|
PROTEIN SUPPLEMENT ORAL
|
Facility
|
OP
|
$3.52
|
|
|
Service Code
|
NDC 43900028430
|
| Hospital Charge Code |
150950
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$3.17 |
| Rate for Payer: Aetna American Axle |
$2.29
|
| Rate for Payer: Aetna Commercial |
$2.99
|
| Rate for Payer: Aetna Medicare |
$1.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.29
|
| Rate for Payer: BCBS Complete |
$1.41
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cofinity Advantage |
$2.46
|
| Rate for Payer: Cofinity Commercial |
$3.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.82
|
| Rate for Payer: Healthscope Commercial |
$3.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.64
|
| Rate for Payer: PHP Commercial |
$2.99
|
| Rate for Payer: Priority Health SBD |
$2.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.29
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Exchange |
$1.38
|
| Rate for Payer: UMR Bronson Commercial |
$1.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.64
|
|
|
PROTEIN SUPPLEMENT ORAL
|
Facility
|
IP
|
$3.52
|
|
|
Service Code
|
NDC 43900028430
|
| Hospital Charge Code |
150950
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.55 |
| Max. Negotiated Rate |
$3.17 |
| Rate for Payer: Aetna American Axle |
$2.29
|
| Rate for Payer: Aetna Commercial |
$2.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.29
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cofinity Advantage |
$2.46
|
| Rate for Payer: Cofinity Commercial |
$3.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.82
|
| Rate for Payer: Healthscope Commercial |
$3.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.64
|
| Rate for Payer: PHP Commercial |
$2.99
|
| Rate for Payer: Priority Health SBD |
$2.22
|
| Rate for Payer: UMR Bronson Commercial |
$1.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.64
|
|
|
PR OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA
|
Professional
|
Both
|
$4,616.00
|
|
|
Service Code
|
HCPCS 61345
|
| Min. Negotiated Rate |
$1,268.84 |
| Max. Negotiated Rate |
$4,299.83 |
| Rate for Payer: Aetna Commercial |
$2,661.60
|
| Rate for Payer: Aetna Medicare |
$2,065.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,860.23
|
| Rate for Payer: BCBS Complete |
$1,332.28
|
| Rate for Payer: BCBS MAPPO |
$1,986.27
|
| Rate for Payer: BCN Commercial |
$4,299.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,986.27
|
| Rate for Payer: Cash Price |
$3,692.80
|
| Rate for Payer: Cash Price |
$3,692.80
|
| Rate for Payer: Cofinity Commercial |
$2,661.60
|
| Rate for Payer: Cofinity Commercial |
$2,860.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,986.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,085.58
|
| Rate for Payer: Meridian Medicaid |
$1,332.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,184.90
|
| Rate for Payer: Nomi Health Commercial |
$2,383.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,462.00
|
| Rate for Payer: PACE SWMI |
$1,986.27
|
| Rate for Payer: PHP Commercial |
$2,780.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,986.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,268.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,614.98
|
| Rate for Payer: Priority Health Medicare |
$1,986.27
|
| Rate for Payer: Priority Health SBD |
$3,614.98
|
| Rate for Payer: Priority Health Tiered Network |
$3,614.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,986.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,600.20
|
| Rate for Payer: UHC Core |
$3,600.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,986.27
|
| Rate for Payer: UHC Exchange |
$3,600.20
|
| Rate for Payer: UHC Medicaid |
$1,268.84
|
| Rate for Payer: UHCCP Medicaid |
$1,268.84
|
| Rate for Payer: UMR Bronson Commercial |
$2,123.36
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Aetna Commercial |
$112.63
|
| Rate for Payer: Aetna Medicare |
$87.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.03
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS MAPPO |
$84.05
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$84.05
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$112.63
|
| Rate for Payer: Cofinity Commercial |
$121.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.25
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.45
|
| Rate for Payer: Nomi Health Commercial |
$100.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$84.05
|
| Rate for Payer: PHP Commercial |
$117.67
|
| Rate for Payer: PHP Medicare Advantage |
$84.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.34
|
| Rate for Payer: Priority Health Medicare |
$84.05
|
| Rate for Payer: Priority Health SBD |
$131.34
|
| Rate for Payer: Priority Health Tiered Network |
$131.34
|
| Rate for Payer: Railroad Medicare Medicare |
$84.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.91
|
| Rate for Payer: UHC Core |
$150.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.05
|
| Rate for Payer: UHC Exchange |
$150.91
|
| Rate for Payer: UHC Medicaid |
$55.17
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$272.43 |
| Max. Negotiated Rate |
$1,221.00 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare |
$432.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.25
|
| Rate for Payer: BCBS Complete |
$286.05
|
| Rate for Payer: BCBS MAPPO |
$415.45
|
| Rate for Payer: BCN Commercial |
$711.11
|
| Rate for Payer: BCN Medicare Advantage |
$415.45
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$556.70
|
| Rate for Payer: Cofinity Commercial |
$598.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.22
|
| Rate for Payer: Meridian Medicaid |
$286.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.00
|
| Rate for Payer: Nomi Health Commercial |
$498.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,221.00
|
| Rate for Payer: PACE SWMI |
$415.45
|
| Rate for Payer: PHP Commercial |
$581.63
|
| Rate for Payer: PHP Medicare Advantage |
$415.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$702.66
|
| Rate for Payer: Priority Health Medicare |
$415.45
|
| Rate for Payer: Priority Health SBD |
$702.66
|
| Rate for Payer: Priority Health Tiered Network |
$702.66
|
| Rate for Payer: Railroad Medicare Medicare |
$415.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.44
|
| Rate for Payer: UHC Core |
$793.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$415.45
|
| Rate for Payer: UHC Exchange |
$793.44
|
| Rate for Payer: UHC Medicaid |
$272.43
|
| Rate for Payer: UHCCP Medicaid |
$272.43
|
| Rate for Payer: UMR Bronson Commercial |
$748.88
|
|
|
PR OVARIAN CYSTECTOMY UNI/BI
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 58925
|
| Min. Negotiated Rate |
$445.17 |
| Max. Negotiated Rate |
$1,842.75 |
| Rate for Payer: Aetna Commercial |
$924.53
|
| Rate for Payer: Aetna Medicare |
$717.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$993.53
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS MAPPO |
$689.95
|
| Rate for Payer: BCN Commercial |
$1,156.31
|
| Rate for Payer: BCN Medicare Advantage |
$689.95
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cofinity Commercial |
$924.53
|
| Rate for Payer: Cofinity Commercial |
$993.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$724.45
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$758.95
|
| Rate for Payer: Nomi Health Commercial |
$827.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,842.75
|
| Rate for Payer: PACE SWMI |
$689.95
|
| Rate for Payer: PHP Commercial |
$965.93
|
| Rate for Payer: PHP Medicare Advantage |
$689.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,171.10
|
| Rate for Payer: Priority Health Medicare |
$689.95
|
| Rate for Payer: Priority Health SBD |
$1,171.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,171.10
|
| Rate for Payer: Railroad Medicare Medicare |
$689.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.72
|
| Rate for Payer: UHC Core |
$1,340.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$689.95
|
| Rate for Payer: UHC Exchange |
$1,340.72
|
| Rate for Payer: UHC Medicaid |
$445.17
|
| Rate for Payer: UHCCP Medicaid |
$445.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,130.22
|
|
|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.51
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.51
|
| Rate for Payer: BCBS Trust/PPO |
$0.50
|
| Rate for Payer: BCN Commercial |
$0.50
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.50
|
| Rate for Payer: UHC Core |
$0.50
|
| Rate for Payer: UHC Exchange |
$0.50
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
|
|
PR PACKING STRIPS, NON-IMPREG
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS A6407
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna Commercial |
$3.56
|
| Rate for Payer: Aetna Medicare |
$2.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.56
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$2.66
|
| Rate for Payer: BCN Commercial |
$2.55
|
| Rate for Payer: BCN Medicare Advantage |
$2.66
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$3.56
|
| Rate for Payer: Cofinity Commercial |
$3.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.93
|
| Rate for Payer: Nomi Health Commercial |
$3.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PACE SWMI |
$2.66
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: PHP Medicare Advantage |
$2.66
|
| Rate for Payer: Priority Health Medicare |
$2.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.66
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$2.76
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,546.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$388.09 |
| Max. Negotiated Rate |
$1,909.50 |
| Rate for Payer: Aetna Commercial |
$795.12
|
| Rate for Payer: Aetna Medicare |
$617.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$854.45
|
| Rate for Payer: BCBS Complete |
$407.49
|
| Rate for Payer: BCBS MAPPO |
$593.37
|
| Rate for Payer: BCN Commercial |
$1,035.31
|
| Rate for Payer: BCN Medicare Advantage |
$593.37
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cofinity Commercial |
$795.12
|
| Rate for Payer: Cofinity Commercial |
$854.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$593.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$623.04
|
| Rate for Payer: Meridian Medicaid |
$407.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$652.71
|
| Rate for Payer: Nomi Health Commercial |
$712.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,909.50
|
| Rate for Payer: PACE SWMI |
$593.37
|
| Rate for Payer: PHP Commercial |
$830.72
|
| Rate for Payer: PHP Medicare Advantage |
$593.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,261.44
|
| Rate for Payer: Priority Health Medicare |
$593.37
|
| Rate for Payer: Priority Health SBD |
$1,261.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,261.44
|
| Rate for Payer: Railroad Medicare Medicare |
$593.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,196.84
|
| Rate for Payer: UHC Core |
$1,196.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$593.37
|
| Rate for Payer: UHC Exchange |
$1,196.84
|
| Rate for Payer: UHC Medicaid |
$388.09
|
| Rate for Payer: UHCCP Medicaid |
$388.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,171.16
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,826.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$2,507.69 |
| Max. Negotiated Rate |
$5,869.50 |
| Rate for Payer: Aetna Commercial |
$4,176.69
|
| Rate for Payer: Aetna Medicare |
$3,913.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,176.69
|
| Rate for Payer: BCN Commercial |
$2,507.69
|
| Rate for Payer: Cash Price |
$6,260.80
|
| Rate for Payer: Cash Price |
$6,260.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,869.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,682.28
|
| Rate for Payer: Priority Health SBD |
$5,682.28
|
| Rate for Payer: Priority Health Tiered Network |
$5,682.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,515.85
|
| Rate for Payer: UHC Core |
$5,515.85
|
| Rate for Payer: UHC Exchange |
$5,515.85
|
| Rate for Payer: UMR Bronson Commercial |
$3,599.96
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,550.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$993.01 |
| Max. Negotiated Rate |
$3,053.21 |
| Rate for Payer: Aetna Commercial |
$2,082.56
|
| Rate for Payer: Aetna Medicare |
$1,616.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,082.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,237.98
|
| Rate for Payer: BCBS Complete |
$1,042.66
|
| Rate for Payer: BCBS MAPPO |
$1,554.15
|
| Rate for Payer: BCN Commercial |
$2,505.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,554.15
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cofinity Commercial |
$2,237.98
|
| Rate for Payer: Cofinity Commercial |
$2,082.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,554.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,631.86
|
| Rate for Payer: Meridian Medicaid |
$1,042.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,709.57
|
| Rate for Payer: Nomi Health Commercial |
$1,864.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,662.50
|
| Rate for Payer: PACE SWMI |
$1,554.15
|
| Rate for Payer: PHP Commercial |
$2,175.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,554.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$993.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,053.21
|
| Rate for Payer: Priority Health Medicare |
$1,554.15
|
| Rate for Payer: Priority Health SBD |
$3,053.21
|
| Rate for Payer: Priority Health Tiered Network |
$3,053.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,554.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,975.77
|
| Rate for Payer: UHC Core |
$2,975.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,554.15
|
| Rate for Payer: UHC Exchange |
$2,975.77
|
| Rate for Payer: UHC Medicaid |
$993.01
|
| Rate for Payer: UHCCP Medicaid |
$993.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,633.00
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,370.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$805.78 |
| Max. Negotiated Rate |
$2,527.50 |
| Rate for Payer: Aetna Commercial |
$1,686.12
|
| Rate for Payer: Aetna Medicare |
$1,308.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,686.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.95
|
| Rate for Payer: BCBS Complete |
$846.07
|
| Rate for Payer: BCBS MAPPO |
$1,258.30
|
| Rate for Payer: BCN Commercial |
$2,024.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,258.30
|
| Rate for Payer: Cash Price |
$2,696.00
|
| Rate for Payer: Cash Price |
$2,696.00
|
| Rate for Payer: Cofinity Commercial |
$1,686.12
|
| Rate for Payer: Cofinity Commercial |
$1,811.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,258.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,321.21
|
| Rate for Payer: Meridian Medicaid |
$846.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,384.13
|
| Rate for Payer: Nomi Health Commercial |
$1,509.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,527.50
|
| Rate for Payer: PACE SWMI |
$1,258.30
|
| Rate for Payer: PHP Commercial |
$1,761.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,258.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,466.48
|
| Rate for Payer: Priority Health Medicare |
$1,258.30
|
| Rate for Payer: Priority Health SBD |
$2,466.48
|
| Rate for Payer: Priority Health Tiered Network |
$2,466.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,258.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,404.05
|
| Rate for Payer: UHC Core |
$2,404.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,258.30
|
| Rate for Payer: UHC Exchange |
$2,404.05
|
| Rate for Payer: UHC Medicaid |
$805.78
|
| Rate for Payer: UHCCP Medicaid |
$805.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,550.20
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,611.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$765.31 |
| Max. Negotiated Rate |
$2,451.21 |
| Rate for Payer: Aetna Commercial |
$1,587.36
|
| Rate for Payer: Aetna Medicare |
$1,231.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,705.82
|
| Rate for Payer: BCBS Complete |
$803.58
|
| Rate for Payer: BCBS MAPPO |
$1,184.60
|
| Rate for Payer: BCN Commercial |
$2,093.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.60
|
| Rate for Payer: Cash Price |
$2,088.80
|
| Rate for Payer: Cash Price |
$2,088.80
|
| Rate for Payer: Cofinity Commercial |
$1,587.36
|
| Rate for Payer: Cofinity Commercial |
$1,705.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.83
|
| Rate for Payer: Meridian Medicaid |
$803.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,303.06
|
| Rate for Payer: Nomi Health Commercial |
$1,421.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,958.25
|
| Rate for Payer: PACE SWMI |
$1,184.60
|
| Rate for Payer: PHP Commercial |
$1,658.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,269.53
|
| Rate for Payer: Priority Health Medicare |
$1,184.60
|
| Rate for Payer: Priority Health SBD |
$2,269.53
|
| Rate for Payer: Priority Health Tiered Network |
$2,269.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,184.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,451.21
|
| Rate for Payer: UHC Core |
$2,451.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,184.60
|
| Rate for Payer: UHC Exchange |
$2,451.21
|
| Rate for Payer: UHC Medicaid |
$765.31
|
| Rate for Payer: UHCCP Medicaid |
$765.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,201.06
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$134.62 |
| Max. Negotiated Rate |
$432.32 |
| Rate for Payer: Aetna Commercial |
$283.92
|
| Rate for Payer: Aetna Medicare |
$220.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.11
|
| Rate for Payer: BCBS Complete |
$141.35
|
| Rate for Payer: BCBS MAPPO |
$211.88
|
| Rate for Payer: BCN Commercial |
$358.05
|
| Rate for Payer: BCN Medicare Advantage |
$211.88
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$283.92
|
| Rate for Payer: Cofinity Commercial |
$305.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.47
|
| Rate for Payer: Meridian Medicaid |
$141.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.07
|
| Rate for Payer: Nomi Health Commercial |
$254.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
| Rate for Payer: PACE SWMI |
$211.88
|
| Rate for Payer: PHP Commercial |
$296.63
|
| Rate for Payer: PHP Medicare Advantage |
$211.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$388.24
|
| Rate for Payer: Priority Health Medicare |
$211.88
|
| Rate for Payer: Priority Health SBD |
$388.24
|
| Rate for Payer: Priority Health Tiered Network |
$388.24
|
| Rate for Payer: Railroad Medicare Medicare |
$211.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.32
|
| Rate for Payer: UHC Core |
$432.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.88
|
| Rate for Payer: UHC Exchange |
$432.32
|
| Rate for Payer: UHC Medicaid |
$134.62
|
| Rate for Payer: UHCCP Medicaid |
$134.62
|
| Rate for Payer: UMR Bronson Commercial |
$230.00
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$3,612.00
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$568.50 |
| Max. Negotiated Rate |
$2,709.00 |
| Rate for Payer: Aetna Commercial |
$1,182.64
|
| Rate for Payer: Aetna Medicare |
$917.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,270.90
|
| Rate for Payer: BCBS Complete |
$596.92
|
| Rate for Payer: BCBS MAPPO |
$882.57
|
| Rate for Payer: BCN Commercial |
$1,460.58
|
| Rate for Payer: BCN Medicare Advantage |
$882.57
|
| Rate for Payer: Cash Price |
$2,889.60
|
| Rate for Payer: Cash Price |
$2,889.60
|
| Rate for Payer: Cofinity Commercial |
$1,182.64
|
| Rate for Payer: Cofinity Commercial |
$1,270.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$926.70
|
| Rate for Payer: Meridian Medicaid |
$596.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$970.83
|
| Rate for Payer: Nomi Health Commercial |
$1,059.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,709.00
|
| Rate for Payer: PACE SWMI |
$882.57
|
| Rate for Payer: PHP Commercial |
$1,235.60
|
| Rate for Payer: PHP Medicare Advantage |
$882.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,583.76
|
| Rate for Payer: Priority Health Medicare |
$882.57
|
| Rate for Payer: Priority Health SBD |
$1,583.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,583.76
|
| Rate for Payer: Railroad Medicare Medicare |
$882.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.20
|
| Rate for Payer: UHC Core |
$1,707.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$882.57
|
| Rate for Payer: UHC Exchange |
$1,707.20
|
| Rate for Payer: UHC Medicaid |
$568.50
|
| Rate for Payer: UHCCP Medicaid |
$568.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,661.52
|
|
|
PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR
|
Professional
|
Both
|
$3,995.00
|
|
|
Service Code
|
HCPCS 60502
|
| Min. Negotiated Rate |
$767.01 |
| Max. Negotiated Rate |
$2,996.25 |
| Rate for Payer: Aetna Commercial |
$1,598.86
|
| Rate for Payer: Aetna Medicare |
$1,240.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,718.18
|
| Rate for Payer: BCBS Complete |
$805.36
|
| Rate for Payer: BCBS MAPPO |
$1,193.18
|
| Rate for Payer: BCN Commercial |
$1,961.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,193.18
|
| Rate for Payer: Cash Price |
$3,196.00
|
| Rate for Payer: Cash Price |
$3,196.00
|
| Rate for Payer: Cofinity Commercial |
$1,598.86
|
| Rate for Payer: Cofinity Commercial |
$1,718.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,193.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,252.84
|
| Rate for Payer: Meridian Medicaid |
$805.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,312.50
|
| Rate for Payer: Nomi Health Commercial |
$1,431.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,996.25
|
| Rate for Payer: PACE SWMI |
$1,193.18
|
| Rate for Payer: PHP Commercial |
$1,670.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,193.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$767.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,126.99
|
| Rate for Payer: Priority Health Medicare |
$1,193.18
|
| Rate for Payer: Priority Health SBD |
$2,126.99
|
| Rate for Payer: Priority Health Tiered Network |
$2,126.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,193.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,291.21
|
| Rate for Payer: UHC Core |
$2,291.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,193.18
|
| Rate for Payer: UHC Exchange |
$2,291.21
|
| Rate for Payer: UHC Medicaid |
$767.01
|
| Rate for Payer: UHCCP Medicaid |
$767.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,837.70
|
|
|
PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH
|
Professional
|
Both
|
$1,988.00
|
|
|
Service Code
|
HCPCS 57285
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$1,491.00 |
| Rate for Payer: Aetna Commercial |
$814.71
|
| Rate for Payer: Aetna Medicare |
$632.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.51
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$607.99
|
| Rate for Payer: BCN Commercial |
$1,038.79
|
| Rate for Payer: BCN Medicare Advantage |
$607.99
|
| Rate for Payer: Cash Price |
$1,590.40
|
| Rate for Payer: Cash Price |
$1,590.40
|
| Rate for Payer: Cofinity Commercial |
$814.71
|
| Rate for Payer: Cofinity Commercial |
$875.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$638.39
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$668.79
|
| Rate for Payer: Nomi Health Commercial |
$729.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.00
|
| Rate for Payer: PACE SWMI |
$607.99
|
| Rate for Payer: PHP Commercial |
$851.19
|
| Rate for Payer: PHP Medicare Advantage |
$607.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,052.07
|
| Rate for Payer: Priority Health Medicare |
$607.99
|
| Rate for Payer: Priority Health SBD |
$1,052.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,052.07
|
| Rate for Payer: Railroad Medicare Medicare |
$607.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,213.09
|
| Rate for Payer: UHC Core |
$1,213.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$607.99
|
| Rate for Payer: UHC Exchange |
$1,213.09
|
| Rate for Payer: UHC Medicaid |
$392.13
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
| Rate for Payer: UMR Bronson Commercial |
$914.48
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$88.50 |
| Rate for Payer: Aetna Commercial |
$18.37
|
| Rate for Payer: Aetna Medicare |
$14.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.74
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$13.71
|
| Rate for Payer: BCN Commercial |
$22.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.71
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Commercial |
$19.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.08
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.50
|
| Rate for Payer: PACE SWMI |
$13.71
|
| Rate for Payer: PHP Commercial |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$13.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.97
|
| Rate for Payer: Priority Health Medicare |
$13.71
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: Priority Health Tiered Network |
$20.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.45
|
| Rate for Payer: UHC Core |
$28.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.71
|
| Rate for Payer: UHC Exchange |
$28.45
|
| Rate for Payer: UHC Medicaid |
$8.73
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
| Rate for Payer: UMR Bronson Commercial |
$54.28
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$26.40
|
| Rate for Payer: Aetna Medicare |
$20.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.37
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$19.70
|
| Rate for Payer: BCN Commercial |
$32.87
|
| Rate for Payer: BCN Medicare Advantage |
$19.70
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$28.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.68
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.67
|
| Rate for Payer: Nomi Health Commercial |
$23.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$19.70
|
| Rate for Payer: PHP Commercial |
$27.58
|
| Rate for Payer: PHP Medicare Advantage |
$19.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.08
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health SBD |
$30.08
|
| Rate for Payer: Priority Health Tiered Network |
$30.08
|
| Rate for Payer: Railroad Medicare Medicare |
$19.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.43
|
| Rate for Payer: UHC Core |
$41.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.70
|
| Rate for Payer: UHC Exchange |
$41.43
|
| Rate for Payer: UHC Medicaid |
$12.57
|
| Rate for Payer: UHCCP Medicaid |
$12.57
|
| Rate for Payer: UMR Bronson Commercial |
$57.96
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$113.25 |
| Rate for Payer: Aetna Commercial |
$34.00
|
| Rate for Payer: Aetna Medicare |
$26.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.53
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$25.37
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: BCN Medicare Advantage |
$25.37
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$34.00
|
| Rate for Payer: Cofinity Commercial |
$36.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.64
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.91
|
| Rate for Payer: Nomi Health Commercial |
$30.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.25
|
| Rate for Payer: PACE SWMI |
$25.37
|
| Rate for Payer: PHP Commercial |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$25.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.28
|
| Rate for Payer: Priority Health Medicare |
$25.37
|
| Rate for Payer: Priority Health SBD |
$38.28
|
| Rate for Payer: Priority Health Tiered Network |
$38.28
|
| Rate for Payer: Railroad Medicare Medicare |
$25.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.57
|
| Rate for Payer: UHC Core |
$52.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.37
|
| Rate for Payer: UHC Exchange |
$52.57
|
| Rate for Payer: UHC Medicaid |
$16.19
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
| Rate for Payer: UMR Bronson Commercial |
$69.46
|
|
|
PR PARTIAL EXCISION BONE CLAVICLE
|
Professional
|
Both
|
$1,464.00
|
|
|
Service Code
|
HCPCS 23180
|
| Min. Negotiated Rate |
$417.69 |
| Max. Negotiated Rate |
$1,160.37 |
| Rate for Payer: Aetna Commercial |
$853.46
|
| Rate for Payer: Aetna Medicare |
$662.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.15
|
| Rate for Payer: BCBS Complete |
$438.57
|
| Rate for Payer: BCBS MAPPO |
$636.91
|
| Rate for Payer: BCN Commercial |
$1,057.21
|
| Rate for Payer: BCN Medicare Advantage |
$636.91
|
| Rate for Payer: Cash Price |
$1,171.20
|
| Rate for Payer: Cash Price |
$1,171.20
|
| Rate for Payer: Cofinity Commercial |
$853.46
|
| Rate for Payer: Cofinity Commercial |
$917.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.76
|
| Rate for Payer: Meridian Medicaid |
$438.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$700.60
|
| Rate for Payer: Nomi Health Commercial |
$764.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.00
|
| Rate for Payer: PACE SWMI |
$636.91
|
| Rate for Payer: PHP Commercial |
$891.67
|
| Rate for Payer: PHP Medicare Advantage |
$636.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,130.14
|
| Rate for Payer: Priority Health Medicare |
$636.91
|
| Rate for Payer: Priority Health SBD |
$1,130.14
|
| Rate for Payer: Priority Health Tiered Network |
$1,130.14
|
| Rate for Payer: Railroad Medicare Medicare |
$636.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,160.37
|
| Rate for Payer: UHC Core |
$1,160.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$636.91
|
| Rate for Payer: UHC Exchange |
$1,160.37
|
| Rate for Payer: UHC Medicaid |
$417.69
|
| Rate for Payer: UHCCP Medicaid |
$417.69
|
| Rate for Payer: UMR Bronson Commercial |
$673.44
|
|
|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$388.94 |
| Max. Negotiated Rate |
$1,842.75 |
| Rate for Payer: Aetna Commercial |
$798.40
|
| Rate for Payer: Aetna Medicare |
$619.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.98
|
| Rate for Payer: BCBS Complete |
$408.39
|
| Rate for Payer: BCBS MAPPO |
$595.82
|
| Rate for Payer: BCN Commercial |
$997.95
|
| Rate for Payer: BCN Medicare Advantage |
$595.82
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cofinity Commercial |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$857.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.61
|
| Rate for Payer: Meridian Medicaid |
$408.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$655.40
|
| Rate for Payer: Nomi Health Commercial |
$714.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,842.75
|
| Rate for Payer: PACE SWMI |
$595.82
|
| Rate for Payer: PHP Commercial |
$834.15
|
| Rate for Payer: PHP Medicare Advantage |
$595.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,066.78
|
| Rate for Payer: Priority Health Medicare |
$595.82
|
| Rate for Payer: Priority Health SBD |
$1,066.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,066.78
|
| Rate for Payer: Railroad Medicare Medicare |
$595.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,157.80
|
| Rate for Payer: UHC Core |
$1,157.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$595.82
|
| Rate for Payer: UHC Exchange |
$1,157.80
|
| Rate for Payer: UHC Medicaid |
$388.94
|
| Rate for Payer: UHCCP Medicaid |
$388.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,130.22
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$418.33 |
| Max. Negotiated Rate |
$1,225.83 |
| Rate for Payer: Aetna Commercial |
$857.28
|
| Rate for Payer: Aetna Medicare |
$665.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.25
|
| Rate for Payer: BCBS Complete |
$439.25
|
| Rate for Payer: BCBS MAPPO |
$639.76
|
| Rate for Payer: BCN Commercial |
$1,076.14
|
| Rate for Payer: BCN Medicare Advantage |
$639.76
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cofinity Commercial |
$857.28
|
| Rate for Payer: Cofinity Commercial |
$921.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.75
|
| Rate for Payer: Meridian Medicaid |
$439.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$703.74
|
| Rate for Payer: Nomi Health Commercial |
$767.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,104.00
|
| Rate for Payer: PACE SWMI |
$639.76
|
| Rate for Payer: PHP Commercial |
$895.66
|
| Rate for Payer: PHP Medicare Advantage |
$639.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,150.36
|
| Rate for Payer: Priority Health Medicare |
$639.76
|
| Rate for Payer: Priority Health SBD |
$1,150.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,150.36
|
| Rate for Payer: Railroad Medicare Medicare |
$639.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.83
|
| Rate for Payer: UHC Core |
$1,225.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$639.76
|
| Rate for Payer: UHC Exchange |
$1,225.83
|
| Rate for Payer: UHC Medicaid |
$418.33
|
| Rate for Payer: UHCCP Medicaid |
$418.33
|
| Rate for Payer: UMR Bronson Commercial |
$677.12
|
|
|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$1,498.00
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$300.76 |
| Max. Negotiated Rate |
$1,123.50 |
| Rate for Payer: Aetna Commercial |
$613.36
|
| Rate for Payer: Aetna Medicare |
$476.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.13
|
| Rate for Payer: BCBS Complete |
$315.80
|
| Rate for Payer: BCBS MAPPO |
$457.73
|
| Rate for Payer: BCN Commercial |
$770.87
|
| Rate for Payer: BCN Medicare Advantage |
$457.73
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Cofinity Commercial |
$613.36
|
| Rate for Payer: Cofinity Commercial |
$659.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$480.62
|
| Rate for Payer: Meridian Medicaid |
$315.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$503.50
|
| Rate for Payer: Nomi Health Commercial |
$549.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,123.50
|
| Rate for Payer: PACE SWMI |
$457.73
|
| Rate for Payer: PHP Commercial |
$640.82
|
| Rate for Payer: PHP Medicare Advantage |
$457.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$824.04
|
| Rate for Payer: Priority Health Medicare |
$457.73
|
| Rate for Payer: Priority Health SBD |
$824.04
|
| Rate for Payer: Priority Health Tiered Network |
$824.04
|
| Rate for Payer: Railroad Medicare Medicare |
$457.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.00
|
| Rate for Payer: UHC Core |
$868.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.73
|
| Rate for Payer: UHC Exchange |
$868.00
|
| Rate for Payer: UHC Medicaid |
$300.76
|
| Rate for Payer: UHCCP Medicaid |
$300.76
|
| Rate for Payer: UMR Bronson Commercial |
$689.08
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$380.42 |
| Max. Negotiated Rate |
$1,144.50 |
| Rate for Payer: Aetna Commercial |
$774.36
|
| Rate for Payer: Aetna Medicare |
$601.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.15
|
| Rate for Payer: BCBS Complete |
$399.44
|
| Rate for Payer: BCBS MAPPO |
$577.88
|
| Rate for Payer: BCN Commercial |
$965.58
|
| Rate for Payer: BCN Medicare Advantage |
$577.88
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$774.36
|
| Rate for Payer: Cofinity Commercial |
$832.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.77
|
| Rate for Payer: Meridian Medicaid |
$399.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.67
|
| Rate for Payer: Nomi Health Commercial |
$693.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.50
|
| Rate for Payer: PACE SWMI |
$577.88
|
| Rate for Payer: PHP Commercial |
$809.03
|
| Rate for Payer: PHP Medicare Advantage |
$577.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,032.19
|
| Rate for Payer: Priority Health Medicare |
$577.88
|
| Rate for Payer: Priority Health SBD |
$1,032.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,032.19
|
| Rate for Payer: Railroad Medicare Medicare |
$577.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,083.32
|
| Rate for Payer: UHC Core |
$1,083.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.88
|
| Rate for Payer: UHC Exchange |
$1,083.32
|
| Rate for Payer: UHC Medicaid |
$380.42
|
| Rate for Payer: UHCCP Medicaid |
$380.42
|
| Rate for Payer: UMR Bronson Commercial |
$701.96
|
|
