|
PR RABIES VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 90675
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$451.70 |
| Rate for Payer: Aetna Commercial |
$420.33
|
| Rate for Payer: Aetna Medicare |
$326.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.33
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$313.68
|
| Rate for Payer: BCN Medicare Advantage |
$313.68
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cofinity Commercial |
$451.70
|
| Rate for Payer: Cofinity Commercial |
$420.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.36
|
| Rate for Payer: Nomi Health Commercial |
$376.42
|
| Rate for Payer: PACE SWMI |
$313.68
|
| Rate for Payer: PHP Commercial |
$439.15
|
| Rate for Payer: PHP Medicare Advantage |
$313.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health Medicare |
$313.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.68
|
| Rate for Payer: UHC Medicare Advantage |
$313.68
|
| Rate for Payer: UMR Bronson Commercial |
$95.68
|
|
|
PR RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY
|
Professional
|
Both
|
$6,028.00
|
|
|
Service Code
|
HCPCS 58210
|
| Min. Negotiated Rate |
$1,749.98 |
| Max. Negotiated Rate |
$3,918.20 |
| Rate for Payer: Aetna Commercial |
$2,344.97
|
| Rate for Payer: Aetna Medicare |
$1,819.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,519.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.97
|
| Rate for Payer: BCBS Complete |
$2,411.20
|
| Rate for Payer: BCBS MAPPO |
$1,749.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,749.98
|
| Rate for Payer: Cash Price |
$4,822.40
|
| Rate for Payer: Cash Price |
$4,822.40
|
| Rate for Payer: Cofinity Commercial |
$2,519.97
|
| Rate for Payer: Cofinity Commercial |
$2,344.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,749.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,837.48
|
| Rate for Payer: Nomi Health Commercial |
$2,099.98
|
| Rate for Payer: PACE SWMI |
$1,749.98
|
| Rate for Payer: PHP Commercial |
$2,449.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,749.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,918.20
|
| Rate for Payer: Priority Health Medicare |
$1,749.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,749.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,749.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,772.88
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS
|
Professional
|
Both
|
$2,719.00
|
|
|
Service Code
|
HCPCS 25115
|
| Min. Negotiated Rate |
$732.84 |
| Max. Negotiated Rate |
$1,767.35 |
| Rate for Payer: Aetna Commercial |
$982.01
|
| Rate for Payer: Aetna Medicare |
$762.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.29
|
| Rate for Payer: BCBS Complete |
$1,087.60
|
| Rate for Payer: BCBS MAPPO |
$732.84
|
| Rate for Payer: BCN Medicare Advantage |
$732.84
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cofinity Commercial |
$982.01
|
| Rate for Payer: Cofinity Commercial |
$1,055.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.48
|
| Rate for Payer: Nomi Health Commercial |
$879.41
|
| Rate for Payer: PACE SWMI |
$732.84
|
| Rate for Payer: PHP Commercial |
$1,025.98
|
| Rate for Payer: PHP Medicare Advantage |
$732.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,767.35
|
| Rate for Payer: Priority Health Medicare |
$732.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.84
|
| Rate for Payer: UHC Medicare Advantage |
$732.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,250.74
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS
|
Professional
|
Both
|
$2,330.00
|
|
|
Service Code
|
HCPCS 25116
|
| Min. Negotiated Rate |
$585.05 |
| Max. Negotiated Rate |
$1,514.50 |
| Rate for Payer: Aetna Commercial |
$783.97
|
| Rate for Payer: Aetna Medicare |
$608.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.97
|
| Rate for Payer: BCBS Complete |
$932.00
|
| Rate for Payer: BCBS MAPPO |
$585.05
|
| Rate for Payer: BCN Medicare Advantage |
$585.05
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cofinity Commercial |
$842.47
|
| Rate for Payer: Cofinity Commercial |
$783.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.30
|
| Rate for Payer: Nomi Health Commercial |
$702.06
|
| Rate for Payer: PACE SWMI |
$585.05
|
| Rate for Payer: PHP Commercial |
$819.07
|
| Rate for Payer: PHP Medicare Advantage |
$585.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.50
|
| Rate for Payer: Priority Health Medicare |
$585.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.05
|
| Rate for Payer: UHC Medicare Advantage |
$585.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,071.80
|
|
|
PR RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 69150
|
| Min. Negotiated Rate |
$760.80 |
| Max. Negotiated Rate |
$1,360.86 |
| Rate for Payer: Aetna Commercial |
$1,266.35
|
| Rate for Payer: Aetna Medicare |
$982.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,360.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.35
|
| Rate for Payer: BCBS Complete |
$760.80
|
| Rate for Payer: BCBS MAPPO |
$945.04
|
| Rate for Payer: BCN Medicare Advantage |
$945.04
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,360.86
|
| Rate for Payer: Cofinity Commercial |
$1,266.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.29
|
| Rate for Payer: Nomi Health Commercial |
$1,134.05
|
| Rate for Payer: PACE SWMI |
$945.04
|
| Rate for Payer: PHP Commercial |
$1,323.06
|
| Rate for Payer: PHP Medicare Advantage |
$945.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.30
|
| Rate for Payer: Priority Health Medicare |
$945.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.04
|
| Rate for Payer: UHC Medicare Advantage |
$945.04
|
| Rate for Payer: UMR Bronson Commercial |
$874.92
|
|
|
PR RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP
|
Professional
|
Both
|
$3,040.00
|
|
|
Service Code
|
HCPCS 42844
|
| Min. Negotiated Rate |
$1,216.00 |
| Max. Negotiated Rate |
$1,976.00 |
| Rate for Payer: Aetna Commercial |
$1,725.81
|
| Rate for Payer: Aetna Medicare |
$1,339.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,854.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,725.81
|
| Rate for Payer: BCBS Complete |
$1,216.00
|
| Rate for Payer: BCBS MAPPO |
$1,287.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,287.92
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cofinity Commercial |
$1,854.60
|
| Rate for Payer: Cofinity Commercial |
$1,725.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,287.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,352.32
|
| Rate for Payer: Nomi Health Commercial |
$1,545.50
|
| Rate for Payer: PACE SWMI |
$1,287.92
|
| Rate for Payer: PHP Commercial |
$1,803.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,287.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.00
|
| Rate for Payer: Priority Health Medicare |
$1,287.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,287.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,287.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,398.40
|
|
|
PR RADICAL RESECTION STERNUM
|
Professional
|
Both
|
$2,674.00
|
|
|
Service Code
|
HCPCS 21630
|
| Min. Negotiated Rate |
$1,069.60 |
| Max. Negotiated Rate |
$1,810.22 |
| Rate for Payer: Aetna Commercial |
$1,684.51
|
| Rate for Payer: Aetna Medicare |
$1,307.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,810.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,684.51
|
| Rate for Payer: BCBS Complete |
$1,069.60
|
| Rate for Payer: BCBS MAPPO |
$1,257.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.10
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,810.22
|
| Rate for Payer: Cofinity Commercial |
$1,684.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.95
|
| Rate for Payer: Nomi Health Commercial |
$1,508.52
|
| Rate for Payer: PACE SWMI |
$1,257.10
|
| Rate for Payer: PHP Commercial |
$1,759.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,738.10
|
| Rate for Payer: Priority Health Medicare |
$1,257.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,230.04
|
|
|
PR RADICAL RESECTION TONSIL W/O CLOSURE
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 42842
|
| Min. Negotiated Rate |
$720.80 |
| Max. Negotiated Rate |
$1,358.40 |
| Rate for Payer: Aetna Commercial |
$1,264.06
|
| Rate for Payer: Aetna Medicare |
$981.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,264.06
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$943.33
|
| Rate for Payer: BCN Medicare Advantage |
$943.33
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,358.40
|
| Rate for Payer: Cofinity Commercial |
$1,264.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$990.50
|
| Rate for Payer: Nomi Health Commercial |
$1,132.00
|
| Rate for Payer: PACE SWMI |
$943.33
|
| Rate for Payer: PHP Commercial |
$1,320.66
|
| Rate for Payer: PHP Medicare Advantage |
$943.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$943.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.33
|
| Rate for Payer: UHC Medicare Advantage |
$943.33
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR RADICAL RESECTION TUMOR CLAVICLE
|
Professional
|
Both
|
$2,630.00
|
|
|
Service Code
|
HCPCS 23200
|
| Min. Negotiated Rate |
$1,052.00 |
| Max. Negotiated Rate |
$2,086.89 |
| Rate for Payer: Aetna Commercial |
$1,941.97
|
| Rate for Payer: Aetna Medicare |
$1,507.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,086.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.97
|
| Rate for Payer: BCBS Complete |
$1,052.00
|
| Rate for Payer: BCBS MAPPO |
$1,449.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,449.23
|
| Rate for Payer: Cash Price |
$2,104.00
|
| Rate for Payer: Cash Price |
$2,104.00
|
| Rate for Payer: Cofinity Commercial |
$2,086.89
|
| Rate for Payer: Cofinity Commercial |
$1,941.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,449.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,521.69
|
| Rate for Payer: Nomi Health Commercial |
$1,739.08
|
| Rate for Payer: PACE SWMI |
$1,449.23
|
| Rate for Payer: PHP Commercial |
$2,028.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,449.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,709.50
|
| Rate for Payer: Priority Health Medicare |
$1,449.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,449.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,449.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,209.80
|
|
|
PR RADICAL RESECTION TUMOR FEMOR OR KNEE
|
Professional
|
Both
|
$5,511.00
|
|
|
Service Code
|
HCPCS 27365
|
| Min. Negotiated Rate |
$1,976.41 |
| Max. Negotiated Rate |
$3,582.15 |
| Rate for Payer: Aetna Commercial |
$2,648.39
|
| Rate for Payer: Aetna Medicare |
$2,055.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,846.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,648.39
|
| Rate for Payer: BCBS Complete |
$2,204.40
|
| Rate for Payer: BCBS MAPPO |
$1,976.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,976.41
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,846.03
|
| Rate for Payer: Cofinity Commercial |
$2,648.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,976.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,075.23
|
| Rate for Payer: Nomi Health Commercial |
$2,371.69
|
| Rate for Payer: PACE SWMI |
$1,976.41
|
| Rate for Payer: PHP Commercial |
$2,766.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,976.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.15
|
| Rate for Payer: Priority Health Medicare |
$1,976.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,976.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,976.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,535.06
|
|
|
PR RADICAL RESECTION TUMOR METACARPAL
|
Professional
|
Both
|
$3,029.00
|
|
|
Service Code
|
HCPCS 26250
|
| Min. Negotiated Rate |
$1,027.84 |
| Max. Negotiated Rate |
$1,968.85 |
| Rate for Payer: Aetna Commercial |
$1,377.31
|
| Rate for Payer: Aetna Medicare |
$1,068.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,480.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.31
|
| Rate for Payer: BCBS Complete |
$1,211.60
|
| Rate for Payer: BCBS MAPPO |
$1,027.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.84
|
| Rate for Payer: Cash Price |
$2,423.20
|
| Rate for Payer: Cash Price |
$2,423.20
|
| Rate for Payer: Cofinity Commercial |
$1,480.09
|
| Rate for Payer: Cofinity Commercial |
$1,377.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,079.23
|
| Rate for Payer: Nomi Health Commercial |
$1,233.41
|
| Rate for Payer: PACE SWMI |
$1,027.84
|
| Rate for Payer: PHP Commercial |
$1,438.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.85
|
| Rate for Payer: Priority Health Medicare |
$1,027.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,393.34
|
|
|
PR RADICAL RESECTION TUMOR METATARSAL
|
Professional
|
Both
|
$1,379.00
|
|
|
Service Code
|
HCPCS 28173
|
| Min. Negotiated Rate |
$551.60 |
| Max. Negotiated Rate |
$1,000.81 |
| Rate for Payer: Aetna Commercial |
$931.31
|
| Rate for Payer: Aetna Medicare |
$722.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.81
|
| Rate for Payer: BCBS Complete |
$551.60
|
| Rate for Payer: BCBS MAPPO |
$695.01
|
| Rate for Payer: BCN Medicare Advantage |
$695.01
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cofinity Commercial |
$931.31
|
| Rate for Payer: Cofinity Commercial |
$1,000.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.76
|
| Rate for Payer: Nomi Health Commercial |
$834.01
|
| Rate for Payer: PACE SWMI |
$695.01
|
| Rate for Payer: PHP Commercial |
$973.01
|
| Rate for Payer: PHP Medicare Advantage |
$695.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$896.35
|
| Rate for Payer: Priority Health Medicare |
$695.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.01
|
| Rate for Payer: UHC Medicare Advantage |
$695.01
|
| Rate for Payer: UMR Bronson Commercial |
$634.34
|
|
|
PR RADICAL RESECTION TUMOR RADIUS OR ULNA
|
Professional
|
Both
|
$2,595.00
|
|
|
Service Code
|
HCPCS 25170
|
| Min. Negotiated Rate |
$1,038.00 |
| Max. Negotiated Rate |
$2,035.22 |
| Rate for Payer: Aetna Commercial |
$1,893.89
|
| Rate for Payer: Aetna Medicare |
$1,469.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,035.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,893.89
|
| Rate for Payer: BCBS Complete |
$1,038.00
|
| Rate for Payer: BCBS MAPPO |
$1,413.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.35
|
| Rate for Payer: Cash Price |
$2,076.00
|
| Rate for Payer: Cash Price |
$2,076.00
|
| Rate for Payer: Cofinity Commercial |
$2,035.22
|
| Rate for Payer: Cofinity Commercial |
$1,893.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.02
|
| Rate for Payer: Nomi Health Commercial |
$1,696.02
|
| Rate for Payer: PACE SWMI |
$1,413.35
|
| Rate for Payer: PHP Commercial |
$1,978.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,686.75
|
| Rate for Payer: Priority Health Medicare |
$1,413.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,413.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,413.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,193.70
|
|
|
PR RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,314.00
|
|
|
Service Code
|
HCPCS 24150
|
| Min. Negotiated Rate |
$925.60 |
| Max. Negotiated Rate |
$2,141.16 |
| Rate for Payer: Aetna Commercial |
$1,992.47
|
| Rate for Payer: Aetna Medicare |
$1,546.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,141.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,992.47
|
| Rate for Payer: BCBS Complete |
$925.60
|
| Rate for Payer: BCBS MAPPO |
$1,486.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,486.92
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cofinity Commercial |
$2,141.16
|
| Rate for Payer: Cofinity Commercial |
$1,992.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,486.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,561.27
|
| Rate for Payer: Nomi Health Commercial |
$1,784.30
|
| Rate for Payer: PACE SWMI |
$1,486.92
|
| Rate for Payer: PHP Commercial |
$2,081.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,486.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.10
|
| Rate for Payer: Priority Health Medicare |
$1,486.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,486.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,486.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,064.44
|
|
|
PR RADICAL STYLOIDECTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,539.00
|
|
|
Service Code
|
HCPCS 25230
|
| Min. Negotiated Rate |
$421.03 |
| Max. Negotiated Rate |
$1,000.35 |
| Rate for Payer: Aetna Commercial |
$564.18
|
| Rate for Payer: Aetna Medicare |
$437.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.18
|
| Rate for Payer: BCBS Complete |
$615.60
|
| Rate for Payer: BCBS MAPPO |
$421.03
|
| Rate for Payer: BCN Medicare Advantage |
$421.03
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cofinity Commercial |
$606.28
|
| Rate for Payer: Cofinity Commercial |
$564.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.08
|
| Rate for Payer: Nomi Health Commercial |
$505.24
|
| Rate for Payer: PACE SWMI |
$421.03
|
| Rate for Payer: PHP Commercial |
$589.44
|
| Rate for Payer: PHP Medicare Advantage |
$421.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,000.35
|
| Rate for Payer: Priority Health Medicare |
$421.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.03
|
| Rate for Payer: UHC Medicare Advantage |
$421.03
|
| Rate for Payer: UMR Bronson Commercial |
$707.94
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$186.42 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$249.80
|
| Rate for Payer: Aetna Medicare |
$193.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.80
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS MAPPO |
$186.42
|
| Rate for Payer: BCN Medicare Advantage |
$186.42
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$249.80
|
| Rate for Payer: Cofinity Commercial |
$268.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.74
|
| Rate for Payer: Nomi Health Commercial |
$223.70
|
| Rate for Payer: PACE SWMI |
$186.42
|
| Rate for Payer: PHP Commercial |
$260.99
|
| Rate for Payer: PHP Medicare Advantage |
$186.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$186.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.42
|
| Rate for Payer: UHC Medicare Advantage |
$186.42
|
| Rate for Payer: UMR Bronson Commercial |
$429.64
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$410.96 |
| Max. Negotiated Rate |
$840.60 |
| Rate for Payer: Aetna American Axle |
$607.10
|
| Rate for Payer: Aetna Commercial |
$793.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.10
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$653.80
|
| Rate for Payer: Cofinity Commercial |
$803.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$653.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.20
|
| Rate for Payer: Healthscope Commercial |
$840.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$653.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$700.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.90
|
| Rate for Payer: PHP Commercial |
$793.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health SBD |
$588.42
|
| Rate for Payer: UMR Bronson Commercial |
$410.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$700.50
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$345.58 |
| Max. Negotiated Rate |
$5,360.98 |
| Rate for Payer: Aetna American Axle |
$607.10
|
| Rate for Payer: Aetna Commercial |
$793.90
|
| Rate for Payer: Aetna Medicare |
$1,980.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$653.80
|
| Rate for Payer: Cofinity Commercial |
$803.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$653.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$840.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$653.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$700.50
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.90
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$793.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health SBD |
$588.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,360.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$3,639.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: UMR Bronson Commercial |
$345.58
|
| Rate for Payer: VA VA |
$1,904.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$700.50
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 64625
|
| Min. Negotiated Rate |
$186.42 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$249.80
|
| Rate for Payer: Aetna Medicare |
$193.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.80
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS MAPPO |
$186.42
|
| Rate for Payer: BCN Medicare Advantage |
$186.42
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$268.44
|
| Rate for Payer: Cofinity Commercial |
$249.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.74
|
| Rate for Payer: Nomi Health Commercial |
$223.70
|
| Rate for Payer: PACE SWMI |
$186.42
|
| Rate for Payer: PHP Commercial |
$260.99
|
| Rate for Payer: PHP Medicare Advantage |
$186.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$186.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.42
|
| Rate for Payer: UHC Medicare Advantage |
$186.42
|
| Rate for Payer: UMR Bronson Commercial |
$429.64
|
|
|
PR RAD RESCJ CAPSL TISS&HTRTPC B1 ELBW CONTRCT RLS
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 24149
|
| Min. Negotiated Rate |
$1,067.20 |
| Max. Negotiated Rate |
$1,734.20 |
| Rate for Payer: Aetna Commercial |
$1,522.51
|
| Rate for Payer: Aetna Medicare |
$1,181.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,636.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.51
|
| Rate for Payer: BCBS Complete |
$1,067.20
|
| Rate for Payer: BCBS MAPPO |
$1,136.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.20
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,636.13
|
| Rate for Payer: Cofinity Commercial |
$1,522.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,193.01
|
| Rate for Payer: Nomi Health Commercial |
$1,363.44
|
| Rate for Payer: PACE SWMI |
$1,136.20
|
| Rate for Payer: PHP Commercial |
$1,590.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health Medicare |
$1,136.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,227.28
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW <5CM
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 24077
|
| Min. Negotiated Rate |
$738.80 |
| Max. Negotiated Rate |
$1,428.90 |
| Rate for Payer: Aetna Commercial |
$1,329.67
|
| Rate for Payer: Aetna Medicare |
$1,031.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,428.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.67
|
| Rate for Payer: BCBS Complete |
$738.80
|
| Rate for Payer: BCBS MAPPO |
$992.29
|
| Rate for Payer: BCN Medicare Advantage |
$992.29
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,428.90
|
| Rate for Payer: Cofinity Commercial |
$1,329.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.90
|
| Rate for Payer: Nomi Health Commercial |
$1,190.75
|
| Rate for Payer: PACE SWMI |
$992.29
|
| Rate for Payer: PHP Commercial |
$1,389.21
|
| Rate for Payer: PHP Medicare Advantage |
$992.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health Medicare |
$992.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.29
|
| Rate for Payer: UHC Medicare Advantage |
$992.29
|
| Rate for Payer: UMR Bronson Commercial |
$849.62
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW 5CM+
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 24079
|
| Min. Negotiated Rate |
$1,246.80 |
| Max. Negotiated Rate |
$2,026.05 |
| Rate for Payer: Aetna Commercial |
$1,720.75
|
| Rate for Payer: Aetna Medicare |
$1,335.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,849.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,720.75
|
| Rate for Payer: BCBS Complete |
$1,246.80
|
| Rate for Payer: BCBS MAPPO |
$1,284.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,284.14
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,849.16
|
| Rate for Payer: Cofinity Commercial |
$1,720.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,284.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,348.35
|
| Rate for Payer: Nomi Health Commercial |
$1,540.97
|
| Rate for Payer: PACE SWMI |
$1,284.14
|
| Rate for Payer: PHP Commercial |
$1,797.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,284.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health Medicare |
$1,284.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,284.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,284.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,433.82
|
|
|
PR RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>
|
Professional
|
Both
|
$3,940.00
|
|
|
Service Code
|
HCPCS 25078
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$2,561.00 |
| Rate for Payer: Aetna Commercial |
$1,512.06
|
| Rate for Payer: Aetna Medicare |
$1,173.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,624.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,512.06
|
| Rate for Payer: BCBS Complete |
$1,576.00
|
| Rate for Payer: BCBS MAPPO |
$1,128.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.40
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,624.90
|
| Rate for Payer: Cofinity Commercial |
$1,512.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.82
|
| Rate for Payer: Nomi Health Commercial |
$1,354.08
|
| Rate for Payer: PACE SWMI |
$1,128.40
|
| Rate for Payer: PHP Commercial |
$1,579.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,561.00
|
| Rate for Payer: Priority Health Medicare |
$1,128.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,812.40
|
|
|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 26118
|
| Min. Negotiated Rate |
$1,015.82 |
| Max. Negotiated Rate |
$2,280.85 |
| Rate for Payer: Aetna Commercial |
$1,361.20
|
| Rate for Payer: Aetna Medicare |
$1,056.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.20
|
| Rate for Payer: BCBS Complete |
$1,403.60
|
| Rate for Payer: BCBS MAPPO |
$1,015.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.82
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cofinity Commercial |
$1,462.78
|
| Rate for Payer: Cofinity Commercial |
$1,361.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.61
|
| Rate for Payer: Nomi Health Commercial |
$1,218.98
|
| Rate for Payer: PACE SWMI |
$1,015.82
|
| Rate for Payer: PHP Commercial |
$1,422.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,280.85
|
| Rate for Payer: Priority Health Medicare |
$1,015.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,015.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,614.14
|
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$4,271.00
|
|
|
Service Code
|
HCPCS 27075
|
| Min. Negotiated Rate |
$1,708.40 |
| Max. Negotiated Rate |
$2,884.19 |
| Rate for Payer: Aetna Commercial |
$2,683.90
|
| Rate for Payer: Aetna Medicare |
$2,083.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,884.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,683.90
|
| Rate for Payer: BCBS Complete |
$1,708.40
|
| Rate for Payer: BCBS MAPPO |
$2,002.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,002.91
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cofinity Commercial |
$2,884.19
|
| Rate for Payer: Cofinity Commercial |
$2,683.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,002.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,103.06
|
| Rate for Payer: Nomi Health Commercial |
$2,403.49
|
| Rate for Payer: PACE SWMI |
$2,002.91
|
| Rate for Payer: PHP Commercial |
$2,804.07
|
| Rate for Payer: PHP Medicare Advantage |
$2,002.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.15
|
| Rate for Payer: Priority Health Medicare |
$2,002.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,002.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,002.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,964.66
|
|
