|
PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
HCPCS 26117
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,824.00 |
| Rate for Payer: Aetna Commercial |
$907.17
|
| Rate for Payer: Aetna Medicare |
$704.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.87
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$676.99
|
| Rate for Payer: BCN Commercial |
$1,141.37
|
| Rate for Payer: BCN Medicare Advantage |
$676.99
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cofinity Commercial |
$907.17
|
| Rate for Payer: Cofinity Commercial |
$974.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.84
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$744.69
|
| Rate for Payer: Nomi Health Commercial |
$812.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.00
|
| Rate for Payer: PACE SWMI |
$676.99
|
| Rate for Payer: PHP Commercial |
$947.79
|
| Rate for Payer: PHP Medicare Advantage |
$676.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,220.09
|
| Rate for Payer: Priority Health Medicare |
$676.99
|
| Rate for Payer: Priority Health SBD |
$1,220.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,220.09
|
| Rate for Payer: Railroad Medicare Medicare |
$676.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.63
|
| Rate for Payer: UHC Core |
$1,296.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$676.99
|
| Rate for Payer: UHC Exchange |
$1,296.63
|
| Rate for Payer: UHC Medicaid |
$442.83
|
| Rate for Payer: UHCCP Medicaid |
$442.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.72
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM
|
Professional
|
Both
|
$3,257.00
|
|
|
Service Code
|
HCPCS 27049
|
| Min. Negotiated Rate |
$823.88 |
| Max. Negotiated Rate |
$2,442.75 |
| Rate for Payer: Aetna Commercial |
$1,705.62
|
| Rate for Payer: Aetna Medicare |
$1,323.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,705.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,832.90
|
| Rate for Payer: BCBS Complete |
$865.07
|
| Rate for Payer: BCBS MAPPO |
$1,272.85
|
| Rate for Payer: BCN Commercial |
$2,152.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,272.85
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cofinity Commercial |
$1,705.62
|
| Rate for Payer: Cofinity Commercial |
$1,832.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,272.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,336.49
|
| Rate for Payer: Meridian Medicaid |
$865.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,400.13
|
| Rate for Payer: Nomi Health Commercial |
$1,527.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.75
|
| Rate for Payer: PACE SWMI |
$1,272.85
|
| Rate for Payer: PHP Commercial |
$1,781.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,272.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$823.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,300.73
|
| Rate for Payer: Priority Health Medicare |
$1,272.85
|
| Rate for Payer: Priority Health SBD |
$2,300.73
|
| Rate for Payer: Priority Health Tiered Network |
$2,300.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,272.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,362.08
|
| Rate for Payer: UHC Core |
$2,362.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,272.85
|
| Rate for Payer: UHC Exchange |
$2,362.08
|
| Rate for Payer: UHC Medicaid |
$823.88
|
| Rate for Payer: UHCCP Medicaid |
$823.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,498.22
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM
|
Professional
|
Both
|
$3,479.00
|
|
|
Service Code
|
HCPCS 27329
|
| Min. Negotiated Rate |
$616.00 |
| Max. Negotiated Rate |
$2,609.25 |
| Rate for Payer: Aetna Commercial |
$1,275.10
|
| Rate for Payer: Aetna Medicare |
$989.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,275.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,370.26
|
| Rate for Payer: BCBS Complete |
$646.80
|
| Rate for Payer: BCBS MAPPO |
$951.57
|
| Rate for Payer: BCN Commercial |
$1,573.62
|
| Rate for Payer: BCN Medicare Advantage |
$951.57
|
| Rate for Payer: Cash Price |
$2,783.20
|
| Rate for Payer: Cash Price |
$2,783.20
|
| Rate for Payer: Cofinity Commercial |
$1,275.10
|
| Rate for Payer: Cofinity Commercial |
$1,370.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$951.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$999.15
|
| Rate for Payer: Meridian Medicaid |
$646.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,046.73
|
| Rate for Payer: Nomi Health Commercial |
$1,141.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,609.25
|
| Rate for Payer: PACE SWMI |
$951.57
|
| Rate for Payer: PHP Commercial |
$1,332.20
|
| Rate for Payer: PHP Medicare Advantage |
$951.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,682.16
|
| Rate for Payer: Priority Health Medicare |
$951.57
|
| Rate for Payer: Priority Health SBD |
$1,682.16
|
| Rate for Payer: Priority Health Tiered Network |
$1,682.16
|
| Rate for Payer: Railroad Medicare Medicare |
$951.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.85
|
| Rate for Payer: UHC Core |
$1,832.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$951.57
|
| Rate for Payer: UHC Exchange |
$1,832.85
|
| Rate for Payer: UHC Medicaid |
$616.00
|
| Rate for Payer: UHCCP Medicaid |
$616.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,600.34
|
|
|
PR RAPID DESENSITIZATION PROCEDURE EACH HOUR
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 95180
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$114.74
|
| Rate for Payer: Aetna Medicare |
$89.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.31
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$85.63
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: BCN Medicare Advantage |
$85.63
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$114.74
|
| Rate for Payer: Cofinity Commercial |
$123.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.91
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.19
|
| Rate for Payer: Nomi Health Commercial |
$102.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.75
|
| Rate for Payer: PACE SWMI |
$85.63
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: PHP Medicare Advantage |
$85.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.96
|
| Rate for Payer: Priority Health Medicare |
$85.63
|
| Rate for Payer: Priority Health SBD |
$142.96
|
| Rate for Payer: Priority Health Tiered Network |
$142.96
|
| Rate for Payer: Railroad Medicare Medicare |
$85.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.20
|
| Rate for Payer: UHC Core |
$167.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.63
|
| Rate for Payer: UHC Exchange |
$167.20
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
| Rate for Payer: UMR Bronson Commercial |
$120.06
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 28313
|
| Min. Negotiated Rate |
$336.18 |
| Max. Negotiated Rate |
$657.75 |
| Rate for Payer: Aetna Commercial |
$450.48
|
| Rate for Payer: Aetna Medicare |
$349.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.10
|
| Rate for Payer: BCBS Complete |
$350.80
|
| Rate for Payer: BCBS MAPPO |
$336.18
|
| Rate for Payer: BCN Commercial |
$555.25
|
| Rate for Payer: BCN Medicare Advantage |
$336.18
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$484.10
|
| Rate for Payer: Cofinity Commercial |
$450.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$369.80
|
| Rate for Payer: Nomi Health Commercial |
$403.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.75
|
| Rate for Payer: PACE SWMI |
$336.18
|
| Rate for Payer: PHP Commercial |
$470.65
|
| Rate for Payer: PHP Medicare Advantage |
$336.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$593.54
|
| Rate for Payer: Priority Health Medicare |
$336.18
|
| Rate for Payer: Priority Health SBD |
$593.54
|
| Rate for Payer: Priority Health Tiered Network |
$593.54
|
| Rate for Payer: Railroad Medicare Medicare |
$336.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.55
|
| Rate for Payer: UHC Core |
$618.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$336.18
|
| Rate for Payer: UHC Exchange |
$618.55
|
| Rate for Payer: UMR Bronson Commercial |
$403.42
|
|
|
PR RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD
|
Professional
|
Both
|
$7,412.00
|
|
|
Service Code
|
HCPCS 21175
|
| Min. Negotiated Rate |
$1,231.99 |
| Max. Negotiated Rate |
$5,559.00 |
| Rate for Payer: Aetna Commercial |
$2,549.73
|
| Rate for Payer: Aetna Medicare |
$1,978.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,549.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,740.00
|
| Rate for Payer: BCBS Complete |
$1,293.59
|
| Rate for Payer: BCBS MAPPO |
$1,902.78
|
| Rate for Payer: BCN Commercial |
$3,634.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,902.78
|
| Rate for Payer: Cash Price |
$5,929.60
|
| Rate for Payer: Cash Price |
$5,929.60
|
| Rate for Payer: Cofinity Commercial |
$2,740.00
|
| Rate for Payer: Cofinity Commercial |
$2,549.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,902.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,997.92
|
| Rate for Payer: Meridian Medicaid |
$1,293.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,093.06
|
| Rate for Payer: Nomi Health Commercial |
$2,283.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,559.00
|
| Rate for Payer: PACE SWMI |
$1,902.78
|
| Rate for Payer: PHP Commercial |
$2,663.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,902.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,231.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,536.26
|
| Rate for Payer: Priority Health Medicare |
$1,902.78
|
| Rate for Payer: Priority Health SBD |
$3,536.26
|
| Rate for Payer: Priority Health Tiered Network |
$3,536.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,902.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,910.04
|
| Rate for Payer: UHC Core |
$3,910.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,902.78
|
| Rate for Payer: UHC Exchange |
$3,910.04
|
| Rate for Payer: UHC Medicaid |
$1,231.99
|
| Rate for Payer: UHCCP Medicaid |
$1,231.99
|
| Rate for Payer: UMR Bronson Commercial |
$3,409.52
|
|
|
PR RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT
|
Professional
|
Both
|
$1,252.00
|
|
|
Service Code
|
HCPCS 26545
|
| Min. Negotiated Rate |
$451.13 |
| Max. Negotiated Rate |
$1,239.42 |
| Rate for Payer: Aetna Commercial |
$905.13
|
| Rate for Payer: Aetna Medicare |
$702.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.68
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS MAPPO |
$675.47
|
| Rate for Payer: BCN Commercial |
$1,107.01
|
| Rate for Payer: BCN Medicare Advantage |
$675.47
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cofinity Commercial |
$905.13
|
| Rate for Payer: Cofinity Commercial |
$972.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.24
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$743.02
|
| Rate for Payer: Nomi Health Commercial |
$810.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$939.00
|
| Rate for Payer: PACE SWMI |
$675.47
|
| Rate for Payer: PHP Commercial |
$945.66
|
| Rate for Payer: PHP Medicare Advantage |
$675.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.36
|
| Rate for Payer: Priority Health Medicare |
$675.47
|
| Rate for Payer: Priority Health SBD |
$1,183.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,183.36
|
| Rate for Payer: Railroad Medicare Medicare |
$675.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.42
|
| Rate for Payer: UHC Core |
$1,239.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$675.47
|
| Rate for Payer: UHC Exchange |
$1,239.42
|
| Rate for Payer: UHC Medicaid |
$451.13
|
| Rate for Payer: UHCCP Medicaid |
$451.13
|
| Rate for Payer: UMR Bronson Commercial |
$575.92
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS
|
Professional
|
Both
|
$3,673.00
|
|
|
Service Code
|
HCPCS 26542
|
| Min. Negotiated Rate |
$444.32 |
| Max. Negotiated Rate |
$2,754.75 |
| Rate for Payer: Aetna Commercial |
$891.38
|
| Rate for Payer: Aetna Medicare |
$691.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.90
|
| Rate for Payer: BCBS Complete |
$466.54
|
| Rate for Payer: BCBS MAPPO |
$665.21
|
| Rate for Payer: BCN Commercial |
$1,091.58
|
| Rate for Payer: BCN Medicare Advantage |
$665.21
|
| Rate for Payer: Cash Price |
$2,938.40
|
| Rate for Payer: Cash Price |
$2,938.40
|
| Rate for Payer: Cofinity Commercial |
$891.38
|
| Rate for Payer: Cofinity Commercial |
$957.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.47
|
| Rate for Payer: Meridian Medicaid |
$466.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$731.73
|
| Rate for Payer: Nomi Health Commercial |
$798.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,754.75
|
| Rate for Payer: PACE SWMI |
$665.21
|
| Rate for Payer: PHP Commercial |
$931.29
|
| Rate for Payer: PHP Medicare Advantage |
$665.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,166.87
|
| Rate for Payer: Priority Health Medicare |
$665.21
|
| Rate for Payer: Priority Health SBD |
$1,166.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,166.87
|
| Rate for Payer: Railroad Medicare Medicare |
$665.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,188.84
|
| Rate for Payer: UHC Core |
$1,188.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$665.21
|
| Rate for Payer: UHC Exchange |
$1,188.84
|
| Rate for Payer: UHC Medicaid |
$444.32
|
| Rate for Payer: UHCCP Medicaid |
$444.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,689.58
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF
|
Professional
|
Both
|
$2,451.00
|
|
|
Service Code
|
HCPCS 26541
|
| Min. Negotiated Rate |
$509.92 |
| Max. Negotiated Rate |
$1,838.25 |
| Rate for Payer: Aetna Commercial |
$1,027.67
|
| Rate for Payer: Aetna Medicare |
$797.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,104.36
|
| Rate for Payer: BCBS Complete |
$535.42
|
| Rate for Payer: BCBS MAPPO |
$766.92
|
| Rate for Payer: BCN Commercial |
$1,264.37
|
| Rate for Payer: BCN Medicare Advantage |
$766.92
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Cofinity Commercial |
$1,027.67
|
| Rate for Payer: Cofinity Commercial |
$1,104.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$805.27
|
| Rate for Payer: Meridian Medicaid |
$535.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$843.61
|
| Rate for Payer: Nomi Health Commercial |
$920.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.25
|
| Rate for Payer: PACE SWMI |
$766.92
|
| Rate for Payer: PHP Commercial |
$1,073.69
|
| Rate for Payer: PHP Medicare Advantage |
$766.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,351.58
|
| Rate for Payer: Priority Health Medicare |
$766.92
|
| Rate for Payer: Priority Health SBD |
$1,351.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,351.58
|
| Rate for Payer: Railroad Medicare Medicare |
$766.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,397.74
|
| Rate for Payer: UHC Core |
$1,397.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$766.92
|
| Rate for Payer: UHC Exchange |
$1,397.74
|
| Rate for Payer: UHC Medicaid |
$509.92
|
| Rate for Payer: UHCCP Medicaid |
$509.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,127.46
|
|
|
PR RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 21181
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$879.99
|
| Rate for Payer: Aetna Medicare |
$682.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$945.66
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS MAPPO |
$656.71
|
| Rate for Payer: BCN Commercial |
$1,121.95
|
| Rate for Payer: BCN Medicare Advantage |
$656.71
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cofinity Commercial |
$879.99
|
| Rate for Payer: Cofinity Commercial |
$945.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$656.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$689.55
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$722.38
|
| Rate for Payer: Nomi Health Commercial |
$788.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.00
|
| Rate for Payer: PACE SWMI |
$656.71
|
| Rate for Payer: PHP Commercial |
$919.39
|
| Rate for Payer: PHP Medicare Advantage |
$656.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,199.34
|
| Rate for Payer: Priority Health Medicare |
$656.71
|
| Rate for Payer: Priority Health SBD |
$1,199.34
|
| Rate for Payer: Priority Health Tiered Network |
$1,199.34
|
| Rate for Payer: Railroad Medicare Medicare |
$656.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.84
|
| Rate for Payer: UHC Core |
$1,296.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$656.71
|
| Rate for Payer: UHC Exchange |
$1,296.84
|
| Rate for Payer: UHC Medicaid |
$428.98
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
| Rate for Payer: UMR Bronson Commercial |
$828.00
|
|
|
PR RCNSTJ DISLC PATELLA W/PATELLECTOMY
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 27424
|
| Min. Negotiated Rate |
$449.00 |
| Max. Negotiated Rate |
$1,305.84 |
| Rate for Payer: Aetna Commercial |
$920.85
|
| Rate for Payer: Aetna Medicare |
$714.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.57
|
| Rate for Payer: BCBS Complete |
$471.45
|
| Rate for Payer: BCBS MAPPO |
$687.20
|
| Rate for Payer: BCN Commercial |
$1,145.36
|
| Rate for Payer: BCN Medicare Advantage |
$687.20
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$920.85
|
| Rate for Payer: Cofinity Commercial |
$989.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.56
|
| Rate for Payer: Meridian Medicaid |
$471.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$755.92
|
| Rate for Payer: Nomi Health Commercial |
$824.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,173.75
|
| Rate for Payer: PACE SWMI |
$687.20
|
| Rate for Payer: PHP Commercial |
$962.08
|
| Rate for Payer: PHP Medicare Advantage |
$687.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,224.35
|
| Rate for Payer: Priority Health Medicare |
$687.20
|
| Rate for Payer: Priority Health SBD |
$1,224.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,224.35
|
| Rate for Payer: Railroad Medicare Medicare |
$687.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.84
|
| Rate for Payer: UHC Core |
$1,305.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$687.20
|
| Rate for Payer: UHC Exchange |
$1,305.84
|
| Rate for Payer: UHC Medicaid |
$449.00
|
| Rate for Payer: UHCCP Medicaid |
$449.00
|
| Rate for Payer: UMR Bronson Commercial |
$719.90
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
IP
|
$2,382.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,048.08 |
| Max. Negotiated Rate |
$2,143.80 |
| Rate for Payer: Aetna American Axle |
$1,548.30
|
| Rate for Payer: Aetna Commercial |
$2,024.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,548.30
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cofinity Advantage |
$1,667.40
|
| Rate for Payer: Cofinity Commercial |
$2,048.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,905.60
|
| Rate for Payer: Healthscope Commercial |
$2,143.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,667.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,786.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,024.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,786.50
|
| Rate for Payer: PHP Commercial |
$2,024.70
|
| Rate for Payer: Priority Health SBD |
$1,500.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,048.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,786.50
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
OP
|
$2,382.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$881.34 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna American Axle |
$1,548.30
|
| Rate for Payer: Aetna Commercial |
$2,024.70
|
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,548.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,985.59
|
| Rate for Payer: BCN Commercial |
$4,985.59
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cofinity Advantage |
$1,667.40
|
| Rate for Payer: Cofinity Commercial |
$2,048.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,905.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Healthscope Commercial |
$2,143.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,667.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,786.50
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,024.70
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,786.50
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Commercial |
$2,024.70
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health SBD |
$1,500.66
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: UMR Bronson Commercial |
$881.34
|
| Rate for Payer: VA VA |
$7,230.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,786.50
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,382.00
|
|
|
Service Code
|
HCPCS 27422
|
| Min. Negotiated Rate |
$445.60 |
| Max. Negotiated Rate |
$1,786.50 |
| Rate for Payer: Aetna Commercial |
$913.72
|
| Rate for Payer: Aetna Medicare |
$709.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$981.91
|
| Rate for Payer: BCBS Complete |
$467.88
|
| Rate for Payer: BCBS MAPPO |
$681.88
|
| Rate for Payer: BCN Commercial |
$1,135.89
|
| Rate for Payer: BCN Medicare Advantage |
$681.88
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cofinity Commercial |
$913.72
|
| Rate for Payer: Cofinity Commercial |
$981.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.97
|
| Rate for Payer: Meridian Medicaid |
$467.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$750.07
|
| Rate for Payer: Nomi Health Commercial |
$818.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,786.50
|
| Rate for Payer: PACE SWMI |
$681.88
|
| Rate for Payer: PHP Commercial |
$954.63
|
| Rate for Payer: PHP Medicare Advantage |
$681.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,214.23
|
| Rate for Payer: Priority Health Medicare |
$681.88
|
| Rate for Payer: Priority Health SBD |
$1,214.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,214.23
|
| Rate for Payer: Railroad Medicare Medicare |
$681.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.21
|
| Rate for Payer: UHC Core |
$1,299.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$681.88
|
| Rate for Payer: UHC Exchange |
$1,299.21
|
| Rate for Payer: UHC Medicaid |
$445.60
|
| Rate for Payer: UHCCP Medicaid |
$445.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,095.72
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,382.00
|
|
|
Service Code
|
HCPCS 27422
|
| Hospital Charge Code |
27422
|
| Min. Negotiated Rate |
$445.60 |
| Max. Negotiated Rate |
$1,786.50 |
| Rate for Payer: Aetna Commercial |
$913.72
|
| Rate for Payer: Aetna Medicare |
$709.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$981.91
|
| Rate for Payer: BCBS Complete |
$467.88
|
| Rate for Payer: BCBS MAPPO |
$681.88
|
| Rate for Payer: BCN Commercial |
$1,135.89
|
| Rate for Payer: BCN Medicare Advantage |
$681.88
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cofinity Commercial |
$913.72
|
| Rate for Payer: Cofinity Commercial |
$981.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.97
|
| Rate for Payer: Meridian Medicaid |
$467.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$750.07
|
| Rate for Payer: Nomi Health Commercial |
$818.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,786.50
|
| Rate for Payer: PACE SWMI |
$681.88
|
| Rate for Payer: PHP Commercial |
$954.63
|
| Rate for Payer: PHP Medicare Advantage |
$681.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,214.23
|
| Rate for Payer: Priority Health Medicare |
$681.88
|
| Rate for Payer: Priority Health SBD |
$1,214.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,214.23
|
| Rate for Payer: Railroad Medicare Medicare |
$681.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.21
|
| Rate for Payer: UHC Core |
$1,299.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$681.88
|
| Rate for Payer: UHC Exchange |
$1,299.21
|
| Rate for Payer: UHC Medicaid |
$445.60
|
| Rate for Payer: UHCCP Medicaid |
$445.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,095.72
|
|
|
PR RCNSTJ DISLOCATING PATELLA
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 27420
|
| Min. Negotiated Rate |
$449.64 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$922.16
|
| Rate for Payer: Aetna Medicare |
$715.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.98
|
| Rate for Payer: BCBS Complete |
$472.12
|
| Rate for Payer: BCBS MAPPO |
$688.18
|
| Rate for Payer: BCN Commercial |
$1,140.37
|
| Rate for Payer: BCN Medicare Advantage |
$688.18
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cofinity Commercial |
$922.16
|
| Rate for Payer: Cofinity Commercial |
$990.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.59
|
| Rate for Payer: Meridian Medicaid |
$472.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$757.00
|
| Rate for Payer: Nomi Health Commercial |
$825.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,803.75
|
| Rate for Payer: PACE SWMI |
$688.18
|
| Rate for Payer: PHP Commercial |
$963.45
|
| Rate for Payer: PHP Medicare Advantage |
$688.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,219.02
|
| Rate for Payer: Priority Health Medicare |
$688.18
|
| Rate for Payer: Priority Health SBD |
$1,219.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,219.02
|
| Rate for Payer: Railroad Medicare Medicare |
$688.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.84
|
| Rate for Payer: UHC Core |
$1,298.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.18
|
| Rate for Payer: UHC Exchange |
$1,298.84
|
| Rate for Payer: UHC Medicaid |
$449.64
|
| Rate for Payer: UHCCP Medicaid |
$449.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.30
|
|
|
PR RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT
|
Professional
|
Both
|
$3,111.00
|
|
|
Service Code
|
HCPCS 24344
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$2,333.25 |
| Rate for Payer: Aetna Commercial |
$1,348.92
|
| Rate for Payer: Aetna Medicare |
$1,046.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.59
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCBS MAPPO |
$1,006.66
|
| Rate for Payer: BCN Commercial |
$1,682.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.66
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$1,348.92
|
| Rate for Payer: Cofinity Commercial |
$1,449.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,056.99
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,107.33
|
| Rate for Payer: Nomi Health Commercial |
$1,207.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,333.25
|
| Rate for Payer: PACE SWMI |
$1,006.66
|
| Rate for Payer: PHP Commercial |
$1,409.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,798.20
|
| Rate for Payer: Priority Health Medicare |
$1,006.66
|
| Rate for Payer: Priority Health SBD |
$1,798.20
|
| Rate for Payer: Priority Health Tiered Network |
$1,798.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,006.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,910.07
|
| Rate for Payer: UHC Core |
$1,910.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,006.66
|
| Rate for Payer: UHC Exchange |
$1,910.07
|
| Rate for Payer: UHC Medicaid |
$657.11
|
| Rate for Payer: UHCCP Medicaid |
$657.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,431.06
|
|
|
PR RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF
|
Professional
|
Both
|
$3,435.00
|
|
|
Service Code
|
HCPCS 24346
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$2,576.25 |
| Rate for Payer: Aetna Commercial |
$1,348.92
|
| Rate for Payer: Aetna Medicare |
$1,046.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.59
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCBS MAPPO |
$1,006.66
|
| Rate for Payer: BCN Commercial |
$1,682.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.66
|
| Rate for Payer: Cash Price |
$2,748.00
|
| Rate for Payer: Cash Price |
$2,748.00
|
| Rate for Payer: Cofinity Commercial |
$1,348.92
|
| Rate for Payer: Cofinity Commercial |
$1,449.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,056.99
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,107.33
|
| Rate for Payer: Nomi Health Commercial |
$1,207.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,576.25
|
| Rate for Payer: PACE SWMI |
$1,006.66
|
| Rate for Payer: PHP Commercial |
$1,409.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,798.20
|
| Rate for Payer: Priority Health Medicare |
$1,006.66
|
| Rate for Payer: Priority Health SBD |
$1,798.20
|
| Rate for Payer: Priority Health Tiered Network |
$1,798.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,006.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.56
|
| Rate for Payer: UHC Core |
$1,922.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,006.66
|
| Rate for Payer: UHC Exchange |
$1,922.56
|
| Rate for Payer: UHC Medicaid |
$657.11
|
| Rate for Payer: UHCCP Medicaid |
$657.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,580.10
|
|
|
PR RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT
|
Professional
|
Both
|
$6,655.00
|
|
|
Service Code
|
HCPCS 21194
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$4,991.25 |
| Rate for Payer: Aetna Commercial |
$1,677.97
|
| Rate for Payer: Aetna Medicare |
$1,302.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,677.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,803.20
|
| Rate for Payer: BCBS Complete |
$856.80
|
| Rate for Payer: BCBS MAPPO |
$1,252.22
|
| Rate for Payer: BCN Commercial |
$2,130.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,252.22
|
| Rate for Payer: Cash Price |
$5,324.00
|
| Rate for Payer: Cash Price |
$5,324.00
|
| Rate for Payer: Cofinity Commercial |
$1,677.97
|
| Rate for Payer: Cofinity Commercial |
$1,803.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,252.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,314.83
|
| Rate for Payer: Meridian Medicaid |
$856.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,377.44
|
| Rate for Payer: Nomi Health Commercial |
$1,502.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,991.25
|
| Rate for Payer: PACE SWMI |
$1,252.22
|
| Rate for Payer: PHP Commercial |
$1,753.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,252.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,277.29
|
| Rate for Payer: Priority Health Medicare |
$1,252.22
|
| Rate for Payer: Priority Health SBD |
$2,277.29
|
| Rate for Payer: Priority Health Tiered Network |
$2,277.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,252.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,496.60
|
| Rate for Payer: UHC Core |
$2,496.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,252.22
|
| Rate for Payer: UHC Exchange |
$2,496.60
|
| Rate for Payer: UHC Medicaid |
$816.00
|
| Rate for Payer: UHCCP Medicaid |
$816.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,061.30
|
|
|
PR RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE
|
Professional
|
Both
|
$3,614.00
|
|
|
Service Code
|
HCPCS 21244
|
| Min. Negotiated Rate |
$572.33 |
| Max. Negotiated Rate |
$2,710.50 |
| Rate for Payer: Aetna Commercial |
$1,168.47
|
| Rate for Payer: Aetna Medicare |
$906.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,168.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,255.67
|
| Rate for Payer: BCBS Complete |
$600.95
|
| Rate for Payer: BCBS MAPPO |
$871.99
|
| Rate for Payer: BCN Commercial |
$1,506.40
|
| Rate for Payer: BCN Medicare Advantage |
$871.99
|
| Rate for Payer: Cash Price |
$2,891.20
|
| Rate for Payer: Cash Price |
$2,891.20
|
| Rate for Payer: Cofinity Commercial |
$1,168.47
|
| Rate for Payer: Cofinity Commercial |
$1,255.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$871.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.59
|
| Rate for Payer: Meridian Medicaid |
$600.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$959.19
|
| Rate for Payer: Nomi Health Commercial |
$1,046.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,710.50
|
| Rate for Payer: PACE SWMI |
$871.99
|
| Rate for Payer: PHP Commercial |
$1,220.79
|
| Rate for Payer: PHP Medicare Advantage |
$871.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,610.29
|
| Rate for Payer: Priority Health Medicare |
$871.99
|
| Rate for Payer: Priority Health SBD |
$1,610.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,610.29
|
| Rate for Payer: Railroad Medicare Medicare |
$871.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,766.24
|
| Rate for Payer: UHC Core |
$1,766.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$871.99
|
| Rate for Payer: UHC Exchange |
$1,766.24
|
| Rate for Payer: UHC Medicaid |
$572.33
|
| Rate for Payer: UHCCP Medicaid |
$572.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,662.44
|
|
|
PR RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE
|
Professional
|
Both
|
$1,791.00
|
|
|
Service Code
|
HCPCS 26587
|
| Min. Negotiated Rate |
$619.40 |
| Max. Negotiated Rate |
$1,819.20 |
| Rate for Payer: Aetna Commercial |
$1,272.46
|
| Rate for Payer: Aetna Medicare |
$987.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.42
|
| Rate for Payer: BCBS Complete |
$650.37
|
| Rate for Payer: BCBS MAPPO |
$949.60
|
| Rate for Payer: BCN Commercial |
$1,590.05
|
| Rate for Payer: BCN Medicare Advantage |
$949.60
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cofinity Commercial |
$1,272.46
|
| Rate for Payer: Cofinity Commercial |
$1,367.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$949.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.08
|
| Rate for Payer: Meridian Medicaid |
$650.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,044.56
|
| Rate for Payer: Nomi Health Commercial |
$1,139.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.25
|
| Rate for Payer: PACE SWMI |
$949.60
|
| Rate for Payer: PHP Commercial |
$1,329.44
|
| Rate for Payer: PHP Medicare Advantage |
$949.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,699.72
|
| Rate for Payer: Priority Health Medicare |
$949.60
|
| Rate for Payer: Priority Health SBD |
$1,699.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,699.72
|
| Rate for Payer: Railroad Medicare Medicare |
$949.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,819.20
|
| Rate for Payer: UHC Core |
$1,819.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$949.60
|
| Rate for Payer: UHC Exchange |
$1,819.20
|
| Rate for Payer: UHC Medicaid |
$619.40
|
| Rate for Payer: UHCCP Medicaid |
$619.40
|
| Rate for Payer: UMR Bronson Commercial |
$823.86
|
|
|
PR RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 28238
|
| Min. Negotiated Rate |
$292.88 |
| Max. Negotiated Rate |
$1,144.50 |
| Rate for Payer: Aetna Commercial |
$601.27
|
| Rate for Payer: Aetna Medicare |
$466.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.14
|
| Rate for Payer: BCBS Complete |
$307.52
|
| Rate for Payer: BCBS MAPPO |
$448.71
|
| Rate for Payer: BCN Commercial |
$734.53
|
| Rate for Payer: BCN Medicare Advantage |
$448.71
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$601.27
|
| Rate for Payer: Cofinity Commercial |
$646.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.15
|
| Rate for Payer: Meridian Medicaid |
$307.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$493.58
|
| Rate for Payer: Nomi Health Commercial |
$538.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.50
|
| Rate for Payer: PACE SWMI |
$448.71
|
| Rate for Payer: PHP Commercial |
$628.19
|
| Rate for Payer: PHP Medicare Advantage |
$448.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$785.18
|
| Rate for Payer: Priority Health Medicare |
$448.71
|
| Rate for Payer: Priority Health SBD |
$785.18
|
| Rate for Payer: Priority Health Tiered Network |
$785.18
|
| Rate for Payer: Railroad Medicare Medicare |
$448.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$849.61
|
| Rate for Payer: UHC Core |
$849.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$448.71
|
| Rate for Payer: UHC Exchange |
$849.61
|
| Rate for Payer: UHC Medicaid |
$292.88
|
| Rate for Payer: UHCCP Medicaid |
$292.88
|
| Rate for Payer: UMR Bronson Commercial |
$701.96
|
|
|
PR RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ
|
Professional
|
Both
|
$3,547.00
|
|
|
Service Code
|
HCPCS 25337
|
| Min. Negotiated Rate |
$528.24 |
| Max. Negotiated Rate |
$2,660.25 |
| Rate for Payer: Aetna Commercial |
$1,079.13
|
| Rate for Payer: Aetna Medicare |
$837.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,159.66
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS MAPPO |
$805.32
|
| Rate for Payer: BCN Commercial |
$1,360.99
|
| Rate for Payer: BCN Medicare Advantage |
$805.32
|
| Rate for Payer: Cash Price |
$2,837.60
|
| Rate for Payer: Cash Price |
$2,837.60
|
| Rate for Payer: Cofinity Commercial |
$1,079.13
|
| Rate for Payer: Cofinity Commercial |
$1,159.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.59
|
| Rate for Payer: Meridian Medicaid |
$554.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$885.85
|
| Rate for Payer: Nomi Health Commercial |
$966.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,660.25
|
| Rate for Payer: PACE SWMI |
$805.32
|
| Rate for Payer: PHP Commercial |
$1,127.45
|
| Rate for Payer: PHP Medicare Advantage |
$805.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,454.85
|
| Rate for Payer: Priority Health Medicare |
$805.32
|
| Rate for Payer: Priority Health SBD |
$1,454.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,454.85
|
| Rate for Payer: Railroad Medicare Medicare |
$805.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,539.92
|
| Rate for Payer: UHC Core |
$1,539.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$805.32
|
| Rate for Payer: UHC Exchange |
$1,539.92
|
| Rate for Payer: UHC Medicaid |
$528.24
|
| Rate for Payer: UHCCP Medicaid |
$528.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,631.62
|
|
|
PR RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD
|
Professional
|
Both
|
$4,612.00
|
|
|
Service Code
|
HCPCS 21172
|
| Min. Negotiated Rate |
$1,332.32 |
| Max. Negotiated Rate |
$3,667.92 |
| Rate for Payer: Aetna Commercial |
$2,775.52
|
| Rate for Payer: Aetna Medicare |
$2,154.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,775.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,982.64
|
| Rate for Payer: BCBS Complete |
$1,398.94
|
| Rate for Payer: BCBS MAPPO |
$2,071.28
|
| Rate for Payer: BCN Commercial |
$3,204.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,071.28
|
| Rate for Payer: Cash Price |
$3,689.60
|
| Rate for Payer: Cash Price |
$3,689.60
|
| Rate for Payer: Cofinity Commercial |
$2,775.52
|
| Rate for Payer: Cofinity Commercial |
$2,982.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,071.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,174.84
|
| Rate for Payer: Meridian Medicaid |
$1,398.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,278.41
|
| Rate for Payer: Nomi Health Commercial |
$2,485.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,459.00
|
| Rate for Payer: PACE SWMI |
$2,071.28
|
| Rate for Payer: PHP Commercial |
$2,899.79
|
| Rate for Payer: PHP Medicare Advantage |
$2,071.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,332.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,425.53
|
| Rate for Payer: Priority Health Medicare |
$2,071.28
|
| Rate for Payer: Priority Health SBD |
$3,425.53
|
| Rate for Payer: Priority Health Tiered Network |
$3,425.53
|
| Rate for Payer: Railroad Medicare Medicare |
$2,071.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,667.92
|
| Rate for Payer: UHC Core |
$3,667.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,071.28
|
| Rate for Payer: UHC Exchange |
$3,667.92
|
| Rate for Payer: UHC Medicaid |
$1,332.32
|
| Rate for Payer: UHCCP Medicaid |
$1,332.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,121.52
|
|
|
PR RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX
|
Professional
|
Both
|
$1,477.00
|
|
|
Service Code
|
HCPCS 26502
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$1,245.20 |
| Rate for Payer: Aetna Commercial |
$953.92
|
| Rate for Payer: Aetna Medicare |
$740.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.92
|
| Rate for Payer: BCBS Complete |
$498.96
|
| Rate for Payer: BCBS MAPPO |
$711.88
|
| Rate for Payer: BCN Commercial |
$1,139.88
|
| Rate for Payer: BCN Medicare Advantage |
$711.88
|
| Rate for Payer: Cash Price |
$1,181.60
|
| Rate for Payer: Cash Price |
$1,181.60
|
| Rate for Payer: Cofinity Commercial |
$1,025.11
|
| Rate for Payer: Cofinity Commercial |
$953.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.47
|
| Rate for Payer: Meridian Medicaid |
$498.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$783.07
|
| Rate for Payer: Nomi Health Commercial |
$854.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,107.75
|
| Rate for Payer: PACE SWMI |
$711.88
|
| Rate for Payer: PHP Commercial |
$996.63
|
| Rate for Payer: PHP Medicare Advantage |
$711.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,218.50
|
| Rate for Payer: Priority Health Medicare |
$711.88
|
| Rate for Payer: Priority Health SBD |
$1,218.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,218.50
|
| Rate for Payer: Railroad Medicare Medicare |
$711.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,245.20
|
| Rate for Payer: UHC Core |
$1,245.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$711.88
|
| Rate for Payer: UHC Exchange |
$1,245.20
|
| Rate for Payer: UHC Medicaid |
$475.20
|
| Rate for Payer: UHCCP Medicaid |
$475.20
|
| Rate for Payer: UMR Bronson Commercial |
$679.42
|
|
