate for Payer: UMR Bronson Commercial |
$460.00
|
|
|
PR OSTECTOMY PRTL 5TH METAR HEAD SPX
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 28110
|
| Min. Negotiated Rate |
$179.99 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Aetna Commercial |
$365.74
|
| Rate for Payer: Aetna Medicare |
$283.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.03
|
| Rate for Payer: BCBS Complete |
$188.99
|
| Rate for Payer: BCBS MAPPO |
$272.94
|
| Rate for Payer: BCN Commercial |
$450.17
|
| Rate for Payer: BCN Medicare Advantage |
$272.94
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$365.74
|
| Rate for Payer: Cofinity Commercial |
$393.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.59
|
| Rate for Payer: Meridian Medicaid |
$188.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.23
|
| Rate for Payer: Nomi Health Commercial |
$327.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.75
|
| Rate for Payer: PACE SWMI |
$272.94
|
| Rate for Payer: PHP Commercial |
$382.12
|
| Rate for Payer: PHP Medicare Advantage |
$272.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$481.22
|
| Rate for Payer: Priority Health Medicare |
$272.94
|
| Rate for Payer: Priority Health SBD |
$481.22
|
| Rate for Payer: Priority Health Tiered Network |
$481.22
|
| Rate for Payer: Railroad Medicare Medicare |
$272.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.57
|
| Rate for Payer: UHC Core |
$504.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.94
|
| Rate for Payer: UHC Exchange |
$504.57
|
| Rate for Payer: UHC Medicaid |
$179.99
|
| Rate for Payer: UHCCP Medicaid |
$179.99
|
| Rate for Payer: UMR Bronson Commercial |
$432.86
|
|
|
PR OSTECTOMY STERNUM PARTIAL
|
Professional
|
Both
|
$4,072.00
|
|
|
Service Code
|
HCPCS 21620
|
| Min. Negotiated Rate |
$319.07 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Aetna Commercial |
$656.41
|
| Rate for Payer: Aetna Medicare |
$509.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.40
|
| Rate for Payer: BCBS Complete |
$335.02
|
| Rate for Payer: BCBS MAPPO |
$489.86
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: BCN Medicare Advantage |
$489.86
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cofinity Commercial |
$656.41
|
| Rate for Payer: Cofinity Commercial |
$705.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.35
|
| Rate for Payer: Meridian Medicaid |
$335.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$538.85
|
| Rate for Payer: Nomi Health Commercial |
$587.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,054.00
|
| Rate for Payer: PACE SWMI |
$489.86
|
| Rate for Payer: PHP Commercial |
$685.80
|
| Rate for Payer: PHP Medicare Advantage |
$489.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$811.27
|
| Rate for Payer: Priority Health Medicare |
$489.86
|
| Rate for Payer: Priority Health SBD |
$811.27
|
| Rate for Payer: Priority Health Tiered Network |
$811.27
|
| Rate for Payer: Railroad Medicare Medicare |
$489.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.81
|
| Rate for Payer: UHC Core |
$886.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$489.86
|
| Rate for Payer: UHC Exchange |
$886.81
|
| Rate for Payer: UHC Medicaid |
$319.07
|
| Rate for Payer: UHCCP Medicaid |
$319.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,873.12
|
|
|
PR OSTECTOMY TARSAL COALITION
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 28116
|
| Min. Negotiated Rate |
$309.70 |
| Max. Negotiated Rate |
$1,111.50 |
| Rate for Payer: Aetna Commercial |
$636.19
|
| Rate for Payer: Aetna Medicare |
$493.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.67
|
| Rate for Payer: BCBS Complete |
$325.19
|
| Rate for Payer: BCBS MAPPO |
$474.77
|
| Rate for Payer: BCN Commercial |
$788.80
|
| Rate for Payer: BCN Medicare Advantage |
$474.77
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$636.19
|
| Rate for Payer: Cofinity Commercial |
$683.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.51
|
| Rate for Payer: Meridian Medicaid |
$325.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.25
|
| Rate for Payer: Nomi Health Commercial |
$569.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.50
|
| Rate for Payer: PACE SWMI |
$474.77
|
| Rate for Payer: PHP Commercial |
$664.68
|
| Rate for Payer: PHP Medicare Advantage |
$474.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$843.21
|
| Rate for Payer: Priority Health Medicare |
$474.77
|
| Rate for Payer: Priority Health SBD |
$843.21
|
| Rate for Payer: Priority Health Tiered Network |
$843.21
|
| Rate for Payer: Railroad Medicare Medicare |
$474.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.23
|
| Rate for Payer: UHC Core |
$1,009.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$474.77
|
| Rate for Payer: UHC Exchange |
$1,009.23
|
| Rate for Payer: UHC Medicaid |
$309.70
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
| Rate for Payer: UMR Bronson Commercial |
$681.72
|
|
|
PR OSTEOCHONDRAL ALLOGRAFT KNEE OPEN
|
Professional
|
Both
|
$4,712.00
|
|
|
Service Code
|
HCPCS 27415
|
| Min. Negotiated Rate |
$802.58 |
| Max. Negotiated Rate |
$3,534.00 |
| Rate for Payer: Aetna Commercial |
$1,655.78
|
| Rate for Payer: Aetna Medicare |
$1,285.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,655.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,779.35
|
| Rate for Payer: BCBS Complete |
$842.71
|
| Rate for Payer: BCBS MAPPO |
$1,235.66
|
| Rate for Payer: BCN Commercial |
$2,079.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.66
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,655.78
|
| Rate for Payer: Cofinity Commercial |
$1,779.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,297.44
|
| Rate for Payer: Meridian Medicaid |
$842.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,359.23
|
| Rate for Payer: Nomi Health Commercial |
$1,482.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,534.00
|
| Rate for Payer: PACE SWMI |
$1,235.66
|
| Rate for Payer: PHP Commercial |
$1,729.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$802.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,222.47
|
| Rate for Payer: Priority Health Medicare |
$1,235.66
|
| Rate for Payer: Priority Health SBD |
$2,222.47
|
| Rate for Payer: Priority Health Tiered Network |
$2,222.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,235.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,407.06
|
| Rate for Payer: UHC Core |
$2,407.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,235.66
|
| Rate for Payer: UHC Exchange |
$2,407.06
|
| Rate for Payer: UHC Medicaid |
$802.58
|
| Rate for Payer: UHCCP Medicaid |
$802.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,167.52
|
|
|
PR OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 27416
|
| Min. Negotiated Rate |
$575.53 |
| Max. Negotiated Rate |
$2,392.50 |
| Rate for Payer: Aetna Commercial |
$1,186.33
|
| Rate for Payer: Aetna Medicare |
$920.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,274.86
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCBS MAPPO |
$885.32
|
| Rate for Payer: BCN Commercial |
$1,489.96
|
| Rate for Payer: BCN Medicare Advantage |
$885.32
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,186.33
|
| Rate for Payer: Cofinity Commercial |
$1,274.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$885.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$929.59
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$973.85
|
| Rate for Payer: Nomi Health Commercial |
$1,062.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,392.50
|
| Rate for Payer: PACE SWMI |
$885.32
|
| Rate for Payer: PHP Commercial |
$1,239.45
|
| Rate for Payer: PHP Medicare Advantage |
$885.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,592.73
|
| Rate for Payer: Priority Health Medicare |
$885.32
|
| Rate for Payer: Priority Health SBD |
$1,592.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.73
|
| Rate for Payer: Railroad Medicare Medicare |
$885.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,718.25
|
| Rate for Payer: UHC Core |
$1,718.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$885.32
|
| Rate for Payer: UHC Exchange |
$1,718.25
|
| Rate for Payer: UHC Medicaid |
$575.53
|
| Rate for Payer: UHCCP Medicaid |
$575.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,467.40
|
|
