|
PR ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 54530
|
| Min. Negotiated Rate |
$328.23 |
| Max. Negotiated Rate |
$2,667.39 |
| Rate for Payer: Aetna Commercial |
$653.28
|
| Rate for Payer: Aetna Medicare |
$507.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.03
|
| Rate for Payer: BCBS Complete |
$344.64
|
| Rate for Payer: BCBS MAPPO |
$487.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,667.39
|
| Rate for Payer: BCN Commercial |
$736.93
|
| Rate for Payer: BCN Medicare Advantage |
$487.52
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$653.28
|
| Rate for Payer: Cofinity Commercial |
$702.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.90
|
| Rate for Payer: Meridian Medicaid |
$344.64
|
| Rate for Payer: Nomi Health Commercial |
$585.02
|
| Rate for Payer: PACE SWMI |
$487.52
|
| Rate for Payer: PHP Commercial |
$682.53
|
| Rate for Payer: PHP Medicare Advantage |
$487.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$814.88
|
| Rate for Payer: Priority Health Medicare |
$487.52
|
| Rate for Payer: Priority Health Narrow Network |
$814.88
|
| Rate for Payer: Priority Health SBD |
$814.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.52
|
| Rate for Payer: UHC Medicare Advantage |
$487.52
|
| Rate for Payer: UHCCP Medicaid |
$328.23
|
| Rate for Payer: UMR Bronson Commercial |
$445.74
|
|
|
PR ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 54535
|
| Min. Negotiated Rate |
$476.91 |
| Max. Negotiated Rate |
$3,333.04 |
| Rate for Payer: Aetna Commercial |
$953.05
|
| Rate for Payer: Aetna Medicare |
$739.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,024.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.05
|
| Rate for Payer: BCBS Complete |
$500.76
|
| Rate for Payer: BCBS MAPPO |
$711.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,333.04
|
| Rate for Payer: BCN Commercial |
$1,073.63
|
| Rate for Payer: BCN Medicare Advantage |
$711.23
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$1,024.17
|
| Rate for Payer: Cofinity Commercial |
$953.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$746.79
|
| Rate for Payer: Meridian Medicaid |
$500.76
|
| Rate for Payer: Nomi Health Commercial |
$853.48
|
| Rate for Payer: PACE SWMI |
$711.23
|
| Rate for Payer: PHP Commercial |
$995.72
|
| Rate for Payer: PHP Medicare Advantage |
$711.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,185.57
|
| Rate for Payer: Priority Health Medicare |
$711.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,185.57
|
| Rate for Payer: Priority Health SBD |
$1,185.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.23
|
| Rate for Payer: UHC Medicare Advantage |
$711.23
|
| Rate for Payer: UHCCP Medicaid |
$476.91
|
| Rate for Payer: UMR Bronson Commercial |
$644.46
|
|
|
PR ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH
|
Professional
|
Both
|
$615.00
|
|
|
Service Code
|
HCPCS 54520
|
| Min. Negotiated Rate |
$211.94 |
| Max. Negotiated Rate |
$2,233.12 |
| Rate for Payer: Aetna Commercial |
$421.40
|
| Rate for Payer: Aetna Medicare |
$327.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.85
|
| Rate for Payer: BCBS Complete |
$222.54
|
| Rate for Payer: BCBS MAPPO |
$314.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,233.12
|
| Rate for Payer: BCN Commercial |
$475.49
|
| Rate for Payer: BCN Medicare Advantage |
$314.48
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Cofinity Commercial |
$421.40
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.20
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: Nomi Health Commercial |
$377.38
|
| Rate for Payer: PACE SWMI |
$314.48
|
| Rate for Payer: PHP Commercial |
$440.27
|
| Rate for Payer: PHP Medicare Advantage |
$314.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$526.74
|
| Rate for Payer: Priority Health Medicare |
$314.48
|
| Rate for Payer: Priority Health Narrow Network |
$526.74
|
| Rate for Payer: Priority Health SBD |
$526.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.48
|
| Rate for Payer: UHC Medicare Advantage |
$314.48
|
| Rate for Payer: UHCCP Medicaid |
$211.94
|
| Rate for Payer: UMR Bronson Commercial |
$282.90
|
|
|
PR ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$1,499.00
|
|
|
Service Code
|
HCPCS 54650
|
| Min. Negotiated Rate |
$457.31 |
| Max. Negotiated Rate |
$2,517.35 |
| Rate for Payer: Aetna Commercial |
$912.61
|
| Rate for Payer: Aetna Medicare |
$708.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.71
|
| Rate for Payer: BCBS Complete |
$480.18
|
| Rate for Payer: BCBS MAPPO |
$681.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,517.35
|
| Rate for Payer: BCN Commercial |
$1,028.66
|
| Rate for Payer: BCN Medicare Advantage |
$681.05
|
| Rate for Payer: Cash Price |
$1,199.20
|
| Rate for Payer: Cash Price |
$1,199.20
|
| Rate for Payer: Cofinity Commercial |
$912.61
|
| Rate for Payer: Cofinity Commercial |
$980.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.10
|
| Rate for Payer: Meridian Medicaid |
$480.18
|
| Rate for Payer: Nomi Health Commercial |
$817.26
|
| Rate for Payer: PACE SWMI |
$681.05
|
| Rate for Payer: PHP Commercial |
$953.47
|
| Rate for Payer: PHP Medicare Advantage |
$681.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.58
|
| Rate for Payer: Priority Health Medicare |
$681.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.58
|
| Rate for Payer: Priority Health SBD |
$1,136.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.05
|
| Rate for Payer: UHC Medicare Advantage |
$681.05
|
| Rate for Payer: UHCCP Medicaid |
$457.31
|
| Rate for Payer: UMR Bronson Commercial |
$689.54
|
|
|
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH
|
Professional
|
Both
|
$1,756.00
|
|
|
Service Code
|
HCPCS 54640
|
| Min. Negotiated Rate |
$278.18 |
| Max. Negotiated Rate |
$2,048.75 |
| Rate for Payer: Aetna Commercial |
$556.88
|
| Rate for Payer: Aetna Medicare |
$432.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.44
|
| Rate for Payer: BCBS Complete |
$292.09
|
| Rate for Payer: BCBS MAPPO |
$415.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,048.75
|
| Rate for Payer: BCN Commercial |
$623.55
|
| Rate for Payer: BCN Medicare Advantage |
$415.58
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cofinity Commercial |
$598.44
|
| Rate for Payer: Cofinity Commercial |
$556.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.36
|
| Rate for Payer: Meridian Medicaid |
$292.09
|
| Rate for Payer: Nomi Health Commercial |
$498.70
|
| Rate for Payer: PACE SWMI |
$415.58
|
| Rate for Payer: PHP Commercial |
$581.81
|
| Rate for Payer: PHP Medicare Advantage |
$415.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.11
|
| Rate for Payer: Priority Health Medicare |
$415.58
|
| Rate for Payer: Priority Health Narrow Network |
$688.11
|
| Rate for Payer: Priority Health SBD |
$688.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.58
|
| Rate for Payer: UHC Medicare Advantage |
$415.58
|
| Rate for Payer: UHCCP Medicaid |
$278.18
|
| Rate for Payer: UMR Bronson Commercial |
$807.76
|
|
|
PR ORPHENADRINE INJECTION
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS J2360
|
| Min. Negotiated Rate |
$5.01 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Commercial |
$12.66
|
| Rate for Payer: Aetna Medicare |
$9.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.61
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$9.45
|
| Rate for Payer: BCBS Trust/PPO |
$9.88
|
| Rate for Payer: BCN Commercial |
$5.01
|
| Rate for Payer: BCN Medicare Advantage |
$9.45
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$12.66
|
| Rate for Payer: Cofinity Commercial |
$13.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.92
|
| Rate for Payer: Nomi Health Commercial |
$11.34
|
| Rate for Payer: PACE SWMI |
$9.45
|
| Rate for Payer: PHP Commercial |
$13.23
|
| Rate for Payer: PHP Medicare Advantage |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$9.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.45
|
| Rate for Payer: UHC Medicare Advantage |
$9.45
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
|
|
PR ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 97760
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$466.49 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.45
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCBS Trust/PPO |
$466.49
|
| Rate for Payer: BCN Commercial |
$70.86
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Commercial |
$60.72
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health Narrow Network |
$77.25
|
| Rate for Payer: Priority Health SBD |
$77.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.37
|
| Rate for Payer: UHC Medicare Advantage |
$43.37
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
|
|
PR ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 97763
|
| Min. Negotiated Rate |
$42.40 |
| Max. Negotiated Rate |
$674.11 |
| Rate for Payer: Aetna Commercial |
$63.17
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.88
|
| Rate for Payer: BCBS Complete |
$42.40
|
| Rate for Payer: BCBS MAPPO |
$47.14
|
| Rate for Payer: BCBS Trust/PPO |
$674.11
|
| Rate for Payer: BCN Commercial |
$77.70
|
| Rate for Payer: BCN Medicare Advantage |
$47.14
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$67.88
|
| Rate for Payer: Cofinity Commercial |
$63.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.50
|
| Rate for Payer: Nomi Health Commercial |
$56.57
|
| Rate for Payer: PACE SWMI |
$47.14
|
| Rate for Payer: PHP Commercial |
$66.00
|
| Rate for Payer: PHP Medicare Advantage |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$47.14
|
| Rate for Payer: Priority Health Narrow Network |
$77.25
|
| Rate for Payer: Priority Health SBD |
$77.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.14
|
| Rate for Payer: UHC Medicare Advantage |
$47.14
|
| Rate for Payer: UMR Bronson Commercial |
$48.76
|
|
|
PR ORTHOVISC INJ PER DOSE
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS J7324
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$140.69 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: Aetna Medicare |
$101.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.69
|
| Rate for Payer: BCBS Complete |
$75.60
|
| Rate for Payer: BCBS MAPPO |
$97.70
|
| Rate for Payer: BCBS Trust/PPO |
$133.10
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: BCN Medicare Advantage |
$97.70
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cofinity Commercial |
$130.92
|
| Rate for Payer: Cofinity Commercial |
$140.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.58
|
| Rate for Payer: Nomi Health Commercial |
$117.24
|
| Rate for Payer: PACE SWMI |
$97.70
|
| Rate for Payer: PHP Commercial |
$136.78
|
| Rate for Payer: PHP Medicare Advantage |
$97.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.85
|
| Rate for Payer: Priority Health Medicare |
$97.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.70
|
| Rate for Payer: UHC Medicare Advantage |
$97.70
|
| Rate for Payer: UMR Bronson Commercial |
$86.94
|
|
|
PR OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 28114
|
| Min. Negotiated Rate |
$545.28 |
| Max. Negotiated Rate |
$1,554.48 |
| Rate for Payer: Aetna Commercial |
$1,075.66
|
| Rate for Payer: Aetna Medicare |
$834.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.66
|
| Rate for Payer: BCBS Complete |
$572.54
|
| Rate for Payer: BCBS MAPPO |
$802.73
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$1,554.48
|
| Rate for Payer: BCN Medicare Advantage |
$802.73
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,075.66
|
| Rate for Payer: Cofinity Commercial |
$1,155.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.87
|
| Rate for Payer: Meridian Medicaid |
$572.54
|
| Rate for Payer: Nomi Health Commercial |
$963.28
|
| Rate for Payer: PACE SWMI |
$802.73
|
| Rate for Payer: PHP Commercial |
$1,123.82
|
| Rate for Payer: PHP Medicare Advantage |
$802.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.93
|
| Rate for Payer: Priority Health Medicare |
$802.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.93
|
| Rate for Payer: Priority Health SBD |
$1,287.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$802.73
|
| Rate for Payer: UHC Medicare Advantage |
$802.73
|
| Rate for Payer: UHCCP Medicaid |
$545.28
|
| Rate for Payer: UMR Bronson Commercial |
$891.48
|
|
|
PR OSTC PRTL EXOSTC/CONDYLC METAR HEAD
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 28288
|
| Min. Negotiated Rate |
$78.19 |
| Max. Negotiated Rate |
$877.67 |
| Rate for Payer: Aetna Commercial |
$555.27
|
| Rate for Payer: Aetna Medicare |
$430.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$555.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.71
|
| Rate for Payer: BCBS Complete |
$297.23
|
| Rate for Payer: BCBS MAPPO |
$414.38
|
| Rate for Payer: BCBS Trust/PPO |
$78.19
|
| Rate for Payer: BCN Commercial |
$877.67
|
| Rate for Payer: BCN Medicare Advantage |
$414.38
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Commercial |
$555.27
|
| Rate for Payer: Cofinity Commercial |
$596.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$435.10
|
| Rate for Payer: Meridian Medicaid |
$297.23
|
| Rate for Payer: Nomi Health Commercial |
$497.26
|
| Rate for Payer: PACE SWMI |
$414.38
|
| Rate for Payer: PHP Commercial |
$580.13
|
| Rate for Payer: PHP Medicare Advantage |
$414.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.21
|
| Rate for Payer: Priority Health Medicare |
$414.38
|
| Rate for Payer: Priority Health Narrow Network |
$672.21
|
| Rate for Payer: Priority Health SBD |
$672.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$414.38
|
| Rate for Payer: UHC Medicare Advantage |
$414.38
|
| Rate for Payer: UHCCP Medicaid |
$283.08
|
| Rate for Payer: UMR Bronson Commercial |
$454.48
|
|
|
PR OSTECTOMY CALCANEUS
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 28118
|
| Min. Negotiated Rate |
$276.47 |
| Max. Negotiated Rate |
$2,262.71 |
| Rate for Payer: Aetna Commercial |
$545.50
|
| Rate for Payer: Aetna Medicare |
$423.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.21
|
| Rate for Payer: BCBS Complete |
$290.29
|
| Rate for Payer: BCBS MAPPO |
$407.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.71
|
| Rate for Payer: BCN Commercial |
$877.67
|
| Rate for Payer: BCN Medicare Advantage |
$407.09
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$545.50
|
| Rate for Payer: Cofinity Commercial |
$586.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.44
|
| Rate for Payer: Meridian Medicaid |
$290.29
|
| Rate for Payer: Nomi Health Commercial |
$488.51
|
| Rate for Payer: PACE SWMI |
$407.09
|
| Rate for Payer: PHP Commercial |
$569.93
|
| Rate for Payer: PHP Medicare Advantage |
$407.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.37
|
| Rate for Payer: Priority Health Medicare |
$407.09
|
| Rate for Payer: Priority Health Narrow Network |
$652.37
|
| Rate for Payer: Priority Health SBD |
$652.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.09
|
| Rate for Payer: UHC Medicare Advantage |
$407.09
|
| Rate for Payer: UHCCP Medicaid |
$276.47
|
| Rate for Payer: UMR Bronson Commercial |
$473.34
|
|
|
PR OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS
|
Professional
|
Both
|
$1,222.00
|
|
|
Service Code
|
HCPCS 28119
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$811.47 |
| Rate for Payer: Aetna Commercial |
$467.53
|
| Rate for Payer: Aetna Medicare |
$362.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.42
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCBS MAPPO |
$348.90
|
| Rate for Payer: BCBS Trust/PPO |
$811.47
|
| Rate for Payer: BCN Commercial |
$761.85
|
| Rate for Payer: BCN Medicare Advantage |
$348.90
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cofinity Commercial |
$467.53
|
| Rate for Payer: Cofinity Commercial |
$502.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.34
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Nomi Health Commercial |
$418.68
|
| Rate for Payer: PACE SWMI |
$348.90
|
| Rate for Payer: PHP Commercial |
$488.46
|
| Rate for Payer: PHP Medicare Advantage |
$348.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$562.30
|
| Rate for Payer: Priority Health Medicare |
$348.90
|
| Rate for Payer: Priority Health Narrow Network |
$562.30
|
| Rate for Payer: Priority Health SBD |
$562.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.90
|
| Rate for Payer: UHC Medicare Advantage |
$348.90
|
| Rate for Payer: UHCCP Medicaid |
$237.07
|
| Rate for Payer: UMR Bronson Commercial |
$562.12
|
|
|
PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 28111
|
| Min. Negotiated Rate |
$206.82 |
| Max. Negotiated Rate |
$693.44 |
| Rate for Payer: Aetna Commercial |
$409.18
|
| Rate for Payer: Aetna Medicare |
$317.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.72
|
| Rate for Payer: BCBS Complete |
$217.16
|
| Rate for Payer: BCBS MAPPO |
$305.36
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$693.44
|
| Rate for Payer: BCN Medicare Advantage |
$305.36
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$409.18
|
| Rate for Payer: Cofinity Commercial |
$439.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.63
|
| Rate for Payer: Meridian Medicaid |
$217.16
|
| Rate for Payer: Nomi Health Commercial |
$366.43
|
| Rate for Payer: PACE SWMI |
$305.36
|
| Rate for Payer: PHP Commercial |
$427.50
|
| Rate for Payer: PHP Medicare Advantage |
$305.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.54
|
| Rate for Payer: Priority Health Medicare |
$305.36
|
| Rate for Payer: Priority Health Narrow Network |
$490.54
|
| Rate for Payer: Priority Health SBD |
$490.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.36
|
| Rate for Payer: UHC Medicare Advantage |
$305.36
|
| Rate for Payer: UHCCP Medicaid |
$206.82
|
| Rate for Payer: UMR Bronson Commercial |
$382.26
|
|
|
PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Professional
|
Both
|
$1,034.00
|
|
|
Service Code
|
HCPCS 28113
|
| Min. Negotiated Rate |
$278.82 |
| Max. Negotiated Rate |
$850.30 |
| Rate for Payer: Aetna Commercial |
$547.27
|
| Rate for Payer: Aetna Medicare |
$424.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.11
|
| Rate for Payer: BCBS Complete |
$292.76
|
| Rate for Payer: BCBS MAPPO |
$408.41
|
| Rate for Payer: BCBS Trust/PPO |
$522.49
|
| Rate for Payer: BCN Commercial |
$850.30
|
| Rate for Payer: BCN Medicare Advantage |
$408.41
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cofinity Commercial |
$547.27
|
| Rate for Payer: Cofinity Commercial |
$588.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.83
|
| Rate for Payer: Meridian Medicaid |
$292.76
|
| Rate for Payer: Nomi Health Commercial |
$490.09
|
| Rate for Payer: PACE SWMI |
$408.41
|
| Rate for Payer: PHP Commercial |
$571.77
|
| Rate for Payer: PHP Medicare Advantage |
$408.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$657.96
|
| Rate for Payer: Priority Health Medicare |
$408.41
|
| Rate for Payer: Priority Health Narrow Network |
$657.96
|
| Rate for Payer: Priority Health SBD |
$657.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.41
|
| Rate for Payer: UHC Medicare Advantage |
$408.41
|
| Rate for Payer: UHCCP Medicaid |
$278.82
|
| Rate for Payer: UMR Bronson Commercial |
$475.64
|
|
|
PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4
|
Professional
|
Both
|
$971.00
|
|
|
Service Code
|
HCPCS 28112
|
| Min. Negotiated Rate |
$204.27 |
| Max. Negotiated Rate |
$1,106.26 |
| Rate for Payer: Aetna Commercial |
$402.21
|
| Rate for Payer: Aetna Medicare |
$312.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.23
|
| Rate for Payer: BCBS Complete |
$214.48
|
| Rate for Payer: BCBS MAPPO |
$300.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.26
|
| Rate for Payer: BCN Commercial |
$702.23
|
| Rate for Payer: BCN Medicare Advantage |
$300.16
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cofinity Commercial |
$402.21
|
| Rate for Payer: Cofinity Commercial |
$432.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.17
|
| Rate for Payer: Meridian Medicaid |
$214.48
|
| Rate for Payer: Nomi Health Commercial |
$360.19
|
| Rate for Payer: PACE SWMI |
$300.16
|
| Rate for Payer: PHP Commercial |
$420.22
|
| Rate for Payer: PHP Medicare Advantage |
$300.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.91
|
| Rate for Payer: Priority Health Medicare |
$300.16
|
| Rate for Payer: Priority Health Narrow Network |
$482.91
|
| Rate for Payer: Priority Health SBD |
$482.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.16
|
| Rate for Payer: UHC Medicare Advantage |
$300.16
|
| Rate for Payer: UHCCP Medicaid |
$204.27
|
| Rate for Payer: UMR Bronson Commercial |
$446.66
|
|
|
PR OSTECTOMY PRTL 5TH METAR HEAD SPX
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 28110
|
| Min. Negotiated Rate |
$192.55 |
| Max. Negotiated Rate |
$667.54 |
| Rate for Payer: Aetna Commercial |
$378.58
|
| Rate for Payer: Aetna Medicare |
$293.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.83
|
| Rate for Payer: BCBS Complete |
$202.18
|
| Rate for Payer: BCBS MAPPO |
$282.52
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$282.52
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$378.58
|
| Rate for Payer: Cofinity Commercial |
$406.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.65
|
| Rate for Payer: Meridian Medicaid |
$202.18
|
| Rate for Payer: Nomi Health Commercial |
$339.02
|
| Rate for Payer: PACE SWMI |
$282.52
|
| Rate for Payer: PHP Commercial |
$395.53
|
| Rate for Payer: PHP Medicare Advantage |
$282.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.39
|
| Rate for Payer: Priority Health Medicare |
$282.52
|
| Rate for Payer: Priority Health Narrow Network |
$453.39
|
| Rate for Payer: Priority Health SBD |
$453.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.52
|
| Rate for Payer: UHC Medicare Advantage |
$282.52
|
| Rate for Payer: UHCCP Medicaid |
$192.55
|
| Rate for Payer: UMR Bronson Commercial |
$420.44
|
|
|
PR OSTECTOMY STERNUM PARTIAL
|
Professional
|
Both
|
$3,953.00
|
|
|
Service Code
|
HCPCS 21620
|
| Min. Negotiated Rate |
$324.61 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$649.16
|
| Rate for Payer: Aetna Medicare |
$503.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.61
|
| Rate for Payer: BCBS Complete |
$340.84
|
| Rate for Payer: BCBS MAPPO |
$484.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$737.90
|
| Rate for Payer: BCN Medicare Advantage |
$484.45
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cofinity Commercial |
$649.16
|
| Rate for Payer: Cofinity Commercial |
$697.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.67
|
| Rate for Payer: Meridian Medicaid |
$340.84
|
| Rate for Payer: Nomi Health Commercial |
$581.34
|
| Rate for Payer: PACE SWMI |
$484.45
|
| Rate for Payer: PHP Commercial |
$678.23
|
| Rate for Payer: PHP Medicare Advantage |
$484.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,569.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.44
|
| Rate for Payer: Priority Health Medicare |
$484.45
|
| Rate for Payer: Priority Health Narrow Network |
$771.44
|
| Rate for Payer: Priority Health SBD |
$771.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.45
|
| Rate for Payer: UHC Medicare Advantage |
$484.45
|
| Rate for Payer: UHCCP Medicaid |
$324.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,818.38
|
|
|
PR OSTECTOMY TARSAL COALITION
|
Professional
|
Both
|
$1,439.00
|
|
|
Service Code
|
HCPCS 28116
|
| Min. Negotiated Rate |
$337.39 |
| Max. Negotiated Rate |
$1,784.07 |
| Rate for Payer: Aetna Commercial |
$668.79
|
| Rate for Payer: Aetna Medicare |
$519.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$668.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.70
|
| Rate for Payer: BCBS Complete |
$354.26
|
| Rate for Payer: BCBS MAPPO |
$499.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,784.07
|
| Rate for Payer: BCN Commercial |
$1,138.62
|
| Rate for Payer: BCN Medicare Advantage |
$499.10
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cofinity Commercial |
$668.79
|
| Rate for Payer: Cofinity Commercial |
$718.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.06
|
| Rate for Payer: Meridian Medicaid |
$354.26
|
| Rate for Payer: Nomi Health Commercial |
$598.92
|
| Rate for Payer: PACE SWMI |
$499.10
|
| Rate for Payer: PHP Commercial |
$698.74
|
| Rate for Payer: PHP Medicare Advantage |
$499.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$935.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$895.59
|
| Rate for Payer: Priority Health Medicare |
$499.10
|
| Rate for Payer: Priority Health Narrow Network |
$895.59
|
| Rate for Payer: Priority Health SBD |
$895.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$499.10
|
| Rate for Payer: UHC Medicare Advantage |
$499.10
|
| Rate for Payer: UHCCP Medicaid |
$337.39
|
| Rate for Payer: UMR Bronson Commercial |
$661.94
|
|
|
PR OSTEOCHONDRAL ALLOGRAFT KNEE OPEN
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 27415
|
| Min. Negotiated Rate |
$709.51 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,772.16
|
| Rate for Payer: Aetna Medicare |
$1,375.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,772.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.41
|
| Rate for Payer: BCBS Complete |
$933.74
|
| Rate for Payer: BCBS MAPPO |
$1,322.51
|
| Rate for Payer: BCBS Trust/PPO |
$709.51
|
| Rate for Payer: BCN Commercial |
$2,007.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,322.51
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,772.16
|
| Rate for Payer: Cofinity Commercial |
$1,904.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,322.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,388.64
|
| Rate for Payer: Meridian Medicaid |
$933.74
|
| Rate for Payer: Nomi Health Commercial |
$1,587.01
|
| Rate for Payer: PACE SWMI |
$1,322.51
|
| Rate for Payer: PHP Commercial |
$1,851.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,322.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$889.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,106.68
|
| Rate for Payer: Priority Health Medicare |
$1,322.51
|
| Rate for Payer: Priority Health Narrow Network |
$2,106.68
|
| Rate for Payer: Priority Health SBD |
$2,106.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,322.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,322.51
|
| Rate for Payer: UHCCP Medicaid |
$889.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,104.50
|
|
|
PR OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY
|
Professional
|
Both
|
$3,097.00
|
|
|
Service Code
|
HCPCS 27416
|
| Min. Negotiated Rate |
$637.30 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$1,268.89
|
| Rate for Payer: Aetna Medicare |
$984.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,268.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,363.58
|
| Rate for Payer: BCBS Complete |
$669.16
|
| Rate for Payer: BCBS MAPPO |
$946.93
|
| Rate for Payer: BCBS Trust/PPO |
$852.15
|
| Rate for Payer: BCN Commercial |
$1,438.67
|
| Rate for Payer: BCN Medicare Advantage |
$946.93
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,268.89
|
| Rate for Payer: Cofinity Commercial |
$1,363.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$994.28
|
| Rate for Payer: Meridian Medicaid |
$669.16
|
| Rate for Payer: Nomi Health Commercial |
$1,136.32
|
| Rate for Payer: PACE SWMI |
$946.93
|
| Rate for Payer: PHP Commercial |
$1,325.70
|
| Rate for Payer: PHP Medicare Advantage |
$946.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,508.77
|
| Rate for Payer: Priority Health Medicare |
$946.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.77
|
| Rate for Payer: Priority Health SBD |
$1,508.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$946.93
|
| Rate for Payer: UHC Medicare Advantage |
$946.93
|
| Rate for Payer: UHCCP Medicaid |
$637.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.62
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 98925
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$1,227.77 |
| Rate for Payer: Aetna Commercial |
$28.97
|
| Rate for Payer: Aetna Medicare |
$22.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.13
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$21.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.77
|
| Rate for Payer: BCN Commercial |
$30.34
|
| Rate for Payer: BCN Medicare Advantage |
$21.62
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$28.97
|
| Rate for Payer: Cofinity Commercial |
$31.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.70
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$25.94
|
| Rate for Payer: PACE SWMI |
$21.62
|
| Rate for Payer: PHP Commercial |
$30.27
|
| Rate for Payer: PHP Medicare Advantage |
$21.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.76
|
| Rate for Payer: Priority Health Medicare |
$21.62
|
| Rate for Payer: Priority Health Narrow Network |
$30.76
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.62
|
| Rate for Payer: UHC Medicare Advantage |
$21.62
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 98926
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$1,021.73 |
| Rate for Payer: Aetna Commercial |
$43.86
|
| Rate for Payer: Aetna Medicare |
$34.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.13
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$32.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.73
|
| Rate for Payer: BCN Commercial |
$43.39
|
| Rate for Payer: BCN Medicare Advantage |
$32.73
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$47.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.37
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Nomi Health Commercial |
$39.28
|
| Rate for Payer: PACE SWMI |
$32.73
|
| Rate for Payer: PHP Commercial |
$45.82
|
| Rate for Payer: PHP Medicare Advantage |
$32.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Medicare |
$32.73
|
| Rate for Payer: Priority Health Narrow Network |
$46.59
|
| Rate for Payer: Priority Health SBD |
$46.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.73
|
| Rate for Payer: UHC Medicare Advantage |
$32.73
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
| Rate for Payer: UMR Bronson Commercial |
$35.88
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 98927
|
| Min. Negotiated Rate |
$29.18 |
| Max. Negotiated Rate |
$1,177.05 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$45.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.73
|
| Rate for Payer: BCBS Complete |
$30.64
|
| Rate for Payer: BCBS MAPPO |
$43.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,177.05
|
| Rate for Payer: BCN Commercial |
$56.11
|
| Rate for Payer: BCN Medicare Advantage |
$43.56
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$58.37
|
| Rate for Payer: Cofinity Commercial |
$62.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.74
|
| Rate for Payer: Meridian Medicaid |
$30.64
|
| Rate for Payer: Nomi Health Commercial |
$52.27
|
| Rate for Payer: PACE SWMI |
$43.56
|
| Rate for Payer: PHP Commercial |
$60.98
|
| Rate for Payer: PHP Medicare Advantage |
$43.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.96
|
| Rate for Payer: Priority Health Medicare |
$43.56
|
| Rate for Payer: Priority Health Narrow Network |
$61.96
|
| Rate for Payer: Priority Health SBD |
$61.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.56
|
| Rate for Payer: UHC Medicare Advantage |
$43.56
|
| Rate for Payer: UHCCP Medicaid |
$29.18
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 98928
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$332.83 |
| Rate for Payer: Aetna Commercial |
$73.66
|
| Rate for Payer: Aetna Medicare |
$57.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.16
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$54.97
|
| Rate for Payer: BCBS Trust/PPO |
$332.83
|
| Rate for Payer: BCN Commercial |
$69.16
|
| Rate for Payer: BCN Medicare Advantage |
$54.97
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$73.66
|
| Rate for Payer: Cofinity Commercial |
$79.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.72
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Nomi Health Commercial |
$65.96
|
| Rate for Payer: PACE SWMI |
$54.97
|
| Rate for Payer: PHP Commercial |
$76.96
|
| Rate for Payer: PHP Medicare Advantage |
$54.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.25
|
| Rate for Payer: Priority Health Medicare |
$54.97
|
| Rate for Payer: Priority Health Narrow Network |
$78.25
|
| Rate for Payer: Priority Health SBD |
$78.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.97
|
| Rate for Payer: UHC Medicare Advantage |
$54.97
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
