|
PR PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL
|
Professional
|
Both
|
$2,544.00
|
|
|
Service Code
|
HCPCS 47533
|
| Min. Negotiated Rate |
$144.63 |
| Max. Negotiated Rate |
$1,908.00 |
| Rate for Payer: Aetna Commercial |
$303.42
|
| Rate for Payer: Aetna Medicare |
$235.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.06
|
| Rate for Payer: BCBS Complete |
$151.86
|
| Rate for Payer: BCBS MAPPO |
$226.43
|
| Rate for Payer: BCN Commercial |
$383.94
|
| Rate for Payer: BCN Medicare Advantage |
$226.43
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cofinity Commercial |
$303.42
|
| Rate for Payer: Cofinity Commercial |
$326.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.75
|
| Rate for Payer: Meridian Medicaid |
$151.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$249.07
|
| Rate for Payer: Nomi Health Commercial |
$271.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,908.00
|
| Rate for Payer: PACE SWMI |
$226.43
|
| Rate for Payer: PHP Commercial |
$317.00
|
| Rate for Payer: PHP Medicare Advantage |
$226.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$467.81
|
| Rate for Payer: Priority Health Medicare |
$226.43
|
| Rate for Payer: Priority Health SBD |
$467.81
|
| Rate for Payer: Priority Health Tiered Network |
$467.81
|
| Rate for Payer: Railroad Medicare Medicare |
$226.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.83
|
| Rate for Payer: UHC Core |
$474.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.43
|
| Rate for Payer: UHC Exchange |
$474.83
|
| Rate for Payer: UHC Medicaid |
$144.63
|
| Rate for Payer: UHCCP Medicaid |
$144.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.24
|
|
|
PR PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 27756
|
| Min. Negotiated Rate |
$359.97 |
| Max. Negotiated Rate |
$1,281.75 |
| Rate for Payer: Aetna Commercial |
$733.65
|
| Rate for Payer: Aetna Medicare |
$569.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.40
|
| Rate for Payer: BCBS Complete |
$377.97
|
| Rate for Payer: BCBS MAPPO |
$547.50
|
| Rate for Payer: BCN Commercial |
$903.84
|
| Rate for Payer: BCN Medicare Advantage |
$547.50
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cofinity Commercial |
$733.65
|
| Rate for Payer: Cofinity Commercial |
$788.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.88
|
| Rate for Payer: Meridian Medicaid |
$377.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.25
|
| Rate for Payer: Nomi Health Commercial |
$657.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.75
|
| Rate for Payer: PACE SWMI |
$547.50
|
| Rate for Payer: PHP Commercial |
$766.50
|
| Rate for Payer: PHP Medicare Advantage |
$547.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$966.18
|
| Rate for Payer: Priority Health Medicare |
$547.50
|
| Rate for Payer: Priority Health SBD |
$966.18
|
| Rate for Payer: Priority Health Tiered Network |
$966.18
|
| Rate for Payer: Railroad Medicare Medicare |
$547.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.33
|
| Rate for Payer: UHC Core |
$999.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.50
|
| Rate for Payer: UHC Exchange |
$999.33
|
| Rate for Payer: UHC Medicaid |
$359.97
|
| Rate for Payer: UHCCP Medicaid |
$359.97
|
| Rate for Payer: UMR Bronson Commercial |
$786.14
|
|
|
PR PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26650
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$606.15
|
| Rate for Payer: Aetna Medicare |
$470.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.38
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$452.35
|
| Rate for Payer: BCN Commercial |
$747.47
|
| Rate for Payer: BCN Medicare Advantage |
$452.35
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$606.15
|
| Rate for Payer: Cofinity Commercial |
$651.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.97
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$497.58
|
| Rate for Payer: Nomi Health Commercial |
$542.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$452.35
|
| Rate for Payer: PHP Commercial |
$633.29
|
| Rate for Payer: PHP Medicare Advantage |
$452.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$799.02
|
| Rate for Payer: Priority Health Medicare |
$452.35
|
| Rate for Payer: Priority Health SBD |
$799.02
|
| Rate for Payer: Priority Health Tiered Network |
$799.02
|
| Rate for Payer: Railroad Medicare Medicare |
$452.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.99
|
| Rate for Payer: UHC Core |
$824.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$452.35
|
| Rate for Payer: UHC Exchange |
$824.99
|
| Rate for Payer: UHC Medicaid |
$300.12
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR PRQ SKELETAL FIXJ FEMORAL FX DISTAL END
|
Professional
|
Both
|
$2,303.00
|
|
|
Service Code
|
HCPCS 27509
|
| Min. Negotiated Rate |
$416.20 |
| Max. Negotiated Rate |
$1,727.25 |
| Rate for Payer: Aetna Commercial |
$845.43
|
| Rate for Payer: Aetna Medicare |
$656.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$908.52
|
| Rate for Payer: BCBS Complete |
$437.01
|
| Rate for Payer: BCBS MAPPO |
$630.92
|
| Rate for Payer: BCN Commercial |
$1,031.31
|
| Rate for Payer: BCN Medicare Advantage |
$630.92
|
| Rate for Payer: Cash Price |
$1,842.40
|
| Rate for Payer: Cash Price |
$1,842.40
|
| Rate for Payer: Cofinity Commercial |
$845.43
|
| Rate for Payer: Cofinity Commercial |
$908.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.47
|
| Rate for Payer: Meridian Medicaid |
$437.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.01
|
| Rate for Payer: Nomi Health Commercial |
$757.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.25
|
| Rate for Payer: PACE SWMI |
$630.92
|
| Rate for Payer: PHP Commercial |
$883.29
|
| Rate for Payer: PHP Medicare Advantage |
$630.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,102.46
|
| Rate for Payer: Priority Health Medicare |
$630.92
|
| Rate for Payer: Priority Health SBD |
$1,102.46
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.46
|
| Rate for Payer: Railroad Medicare Medicare |
$630.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,147.67
|
| Rate for Payer: UHC Core |
$1,147.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$630.92
|
| Rate for Payer: UHC Exchange |
$1,147.67
|
| Rate for Payer: UHC Medicaid |
$416.20
|
| Rate for Payer: UHCCP Medicaid |
$416.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,059.38
|
|
|
PR PRQ SKELETAL FIXJ METACARPAL FX EACH BONE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26608
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$599.41
|
| Rate for Payer: Aetna Medicare |
$465.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.14
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$447.32
|
| Rate for Payer: BCN Commercial |
$743.98
|
| Rate for Payer: BCN Medicare Advantage |
$447.32
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$599.41
|
| Rate for Payer: Cofinity Commercial |
$644.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.69
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$492.05
|
| Rate for Payer: Nomi Health Commercial |
$536.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$447.32
|
| Rate for Payer: PHP Commercial |
$626.25
|
| Rate for Payer: PHP Medicare Advantage |
$447.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$795.30
|
| Rate for Payer: Priority Health Medicare |
$447.32
|
| Rate for Payer: Priority Health SBD |
$795.30
|
| Rate for Payer: Priority Health Tiered Network |
$795.30
|
| Rate for Payer: Railroad Medicare Medicare |
$447.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.93
|
| Rate for Payer: UHC Core |
$827.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$447.32
|
| Rate for Payer: UHC Exchange |
$827.93
|
| Rate for Payer: UHC Medicaid |
$296.07
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 26676
|
| Min. Negotiated Rate |
$311.83 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Aetna Commercial |
$630.39
|
| Rate for Payer: Aetna Medicare |
$489.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.43
|
| Rate for Payer: BCBS Complete |
$327.42
|
| Rate for Payer: BCBS MAPPO |
$470.44
|
| Rate for Payer: BCN Commercial |
$789.79
|
| Rate for Payer: BCN Medicare Advantage |
$470.44
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$630.39
|
| Rate for Payer: Cofinity Commercial |
$677.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.96
|
| Rate for Payer: Meridian Medicaid |
$327.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.48
|
| Rate for Payer: Nomi Health Commercial |
$564.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,275.00
|
| Rate for Payer: PACE SWMI |
$470.44
|
| Rate for Payer: PHP Commercial |
$658.62
|
| Rate for Payer: PHP Medicare Advantage |
$470.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$844.28
|
| Rate for Payer: Priority Health Medicare |
$470.44
|
| Rate for Payer: Priority Health SBD |
$844.28
|
| Rate for Payer: Priority Health Tiered Network |
$844.28
|
| Rate for Payer: Railroad Medicare Medicare |
$470.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.57
|
| Rate for Payer: UHC Core |
$871.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.44
|
| Rate for Payer: UHC Exchange |
$871.57
|
| Rate for Payer: UHC Medicaid |
$311.83
|
| Rate for Payer: UHCCP Medicaid |
$311.83
|
| Rate for Payer: UMR Bronson Commercial |
$782.00
|
|
|
PR PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 26756
|
| Min. Negotiated Rate |
$264.55 |
| Max. Negotiated Rate |
$849.75 |
| Rate for Payer: Aetna Commercial |
$533.33
|
| Rate for Payer: Aetna Medicare |
$413.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.13
|
| Rate for Payer: BCBS Complete |
$277.78
|
| Rate for Payer: BCBS MAPPO |
$398.01
|
| Rate for Payer: BCN Commercial |
$656.84
|
| Rate for Payer: BCN Medicare Advantage |
$398.01
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$533.33
|
| Rate for Payer: Cofinity Commercial |
$573.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.91
|
| Rate for Payer: Meridian Medicaid |
$277.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.81
|
| Rate for Payer: Nomi Health Commercial |
$477.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$849.75
|
| Rate for Payer: PACE SWMI |
$398.01
|
| Rate for Payer: PHP Commercial |
$557.21
|
| Rate for Payer: PHP Medicare Advantage |
$398.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$702.14
|
| Rate for Payer: Priority Health Medicare |
$398.01
|
| Rate for Payer: Priority Health SBD |
$702.14
|
| Rate for Payer: Priority Health Tiered Network |
$702.14
|
| Rate for Payer: Railroad Medicare Medicare |
$398.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.16
|
| Rate for Payer: UHC Core |
$725.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.01
|
| Rate for Payer: UHC Exchange |
$725.16
|
| Rate for Payer: UHC Medicaid |
$264.55
|
| Rate for Payer: UHCCP Medicaid |
$264.55
|
| Rate for Payer: UMR Bronson Commercial |
$521.18
|
|
|
PR PRQ SKEL FIXJ FEMORAL FX PROX END NECK
|
Professional
|
Both
|
$3,460.00
|
|
|
Service Code
|
HCPCS 27235
|
| Min. Negotiated Rate |
$533.35 |
| Max. Negotiated Rate |
$2,595.00 |
| Rate for Payer: Aetna Commercial |
$1,098.12
|
| Rate for Payer: Aetna Medicare |
$852.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,180.07
|
| Rate for Payer: BCBS Complete |
$560.02
|
| Rate for Payer: BCBS MAPPO |
$819.49
|
| Rate for Payer: BCN Commercial |
$1,512.64
|
| Rate for Payer: BCN Medicare Advantage |
$819.49
|
| Rate for Payer: Cash Price |
$2,768.00
|
| Rate for Payer: Cash Price |
$2,768.00
|
| Rate for Payer: Cofinity Commercial |
$1,098.12
|
| Rate for Payer: Cofinity Commercial |
$1,180.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.46
|
| Rate for Payer: Meridian Medicaid |
$560.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$901.44
|
| Rate for Payer: Nomi Health Commercial |
$983.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,595.00
|
| Rate for Payer: PACE SWMI |
$819.49
|
| Rate for Payer: PHP Commercial |
$1,147.29
|
| Rate for Payer: PHP Medicare Advantage |
$819.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,471.89
|
| Rate for Payer: Priority Health Medicare |
$819.49
|
| Rate for Payer: Priority Health SBD |
$1,471.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,471.89
|
| Rate for Payer: Railroad Medicare Medicare |
$819.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,590.03
|
| Rate for Payer: UHC Core |
$1,590.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$819.49
|
| Rate for Payer: UHC Exchange |
$1,590.03
|
| Rate for Payer: UHC Medicaid |
$533.35
|
| Rate for Payer: UHCCP Medicaid |
$533.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,591.60
|
|
|
PR PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 28496
|
| Min. Negotiated Rate |
$179.13 |
| Max. Negotiated Rate |
$867.00 |
| Rate for Payer: Aetna Commercial |
$357.91
|
| Rate for Payer: Aetna Medicare |
$277.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.62
|
| Rate for Payer: BCBS Complete |
$188.09
|
| Rate for Payer: BCBS MAPPO |
$267.10
|
| Rate for Payer: BCN Commercial |
$425.28
|
| Rate for Payer: BCN Medicare Advantage |
$267.10
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cofinity Commercial |
$357.91
|
| Rate for Payer: Cofinity Commercial |
$384.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.45
|
| Rate for Payer: Meridian Medicaid |
$188.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$293.81
|
| Rate for Payer: Nomi Health Commercial |
$320.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.00
|
| Rate for Payer: PACE SWMI |
$267.10
|
| Rate for Payer: PHP Commercial |
$373.94
|
| Rate for Payer: PHP Medicare Advantage |
$267.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$454.61
|
| Rate for Payer: Priority Health Medicare |
$267.10
|
| Rate for Payer: Priority Health SBD |
$454.61
|
| Rate for Payer: Priority Health Tiered Network |
$454.61
|
| Rate for Payer: Railroad Medicare Medicare |
$267.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.48
|
| Rate for Payer: UHC Core |
$413.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$267.10
|
| Rate for Payer: UHC Exchange |
$413.48
|
| Rate for Payer: UHC Medicaid |
$179.13
|
| Rate for Payer: UHCCP Medicaid |
$179.13
|
| Rate for Payer: UMR Bronson Commercial |
$531.76
|
|
|
PR PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ
|
Professional
|
Both
|
$609.00
|
|
|
Service Code
|
HCPCS 28666
|
| Min. Negotiated Rate |
$104.58 |
| Max. Negotiated Rate |
$456.75 |
| Rate for Payer: Aetna Commercial |
$212.75
|
| Rate for Payer: Aetna Medicare |
$165.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.63
|
| Rate for Payer: BCBS Complete |
$109.81
|
| Rate for Payer: BCBS MAPPO |
$158.77
|
| Rate for Payer: BCN Commercial |
$262.93
|
| Rate for Payer: BCN Medicare Advantage |
$158.77
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cofinity Commercial |
$212.75
|
| Rate for Payer: Cofinity Commercial |
$228.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.71
|
| Rate for Payer: Meridian Medicaid |
$109.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.65
|
| Rate for Payer: Nomi Health Commercial |
$190.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.75
|
| Rate for Payer: PACE SWMI |
$158.77
|
| Rate for Payer: PHP Commercial |
$222.28
|
| Rate for Payer: PHP Medicare Advantage |
$158.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$281.07
|
| Rate for Payer: Priority Health Medicare |
$158.77
|
| Rate for Payer: Priority Health SBD |
$281.07
|
| Rate for Payer: Priority Health Tiered Network |
$281.07
|
| Rate for Payer: Railroad Medicare Medicare |
$158.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.53
|
| Rate for Payer: UHC Core |
$290.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.77
|
| Rate for Payer: UHC Exchange |
$290.53
|
| Rate for Payer: UHC Medicaid |
$104.58
|
| Rate for Payer: UHCCP Medicaid |
$104.58
|
| Rate for Payer: UMR Bronson Commercial |
$280.14
|
|
|
PR PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,431.00
|
|
|
Service Code
|
HCPCS 26776
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$1,073.25 |
| Rate for Payer: Aetna Commercial |
$560.00
|
| Rate for Payer: Aetna Medicare |
$434.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.79
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$417.91
|
| Rate for Payer: BCN Commercial |
$697.17
|
| Rate for Payer: BCN Medicare Advantage |
$417.91
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cofinity Commercial |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$601.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$438.81
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$459.70
|
| Rate for Payer: Nomi Health Commercial |
$501.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,073.25
|
| Rate for Payer: PACE SWMI |
$417.91
|
| Rate for Payer: PHP Commercial |
$585.07
|
| Rate for Payer: PHP Medicare Advantage |
$417.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$745.26
|
| Rate for Payer: Priority Health Medicare |
$417.91
|
| Rate for Payer: Priority Health SBD |
$745.26
|
| Rate for Payer: Priority Health Tiered Network |
$745.26
|
| Rate for Payer: Railroad Medicare Medicare |
$417.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.15
|
| Rate for Payer: UHC Core |
$769.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.91
|
| Rate for Payer: UHC Exchange |
$769.15
|
| Rate for Payer: UHC Medicaid |
$277.33
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
| Rate for Payer: UMR Bronson Commercial |
$658.26
|
|
|
PR PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 26706
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Aetna Commercial |
$540.38
|
| Rate for Payer: Aetna Medicare |
$419.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.71
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS MAPPO |
$403.27
|
| Rate for Payer: BCN Commercial |
$694.18
|
| Rate for Payer: BCN Medicare Advantage |
$403.27
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cofinity Commercial |
$540.38
|
| Rate for Payer: Cofinity Commercial |
$580.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.43
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.60
|
| Rate for Payer: Nomi Health Commercial |
$483.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,062.00
|
| Rate for Payer: PACE SWMI |
$403.27
|
| Rate for Payer: PHP Commercial |
$564.58
|
| Rate for Payer: PHP Medicare Advantage |
$403.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$742.06
|
| Rate for Payer: Priority Health Medicare |
$403.27
|
| Rate for Payer: Priority Health SBD |
$742.06
|
| Rate for Payer: Priority Health Tiered Network |
$742.06
|
| Rate for Payer: Railroad Medicare Medicare |
$403.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.70
|
| Rate for Payer: UHC Core |
$763.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.27
|
| Rate for Payer: UHC Exchange |
$763.70
|
| Rate for Payer: UHC Medicaid |
$266.68
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
| Rate for Payer: UMR Bronson Commercial |
$651.36
|
|
|
PR PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 28636
|
| Min. Negotiated Rate |
$138.66 |
| Max. Negotiated Rate |
$507.75 |
| Rate for Payer: Aetna Commercial |
$282.04
|
| Rate for Payer: Aetna Medicare |
$218.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.09
|
| Rate for Payer: BCBS Complete |
$145.59
|
| Rate for Payer: BCBS MAPPO |
$210.48
|
| Rate for Payer: BCN Commercial |
$343.11
|
| Rate for Payer: BCN Medicare Advantage |
$210.48
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$282.04
|
| Rate for Payer: Cofinity Commercial |
$303.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.00
|
| Rate for Payer: Meridian Medicaid |
$145.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.53
|
| Rate for Payer: Nomi Health Commercial |
$252.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.75
|
| Rate for Payer: PACE SWMI |
$210.48
|
| Rate for Payer: PHP Commercial |
$294.67
|
| Rate for Payer: PHP Medicare Advantage |
$210.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$366.78
|
| Rate for Payer: Priority Health Medicare |
$210.48
|
| Rate for Payer: Priority Health SBD |
$366.78
|
| Rate for Payer: Priority Health Tiered Network |
$366.78
|
| Rate for Payer: Railroad Medicare Medicare |
$210.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.76
|
| Rate for Payer: UHC Core |
$346.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$210.48
|
| Rate for Payer: UHC Exchange |
$346.76
|
| Rate for Payer: UHC Medicaid |
$138.66
|
| Rate for Payer: UHCCP Medicaid |
$138.66
|
| Rate for Payer: UMR Bronson Commercial |
$311.42
|
|
|
PR PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26727
|
| Min. Negotiated Rate |
$291.38 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$589.63
|
| Rate for Payer: Aetna Medicare |
$457.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.63
|
| Rate for Payer: BCBS Complete |
$305.95
|
| Rate for Payer: BCBS MAPPO |
$440.02
|
| Rate for Payer: BCN Commercial |
$734.53
|
| Rate for Payer: BCN Medicare Advantage |
$440.02
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$589.63
|
| Rate for Payer: Cofinity Commercial |
$633.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.02
|
| Rate for Payer: Meridian Medicaid |
$305.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$484.02
|
| Rate for Payer: Nomi Health Commercial |
$528.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$440.02
|
| Rate for Payer: PHP Commercial |
$616.03
|
| Rate for Payer: PHP Medicare Advantage |
$440.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$785.18
|
| Rate for Payer: Priority Health Medicare |
$440.02
|
| Rate for Payer: Priority Health SBD |
$785.18
|
| Rate for Payer: Priority Health Tiered Network |
$785.18
|
| Rate for Payer: Railroad Medicare Medicare |
$440.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.19
|
| Rate for Payer: UHC Core |
$813.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$440.02
|
| Rate for Payer: UHC Exchange |
$813.19
|
| Rate for Payer: UHC Medicaid |
$291.38
|
| Rate for Payer: UHCCP Medicaid |
$291.38
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,007.00
|
|
|
Service Code
|
HCPCS 28576
|
| Min. Negotiated Rate |
$246.44 |
| Max. Negotiated Rate |
$755.25 |
| Rate for Payer: Aetna Commercial |
$499.55
|
| Rate for Payer: Aetna Medicare |
$387.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.83
|
| Rate for Payer: BCBS Complete |
$258.76
|
| Rate for Payer: BCBS MAPPO |
$372.80
|
| Rate for Payer: BCN Commercial |
$605.05
|
| Rate for Payer: BCN Medicare Advantage |
$372.80
|
| Rate for Payer: Cash Price |
$805.60
|
| Rate for Payer: Cash Price |
$805.60
|
| Rate for Payer: Cofinity Commercial |
$499.55
|
| Rate for Payer: Cofinity Commercial |
$536.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.44
|
| Rate for Payer: Meridian Medicaid |
$258.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.08
|
| Rate for Payer: Nomi Health Commercial |
$447.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$755.25
|
| Rate for Payer: PACE SWMI |
$372.80
|
| Rate for Payer: PHP Commercial |
$521.92
|
| Rate for Payer: PHP Medicare Advantage |
$372.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.78
|
| Rate for Payer: Priority Health Medicare |
$372.80
|
| Rate for Payer: Priority Health SBD |
$646.78
|
| Rate for Payer: Priority Health Tiered Network |
$646.78
|
| Rate for Payer: Railroad Medicare Medicare |
$372.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.38
|
| Rate for Payer: UHC Core |
$669.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.80
|
| Rate for Payer: UHC Exchange |
$669.38
|
| Rate for Payer: UHC Medicaid |
$246.44
|
| Rate for Payer: UHCCP Medicaid |
$246.44
|
| Rate for Payer: UMR Bronson Commercial |
$463.22
|
|
|
PR PRQ SKEL FIXJ TARS JT DISLC W/MANJ
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 28606
|
| Min. Negotiated Rate |
$246.87 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: Aetna Commercial |
$501.82
|
| Rate for Payer: Aetna Medicare |
$389.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.27
|
| Rate for Payer: BCBS Complete |
$259.21
|
| Rate for Payer: BCBS MAPPO |
$374.49
|
| Rate for Payer: BCN Commercial |
$612.52
|
| Rate for Payer: BCN Medicare Advantage |
$374.49
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$501.82
|
| Rate for Payer: Cofinity Commercial |
$539.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.21
|
| Rate for Payer: Meridian Medicaid |
$259.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$411.94
|
| Rate for Payer: Nomi Health Commercial |
$449.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,039.50
|
| Rate for Payer: PACE SWMI |
$374.49
|
| Rate for Payer: PHP Commercial |
$524.29
|
| Rate for Payer: PHP Medicare Advantage |
$374.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$654.76
|
| Rate for Payer: Priority Health Medicare |
$374.49
|
| Rate for Payer: Priority Health SBD |
$654.76
|
| Rate for Payer: Priority Health Tiered Network |
$654.76
|
| Rate for Payer: Railroad Medicare Medicare |
$374.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.56
|
| Rate for Payer: UHC Core |
$674.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$374.49
|
| Rate for Payer: UHC Exchange |
$674.56
|
| Rate for Payer: UHC Medicaid |
$246.87
|
| Rate for Payer: UHCCP Medicaid |
$246.87
|
| Rate for Payer: UMR Bronson Commercial |
$637.56
|
|
|
PR PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 28546
|
| Min. Negotiated Rate |
$228.12 |
| Max. Negotiated Rate |
$616.50 |
| Rate for Payer: Aetna Commercial |
$457.34
|
| Rate for Payer: Aetna Medicare |
$354.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.47
|
| Rate for Payer: BCBS Complete |
$239.53
|
| Rate for Payer: BCBS MAPPO |
$341.30
|
| Rate for Payer: BCN Commercial |
$547.78
|
| Rate for Payer: BCN Medicare Advantage |
$341.30
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$457.34
|
| Rate for Payer: Cofinity Commercial |
$491.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.37
|
| Rate for Payer: Meridian Medicaid |
$239.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$375.43
|
| Rate for Payer: Nomi Health Commercial |
$409.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$616.50
|
| Rate for Payer: PACE SWMI |
$341.30
|
| Rate for Payer: PHP Commercial |
$477.82
|
| Rate for Payer: PHP Medicare Advantage |
$341.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$585.56
|
| Rate for Payer: Priority Health Medicare |
$341.30
|
| Rate for Payer: Priority Health SBD |
$585.56
|
| Rate for Payer: Priority Health Tiered Network |
$585.56
|
| Rate for Payer: Railroad Medicare Medicare |
$341.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.55
|
| Rate for Payer: UHC Core |
$587.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$341.30
|
| Rate for Payer: UHC Exchange |
$587.55
|
| Rate for Payer: UHC Medicaid |
$228.12
|
| Rate for Payer: UHCCP Medicaid |
$228.12
|
| Rate for Payer: UMR Bronson Commercial |
$378.12
|
|
|
PR PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCN W/MNPJ EA
|
Professional
|
Both
|
$478.00
|
|
|
Service Code
|
HCPCS 28456
|
| Min. Negotiated Rate |
$219.88 |
| Max. Negotiated Rate |
$609.52 |
| Rate for Payer: Aetna Commercial |
$485.68
|
| Rate for Payer: Aetna Medicare |
$376.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.93
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$362.45
|
| Rate for Payer: BCN Commercial |
$570.19
|
| Rate for Payer: BCN Medicare Advantage |
$362.45
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Cofinity Commercial |
$485.68
|
| Rate for Payer: Cofinity Commercial |
$521.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.57
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.69
|
| Rate for Payer: Nomi Health Commercial |
$434.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.50
|
| Rate for Payer: PACE SWMI |
$362.45
|
| Rate for Payer: PHP Commercial |
$507.43
|
| Rate for Payer: PHP Medicare Advantage |
$362.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$609.52
|
| Rate for Payer: Priority Health Medicare |
$362.45
|
| Rate for Payer: Priority Health SBD |
$609.52
|
| Rate for Payer: Priority Health Tiered Network |
$609.52
|
| Rate for Payer: Railroad Medicare Medicare |
$362.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.87
|
| Rate for Payer: UHC Core |
$577.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.45
|
| Rate for Payer: UHC Exchange |
$577.87
|
| Rate for Payer: UHC Medicaid |
$244.52
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
| Rate for Payer: UMR Bronson Commercial |
$219.88
|
|
|
PR PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT
|
Professional
|
Both
|
$2,115.00
|
|
|
Service Code
|
HCPCS 93580
|
| Min. Negotiated Rate |
$538.25 |
| Max. Negotiated Rate |
$1,610.82 |
| Rate for Payer: Aetna Commercial |
$1,140.09
|
| Rate for Payer: Aetna Medicare |
$884.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,140.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,225.17
|
| Rate for Payer: BCBS Complete |
$565.16
|
| Rate for Payer: BCBS MAPPO |
$850.81
|
| Rate for Payer: BCN Commercial |
$1,421.73
|
| Rate for Payer: BCN Medicare Advantage |
$850.81
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cofinity Commercial |
$1,140.09
|
| Rate for Payer: Cofinity Commercial |
$1,225.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$850.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$893.35
|
| Rate for Payer: Meridian Medicaid |
$565.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$935.89
|
| Rate for Payer: Nomi Health Commercial |
$1,020.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,586.25
|
| Rate for Payer: PACE SWMI |
$850.81
|
| Rate for Payer: PHP Commercial |
$1,191.13
|
| Rate for Payer: PHP Medicare Advantage |
$850.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,351.28
|
| Rate for Payer: Priority Health Medicare |
$850.81
|
| Rate for Payer: Priority Health SBD |
$1,351.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,351.28
|
| Rate for Payer: Railroad Medicare Medicare |
$850.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,610.82
|
| Rate for Payer: UHC Core |
$1,610.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$850.81
|
| Rate for Payer: UHC Exchange |
$1,610.82
|
| Rate for Payer: UHC Medicaid |
$538.25
|
| Rate for Payer: UHCCP Medicaid |
$538.25
|
| Rate for Payer: UMR Bronson Commercial |
$972.90
|
|
|
PR PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING
|
Professional
|
Both
|
$528.00
|
|
|
Service Code
|
HCPCS 37197
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$539.17 |
| Rate for Payer: Aetna Commercial |
$356.82
|
| Rate for Payer: Aetna Medicare |
$276.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$356.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.44
|
| Rate for Payer: BCBS Complete |
$177.13
|
| Rate for Payer: BCBS MAPPO |
$266.28
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$266.28
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$356.82
|
| Rate for Payer: Cofinity Commercial |
$383.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.59
|
| Rate for Payer: Meridian Medicaid |
$177.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$292.91
|
| Rate for Payer: Nomi Health Commercial |
$319.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.00
|
| Rate for Payer: PACE SWMI |
$266.28
|
| Rate for Payer: PHP Commercial |
$372.79
|
| Rate for Payer: PHP Medicare Advantage |
$266.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$471.25
|
| Rate for Payer: Priority Health Medicare |
$266.28
|
| Rate for Payer: Priority Health SBD |
$471.25
|
| Rate for Payer: Priority Health Tiered Network |
$471.25
|
| Rate for Payer: Railroad Medicare Medicare |
$266.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.17
|
| Rate for Payer: UHC Core |
$539.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$266.28
|
| Rate for Payer: UHC Exchange |
$539.17
|
| Rate for Payer: UHC Medicaid |
$168.70
|
| Rate for Payer: UHCCP Medicaid |
$168.70
|
| Rate for Payer: UMR Bronson Commercial |
$242.88
|
|
|
PR PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN
|
Professional
|
Both
|
$1,896.00
|
|
|
Service Code
|
HCPCS 37187
|
| Min. Negotiated Rate |
$220.46 |
| Max. Negotiated Rate |
$1,422.00 |
| Rate for Payer: Aetna Commercial |
$465.15
|
| Rate for Payer: Aetna Medicare |
$361.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.87
|
| Rate for Payer: BCBS Complete |
$231.48
|
| Rate for Payer: BCBS MAPPO |
$347.13
|
| Rate for Payer: BCN Commercial |
$574.17
|
| Rate for Payer: BCN Medicare Advantage |
$347.13
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cofinity Commercial |
$465.15
|
| Rate for Payer: Cofinity Commercial |
$499.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.49
|
| Rate for Payer: Meridian Medicaid |
$231.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$381.84
|
| Rate for Payer: Nomi Health Commercial |
$416.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.00
|
| Rate for Payer: PACE SWMI |
$347.13
|
| Rate for Payer: PHP Commercial |
$485.98
|
| Rate for Payer: PHP Medicare Advantage |
$347.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$617.46
|
| Rate for Payer: Priority Health Medicare |
$347.13
|
| Rate for Payer: Priority Health SBD |
$617.46
|
| Rate for Payer: Priority Health Tiered Network |
$617.46
|
| Rate for Payer: Railroad Medicare Medicare |
$347.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.13
|
| Rate for Payer: UHC Core |
$703.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.13
|
| Rate for Payer: UHC Exchange |
$703.13
|
| Rate for Payer: UHC Medicaid |
$220.46
|
| Rate for Payer: UHCCP Medicaid |
$220.46
|
| Rate for Payer: UMR Bronson Commercial |
$872.16
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH
|
Professional
|
Both
|
$1,110.00
|
|
|
Service Code
|
HCPCS 92921
|
| Min. Negotiated Rate |
$208.27 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: Aetna Medicare |
$555.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.69
|
| Rate for Payer: BCBS Complete |
$444.00
|
| Rate for Payer: BCN Commercial |
$208.27
|
| Rate for Payer: Cash Price |
$888.00
|
| Rate for Payer: Cash Price |
$888.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$832.50
|
| Rate for Payer: UMR Bronson Commercial |
$510.60
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 92938
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.80
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: BCN Commercial |
$231.26
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: UMR Bronson Commercial |
$132.94
|
|
|
PR PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
HCPCS 92934
|
| Min. Negotiated Rate |
$259.76 |
| Max. Negotiated Rate |
$961.50 |
| Rate for Payer: Aetna Commercial |
$273.84
|
| Rate for Payer: Aetna Medicare |
$641.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.84
|
| Rate for Payer: BCBS Complete |
$512.80
|
| Rate for Payer: BCN Commercial |
$259.76
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.50
|
| Rate for Payer: UMR Bronson Commercial |
$589.72
|
|
|
PR PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH
|
Professional
|
Both
|
$1,249.00
|
|
|
Service Code
|
HCPCS 92929
|
| Min. Negotiated Rate |
$231.39 |
| Max. Negotiated Rate |
$936.75 |
| Rate for Payer: Aetna Commercial |
$352.65
|
| Rate for Payer: Aetna Medicare |
$624.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.65
|
| Rate for Payer: BCBS Complete |
$499.60
|
| Rate for Payer: BCN Commercial |
$231.39
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$936.75
|
| Rate for Payer: UMR Bronson Commercial |
$574.54
|
|
