|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$50.52 |
| Rate for Payer: Aetna Commercial |
$38.65
|
| Rate for Payer: Aetna Medicare |
$29.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.53
|
| Rate for Payer: BCBS Complete |
$19.68
|
| Rate for Payer: BCBS MAPPO |
$28.84
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.84
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Cofinity Commercial |
$41.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.28
|
| Rate for Payer: Meridian Medicaid |
$19.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.72
|
| Rate for Payer: Nomi Health Commercial |
$34.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$28.84
|
| Rate for Payer: PHP Commercial |
$40.38
|
| Rate for Payer: PHP Medicare Advantage |
$28.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.18
|
| Rate for Payer: Priority Health Medicare |
$28.84
|
| Rate for Payer: Priority Health SBD |
$41.18
|
| Rate for Payer: Priority Health Tiered Network |
$41.18
|
| Rate for Payer: Railroad Medicare Medicare |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.52
|
| Rate for Payer: UHC Core |
$50.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.84
|
| Rate for Payer: UHC Exchange |
$50.52
|
| Rate for Payer: UHC Medicaid |
$18.74
|
| Rate for Payer: UHCCP Medicaid |
$18.74
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$24.38 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$30.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$29.04
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: BCN Medicare Advantage |
$29.04
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$41.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.94
|
| Rate for Payer: Nomi Health Commercial |
$34.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$29.04
|
| Rate for Payer: PHP Commercial |
$40.66
|
| Rate for Payer: PHP Medicare Advantage |
$29.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28.40
|
| Rate for Payer: Priority Health Medicare |
$29.04
|
| Rate for Payer: Priority Health SBD |
$28.40
|
| Rate for Payer: Priority Health Tiered Network |
$28.40
|
| Rate for Payer: Railroad Medicare Medicare |
$29.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.33
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.04
|
| Rate for Payer: UHC Exchange |
$38.33
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$150.39 |
| Rate for Payer: Aetna Commercial |
$128.64
|
| Rate for Payer: Aetna Medicare |
$99.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.24
|
| Rate for Payer: BCBS MAPPO |
$96.00
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$96.00
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$138.24
|
| Rate for Payer: Cofinity Commercial |
$128.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.60
|
| Rate for Payer: Nomi Health Commercial |
$115.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: PACE SWMI |
$96.00
|
| Rate for Payer: PHP Commercial |
$134.40
|
| Rate for Payer: PHP Medicare Advantage |
$96.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.94
|
| Rate for Payer: Priority Health Medicare |
$96.00
|
| Rate for Payer: Priority Health SBD |
$142.94
|
| Rate for Payer: Priority Health Tiered Network |
$142.94
|
| Rate for Payer: Railroad Medicare Medicare |
$96.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.28
|
| Rate for Payer: UHC Core |
$44.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.00
|
| Rate for Payer: UHC Exchange |
$44.28
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$30.38 |
| Rate for Payer: Aetna Commercial |
$26.76
|
| Rate for Payer: Aetna Medicare |
$20.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.76
|
| Rate for Payer: BCBS MAPPO |
$19.97
|
| Rate for Payer: BCN Commercial |
$30.38
|
| Rate for Payer: BCN Medicare Advantage |
$19.97
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$26.76
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.97
|
| Rate for Payer: Nomi Health Commercial |
$23.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$19.97
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$19.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.32
|
| Rate for Payer: Priority Health Medicare |
$19.97
|
| Rate for Payer: Priority Health SBD |
$27.32
|
| Rate for Payer: Priority Health Tiered Network |
$27.32
|
| Rate for Payer: Railroad Medicare Medicare |
$19.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.42
|
| Rate for Payer: UHC Core |
$24.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.97
|
| Rate for Payer: UHC Exchange |
$24.42
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
PR REM MNTR PHYSIOL PARAM DEV SPLY W/REC 16-30 DAYS
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$47.64 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$63.84
|
| Rate for Payer: Aetna Medicare |
$49.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.60
|
| Rate for Payer: BCBS MAPPO |
$47.64
|
| Rate for Payer: BCN Commercial |
$66.24
|
| Rate for Payer: BCN Medicare Advantage |
$47.64
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$68.60
|
| Rate for Payer: Cofinity Commercial |
$63.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.40
|
| Rate for Payer: Nomi Health Commercial |
$57.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE SWMI |
$47.64
|
| Rate for Payer: PHP Commercial |
$66.70
|
| Rate for Payer: PHP Medicare Advantage |
$47.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59.58
|
| Rate for Payer: Priority Health Medicare |
$47.64
|
| Rate for Payer: Priority Health SBD |
$59.58
|
| Rate for Payer: Priority Health Tiered Network |
$59.58
|
| Rate for Payer: Railroad Medicare Medicare |
$47.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.17
|
| Rate for Payer: UHC Core |
$81.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.64
|
| Rate for Payer: UHC Exchange |
$81.17
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna Commercial |
$39.50
|
| Rate for Payer: Aetna Medicare |
$30.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.45
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.48
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$29.48
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.95
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.43
|
| Rate for Payer: Nomi Health Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.00
|
| Rate for Payer: PACE SWMI |
$29.48
|
| Rate for Payer: PHP Commercial |
$41.27
|
| Rate for Payer: PHP Medicare Advantage |
$29.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.69
|
| Rate for Payer: Priority Health Medicare |
$29.48
|
| Rate for Payer: Priority Health SBD |
$49.69
|
| Rate for Payer: Priority Health Tiered Network |
$49.69
|
| Rate for Payer: Railroad Medicare Medicare |
$29.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.46
|
| Rate for Payer: UHC Core |
$58.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.48
|
| Rate for Payer: UHC Exchange |
$58.46
|
| Rate for Payer: UHC Medicaid |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
| Rate for Payer: UMR Bronson Commercial |
$47.84
|
|
|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$10.60
|
| Rate for Payer: Aetna Medicare |
$8.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$7.91
|
| Rate for Payer: BCN Commercial |
$13.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.91
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$11.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.31
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.70
|
| Rate for Payer: Nomi Health Commercial |
$9.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE SWMI |
$7.91
|
| Rate for Payer: PHP Commercial |
$11.07
|
| Rate for Payer: PHP Medicare Advantage |
$7.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.09
|
| Rate for Payer: Priority Health Medicare |
$7.91
|
| Rate for Payer: Priority Health SBD |
$12.09
|
| Rate for Payer: Priority Health Tiered Network |
$12.09
|
| Rate for Payer: Railroad Medicare Medicare |
$7.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.02
|
| Rate for Payer: UHC Core |
$13.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.91
|
| Rate for Payer: UHC Exchange |
$13.02
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UMR Bronson Commercial |
$11.50
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$79.41 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$106.41
|
| Rate for Payer: Aetna Medicare |
$82.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.35
|
| Rate for Payer: BCBS Complete |
$99.20
|
| Rate for Payer: BCBS MAPPO |
$79.41
|
| Rate for Payer: BCN Commercial |
$130.47
|
| Rate for Payer: BCN Medicare Advantage |
$79.41
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$114.35
|
| Rate for Payer: Cofinity Commercial |
$106.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.35
|
| Rate for Payer: Nomi Health Commercial |
$95.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PACE SWMI |
$79.41
|
| Rate for Payer: PHP Commercial |
$111.17
|
| Rate for Payer: PHP Medicare Advantage |
$79.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$158.97
|
| Rate for Payer: Priority Health Medicare |
$79.41
|
| Rate for Payer: Priority Health SBD |
$158.97
|
| Rate for Payer: Priority Health Tiered Network |
$158.97
|
| Rate for Payer: Railroad Medicare Medicare |
$79.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.70
|
| Rate for Payer: UHC Core |
$156.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.41
|
| Rate for Payer: UHC Exchange |
$156.70
|
| Rate for Payer: UMR Bronson Commercial |
$114.08
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$337.61 |
| Max. Negotiated Rate |
$1,407.75 |
| Rate for Payer: Aetna Commercial |
$689.98
|
| Rate for Payer: Aetna Medicare |
$535.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$741.47
|
| Rate for Payer: BCBS Complete |
$354.49
|
| Rate for Payer: BCBS MAPPO |
$514.91
|
| Rate for Payer: BCN Commercial |
$861.01
|
| Rate for Payer: BCN Medicare Advantage |
$514.91
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$741.47
|
| Rate for Payer: Cofinity Commercial |
$689.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$514.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$540.66
|
| Rate for Payer: Meridian Medicaid |
$354.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$566.40
|
| Rate for Payer: Nomi Health Commercial |
$617.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,407.75
|
| Rate for Payer: PACE SWMI |
$514.91
|
| Rate for Payer: PHP Commercial |
$720.87
|
| Rate for Payer: PHP Medicare Advantage |
$514.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$920.39
|
| Rate for Payer: Priority Health Medicare |
$514.91
|
| Rate for Payer: Priority Health SBD |
$920.39
|
| Rate for Payer: Priority Health Tiered Network |
$920.39
|
| Rate for Payer: Railroad Medicare Medicare |
$514.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.64
|
| Rate for Payer: UHC Core |
$998.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$514.91
|
| Rate for Payer: UHC Exchange |
$998.64
|
| Rate for Payer: UHC Medicaid |
$337.61
|
| Rate for Payer: UHCCP Medicaid |
$337.61
|
| Rate for Payer: UMR Bronson Commercial |
$863.42
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$4,164.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$670.10 |
| Max. Negotiated Rate |
$3,123.00 |
| Rate for Payer: Aetna Commercial |
$1,393.13
|
| Rate for Payer: Aetna Medicare |
$1,081.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,497.10
|
| Rate for Payer: BCBS Complete |
$703.61
|
| Rate for Payer: BCBS MAPPO |
$1,039.65
|
| Rate for Payer: BCN Commercial |
$1,848.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.65
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,393.13
|
| Rate for Payer: Cofinity Commercial |
$1,497.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,091.63
|
| Rate for Payer: Meridian Medicaid |
$703.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,143.62
|
| Rate for Payer: Nomi Health Commercial |
$1,247.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,123.00
|
| Rate for Payer: PACE SWMI |
$1,039.65
|
| Rate for Payer: PHP Commercial |
$1,455.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,798.74
|
| Rate for Payer: Priority Health Medicare |
$1,039.65
|
| Rate for Payer: Priority Health SBD |
$1,798.74
|
| Rate for Payer: Priority Health Tiered Network |
$1,798.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,039.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,954.58
|
| Rate for Payer: UHC Core |
$1,954.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,039.65
|
| Rate for Payer: UHC Exchange |
$1,954.58
|
| Rate for Payer: UHC Medicaid |
$670.10
|
| Rate for Payer: UHCCP Medicaid |
$670.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,915.44
|
|
|
PR REMOVAL/BIVALVING FULL ARM/FULL LEG CAST
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 29705
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Aetna Commercial |
$53.99
|
| Rate for Payer: Aetna Medicare |
$41.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.02
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$40.29
|
| Rate for Payer: BCN Commercial |
$67.72
|
| Rate for Payer: BCN Medicare Advantage |
$40.29
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$53.99
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.30
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.32
|
| Rate for Payer: Nomi Health Commercial |
$48.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$40.29
|
| Rate for Payer: PHP Commercial |
$56.41
|
| Rate for Payer: PHP Medicare Advantage |
$40.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.39
|
| Rate for Payer: Priority Health Medicare |
$40.29
|
| Rate for Payer: Priority Health SBD |
$72.39
|
| Rate for Payer: Priority Health Tiered Network |
$72.39
|
| Rate for Payer: Railroad Medicare Medicare |
$40.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.90
|
| Rate for Payer: UHC Core |
$79.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.29
|
| Rate for Payer: UHC Exchange |
$79.90
|
| Rate for Payer: UHC Medicaid |
$25.99
|
| Rate for Payer: UHCCP Medicaid |
$25.99
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
|
|
PR REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 59871
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$161.99
|
| Rate for Payer: Aetna Medicare |
$125.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.08
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$120.89
|
| Rate for Payer: BCN Commercial |
$199.69
|
| Rate for Payer: BCN Medicare Advantage |
$120.89
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$161.99
|
| Rate for Payer: Cofinity Commercial |
$174.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.93
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.98
|
| Rate for Payer: Nomi Health Commercial |
$145.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: PACE SWMI |
$120.89
|
| Rate for Payer: PHP Commercial |
$169.25
|
| Rate for Payer: PHP Medicare Advantage |
$120.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.51
|
| Rate for Payer: Priority Health Medicare |
$120.89
|
| Rate for Payer: Priority Health SBD |
$188.51
|
| Rate for Payer: Priority Health Tiered Network |
$188.51
|
| Rate for Payer: Railroad Medicare Medicare |
$120.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.65
|
| Rate for Payer: UHC Core |
$235.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.89
|
| Rate for Payer: UHC Exchange |
$235.65
|
| Rate for Payer: UHC Medicaid |
$76.89
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 21029
|
| Min. Negotiated Rate |
$364.23 |
| Max. Negotiated Rate |
$1,196.25 |
| Rate for Payer: Aetna Commercial |
$743.66
|
| Rate for Payer: Aetna Medicare |
$577.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$799.16
|
| Rate for Payer: BCBS Complete |
$382.44
|
| Rate for Payer: BCBS MAPPO |
$554.97
|
| Rate for Payer: BCN Commercial |
$950.64
|
| Rate for Payer: BCN Medicare Advantage |
$554.97
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$743.66
|
| Rate for Payer: Cofinity Commercial |
$799.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.72
|
| Rate for Payer: Meridian Medicaid |
$382.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$610.47
|
| Rate for Payer: Nomi Health Commercial |
$665.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,196.25
|
| Rate for Payer: PACE SWMI |
$554.97
|
| Rate for Payer: PHP Commercial |
$776.96
|
| Rate for Payer: PHP Medicare Advantage |
$554.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,016.21
|
| Rate for Payer: Priority Health Medicare |
$554.97
|
| Rate for Payer: Priority Health SBD |
$1,016.21
|
| Rate for Payer: Priority Health Tiered Network |
$1,016.21
|
| Rate for Payer: Railroad Medicare Medicare |
$554.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,078.77
|
| Rate for Payer: UHC Core |
$1,078.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$554.97
|
| Rate for Payer: UHC Exchange |
$1,078.77
|
| Rate for Payer: UHC Medicaid |
$364.23
|
| Rate for Payer: UHCCP Medicaid |
$364.23
|
| Rate for Payer: UMR Bronson Commercial |
$733.70
|
|
|
PR REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 64570
|
| Min. Negotiated Rate |
$488.62 |
| Max. Negotiated Rate |
$1,317.01 |
| Rate for Payer: Aetna Commercial |
$1,008.10
|
| Rate for Payer: Aetna Medicare |
$782.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.33
|
| Rate for Payer: BCBS Complete |
$513.05
|
| Rate for Payer: BCBS MAPPO |
$752.31
|
| Rate for Payer: BCN Commercial |
$1,133.90
|
| Rate for Payer: BCN Medicare Advantage |
$752.31
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,008.10
|
| Rate for Payer: Cofinity Commercial |
$1,083.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$789.93
|
| Rate for Payer: Meridian Medicaid |
$513.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$827.54
|
| Rate for Payer: Nomi Health Commercial |
$902.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.25
|
| Rate for Payer: PACE SWMI |
$752.31
|
| Rate for Payer: PHP Commercial |
$1,053.23
|
| Rate for Payer: PHP Medicare Advantage |
$752.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,317.01
|
| Rate for Payer: Priority Health Medicare |
$752.31
|
| Rate for Payer: Priority Health SBD |
$1,317.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,317.01
|
| Rate for Payer: Railroad Medicare Medicare |
$752.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,277.51
|
| Rate for Payer: UHC Core |
$1,277.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$752.31
|
| Rate for Payer: UHC Exchange |
$1,277.51
|
| Rate for Payer: UHC Medicaid |
$488.62
|
| Rate for Payer: UHCCP Medicaid |
$488.62
|
| Rate for Payer: UMR Bronson Commercial |
$730.02
|
|
|
PR REMOVAL DEEP DRUG DELIVERY DEVICE
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 20701
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Commercial |
$73.32
|
| Rate for Payer: Aetna Medicare |
$56.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.80
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCBS MAPPO |
$54.72
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: BCN Medicare Advantage |
$54.72
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$73.32
|
| Rate for Payer: Cofinity Commercial |
$78.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.46
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.19
|
| Rate for Payer: Nomi Health Commercial |
$65.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$54.72
|
| Rate for Payer: PHP Commercial |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$54.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.67
|
| Rate for Payer: Priority Health Medicare |
$54.72
|
| Rate for Payer: Priority Health SBD |
$101.67
|
| Rate for Payer: Priority Health Tiered Network |
$101.67
|
| Rate for Payer: Railroad Medicare Medicare |
$54.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.60
|
| Rate for Payer: UHC Core |
$111.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.72
|
| Rate for Payer: UHC Exchange |
$111.60
|
| Rate for Payer: UHC Medicaid |
$34.93
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
| Rate for Payer: UMR Bronson Commercial |
$72.68
|
|
|
PR REMOVAL EMBEDDED FOREIGN BODY EYELID
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 67938
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$370.50 |
| Rate for Payer: Aetna Commercial |
$128.43
|
| Rate for Payer: Aetna Medicare |
$99.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.01
|
| Rate for Payer: BCBS Complete |
$67.09
|
| Rate for Payer: BCBS MAPPO |
$95.84
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$95.84
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cofinity Commercial |
$128.43
|
| Rate for Payer: Cofinity Commercial |
$138.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.63
|
| Rate for Payer: Meridian Medicaid |
$67.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.42
|
| Rate for Payer: Nomi Health Commercial |
$115.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.50
|
| Rate for Payer: PACE SWMI |
$95.84
|
| Rate for Payer: PHP Commercial |
$134.18
|
| Rate for Payer: PHP Medicare Advantage |
$95.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$200.08
|
| Rate for Payer: Priority Health Medicare |
$95.84
|
| Rate for Payer: Priority Health SBD |
$200.08
|
| Rate for Payer: Priority Health Tiered Network |
$200.08
|
| Rate for Payer: Railroad Medicare Medicare |
$95.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.31
|
| Rate for Payer: UHC Core |
$196.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.84
|
| Rate for Payer: UHC Exchange |
$196.31
|
| Rate for Payer: UHC Medicaid |
$63.90
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
| Rate for Payer: UMR Bronson Commercial |
$227.24
|
|
|
PR REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 20694
|
| Min. Negotiated Rate |
$209.38 |
| Max. Negotiated Rate |
$737.25 |
| Rate for Payer: Aetna Commercial |
$425.56
|
| Rate for Payer: Aetna Medicare |
$330.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.32
|
| Rate for Payer: BCBS Complete |
$219.85
|
| Rate for Payer: BCBS MAPPO |
$317.58
|
| Rate for Payer: BCN Commercial |
$525.37
|
| Rate for Payer: BCN Medicare Advantage |
$317.58
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cofinity Commercial |
$425.56
|
| Rate for Payer: Cofinity Commercial |
$457.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.46
|
| Rate for Payer: Meridian Medicaid |
$219.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$349.34
|
| Rate for Payer: Nomi Health Commercial |
$381.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.25
|
| Rate for Payer: PACE SWMI |
$317.58
|
| Rate for Payer: PHP Commercial |
$444.61
|
| Rate for Payer: PHP Medicare Advantage |
$317.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$561.61
|
| Rate for Payer: Priority Health Medicare |
$317.58
|
| Rate for Payer: Priority Health SBD |
$561.61
|
| Rate for Payer: Priority Health Tiered Network |
$561.61
|
| Rate for Payer: Railroad Medicare Medicare |
$317.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.41
|
| Rate for Payer: UHC Core |
$585.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$317.58
|
| Rate for Payer: UHC Exchange |
$585.41
|
| Rate for Payer: UHC Medicaid |
$209.38
|
| Rate for Payer: UHCCP Medicaid |
$209.38
|
| Rate for Payer: UMR Bronson Commercial |
$452.18
|
|
|
PR REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 65205
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$31.89
|
| Rate for Payer: Aetna Medicare |
$24.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.27
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$23.80
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$23.80
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$31.89
|
| Rate for Payer: Cofinity Commercial |
$34.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.99
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.18
|
| Rate for Payer: Nomi Health Commercial |
$28.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$23.80
|
| Rate for Payer: PHP Commercial |
$33.32
|
| Rate for Payer: PHP Medicare Advantage |
$23.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.17
|
| Rate for Payer: Priority Health Medicare |
$23.80
|
| Rate for Payer: Priority Health SBD |
$50.17
|
| Rate for Payer: Priority Health Tiered Network |
$50.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.41
|
| Rate for Payer: UHC Core |
$50.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.80
|
| Rate for Payer: UHC Exchange |
$50.41
|
| Rate for Payer: UHC Medicaid |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
| Rate for Payer: UMR Bronson Commercial |
$92.00
|
|
|
PR REMOVAL FOREIGN BODY DEEP PENILE TISSUE
|
Professional
|
Both
|
$876.00
|
|
|
Service Code
|
HCPCS 54115
|
| Min. Negotiated Rate |
$252.62 |
| Max. Negotiated Rate |
$744.55 |
| Rate for Payer: Aetna Commercial |
$519.54
|
| Rate for Payer: Aetna Medicare |
$403.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.32
|
| Rate for Payer: BCBS Complete |
$265.25
|
| Rate for Payer: BCBS MAPPO |
$387.72
|
| Rate for Payer: BCN Commercial |
$644.38
|
| Rate for Payer: BCN Medicare Advantage |
$387.72
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cofinity Commercial |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$558.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.11
|
| Rate for Payer: Meridian Medicaid |
$265.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$426.49
|
| Rate for Payer: Nomi Health Commercial |
$465.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.00
|
| Rate for Payer: PACE SWMI |
$387.72
|
| Rate for Payer: PHP Commercial |
$542.81
|
| Rate for Payer: PHP Medicare Advantage |
$387.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$701.94
|
| Rate for Payer: Priority Health Medicare |
$387.72
|
| Rate for Payer: Priority Health SBD |
$701.94
|
| Rate for Payer: Priority Health Tiered Network |
$701.94
|
| Rate for Payer: Railroad Medicare Medicare |
$387.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$744.55
|
| Rate for Payer: UHC Core |
$744.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.72
|
| Rate for Payer: UHC Exchange |
$744.55
|
| Rate for Payer: UHC Medicaid |
$252.62
|
| Rate for Payer: UHCCP Medicaid |
$252.62
|
| Rate for Payer: UMR Bronson Commercial |
$402.96
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$860.25 |
| Rate for Payer: Aetna Commercial |
$509.04
|
| Rate for Payer: Aetna Medicare |
$395.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.03
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCBS MAPPO |
$379.88
|
| Rate for Payer: BCN Commercial |
$614.51
|
| Rate for Payer: BCN Medicare Advantage |
$379.88
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$509.04
|
| Rate for Payer: Cofinity Commercial |
$547.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.87
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$417.87
|
| Rate for Payer: Nomi Health Commercial |
$455.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE SWMI |
$379.88
|
| Rate for Payer: PHP Commercial |
$531.83
|
| Rate for Payer: PHP Medicare Advantage |
$379.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$656.90
|
| Rate for Payer: Priority Health Medicare |
$379.88
|
| Rate for Payer: Priority Health SBD |
$656.90
|
| Rate for Payer: Priority Health Tiered Network |
$656.90
|
| Rate for Payer: Railroad Medicare Medicare |
$379.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.18
|
| Rate for Payer: UHC Core |
$699.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$379.88
|
| Rate for Payer: UHC Exchange |
$699.18
|
| Rate for Payer: UHC Medicaid |
$249.64
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
| Rate for Payer: UMR Bronson Commercial |
$527.62
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,147.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$424.39 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$745.55
|
| Rate for Payer: Aetna Commercial |
$974.95
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.27
|
| Rate for Payer: BCN Commercial |
$2,264.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Advantage |
$802.90
|
| Rate for Payer: Cofinity Commercial |
$986.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$917.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,032.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$802.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.25
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$974.95
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$974.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$722.61
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$424.39
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.25
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$860.25 |
| Rate for Payer: Aetna Commercial |
$509.04
|
| Rate for Payer: Aetna Medicare |
$395.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.03
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCBS MAPPO |
$379.88
|
| Rate for Payer: BCN Commercial |
$614.51
|
| Rate for Payer: BCN Medicare Advantage |
$379.88
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$509.04
|
| Rate for Payer: Cofinity Commercial |
$547.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.87
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$417.87
|
| Rate for Payer: Nomi Health Commercial |
$455.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE SWMI |
$379.88
|
| Rate for Payer: PHP Commercial |
$531.83
|
| Rate for Payer: PHP Medicare Advantage |
$379.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$656.90
|
| Rate for Payer: Priority Health Medicare |
$379.88
|
| Rate for Payer: Priority Health SBD |
$656.90
|
| Rate for Payer: Priority Health Tiered Network |
$656.90
|
| Rate for Payer: Railroad Medicare Medicare |
$379.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.18
|
| Rate for Payer: UHC Core |
$699.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$379.88
|
| Rate for Payer: UHC Exchange |
$699.18
|
| Rate for Payer: UHC Medicaid |
$249.64
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
| Rate for Payer: UMR Bronson Commercial |
$527.62
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,147.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$504.68 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna American Axle |
$745.55
|
| Rate for Payer: Aetna Commercial |
$974.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.55
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Advantage |
$802.90
|
| Rate for Payer: Cofinity Commercial |
$986.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$917.60
|
| Rate for Payer: Healthscope Commercial |
$1,032.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$802.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$974.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PHP Commercial |
$974.95
|
| Rate for Payer: Priority Health SBD |
$722.61
|
| Rate for Payer: UMR Bronson Commercial |
$504.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.25
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$217.47 |
| Max. Negotiated Rate |
$727.50 |
| Rate for Payer: Aetna Commercial |
$444.73
|
| Rate for Payer: Aetna Medicare |
$345.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.92
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS MAPPO |
$331.89
|
| Rate for Payer: BCN Commercial |
$552.76
|
| Rate for Payer: BCN Medicare Advantage |
$331.89
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$444.73
|
| Rate for Payer: Cofinity Commercial |
$477.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.48
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.08
|
| Rate for Payer: Nomi Health Commercial |
$398.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.50
|
| Rate for Payer: PACE SWMI |
$331.89
|
| Rate for Payer: PHP Commercial |
$464.65
|
| Rate for Payer: PHP Medicare Advantage |
$331.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$590.89
|
| Rate for Payer: Priority Health Medicare |
$331.89
|
| Rate for Payer: Priority Health SBD |
$590.89
|
| Rate for Payer: Priority Health Tiered Network |
$590.89
|
| Rate for Payer: Railroad Medicare Medicare |
$331.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$645.12
|
| Rate for Payer: UHC Core |
$645.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.89
|
| Rate for Payer: UHC Exchange |
$645.12
|
| Rate for Payer: UHC Medicaid |
$217.47
|
| Rate for Payer: UHCCP Medicaid |
$217.47
|
| Rate for Payer: UMR Bronson Commercial |
$446.20
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$381.78
|
| Rate for Payer: Aetna Medicare |
$296.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$381.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.27
|
| Rate for Payer: BCBS Complete |
$196.59
|
| Rate for Payer: BCBS MAPPO |
$284.91
|
| Rate for Payer: BCN Commercial |
$473.08
|
| Rate for Payer: BCN Medicare Advantage |
$284.91
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$381.78
|
| Rate for Payer: Cofinity Commercial |
$410.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.16
|
| Rate for Payer: Meridian Medicaid |
$196.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.40
|
| Rate for Payer: Nomi Health Commercial |
$341.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$284.91
|
| Rate for Payer: PHP Commercial |
$398.87
|
| Rate for Payer: PHP Medicare Advantage |
$284.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$505.71
|
| Rate for Payer: Priority Health Medicare |
$284.91
|
| Rate for Payer: Priority Health SBD |
$505.71
|
| Rate for Payer: Priority Health Tiered Network |
$505.71
|
| Rate for Payer: Railroad Medicare Medicare |
$284.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.75
|
| Rate for Payer: UHC Core |
$545.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$284.91
|
| Rate for Payer: UHC Exchange |
$545.75
|
| Rate for Payer: UHC Medicaid |
$187.23
|
| Rate for Payer: UHCCP Medicaid |
$187.23
|
| Rate for Payer: UMR Bronson Commercial |
$362.48
|
|
