|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
OP
|
$116.71
|
|
|
Service Code
|
NDC 24208073006
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.18 |
| Max. Negotiated Rate |
$105.04 |
| Rate for Payer: Aetna American Axle |
$75.86
|
| Rate for Payer: Aetna Commercial |
$99.20
|
| Rate for Payer: Aetna Medicare |
$58.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.86
|
| Rate for Payer: BCBS Complete |
$46.68
|
| Rate for Payer: Cash Price |
$93.37
|
| Rate for Payer: Cofinity Commercial |
$100.37
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.37
|
| Rate for Payer: Healthscope Commercial |
$105.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.20
|
| Rate for Payer: PHP Commercial |
$99.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.86
|
| Rate for Payer: Priority Health SBD |
$73.53
|
| Rate for Payer: UMR Bronson Commercial |
$43.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.53
|
|
|
PR OPEN ABLATION 1/>RENAL MASS LESION CRYOSURGICAL
|
Professional
|
Both
|
$2,527.00
|
|
|
Service Code
|
HCPCS 50250
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$4,748.36 |
| Rate for Payer: Aetna Commercial |
$1,552.95
|
| Rate for Payer: Aetna Medicare |
$1,205.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,668.84
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS MAPPO |
$1,158.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,748.36
|
| Rate for Payer: BCN Commercial |
$1,748.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,158.92
|
| Rate for Payer: Cash Price |
$2,021.60
|
| Rate for Payer: Cash Price |
$2,021.60
|
| Rate for Payer: Cofinity Commercial |
$1,552.95
|
| Rate for Payer: Cofinity Commercial |
$1,668.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,158.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,216.87
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Nomi Health Commercial |
$1,390.70
|
| Rate for Payer: PACE SWMI |
$1,158.92
|
| Rate for Payer: PHP Commercial |
$1,622.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,158.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,926.94
|
| Rate for Payer: Priority Health Medicare |
$1,158.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,926.94
|
| Rate for Payer: Priority Health SBD |
$1,926.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,158.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,158.92
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,162.42
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$289.47 |
| Max. Negotiated Rate |
$900.10 |
| Rate for Payer: Aetna Commercial |
$580.80
|
| Rate for Payer: Aetna Medicare |
$450.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.14
|
| Rate for Payer: BCBS Complete |
$303.94
|
| Rate for Payer: BCBS MAPPO |
$433.43
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$433.43
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$624.14
|
| Rate for Payer: Cofinity Commercial |
$580.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.10
|
| Rate for Payer: Meridian Medicaid |
$303.94
|
| Rate for Payer: Nomi Health Commercial |
$520.12
|
| Rate for Payer: PACE SWMI |
$433.43
|
| Rate for Payer: PHP Commercial |
$606.80
|
| Rate for Payer: PHP Medicare Advantage |
$433.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$900.10
|
| Rate for Payer: Priority Health Medicare |
$433.43
|
| Rate for Payer: Priority Health Narrow Network |
$900.10
|
| Rate for Payer: Priority Health SBD |
$900.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.43
|
| Rate for Payer: UHC Medicare Advantage |
$433.43
|
| Rate for Payer: UHCCP Medicaid |
$289.47
|
| Rate for Payer: UMR Bronson Commercial |
$414.46
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Facility
|
IP
|
$901.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$396.44 |
| Max. Negotiated Rate |
$810.90 |
| Rate for Payer: Aetna American Axle |
$585.65
|
| Rate for Payer: Aetna Commercial |
$765.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.65
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$630.70
|
| Rate for Payer: Cofinity Commercial |
$774.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.80
|
| Rate for Payer: Healthscope Commercial |
$810.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$630.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.85
|
| Rate for Payer: PHP Commercial |
$765.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health SBD |
$567.63
|
| Rate for Payer: UMR Bronson Commercial |
$396.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.75
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 38531
|
| Min. Negotiated Rate |
$289.47 |
| Max. Negotiated Rate |
$900.10 |
| Rate for Payer: Aetna Commercial |
$580.80
|
| Rate for Payer: Aetna Medicare |
$450.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.14
|
| Rate for Payer: BCBS Complete |
$303.94
|
| Rate for Payer: BCBS MAPPO |
$433.43
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$433.43
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$624.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.10
|
| Rate for Payer: Meridian Medicaid |
$303.94
|
| Rate for Payer: Nomi Health Commercial |
$520.12
|
| Rate for Payer: PACE SWMI |
$433.43
|
| Rate for Payer: PHP Commercial |
$606.80
|
| Rate for Payer: PHP Medicare Advantage |
$433.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$900.10
|
| Rate for Payer: Priority Health Medicare |
$433.43
|
| Rate for Payer: Priority Health Narrow Network |
$900.10
|
| Rate for Payer: Priority Health SBD |
$900.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.43
|
| Rate for Payer: UHC Medicare Advantage |
$433.43
|
| Rate for Payer: UHCCP Medicaid |
$289.47
|
| Rate for Payer: UMR Bronson Commercial |
$414.46
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Facility
|
OP
|
$901.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$333.37 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna American Axle |
$585.65
|
| Rate for Payer: Aetna Commercial |
$765.85
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,689.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,689.81
|
| Rate for Payer: BCBS Complete |
$2,111.54
|
| Rate for Payer: BCBS MAPPO |
$3,751.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,995.12
|
| Rate for Payer: BCN Commercial |
$2,995.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$774.86
|
| Rate for Payer: Cofinity Commercial |
$630.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$810.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$630.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.75
|
| Rate for Payer: Mclaren Medicaid |
$2,010.99
|
| Rate for Payer: Mclaren Medicare |
$3,751.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,939.44
|
| Rate for Payer: Meridian Medicaid |
$2,111.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,314.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.85
|
| Rate for Payer: Nomi Health Commercial |
$7,878.88
|
| Rate for Payer: PACE Medicare |
$3,564.26
|
| Rate for Payer: PACE SWMI |
$3,751.85
|
| Rate for Payer: PHP Commercial |
$765.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,751.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,010.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.02
|
| Rate for Payer: Priority Health Medicare |
$3,751.85
|
| Rate for Payer: Priority Health Narrow Network |
$9,433.62
|
| Rate for Payer: Priority Health SBD |
$567.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.52
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Exchange |
$436.84
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,010.99
|
| Rate for Payer: UMR Bronson Commercial |
$333.37
|
| Rate for Payer: VA VA |
$3,751.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.75
|
|
|
PR OPEN CLOSURE MAJOR BRONCHIAL FISTULA
|
Professional
|
Both
|
$4,782.00
|
|
|
Service Code
|
HCPCS 32815
|
| Min. Negotiated Rate |
$1,282.18 |
| Max. Negotiated Rate |
$4,031.10 |
| Rate for Payer: Aetna Commercial |
$3,603.76
|
| Rate for Payer: Aetna Medicare |
$2,796.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,603.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,872.69
|
| Rate for Payer: BCBS Complete |
$1,853.17
|
| Rate for Payer: BCBS MAPPO |
$2,689.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.18
|
| Rate for Payer: BCN Commercial |
$4,031.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,689.37
|
| Rate for Payer: Cash Price |
$3,825.60
|
| Rate for Payer: Cash Price |
$3,825.60
|
| Rate for Payer: Cofinity Commercial |
$3,872.69
|
| Rate for Payer: Cofinity Commercial |
$3,603.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,689.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,823.84
|
| Rate for Payer: Meridian Medicaid |
$1,853.17
|
| Rate for Payer: Nomi Health Commercial |
$3,227.24
|
| Rate for Payer: PACE SWMI |
$2,689.37
|
| Rate for Payer: PHP Commercial |
$3,765.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,689.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,764.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,108.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,829.63
|
| Rate for Payer: Priority Health Medicare |
$2,689.37
|
| Rate for Payer: Priority Health Narrow Network |
$3,829.63
|
| Rate for Payer: Priority Health SBD |
$3,829.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,689.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,689.37
|
| Rate for Payer: UHCCP Medicaid |
$1,764.92
|
| Rate for Payer: UMR Bronson Commercial |
$2,199.72
|
|
|
PR OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM
|
Professional
|
Both
|
$4,070.00
|
|
|
Service Code
|
HCPCS 49188
|
| Min. Negotiated Rate |
$1,284.82 |
| Max. Negotiated Rate |
$2,791.57 |
| Rate for Payer: Aetna Commercial |
$2,597.71
|
| Rate for Payer: Aetna Medicare |
$2,016.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,597.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,791.57
|
| Rate for Payer: BCBS Complete |
$1,349.06
|
| Rate for Payer: BCBS MAPPO |
$1,938.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,938.59
|
| Rate for Payer: Cash Price |
$3,256.00
|
| Rate for Payer: Cash Price |
$3,256.00
|
| Rate for Payer: Cofinity Commercial |
$2,791.57
|
| Rate for Payer: Cofinity Commercial |
$2,597.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,938.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,035.52
|
| Rate for Payer: Meridian Medicaid |
$1,349.06
|
| Rate for Payer: Nomi Health Commercial |
$2,326.31
|
| Rate for Payer: PACE SWMI |
$1,938.59
|
| Rate for Payer: PHP Commercial |
$2,714.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,938.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,284.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,645.50
|
| Rate for Payer: Priority Health Medicare |
$1,938.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,938.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,938.59
|
| Rate for Payer: UHCCP Medicaid |
$1,284.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,872.20
|
|
|
PR OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS
|
Professional
|
Both
|
$2,694.00
|
|
|
Service Code
|
HCPCS 49186
|
| Min. Negotiated Rate |
$841.35 |
| Max. Negotiated Rate |
$1,821.02 |
| Rate for Payer: Aetna Commercial |
$1,694.56
|
| Rate for Payer: Aetna Medicare |
$1,315.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,821.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.56
|
| Rate for Payer: BCBS Complete |
$883.42
|
| Rate for Payer: BCBS MAPPO |
$1,264.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,264.60
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cofinity Commercial |
$1,821.02
|
| Rate for Payer: Cofinity Commercial |
$1,694.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,264.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,327.83
|
| Rate for Payer: Meridian Medicaid |
$883.42
|
| Rate for Payer: Nomi Health Commercial |
$1,517.52
|
| Rate for Payer: PACE SWMI |
$1,264.60
|
| Rate for Payer: PHP Commercial |
$1,770.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,264.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.10
|
| Rate for Payer: Priority Health Medicare |
$1,264.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,264.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,264.60
|
| Rate for Payer: UHCCP Medicaid |
$841.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,239.24
|
|
|
PR OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 35600
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$1,077.73 |
| Rate for Payer: Aetna Commercial |
$238.71
|
| Rate for Payer: Aetna Medicare |
$185.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.52
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$178.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.73
|
| Rate for Payer: BCN Commercial |
$264.86
|
| Rate for Payer: BCN Medicare Advantage |
$178.14
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$238.71
|
| Rate for Payer: Cofinity Commercial |
$256.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.05
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$213.77
|
| Rate for Payer: PACE SWMI |
$178.14
|
| Rate for Payer: PHP Commercial |
$249.40
|
| Rate for Payer: PHP Medicare Advantage |
$178.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.31
|
| Rate for Payer: Priority Health Medicare |
$178.14
|
| Rate for Payer: Priority Health Narrow Network |
$289.31
|
| Rate for Payer: Priority Health SBD |
$289.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.14
|
| Rate for Payer: UHC Medicare Advantage |
$178.14
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
| Rate for Payer: UMR Bronson Commercial |
$592.02
|
|
|
PR OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 64568
|
| Min. Negotiated Rate |
$390.86 |
| Max. Negotiated Rate |
$1,259.70 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: Aetna Medicare |
$606.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.15
|
| Rate for Payer: BCBS Complete |
$410.40
|
| Rate for Payer: BCBS MAPPO |
$582.74
|
| Rate for Payer: BCBS Trust/PPO |
$462.79
|
| Rate for Payer: BCN Commercial |
$879.62
|
| Rate for Payer: BCN Medicare Advantage |
$582.74
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$780.87
|
| Rate for Payer: Cofinity Commercial |
$839.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.88
|
| Rate for Payer: Meridian Medicaid |
$410.40
|
| Rate for Payer: Nomi Health Commercial |
$699.29
|
| Rate for Payer: PACE SWMI |
$582.74
|
| Rate for Payer: PHP Commercial |
$815.84
|
| Rate for Payer: PHP Medicare Advantage |
$582.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,036.77
|
| Rate for Payer: Priority Health Medicare |
$582.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,036.77
|
| Rate for Payer: Priority Health SBD |
$1,036.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.74
|
| Rate for Payer: UHC Medicare Advantage |
$582.74
|
| Rate for Payer: UHCCP Medicaid |
$390.86
|
| Rate for Payer: UMR Bronson Commercial |
$891.48
|
|
|
PR OPEN IMPLANTATION NEA PERIPHERAL NERVE
|
Professional
|
Both
|
$995.00
|
|
|
Service Code
|
HCPCS 64575
|
| Min. Negotiated Rate |
$202.99 |
| Max. Negotiated Rate |
$646.75 |
| Rate for Payer: Aetna Commercial |
$402.11
|
| Rate for Payer: Aetna Medicare |
$312.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.12
|
| Rate for Payer: BCBS Complete |
$213.14
|
| Rate for Payer: BCBS MAPPO |
$300.08
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$447.63
|
| Rate for Payer: BCN Medicare Advantage |
$300.08
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cofinity Commercial |
$402.11
|
| Rate for Payer: Cofinity Commercial |
$432.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.08
|
| Rate for Payer: Meridian Medicaid |
$213.14
|
| Rate for Payer: Nomi Health Commercial |
$360.10
|
| Rate for Payer: PACE SWMI |
$300.08
|
| Rate for Payer: PHP Commercial |
$420.11
|
| Rate for Payer: PHP Medicare Advantage |
$300.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.15
|
| Rate for Payer: Priority Health Medicare |
$300.08
|
| Rate for Payer: Priority Health Narrow Network |
$539.15
|
| Rate for Payer: Priority Health SBD |
$539.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.08
|
| Rate for Payer: UHC Medicare Advantage |
$300.08
|
| Rate for Payer: UHCCP Medicaid |
$202.99
|
| Rate for Payer: UMR Bronson Commercial |
$457.70
|
|
|
PR OPEN IMPLANTATION NEA SACRAL NERVE
|
Professional
|
Both
|
$1,517.00
|
|
|
Service Code
|
HCPCS 64581
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,115.82 |
| Rate for Payer: Aetna Commercial |
$844.82
|
| Rate for Payer: Aetna Medicare |
$655.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.86
|
| Rate for Payer: BCBS Complete |
$441.04
|
| Rate for Payer: BCBS MAPPO |
$630.46
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$950.47
|
| Rate for Payer: BCN Medicare Advantage |
$630.46
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cofinity Commercial |
$844.82
|
| Rate for Payer: Cofinity Commercial |
$907.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.98
|
| Rate for Payer: Meridian Medicaid |
$441.04
|
| Rate for Payer: Nomi Health Commercial |
$756.55
|
| Rate for Payer: PACE SWMI |
$630.46
|
| Rate for Payer: PHP Commercial |
$882.64
|
| Rate for Payer: PHP Medicare Advantage |
$630.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.82
|
| Rate for Payer: Priority Health Medicare |
$630.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.82
|
| Rate for Payer: Priority Health SBD |
$1,115.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.46
|
| Rate for Payer: UHC Medicare Advantage |
$630.46
|
| Rate for Payer: UHCCP Medicaid |
$420.04
|
| Rate for Payer: UMR Bronson Commercial |
$697.82
|
|
|
PR OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 64582
|
| Min. Negotiated Rate |
$368.23 |
| Max. Negotiated Rate |
$1,429.17 |
| Rate for Payer: Aetna Commercial |
$1,072.80
|
| Rate for Payer: Aetna Medicare |
$832.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,072.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,152.86
|
| Rate for Payer: BCBS Complete |
$564.05
|
| Rate for Payer: BCBS MAPPO |
$800.60
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$1,258.34
|
| Rate for Payer: BCN Medicare Advantage |
$800.60
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,072.80
|
| Rate for Payer: Cofinity Commercial |
$1,152.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.63
|
| Rate for Payer: Meridian Medicaid |
$564.05
|
| Rate for Payer: Nomi Health Commercial |
$960.72
|
| Rate for Payer: PACE SWMI |
$800.60
|
| Rate for Payer: PHP Commercial |
$1,120.84
|
| Rate for Payer: PHP Medicare Advantage |
$800.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,429.17
|
| Rate for Payer: Priority Health Medicare |
$800.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,429.17
|
| Rate for Payer: Priority Health SBD |
$1,429.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.60
|
| Rate for Payer: UHC Medicare Advantage |
$800.60
|
| Rate for Payer: UHCCP Medicaid |
$537.19
|
| Rate for Payer: UMR Bronson Commercial |
$805.46
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL
|
Professional
|
Both
|
$640.00
|
|
|
Service Code
|
HCPCS 37239
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$2,525.00 |
| Rate for Payer: Aetna Commercial |
$192.80
|
| Rate for Payer: Aetna Medicare |
$149.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.19
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$143.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.39
|
| Rate for Payer: BCN Commercial |
$2,525.00
|
| Rate for Payer: BCN Medicare Advantage |
$143.88
|
| Rate for Payer: Cash Price |
$512.00
|
| Rate for Payer: Cash Price |
$512.00
|
| Rate for Payer: Cofinity Commercial |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$207.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.07
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: PACE SWMI |
$143.88
|
| Rate for Payer: PHP Commercial |
$201.43
|
| Rate for Payer: PHP Medicare Advantage |
$143.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.94
|
| Rate for Payer: Priority Health Medicare |
$143.88
|
| Rate for Payer: Priority Health Narrow Network |
$232.94
|
| Rate for Payer: Priority Health SBD |
$232.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.88
|
| Rate for Payer: UHC Medicare Advantage |
$143.88
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
| Rate for Payer: UMR Bronson Commercial |
$294.40
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL
|
Professional
|
Both
|
$508.00
|
|
|
Service Code
|
HCPCS 37237
|
| Min. Negotiated Rate |
$131.42 |
| Max. Negotiated Rate |
$1,902.42 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: Aetna Medicare |
$210.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.02
|
| Rate for Payer: BCBS Complete |
$137.99
|
| Rate for Payer: BCBS MAPPO |
$202.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.43
|
| Rate for Payer: BCN Commercial |
$1,902.42
|
| Rate for Payer: BCN Medicare Advantage |
$202.10
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cofinity Commercial |
$270.81
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.20
|
| Rate for Payer: Meridian Medicaid |
$137.99
|
| Rate for Payer: Nomi Health Commercial |
$242.52
|
| Rate for Payer: PACE SWMI |
$202.10
|
| Rate for Payer: PHP Commercial |
$282.94
|
| Rate for Payer: PHP Medicare Advantage |
$202.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.08
|
| Rate for Payer: Priority Health Medicare |
$202.10
|
| Rate for Payer: Priority Health Narrow Network |
$327.08
|
| Rate for Payer: Priority Health SBD |
$327.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.10
|
| Rate for Payer: UHC Medicare Advantage |
$202.10
|
| Rate for Payer: UHCCP Medicaid |
$131.42
|
| Rate for Payer: UMR Bronson Commercial |
$233.68
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL
|
Professional
|
Both
|
$1,211.00
|
|
|
Service Code
|
HCPCS 37236
|
| Min. Negotiated Rate |
$274.34 |
| Max. Negotiated Rate |
$4,048.21 |
| Rate for Payer: Aetna Commercial |
$564.14
|
| Rate for Payer: Aetna Medicare |
$437.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.24
|
| Rate for Payer: BCBS Complete |
$288.06
|
| Rate for Payer: BCBS MAPPO |
$421.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.84
|
| Rate for Payer: BCN Commercial |
$4,048.21
|
| Rate for Payer: BCN Medicare Advantage |
$421.00
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Cofinity Commercial |
$564.14
|
| Rate for Payer: Cofinity Commercial |
$606.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.05
|
| Rate for Payer: Meridian Medicaid |
$288.06
|
| Rate for Payer: Nomi Health Commercial |
$505.20
|
| Rate for Payer: PACE SWMI |
$421.00
|
| Rate for Payer: PHP Commercial |
$589.40
|
| Rate for Payer: PHP Medicare Advantage |
$421.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$682.86
|
| Rate for Payer: Priority Health Medicare |
$421.00
|
| Rate for Payer: Priority Health Narrow Network |
$682.86
|
| Rate for Payer: Priority Health SBD |
$682.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.00
|
| Rate for Payer: UHC Medicare Advantage |
$421.00
|
| Rate for Payer: UHCCP Medicaid |
$274.34
|
| Rate for Payer: UMR Bronson Commercial |
$557.06
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 37238
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$5,084.69 |
| Rate for Payer: Aetna Commercial |
$391.29
|
| Rate for Payer: Aetna Medicare |
$303.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.49
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$292.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.33
|
| Rate for Payer: BCN Commercial |
$5,084.69
|
| Rate for Payer: BCN Medicare Advantage |
$292.01
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cofinity Commercial |
$391.29
|
| Rate for Payer: Cofinity Commercial |
$420.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.61
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Nomi Health Commercial |
$350.41
|
| Rate for Payer: PACE SWMI |
$292.01
|
| Rate for Payer: PHP Commercial |
$408.81
|
| Rate for Payer: PHP Medicare Advantage |
$292.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$835.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.45
|
| Rate for Payer: Priority Health Medicare |
$292.01
|
| Rate for Payer: Priority Health Narrow Network |
$475.45
|
| Rate for Payer: Priority Health SBD |
$475.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.01
|
| Rate for Payer: UHC Medicare Advantage |
$292.01
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
| Rate for Payer: UMR Bronson Commercial |
$591.10
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF ACUTE
|
Professional
|
Both
|
$2,616.00
|
|
|
Service Code
|
HCPCS 23410
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,700.40 |
| Rate for Payer: Aetna Commercial |
$1,059.42
|
| Rate for Payer: Aetna Medicare |
$822.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,059.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,138.48
|
| Rate for Payer: BCBS Complete |
$560.69
|
| Rate for Payer: BCBS MAPPO |
$790.61
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$1,206.54
|
| Rate for Payer: BCN Medicare Advantage |
$790.61
|
| Rate for Payer: Cash Price |
$2,092.80
|
| Rate for Payer: Cash Price |
$2,092.80
|
| Rate for Payer: Cofinity Commercial |
$1,059.42
|
| Rate for Payer: Cofinity Commercial |
$1,138.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$830.14
|
| Rate for Payer: Meridian Medicaid |
$560.69
|
| Rate for Payer: Nomi Health Commercial |
$948.73
|
| Rate for Payer: PACE SWMI |
$790.61
|
| Rate for Payer: PHP Commercial |
$1,106.85
|
| Rate for Payer: PHP Medicare Advantage |
$790.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,700.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,265.03
|
| Rate for Payer: Priority Health Medicare |
$790.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.03
|
| Rate for Payer: Priority Health SBD |
$1,265.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$790.61
|
| Rate for Payer: UHC Medicare Advantage |
$790.61
|
| Rate for Payer: UHCCP Medicaid |
$533.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,203.36
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,119.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$78.96 |
| Max. Negotiated Rate |
$2,027.35 |
| Rate for Payer: Aetna Commercial |
$1,101.68
|
| Rate for Payer: Aetna Medicare |
$855.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,183.90
|
| Rate for Payer: BCBS Complete |
$582.61
|
| Rate for Payer: BCBS MAPPO |
$822.15
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$1,379.62
|
| Rate for Payer: BCN Medicare Advantage |
$822.15
|
| Rate for Payer: Cash Price |
$2,495.20
|
| Rate for Payer: Cash Price |
$2,495.20
|
| Rate for Payer: Cofinity Commercial |
$1,101.68
|
| Rate for Payer: Cofinity Commercial |
$1,183.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.26
|
| Rate for Payer: Meridian Medicaid |
$582.61
|
| Rate for Payer: Nomi Health Commercial |
$986.58
|
| Rate for Payer: PACE SWMI |
$822.15
|
| Rate for Payer: PHP Commercial |
$1,151.01
|
| Rate for Payer: PHP Medicare Advantage |
$822.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,027.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.90
|
| Rate for Payer: Priority Health Medicare |
$822.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,314.90
|
| Rate for Payer: Priority Health SBD |
$1,314.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.15
|
| Rate for Payer: UHC Medicare Advantage |
$822.15
|
| Rate for Payer: UHCCP Medicaid |
$554.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,434.74
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27814
|
| Min. Negotiated Rate |
$496.93 |
| Max. Negotiated Rate |
$1,953.25 |
| Rate for Payer: Aetna Commercial |
$984.90
|
| Rate for Payer: Aetna Medicare |
$764.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.90
|
| Rate for Payer: BCBS Complete |
$521.78
|
| Rate for Payer: BCBS MAPPO |
$735.00
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$735.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$984.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.75
|
| Rate for Payer: Meridian Medicaid |
$521.78
|
| Rate for Payer: Nomi Health Commercial |
$882.00
|
| Rate for Payer: PACE SWMI |
$735.00
|
| Rate for Payer: PHP Commercial |
$1,029.00
|
| Rate for Payer: PHP Medicare Advantage |
$735.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,180.05
|
| Rate for Payer: Priority Health Medicare |
$735.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,180.05
|
| Rate for Payer: Priority Health SBD |
$1,180.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.00
|
| Rate for Payer: UHC Medicare Advantage |
$735.00
|
| Rate for Payer: UHCCP Medicaid |
$496.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,382.30
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
OP
|
$3,005.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$740.21 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna American Axle |
$1,953.25
|
| Rate for Payer: Aetna Commercial |
$2,554.25
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,953.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,808.58
|
| Rate for Payer: BCN Commercial |
$5,808.58
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$2,584.30
|
| Rate for Payer: Cofinity Commercial |
$2,103.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,103.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,404.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,704.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,253.75
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,554.25
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$2,554.25
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$1,893.15
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.23
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$740.21
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.85
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,253.75
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
IP
|
$3,005.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$1,322.20 |
| Max. Negotiated Rate |
$2,704.50 |
| Rate for Payer: Aetna American Axle |
$1,953.25
|
| Rate for Payer: Aetna Commercial |
$2,554.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,953.25
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$2,103.50
|
| Rate for Payer: Cofinity Commercial |
$2,584.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,103.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,404.00
|
| Rate for Payer: Healthscope Commercial |
$2,704.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,253.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,554.25
|
| Rate for Payer: PHP Commercial |
$2,554.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health SBD |
$1,893.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,322.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,253.75
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$496.93 |
| Max. Negotiated Rate |
$1,953.25 |
| Rate for Payer: Aetna Commercial |
$984.90
|
| Rate for Payer: Aetna Medicare |
$764.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.90
|
| Rate for Payer: BCBS Complete |
$521.78
|
| Rate for Payer: BCBS MAPPO |
$735.00
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$735.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$984.90
|
| Rate for Payer: Cofinity Commercial |
$1,058.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.75
|
| Rate for Payer: Meridian Medicaid |
$521.78
|
| Rate for Payer: Nomi Health Commercial |
$882.00
|
| Rate for Payer: PACE SWMI |
$735.00
|
| Rate for Payer: PHP Commercial |
$1,029.00
|
| Rate for Payer: PHP Medicare Advantage |
$735.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,180.05
|
| Rate for Payer: Priority Health Medicare |
$735.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,180.05
|
| Rate for Payer: Priority Health SBD |
$1,180.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.00
|
| Rate for Payer: UHC Medicare Advantage |
$735.00
|
| Rate for Payer: UHCCP Medicaid |
$496.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,382.30
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,366.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$725.27 |
| Max. Negotiated Rate |
$2,187.90 |
| Rate for Payer: Aetna Commercial |
$1,437.07
|
| Rate for Payer: Aetna Medicare |
$1,115.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,544.31
|
| Rate for Payer: BCBS Complete |
$761.53
|
| Rate for Payer: BCBS MAPPO |
$1,072.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: BCN Commercial |
$1,648.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.44
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cofinity Commercial |
$1,437.07
|
| Rate for Payer: Cofinity Commercial |
$1,544.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,126.06
|
| Rate for Payer: Meridian Medicaid |
$761.53
|
| Rate for Payer: Nomi Health Commercial |
$1,286.93
|
| Rate for Payer: PACE SWMI |
$1,072.44
|
| Rate for Payer: PHP Commercial |
$1,501.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,187.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.51
|
| Rate for Payer: Priority Health Medicare |
$1,072.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.51
|
| Rate for Payer: Priority Health SBD |
$1,723.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,072.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.44
|
| Rate for Payer: UHCCP Medicaid |
$725.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,548.36
|
|
