|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$413.01 |
| Max. Negotiated Rate |
$976.51 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$631.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.95
|
| Rate for Payer: BCBS Complete |
$433.66
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCBS Trust/PPO |
$889.13
|
| Rate for Payer: BCN Commercial |
$930.44
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Meridian Medicaid |
$433.66
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Commercial |
$849.67
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.51
|
| Rate for Payer: Priority Health Medicare |
$606.91
|
| Rate for Payer: Priority Health Narrow Network |
$976.51
|
| Rate for Payer: Priority Health SBD |
$976.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
| Rate for Payer: UHCCP Medicaid |
$413.01
|
| Rate for Payer: UMR Bronson Commercial |
$681.72
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
IP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$652.08 |
| Max. Negotiated Rate |
$1,333.80 |
| Rate for Payer: Aetna American Axle |
$963.30
|
| Rate for Payer: Aetna Commercial |
$1,259.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.30
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,037.40
|
| Rate for Payer: Cofinity Commercial |
$1,274.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,037.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Healthscope Commercial |
$1,333.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,037.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: PHP Commercial |
$1,259.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health SBD |
$933.66
|
| Rate for Payer: UMR Bronson Commercial |
$652.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.50
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
OP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$548.34 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$963.30
|
| Rate for Payer: Aetna Commercial |
$1,259.70
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,372.99
|
| Rate for Payer: BCN Commercial |
$2,372.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,037.40
|
| Rate for Payer: Cofinity Commercial |
$1,274.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,037.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,333.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,037.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,259.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$933.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.25
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$608.41
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$548.34
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.50
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$96.79 |
| Max. Negotiated Rate |
$1,148.50 |
| Rate for Payer: Aetna Commercial |
$957.26
|
| Rate for Payer: Aetna Medicare |
$742.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,028.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.26
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS MAPPO |
$714.37
|
| Rate for Payer: BCBS Trust/PPO |
$96.79
|
| Rate for Payer: BCN Commercial |
$1,092.19
|
| Rate for Payer: BCN Medicare Advantage |
$714.37
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,028.69
|
| Rate for Payer: Cofinity Commercial |
$957.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.09
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Nomi Health Commercial |
$857.24
|
| Rate for Payer: PACE SWMI |
$714.37
|
| Rate for Payer: PHP Commercial |
$1,000.12
|
| Rate for Payer: PHP Medicare Advantage |
$714.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.50
|
| Rate for Payer: Priority Health Medicare |
$714.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.50
|
| Rate for Payer: Priority Health SBD |
$1,148.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.37
|
| Rate for Payer: UHC Medicare Advantage |
$714.37
|
| Rate for Payer: UHCCP Medicaid |
$483.51
|
| Rate for Payer: UMR Bronson Commercial |
$765.44
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$384.68 |
| Max. Negotiated Rate |
$1,487.85 |
| Rate for Payer: Aetna Commercial |
$759.44
|
| Rate for Payer: Aetna Medicare |
$589.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.12
|
| Rate for Payer: BCBS Complete |
$403.91
|
| Rate for Payer: BCBS MAPPO |
$566.75
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: BCN Medicare Advantage |
$566.75
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$759.44
|
| Rate for Payer: Cofinity Commercial |
$816.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.09
|
| Rate for Payer: Meridian Medicaid |
$403.91
|
| Rate for Payer: Nomi Health Commercial |
$680.10
|
| Rate for Payer: PACE SWMI |
$566.75
|
| Rate for Payer: PHP Commercial |
$793.45
|
| Rate for Payer: PHP Medicare Advantage |
$566.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.82
|
| Rate for Payer: Priority Health Medicare |
$566.75
|
| Rate for Payer: Priority Health Narrow Network |
$908.82
|
| Rate for Payer: Priority Health SBD |
$908.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.75
|
| Rate for Payer: UHC Medicare Advantage |
$566.75
|
| Rate for Payer: UHCCP Medicaid |
$384.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.94
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$1,043.68 |
| Rate for Payer: Aetna Commercial |
$871.08
|
| Rate for Payer: Aetna Medicare |
$676.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.09
|
| Rate for Payer: BCBS Complete |
$463.18
|
| Rate for Payer: BCBS MAPPO |
$650.06
|
| Rate for Payer: BCBS Trust/PPO |
$38.63
|
| Rate for Payer: BCN Commercial |
$992.51
|
| Rate for Payer: BCN Medicare Advantage |
$650.06
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$871.08
|
| Rate for Payer: Cofinity Commercial |
$936.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.56
|
| Rate for Payer: Meridian Medicaid |
$463.18
|
| Rate for Payer: Nomi Health Commercial |
$780.07
|
| Rate for Payer: PACE SWMI |
$650.06
|
| Rate for Payer: PHP Commercial |
$910.08
|
| Rate for Payer: PHP Medicare Advantage |
$650.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.68
|
| Rate for Payer: Priority Health Medicare |
$650.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.68
|
| Rate for Payer: Priority Health SBD |
$1,043.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.06
|
| Rate for Payer: UHC Medicare Advantage |
$650.06
|
| Rate for Payer: UHCCP Medicaid |
$441.12
|
| Rate for Payer: UMR Bronson Commercial |
$581.90
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$321.63 |
| Max. Negotiated Rate |
$978.82 |
| Rate for Payer: Aetna Commercial |
$634.78
|
| Rate for Payer: Aetna Medicare |
$492.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.16
|
| Rate for Payer: BCBS Complete |
$337.71
|
| Rate for Payer: BCBS MAPPO |
$473.72
|
| Rate for Payer: BCBS Trust/PPO |
$732.22
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$473.72
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$634.78
|
| Rate for Payer: Cofinity Commercial |
$682.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.41
|
| Rate for Payer: Meridian Medicaid |
$337.71
|
| Rate for Payer: Nomi Health Commercial |
$568.46
|
| Rate for Payer: PACE SWMI |
$473.72
|
| Rate for Payer: PHP Commercial |
$663.21
|
| Rate for Payer: PHP Medicare Advantage |
$473.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.81
|
| Rate for Payer: Priority Health Medicare |
$473.72
|
| Rate for Payer: Priority Health Narrow Network |
$763.81
|
| Rate for Payer: Priority Health SBD |
$763.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.72
|
| Rate for Payer: UHC Medicare Advantage |
$473.72
|
| Rate for Payer: UHCCP Medicaid |
$321.63
|
| Rate for Payer: UMR Bronson Commercial |
$586.04
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,763.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$536.97 |
| Max. Negotiated Rate |
$2,231.54 |
| Rate for Payer: Aetna Commercial |
$1,066.98
|
| Rate for Payer: Aetna Medicare |
$828.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,146.60
|
| Rate for Payer: BCBS Complete |
$563.82
|
| Rate for Payer: BCBS MAPPO |
$796.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,231.54
|
| Rate for Payer: BCN Commercial |
$1,219.25
|
| Rate for Payer: BCN Medicare Advantage |
$796.25
|
| Rate for Payer: Cash Price |
$2,210.40
|
| Rate for Payer: Cash Price |
$2,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,066.98
|
| Rate for Payer: Cofinity Commercial |
$1,146.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.06
|
| Rate for Payer: Meridian Medicaid |
$563.82
|
| Rate for Payer: Nomi Health Commercial |
$955.50
|
| Rate for Payer: PACE SWMI |
$796.25
|
| Rate for Payer: PHP Commercial |
$1,114.75
|
| Rate for Payer: PHP Medicare Advantage |
$796.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,280.29
|
| Rate for Payer: Priority Health Medicare |
$796.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,280.29
|
| Rate for Payer: Priority Health SBD |
$1,280.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.25
|
| Rate for Payer: UHC Medicare Advantage |
$796.25
|
| Rate for Payer: UHCCP Medicaid |
$536.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,270.98
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$373.82 |
| Max. Negotiated Rate |
$881.85 |
| Rate for Payer: Aetna Commercial |
$737.92
|
| Rate for Payer: Aetna Medicare |
$572.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.99
|
| Rate for Payer: BCBS Complete |
$392.51
|
| Rate for Payer: BCBS MAPPO |
$550.69
|
| Rate for Payer: BCBS Trust/PPO |
$386.72
|
| Rate for Payer: BCN Commercial |
$839.55
|
| Rate for Payer: BCN Medicare Advantage |
$550.69
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cofinity Commercial |
$737.92
|
| Rate for Payer: Cofinity Commercial |
$792.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.22
|
| Rate for Payer: Meridian Medicaid |
$392.51
|
| Rate for Payer: Nomi Health Commercial |
$660.83
|
| Rate for Payer: PACE SWMI |
$550.69
|
| Rate for Payer: PHP Commercial |
$770.97
|
| Rate for Payer: PHP Medicare Advantage |
$550.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$766.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$881.85
|
| Rate for Payer: Priority Health Medicare |
$550.69
|
| Rate for Payer: Priority Health Narrow Network |
$881.85
|
| Rate for Payer: Priority Health SBD |
$881.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.69
|
| Rate for Payer: UHC Medicare Advantage |
$550.69
|
| Rate for Payer: UHCCP Medicaid |
$373.82
|
| Rate for Payer: UMR Bronson Commercial |
$542.34
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,227.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$2,097.55 |
| Rate for Payer: Aetna Commercial |
$1,236.87
|
| Rate for Payer: Aetna Medicare |
$959.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.18
|
| Rate for Payer: BCBS Complete |
$657.53
|
| Rate for Payer: BCBS MAPPO |
$923.04
|
| Rate for Payer: BCBS Trust/PPO |
$50.72
|
| Rate for Payer: BCN Commercial |
$1,435.25
|
| Rate for Payer: BCN Medicare Advantage |
$923.04
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cofinity Commercial |
$1,236.87
|
| Rate for Payer: Cofinity Commercial |
$1,329.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.19
|
| Rate for Payer: Meridian Medicaid |
$657.53
|
| Rate for Payer: Nomi Health Commercial |
$1,107.65
|
| Rate for Payer: PACE SWMI |
$923.04
|
| Rate for Payer: PHP Commercial |
$1,292.26
|
| Rate for Payer: PHP Medicare Advantage |
$923.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,097.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,497.07
|
| Rate for Payer: Priority Health Medicare |
$923.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,497.07
|
| Rate for Payer: Priority Health SBD |
$1,497.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.04
|
| Rate for Payer: UHC Medicare Advantage |
$923.04
|
| Rate for Payer: UHCCP Medicaid |
$626.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,484.42
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$239.32 |
| Max. Negotiated Rate |
$826.80 |
| Rate for Payer: Aetna Commercial |
$574.12
|
| Rate for Payer: Aetna Medicare |
$445.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.97
|
| Rate for Payer: BCBS Complete |
$306.62
|
| Rate for Payer: BCBS MAPPO |
$428.45
|
| Rate for Payer: BCBS Trust/PPO |
$239.32
|
| Rate for Payer: BCN Commercial |
$653.85
|
| Rate for Payer: BCN Medicare Advantage |
$428.45
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$574.12
|
| Rate for Payer: Cofinity Commercial |
$616.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.87
|
| Rate for Payer: Meridian Medicaid |
$306.62
|
| Rate for Payer: Nomi Health Commercial |
$514.14
|
| Rate for Payer: PACE SWMI |
$428.45
|
| Rate for Payer: PHP Commercial |
$599.83
|
| Rate for Payer: PHP Medicare Advantage |
$428.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.52
|
| Rate for Payer: Priority Health Medicare |
$428.45
|
| Rate for Payer: Priority Health Narrow Network |
$690.52
|
| Rate for Payer: Priority Health SBD |
$690.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.45
|
| Rate for Payer: UHC Medicare Advantage |
$428.45
|
| Rate for Payer: UHCCP Medicaid |
$292.02
|
| Rate for Payer: UMR Bronson Commercial |
$585.12
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$639.88
|
| Rate for Payer: Aetna Medicare |
$496.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.63
|
| Rate for Payer: BCBS Complete |
$341.07
|
| Rate for Payer: BCBS MAPPO |
$477.52
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$729.59
|
| Rate for Payer: BCN Medicare Advantage |
$477.52
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$639.88
|
| Rate for Payer: Cofinity Commercial |
$687.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.40
|
| Rate for Payer: Meridian Medicaid |
$341.07
|
| Rate for Payer: Nomi Health Commercial |
$573.02
|
| Rate for Payer: PACE SWMI |
$477.52
|
| Rate for Payer: PHP Commercial |
$668.53
|
| Rate for Payer: PHP Medicare Advantage |
$477.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.88
|
| Rate for Payer: Priority Health Medicare |
$477.52
|
| Rate for Payer: Priority Health Narrow Network |
$768.88
|
| Rate for Payer: Priority Health SBD |
$768.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.52
|
| Rate for Payer: UHC Medicare Advantage |
$477.52
|
| Rate for Payer: UHCCP Medicaid |
$324.83
|
| Rate for Payer: UMR Bronson Commercial |
$626.98
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,528.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$303.65 |
| Max. Negotiated Rate |
$1,362.23 |
| Rate for Payer: Aetna Commercial |
$1,121.67
|
| Rate for Payer: Aetna Medicare |
$870.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,205.38
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$837.07
|
| Rate for Payer: BCBS Trust/PPO |
$303.65
|
| Rate for Payer: BCN Commercial |
$1,302.82
|
| Rate for Payer: BCN Medicare Advantage |
$837.07
|
| Rate for Payer: Cash Price |
$1,222.40
|
| Rate for Payer: Cash Price |
$1,222.40
|
| Rate for Payer: Cofinity Commercial |
$1,121.67
|
| Rate for Payer: Cofinity Commercial |
$1,205.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$837.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$878.92
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Nomi Health Commercial |
$1,004.48
|
| Rate for Payer: PACE SWMI |
$837.07
|
| Rate for Payer: PHP Commercial |
$1,171.90
|
| Rate for Payer: PHP Medicare Advantage |
$837.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$993.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,362.23
|
| Rate for Payer: Priority Health Medicare |
$837.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,362.23
|
| Rate for Payer: Priority Health SBD |
$1,362.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$837.07
|
| Rate for Payer: UHC Medicare Advantage |
$837.07
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
| Rate for Payer: UMR Bronson Commercial |
$702.88
|
|
|
PR PARTIAL HYMENECTOMY OR REVISION HYMENAL RING
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$130.78 |
| Max. Negotiated Rate |
$2,047.16 |
| Rate for Payer: Aetna Commercial |
$258.97
|
| Rate for Payer: Aetna Medicare |
$200.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.29
|
| Rate for Payer: BCBS Complete |
$137.32
|
| Rate for Payer: BCBS MAPPO |
$193.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.16
|
| Rate for Payer: BCN Commercial |
$299.56
|
| Rate for Payer: BCN Medicare Advantage |
$193.26
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$258.97
|
| Rate for Payer: Cofinity Commercial |
$278.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.92
|
| Rate for Payer: Meridian Medicaid |
$137.32
|
| Rate for Payer: Nomi Health Commercial |
$231.91
|
| Rate for Payer: PACE SWMI |
$193.26
|
| Rate for Payer: PHP Commercial |
$270.56
|
| Rate for Payer: PHP Medicare Advantage |
$193.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.07
|
| Rate for Payer: Priority Health Medicare |
$193.26
|
| Rate for Payer: Priority Health Narrow Network |
$305.07
|
| Rate for Payer: Priority Health SBD |
$305.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.26
|
| Rate for Payer: UHC Medicare Advantage |
$193.26
|
| Rate for Payer: UHCCP Medicaid |
$130.78
|
| Rate for Payer: UMR Bronson Commercial |
$302.22
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$218.54 |
| Max. Negotiated Rate |
$805.13 |
| Rate for Payer: Aetna Commercial |
$429.87
|
| Rate for Payer: Aetna Medicare |
$333.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.95
|
| Rate for Payer: BCBS Complete |
$229.47
|
| Rate for Payer: BCBS MAPPO |
$320.80
|
| Rate for Payer: BCBS Trust/PPO |
$805.13
|
| Rate for Payer: BCN Commercial |
$690.50
|
| Rate for Payer: BCN Medicare Advantage |
$320.80
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$429.87
|
| Rate for Payer: Cofinity Commercial |
$461.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.84
|
| Rate for Payer: Meridian Medicaid |
$229.47
|
| Rate for Payer: Nomi Health Commercial |
$384.96
|
| Rate for Payer: PACE SWMI |
$320.80
|
| Rate for Payer: PHP Commercial |
$449.12
|
| Rate for Payer: PHP Medicare Advantage |
$320.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.99
|
| Rate for Payer: Priority Health Medicare |
$320.80
|
| Rate for Payer: Priority Health Narrow Network |
$515.99
|
| Rate for Payer: Priority Health SBD |
$515.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.80
|
| Rate for Payer: UHC Medicare Advantage |
$320.80
|
| Rate for Payer: UHCCP Medicaid |
$218.54
|
| Rate for Payer: UMR Bronson Commercial |
$420.44
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,101.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$428.77 |
| Max. Negotiated Rate |
$1,365.65 |
| Rate for Payer: Aetna Commercial |
$848.03
|
| Rate for Payer: Aetna Medicare |
$658.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$911.32
|
| Rate for Payer: BCBS Complete |
$450.21
|
| Rate for Payer: BCBS MAPPO |
$632.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.24
|
| Rate for Payer: BCN Commercial |
$966.61
|
| Rate for Payer: BCN Medicare Advantage |
$632.86
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cofinity Commercial |
$911.32
|
| Rate for Payer: Cofinity Commercial |
$848.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.50
|
| Rate for Payer: Meridian Medicaid |
$450.21
|
| Rate for Payer: Nomi Health Commercial |
$759.43
|
| Rate for Payer: PACE SWMI |
$632.86
|
| Rate for Payer: PHP Commercial |
$886.00
|
| Rate for Payer: PHP Medicare Advantage |
$632.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,015.69
|
| Rate for Payer: Priority Health Medicare |
$632.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,015.69
|
| Rate for Payer: Priority Health SBD |
$1,015.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.86
|
| Rate for Payer: UHC Medicare Advantage |
$632.86
|
| Rate for Payer: UHCCP Medicaid |
$428.77
|
| Rate for Payer: UMR Bronson Commercial |
$966.46
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$1,168.60 |
| Rate for Payer: Aetna Commercial |
$38.02
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$28.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.60
|
| Rate for Payer: BCN Commercial |
$44.96
|
| Rate for Payer: BCN Medicare Advantage |
$28.37
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.79
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE SWMI |
$28.37
|
| Rate for Payer: PHP Commercial |
$39.72
|
| Rate for Payer: PHP Medicare Advantage |
$28.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.43
|
| Rate for Payer: Priority Health Medicare |
$28.37
|
| Rate for Payer: Priority Health Narrow Network |
$43.43
|
| Rate for Payer: Priority Health SBD |
$43.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.37
|
| Rate for Payer: UHC Medicare Advantage |
$28.37
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$371.50 |
| Rate for Payer: Aetna Commercial |
$345.71
|
| Rate for Payer: Aetna Medicare |
$268.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.50
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$257.99
|
| Rate for Payer: BCBS Trust/PPO |
$270.00
|
| Rate for Payer: BCN Commercial |
$231.18
|
| Rate for Payer: BCN Medicare Advantage |
$257.99
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$345.71
|
| Rate for Payer: Cofinity Commercial |
$371.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.89
|
| Rate for Payer: Nomi Health Commercial |
$309.59
|
| Rate for Payer: PACE SWMI |
$257.99
|
| Rate for Payer: PHP Commercial |
$361.18
|
| Rate for Payer: PHP Medicare Advantage |
$257.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health Medicare |
$257.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.99
|
| Rate for Payer: UHC Medicare Advantage |
$257.99
|
| Rate for Payer: UMR Bronson Commercial |
$133.40
|
|
|
PR PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 90677
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$419.29
|
| Rate for Payer: Aetna Medicare |
$325.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.58
|
| Rate for Payer: BCBS Complete |
$158.00
|
| Rate for Payer: BCBS MAPPO |
$312.90
|
| Rate for Payer: BCBS Trust/PPO |
$298.65
|
| Rate for Payer: BCN Commercial |
$298.65
|
| Rate for Payer: BCN Medicare Advantage |
$312.90
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cofinity Commercial |
$419.29
|
| Rate for Payer: Cofinity Commercial |
$450.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.55
|
| Rate for Payer: Nomi Health Commercial |
$375.48
|
| Rate for Payer: PACE SWMI |
$312.90
|
| Rate for Payer: PHP Commercial |
$438.06
|
| Rate for Payer: PHP Medicare Advantage |
$312.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.75
|
| Rate for Payer: Priority Health Medicare |
$312.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.90
|
| Rate for Payer: UHC Medicare Advantage |
$312.90
|
| Rate for Payer: UMR Bronson Commercial |
$181.70
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 96573
|
| Min. Negotiated Rate |
$146.00 |
| Max. Negotiated Rate |
$1,125.28 |
| Rate for Payer: Aetna Commercial |
$261.90
|
| Rate for Payer: Aetna Medicare |
$203.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.45
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$195.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.28
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$195.45
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$261.90
|
| Rate for Payer: Cofinity Commercial |
$281.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.22
|
| Rate for Payer: Nomi Health Commercial |
$234.54
|
| Rate for Payer: PACE SWMI |
$195.45
|
| Rate for Payer: PHP Commercial |
$273.63
|
| Rate for Payer: PHP Medicare Advantage |
$195.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.58
|
| Rate for Payer: Priority Health Medicare |
$195.45
|
| Rate for Payer: Priority Health Narrow Network |
$307.58
|
| Rate for Payer: Priority Health SBD |
$307.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.45
|
| Rate for Payer: UHC Medicare Advantage |
$195.45
|
| Rate for Payer: UMR Bronson Commercial |
$167.90
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 96567
|
| Min. Negotiated Rate |
$87.20 |
| Max. Negotiated Rate |
$2,195.61 |
| Rate for Payer: Aetna Commercial |
$156.08
|
| Rate for Payer: Aetna Medicare |
$121.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.73
|
| Rate for Payer: BCBS Complete |
$87.20
|
| Rate for Payer: BCBS MAPPO |
$116.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,195.61
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$116.48
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$167.73
|
| Rate for Payer: Cofinity Commercial |
$156.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.30
|
| Rate for Payer: Nomi Health Commercial |
$139.78
|
| Rate for Payer: PACE SWMI |
$116.48
|
| Rate for Payer: PHP Commercial |
$163.07
|
| Rate for Payer: PHP Medicare Advantage |
$116.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.90
|
| Rate for Payer: Priority Health Medicare |
$116.48
|
| Rate for Payer: Priority Health Narrow Network |
$185.90
|
| Rate for Payer: Priority Health SBD |
$185.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.48
|
| Rate for Payer: UHC Medicare Advantage |
$116.48
|
| Rate for Payer: UMR Bronson Commercial |
$100.28
|
|
|
PR PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR
|
Professional
|
Both
|
$1,298.00
|
|
|
Service Code
|
HCPCS 38770
|
| Min. Negotiated Rate |
$391.47 |
| Max. Negotiated Rate |
$1,609.78 |
| Rate for Payer: Aetna Commercial |
$1,035.19
|
| Rate for Payer: Aetna Medicare |
$803.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.44
|
| Rate for Payer: BCBS Complete |
$542.36
|
| Rate for Payer: BCBS MAPPO |
$772.53
|
| Rate for Payer: BCBS Trust/PPO |
$391.47
|
| Rate for Payer: BCN Commercial |
$1,166.96
|
| Rate for Payer: BCN Medicare Advantage |
$772.53
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cofinity Commercial |
$1,112.44
|
| Rate for Payer: Cofinity Commercial |
$1,035.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.16
|
| Rate for Payer: Meridian Medicaid |
$542.36
|
| Rate for Payer: Nomi Health Commercial |
$927.04
|
| Rate for Payer: PACE SWMI |
$772.53
|
| Rate for Payer: PHP Commercial |
$1,081.54
|
| Rate for Payer: PHP Medicare Advantage |
$772.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,609.78
|
| Rate for Payer: Priority Health Medicare |
$772.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,609.78
|
| Rate for Payer: Priority Health SBD |
$1,609.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.53
|
| Rate for Payer: UHC Medicare Advantage |
$772.53
|
| Rate for Payer: UHCCP Medicaid |
$516.53
|
| Rate for Payer: UMR Bronson Commercial |
$597.08
|
|
|
PR PELVIC EXAMINATION
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 99459
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$25.27
|
| Rate for Payer: Aetna Medicare |
$19.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.16
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$18.86
|
| Rate for Payer: BCN Medicare Advantage |
$18.86
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Cofinity Commercial |
$27.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.80
|
| Rate for Payer: Nomi Health Commercial |
$22.63
|
| Rate for Payer: PACE SWMI |
$18.86
|
| Rate for Payer: PHP Commercial |
$26.40
|
| Rate for Payer: PHP Medicare Advantage |
$18.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.52
|
| Rate for Payer: Priority Health Medicare |
$18.86
|
| Rate for Payer: Priority Health Narrow Network |
$30.52
|
| Rate for Payer: Priority Health SBD |
$30.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.86
|
| Rate for Payer: UHC Medicare Advantage |
$18.86
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 57410
|
| Hospital Charge Code |
57410
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$1,808.90 |
| Rate for Payer: Aetna Commercial |
$135.89
|
| Rate for Payer: Aetna Medicare |
$105.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.03
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$101.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.90
|
| Rate for Payer: BCN Commercial |
$153.45
|
| Rate for Payer: BCN Medicare Advantage |
$101.41
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$146.03
|
| Rate for Payer: Cofinity Commercial |
$135.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.48
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Nomi Health Commercial |
$121.69
|
| Rate for Payer: PACE SWMI |
$101.41
|
| Rate for Payer: PHP Commercial |
$141.97
|
| Rate for Payer: PHP Medicare Advantage |
$101.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.24
|
| Rate for Payer: Priority Health Medicare |
$101.41
|
| Rate for Payer: Priority Health Narrow Network |
$158.24
|
| Rate for Payer: Priority Health SBD |
$158.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.41
|
| Rate for Payer: UHC Medicare Advantage |
$101.41
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: UMR Bronson Commercial |
$90.16
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 57410
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$1,808.90 |
| Rate for Payer: Aetna Commercial |
$135.89
|
| Rate for Payer: Aetna Medicare |
$105.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.03
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$101.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.90
|
| Rate for Payer: BCN Commercial |
$153.45
|
| Rate for Payer: BCN Medicare Advantage |
$101.41
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$135.89
|
| Rate for Payer: Cofinity Commercial |
$146.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.48
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Nomi Health Commercial |
$121.69
|
| Rate for Payer: PACE SWMI |
$101.41
|
| Rate for Payer: PHP Commercial |
$141.97
|
| Rate for Payer: PHP Medicare Advantage |
$101.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.24
|
| Rate for Payer: Priority Health Medicare |
$101.41
|
| Rate for Payer: Priority Health Narrow Network |
$158.24
|
| Rate for Payer: Priority Health SBD |
$158.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.41
|
| Rate for Payer: UHC Medicare Advantage |
$101.41
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: UMR Bronson Commercial |
$90.16
|
|
