|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$846.89 |
| Max. Negotiated Rate |
$3,703.38 |
| Rate for Payer: Aetna Commercial |
$1,698.02
|
| Rate for Payer: Aetna Medicare |
$1,317.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,698.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,824.74
|
| Rate for Payer: BCBS Complete |
$889.23
|
| Rate for Payer: BCBS MAPPO |
$1,267.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.38
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,267.18
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,824.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,267.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,330.54
|
| Rate for Payer: Meridian Medicaid |
$889.23
|
| Rate for Payer: Nomi Health Commercial |
$1,520.62
|
| Rate for Payer: PACE SWMI |
$1,267.18
|
| Rate for Payer: PHP Commercial |
$1,774.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,267.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,105.36
|
| Rate for Payer: Priority Health Medicare |
$1,267.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,105.36
|
| Rate for Payer: Priority Health SBD |
$2,105.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,267.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,267.18
|
| Rate for Payer: UHCCP Medicaid |
$846.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,163.80
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,808.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$931.02 |
| Max. Negotiated Rate |
$5,250.25 |
| Rate for Payer: Aetna Commercial |
$1,866.69
|
| Rate for Payer: Aetna Medicare |
$1,448.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,866.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,005.99
|
| Rate for Payer: BCBS Complete |
$977.57
|
| Rate for Payer: BCBS MAPPO |
$1,393.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,250.25
|
| Rate for Payer: BCN Commercial |
$2,103.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,393.05
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cofinity Commercial |
$1,866.69
|
| Rate for Payer: Cofinity Commercial |
$2,005.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,393.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,462.70
|
| Rate for Payer: Meridian Medicaid |
$977.57
|
| Rate for Payer: Nomi Health Commercial |
$1,671.66
|
| Rate for Payer: PACE SWMI |
$1,393.05
|
| Rate for Payer: PHP Commercial |
$1,950.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,393.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,825.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,315.22
|
| Rate for Payer: Priority Health Medicare |
$1,393.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,315.22
|
| Rate for Payer: Priority Health SBD |
$2,315.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,393.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.05
|
| Rate for Payer: UHCCP Medicaid |
$931.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.68
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$676.28 |
| Max. Negotiated Rate |
$4,223.76 |
| Rate for Payer: Aetna Commercial |
$1,359.50
|
| Rate for Payer: Aetna Medicare |
$1,055.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,460.95
|
| Rate for Payer: BCBS Complete |
$710.09
|
| Rate for Payer: BCBS MAPPO |
$1,014.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,223.76
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.55
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$1,359.50
|
| Rate for Payer: Cofinity Commercial |
$1,460.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,065.28
|
| Rate for Payer: Meridian Medicaid |
$710.09
|
| Rate for Payer: Nomi Health Commercial |
$1,217.46
|
| Rate for Payer: PACE SWMI |
$1,014.55
|
| Rate for Payer: PHP Commercial |
$1,420.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,672.90
|
| Rate for Payer: Priority Health Medicare |
$1,014.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,672.90
|
| Rate for Payer: Priority Health SBD |
$1,672.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.55
|
| Rate for Payer: UHCCP Medicaid |
$676.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,704.30
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,384.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$814.51 |
| Max. Negotiated Rate |
$3,770.48 |
| Rate for Payer: Aetna Commercial |
$1,637.71
|
| Rate for Payer: Aetna Medicare |
$1,271.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,637.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,759.92
|
| Rate for Payer: BCBS Complete |
$855.24
|
| Rate for Payer: BCBS MAPPO |
$1,222.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,770.48
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.17
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cofinity Commercial |
$1,637.71
|
| Rate for Payer: Cofinity Commercial |
$1,759.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.28
|
| Rate for Payer: Meridian Medicaid |
$855.24
|
| Rate for Payer: Nomi Health Commercial |
$1,466.60
|
| Rate for Payer: PACE SWMI |
$1,222.17
|
| Rate for Payer: PHP Commercial |
$1,711.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$814.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,849.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,024.94
|
| Rate for Payer: Priority Health Medicare |
$1,222.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,024.94
|
| Rate for Payer: Priority Health SBD |
$2,024.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.17
|
| Rate for Payer: UHCCP Medicaid |
$814.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,016.64
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,454.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$755.72 |
| Max. Negotiated Rate |
$3,687.01 |
| Rate for Payer: Aetna Commercial |
$1,515.49
|
| Rate for Payer: Aetna Medicare |
$1,176.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.58
|
| Rate for Payer: BCBS Complete |
$793.51
|
| Rate for Payer: BCBS MAPPO |
$1,130.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,687.01
|
| Rate for Payer: BCN Commercial |
$1,734.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,130.96
|
| Rate for Payer: Cash Price |
$2,763.20
|
| Rate for Payer: Cash Price |
$2,763.20
|
| Rate for Payer: Cofinity Commercial |
$1,515.49
|
| Rate for Payer: Cofinity Commercial |
$1,628.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,130.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.51
|
| Rate for Payer: Meridian Medicaid |
$793.51
|
| Rate for Payer: Nomi Health Commercial |
$1,357.15
|
| Rate for Payer: PACE SWMI |
$1,130.96
|
| Rate for Payer: PHP Commercial |
$1,583.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,130.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$755.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,921.62
|
| Rate for Payer: Priority Health Medicare |
$1,130.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,921.62
|
| Rate for Payer: Priority Health SBD |
$1,921.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,130.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,130.96
|
| Rate for Payer: UHCCP Medicaid |
$755.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,588.84
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$828.78 |
| Max. Negotiated Rate |
$4,336.29 |
| Rate for Payer: Aetna Commercial |
$1,664.19
|
| Rate for Payer: Aetna Medicare |
$1,291.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,788.38
|
| Rate for Payer: BCBS Complete |
$870.22
|
| Rate for Payer: BCBS MAPPO |
$1,241.93
|
| Rate for Payer: BCBS Trust/PPO |
$4,336.29
|
| Rate for Payer: BCN Commercial |
$1,874.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,241.93
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cofinity Commercial |
$1,664.19
|
| Rate for Payer: Cofinity Commercial |
$1,788.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,241.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,304.03
|
| Rate for Payer: Meridian Medicaid |
$870.22
|
| Rate for Payer: Nomi Health Commercial |
$1,490.32
|
| Rate for Payer: PACE SWMI |
$1,241.93
|
| Rate for Payer: PHP Commercial |
$1,738.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,241.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,058.50
|
| Rate for Payer: Priority Health Medicare |
$1,241.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,058.50
|
| Rate for Payer: Priority Health SBD |
$2,058.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,241.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,241.93
|
| Rate for Payer: UHCCP Medicaid |
$828.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,144.48
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$2,064.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$2,591.84 |
| Rate for Payer: Aetna Commercial |
$1,454.64
|
| Rate for Payer: Aetna Medicare |
$1,128.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,454.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.19
|
| Rate for Payer: BCBS Complete |
$761.97
|
| Rate for Payer: BCBS MAPPO |
$1,085.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.84
|
| Rate for Payer: BCN Commercial |
$1,636.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,085.55
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cofinity Commercial |
$1,454.64
|
| Rate for Payer: Cofinity Commercial |
$1,563.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,085.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,139.83
|
| Rate for Payer: Meridian Medicaid |
$761.97
|
| Rate for Payer: Nomi Health Commercial |
$1,302.66
|
| Rate for Payer: PACE SWMI |
$1,085.55
|
| Rate for Payer: PHP Commercial |
$1,519.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,085.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,341.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,804.45
|
| Rate for Payer: Priority Health Medicare |
$1,085.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,804.45
|
| Rate for Payer: Priority Health SBD |
$1,804.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,085.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,085.55
|
| Rate for Payer: UHCCP Medicaid |
$725.69
|
| Rate for Payer: UMR Bronson Commercial |
$949.44
|
|
|
PR NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$926.55 |
| Max. Negotiated Rate |
$2,775.16 |
| Rate for Payer: Aetna Commercial |
$1,859.30
|
| Rate for Payer: Aetna Medicare |
$1,443.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.06
|
| Rate for Payer: BCBS Complete |
$972.88
|
| Rate for Payer: BCBS MAPPO |
$1,387.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,775.16
|
| Rate for Payer: BCN Commercial |
$2,090.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,387.54
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,859.30
|
| Rate for Payer: Cofinity Commercial |
$1,998.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,387.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,456.92
|
| Rate for Payer: Meridian Medicaid |
$972.88
|
| Rate for Payer: Nomi Health Commercial |
$1,665.05
|
| Rate for Payer: PACE SWMI |
$1,387.54
|
| Rate for Payer: PHP Commercial |
$1,942.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,387.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,303.49
|
| Rate for Payer: Priority Health Medicare |
$1,387.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,303.49
|
| Rate for Payer: Priority Health SBD |
$2,303.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,387.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,387.54
|
| Rate for Payer: UHCCP Medicaid |
$926.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.44
|
|
|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$828.57 |
| Max. Negotiated Rate |
$2,060.62 |
| Rate for Payer: Aetna Commercial |
$1,679.21
|
| Rate for Payer: Aetna Medicare |
$1,303.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,804.52
|
| Rate for Payer: BCBS Complete |
$870.00
|
| Rate for Payer: BCBS MAPPO |
$1,253.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.58
|
| Rate for Payer: BCN Commercial |
$1,819.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,253.14
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cofinity Commercial |
$1,679.21
|
| Rate for Payer: Cofinity Commercial |
$1,804.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,315.80
|
| Rate for Payer: Meridian Medicaid |
$870.00
|
| Rate for Payer: Nomi Health Commercial |
$1,503.77
|
| Rate for Payer: PACE SWMI |
$1,253.14
|
| Rate for Payer: PHP Commercial |
$1,754.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,253.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,498.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,060.62
|
| Rate for Payer: Priority Health Medicare |
$1,253.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,060.62
|
| Rate for Payer: Priority Health SBD |
$2,060.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,253.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,253.14
|
| Rate for Payer: UHCCP Medicaid |
$828.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,060.30
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,765.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$3,134.93 |
| Rate for Payer: Aetna Commercial |
$1,184.22
|
| Rate for Payer: Aetna Medicare |
$919.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.60
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCBS MAPPO |
$883.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,134.93
|
| Rate for Payer: BCN Commercial |
$1,332.14
|
| Rate for Payer: BCN Medicare Advantage |
$883.75
|
| Rate for Payer: Cash Price |
$1,412.00
|
| Rate for Payer: Cash Price |
$1,412.00
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Cofinity Commercial |
$1,272.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$883.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$927.94
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Nomi Health Commercial |
$1,060.50
|
| Rate for Payer: PACE SWMI |
$883.75
|
| Rate for Payer: PHP Commercial |
$1,237.25
|
| Rate for Payer: PHP Medicare Advantage |
$883.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,469.44
|
| Rate for Payer: Priority Health Medicare |
$883.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,469.44
|
| Rate for Payer: Priority Health SBD |
$1,469.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$883.75
|
| Rate for Payer: UHC Medicare Advantage |
$883.75
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
| Rate for Payer: UMR Bronson Commercial |
$811.90
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$532.00
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$299.95
|
| Rate for Payer: Aetna Commercial |
$299.95
|
| Rate for Payer: Aetna Medicare |
$232.79
|
| Rate for Payer: Aetna Medicare |
$232.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.95
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$223.84
|
| Rate for Payer: BCBS MAPPO |
$223.84
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Medicare Advantage |
$223.84
|
| Rate for Payer: BCN Medicare Advantage |
$223.84
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$299.95
|
| Rate for Payer: Cofinity Commercial |
$322.33
|
| Rate for Payer: Cofinity Commercial |
$322.33
|
| Rate for Payer: Cofinity Commercial |
$299.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.03
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Nomi Health Commercial |
$268.61
|
| Rate for Payer: Nomi Health Commercial |
$268.61
|
| Rate for Payer: PACE SWMI |
$223.84
|
| Rate for Payer: PACE SWMI |
$223.84
|
| Rate for Payer: PHP Commercial |
$313.38
|
| Rate for Payer: PHP Commercial |
$313.38
|
| Rate for Payer: PHP Medicare Advantage |
$223.84
|
| Rate for Payer: PHP Medicare Advantage |
$223.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.72
|
| Rate for Payer: Priority Health Medicare |
$223.84
|
| Rate for Payer: Priority Health Medicare |
$223.84
|
| Rate for Payer: Priority Health Narrow Network |
$334.72
|
| Rate for Payer: Priority Health Narrow Network |
$334.72
|
| Rate for Payer: Priority Health SBD |
$208.52
|
| Rate for Payer: Priority Health SBD |
$208.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.84
|
| Rate for Payer: UHC Medicare Advantage |
$223.84
|
| Rate for Payer: UHC Medicare Advantage |
$223.84
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UMR Bronson Commercial |
$146.74
|
| Rate for Payer: UMR Bronson Commercial |
$244.72
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 95907
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$1,173.88 |
| Rate for Payer: Aetna Commercial |
$109.06
|
| Rate for Payer: Aetna Commercial |
$109.06
|
| Rate for Payer: Aetna Medicare |
$84.65
|
| Rate for Payer: Aetna Medicare |
$84.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.06
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$81.39
|
| Rate for Payer: BCBS MAPPO |
$81.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: BCN Medicare Advantage |
$81.39
|
| Rate for Payer: BCN Medicare Advantage |
$81.39
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$109.06
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$109.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.46
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Nomi Health Commercial |
$97.67
|
| Rate for Payer: Nomi Health Commercial |
$97.67
|
| Rate for Payer: PACE SWMI |
$81.39
|
| Rate for Payer: PACE SWMI |
$81.39
|
| Rate for Payer: PHP Commercial |
$113.95
|
| Rate for Payer: PHP Commercial |
$113.95
|
| Rate for Payer: PHP Medicare Advantage |
$81.39
|
| Rate for Payer: PHP Medicare Advantage |
$81.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.13
|
| Rate for Payer: Priority Health Medicare |
$81.39
|
| Rate for Payer: Priority Health Medicare |
$81.39
|
| Rate for Payer: Priority Health Narrow Network |
$122.13
|
| Rate for Payer: Priority Health Narrow Network |
$122.13
|
| Rate for Payer: Priority Health SBD |
$70.11
|
| Rate for Payer: Priority Health SBD |
$70.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.39
|
| Rate for Payer: UHC Medicare Advantage |
$81.39
|
| Rate for Payer: UHC Medicare Advantage |
$81.39
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
| Rate for Payer: UMR Bronson Commercial |
$78.20
|
| Rate for Payer: UMR Bronson Commercial |
$41.86
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 95913
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$570.05 |
| Rate for Payer: Aetna Commercial |
$351.29
|
| Rate for Payer: Aetna Commercial |
$351.29
|
| Rate for Payer: Aetna Medicare |
$272.65
|
| Rate for Payer: Aetna Medicare |
$272.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.29
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$262.16
|
| Rate for Payer: BCBS MAPPO |
$262.16
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Medicare Advantage |
$262.16
|
| Rate for Payer: BCN Medicare Advantage |
$262.16
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$351.29
|
| Rate for Payer: Cofinity Commercial |
$377.51
|
| Rate for Payer: Cofinity Commercial |
$377.51
|
| Rate for Payer: Cofinity Commercial |
$351.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.27
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Nomi Health Commercial |
$314.59
|
| Rate for Payer: Nomi Health Commercial |
$314.59
|
| Rate for Payer: PACE SWMI |
$262.16
|
| Rate for Payer: PACE SWMI |
$262.16
|
| Rate for Payer: PHP Commercial |
$367.02
|
| Rate for Payer: PHP Commercial |
$367.02
|
| Rate for Payer: PHP Medicare Advantage |
$262.16
|
| Rate for Payer: PHP Medicare Advantage |
$262.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.28
|
| Rate for Payer: Priority Health Medicare |
$262.16
|
| Rate for Payer: Priority Health Medicare |
$262.16
|
| Rate for Payer: Priority Health Narrow Network |
$386.28
|
| Rate for Payer: Priority Health Narrow Network |
$386.28
|
| Rate for Payer: Priority Health SBD |
$246.51
|
| Rate for Payer: Priority Health SBD |
$246.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.16
|
| Rate for Payer: UHC Medicare Advantage |
$262.16
|
| Rate for Payer: UHC Medicare Advantage |
$262.16
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
| Rate for Payer: UMR Bronson Commercial |
$245.64
|
| Rate for Payer: UMR Bronson Commercial |
$403.42
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$1,235.69 |
| Rate for Payer: Aetna Commercial |
$135.70
|
| Rate for Payer: Aetna Commercial |
$135.70
|
| Rate for Payer: Aetna Medicare |
$105.32
|
| Rate for Payer: Aetna Medicare |
$105.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.70
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$101.27
|
| Rate for Payer: BCBS MAPPO |
$101.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: BCN Medicare Advantage |
$101.27
|
| Rate for Payer: BCN Medicare Advantage |
$101.27
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cofinity Commercial |
$135.70
|
| Rate for Payer: Cofinity Commercial |
$145.83
|
| Rate for Payer: Cofinity Commercial |
$145.83
|
| Rate for Payer: Cofinity Commercial |
$135.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.33
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PACE SWMI |
$101.27
|
| Rate for Payer: PACE SWMI |
$101.27
|
| Rate for Payer: PHP Commercial |
$141.78
|
| Rate for Payer: PHP Commercial |
$141.78
|
| Rate for Payer: PHP Medicare Advantage |
$101.27
|
| Rate for Payer: PHP Medicare Advantage |
$101.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.52
|
| Rate for Payer: Priority Health Medicare |
$101.27
|
| Rate for Payer: Priority Health Medicare |
$101.27
|
| Rate for Payer: Priority Health Narrow Network |
$151.52
|
| Rate for Payer: Priority Health Narrow Network |
$151.52
|
| Rate for Payer: Priority Health SBD |
$87.75
|
| Rate for Payer: Priority Health SBD |
$87.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.27
|
| Rate for Payer: UHC Medicare Advantage |
$101.27
|
| Rate for Payer: UHC Medicare Advantage |
$101.27
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
| Rate for Payer: UMR Bronson Commercial |
$100.28
|
| Rate for Payer: UMR Bronson Commercial |
$155.94
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$1,003.24 |
| Rate for Payer: Aetna Commercial |
$163.23
|
| Rate for Payer: Aetna Commercial |
$163.23
|
| Rate for Payer: Aetna Medicare |
$126.68
|
| Rate for Payer: Aetna Medicare |
$126.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.23
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS MAPPO |
$121.81
|
| Rate for Payer: BCBS MAPPO |
$121.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCN Commercial |
$194.98
|
| Rate for Payer: BCN Commercial |
$194.98
|
| Rate for Payer: BCN Medicare Advantage |
$121.81
|
| Rate for Payer: BCN Medicare Advantage |
$121.81
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$163.23
|
| Rate for Payer: Cofinity Commercial |
$175.41
|
| Rate for Payer: Cofinity Commercial |
$175.41
|
| Rate for Payer: Cofinity Commercial |
$163.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.90
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Nomi Health Commercial |
$146.17
|
| Rate for Payer: Nomi Health Commercial |
$146.17
|
| Rate for Payer: PACE SWMI |
$121.81
|
| Rate for Payer: PACE SWMI |
$121.81
|
| Rate for Payer: PHP Commercial |
$170.53
|
| Rate for Payer: PHP Commercial |
$170.53
|
| Rate for Payer: PHP Medicare Advantage |
$121.81
|
| Rate for Payer: PHP Medicare Advantage |
$121.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.84
|
| Rate for Payer: Priority Health Medicare |
$121.81
|
| Rate for Payer: Priority Health Medicare |
$121.81
|
| Rate for Payer: Priority Health Narrow Network |
$181.84
|
| Rate for Payer: Priority Health Narrow Network |
$181.84
|
| Rate for Payer: Priority Health SBD |
$104.94
|
| Rate for Payer: Priority Health SBD |
$104.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.81
|
| Rate for Payer: UHC Medicare Advantage |
$121.81
|
| Rate for Payer: UHC Medicare Advantage |
$121.81
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
| Rate for Payer: UMR Bronson Commercial |
$186.76
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$534.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$213.56
|
| Rate for Payer: Aetna Commercial |
$213.56
|
| Rate for Payer: Aetna Medicare |
$165.74
|
| Rate for Payer: Aetna Medicare |
$165.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.56
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$159.37
|
| Rate for Payer: BCBS MAPPO |
$159.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Medicare Advantage |
$159.37
|
| Rate for Payer: BCN Medicare Advantage |
$159.37
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cofinity Commercial |
$213.56
|
| Rate for Payer: Cofinity Commercial |
$229.49
|
| Rate for Payer: Cofinity Commercial |
$229.49
|
| Rate for Payer: Cofinity Commercial |
$213.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.34
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Nomi Health Commercial |
$191.24
|
| Rate for Payer: Nomi Health Commercial |
$191.24
|
| Rate for Payer: PACE SWMI |
$159.37
|
| Rate for Payer: PACE SWMI |
$159.37
|
| Rate for Payer: PHP Commercial |
$223.12
|
| Rate for Payer: PHP Commercial |
$223.12
|
| Rate for Payer: PHP Medicare Advantage |
$159.37
|
| Rate for Payer: PHP Medicare Advantage |
$159.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.47
|
| Rate for Payer: Priority Health Medicare |
$159.37
|
| Rate for Payer: Priority Health Medicare |
$159.37
|
| Rate for Payer: Priority Health Narrow Network |
$237.47
|
| Rate for Payer: Priority Health Narrow Network |
$237.47
|
| Rate for Payer: Priority Health SBD |
$139.77
|
| Rate for Payer: Priority Health SBD |
$139.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.37
|
| Rate for Payer: UHC Medicare Advantage |
$159.37
|
| Rate for Payer: UHC Medicare Advantage |
$159.37
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
| Rate for Payer: UMR Bronson Commercial |
$245.64
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$640.30 |
| Rate for Payer: Aetna Commercial |
$256.89
|
| Rate for Payer: Aetna Commercial |
$256.89
|
| Rate for Payer: Aetna Medicare |
$199.38
|
| Rate for Payer: Aetna Medicare |
$199.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.89
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$191.71
|
| Rate for Payer: BCBS MAPPO |
$191.71
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$191.71
|
| Rate for Payer: BCN Medicare Advantage |
$191.71
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$256.89
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Cofinity Commercial |
$256.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.30
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Nomi Health Commercial |
$230.05
|
| Rate for Payer: Nomi Health Commercial |
$230.05
|
| Rate for Payer: PACE SWMI |
$191.71
|
| Rate for Payer: PACE SWMI |
$191.71
|
| Rate for Payer: PHP Commercial |
$268.39
|
| Rate for Payer: PHP Commercial |
$268.39
|
| Rate for Payer: PHP Medicare Advantage |
$191.71
|
| Rate for Payer: PHP Medicare Advantage |
$191.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.31
|
| Rate for Payer: Priority Health Medicare |
$191.71
|
| Rate for Payer: Priority Health Medicare |
$191.71
|
| Rate for Payer: Priority Health Narrow Network |
$286.31
|
| Rate for Payer: Priority Health Narrow Network |
$286.31
|
| Rate for Payer: Priority Health SBD |
$174.59
|
| Rate for Payer: Priority Health SBD |
$174.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.71
|
| Rate for Payer: UHC Medicare Advantage |
$191.71
|
| Rate for Payer: UHC Medicare Advantage |
$191.71
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
| Rate for Payer: UMR Bronson Commercial |
$208.38
|
| Rate for Payer: UMR Bronson Commercial |
$297.62
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,147.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,797.71 |
| Rate for Payer: Aetna Commercial |
$1,353.92
|
| Rate for Payer: Aetna Medicare |
$1,050.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,353.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,454.96
|
| Rate for Payer: BCBS Complete |
$711.88
|
| Rate for Payer: BCBS MAPPO |
$1,010.39
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$1,535.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,010.39
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cofinity Commercial |
$1,353.92
|
| Rate for Payer: Cofinity Commercial |
$1,454.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,010.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,060.91
|
| Rate for Payer: Meridian Medicaid |
$711.88
|
| Rate for Payer: Nomi Health Commercial |
$1,212.47
|
| Rate for Payer: PACE SWMI |
$1,010.39
|
| Rate for Payer: PHP Commercial |
$1,414.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,010.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.71
|
| Rate for Payer: Priority Health Medicare |
$1,010.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,797.71
|
| Rate for Payer: Priority Health SBD |
$1,797.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,010.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,010.39
|
| Rate for Payer: UHCCP Medicaid |
$677.98
|
| Rate for Payer: UMR Bronson Commercial |
$987.62
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG >4 CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 64893
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$1,916.01 |
| Rate for Payer: Aetna Commercial |
$1,444.32
|
| Rate for Payer: Aetna Medicare |
$1,120.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.10
|
| Rate for Payer: BCBS Complete |
$759.07
|
| Rate for Payer: BCBS MAPPO |
$1,077.85
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,636.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.85
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,444.32
|
| Rate for Payer: Cofinity Commercial |
$1,552.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.74
|
| Rate for Payer: Meridian Medicaid |
$759.07
|
| Rate for Payer: Nomi Health Commercial |
$1,293.42
|
| Rate for Payer: PACE SWMI |
$1,077.85
|
| Rate for Payer: PHP Commercial |
$1,508.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,916.01
|
| Rate for Payer: Priority Health Medicare |
$1,077.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,916.01
|
| Rate for Payer: Priority Health SBD |
$1,916.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.85
|
| Rate for Payer: UHCCP Medicaid |
$722.92
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR NERVE GRAFT 1 STRAND HAND/FOOT <4 CM
|
Professional
|
Both
|
$3,711.00
|
|
|
Service Code
|
HCPCS 64890
|
| Min. Negotiated Rate |
$359.24 |
| Max. Negotiated Rate |
$2,412.15 |
| Rate for Payer: Aetna Commercial |
$1,391.84
|
| Rate for Payer: Aetna Medicare |
$1,080.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,391.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,495.71
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,038.69
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$1,576.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,038.69
|
| Rate for Payer: Cash Price |
$2,968.80
|
| Rate for Payer: Cash Price |
$2,968.80
|
| Rate for Payer: Cofinity Commercial |
$1,391.84
|
| Rate for Payer: Cofinity Commercial |
$1,495.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,038.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,090.62
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Nomi Health Commercial |
$1,246.43
|
| Rate for Payer: PACE SWMI |
$1,038.69
|
| Rate for Payer: PHP Commercial |
$1,454.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,038.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,846.63
|
| Rate for Payer: Priority Health Medicare |
$1,038.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,846.63
|
| Rate for Payer: Priority Health SBD |
$1,846.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,038.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,038.69
|
| Rate for Payer: UHCCP Medicaid |
$696.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,707.06
|
|
|
PR NERVE GRAFT EACH NERVE MULTIPLE STRANDS
|
Professional
|
Both
|
$2,944.00
|
|
|
Service Code
|
HCPCS 64902
|
| Min. Negotiated Rate |
$379.32 |
| Max. Negotiated Rate |
$1,913.60 |
| Rate for Payer: Aetna Commercial |
$881.61
|
| Rate for Payer: Aetna Medicare |
$684.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.40
|
| Rate for Payer: BCBS Complete |
$458.03
|
| Rate for Payer: BCBS MAPPO |
$657.92
|
| Rate for Payer: BCBS Trust/PPO |
$379.32
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$657.92
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cofinity Commercial |
$881.61
|
| Rate for Payer: Cofinity Commercial |
$947.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.82
|
| Rate for Payer: Meridian Medicaid |
$458.03
|
| Rate for Payer: Nomi Health Commercial |
$789.50
|
| Rate for Payer: PACE SWMI |
$657.92
|
| Rate for Payer: PHP Commercial |
$921.09
|
| Rate for Payer: PHP Medicare Advantage |
$657.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,913.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,156.77
|
| Rate for Payer: Priority Health Medicare |
$657.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.77
|
| Rate for Payer: Priority Health SBD |
$1,156.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.92
|
| Rate for Payer: UHC Medicare Advantage |
$657.92
|
| Rate for Payer: UHCCP Medicaid |
$436.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,354.24
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG <4 CM
|
Professional
|
Both
|
$2,622.00
|
|
|
Service Code
|
HCPCS 64897
|
| Min. Negotiated Rate |
$407.32 |
| Max. Negotiated Rate |
$2,161.69 |
| Rate for Payer: Aetna Commercial |
$1,632.58
|
| Rate for Payer: Aetna Medicare |
$1,267.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.41
|
| Rate for Payer: BCBS Complete |
$856.80
|
| Rate for Payer: BCBS MAPPO |
$1,218.34
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$1,846.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.34
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cofinity Commercial |
$1,632.58
|
| Rate for Payer: Cofinity Commercial |
$1,754.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.26
|
| Rate for Payer: Meridian Medicaid |
$856.80
|
| Rate for Payer: Nomi Health Commercial |
$1,462.01
|
| Rate for Payer: PACE SWMI |
$1,218.34
|
| Rate for Payer: PHP Commercial |
$1,705.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,704.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,161.69
|
| Rate for Payer: Priority Health Medicare |
$1,218.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,161.69
|
| Rate for Payer: Priority Health SBD |
$2,161.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.34
|
| Rate for Payer: UHCCP Medicaid |
$816.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,206.12
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG >4 CM
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 64898
|
| Min. Negotiated Rate |
$367.70 |
| Max. Negotiated Rate |
$2,340.83 |
| Rate for Payer: Aetna Commercial |
$1,768.02
|
| Rate for Payer: Aetna Medicare |
$1,372.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,768.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,899.96
|
| Rate for Payer: BCBS Complete |
$927.93
|
| Rate for Payer: BCBS MAPPO |
$1,319.42
|
| Rate for Payer: BCBS Trust/PPO |
$367.70
|
| Rate for Payer: BCN Commercial |
$1,999.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.42
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cofinity Commercial |
$1,768.02
|
| Rate for Payer: Cofinity Commercial |
$1,899.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.39
|
| Rate for Payer: Meridian Medicaid |
$927.93
|
| Rate for Payer: Nomi Health Commercial |
$1,583.30
|
| Rate for Payer: PACE SWMI |
$1,319.42
|
| Rate for Payer: PHP Commercial |
$1,847.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,340.83
|
| Rate for Payer: Priority Health Medicare |
$1,319.42
|
| Rate for Payer: Priority Health Narrow Network |
$2,340.83
|
| Rate for Payer: Priority Health SBD |
$2,340.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,319.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,319.42
|
| Rate for Payer: UHCCP Medicaid |
$883.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,467.86
|
|
|
PR NERVE GRAFT MLT STRANDS HAND/FOOT <4 CM
|
Professional
|
Both
|
$3,215.00
|
|
|
Service Code
|
HCPCS 64895
|
| Min. Negotiated Rate |
$219.77 |
| Max. Negotiated Rate |
$2,260.08 |
| Rate for Payer: Aetna Commercial |
$1,707.33
|
| Rate for Payer: Aetna Medicare |
$1,325.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,707.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,834.75
|
| Rate for Payer: BCBS Complete |
$895.72
|
| Rate for Payer: BCBS MAPPO |
$1,274.13
|
| Rate for Payer: BCBS Trust/PPO |
$219.77
|
| Rate for Payer: BCN Commercial |
$1,932.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,274.13
|
| Rate for Payer: Cash Price |
$2,572.00
|
| Rate for Payer: Cash Price |
$2,572.00
|
| Rate for Payer: Cofinity Commercial |
$1,834.75
|
| Rate for Payer: Cofinity Commercial |
$1,707.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,274.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,337.84
|
| Rate for Payer: Meridian Medicaid |
$895.72
|
| Rate for Payer: Nomi Health Commercial |
$1,528.96
|
| Rate for Payer: PACE SWMI |
$1,274.13
|
| Rate for Payer: PHP Commercial |
$1,783.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,274.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$853.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,089.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,260.08
|
| Rate for Payer: Priority Health Medicare |
$1,274.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,260.08
|
| Rate for Payer: Priority Health SBD |
$2,260.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,274.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,274.13
|
| Rate for Payer: UHCCP Medicaid |
$853.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,478.90
|
|
|
PR NERVE PEDICLE TRANSFER FIRST STAGE
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 64905
|
| Min. Negotiated Rate |
$641.34 |
| Max. Negotiated Rate |
$1,712.41 |
| Rate for Payer: Aetna Commercial |
$1,281.52
|
| Rate for Payer: Aetna Medicare |
$994.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.16
|
| Rate for Payer: BCBS Complete |
$673.41
|
| Rate for Payer: BCBS MAPPO |
$956.36
|
| Rate for Payer: BCN Commercial |
$1,469.46
|
| Rate for Payer: BCN Medicare Advantage |
$956.36
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cofinity Commercial |
$1,281.52
|
| Rate for Payer: Cofinity Commercial |
$1,377.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.18
|
| Rate for Payer: Meridian Medicaid |
$673.41
|
| Rate for Payer: Nomi Health Commercial |
$1,147.63
|
| Rate for Payer: PACE SWMI |
$956.36
|
| Rate for Payer: PHP Commercial |
$1,338.90
|
| Rate for Payer: PHP Medicare Advantage |
$956.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,447.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,712.41
|
| Rate for Payer: Priority Health Medicare |
$956.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,712.41
|
| Rate for Payer: Priority Health SBD |
$1,712.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.36
|
| Rate for Payer: UHC Medicare Advantage |
$956.36
|
| Rate for Payer: UHCCP Medicaid |
$641.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.42
|
|
