|
PR PRO HEALTH NURSE VISIT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.08 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna American Axle |
$21.22
|
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$16.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health SBD |
$20.56
|
| Rate for Payer: UMR Bronson Commercial |
$12.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.36 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna American Axle |
$21.22
|
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health SBD |
$20.56
|
| Rate for Payer: UMR Bronson Commercial |
$14.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$35.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: BCBS Complete |
$28.56
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
PR PRO HEALTH VISION TESTING
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.57
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.57
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
PR PRO HEALTH VISION TESTING
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.57
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.57
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
PR PROHEALTH WORKSTATION EVAL
|
Facility
|
OP
|
$102.00
|
|
| Hospital Charge Code |
98300182
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$37.74 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$37.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
PR PROHEALTH WORKSTATION EVAL
|
Facility
|
IP
|
$102.00
|
|
| Hospital Charge Code |
98300182
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$44.88 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$44.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
PR PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 99359
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
|
|
PR PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 99358
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
|
|
PR PROLONGED EXTRACORPOREAL CIRCULATION INIT DAY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 33960
|
| Min. Negotiated Rate |
$1,108.80 |
| Max. Negotiated Rate |
$1,801.80 |
| Rate for Payer: Aetna Medicare |
$1,386.00
|
| Rate for Payer: BCBS Complete |
$1,108.80
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,275.12
|
|
|
PR PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 99418
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$51.35 |
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 99417
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$42.90 |
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
|
|
PR PROLONGED SVC I/P OR OBS SETTING 1ST HOUR
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 99356
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$196.95 |
| Rate for Payer: Aetna Medicare |
$151.50
|
| Rate for Payer: BCBS Complete |
$121.20
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: UMR Bronson Commercial |
$139.38
|
|
|
PR PROLONGED SVC I/P OR OBS SETTING EA ADDL 30 MIN
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 99357
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: UMR Bronson Commercial |
$73.60
|
|
|
PR PROLONGED SVC OUTPATIENT SETTING 1ST HOUR
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 99354
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$151.45 |
| Rate for Payer: Aetna Medicare |
$116.50
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.45
|
| Rate for Payer: UMR Bronson Commercial |
$107.18
|
|
|
PR PROLONGED SVC OUTPATIENT SETTING EA ADDL 30 MIN
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 99355
|
| Min. Negotiated Rate |
$69.20 |
| Max. Negotiated Rate |
$112.45 |
| Rate for Payer: Aetna Medicare |
$86.50
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.45
|
| Rate for Payer: UMR Bronson Commercial |
$79.58
|
|
|
PR PROLONG INPT EVAL ADD15 M
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS G0316
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$41.63 |
| Rate for Payer: Aetna Commercial |
$38.74
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.74
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$38.74
|
| Rate for Payer: Cofinity Commercial |
$41.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Nomi Health Commercial |
$34.69
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$40.47
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.91
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR PROLONG OUTPT/OFFICE VIS
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS G2212
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$42.90 |
| Rate for Payer: Aetna Commercial |
$39.14
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.14
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Cofinity Commercial |
$39.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$35.05
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$40.89
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.21
|
| Rate for Payer: UHC Medicare Advantage |
$29.21
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
|
|
PR PROMETHAZINE HCL INJECTION
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS J2550
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Aetna Commercial |
$3.95
|
| Rate for Payer: Aetna Medicare |
$3.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.95
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$2.95
|
| Rate for Payer: BCN Medicare Advantage |
$2.95
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$4.25
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.10
|
| Rate for Payer: Nomi Health Commercial |
$3.54
|
| Rate for Payer: PACE SWMI |
$2.95
|
| Rate for Payer: PHP Commercial |
$4.13
|
| Rate for Payer: PHP Medicare Advantage |
$2.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$2.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.95
|
| Rate for Payer: UHC Medicare Advantage |
$2.95
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
|
|
PR PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR
|
Professional
|
Both
|
$2,782.00
|
|
|
Service Code
|
HCPCS 27495
|
| Min. Negotiated Rate |
$1,088.89 |
| Max. Negotiated Rate |
$1,808.30 |
| Rate for Payer: Aetna Commercial |
$1,459.11
|
| Rate for Payer: Aetna Medicare |
$1,132.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,459.11
|
| Rate for Payer: BCBS Complete |
$1,112.80
|
| Rate for Payer: BCBS MAPPO |
$1,088.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,088.89
|
| Rate for Payer: Cash Price |
$2,225.60
|
| Rate for Payer: Cash Price |
$2,225.60
|
| Rate for Payer: Cofinity Commercial |
$1,568.00
|
| Rate for Payer: Cofinity Commercial |
$1,459.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,088.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,143.33
|
| Rate for Payer: Nomi Health Commercial |
$1,306.67
|
| Rate for Payer: PACE SWMI |
$1,088.89
|
| Rate for Payer: PHP Commercial |
$1,524.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,088.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,808.30
|
| Rate for Payer: Priority Health Medicare |
$1,088.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,088.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,088.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,279.72
|
|
|
PR PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA
|
Professional
|
Both
|
$2,148.00
|
|
|
Service Code
|
HCPCS 27745
|
| Min. Negotiated Rate |
$707.39 |
| Max. Negotiated Rate |
$1,396.20 |
| Rate for Payer: Aetna Commercial |
$947.90
|
| Rate for Payer: Aetna Medicare |
$735.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.64
|
| Rate for Payer: BCBS Complete |
$859.20
|
| Rate for Payer: BCBS MAPPO |
$707.39
|
| Rate for Payer: BCN Medicare Advantage |
$707.39
|
| Rate for Payer: Cash Price |
$1,718.40
|
| Rate for Payer: Cash Price |
$1,718.40
|
| Rate for Payer: Cofinity Commercial |
$947.90
|
| Rate for Payer: Cofinity Commercial |
$1,018.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.76
|
| Rate for Payer: Nomi Health Commercial |
$848.87
|
| Rate for Payer: PACE SWMI |
$707.39
|
| Rate for Payer: PHP Commercial |
$990.35
|
| Rate for Payer: PHP Medicare Advantage |
$707.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.20
|
| Rate for Payer: Priority Health Medicare |
$707.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.39
|
| Rate for Payer: UHC Medicare Advantage |
$707.39
|
| Rate for Payer: UMR Bronson Commercial |
$988.08
|
|
|
PR PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR
|
Professional
|
Both
|
$2,041.00
|
|
|
Service Code
|
HCPCS 27187
|
| Min. Negotiated Rate |
$816.40 |
| Max. Negotiated Rate |
$1,383.39 |
| Rate for Payer: Aetna Commercial |
$1,287.32
|
| Rate for Payer: Aetna Medicare |
$999.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,383.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.32
|
| Rate for Payer: BCBS Complete |
$816.40
|
| Rate for Payer: BCBS MAPPO |
$960.69
|
| Rate for Payer: BCN Medicare Advantage |
$960.69
|
| Rate for Payer: Cash Price |
$1,632.80
|
| Rate for Payer: Cash Price |
$1,632.80
|
| Rate for Payer: Cofinity Commercial |
$1,383.39
|
| Rate for Payer: Cofinity Commercial |
$1,287.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,008.72
|
| Rate for Payer: Nomi Health Commercial |
$1,152.83
|
| Rate for Payer: PACE SWMI |
$960.69
|
| Rate for Payer: PHP Commercial |
$1,344.97
|
| Rate for Payer: PHP Medicare Advantage |
$960.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.65
|
| Rate for Payer: Priority Health Medicare |
$960.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$960.69
|
| Rate for Payer: UHC Medicare Advantage |
$960.69
|
| Rate for Payer: UMR Bronson Commercial |
$938.86
|
|
|
PR PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT
|
Professional
|
Both
|
$2,582.00
|
|
|
Service Code
|
HCPCS 24498
|
| Min. Negotiated Rate |
$833.94 |
| Max. Negotiated Rate |
$1,678.30 |
| Rate for Payer: Aetna Commercial |
$1,117.48
|
| Rate for Payer: Aetna Medicare |
$867.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,117.48
|
| Rate for Payer: BCBS Complete |
$1,032.80
|
| Rate for Payer: BCBS MAPPO |
$833.94
|
| Rate for Payer: BCN Medicare Advantage |
$833.94
|
| Rate for Payer: Cash Price |
$2,065.60
|
| Rate for Payer: Cash Price |
$2,065.60
|
| Rate for Payer: Cofinity Commercial |
$1,200.87
|
| Rate for Payer: Cofinity Commercial |
$1,117.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$833.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$875.64
|
| Rate for Payer: Nomi Health Commercial |
$1,000.73
|
| Rate for Payer: PACE SWMI |
$833.94
|
| Rate for Payer: PHP Commercial |
$1,167.52
|
| Rate for Payer: PHP Medicare Advantage |
$833.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,678.30
|
| Rate for Payer: Priority Health Medicare |
$833.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$833.94
|
| Rate for Payer: UHC Medicare Advantage |
$833.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,187.72
|
|
|
PR PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS
|
Professional
|
Both
|
$2,090.00
|
|
|
Service Code
|
HCPCS 23491
|
| Min. Negotiated Rate |
$836.00 |
| Max. Negotiated Rate |
$1,411.66 |
| Rate for Payer: Aetna Commercial |
$1,313.63
|
| Rate for Payer: Aetna Medicare |
$1,019.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,411.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.63
|
| Rate for Payer: BCBS Complete |
$836.00
|
| Rate for Payer: BCBS MAPPO |
$980.32
|
| Rate for Payer: BCN Medicare Advantage |
$980.32
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cofinity Commercial |
$1,411.66
|
| Rate for Payer: Cofinity Commercial |
$1,313.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$980.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,029.34
|
| Rate for Payer: Nomi Health Commercial |
$1,176.38
|
| Rate for Payer: PACE SWMI |
$980.32
|
| Rate for Payer: PHP Commercial |
$1,372.45
|
| Rate for Payer: PHP Medicare Advantage |
$980.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,358.50
|
| Rate for Payer: Priority Health Medicare |
$980.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$980.32
|
| Rate for Payer: UHC Medicare Advantage |
$980.32
|
| Rate for Payer: UMR Bronson Commercial |
$961.40
|
|
