|
PR PROTECTOR HEEL OR ELBOW
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS E0191
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$10.47
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.47
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
|
|
PR PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
HCPCS 62267
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$908.70 |
| Rate for Payer: Aetna Commercial |
$195.72
|
| Rate for Payer: Aetna Medicare |
$151.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.33
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$146.06
|
| Rate for Payer: BCBS Trust/PPO |
$552.60
|
| Rate for Payer: BCN Commercial |
$391.43
|
| Rate for Payer: BCN Medicare Advantage |
$146.06
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cofinity Commercial |
$195.72
|
| Rate for Payer: Cofinity Commercial |
$210.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.36
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Nomi Health Commercial |
$175.27
|
| Rate for Payer: PACE SWMI |
$146.06
|
| Rate for Payer: PHP Commercial |
$204.48
|
| Rate for Payer: PHP Medicare Advantage |
$146.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$908.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.77
|
| Rate for Payer: Priority Health Medicare |
$146.06
|
| Rate for Payer: Priority Health Narrow Network |
$258.77
|
| Rate for Payer: Priority Health SBD |
$258.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.06
|
| Rate for Payer: UHC Medicare Advantage |
$146.06
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
| Rate for Payer: UMR Bronson Commercial |
$643.08
|
|
|
PR PRQ BALLOON VALVULOPLASTY AORTIC VALVE
|
Professional
|
Both
|
$2,680.00
|
|
|
Service Code
|
HCPCS 92986
|
| Min. Negotiated Rate |
$384.07 |
| Max. Negotiated Rate |
$1,889.23 |
| Rate for Payer: Aetna Commercial |
$1,688.63
|
| Rate for Payer: Aetna Medicare |
$1,310.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,688.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,814.64
|
| Rate for Payer: BCBS Complete |
$874.25
|
| Rate for Payer: BCBS MAPPO |
$1,260.17
|
| Rate for Payer: BCBS Trust/PPO |
$384.07
|
| Rate for Payer: BCN Commercial |
$1,889.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,260.17
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cofinity Commercial |
$1,688.63
|
| Rate for Payer: Cofinity Commercial |
$1,814.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,260.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,323.18
|
| Rate for Payer: Meridian Medicaid |
$874.25
|
| Rate for Payer: Nomi Health Commercial |
$1,512.20
|
| Rate for Payer: PACE SWMI |
$1,260.17
|
| Rate for Payer: PHP Commercial |
$1,764.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,260.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$832.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,742.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,835.32
|
| Rate for Payer: Priority Health Medicare |
$1,260.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,835.32
|
| Rate for Payer: Priority Health SBD |
$1,835.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,260.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,260.17
|
| Rate for Payer: UHCCP Medicaid |
$832.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,232.80
|
|
|
PR PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING
|
Professional
|
Both
|
$1,989.00
|
|
|
Service Code
|
HCPCS 64561
|
| Min. Negotiated Rate |
$193.62 |
| Max. Negotiated Rate |
$1,292.85 |
| Rate for Payer: Aetna Commercial |
$388.09
|
| Rate for Payer: Aetna Medicare |
$301.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.05
|
| Rate for Payer: BCBS Complete |
$203.30
|
| Rate for Payer: BCBS MAPPO |
$289.62
|
| Rate for Payer: BCBS Trust/PPO |
$449.58
|
| Rate for Payer: BCN Commercial |
$1,084.87
|
| Rate for Payer: BCN Medicare Advantage |
$289.62
|
| Rate for Payer: Cash Price |
$1,591.20
|
| Rate for Payer: Cash Price |
$1,591.20
|
| Rate for Payer: Cofinity Commercial |
$388.09
|
| Rate for Payer: Cofinity Commercial |
$417.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.10
|
| Rate for Payer: Meridian Medicaid |
$203.30
|
| Rate for Payer: Nomi Health Commercial |
$347.54
|
| Rate for Payer: PACE SWMI |
$289.62
|
| Rate for Payer: PHP Commercial |
$405.47
|
| Rate for Payer: PHP Medicare Advantage |
$289.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,292.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.25
|
| Rate for Payer: Priority Health Medicare |
$289.62
|
| Rate for Payer: Priority Health Narrow Network |
$515.25
|
| Rate for Payer: Priority Health SBD |
$515.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.62
|
| Rate for Payer: UHC Medicare Advantage |
$289.62
|
| Rate for Payer: UHCCP Medicaid |
$193.62
|
| Rate for Payer: UMR Bronson Commercial |
$914.94
|
|
|
PR PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 64553
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$3,712.00 |
| Rate for Payer: Aetna Commercial |
$596.68
|
| Rate for Payer: Aetna Medicare |
$463.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.20
|
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: BCBS MAPPO |
$445.28
|
| Rate for Payer: BCBS Trust/PPO |
$264.15
|
| Rate for Payer: BCN Commercial |
$3,712.00
|
| Rate for Payer: BCN Medicare Advantage |
$445.28
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Commercial |
$641.20
|
| Rate for Payer: Cofinity Commercial |
$596.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.54
|
| Rate for Payer: Nomi Health Commercial |
$534.34
|
| Rate for Payer: PACE SWMI |
$445.28
|
| Rate for Payer: PHP Commercial |
$623.39
|
| Rate for Payer: PHP Medicare Advantage |
$445.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.41
|
| Rate for Payer: Priority Health Medicare |
$445.28
|
| Rate for Payer: Priority Health Narrow Network |
$781.41
|
| Rate for Payer: Priority Health SBD |
$781.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.28
|
| Rate for Payer: UHC Medicare Advantage |
$445.28
|
| Rate for Payer: UMR Bronson Commercial |
$208.84
|
|
|
PR PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 64555
|
| Min. Negotiated Rate |
$200.23 |
| Max. Negotiated Rate |
$3,168.10 |
| Rate for Payer: Aetna Commercial |
$416.74
|
| Rate for Payer: Aetna Medicare |
$323.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.74
|
| Rate for Payer: BCBS Complete |
$219.40
|
| Rate for Payer: BCBS MAPPO |
$311.00
|
| Rate for Payer: BCBS Trust/PPO |
$200.23
|
| Rate for Payer: BCN Commercial |
$3,168.10
|
| Rate for Payer: BCN Medicare Advantage |
$311.00
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cofinity Commercial |
$447.84
|
| Rate for Payer: Cofinity Commercial |
$416.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.55
|
| Rate for Payer: Meridian Medicaid |
$219.40
|
| Rate for Payer: Nomi Health Commercial |
$373.20
|
| Rate for Payer: PACE SWMI |
$311.00
|
| Rate for Payer: PHP Commercial |
$435.40
|
| Rate for Payer: PHP Medicare Advantage |
$311.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.51
|
| Rate for Payer: Priority Health Medicare |
$311.00
|
| Rate for Payer: Priority Health Narrow Network |
$550.51
|
| Rate for Payer: Priority Health SBD |
$550.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.00
|
| Rate for Payer: UHC Medicare Advantage |
$311.00
|
| Rate for Payer: UHCCP Medicaid |
$208.95
|
| Rate for Payer: UMR Bronson Commercial |
$229.08
|
|
|
PR PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL
|
Professional
|
Both
|
$5,346.00
|
|
|
Service Code
|
HCPCS 63650
|
| Min. Negotiated Rate |
$227.17 |
| Max. Negotiated Rate |
$3,474.90 |
| Rate for Payer: Aetna Commercial |
$529.69
|
| Rate for Payer: Aetna Medicare |
$411.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.22
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS MAPPO |
$395.29
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$3,375.79
|
| Rate for Payer: BCN Medicare Advantage |
$395.29
|
| Rate for Payer: Cash Price |
$4,276.80
|
| Rate for Payer: Cash Price |
$4,276.80
|
| Rate for Payer: Cofinity Commercial |
$529.69
|
| Rate for Payer: Cofinity Commercial |
$569.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.05
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Nomi Health Commercial |
$474.35
|
| Rate for Payer: PACE SWMI |
$395.29
|
| Rate for Payer: PHP Commercial |
$553.41
|
| Rate for Payer: PHP Medicare Advantage |
$395.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,474.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$706.34
|
| Rate for Payer: Priority Health Medicare |
$395.29
|
| Rate for Payer: Priority Health Narrow Network |
$706.34
|
| Rate for Payer: Priority Health SBD |
$706.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.29
|
| Rate for Payer: UHC Medicare Advantage |
$395.29
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
| Rate for Payer: UMR Bronson Commercial |
$2,459.16
|
|
|
PR PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL
|
Professional
|
Both
|
$2,470.00
|
|
|
Service Code
|
HCPCS 47533
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$2,075.16 |
| Rate for Payer: Aetna Commercial |
$331.44
|
| Rate for Payer: Aetna Medicare |
$257.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$356.17
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS MAPPO |
$247.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,075.16
|
| Rate for Payer: BCN Commercial |
$1,723.56
|
| Rate for Payer: BCN Medicare Advantage |
$247.34
|
| Rate for Payer: Cash Price |
$1,976.00
|
| Rate for Payer: Cash Price |
$1,976.00
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Commercial |
$356.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.71
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Nomi Health Commercial |
$296.81
|
| Rate for Payer: PACE SWMI |
$247.34
|
| Rate for Payer: PHP Commercial |
$346.28
|
| Rate for Payer: PHP Medicare Advantage |
$247.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$455.80
|
| Rate for Payer: Priority Health Medicare |
$247.34
|
| Rate for Payer: Priority Health Narrow Network |
$455.80
|
| Rate for Payer: Priority Health SBD |
$455.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.34
|
| Rate for Payer: UHC Medicare Advantage |
$247.34
|
| Rate for Payer: UHCCP Medicaid |
$164.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,136.20
|
|
|
PR PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 28436
|
| Min. Negotiated Rate |
$325.89 |
| Max. Negotiated Rate |
$775.50 |
| Rate for Payer: Aetna Commercial |
$634.52
|
| Rate for Payer: Aetna Medicare |
$492.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.87
|
| Rate for Payer: BCBS Complete |
$342.18
|
| Rate for Payer: BCBS MAPPO |
$473.52
|
| Rate for Payer: BCBS Trust/PPO |
$387.77
|
| Rate for Payer: BCN Commercial |
$736.93
|
| Rate for Payer: BCN Medicare Advantage |
$473.52
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cofinity Commercial |
$634.52
|
| Rate for Payer: Cofinity Commercial |
$681.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.20
|
| Rate for Payer: Meridian Medicaid |
$342.18
|
| Rate for Payer: Nomi Health Commercial |
$568.22
|
| Rate for Payer: PACE SWMI |
$473.52
|
| Rate for Payer: PHP Commercial |
$662.93
|
| Rate for Payer: PHP Medicare Advantage |
$473.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$775.50
|
| Rate for Payer: Priority Health Medicare |
$473.52
|
| Rate for Payer: Priority Health Narrow Network |
$775.50
|
| Rate for Payer: Priority Health SBD |
$775.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.52
|
| Rate for Payer: UHC Medicare Advantage |
$473.52
|
| Rate for Payer: UHCCP Medicaid |
$325.89
|
| Rate for Payer: UMR Bronson Commercial |
$525.32
|
|
|
PR PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 27756
|
| Min. Negotiated Rate |
$386.60 |
| Max. Negotiated Rate |
$2,701.20 |
| Rate for Payer: Aetna Commercial |
$762.80
|
| Rate for Payer: Aetna Medicare |
$592.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.72
|
| Rate for Payer: BCBS Complete |
$405.93
|
| Rate for Payer: BCBS MAPPO |
$569.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,701.20
|
| Rate for Payer: BCN Commercial |
$853.23
|
| Rate for Payer: BCN Medicare Advantage |
$569.25
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cofinity Commercial |
$762.80
|
| Rate for Payer: Cofinity Commercial |
$819.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$597.71
|
| Rate for Payer: Meridian Medicaid |
$405.93
|
| Rate for Payer: Nomi Health Commercial |
$683.10
|
| Rate for Payer: PACE SWMI |
$569.25
|
| Rate for Payer: PHP Commercial |
$796.95
|
| Rate for Payer: PHP Medicare Advantage |
$569.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.13
|
| Rate for Payer: Priority Health Medicare |
$569.25
|
| Rate for Payer: Priority Health Narrow Network |
$898.13
|
| Rate for Payer: Priority Health SBD |
$898.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$569.25
|
| Rate for Payer: UHC Medicare Advantage |
$569.25
|
| Rate for Payer: UHCCP Medicaid |
$386.60
|
| Rate for Payer: UMR Bronson Commercial |
$763.14
|
|
|
PR PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26650
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$624.92
|
| Rate for Payer: Aetna Medicare |
$485.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.56
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS MAPPO |
$466.36
|
| Rate for Payer: BCBS Trust/PPO |
$34.87
|
| Rate for Payer: BCN Commercial |
$717.37
|
| Rate for Payer: BCN Medicare Advantage |
$466.36
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$624.92
|
| Rate for Payer: Cofinity Commercial |
$671.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.68
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Nomi Health Commercial |
$559.63
|
| Rate for Payer: PACE SWMI |
$466.36
|
| Rate for Payer: PHP Commercial |
$652.90
|
| Rate for Payer: PHP Medicare Advantage |
$466.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.63
|
| Rate for Payer: Priority Health Medicare |
$466.36
|
| Rate for Payer: Priority Health Narrow Network |
$754.63
|
| Rate for Payer: Priority Health SBD |
$754.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.36
|
| Rate for Payer: UHC Medicare Advantage |
$466.36
|
| Rate for Payer: UHCCP Medicaid |
$319.71
|
| Rate for Payer: UMR Bronson Commercial |
$708.40
|
|
|
PR PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 28406
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$1,368.30 |
| Rate for Payer: Aetna Commercial |
$758.10
|
| Rate for Payer: Aetna Medicare |
$588.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.68
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS MAPPO |
$565.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,368.30
|
| Rate for Payer: BCN Commercial |
$833.68
|
| Rate for Payer: BCN Medicare Advantage |
$565.75
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cofinity Commercial |
$758.10
|
| Rate for Payer: Cofinity Commercial |
$814.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.04
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Nomi Health Commercial |
$678.90
|
| Rate for Payer: PACE SWMI |
$565.75
|
| Rate for Payer: PHP Commercial |
$792.05
|
| Rate for Payer: PHP Medicare Advantage |
$565.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$919.52
|
| Rate for Payer: Priority Health Medicare |
$565.75
|
| Rate for Payer: Priority Health Narrow Network |
$919.52
|
| Rate for Payer: Priority Health SBD |
$919.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$565.75
|
| Rate for Payer: UHC Medicare Advantage |
$565.75
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
| Rate for Payer: UMR Bronson Commercial |
$722.66
|
|
|
PR PRQ SKELETAL FIXJ FEMORAL FX DISTAL END
|
Professional
|
Both
|
$2,236.00
|
|
|
Service Code
|
HCPCS 27509
|
| Min. Negotiated Rate |
$441.12 |
| Max. Negotiated Rate |
$1,481.35 |
| Rate for Payer: Aetna Commercial |
$867.68
|
| Rate for Payer: Aetna Medicare |
$673.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.43
|
| Rate for Payer: BCBS Complete |
$463.18
|
| Rate for Payer: BCBS MAPPO |
$647.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.35
|
| Rate for Payer: BCN Commercial |
$1,000.32
|
| Rate for Payer: BCN Medicare Advantage |
$647.52
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cofinity Commercial |
$867.68
|
| Rate for Payer: Cofinity Commercial |
$932.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.90
|
| Rate for Payer: Meridian Medicaid |
$463.18
|
| Rate for Payer: Nomi Health Commercial |
$777.02
|
| Rate for Payer: PACE SWMI |
$647.52
|
| Rate for Payer: PHP Commercial |
$906.53
|
| Rate for Payer: PHP Medicare Advantage |
$647.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,453.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.72
|
| Rate for Payer: Priority Health Medicare |
$647.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.72
|
| Rate for Payer: Priority Health SBD |
$1,046.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.52
|
| Rate for Payer: UHC Medicare Advantage |
$647.52
|
| Rate for Payer: UHCCP Medicaid |
$441.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,028.56
|
|
|
PR PRQ SKELETAL FIXJ METACARPAL FX EACH BONE
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26608
|
| Min. Negotiated Rate |
$58.11 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$623.15
|
| Rate for Payer: Aetna Medicare |
$483.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.66
|
| Rate for Payer: BCBS Complete |
$334.13
|
| Rate for Payer: BCBS MAPPO |
$465.04
|
| Rate for Payer: BCBS Trust/PPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$716.89
|
| Rate for Payer: BCN Medicare Advantage |
$465.04
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$623.15
|
| Rate for Payer: Cofinity Commercial |
$669.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.29
|
| Rate for Payer: Meridian Medicaid |
$334.13
|
| Rate for Payer: Nomi Health Commercial |
$558.05
|
| Rate for Payer: PACE SWMI |
$465.04
|
| Rate for Payer: PHP Commercial |
$651.06
|
| Rate for Payer: PHP Medicare Advantage |
$465.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.15
|
| Rate for Payer: Priority Health Medicare |
$465.04
|
| Rate for Payer: Priority Health Narrow Network |
$755.15
|
| Rate for Payer: Priority Health SBD |
$755.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.04
|
| Rate for Payer: UHC Medicare Advantage |
$465.04
|
| Rate for Payer: UHCCP Medicaid |
$318.22
|
| Rate for Payer: UMR Bronson Commercial |
$708.40
|
|
|
PR PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT
|
Professional
|
Both
|
$1,650.00
|
|
|
Service Code
|
HCPCS 26676
|
| Min. Negotiated Rate |
$65.37 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$660.89
|
| Rate for Payer: Aetna Medicare |
$512.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.21
|
| Rate for Payer: BCBS Complete |
$354.71
|
| Rate for Payer: BCBS MAPPO |
$493.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.37
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: BCN Medicare Advantage |
$493.20
|
| Rate for Payer: Cash Price |
$1,320.00
|
| Rate for Payer: Cash Price |
$1,320.00
|
| Rate for Payer: Cofinity Commercial |
$660.89
|
| Rate for Payer: Cofinity Commercial |
$710.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.86
|
| Rate for Payer: Meridian Medicaid |
$354.71
|
| Rate for Payer: Nomi Health Commercial |
$591.84
|
| Rate for Payer: PACE SWMI |
$493.20
|
| Rate for Payer: PHP Commercial |
$690.48
|
| Rate for Payer: PHP Medicare Advantage |
$493.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.43
|
| Rate for Payer: Priority Health Medicare |
$493.20
|
| Rate for Payer: Priority Health Narrow Network |
$799.43
|
| Rate for Payer: Priority Health SBD |
$799.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.20
|
| Rate for Payer: UHC Medicare Advantage |
$493.20
|
| Rate for Payer: UHCCP Medicaid |
$337.82
|
| Rate for Payer: UMR Bronson Commercial |
$759.00
|
|
|
PR PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 26756
|
| Min. Negotiated Rate |
$280.95 |
| Max. Negotiated Rate |
$715.00 |
| Rate for Payer: Aetna Commercial |
$548.26
|
| Rate for Payer: Aetna Medicare |
$425.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.18
|
| Rate for Payer: BCBS Complete |
$295.00
|
| Rate for Payer: BCBS MAPPO |
$409.15
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$633.33
|
| Rate for Payer: BCN Medicare Advantage |
$409.15
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$548.26
|
| Rate for Payer: Cofinity Commercial |
$589.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.61
|
| Rate for Payer: Meridian Medicaid |
$295.00
|
| Rate for Payer: Nomi Health Commercial |
$490.98
|
| Rate for Payer: PACE SWMI |
$409.15
|
| Rate for Payer: PHP Commercial |
$572.81
|
| Rate for Payer: PHP Medicare Advantage |
$409.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$715.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$666.61
|
| Rate for Payer: Priority Health Medicare |
$409.15
|
| Rate for Payer: Priority Health Narrow Network |
$666.61
|
| Rate for Payer: Priority Health SBD |
$666.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.15
|
| Rate for Payer: UHC Medicare Advantage |
$409.15
|
| Rate for Payer: UHCCP Medicaid |
$280.95
|
| Rate for Payer: UMR Bronson Commercial |
$506.00
|
|
|
PR PRQ SKEL FIXJ FEMORAL FX PROX END NECK
|
Professional
|
Both
|
$3,359.00
|
|
|
Service Code
|
HCPCS 27235
|
| Min. Negotiated Rate |
$588.95 |
| Max. Negotiated Rate |
$2,183.35 |
| Rate for Payer: Aetna Commercial |
$1,171.71
|
| Rate for Payer: Aetna Medicare |
$909.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.15
|
| Rate for Payer: BCBS Complete |
$618.40
|
| Rate for Payer: BCBS MAPPO |
$874.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.62
|
| Rate for Payer: BCN Commercial |
$1,463.55
|
| Rate for Payer: BCN Medicare Advantage |
$874.41
|
| Rate for Payer: Cash Price |
$2,687.20
|
| Rate for Payer: Cash Price |
$2,687.20
|
| Rate for Payer: Cofinity Commercial |
$1,171.71
|
| Rate for Payer: Cofinity Commercial |
$1,259.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$918.13
|
| Rate for Payer: Meridian Medicaid |
$618.40
|
| Rate for Payer: Nomi Health Commercial |
$1,049.29
|
| Rate for Payer: PACE SWMI |
$874.41
|
| Rate for Payer: PHP Commercial |
$1,224.17
|
| Rate for Payer: PHP Medicare Advantage |
$874.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,395.81
|
| Rate for Payer: Priority Health Medicare |
$874.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,395.81
|
| Rate for Payer: Priority Health SBD |
$1,395.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$874.41
|
| Rate for Payer: UHC Medicare Advantage |
$874.41
|
| Rate for Payer: UHCCP Medicaid |
$588.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,545.14
|
|
|
PR PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 28496
|
| Min. Negotiated Rate |
$181.90 |
| Max. Negotiated Rate |
$729.30 |
| Rate for Payer: Aetna Commercial |
$352.58
|
| Rate for Payer: Aetna Medicare |
$273.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.89
|
| Rate for Payer: BCBS Complete |
$191.00
|
| Rate for Payer: BCBS MAPPO |
$263.12
|
| Rate for Payer: BCBS Trust/PPO |
$690.49
|
| Rate for Payer: BCN Commercial |
$667.05
|
| Rate for Payer: BCN Medicare Advantage |
$263.12
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$352.58
|
| Rate for Payer: Cofinity Commercial |
$378.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.28
|
| Rate for Payer: Meridian Medicaid |
$191.00
|
| Rate for Payer: Nomi Health Commercial |
$315.74
|
| Rate for Payer: PACE SWMI |
$263.12
|
| Rate for Payer: PHP Commercial |
$368.37
|
| Rate for Payer: PHP Medicare Advantage |
$263.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.96
|
| Rate for Payer: Priority Health Medicare |
$263.12
|
| Rate for Payer: Priority Health Narrow Network |
$428.96
|
| Rate for Payer: Priority Health SBD |
$428.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.12
|
| Rate for Payer: UHC Medicare Advantage |
$263.12
|
| Rate for Payer: UHCCP Medicaid |
$181.90
|
| Rate for Payer: UMR Bronson Commercial |
$516.12
|
|
|
PR PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ
|
Professional
|
Both
|
$2,375.00
|
|
|
Service Code
|
HCPCS 24582
|
| Min. Negotiated Rate |
$473.89 |
| Max. Negotiated Rate |
$1,543.75 |
| Rate for Payer: Aetna Commercial |
$1,056.72
|
| Rate for Payer: Aetna Medicare |
$820.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,135.58
|
| Rate for Payer: BCBS Complete |
$562.93
|
| Rate for Payer: BCBS MAPPO |
$788.60
|
| Rate for Payer: BCBS Trust/PPO |
$473.89
|
| Rate for Payer: BCN Commercial |
$1,205.57
|
| Rate for Payer: BCN Medicare Advantage |
$788.60
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cofinity Commercial |
$1,056.72
|
| Rate for Payer: Cofinity Commercial |
$1,135.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$828.03
|
| Rate for Payer: Meridian Medicaid |
$562.93
|
| Rate for Payer: Nomi Health Commercial |
$946.32
|
| Rate for Payer: PACE SWMI |
$788.60
|
| Rate for Payer: PHP Commercial |
$1,104.04
|
| Rate for Payer: PHP Medicare Advantage |
$788.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,543.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,268.59
|
| Rate for Payer: Priority Health Medicare |
$788.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,268.59
|
| Rate for Payer: Priority Health SBD |
$1,268.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$788.60
|
| Rate for Payer: UHC Medicare Advantage |
$788.60
|
| Rate for Payer: UHCCP Medicaid |
$536.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,092.50
|
|
|
PR PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 24566
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$1,225.90 |
| Rate for Payer: Aetna Commercial |
$934.77
|
| Rate for Payer: Aetna Medicare |
$725.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.77
|
| Rate for Payer: BCBS Complete |
$497.63
|
| Rate for Payer: BCBS MAPPO |
$697.59
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,064.83
|
| Rate for Payer: BCN Medicare Advantage |
$697.59
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,004.53
|
| Rate for Payer: Cofinity Commercial |
$934.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.47
|
| Rate for Payer: Meridian Medicaid |
$497.63
|
| Rate for Payer: Nomi Health Commercial |
$837.11
|
| Rate for Payer: PACE SWMI |
$697.59
|
| Rate for Payer: PHP Commercial |
$976.63
|
| Rate for Payer: PHP Medicare Advantage |
$697.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,120.51
|
| Rate for Payer: Priority Health Medicare |
$697.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.51
|
| Rate for Payer: Priority Health SBD |
$1,120.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.59
|
| Rate for Payer: UHC Medicare Advantage |
$697.59
|
| Rate for Payer: UHCCP Medicaid |
$473.93
|
| Rate for Payer: UMR Bronson Commercial |
$867.56
|
|
|
PR PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 28666
|
| Min. Negotiated Rate |
$112.46 |
| Max. Negotiated Rate |
$384.15 |
| Rate for Payer: Aetna Commercial |
$221.14
|
| Rate for Payer: Aetna Medicare |
$171.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.64
|
| Rate for Payer: BCBS Complete |
$118.08
|
| Rate for Payer: BCBS MAPPO |
$165.03
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$165.03
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$221.14
|
| Rate for Payer: Cofinity Commercial |
$237.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.28
|
| Rate for Payer: Meridian Medicaid |
$118.08
|
| Rate for Payer: Nomi Health Commercial |
$198.04
|
| Rate for Payer: PACE SWMI |
$165.03
|
| Rate for Payer: PHP Commercial |
$231.04
|
| Rate for Payer: PHP Medicare Advantage |
$165.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.69
|
| Rate for Payer: Priority Health Medicare |
$165.03
|
| Rate for Payer: Priority Health Narrow Network |
$269.69
|
| Rate for Payer: Priority Health SBD |
$269.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.03
|
| Rate for Payer: UHC Medicare Advantage |
$165.03
|
| Rate for Payer: UHCCP Medicaid |
$112.46
|
| Rate for Payer: UMR Bronson Commercial |
$271.86
|
|
|
PR PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 26776
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$902.85 |
| Rate for Payer: Aetna Commercial |
$582.85
|
| Rate for Payer: Aetna Medicare |
$452.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.34
|
| Rate for Payer: BCBS Complete |
$313.11
|
| Rate for Payer: BCBS MAPPO |
$434.96
|
| Rate for Payer: BCBS Trust/PPO |
$132.60
|
| Rate for Payer: BCN Commercial |
$669.98
|
| Rate for Payer: BCN Medicare Advantage |
$434.96
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cofinity Commercial |
$582.85
|
| Rate for Payer: Cofinity Commercial |
$626.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.71
|
| Rate for Payer: Meridian Medicaid |
$313.11
|
| Rate for Payer: Nomi Health Commercial |
$521.95
|
| Rate for Payer: PACE SWMI |
$434.96
|
| Rate for Payer: PHP Commercial |
$608.94
|
| Rate for Payer: PHP Medicare Advantage |
$434.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$705.79
|
| Rate for Payer: Priority Health Medicare |
$434.96
|
| Rate for Payer: Priority Health Narrow Network |
$705.79
|
| Rate for Payer: Priority Health SBD |
$705.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.96
|
| Rate for Payer: UHC Medicare Advantage |
$434.96
|
| Rate for Payer: UHCCP Medicaid |
$298.20
|
| Rate for Payer: UMR Bronson Commercial |
$638.94
|
|
|
PR PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ
|
Professional
|
Both
|
$1,375.00
|
|
|
Service Code
|
HCPCS 26706
|
| Min. Negotiated Rate |
$258.87 |
| Max. Negotiated Rate |
$893.75 |
| Rate for Payer: Aetna Commercial |
$581.04
|
| Rate for Payer: Aetna Medicare |
$450.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.40
|
| Rate for Payer: BCBS Complete |
$311.77
|
| Rate for Payer: BCBS MAPPO |
$433.61
|
| Rate for Payer: BCBS Trust/PPO |
$258.87
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$433.61
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cofinity Commercial |
$581.04
|
| Rate for Payer: Cofinity Commercial |
$624.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.29
|
| Rate for Payer: Meridian Medicaid |
$311.77
|
| Rate for Payer: Nomi Health Commercial |
$520.33
|
| Rate for Payer: PACE SWMI |
$433.61
|
| Rate for Payer: PHP Commercial |
$607.05
|
| Rate for Payer: PHP Medicare Advantage |
$433.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$893.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.21
|
| Rate for Payer: Priority Health Medicare |
$433.61
|
| Rate for Payer: Priority Health Narrow Network |
$701.21
|
| Rate for Payer: Priority Health SBD |
$701.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.61
|
| Rate for Payer: UHC Medicare Advantage |
$433.61
|
| Rate for Payer: UHCCP Medicaid |
$296.92
|
| Rate for Payer: UMR Bronson Commercial |
$632.50
|
|
|
PR PRQ SKEL FIXJ METAR FX W/MANJ
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 28476
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$700.05 |
| Rate for Payer: Aetna Commercial |
$495.89
|
| Rate for Payer: Aetna Medicare |
$384.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.90
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$370.07
|
| Rate for Payer: BCBS Trust/PPO |
$394.11
|
| Rate for Payer: BCN Commercial |
$575.66
|
| Rate for Payer: BCN Medicare Advantage |
$370.07
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$495.89
|
| Rate for Payer: Cofinity Commercial |
$532.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.57
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Nomi Health Commercial |
$444.08
|
| Rate for Payer: PACE SWMI |
$370.07
|
| Rate for Payer: PHP Commercial |
$518.10
|
| Rate for Payer: PHP Medicare Advantage |
$370.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.00
|
| Rate for Payer: Priority Health Medicare |
$370.07
|
| Rate for Payer: Priority Health Narrow Network |
$603.00
|
| Rate for Payer: Priority Health SBD |
$603.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.07
|
| Rate for Payer: UHC Medicare Advantage |
$370.07
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
| Rate for Payer: UMR Bronson Commercial |
$495.42
|
|
|
PR PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 28636
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$456.42 |
| Rate for Payer: Aetna Commercial |
$289.33
|
| Rate for Payer: Aetna Medicare |
$224.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.92
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$215.92
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$456.42
|
| Rate for Payer: BCN Medicare Advantage |
$215.92
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$289.33
|
| Rate for Payer: Cofinity Commercial |
$310.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.72
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Nomi Health Commercial |
$259.10
|
| Rate for Payer: PACE SWMI |
$215.92
|
| Rate for Payer: PHP Commercial |
$302.29
|
| Rate for Payer: PHP Medicare Advantage |
$215.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.03
|
| Rate for Payer: Priority Health Medicare |
$215.92
|
| Rate for Payer: Priority Health Narrow Network |
$346.03
|
| Rate for Payer: Priority Health SBD |
$346.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.92
|
| Rate for Payer: UHC Medicare Advantage |
$215.92
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
| Rate for Payer: UMR Bronson Commercial |
$302.22
|
|
