|
PR NERVE REPAIR W/CONDUIT EACH NERVE
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 64910
|
| Min. Negotiated Rate |
$272.60 |
| Max. Negotiated Rate |
$1,703.65 |
| Rate for Payer: Aetna Commercial |
$974.74
|
| Rate for Payer: Aetna Medicare |
$756.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,047.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.74
|
| Rate for Payer: BCBS Complete |
$517.52
|
| Rate for Payer: BCBS MAPPO |
$727.42
|
| Rate for Payer: BCBS Trust/PPO |
$272.60
|
| Rate for Payer: BCN Commercial |
$1,113.21
|
| Rate for Payer: BCN Medicare Advantage |
$727.42
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,047.48
|
| Rate for Payer: Cofinity Commercial |
$974.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.79
|
| Rate for Payer: Meridian Medicaid |
$517.52
|
| Rate for Payer: Nomi Health Commercial |
$872.90
|
| Rate for Payer: PACE SWMI |
$727.42
|
| Rate for Payer: PHP Commercial |
$1,018.39
|
| Rate for Payer: PHP Medicare Advantage |
$727.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,306.91
|
| Rate for Payer: Priority Health Medicare |
$727.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,306.91
|
| Rate for Payer: Priority Health SBD |
$1,306.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$727.42
|
| Rate for Payer: UHC Medicare Advantage |
$727.42
|
| Rate for Payer: UHCCP Medicaid |
$492.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,205.66
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 64913
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$291.18 |
| Rate for Payer: Aetna Commercial |
$219.37
|
| Rate for Payer: Aetna Medicare |
$170.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.74
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS MAPPO |
$163.71
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: BCN Medicare Advantage |
$163.71
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$219.37
|
| Rate for Payer: Cofinity Commercial |
$235.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.90
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Nomi Health Commercial |
$196.45
|
| Rate for Payer: PACE SWMI |
$163.71
|
| Rate for Payer: PHP Commercial |
$229.19
|
| Rate for Payer: PHP Medicare Advantage |
$163.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.18
|
| Rate for Payer: Priority Health Medicare |
$163.71
|
| Rate for Payer: Priority Health Narrow Network |
$291.18
|
| Rate for Payer: Priority Health SBD |
$291.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.71
|
| Rate for Payer: UHC Medicare Advantage |
$163.71
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND
|
Professional
|
Both
|
$1,592.00
|
|
|
Service Code
|
HCPCS 64912
|
| Min. Negotiated Rate |
$311.17 |
| Max. Negotiated Rate |
$1,533.25 |
| Rate for Payer: Aetna Commercial |
$1,141.37
|
| Rate for Payer: Aetna Medicare |
$885.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.55
|
| Rate for Payer: BCBS Complete |
$605.64
|
| Rate for Payer: BCBS MAPPO |
$851.77
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$1,309.17
|
| Rate for Payer: BCN Medicare Advantage |
$851.77
|
| Rate for Payer: Cash Price |
$1,273.60
|
| Rate for Payer: Cash Price |
$1,273.60
|
| Rate for Payer: Cofinity Commercial |
$1,226.55
|
| Rate for Payer: Cofinity Commercial |
$1,141.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$851.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$894.36
|
| Rate for Payer: Meridian Medicaid |
$605.64
|
| Rate for Payer: Nomi Health Commercial |
$1,022.12
|
| Rate for Payer: PACE SWMI |
$851.77
|
| Rate for Payer: PHP Commercial |
$1,192.48
|
| Rate for Payer: PHP Medicare Advantage |
$851.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.25
|
| Rate for Payer: Priority Health Medicare |
$851.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,533.25
|
| Rate for Payer: Priority Health SBD |
$1,533.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$851.77
|
| Rate for Payer: UHC Medicare Advantage |
$851.77
|
| Rate for Payer: UHCCP Medicaid |
$576.80
|
| Rate for Payer: UMR Bronson Commercial |
$732.32
|
|
|
PR NEURAXIAL LABOR ANALG/ANES PLND VAGINAL DELIVERY
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01967
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.00
|
| Rate for Payer: Priority Health Narrow Network |
$650.00
|
| Rate for Payer: Priority Health SBD |
$650.00
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 96116
|
| Min. Negotiated Rate |
$50.27 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$101.16
|
| Rate for Payer: Aetna Medicare |
$78.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.71
|
| Rate for Payer: BCBS Complete |
$52.78
|
| Rate for Payer: BCBS MAPPO |
$75.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$134.38
|
| Rate for Payer: BCN Medicare Advantage |
$75.49
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$101.16
|
| Rate for Payer: Cofinity Commercial |
$108.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.26
|
| Rate for Payer: Meridian Medicaid |
$52.78
|
| Rate for Payer: Nomi Health Commercial |
$90.59
|
| Rate for Payer: PACE SWMI |
$75.49
|
| Rate for Payer: PHP Commercial |
$105.69
|
| Rate for Payer: PHP Medicare Advantage |
$75.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.20
|
| Rate for Payer: Priority Health Medicare |
$75.49
|
| Rate for Payer: Priority Health Narrow Network |
$107.20
|
| Rate for Payer: Priority Health SBD |
$107.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.49
|
| Rate for Payer: UHC Medicare Advantage |
$75.49
|
| Rate for Payer: UHCCP Medicaid |
$50.27
|
| Rate for Payer: UMR Bronson Commercial |
$99.36
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 96121
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$1,458.64 |
| Rate for Payer: Aetna Commercial |
$84.84
|
| Rate for Payer: Aetna Medicare |
$65.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.17
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS MAPPO |
$63.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.64
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$63.31
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$84.84
|
| Rate for Payer: Cofinity Commercial |
$91.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.48
|
| Rate for Payer: Meridian Medicaid |
$44.06
|
| Rate for Payer: Nomi Health Commercial |
$75.97
|
| Rate for Payer: PACE SWMI |
$63.31
|
| Rate for Payer: PHP Commercial |
$88.63
|
| Rate for Payer: PHP Medicare Advantage |
$63.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.11
|
| Rate for Payer: Priority Health Medicare |
$63.31
|
| Rate for Payer: Priority Health Narrow Network |
$89.11
|
| Rate for Payer: Priority Health SBD |
$89.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.31
|
| Rate for Payer: UHC Medicare Advantage |
$63.31
|
| Rate for Payer: UHCCP Medicaid |
$41.96
|
| Rate for Payer: UMR Bronson Commercial |
$76.82
|
|
|
PR NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY
|
Professional
|
Both
|
$4,388.00
|
|
|
Service Code
|
HCPCS 62164
|
| Min. Negotiated Rate |
$1,230.41 |
| Max. Negotiated Rate |
$4,290.63 |
| Rate for Payer: Aetna Commercial |
$2,785.31
|
| Rate for Payer: Aetna Medicare |
$2,161.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,785.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,993.17
|
| Rate for Payer: BCBS Complete |
$1,435.38
|
| Rate for Payer: BCBS MAPPO |
$2,078.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
| Rate for Payer: BCN Commercial |
$4,290.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,078.59
|
| Rate for Payer: Cash Price |
$3,510.40
|
| Rate for Payer: Cash Price |
$3,510.40
|
| Rate for Payer: Cofinity Commercial |
$2,785.31
|
| Rate for Payer: Cofinity Commercial |
$2,993.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,078.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,182.52
|
| Rate for Payer: Meridian Medicaid |
$1,435.38
|
| Rate for Payer: Nomi Health Commercial |
$2,494.31
|
| Rate for Payer: PACE SWMI |
$2,078.59
|
| Rate for Payer: PHP Commercial |
$2,910.03
|
| Rate for Payer: PHP Medicare Advantage |
$2,078.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,367.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,852.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,632.96
|
| Rate for Payer: Priority Health Medicare |
$2,078.59
|
| Rate for Payer: Priority Health Narrow Network |
$3,632.96
|
| Rate for Payer: Priority Health SBD |
$3,632.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,078.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,078.59
|
| Rate for Payer: UHCCP Medicaid |
$1,367.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,018.48
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 95937
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna Commercial |
$123.00
|
| Rate for Payer: Aetna Medicare |
$95.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.18
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$91.79
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$153.93
|
| Rate for Payer: BCN Medicare Advantage |
$91.79
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$123.00
|
| Rate for Payer: Cofinity Commercial |
$132.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.38
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Nomi Health Commercial |
$110.15
|
| Rate for Payer: PACE SWMI |
$91.79
|
| Rate for Payer: PHP Commercial |
$128.51
|
| Rate for Payer: PHP Medicare Advantage |
$91.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.13
|
| Rate for Payer: Priority Health Medicare |
$91.79
|
| Rate for Payer: Priority Health Narrow Network |
$141.13
|
| Rate for Payer: Priority Health SBD |
$45.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.79
|
| Rate for Payer: UHC Medicare Advantage |
$91.79
|
| Rate for Payer: UHCCP Medicaid |
$21.51
|
| Rate for Payer: UMR Bronson Commercial |
$71.76
|
|
|
PR NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 64702
|
| Min. Negotiated Rate |
$336.75 |
| Max. Negotiated Rate |
$4,639.00 |
| Rate for Payer: Aetna Commercial |
$661.04
|
| Rate for Payer: Aetna Medicare |
$513.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.37
|
| Rate for Payer: BCBS Complete |
$353.59
|
| Rate for Payer: BCBS MAPPO |
$493.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,639.00
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: BCN Medicare Advantage |
$493.31
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cofinity Commercial |
$661.04
|
| Rate for Payer: Cofinity Commercial |
$710.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.98
|
| Rate for Payer: Meridian Medicaid |
$353.59
|
| Rate for Payer: Nomi Health Commercial |
$591.97
|
| Rate for Payer: PACE SWMI |
$493.31
|
| Rate for Payer: PHP Commercial |
$690.63
|
| Rate for Payer: PHP Medicare Advantage |
$493.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$891.19
|
| Rate for Payer: Priority Health Medicare |
$493.31
|
| Rate for Payer: Priority Health Narrow Network |
$891.19
|
| Rate for Payer: Priority Health SBD |
$891.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.31
|
| Rate for Payer: UHC Medicare Advantage |
$493.31
|
| Rate for Payer: UHCCP Medicaid |
$336.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,144.48
|
|
|
PR NEUROPLASTY NERVE HAND/FOOT
|
Professional
|
Both
|
$1,888.00
|
|
|
Service Code
|
HCPCS 64704
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$6,889.56 |
| Rate for Payer: Aetna Commercial |
$416.95
|
| Rate for Payer: Aetna Medicare |
$323.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.07
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$311.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,889.56
|
| Rate for Payer: BCN Commercial |
$474.51
|
| Rate for Payer: BCN Medicare Advantage |
$311.16
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$416.95
|
| Rate for Payer: Cofinity Commercial |
$448.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.72
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Nomi Health Commercial |
$373.39
|
| Rate for Payer: PACE SWMI |
$311.16
|
| Rate for Payer: PHP Commercial |
$435.62
|
| Rate for Payer: PHP Medicare Advantage |
$311.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.62
|
| Rate for Payer: Priority Health Medicare |
$311.16
|
| Rate for Payer: Priority Health Narrow Network |
$559.62
|
| Rate for Payer: Priority Health SBD |
$559.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.16
|
| Rate for Payer: UHC Medicare Advantage |
$311.16
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
| Rate for Payer: UMR Bronson Commercial |
$868.48
|
|
|
PR NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 64716
|
| Min. Negotiated Rate |
$330.79 |
| Max. Negotiated Rate |
$5,621.64 |
| Rate for Payer: Aetna Commercial |
$653.25
|
| Rate for Payer: Aetna Medicare |
$507.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.00
|
| Rate for Payer: BCBS Complete |
$347.33
|
| Rate for Payer: BCBS MAPPO |
$487.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,621.64
|
| Rate for Payer: BCN Commercial |
$751.59
|
| Rate for Payer: BCN Medicare Advantage |
$487.50
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$653.25
|
| Rate for Payer: Cofinity Commercial |
$702.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.88
|
| Rate for Payer: Meridian Medicaid |
$347.33
|
| Rate for Payer: Nomi Health Commercial |
$585.00
|
| Rate for Payer: PACE SWMI |
$487.50
|
| Rate for Payer: PHP Commercial |
$682.50
|
| Rate for Payer: PHP Medicare Advantage |
$487.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$880.93
|
| Rate for Payer: Priority Health Medicare |
$487.50
|
| Rate for Payer: Priority Health Narrow Network |
$880.93
|
| Rate for Payer: Priority Health SBD |
$880.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.50
|
| Rate for Payer: UHC Medicare Advantage |
$487.50
|
| Rate for Payer: UHCCP Medicaid |
$330.79
|
| Rate for Payer: UMR Bronson Commercial |
$441.60
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
OP
|
$3,146.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$583.02 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna American Axle |
$2,044.90
|
| Rate for Payer: Aetna Commercial |
$2,674.10
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,172.79
|
| Rate for Payer: BCN Commercial |
$3,172.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$2,202.20
|
| Rate for Payer: Cofinity Commercial |
$2,705.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,202.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,516.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,831.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,202.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,359.50
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,674.10
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,674.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,981.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.32
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$583.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,164.02
|
| Rate for Payer: VA VA |
$1,913.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,359.50
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
IP
|
$3,146.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$1,384.24 |
| Max. Negotiated Rate |
$2,831.40 |
| Rate for Payer: Aetna American Axle |
$2,044.90
|
| Rate for Payer: Aetna Commercial |
$2,674.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.90
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$2,202.20
|
| Rate for Payer: Cofinity Commercial |
$2,705.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,202.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,516.80
|
| Rate for Payer: Healthscope Commercial |
$2,831.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,202.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,359.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,674.10
|
| Rate for Payer: PHP Commercial |
$2,674.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health SBD |
$1,981.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,384.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,359.50
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,146.00
|
|
|
Service Code
|
HCPCS 64718
|
| Min. Negotiated Rate |
$396.18 |
| Max. Negotiated Rate |
$4,438.25 |
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Aetna Commercial |
$779.04
|
| Rate for Payer: Aetna Medicare |
$604.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.17
|
| Rate for Payer: BCBS Complete |
$415.99
|
| Rate for Payer: BCBS MAPPO |
$581.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.25
|
| Rate for Payer: BCN Commercial |
$889.40
|
| Rate for Payer: BCN Medicare Advantage |
$581.37
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$779.04
|
| Rate for Payer: Cofinity Commercial |
$837.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.44
|
| Rate for Payer: Meridian Medicaid |
$415.99
|
| Rate for Payer: Nomi Health Commercial |
$697.64
|
| Rate for Payer: PACE SWMI |
$581.37
|
| Rate for Payer: PHP Commercial |
$813.92
|
| Rate for Payer: PHP Medicare Advantage |
$581.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.00
|
| Rate for Payer: Priority Health Medicare |
$581.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.00
|
| Rate for Payer: Priority Health SBD |
$1,047.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.37
|
| Rate for Payer: UHC Medicare Advantage |
$581.37
|
| Rate for Payer: UHCCP Medicaid |
$396.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,447.16
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,146.00
|
|
|
Service Code
|
HCPCS 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$396.18 |
| Max. Negotiated Rate |
$4,438.25 |
| Rate for Payer: Aetna Commercial |
$779.04
|
| Rate for Payer: Aetna Medicare |
$604.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.17
|
| Rate for Payer: BCBS Complete |
$415.99
|
| Rate for Payer: BCBS MAPPO |
$581.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.25
|
| Rate for Payer: BCN Commercial |
$889.40
|
| Rate for Payer: BCN Medicare Advantage |
$581.37
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$837.17
|
| Rate for Payer: Cofinity Commercial |
$779.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.44
|
| Rate for Payer: Meridian Medicaid |
$415.99
|
| Rate for Payer: Nomi Health Commercial |
$697.64
|
| Rate for Payer: PACE SWMI |
$581.37
|
| Rate for Payer: PHP Commercial |
$813.92
|
| Rate for Payer: PHP Medicare Advantage |
$581.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.00
|
| Rate for Payer: Priority Health Medicare |
$581.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.00
|
| Rate for Payer: Priority Health SBD |
$1,047.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.37
|
| Rate for Payer: UHC Medicare Advantage |
$581.37
|
| Rate for Payer: UHCCP Medicaid |
$396.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,447.16
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Facility
|
IP
|
$1,572.00
|
|
|
Service Code
|
CPT 64719
|
| Hospital Charge Code |
64719
|
| Min. Negotiated Rate |
$691.68 |
| Max. Negotiated Rate |
$1,414.80 |
| Rate for Payer: Aetna American Axle |
$1,021.80
|
| Rate for Payer: Aetna Commercial |
$1,336.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.80
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$1,100.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,100.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,257.60
|
| Rate for Payer: Healthscope Commercial |
$1,414.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,100.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,179.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,336.20
|
| Rate for Payer: PHP Commercial |
$1,336.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health SBD |
$990.36
|
| Rate for Payer: UMR Bronson Commercial |
$691.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,179.00
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 64719
|
| Hospital Charge Code |
64719
|
| Min. Negotiated Rate |
$267.74 |
| Max. Negotiated Rate |
$3,989.19 |
| Rate for Payer: Aetna Commercial |
$526.31
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.59
|
| Rate for Payer: BCBS Complete |
$281.13
|
| Rate for Payer: BCBS MAPPO |
$392.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.19
|
| Rate for Payer: BCN Commercial |
$602.05
|
| Rate for Payer: BCN Medicare Advantage |
$392.77
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Cofinity Commercial |
$565.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.41
|
| Rate for Payer: Meridian Medicaid |
$281.13
|
| Rate for Payer: Nomi Health Commercial |
$471.32
|
| Rate for Payer: PACE SWMI |
$392.77
|
| Rate for Payer: PHP Commercial |
$549.88
|
| Rate for Payer: PHP Medicare Advantage |
$392.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.62
|
| Rate for Payer: Priority Health Medicare |
$392.77
|
| Rate for Payer: Priority Health Narrow Network |
$708.62
|
| Rate for Payer: Priority Health SBD |
$708.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.77
|
| Rate for Payer: UHC Medicare Advantage |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$267.74
|
| Rate for Payer: UMR Bronson Commercial |
$723.12
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Facility
|
OP
|
$1,572.00
|
|
|
Service Code
|
CPT 64719
|
| Hospital Charge Code |
64719
|
| Min. Negotiated Rate |
$394.49 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna American Axle |
$1,021.80
|
| Rate for Payer: Aetna Commercial |
$1,336.20
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,433.52
|
| Rate for Payer: BCN Commercial |
$1,433.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$1,100.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,100.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,257.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$1,414.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,100.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,336.20
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$1,336.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$990.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.94
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$394.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: UMR Bronson Commercial |
$581.64
|
| Rate for Payer: VA VA |
$1,913.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,179.00
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 64719
|
| Min. Negotiated Rate |
$267.74 |
| Max. Negotiated Rate |
$3,989.19 |
| Rate for Payer: Aetna Commercial |
$526.31
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.59
|
| Rate for Payer: BCBS Complete |
$281.13
|
| Rate for Payer: BCBS MAPPO |
$392.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.19
|
| Rate for Payer: BCN Commercial |
$602.05
|
| Rate for Payer: BCN Medicare Advantage |
$392.77
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Cofinity Commercial |
$565.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.41
|
| Rate for Payer: Meridian Medicaid |
$281.13
|
| Rate for Payer: Nomi Health Commercial |
$471.32
|
| Rate for Payer: PACE SWMI |
$392.77
|
| Rate for Payer: PHP Commercial |
$549.88
|
| Rate for Payer: PHP Medicare Advantage |
$392.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.62
|
| Rate for Payer: Priority Health Medicare |
$392.77
|
| Rate for Payer: Priority Health Narrow Network |
$708.62
|
| Rate for Payer: Priority Health SBD |
$708.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.77
|
| Rate for Payer: UHC Medicare Advantage |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$267.74
|
| Rate for Payer: UMR Bronson Commercial |
$723.12
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Facility
|
IP
|
$2,254.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
64721
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$991.76 |
| Max. Negotiated Rate |
$2,028.60 |
| Rate for Payer: Aetna American Axle |
$1,465.10
|
| Rate for Payer: Aetna Commercial |
$1,915.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.10
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$1,577.80
|
| Rate for Payer: Cofinity Commercial |
$1,938.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,577.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.20
|
| Rate for Payer: Healthscope Commercial |
$2,028.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,577.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,690.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,915.90
|
| Rate for Payer: PHP Commercial |
$1,915.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health SBD |
$1,420.02
|
| Rate for Payer: UMR Bronson Commercial |
$991.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,690.50
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Facility
|
OP
|
$2,254.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
64721
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$421.98 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna American Axle |
$1,465.10
|
| Rate for Payer: Aetna Commercial |
$1,915.90
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,999.57
|
| Rate for Payer: BCN Commercial |
$1,999.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$1,938.44
|
| Rate for Payer: Cofinity Commercial |
$1,577.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,577.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,028.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,577.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,690.50
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,915.90
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$1,915.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,420.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.18
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$421.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: UMR Bronson Commercial |
$833.98
|
| Rate for Payer: VA VA |
$1,913.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,690.50
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Professional
|
Both
|
$2,254.00
|
|
|
Service Code
|
HCPCS 64721
|
| Hospital Charge Code |
64721
|
| Min. Negotiated Rate |
$287.34 |
| Max. Negotiated Rate |
$6,985.18 |
| Rate for Payer: Aetna Commercial |
$563.09
|
| Rate for Payer: Aetna Medicare |
$437.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.12
|
| Rate for Payer: BCBS Complete |
$301.71
|
| Rate for Payer: BCBS MAPPO |
$420.22
|
| Rate for Payer: BCBS Trust/PPO |
$6,985.18
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$420.22
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$563.09
|
| Rate for Payer: Cofinity Commercial |
$605.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.23
|
| Rate for Payer: Meridian Medicaid |
$301.71
|
| Rate for Payer: Nomi Health Commercial |
$504.26
|
| Rate for Payer: PACE SWMI |
$420.22
|
| Rate for Payer: PHP Commercial |
$588.31
|
| Rate for Payer: PHP Medicare Advantage |
$420.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.37
|
| Rate for Payer: Priority Health Medicare |
$420.22
|
| Rate for Payer: Priority Health Narrow Network |
$760.37
|
| Rate for Payer: Priority Health SBD |
$760.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.22
|
| Rate for Payer: UHC Medicare Advantage |
$420.22
|
| Rate for Payer: UHCCP Medicaid |
$287.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,036.84
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Professional
|
Both
|
$2,254.00
|
|
|
Service Code
|
HCPCS 64721
|
| Min. Negotiated Rate |
$287.34 |
| Max. Negotiated Rate |
$6,985.18 |
| Rate for Payer: Aetna Commercial |
$563.09
|
| Rate for Payer: Aetna Medicare |
$437.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.12
|
| Rate for Payer: BCBS Complete |
$301.71
|
| Rate for Payer: BCBS MAPPO |
$420.22
|
| Rate for Payer: BCBS Trust/PPO |
$6,985.18
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$420.22
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$563.09
|
| Rate for Payer: Cofinity Commercial |
$605.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.23
|
| Rate for Payer: Meridian Medicaid |
$301.71
|
| Rate for Payer: Nomi Health Commercial |
$504.26
|
| Rate for Payer: PACE SWMI |
$420.22
|
| Rate for Payer: PHP Commercial |
$588.31
|
| Rate for Payer: PHP Medicare Advantage |
$420.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.37
|
| Rate for Payer: Priority Health Medicare |
$420.22
|
| Rate for Payer: Priority Health Narrow Network |
$760.37
|
| Rate for Payer: Priority Health SBD |
$760.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.22
|
| Rate for Payer: UHC Medicare Advantage |
$420.22
|
| Rate for Payer: UHCCP Medicaid |
$287.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,036.84
|
|
|
PR NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 96132
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$2,343.54 |
| Rate for Payer: Aetna Commercial |
$136.57
|
| Rate for Payer: Aetna Medicare |
$106.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.76
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$101.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,343.54
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Medicare Advantage |
$101.92
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$136.57
|
| Rate for Payer: Cofinity Commercial |
$146.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.02
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Nomi Health Commercial |
$122.30
|
| Rate for Payer: PACE SWMI |
$101.92
|
| Rate for Payer: PHP Commercial |
$142.69
|
| Rate for Payer: PHP Medicare Advantage |
$101.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.02
|
| Rate for Payer: Priority Health Medicare |
$101.92
|
| Rate for Payer: Priority Health Narrow Network |
$142.02
|
| Rate for Payer: Priority Health SBD |
$142.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.92
|
| Rate for Payer: UHC Medicare Advantage |
$101.92
|
| Rate for Payer: UHCCP Medicaid |
$67.73
|
| Rate for Payer: UMR Bronson Commercial |
$122.36
|
|
|
PR NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 96133
|
| Min. Negotiated Rate |
$47.93 |
| Max. Negotiated Rate |
$150.57 |
| Rate for Payer: Aetna Commercial |
$96.86
|
| Rate for Payer: Aetna Medicare |
$75.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.86
|
| Rate for Payer: BCBS Complete |
$50.33
|
| Rate for Payer: BCBS MAPPO |
$72.28
|
| Rate for Payer: BCBS Trust/PPO |
$150.57
|
| Rate for Payer: BCN Commercial |
$142.69
|
| Rate for Payer: BCN Medicare Advantage |
$72.28
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$104.08
|
| Rate for Payer: Cofinity Commercial |
$96.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.89
|
| Rate for Payer: Meridian Medicaid |
$50.33
|
| Rate for Payer: Nomi Health Commercial |
$86.74
|
| Rate for Payer: PACE SWMI |
$72.28
|
| Rate for Payer: PHP Commercial |
$101.19
|
| Rate for Payer: PHP Medicare Advantage |
$72.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.22
|
| Rate for Payer: Priority Health Medicare |
$72.28
|
| Rate for Payer: Priority Health Narrow Network |
$102.22
|
| Rate for Payer: Priority Health SBD |
$102.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.28
|
| Rate for Payer: UHC Medicare Advantage |
$72.28
|
| Rate for Payer: UHCCP Medicaid |
$47.93
|
| Rate for Payer: UMR Bronson Commercial |
$93.38
|
|
