|
PR RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX
|
Professional
|
Both
|
$3,465.00
|
|
|
Service Code
|
HCPCS 69310
|
| Min. Negotiated Rate |
$1,033.61 |
| Max. Negotiated Rate |
$2,252.25 |
| Rate for Payer: Aetna Commercial |
$1,385.04
|
| Rate for Payer: Aetna Medicare |
$1,074.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,488.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,385.04
|
| Rate for Payer: BCBS Complete |
$1,386.00
|
| Rate for Payer: BCBS MAPPO |
$1,033.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.61
|
| Rate for Payer: Cash Price |
$2,772.00
|
| Rate for Payer: Cash Price |
$2,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,488.40
|
| Rate for Payer: Cofinity Commercial |
$1,385.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,085.29
|
| Rate for Payer: Nomi Health Commercial |
$1,240.33
|
| Rate for Payer: PACE SWMI |
$1,033.61
|
| Rate for Payer: PHP Commercial |
$1,447.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.25
|
| Rate for Payer: Priority Health Medicare |
$1,033.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,033.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,033.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,593.90
|
|
|
PR RECONSTRUCTION NAIL BED W/GRAFT
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 11762
|
| Min. Negotiated Rate |
$178.80 |
| Max. Negotiated Rate |
$290.55 |
| Rate for Payer: Aetna Commercial |
$239.89
|
| Rate for Payer: Aetna Medicare |
$186.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.89
|
| Rate for Payer: BCBS Complete |
$178.80
|
| Rate for Payer: BCBS MAPPO |
$179.02
|
| Rate for Payer: BCN Medicare Advantage |
$179.02
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cofinity Commercial |
$257.79
|
| Rate for Payer: Cofinity Commercial |
$239.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.97
|
| Rate for Payer: Nomi Health Commercial |
$214.82
|
| Rate for Payer: PACE SWMI |
$179.02
|
| Rate for Payer: PHP Commercial |
$250.63
|
| Rate for Payer: PHP Medicare Advantage |
$179.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.55
|
| Rate for Payer: Priority Health Medicare |
$179.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.02
|
| Rate for Payer: UHC Medicare Advantage |
$179.02
|
| Rate for Payer: UMR Bronson Commercial |
$205.62
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,986.00
|
|
|
Service Code
|
HCPCS 23420
|
| Min. Negotiated Rate |
$940.72 |
| Max. Negotiated Rate |
$2,590.90 |
| Rate for Payer: Aetna Commercial |
$1,260.56
|
| Rate for Payer: Aetna Medicare |
$978.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.56
|
| Rate for Payer: BCBS Complete |
$1,594.40
|
| Rate for Payer: BCBS MAPPO |
$940.72
|
| Rate for Payer: BCN Medicare Advantage |
$940.72
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$1,354.64
|
| Rate for Payer: Cofinity Commercial |
$1,260.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.76
|
| Rate for Payer: Nomi Health Commercial |
$1,128.86
|
| Rate for Payer: PACE SWMI |
$940.72
|
| Rate for Payer: PHP Commercial |
$1,317.01
|
| Rate for Payer: PHP Medicare Advantage |
$940.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health Medicare |
$940.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.72
|
| Rate for Payer: UHC Medicare Advantage |
$940.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,833.56
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,986.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$940.72 |
| Max. Negotiated Rate |
$2,590.90 |
| Rate for Payer: Aetna Commercial |
$1,260.56
|
| Rate for Payer: Aetna Medicare |
$978.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.56
|
| Rate for Payer: BCBS Complete |
$1,594.40
|
| Rate for Payer: BCBS MAPPO |
$940.72
|
| Rate for Payer: BCN Medicare Advantage |
$940.72
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$1,260.56
|
| Rate for Payer: Cofinity Commercial |
$1,354.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.76
|
| Rate for Payer: Nomi Health Commercial |
$1,128.86
|
| Rate for Payer: PACE SWMI |
$940.72
|
| Rate for Payer: PHP Commercial |
$1,317.01
|
| Rate for Payer: PHP Medicare Advantage |
$940.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health Medicare |
$940.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.72
|
| Rate for Payer: UHC Medicare Advantage |
$940.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,833.56
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
IP
|
$3,986.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$1,753.84 |
| Max. Negotiated Rate |
$3,587.40 |
| Rate for Payer: Aetna American Axle |
$2,590.90
|
| Rate for Payer: Aetna Commercial |
$3,388.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,590.90
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$2,790.20
|
| Rate for Payer: Cofinity Commercial |
$3,427.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,790.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,188.80
|
| Rate for Payer: Healthscope Commercial |
$3,587.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,790.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,989.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,388.10
|
| Rate for Payer: PHP Commercial |
$3,388.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health SBD |
$2,511.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,753.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,989.50
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
OP
|
$3,986.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$1,474.82 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna American Axle |
$2,590.90
|
| Rate for Payer: Aetna Commercial |
$3,388.10
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,590.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$3,427.96
|
| Rate for Payer: Cofinity Commercial |
$2,790.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,790.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,188.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$3,587.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,790.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,989.50
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,388.10
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$3,388.10
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$2,511.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$13,314.90
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,474.82
|
| Rate for Payer: VA VA |
$6,967.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,989.50
|
|
|
PR RECONSTRUCTION TOE POLYDACTYLY
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 28344
|
| Min. Negotiated Rate |
$266.99 |
| Max. Negotiated Rate |
$536.25 |
| Rate for Payer: Aetna Commercial |
$357.77
|
| Rate for Payer: Aetna Medicare |
$277.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.77
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS MAPPO |
$266.99
|
| Rate for Payer: BCN Medicare Advantage |
$266.99
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$384.47
|
| Rate for Payer: Cofinity Commercial |
$357.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.34
|
| Rate for Payer: Nomi Health Commercial |
$320.39
|
| Rate for Payer: PACE SWMI |
$266.99
|
| Rate for Payer: PHP Commercial |
$373.79
|
| Rate for Payer: PHP Medicare Advantage |
$266.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health Medicare |
$266.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.99
|
| Rate for Payer: UHC Medicare Advantage |
$266.99
|
| Rate for Payer: UMR Bronson Commercial |
$379.50
|
|
|
PR RECONSTRUCTION VENA CAVA ANY METHOD
|
Professional
|
Both
|
$2,399.00
|
|
|
Service Code
|
HCPCS 34502
|
| Min. Negotiated Rate |
$959.60 |
| Max. Negotiated Rate |
$2,130.94 |
| Rate for Payer: Aetna Commercial |
$1,982.96
|
| Rate for Payer: Aetna Medicare |
$1,539.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,130.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,982.96
|
| Rate for Payer: BCBS Complete |
$959.60
|
| Rate for Payer: BCBS MAPPO |
$1,479.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,479.82
|
| Rate for Payer: Cash Price |
$1,919.20
|
| Rate for Payer: Cash Price |
$1,919.20
|
| Rate for Payer: Cofinity Commercial |
$2,130.94
|
| Rate for Payer: Cofinity Commercial |
$1,982.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,479.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,553.81
|
| Rate for Payer: Nomi Health Commercial |
$1,775.78
|
| Rate for Payer: PACE SWMI |
$1,479.82
|
| Rate for Payer: PHP Commercial |
$2,071.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,479.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,559.35
|
| Rate for Payer: Priority Health Medicare |
$1,479.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,479.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,103.54
|
|
|
PR RECTAL SESATION TONE & COMPLIANCE TEST
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 91120
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$612.27 |
| Rate for Payer: Aetna Commercial |
$569.75
|
| Rate for Payer: Aetna Commercial |
$569.75
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.75
|
| Rate for Payer: BCBS Complete |
$284.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS MAPPO |
$425.19
|
| Rate for Payer: BCBS MAPPO |
$425.19
|
| Rate for Payer: BCN Medicare Advantage |
$425.19
|
| Rate for Payer: BCN Medicare Advantage |
$425.19
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$612.27
|
| Rate for Payer: Cofinity Commercial |
$569.75
|
| Rate for Payer: Cofinity Commercial |
$612.27
|
| Rate for Payer: Cofinity Commercial |
$569.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.45
|
| Rate for Payer: Nomi Health Commercial |
$510.23
|
| Rate for Payer: Nomi Health Commercial |
$510.23
|
| Rate for Payer: PACE SWMI |
$425.19
|
| Rate for Payer: PACE SWMI |
$425.19
|
| Rate for Payer: PHP Commercial |
$595.27
|
| Rate for Payer: PHP Commercial |
$595.27
|
| Rate for Payer: PHP Medicare Advantage |
$425.19
|
| Rate for Payer: PHP Medicare Advantage |
$425.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Medicare |
$425.19
|
| Rate for Payer: Priority Health Medicare |
$425.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.19
|
| Rate for Payer: UHC Medicare Advantage |
$425.19
|
| Rate for Payer: UHC Medicare Advantage |
$425.19
|
| Rate for Payer: UMR Bronson Commercial |
$326.60
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,793.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$717.20 |
| Max. Negotiated Rate |
$1,165.45 |
| Rate for Payer: Aetna Medicare |
$896.50
|
| Rate for Payer: BCBS Complete |
$717.20
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.45
|
| Rate for Payer: UMR Bronson Commercial |
$824.78
|
|
|
PR REGION IV LOCAL ANESTH,UPPER/LOWER EXT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01995
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR REIMPLANTATION ANOMALOUS PULMONARY ARTERY
|
Professional
|
Both
|
$6,703.00
|
|
|
Service Code
|
HCPCS 33788
|
| Min. Negotiated Rate |
$1,472.16 |
| Max. Negotiated Rate |
$4,356.95 |
| Rate for Payer: Aetna Commercial |
$1,972.69
|
| Rate for Payer: Aetna Medicare |
$1,531.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,119.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,972.69
|
| Rate for Payer: BCBS Complete |
$2,681.20
|
| Rate for Payer: BCBS MAPPO |
$1,472.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,472.16
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,972.69
|
| Rate for Payer: Cofinity Commercial |
$2,119.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,472.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,545.77
|
| Rate for Payer: Nomi Health Commercial |
$1,766.59
|
| Rate for Payer: PACE SWMI |
$1,472.16
|
| Rate for Payer: PHP Commercial |
$2,061.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,472.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,356.95
|
| Rate for Payer: Priority Health Medicare |
$1,472.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,472.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,472.16
|
| Rate for Payer: UMR Bronson Commercial |
$3,083.38
|
|
|
PR REINSERTION SPINAL FIXATION DEVICE
|
Professional
|
Both
|
$5,000.00
|
|
|
Service Code
|
HCPCS 22849
|
| Min. Negotiated Rate |
$1,275.97 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Aetna Commercial |
$1,709.80
|
| Rate for Payer: Aetna Medicare |
$1,327.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.80
|
| Rate for Payer: BCBS Complete |
$2,000.00
|
| Rate for Payer: BCBS MAPPO |
$1,275.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.97
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,837.40
|
| Rate for Payer: Cofinity Commercial |
$1,709.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.77
|
| Rate for Payer: Nomi Health Commercial |
$1,531.16
|
| Rate for Payer: PACE SWMI |
$1,275.97
|
| Rate for Payer: PHP Commercial |
$1,786.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,250.00
|
| Rate for Payer: Priority Health Medicare |
$1,275.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.97
|
| Rate for Payer: UMR Bronson Commercial |
$2,300.00
|
|
|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,043.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$417.20 |
| Max. Negotiated Rate |
$864.95 |
| Rate for Payer: Aetna Commercial |
$804.88
|
| Rate for Payer: Aetna Medicare |
$624.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.88
|
| Rate for Payer: BCBS Complete |
$417.20
|
| Rate for Payer: BCBS MAPPO |
$600.66
|
| Rate for Payer: BCN Medicare Advantage |
$600.66
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cofinity Commercial |
$864.95
|
| Rate for Payer: Cofinity Commercial |
$804.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.69
|
| Rate for Payer: Nomi Health Commercial |
$720.79
|
| Rate for Payer: PACE SWMI |
$600.66
|
| Rate for Payer: PHP Commercial |
$840.92
|
| Rate for Payer: PHP Medicare Advantage |
$600.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.95
|
| Rate for Payer: Priority Health Medicare |
$600.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.66
|
| Rate for Payer: UHC Medicare Advantage |
$600.66
|
| Rate for Payer: UMR Bronson Commercial |
$479.78
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,326.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$661.61 |
| Max. Negotiated Rate |
$1,511.90 |
| Rate for Payer: Aetna Commercial |
$886.56
|
| Rate for Payer: Aetna Medicare |
$688.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.56
|
| Rate for Payer: BCBS Complete |
$930.40
|
| Rate for Payer: BCBS MAPPO |
$661.61
|
| Rate for Payer: BCN Medicare Advantage |
$661.61
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cofinity Commercial |
$952.72
|
| Rate for Payer: Cofinity Commercial |
$886.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.69
|
| Rate for Payer: Nomi Health Commercial |
$793.93
|
| Rate for Payer: PACE SWMI |
$661.61
|
| Rate for Payer: PHP Commercial |
$926.25
|
| Rate for Payer: PHP Medicare Advantage |
$661.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.90
|
| Rate for Payer: Priority Health Medicare |
$661.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$661.61
|
| Rate for Payer: UHC Medicare Advantage |
$661.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.96
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$347.15 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$465.18
|
| Rate for Payer: Aetna Medicare |
$361.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.18
|
| Rate for Payer: BCBS Complete |
$553.60
|
| Rate for Payer: BCBS MAPPO |
$347.15
|
| Rate for Payer: BCN Medicare Advantage |
$347.15
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$499.90
|
| Rate for Payer: Cofinity Commercial |
$465.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.51
|
| Rate for Payer: Nomi Health Commercial |
$416.58
|
| Rate for Payer: PACE SWMI |
$347.15
|
| Rate for Payer: PHP Commercial |
$486.01
|
| Rate for Payer: PHP Medicare Advantage |
$347.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health Medicare |
$347.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$347.15
|
| Rate for Payer: UHC Medicare Advantage |
$347.15
|
| Rate for Payer: UMR Bronson Commercial |
$636.64
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$629.51 |
| Max. Negotiated Rate |
$1,030.90 |
| Rate for Payer: Aetna Commercial |
$843.54
|
| Rate for Payer: Aetna Medicare |
$654.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.54
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$629.51
|
| Rate for Payer: BCN Medicare Advantage |
$629.51
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$906.49
|
| Rate for Payer: Cofinity Commercial |
$843.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$660.99
|
| Rate for Payer: Nomi Health Commercial |
$755.41
|
| Rate for Payer: PACE SWMI |
$629.51
|
| Rate for Payer: PHP Commercial |
$881.31
|
| Rate for Payer: PHP Medicare Advantage |
$629.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$629.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.51
|
| Rate for Payer: UHC Medicare Advantage |
$629.51
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$387.40 |
| Max. Negotiated Rate |
$882.05 |
| Rate for Payer: Aetna Commercial |
$519.12
|
| Rate for Payer: Aetna Medicare |
$402.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.12
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$387.40
|
| Rate for Payer: BCN Medicare Advantage |
$387.40
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$557.86
|
| Rate for Payer: Cofinity Commercial |
$519.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.77
|
| Rate for Payer: Nomi Health Commercial |
$464.88
|
| Rate for Payer: PACE SWMI |
$387.40
|
| Rate for Payer: PHP Commercial |
$542.36
|
| Rate for Payer: PHP Medicare Advantage |
$387.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.05
|
| Rate for Payer: Priority Health Medicare |
$387.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.40
|
| Rate for Payer: UHC Medicare Advantage |
$387.40
|
| Rate for Payer: UMR Bronson Commercial |
$624.22
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$324.53 |
| Max. Negotiated Rate |
$748.15 |
| Rate for Payer: Aetna Commercial |
$434.87
|
| Rate for Payer: Aetna Medicare |
$337.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.87
|
| Rate for Payer: BCBS Complete |
$460.40
|
| Rate for Payer: BCBS MAPPO |
$324.53
|
| Rate for Payer: BCN Medicare Advantage |
$324.53
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$467.32
|
| Rate for Payer: Cofinity Commercial |
$434.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.76
|
| Rate for Payer: Nomi Health Commercial |
$389.44
|
| Rate for Payer: PACE SWMI |
$324.53
|
| Rate for Payer: PHP Commercial |
$454.34
|
| Rate for Payer: PHP Medicare Advantage |
$324.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health Medicare |
$324.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.53
|
| Rate for Payer: UHC Medicare Advantage |
$324.53
|
| Rate for Payer: UMR Bronson Commercial |
$529.46
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$78.90 |
| Rate for Payer: Aetna Commercial |
$73.42
|
| Rate for Payer: Aetna Medicare |
$56.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.42
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$54.79
|
| Rate for Payer: BCN Medicare Advantage |
$54.79
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$78.90
|
| Rate for Payer: Cofinity Commercial |
$73.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.53
|
| Rate for Payer: Nomi Health Commercial |
$65.75
|
| Rate for Payer: PACE SWMI |
$54.79
|
| Rate for Payer: PHP Commercial |
$76.71
|
| Rate for Payer: PHP Medicare Advantage |
$54.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$54.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.79
|
| Rate for Payer: UHC Medicare Advantage |
$54.79
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$150.80 |
| Rate for Payer: Aetna Medicare |
$116.00
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.80
|
| Rate for Payer: UMR Bronson Commercial |
$106.72
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$40.30 |
| Rate for Payer: Aetna Commercial |
$37.12
|
| Rate for Payer: Aetna Medicare |
$28.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.89
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$27.70
|
| Rate for Payer: BCN Medicare Advantage |
$27.70
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$37.12
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.09
|
| Rate for Payer: Nomi Health Commercial |
$33.24
|
| Rate for Payer: PACE SWMI |
$27.70
|
| Rate for Payer: PHP Commercial |
$38.78
|
| Rate for Payer: PHP Medicare Advantage |
$27.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$27.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.70
|
| Rate for Payer: UHC Medicare Advantage |
$27.70
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$17.77 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Commercial |
$23.81
|
| Rate for Payer: Aetna Medicare |
$18.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.81
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$17.77
|
| Rate for Payer: BCN Medicare Advantage |
$17.77
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$25.59
|
| Rate for Payer: Cofinity Commercial |
$23.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.66
|
| Rate for Payer: Nomi Health Commercial |
$21.32
|
| Rate for Payer: PACE SWMI |
$17.77
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: PHP Medicare Advantage |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.77
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$130.80 |
| Rate for Payer: Aetna Commercial |
$121.71
|
| Rate for Payer: Aetna Medicare |
$94.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.71
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$90.83
|
| Rate for Payer: BCN Medicare Advantage |
$90.83
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$130.80
|
| Rate for Payer: Cofinity Commercial |
$121.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$109.00
|
| Rate for Payer: PACE SWMI |
$90.83
|
| Rate for Payer: PHP Commercial |
$127.16
|
| Rate for Payer: PHP Medicare Advantage |
$90.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$90.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.83
|
| Rate for Payer: UHC Medicare Advantage |
$90.83
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$72.15 |
| Rate for Payer: Aetna Commercial |
$52.64
|
| Rate for Payer: Aetna Medicare |
$40.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.64
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$39.28
|
| Rate for Payer: BCN Medicare Advantage |
$39.28
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$56.56
|
| Rate for Payer: Cofinity Commercial |
$52.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.24
|
| Rate for Payer: Nomi Health Commercial |
$47.14
|
| Rate for Payer: PACE SWMI |
$39.28
|
| Rate for Payer: PHP Commercial |
$54.99
|
| Rate for Payer: PHP Medicare Advantage |
$39.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$39.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.28
|
| Rate for Payer: UHC Medicare Advantage |
$39.28
|
| Rate for Payer: UMR Bronson Commercial |
$51.06
|
|
