|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,286.36 |
| Rate for Payer: Aetna Commercial |
$909.30
|
| Rate for Payer: Aetna Medicare |
$705.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.16
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$678.58
|
| Rate for Payer: BCN Commercial |
$1,130.42
|
| Rate for Payer: BCN Medicare Advantage |
$678.58
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cofinity Commercial |
$909.30
|
| Rate for Payer: Cofinity Commercial |
$977.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.51
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.44
|
| Rate for Payer: Nomi Health Commercial |
$814.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,285.50
|
| Rate for Payer: PACE SWMI |
$678.58
|
| Rate for Payer: PHP Commercial |
$950.01
|
| Rate for Payer: PHP Medicare Advantage |
$678.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,208.39
|
| Rate for Payer: Priority Health Medicare |
$678.58
|
| Rate for Payer: Priority Health SBD |
$1,208.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,208.39
|
| Rate for Payer: Railroad Medicare Medicare |
$678.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,286.36
|
| Rate for Payer: UHC Core |
$1,286.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$678.58
|
| Rate for Payer: UHC Exchange |
$1,286.36
|
| Rate for Payer: UHC Medicaid |
$444.11
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
| Rate for Payer: UMR Bronson Commercial |
$788.44
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,358.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$348.04 |
| Max. Negotiated Rate |
$1,768.50 |
| Rate for Payer: Aetna Commercial |
$710.88
|
| Rate for Payer: Aetna Medicare |
$551.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.93
|
| Rate for Payer: BCBS Complete |
$365.44
|
| Rate for Payer: BCBS MAPPO |
$530.51
|
| Rate for Payer: BCN Commercial |
$899.36
|
| Rate for Payer: BCN Medicare Advantage |
$530.51
|
| Rate for Payer: Cash Price |
$1,886.40
|
| Rate for Payer: Cash Price |
$1,886.40
|
| Rate for Payer: Cofinity Commercial |
$710.88
|
| Rate for Payer: Cofinity Commercial |
$763.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.04
|
| Rate for Payer: Meridian Medicaid |
$365.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$583.56
|
| Rate for Payer: Nomi Health Commercial |
$636.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,768.50
|
| Rate for Payer: PACE SWMI |
$530.51
|
| Rate for Payer: PHP Commercial |
$742.71
|
| Rate for Payer: PHP Medicare Advantage |
$530.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$961.39
|
| Rate for Payer: Priority Health Medicare |
$530.51
|
| Rate for Payer: Priority Health SBD |
$961.39
|
| Rate for Payer: Priority Health Tiered Network |
$961.39
|
| Rate for Payer: Railroad Medicare Medicare |
$530.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.19
|
| Rate for Payer: UHC Core |
$1,014.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$530.51
|
| Rate for Payer: UHC Exchange |
$1,014.19
|
| Rate for Payer: UHC Medicaid |
$348.04
|
| Rate for Payer: UHCCP Medicaid |
$348.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,084.68
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,303.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$408.75 |
| Max. Negotiated Rate |
$1,147.10 |
| Rate for Payer: Aetna Commercial |
$834.04
|
| Rate for Payer: Aetna Medicare |
$647.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.28
|
| Rate for Payer: BCBS Complete |
$429.19
|
| Rate for Payer: BCBS MAPPO |
$622.42
|
| Rate for Payer: BCN Commercial |
$1,031.31
|
| Rate for Payer: BCN Medicare Advantage |
$622.42
|
| Rate for Payer: Cash Price |
$1,042.40
|
| Rate for Payer: Cash Price |
$1,042.40
|
| Rate for Payer: Cofinity Commercial |
$834.04
|
| Rate for Payer: Cofinity Commercial |
$896.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$653.54
|
| Rate for Payer: Meridian Medicaid |
$429.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$684.66
|
| Rate for Payer: Nomi Health Commercial |
$746.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$977.25
|
| Rate for Payer: PACE SWMI |
$622.42
|
| Rate for Payer: PHP Commercial |
$871.39
|
| Rate for Payer: PHP Medicare Advantage |
$622.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,102.46
|
| Rate for Payer: Priority Health Medicare |
$622.42
|
| Rate for Payer: Priority Health SBD |
$1,102.46
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.46
|
| Rate for Payer: Railroad Medicare Medicare |
$622.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,147.10
|
| Rate for Payer: UHC Core |
$1,147.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$622.42
|
| Rate for Payer: UHC Exchange |
$1,147.10
|
| Rate for Payer: UHC Medicaid |
$408.75
|
| Rate for Payer: UHCCP Medicaid |
$408.75
|
| Rate for Payer: UMR Bronson Commercial |
$599.38
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$610.36
|
| Rate for Payer: Aetna Medicare |
$473.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.91
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$455.49
|
| Rate for Payer: BCN Commercial |
$751.96
|
| Rate for Payer: BCN Medicare Advantage |
$455.49
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$610.36
|
| Rate for Payer: Cofinity Commercial |
$655.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.26
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$501.04
|
| Rate for Payer: Nomi Health Commercial |
$546.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$455.49
|
| Rate for Payer: PHP Commercial |
$637.69
|
| Rate for Payer: PHP Medicare Advantage |
$455.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$803.81
|
| Rate for Payer: Priority Health Medicare |
$455.49
|
| Rate for Payer: Priority Health SBD |
$803.81
|
| Rate for Payer: Priority Health Tiered Network |
$803.81
|
| Rate for Payer: Railroad Medicare Medicare |
$455.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.41
|
| Rate for Payer: UHC Core |
$867.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$455.49
|
| Rate for Payer: UHC Exchange |
$867.41
|
| Rate for Payer: UHC Medicaid |
$298.84
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
| Rate for Payer: UMR Bronson Commercial |
$603.52
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,846.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,134.50 |
| Rate for Payer: Aetna Commercial |
$1,007.80
|
| Rate for Payer: Aetna Medicare |
$782.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.01
|
| Rate for Payer: BCBS Complete |
$514.62
|
| Rate for Payer: BCBS MAPPO |
$752.09
|
| Rate for Payer: BCN Commercial |
$1,255.41
|
| Rate for Payer: BCN Medicare Advantage |
$752.09
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cofinity Commercial |
$1,007.80
|
| Rate for Payer: Cofinity Commercial |
$1,083.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$789.69
|
| Rate for Payer: Meridian Medicaid |
$514.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$827.30
|
| Rate for Payer: Nomi Health Commercial |
$902.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,134.50
|
| Rate for Payer: PACE SWMI |
$752.09
|
| Rate for Payer: PHP Commercial |
$1,052.93
|
| Rate for Payer: PHP Medicare Advantage |
$752.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,342.01
|
| Rate for Payer: Priority Health Medicare |
$752.09
|
| Rate for Payer: Priority Health SBD |
$1,342.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,342.01
|
| Rate for Payer: Railroad Medicare Medicare |
$752.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,455.14
|
| Rate for Payer: UHC Core |
$1,455.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$752.09
|
| Rate for Payer: UHC Exchange |
$1,455.14
|
| Rate for Payer: UHC Medicaid |
$490.11
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,309.16
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,214.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$981.88 |
| Rate for Payer: Aetna Commercial |
$696.18
|
| Rate for Payer: Aetna Medicare |
$540.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.14
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$519.54
|
| Rate for Payer: BCN Commercial |
$873.95
|
| Rate for Payer: BCN Medicare Advantage |
$519.54
|
| Rate for Payer: Cash Price |
$971.20
|
| Rate for Payer: Cash Price |
$971.20
|
| Rate for Payer: Cofinity Commercial |
$696.18
|
| Rate for Payer: Cofinity Commercial |
$748.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.52
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$571.49
|
| Rate for Payer: Nomi Health Commercial |
$623.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$910.50
|
| Rate for Payer: PACE SWMI |
$519.54
|
| Rate for Payer: PHP Commercial |
$727.36
|
| Rate for Payer: PHP Medicare Advantage |
$519.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$934.23
|
| Rate for Payer: Priority Health Medicare |
$519.54
|
| Rate for Payer: Priority Health SBD |
$934.23
|
| Rate for Payer: Priority Health Tiered Network |
$934.23
|
| Rate for Payer: Railroad Medicare Medicare |
$519.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$981.88
|
| Rate for Payer: UHC Core |
$981.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$519.54
|
| Rate for Payer: UHC Exchange |
$981.88
|
| Rate for Payer: UHC Medicaid |
$341.01
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
| Rate for Payer: UMR Bronson Commercial |
$558.44
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,324.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$584.26 |
| Max. Negotiated Rate |
$2,493.00 |
| Rate for Payer: Aetna Commercial |
$1,192.57
|
| Rate for Payer: Aetna Medicare |
$925.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.57
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCBS MAPPO |
$889.98
|
| Rate for Payer: BCN Commercial |
$1,464.06
|
| Rate for Payer: BCN Medicare Advantage |
$889.98
|
| Rate for Payer: Cash Price |
$2,659.20
|
| Rate for Payer: Cash Price |
$2,659.20
|
| Rate for Payer: Cofinity Commercial |
$1,192.57
|
| Rate for Payer: Cofinity Commercial |
$1,281.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.48
|
| Rate for Payer: Meridian Medicaid |
$613.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$978.98
|
| Rate for Payer: Nomi Health Commercial |
$1,067.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,493.00
|
| Rate for Payer: PACE SWMI |
$889.98
|
| Rate for Payer: PHP Commercial |
$1,245.97
|
| Rate for Payer: PHP Medicare Advantage |
$889.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,565.05
|
| Rate for Payer: Priority Health Medicare |
$889.98
|
| Rate for Payer: Priority Health SBD |
$1,565.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,565.05
|
| Rate for Payer: Railroad Medicare Medicare |
$889.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,646.51
|
| Rate for Payer: UHC Core |
$1,646.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$889.98
|
| Rate for Payer: UHC Exchange |
$1,646.51
|
| Rate for Payer: UHC Medicaid |
$584.26
|
| Rate for Payer: UHCCP Medicaid |
$584.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,529.04
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,310.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$269.23 |
| Max. Negotiated Rate |
$982.50 |
| Rate for Payer: Aetna Commercial |
$547.28
|
| Rate for Payer: Aetna Medicare |
$424.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.12
|
| Rate for Payer: BCBS Complete |
$282.69
|
| Rate for Payer: BCBS MAPPO |
$408.42
|
| Rate for Payer: BCN Commercial |
$682.73
|
| Rate for Payer: BCN Medicare Advantage |
$408.42
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cofinity Commercial |
$547.28
|
| Rate for Payer: Cofinity Commercial |
$588.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.84
|
| Rate for Payer: Meridian Medicaid |
$282.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$449.26
|
| Rate for Payer: Nomi Health Commercial |
$490.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$982.50
|
| Rate for Payer: PACE SWMI |
$408.42
|
| Rate for Payer: PHP Commercial |
$571.79
|
| Rate for Payer: PHP Medicare Advantage |
$408.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$729.82
|
| Rate for Payer: Priority Health Medicare |
$408.42
|
| Rate for Payer: Priority Health SBD |
$729.82
|
| Rate for Payer: Priority Health Tiered Network |
$729.82
|
| Rate for Payer: Railroad Medicare Medicare |
$408.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.09
|
| Rate for Payer: UHC Core |
$764.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$408.42
|
| Rate for Payer: UHC Exchange |
$764.09
|
| Rate for Payer: UHC Medicaid |
$269.23
|
| Rate for Payer: UHCCP Medicaid |
$269.23
|
| Rate for Payer: UMR Bronson Commercial |
$602.60
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$296.28 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$603.94
|
| Rate for Payer: Aetna Medicare |
$468.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.01
|
| Rate for Payer: BCBS Complete |
$311.09
|
| Rate for Payer: BCBS MAPPO |
$450.70
|
| Rate for Payer: BCN Commercial |
$759.43
|
| Rate for Payer: BCN Medicare Advantage |
$450.70
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cofinity Commercial |
$603.94
|
| Rate for Payer: Cofinity Commercial |
$649.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$473.24
|
| Rate for Payer: Meridian Medicaid |
$311.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$495.77
|
| Rate for Payer: Nomi Health Commercial |
$540.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: PACE SWMI |
$450.70
|
| Rate for Payer: PHP Commercial |
$630.98
|
| Rate for Payer: PHP Medicare Advantage |
$450.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$811.79
|
| Rate for Payer: Priority Health Medicare |
$450.70
|
| Rate for Payer: Priority Health SBD |
$811.79
|
| Rate for Payer: Priority Health Tiered Network |
$811.79
|
| Rate for Payer: Railroad Medicare Medicare |
$450.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.71
|
| Rate for Payer: UHC Core |
$855.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$450.70
|
| Rate for Payer: UHC Exchange |
$855.71
|
| Rate for Payer: UHC Medicaid |
$296.28
|
| Rate for Payer: UHCCP Medicaid |
$296.28
|
| Rate for Payer: UMR Bronson Commercial |
$645.84
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,574.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$526.75 |
| Max. Negotiated Rate |
$1,528.52 |
| Rate for Payer: Aetna Commercial |
$1,076.18
|
| Rate for Payer: Aetna Medicare |
$835.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,076.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,156.49
|
| Rate for Payer: BCBS Complete |
$553.09
|
| Rate for Payer: BCBS MAPPO |
$803.12
|
| Rate for Payer: BCN Commercial |
$1,326.12
|
| Rate for Payer: BCN Medicare Advantage |
$803.12
|
| Rate for Payer: Cash Price |
$1,259.20
|
| Rate for Payer: Cash Price |
$1,259.20
|
| Rate for Payer: Cofinity Commercial |
$1,076.18
|
| Rate for Payer: Cofinity Commercial |
$1,156.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.28
|
| Rate for Payer: Meridian Medicaid |
$553.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.43
|
| Rate for Payer: Nomi Health Commercial |
$963.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,180.50
|
| Rate for Payer: PACE SWMI |
$803.12
|
| Rate for Payer: PHP Commercial |
$1,124.37
|
| Rate for Payer: PHP Medicare Advantage |
$803.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,417.59
|
| Rate for Payer: Priority Health Medicare |
$803.12
|
| Rate for Payer: Priority Health SBD |
$1,417.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,417.59
|
| Rate for Payer: Railroad Medicare Medicare |
$803.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,528.52
|
| Rate for Payer: UHC Core |
$1,528.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$803.12
|
| Rate for Payer: UHC Exchange |
$1,528.52
|
| Rate for Payer: UHC Medicaid |
$526.75
|
| Rate for Payer: UHCCP Medicaid |
$526.75
|
| Rate for Payer: UMR Bronson Commercial |
$724.04
|
|
|
PR PARTIAL HYMENECTOMY OR REVISION HYMENAL RING
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$507.75 |
| Rate for Payer: Aetna Commercial |
$237.73
|
| Rate for Payer: Aetna Medicare |
$184.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.47
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS MAPPO |
$177.41
|
| Rate for Payer: BCN Commercial |
$305.76
|
| Rate for Payer: BCN Medicare Advantage |
$177.41
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$237.73
|
| Rate for Payer: Cofinity Commercial |
$255.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.28
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.15
|
| Rate for Payer: Nomi Health Commercial |
$212.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.75
|
| Rate for Payer: PACE SWMI |
$177.41
|
| Rate for Payer: PHP Commercial |
$248.37
|
| Rate for Payer: PHP Medicare Advantage |
$177.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$309.67
|
| Rate for Payer: Priority Health Medicare |
$177.41
|
| Rate for Payer: Priority Health SBD |
$309.67
|
| Rate for Payer: Priority Health Tiered Network |
$309.67
|
| Rate for Payer: Railroad Medicare Medicare |
$177.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.95
|
| Rate for Payer: UHC Core |
$343.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.41
|
| Rate for Payer: UHC Exchange |
$343.95
|
| Rate for Payer: UHC Medicaid |
$115.87
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
| Rate for Payer: UMR Bronson Commercial |
$311.42
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Aetna Commercial |
$412.56
|
| Rate for Payer: Aetna Medicare |
$320.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.35
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCBS MAPPO |
$307.88
|
| Rate for Payer: BCN Commercial |
$510.93
|
| Rate for Payer: BCN Medicare Advantage |
$307.88
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$412.56
|
| Rate for Payer: Cofinity Commercial |
$443.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.27
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$369.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.75
|
| Rate for Payer: PACE SWMI |
$307.88
|
| Rate for Payer: PHP Commercial |
$431.03
|
| Rate for Payer: PHP Medicare Advantage |
$307.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$546.18
|
| Rate for Payer: Priority Health Medicare |
$307.88
|
| Rate for Payer: Priority Health SBD |
$546.18
|
| Rate for Payer: Priority Health Tiered Network |
$546.18
|
| Rate for Payer: Railroad Medicare Medicare |
$307.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.73
|
| Rate for Payer: UHC Core |
$577.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.88
|
| Rate for Payer: UHC Exchange |
$577.73
|
| Rate for Payer: UHC Medicaid |
$202.78
|
| Rate for Payer: UHCCP Medicaid |
$202.78
|
| Rate for Payer: UMR Bronson Commercial |
$432.86
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,164.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$395.54 |
| Max. Negotiated Rate |
$1,623.00 |
| Rate for Payer: Aetna Commercial |
$808.72
|
| Rate for Payer: Aetna Medicare |
$627.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.07
|
| Rate for Payer: BCBS Complete |
$415.32
|
| Rate for Payer: BCBS MAPPO |
$603.52
|
| Rate for Payer: BCN Commercial |
$1,002.43
|
| Rate for Payer: BCN Medicare Advantage |
$603.52
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cofinity Commercial |
$808.72
|
| Rate for Payer: Cofinity Commercial |
$869.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.70
|
| Rate for Payer: Meridian Medicaid |
$415.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$663.87
|
| Rate for Payer: Nomi Health Commercial |
$724.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.00
|
| Rate for Payer: PACE SWMI |
$603.52
|
| Rate for Payer: PHP Commercial |
$844.93
|
| Rate for Payer: PHP Medicare Advantage |
$603.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,071.58
|
| Rate for Payer: Priority Health Medicare |
$603.52
|
| Rate for Payer: Priority Health SBD |
$1,071.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,071.58
|
| Rate for Payer: Railroad Medicare Medicare |
$603.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.07
|
| Rate for Payer: UHC Core |
$1,137.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$603.52
|
| Rate for Payer: UHC Exchange |
$1,137.07
|
| Rate for Payer: UHC Medicaid |
$395.54
|
| Rate for Payer: UHCCP Medicaid |
$395.54
|
| Rate for Payer: UMR Bronson Commercial |
$995.44
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Aetna Commercial |
$43.00
|
| Rate for Payer: Aetna Medicare |
$33.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.21
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$32.09
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Medicare Advantage |
$32.09
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$46.21
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.30
|
| Rate for Payer: Nomi Health Commercial |
$38.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$32.09
|
| Rate for Payer: PHP Commercial |
$44.93
|
| Rate for Payer: PHP Medicare Advantage |
$32.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44.08
|
| Rate for Payer: Priority Health Medicare |
$32.09
|
| Rate for Payer: Priority Health SBD |
$44.08
|
| Rate for Payer: Priority Health Tiered Network |
$44.08
|
| Rate for Payer: Railroad Medicare Medicare |
$32.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.77
|
| Rate for Payer: UHC Core |
$45.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.09
|
| Rate for Payer: UHC Exchange |
$45.77
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$137.54 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$257.99
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.99
|
| Rate for Payer: BCBS Trust/PPO |
$226.43
|
| Rate for Payer: BCN Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.99
|
| Rate for Payer: UHC Core |
$257.99
|
| Rate for Payer: UHC Exchange |
$257.99
|
| Rate for Payer: UMR Bronson Commercial |
$137.54
|
|
|
PR PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 90677
|
| Min. Negotiated Rate |
$187.22 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$419.29
|
| Rate for Payer: Aetna Medicare |
$325.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.58
|
| Rate for Payer: BCBS MAPPO |
$312.90
|
| Rate for Payer: BCBS Trust/PPO |
$299.25
|
| Rate for Payer: BCN Commercial |
$350.00
|
| Rate for Payer: BCN Medicare Advantage |
$312.90
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$419.29
|
| Rate for Payer: Cofinity Commercial |
$450.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.19
|
| Rate for Payer: Nomi Health Commercial |
$375.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.25
|
| Rate for Payer: PACE SWMI |
$312.90
|
| Rate for Payer: PHP Commercial |
$438.06
|
| Rate for Payer: PHP Medicare Advantage |
$312.90
|
| Rate for Payer: Priority Health Medicare |
$312.90
|
| Rate for Payer: Railroad Medicare Medicare |
$312.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.49
|
| Rate for Payer: UHC Core |
$298.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.90
|
| Rate for Payer: UHC Exchange |
$298.49
|
| Rate for Payer: UMR Bronson Commercial |
$187.22
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 96573
|
| Min. Negotiated Rate |
$172.96 |
| Max. Negotiated Rate |
$327.67 |
| Rate for Payer: Aetna Commercial |
$268.04
|
| Rate for Payer: Aetna Medicare |
$208.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.04
|
| Rate for Payer: BCBS MAPPO |
$200.03
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: BCN Medicare Advantage |
$200.03
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$288.04
|
| Rate for Payer: Cofinity Commercial |
$268.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.03
|
| Rate for Payer: Nomi Health Commercial |
$240.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: PACE SWMI |
$200.03
|
| Rate for Payer: PHP Commercial |
$280.04
|
| Rate for Payer: PHP Medicare Advantage |
$200.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$302.18
|
| Rate for Payer: Priority Health Medicare |
$200.03
|
| Rate for Payer: Priority Health SBD |
$302.18
|
| Rate for Payer: Priority Health Tiered Network |
$302.18
|
| Rate for Payer: Railroad Medicare Medicare |
$200.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.06
|
| Rate for Payer: UHC Core |
$323.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.03
|
| Rate for Payer: UHC Exchange |
$323.06
|
| Rate for Payer: UMR Bronson Commercial |
$172.96
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 96567
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$200.48 |
| Rate for Payer: Aetna Commercial |
$158.24
|
| Rate for Payer: Aetna Medicare |
$122.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.05
|
| Rate for Payer: BCBS Complete |
$90.00
|
| Rate for Payer: BCBS MAPPO |
$118.09
|
| Rate for Payer: BCN Commercial |
$196.71
|
| Rate for Payer: BCN Medicare Advantage |
$118.09
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$170.05
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.90
|
| Rate for Payer: Nomi Health Commercial |
$141.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE SWMI |
$118.09
|
| Rate for Payer: PHP Commercial |
$165.33
|
| Rate for Payer: PHP Medicare Advantage |
$118.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$181.40
|
| Rate for Payer: Priority Health Medicare |
$118.09
|
| Rate for Payer: Priority Health SBD |
$181.40
|
| Rate for Payer: Priority Health Tiered Network |
$181.40
|
| Rate for Payer: Railroad Medicare Medicare |
$118.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.48
|
| Rate for Payer: UHC Core |
$200.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.09
|
| Rate for Payer: UHC Exchange |
$200.48
|
| Rate for Payer: UMR Bronson Commercial |
$103.50
|
|
|
PR PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR
|
Professional
|
Both
|
$1,337.00
|
|
|
Service Code
|
HCPCS 38770
|
| Min. Negotiated Rate |
$471.37 |
| Max. Negotiated Rate |
$1,606.81 |
| Rate for Payer: Aetna Commercial |
$980.02
|
| Rate for Payer: Aetna Medicare |
$760.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,053.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.02
|
| Rate for Payer: BCBS Complete |
$494.94
|
| Rate for Payer: BCBS MAPPO |
$731.36
|
| Rate for Payer: BCN Commercial |
$1,207.61
|
| Rate for Payer: BCN Medicare Advantage |
$731.36
|
| Rate for Payer: Cash Price |
$1,069.60
|
| Rate for Payer: Cash Price |
$1,069.60
|
| Rate for Payer: Cofinity Commercial |
$980.02
|
| Rate for Payer: Cofinity Commercial |
$1,053.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.93
|
| Rate for Payer: Meridian Medicaid |
$494.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$804.50
|
| Rate for Payer: Nomi Health Commercial |
$877.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.75
|
| Rate for Payer: PACE SWMI |
$731.36
|
| Rate for Payer: PHP Commercial |
$1,023.90
|
| Rate for Payer: PHP Medicare Advantage |
$731.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,606.81
|
| Rate for Payer: Priority Health Medicare |
$731.36
|
| Rate for Payer: Priority Health SBD |
$1,606.81
|
| Rate for Payer: Priority Health Tiered Network |
$1,606.81
|
| Rate for Payer: Railroad Medicare Medicare |
$731.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.51
|
| Rate for Payer: UHC Core |
$1,419.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$731.36
|
| Rate for Payer: UHC Exchange |
$1,419.51
|
| Rate for Payer: UHC Medicaid |
$471.37
|
| Rate for Payer: UHCCP Medicaid |
$471.37
|
| Rate for Payer: UMR Bronson Commercial |
$615.02
|
|
|
PR PELVIC EXAMINATION
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 99459
|
| Min. Negotiated Rate |
$15.86 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$16.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.84
|
| Rate for Payer: BCBS MAPPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$31.87
|
| Rate for Payer: BCN Medicare Advantage |
$15.86
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$22.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Nomi Health Commercial |
$19.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PACE SWMI |
$15.86
|
| Rate for Payer: PHP Commercial |
$22.20
|
| Rate for Payer: PHP Medicare Advantage |
$15.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28.67
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health SBD |
$28.67
|
| Rate for Payer: Priority Health Tiered Network |
$28.67
|
| Rate for Payer: Railroad Medicare Medicare |
$15.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.88
|
| Rate for Payer: UHC Core |
$31.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.86
|
| Rate for Payer: UHC Exchange |
$31.88
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 57410
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$187.15 |
| Rate for Payer: Aetna Commercial |
$127.65
|
| Rate for Payer: Aetna Medicare |
$99.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.17
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$95.26
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: BCN Medicare Advantage |
$95.26
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$137.17
|
| Rate for Payer: Cofinity Commercial |
$127.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.02
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.79
|
| Rate for Payer: Nomi Health Commercial |
$114.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.50
|
| Rate for Payer: PACE SWMI |
$95.26
|
| Rate for Payer: PHP Commercial |
$133.36
|
| Rate for Payer: PHP Medicare Advantage |
$95.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$160.89
|
| Rate for Payer: Priority Health Medicare |
$95.26
|
| Rate for Payer: Priority Health SBD |
$160.89
|
| Rate for Payer: Priority Health Tiered Network |
$160.89
|
| Rate for Payer: Railroad Medicare Medicare |
$95.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.15
|
| Rate for Payer: UHC Core |
$187.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.26
|
| Rate for Payer: UHC Exchange |
$187.15
|
| Rate for Payer: UHC Medicaid |
$61.56
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
|
|
PR PELVIC FIXATION OTHER THAN SACRUM
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 22848
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna Commercial |
$428.17
|
| Rate for Payer: Aetna Medicare |
$332.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.12
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$319.53
|
| Rate for Payer: BCN Commercial |
$590.28
|
| Rate for Payer: BCN Medicare Advantage |
$319.53
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cofinity Commercial |
$428.17
|
| Rate for Payer: Cofinity Commercial |
$460.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.51
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$351.48
|
| Rate for Payer: Nomi Health Commercial |
$383.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,383.75
|
| Rate for Payer: PACE SWMI |
$319.53
|
| Rate for Payer: PHP Commercial |
$447.34
|
| Rate for Payer: PHP Medicare Advantage |
$319.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$574.38
|
| Rate for Payer: Priority Health Medicare |
$319.53
|
| Rate for Payer: Priority Health SBD |
$574.38
|
| Rate for Payer: Priority Health Tiered Network |
$574.38
|
| Rate for Payer: Railroad Medicare Medicare |
$319.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.78
|
| Rate for Payer: UHC Core |
$641.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$319.53
|
| Rate for Payer: UHC Exchange |
$641.78
|
| Rate for Payer: UHC Medicaid |
$202.56
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
| Rate for Payer: UMR Bronson Commercial |
$848.70
|
|
|
PR PELVIC RING FRACTURE UNI/BIL
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS G0413
|
| Min. Negotiated Rate |
$623.66 |
| Max. Negotiated Rate |
$2,450.25 |
| Rate for Payer: Aetna Commercial |
$1,287.73
|
| Rate for Payer: Aetna Medicare |
$999.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,383.83
|
| Rate for Payer: BCBS Complete |
$654.84
|
| Rate for Payer: BCBS MAPPO |
$960.99
|
| Rate for Payer: BCN Commercial |
$1,611.97
|
| Rate for Payer: BCN Medicare Advantage |
$960.99
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cofinity Commercial |
$1,287.73
|
| Rate for Payer: Cofinity Commercial |
$1,383.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.04
|
| Rate for Payer: Meridian Medicaid |
$654.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,057.09
|
| Rate for Payer: Nomi Health Commercial |
$1,153.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: PACE SWMI |
$960.99
|
| Rate for Payer: PHP Commercial |
$1,345.39
|
| Rate for Payer: PHP Medicare Advantage |
$960.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,723.15
|
| Rate for Payer: Priority Health Medicare |
$960.99
|
| Rate for Payer: Priority Health SBD |
$1,723.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,723.15
|
| Rate for Payer: Railroad Medicare Medicare |
$960.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,865.33
|
| Rate for Payer: UHC Core |
$1,865.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$960.99
|
| Rate for Payer: UHC Exchange |
$1,865.33
|
| Rate for Payer: UHC Medicaid |
$623.66
|
| Rate for Payer: UHCCP Medicaid |
$623.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,502.82
|
|
|
PR PELVIC RING FX TREAT INT FIX
|
Professional
|
Both
|
$3,228.00
|
|
|
Service Code
|
HCPCS G0414
|
| Min. Negotiated Rate |
$589.37 |
| Max. Negotiated Rate |
$2,421.00 |
| Rate for Payer: Aetna Commercial |
$1,215.69
|
| Rate for Payer: Aetna Medicare |
$943.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,215.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.41
|
| Rate for Payer: BCBS Complete |
$618.84
|
| Rate for Payer: BCBS MAPPO |
$907.23
|
| Rate for Payer: BCN Commercial |
$1,522.83
|
| Rate for Payer: BCN Medicare Advantage |
$907.23
|
| Rate for Payer: Cash Price |
$2,582.40
|
| Rate for Payer: Cash Price |
$2,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,215.69
|
| Rate for Payer: Cofinity Commercial |
$1,306.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$952.59
|
| Rate for Payer: Meridian Medicaid |
$618.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.95
|
| Rate for Payer: Nomi Health Commercial |
$1,088.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.00
|
| Rate for Payer: PACE SWMI |
$907.23
|
| Rate for Payer: PHP Commercial |
$1,270.12
|
| Rate for Payer: PHP Medicare Advantage |
$907.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$589.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,627.86
|
| Rate for Payer: Priority Health Medicare |
$907.23
|
| Rate for Payer: Priority Health SBD |
$1,627.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,627.86
|
| Rate for Payer: Railroad Medicare Medicare |
$907.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.25
|
| Rate for Payer: UHC Core |
$1,760.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$907.23
|
| Rate for Payer: UHC Exchange |
$1,760.25
|
| Rate for Payer: UHC Medicaid |
$589.37
|
| Rate for Payer: UHCCP Medicaid |
$589.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,484.88
|
|
|
PR PENG BENZATHINE/PROCAINE INJ
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J0558
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$28.11 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$20.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$19.89
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: BCN Medicare Advantage |
$19.52
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$26.16
|
| Rate for Payer: Cofinity Commercial |
$28.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.47
|
| Rate for Payer: Nomi Health Commercial |
$23.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PACE SWMI |
$19.52
|
| Rate for Payer: PHP Commercial |
$27.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$19.52
|
| Rate for Payer: Railroad Medicare Medicare |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.52
|
| Rate for Payer: UHC Core |
$19.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.52
|
| Rate for Payer: UHC Exchange |
$19.52
|
| Rate for Payer: UMR Bronson Commercial |
$2.76
|
|
