|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,685.00
|
|
|
Service Code
|
HCPCS 49525
|
| Hospital Charge Code |
49525
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,263.75 |
| Rate for Payer: Aetna Commercial |
$734.29
|
| Rate for Payer: Aetna Medicare |
$569.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.09
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$547.98
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$547.98
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cofinity Commercial |
$734.29
|
| Rate for Payer: Cofinity Commercial |
$789.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$575.38
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.78
|
| Rate for Payer: Nomi Health Commercial |
$657.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.75
|
| Rate for Payer: PACE SWMI |
$547.98
|
| Rate for Payer: PHP Commercial |
$767.17
|
| Rate for Payer: PHP Medicare Advantage |
$547.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,061.22
|
| Rate for Payer: Priority Health Medicare |
$547.98
|
| Rate for Payer: Priority Health SBD |
$1,061.22
|
| Rate for Payer: Priority Health Tiered Network |
$1,061.22
|
| Rate for Payer: Railroad Medicare Medicare |
$547.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.03
|
| Rate for Payer: UHC Core |
$1,019.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.98
|
| Rate for Payer: UHC Exchange |
$1,019.03
|
| Rate for Payer: UHC Medicaid |
$353.58
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
| Rate for Payer: UMR Bronson Commercial |
$775.10
|
|
|
PR RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 12046
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$717.00 |
| Rate for Payer: Aetna Commercial |
$410.44
|
| Rate for Payer: Aetna Medicare |
$318.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.07
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS MAPPO |
$306.30
|
| Rate for Payer: BCN Commercial |
$480.06
|
| Rate for Payer: BCN Medicare Advantage |
$306.30
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$410.44
|
| Rate for Payer: Cofinity Commercial |
$441.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.62
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.93
|
| Rate for Payer: Nomi Health Commercial |
$367.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.00
|
| Rate for Payer: PACE SWMI |
$306.30
|
| Rate for Payer: PHP Commercial |
$428.82
|
| Rate for Payer: PHP Medicare Advantage |
$306.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$439.37
|
| Rate for Payer: Priority Health Medicare |
$306.30
|
| Rate for Payer: Priority Health SBD |
$439.37
|
| Rate for Payer: Priority Health Tiered Network |
$439.37
|
| Rate for Payer: Railroad Medicare Medicare |
$306.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.15
|
| Rate for Payer: UHC Core |
$550.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$306.30
|
| Rate for Payer: UHC Exchange |
$550.15
|
| Rate for Payer: UHC Medicaid |
$199.79
|
| Rate for Payer: UHCCP Medicaid |
$199.79
|
| Rate for Payer: UMR Bronson Commercial |
$439.76
|
|
|
PR RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 41250
|
| Min. Negotiated Rate |
$102.12 |
| Max. Negotiated Rate |
$283.96 |
| Rate for Payer: Aetna Commercial |
$215.41
|
| Rate for Payer: Aetna Medicare |
$167.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.48
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: BCBS MAPPO |
$160.75
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Medicare Advantage |
$160.75
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$215.41
|
| Rate for Payer: Cofinity Commercial |
$231.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.79
|
| Rate for Payer: Meridian Medicaid |
$111.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.82
|
| Rate for Payer: Nomi Health Commercial |
$192.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$160.75
|
| Rate for Payer: PHP Commercial |
$225.05
|
| Rate for Payer: PHP Medicare Advantage |
$160.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$283.96
|
| Rate for Payer: Priority Health Medicare |
$160.75
|
| Rate for Payer: Priority Health SBD |
$283.96
|
| Rate for Payer: Priority Health Tiered Network |
$283.96
|
| Rate for Payer: Railroad Medicare Medicare |
$160.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.85
|
| Rate for Payer: UHC Core |
$266.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.75
|
| Rate for Payer: UHC Exchange |
$266.85
|
| Rate for Payer: UHC Medicaid |
$106.29
|
| Rate for Payer: UHCCP Medicaid |
$106.29
|
| Rate for Payer: UMR Bronson Commercial |
$102.12
|
|
|
PR RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX
|
Professional
|
Both
|
$1,117.00
|
|
|
Service Code
|
HCPCS 41252
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$837.75 |
| Rate for Payer: Aetna Commercial |
$255.34
|
| Rate for Payer: Aetna Medicare |
$198.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.39
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$190.55
|
| Rate for Payer: BCN Commercial |
$315.23
|
| Rate for Payer: BCN Medicare Advantage |
$190.55
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cofinity Commercial |
$255.34
|
| Rate for Payer: Cofinity Commercial |
$274.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.08
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.60
|
| Rate for Payer: Nomi Health Commercial |
$228.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$837.75
|
| Rate for Payer: PACE SWMI |
$190.55
|
| Rate for Payer: PHP Commercial |
$266.77
|
| Rate for Payer: PHP Medicare Advantage |
$190.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$384.07
|
| Rate for Payer: Priority Health Medicare |
$190.55
|
| Rate for Payer: Priority Health SBD |
$384.07
|
| Rate for Payer: Priority Health Tiered Network |
$384.07
|
| Rate for Payer: Railroad Medicare Medicare |
$190.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.97
|
| Rate for Payer: UHC Core |
$363.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$190.55
|
| Rate for Payer: UHC Exchange |
$363.97
|
| Rate for Payer: UHC Medicaid |
$124.61
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
| Rate for Payer: UMR Bronson Commercial |
$513.82
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH
|
Professional
|
Both
|
$3,511.00
|
|
|
Service Code
|
HCPCS 49606
|
| Min. Negotiated Rate |
$676.06 |
| Max. Negotiated Rate |
$2,633.25 |
| Rate for Payer: Aetna Commercial |
$1,416.92
|
| Rate for Payer: Aetna Medicare |
$1,099.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,416.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.66
|
| Rate for Payer: BCBS Complete |
$709.86
|
| Rate for Payer: BCBS MAPPO |
$1,057.40
|
| Rate for Payer: BCN Commercial |
$1,709.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,057.40
|
| Rate for Payer: Cash Price |
$2,808.80
|
| Rate for Payer: Cash Price |
$2,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,416.92
|
| Rate for Payer: Cofinity Commercial |
$1,522.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,057.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,110.27
|
| Rate for Payer: Meridian Medicaid |
$709.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,163.14
|
| Rate for Payer: Nomi Health Commercial |
$1,268.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,633.25
|
| Rate for Payer: PACE SWMI |
$1,057.40
|
| Rate for Payer: PHP Commercial |
$1,480.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,057.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,082.39
|
| Rate for Payer: Priority Health Medicare |
$1,057.40
|
| Rate for Payer: Priority Health SBD |
$2,082.39
|
| Rate for Payer: Priority Health Tiered Network |
$2,082.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,057.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,027.66
|
| Rate for Payer: UHC Core |
$2,027.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,057.40
|
| Rate for Payer: UHC Exchange |
$2,027.66
|
| Rate for Payer: UHC Medicaid |
$676.06
|
| Rate for Payer: UHCCP Medicaid |
$676.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,615.06
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH
|
Professional
|
Both
|
$9,393.00
|
|
|
Service Code
|
HCPCS 49605
|
| Min. Negotiated Rate |
$2,864.00 |
| Max. Negotiated Rate |
$8,938.76 |
| Rate for Payer: Aetna Commercial |
$6,044.95
|
| Rate for Payer: Aetna Medicare |
$4,691.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,044.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,496.07
|
| Rate for Payer: BCBS Complete |
$3,007.20
|
| Rate for Payer: BCBS MAPPO |
$4,511.16
|
| Rate for Payer: BCN Commercial |
$7,336.25
|
| Rate for Payer: BCN Medicare Advantage |
$4,511.16
|
| Rate for Payer: Cash Price |
$7,514.40
|
| Rate for Payer: Cash Price |
$7,514.40
|
| Rate for Payer: Cofinity Commercial |
$6,044.95
|
| Rate for Payer: Cofinity Commercial |
$6,496.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,511.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,736.72
|
| Rate for Payer: Meridian Medicaid |
$3,007.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,962.28
|
| Rate for Payer: Nomi Health Commercial |
$5,413.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,044.75
|
| Rate for Payer: PACE SWMI |
$4,511.16
|
| Rate for Payer: PHP Commercial |
$6,315.62
|
| Rate for Payer: PHP Medicare Advantage |
$4,511.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,938.76
|
| Rate for Payer: Priority Health Medicare |
$4,511.16
|
| Rate for Payer: Priority Health SBD |
$8,938.76
|
| Rate for Payer: Priority Health Tiered Network |
$8,938.76
|
| Rate for Payer: Railroad Medicare Medicare |
$4,511.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,889.05
|
| Rate for Payer: UHC Core |
$8,889.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,511.16
|
| Rate for Payer: UHC Exchange |
$8,889.05
|
| Rate for Payer: UHC Medicaid |
$2,864.00
|
| Rate for Payer: UHCCP Medicaid |
$2,864.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,320.78
|
|
|
PR RPR LIP FTH OVER ONE-HALF VERT HEIGHT/COMPLEX
|
Professional
|
Both
|
$781.00
|
|
|
Service Code
|
HCPCS 40654
|
| Min. Negotiated Rate |
$251.98 |
| Max. Negotiated Rate |
$790.60 |
| Rate for Payer: Aetna Commercial |
$512.52
|
| Rate for Payer: Aetna Medicare |
$397.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.77
|
| Rate for Payer: BCBS Complete |
$264.58
|
| Rate for Payer: BCBS MAPPO |
$382.48
|
| Rate for Payer: BCN Commercial |
$648.87
|
| Rate for Payer: BCN Medicare Advantage |
$382.48
|
| Rate for Payer: Cash Price |
$624.80
|
| Rate for Payer: Cash Price |
$624.80
|
| Rate for Payer: Cofinity Commercial |
$512.52
|
| Rate for Payer: Cofinity Commercial |
$550.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.60
|
| Rate for Payer: Meridian Medicaid |
$264.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$420.73
|
| Rate for Payer: Nomi Health Commercial |
$458.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.75
|
| Rate for Payer: PACE SWMI |
$382.48
|
| Rate for Payer: PHP Commercial |
$535.47
|
| Rate for Payer: PHP Medicare Advantage |
$382.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$790.60
|
| Rate for Payer: Priority Health Medicare |
$382.48
|
| Rate for Payer: Priority Health SBD |
$790.60
|
| Rate for Payer: Priority Health Tiered Network |
$790.60
|
| Rate for Payer: Railroad Medicare Medicare |
$382.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.11
|
| Rate for Payer: UHC Core |
$732.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$382.48
|
| Rate for Payer: UHC Exchange |
$732.11
|
| Rate for Payer: UHC Medicaid |
$251.98
|
| Rate for Payer: UHCCP Medicaid |
$251.98
|
| Rate for Payer: UMR Bronson Commercial |
$359.26
|
|
|
PR RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 46715
|
| Min. Negotiated Rate |
$353.37 |
| Max. Negotiated Rate |
$1,028.45 |
| Rate for Payer: Aetna Commercial |
$726.00
|
| Rate for Payer: Aetna Medicare |
$563.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.18
|
| Rate for Payer: BCBS Complete |
$371.04
|
| Rate for Payer: BCBS MAPPO |
$541.79
|
| Rate for Payer: BCN Commercial |
$844.08
|
| Rate for Payer: BCN Medicare Advantage |
$541.79
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$726.00
|
| Rate for Payer: Cofinity Commercial |
$780.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$568.88
|
| Rate for Payer: Meridian Medicaid |
$371.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$595.97
|
| Rate for Payer: Nomi Health Commercial |
$650.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.00
|
| Rate for Payer: PACE SWMI |
$541.79
|
| Rate for Payer: PHP Commercial |
$758.51
|
| Rate for Payer: PHP Medicare Advantage |
$541.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,028.45
|
| Rate for Payer: Priority Health Medicare |
$541.79
|
| Rate for Payer: Priority Health SBD |
$1,028.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,028.45
|
| Rate for Payer: Railroad Medicare Medicare |
$541.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$969.25
|
| Rate for Payer: UHC Core |
$969.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$541.79
|
| Rate for Payer: UHC Exchange |
$969.25
|
| Rate for Payer: UHC Medicaid |
$353.37
|
| Rate for Payer: UHCCP Medicaid |
$353.37
|
| Rate for Payer: UMR Bronson Commercial |
$563.04
|
|
|
PR RPR LW IMPERFORATE ANUS W/TRPOS FISTULA
|
Professional
|
Both
|
$3,082.00
|
|
|
Service Code
|
HCPCS 46716
|
| Min. Negotiated Rate |
$774.89 |
| Max. Negotiated Rate |
$2,311.50 |
| Rate for Payer: Aetna Commercial |
$1,597.37
|
| Rate for Payer: Aetna Medicare |
$1,239.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,716.58
|
| Rate for Payer: BCBS Complete |
$813.63
|
| Rate for Payer: BCBS MAPPO |
$1,192.07
|
| Rate for Payer: BCN Commercial |
$1,873.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.07
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cofinity Commercial |
$1,597.37
|
| Rate for Payer: Cofinity Commercial |
$1,716.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.67
|
| Rate for Payer: Meridian Medicaid |
$813.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.28
|
| Rate for Payer: Nomi Health Commercial |
$1,430.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,311.50
|
| Rate for Payer: PACE SWMI |
$1,192.07
|
| Rate for Payer: PHP Commercial |
$1,668.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,282.63
|
| Rate for Payer: Priority Health Medicare |
$1,192.07
|
| Rate for Payer: Priority Health SBD |
$2,282.63
|
| Rate for Payer: Priority Health Tiered Network |
$2,282.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,152.36
|
| Rate for Payer: UHC Core |
$2,152.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.07
|
| Rate for Payer: UHC Exchange |
$2,152.36
|
| Rate for Payer: UHC Medicaid |
$774.89
|
| Rate for Payer: UHCCP Medicaid |
$774.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,417.72
|
|
|
PR RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ
|
Professional
|
Both
|
$10,586.00
|
|
|
Service Code
|
HCPCS 39503
|
| Min. Negotiated Rate |
$3,413.33 |
| Max. Negotiated Rate |
$10,686.96 |
| Rate for Payer: Aetna Commercial |
$7,220.64
|
| Rate for Payer: Aetna Medicare |
$5,604.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,220.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,759.50
|
| Rate for Payer: BCBS Complete |
$3,584.00
|
| Rate for Payer: BCBS MAPPO |
$5,388.54
|
| Rate for Payer: BCN Commercial |
$8,529.42
|
| Rate for Payer: BCN Medicare Advantage |
$5,388.54
|
| Rate for Payer: Cash Price |
$8,468.80
|
| Rate for Payer: Cash Price |
$8,468.80
|
| Rate for Payer: Cofinity Commercial |
$7,220.64
|
| Rate for Payer: Cofinity Commercial |
$7,759.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,388.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,657.97
|
| Rate for Payer: Meridian Medicaid |
$3,584.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,927.39
|
| Rate for Payer: Nomi Health Commercial |
$6,466.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,939.50
|
| Rate for Payer: PACE SWMI |
$5,388.54
|
| Rate for Payer: PHP Commercial |
$7,543.96
|
| Rate for Payer: PHP Medicare Advantage |
$5,388.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,413.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,172.31
|
| Rate for Payer: Priority Health Medicare |
$5,388.54
|
| Rate for Payer: Priority Health SBD |
$9,172.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,172.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5,388.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,686.96
|
| Rate for Payer: UHC Core |
$10,686.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,388.54
|
| Rate for Payer: UHC Exchange |
$10,686.96
|
| Rate for Payer: UHC Medicaid |
$3,413.33
|
| Rate for Payer: UHCCP Medicaid |
$3,413.33
|
| Rate for Payer: UMR Bronson Commercial |
$4,869.56
|
|
|
PR RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 53449
|
| Min. Negotiated Rate |
$356.78 |
| Max. Negotiated Rate |
$1,078.09 |
| Rate for Payer: Aetna Commercial |
$737.43
|
| Rate for Payer: Aetna Medicare |
$572.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.46
|
| Rate for Payer: BCBS Complete |
$374.62
|
| Rate for Payer: BCBS MAPPO |
$550.32
|
| Rate for Payer: BCN Commercial |
$921.26
|
| Rate for Payer: BCN Medicare Advantage |
$550.32
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cofinity Commercial |
$737.43
|
| Rate for Payer: Cofinity Commercial |
$792.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.84
|
| Rate for Payer: Meridian Medicaid |
$374.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.35
|
| Rate for Payer: Nomi Health Commercial |
$660.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.00
|
| Rate for Payer: PACE SWMI |
$550.32
|
| Rate for Payer: PHP Commercial |
$770.45
|
| Rate for Payer: PHP Medicare Advantage |
$550.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,003.56
|
| Rate for Payer: Priority Health Medicare |
$550.32
|
| Rate for Payer: Priority Health SBD |
$1,003.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,003.56
|
| Rate for Payer: Railroad Medicare Medicare |
$550.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,078.09
|
| Rate for Payer: UHC Core |
$1,078.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.32
|
| Rate for Payer: UHC Exchange |
$1,078.09
|
| Rate for Payer: UHC Medicaid |
$356.78
|
| Rate for Payer: UHCCP Medicaid |
$356.78
|
| Rate for Payer: UMR Bronson Commercial |
$552.00
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE
|
Professional
|
Both
|
$3,981.00
|
|
|
Service Code
|
HCPCS 27472
|
| Min. Negotiated Rate |
$737.19 |
| Max. Negotiated Rate |
$2,985.75 |
| Rate for Payer: Aetna Commercial |
$1,522.86
|
| Rate for Payer: Aetna Medicare |
$1,181.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,636.50
|
| Rate for Payer: BCBS Complete |
$774.05
|
| Rate for Payer: BCBS MAPPO |
$1,136.46
|
| Rate for Payer: BCN Commercial |
$1,913.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.46
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,522.86
|
| Rate for Payer: Cofinity Commercial |
$1,636.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,193.28
|
| Rate for Payer: Meridian Medicaid |
$774.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,250.11
|
| Rate for Payer: Nomi Health Commercial |
$1,363.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,985.75
|
| Rate for Payer: PACE SWMI |
$1,136.46
|
| Rate for Payer: PHP Commercial |
$1,591.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$737.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,045.20
|
| Rate for Payer: Priority Health Medicare |
$1,136.46
|
| Rate for Payer: Priority Health SBD |
$2,045.20
|
| Rate for Payer: Priority Health Tiered Network |
$2,045.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,136.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,217.60
|
| Rate for Payer: UHC Core |
$2,217.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,136.46
|
| Rate for Payer: UHC Exchange |
$2,217.60
|
| Rate for Payer: UHC Medicaid |
$737.19
|
| Rate for Payer: UHCCP Medicaid |
$737.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,831.26
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/O GRF
|
Professional
|
Both
|
$3,015.00
|
|
|
Service Code
|
HCPCS 27470
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$2,261.25 |
| Rate for Payer: Aetna Commercial |
$1,427.03
|
| Rate for Payer: Aetna Medicare |
$1,107.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,427.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,533.53
|
| Rate for Payer: BCBS Complete |
$726.64
|
| Rate for Payer: BCBS MAPPO |
$1,064.95
|
| Rate for Payer: BCN Commercial |
$1,787.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.95
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cofinity Commercial |
$1,427.03
|
| Rate for Payer: Cofinity Commercial |
$1,533.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,118.20
|
| Rate for Payer: Meridian Medicaid |
$726.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,171.44
|
| Rate for Payer: Nomi Health Commercial |
$1,277.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,261.25
|
| Rate for Payer: PACE SWMI |
$1,064.95
|
| Rate for Payer: PHP Commercial |
$1,490.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,910.53
|
| Rate for Payer: Priority Health Medicare |
$1,064.95
|
| Rate for Payer: Priority Health SBD |
$1,910.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,910.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,064.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,065.19
|
| Rate for Payer: UHC Core |
$2,065.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,064.95
|
| Rate for Payer: UHC Exchange |
$2,065.19
|
| Rate for Payer: UHC Medicaid |
$692.04
|
| Rate for Payer: UHCCP Medicaid |
$692.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,386.90
|
|
|
PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH
|
Professional
|
Both
|
$5,584.00
|
|
|
Service Code
|
HCPCS 27725
|
| Min. Negotiated Rate |
$716.53 |
| Max. Negotiated Rate |
$4,188.00 |
| Rate for Payer: Aetna Commercial |
$1,475.62
|
| Rate for Payer: Aetna Medicare |
$1,145.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,475.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.74
|
| Rate for Payer: BCBS Complete |
$752.36
|
| Rate for Payer: BCBS MAPPO |
$1,101.21
|
| Rate for Payer: BCN Commercial |
$1,845.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.21
|
| Rate for Payer: Cash Price |
$4,467.20
|
| Rate for Payer: Cash Price |
$4,467.20
|
| Rate for Payer: Cofinity Commercial |
$1,475.62
|
| Rate for Payer: Cofinity Commercial |
$1,585.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,156.27
|
| Rate for Payer: Meridian Medicaid |
$752.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,211.33
|
| Rate for Payer: Nomi Health Commercial |
$1,321.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,188.00
|
| Rate for Payer: PACE SWMI |
$1,101.21
|
| Rate for Payer: PHP Commercial |
$1,541.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,972.28
|
| Rate for Payer: Priority Health Medicare |
$1,101.21
|
| Rate for Payer: Priority Health SBD |
$1,972.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,972.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,101.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,129.06
|
| Rate for Payer: UHC Core |
$2,129.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,101.21
|
| Rate for Payer: UHC Exchange |
$2,129.06
|
| Rate for Payer: UHC Medicaid |
$716.53
|
| Rate for Payer: UHCCP Medicaid |
$716.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,568.64
|
|
|
PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT
|
Professional
|
Both
|
$4,914.00
|
|
|
Service Code
|
HCPCS 27724
|
| Min. Negotiated Rate |
$723.56 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$1,499.73
|
| Rate for Payer: Aetna Medicare |
$1,163.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,611.65
|
| Rate for Payer: BCBS Complete |
$759.74
|
| Rate for Payer: BCBS MAPPO |
$1,119.20
|
| Rate for Payer: BCN Commercial |
$1,892.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.20
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,499.73
|
| Rate for Payer: Cofinity Commercial |
$1,611.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,175.16
|
| Rate for Payer: Meridian Medicaid |
$759.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,231.12
|
| Rate for Payer: Nomi Health Commercial |
$1,343.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,685.50
|
| Rate for Payer: PACE SWMI |
$1,119.20
|
| Rate for Payer: PHP Commercial |
$1,566.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$723.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,022.85
|
| Rate for Payer: Priority Health Medicare |
$1,119.20
|
| Rate for Payer: Priority Health SBD |
$2,022.85
|
| Rate for Payer: Priority Health Tiered Network |
$2,022.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,119.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,216.12
|
| Rate for Payer: UHC Core |
$2,216.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,119.20
|
| Rate for Payer: UHC Exchange |
$2,216.12
|
| Rate for Payer: UHC Medicaid |
$723.56
|
| Rate for Payer: UHCCP Medicaid |
$723.56
|
| Rate for Payer: UMR Bronson Commercial |
$2,260.44
|
|
|
PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 28322
|
| Min. Negotiated Rate |
$344.63 |
| Max. Negotiated Rate |
$1,016.25 |
| Rate for Payer: Aetna Commercial |
$706.23
|
| Rate for Payer: Aetna Medicare |
$548.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.94
|
| Rate for Payer: BCBS Complete |
$361.86
|
| Rate for Payer: BCBS MAPPO |
$527.04
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: BCN Medicare Advantage |
$527.04
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$706.23
|
| Rate for Payer: Cofinity Commercial |
$758.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.39
|
| Rate for Payer: Meridian Medicaid |
$361.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.74
|
| Rate for Payer: Nomi Health Commercial |
$632.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,016.25
|
| Rate for Payer: PACE SWMI |
$527.04
|
| Rate for Payer: PHP Commercial |
$737.86
|
| Rate for Payer: PHP Medicare Advantage |
$527.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$937.97
|
| Rate for Payer: Priority Health Medicare |
$527.04
|
| Rate for Payer: Priority Health SBD |
$937.97
|
| Rate for Payer: Priority Health Tiered Network |
$937.97
|
| Rate for Payer: Railroad Medicare Medicare |
$527.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,003.58
|
| Rate for Payer: UHC Core |
$1,003.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.04
|
| Rate for Payer: UHC Exchange |
$1,003.58
|
| Rate for Payer: UHC Medicaid |
$344.63
|
| Rate for Payer: UHCCP Medicaid |
$344.63
|
| Rate for Payer: UMR Bronson Commercial |
$623.30
|
|
|
PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS
|
Professional
|
Both
|
$7,236.00
|
|
|
Service Code
|
HCPCS 33496
|
| Min. Negotiated Rate |
$1,011.75 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Commercial |
$2,121.76
|
| Rate for Payer: Aetna Medicare |
$1,646.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,121.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,280.10
|
| Rate for Payer: BCBS Complete |
$1,062.34
|
| Rate for Payer: BCBS MAPPO |
$1,583.40
|
| Rate for Payer: BCN Commercial |
$2,446.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,583.40
|
| Rate for Payer: Cash Price |
$5,788.80
|
| Rate for Payer: Cash Price |
$5,788.80
|
| Rate for Payer: Cofinity Commercial |
$2,121.76
|
| Rate for Payer: Cofinity Commercial |
$2,280.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,583.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,662.57
|
| Rate for Payer: Meridian Medicaid |
$1,062.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,741.74
|
| Rate for Payer: Nomi Health Commercial |
$1,900.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,427.00
|
| Rate for Payer: PACE SWMI |
$1,583.40
|
| Rate for Payer: PHP Commercial |
$2,216.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,583.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,011.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,630.98
|
| Rate for Payer: Priority Health Medicare |
$1,583.40
|
| Rate for Payer: Priority Health SBD |
$2,630.98
|
| Rate for Payer: Priority Health Tiered Network |
$2,630.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,583.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,963.53
|
| Rate for Payer: UHC Core |
$2,963.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,583.40
|
| Rate for Payer: UHC Exchange |
$2,963.53
|
| Rate for Payer: UHC Medicaid |
$1,011.75
|
| Rate for Payer: UHCCP Medicaid |
$1,011.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,328.56
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$3,338.00
|
|
|
Service Code
|
HCPCS 25405
|
| Min. Negotiated Rate |
$598.96 |
| Max. Negotiated Rate |
$2,503.50 |
| Rate for Payer: Aetna Commercial |
$1,233.79
|
| Rate for Payer: Aetna Medicare |
$957.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,233.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,325.87
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$920.74
|
| Rate for Payer: BCN Commercial |
$1,577.10
|
| Rate for Payer: BCN Medicare Advantage |
$920.74
|
| Rate for Payer: Cash Price |
$2,670.40
|
| Rate for Payer: Cash Price |
$2,670.40
|
| Rate for Payer: Cofinity Commercial |
$1,233.79
|
| Rate for Payer: Cofinity Commercial |
$1,325.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$920.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$966.78
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,012.81
|
| Rate for Payer: Nomi Health Commercial |
$1,104.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,503.50
|
| Rate for Payer: PACE SWMI |
$920.74
|
| Rate for Payer: PHP Commercial |
$1,289.04
|
| Rate for Payer: PHP Medicare Advantage |
$920.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,685.88
|
| Rate for Payer: Priority Health Medicare |
$920.74
|
| Rate for Payer: Priority Health SBD |
$1,685.88
|
| Rate for Payer: Priority Health Tiered Network |
$1,685.88
|
| Rate for Payer: Railroad Medicare Medicare |
$920.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,815.66
|
| Rate for Payer: UHC Core |
$1,815.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$920.74
|
| Rate for Payer: UHC Exchange |
$1,815.66
|
| Rate for Payer: UHC Medicaid |
$598.96
|
| Rate for Payer: UHCCP Medicaid |
$598.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,535.48
|
|
|
PR RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF
|
Professional
|
Both
|
$3,373.00
|
|
|
Service Code
|
HCPCS 25415
|
| Min. Negotiated Rate |
$571.05 |
| Max. Negotiated Rate |
$2,529.75 |
| Rate for Payer: Aetna Commercial |
$1,175.70
|
| Rate for Payer: Aetna Medicare |
$912.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,175.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,263.44
|
| Rate for Payer: BCBS Complete |
$599.60
|
| Rate for Payer: BCBS MAPPO |
$877.39
|
| Rate for Payer: BCN Commercial |
$1,471.04
|
| Rate for Payer: BCN Medicare Advantage |
$877.39
|
| Rate for Payer: Cash Price |
$2,698.40
|
| Rate for Payer: Cash Price |
$2,698.40
|
| Rate for Payer: Cofinity Commercial |
$1,175.70
|
| Rate for Payer: Cofinity Commercial |
$1,263.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$877.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$921.26
|
| Rate for Payer: Meridian Medicaid |
$599.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$965.13
|
| Rate for Payer: Nomi Health Commercial |
$1,052.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,529.75
|
| Rate for Payer: PACE SWMI |
$877.39
|
| Rate for Payer: PHP Commercial |
$1,228.35
|
| Rate for Payer: PHP Medicare Advantage |
$877.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,572.50
|
| Rate for Payer: Priority Health Medicare |
$877.39
|
| Rate for Payer: Priority Health SBD |
$1,572.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,572.50
|
| Rate for Payer: Railroad Medicare Medicare |
$877.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,695.21
|
| Rate for Payer: UHC Core |
$1,695.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$877.39
|
| Rate for Payer: UHC Exchange |
$1,695.21
|
| Rate for Payer: UHC Medicaid |
$571.05
|
| Rate for Payer: UHCCP Medicaid |
$571.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,551.58
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT
|
Professional
|
Both
|
$2,712.00
|
|
|
Service Code
|
HCPCS 25400
|
| Min. Negotiated Rate |
$470.09 |
| Max. Negotiated Rate |
$2,034.00 |
| Rate for Payer: Aetna Commercial |
$965.56
|
| Rate for Payer: Aetna Medicare |
$749.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,037.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.56
|
| Rate for Payer: BCBS Complete |
$493.59
|
| Rate for Payer: BCBS MAPPO |
$720.57
|
| Rate for Payer: BCN Commercial |
$1,223.54
|
| Rate for Payer: BCN Medicare Advantage |
$720.57
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cofinity Commercial |
$1,037.62
|
| Rate for Payer: Cofinity Commercial |
$965.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$720.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$756.60
|
| Rate for Payer: Meridian Medicaid |
$493.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$792.63
|
| Rate for Payer: Nomi Health Commercial |
$864.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,034.00
|
| Rate for Payer: PACE SWMI |
$720.57
|
| Rate for Payer: PHP Commercial |
$1,008.80
|
| Rate for Payer: PHP Medicare Advantage |
$720.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,307.92
|
| Rate for Payer: Priority Health Medicare |
$720.57
|
| Rate for Payer: Priority Health SBD |
$1,307.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,307.92
|
| Rate for Payer: Railroad Medicare Medicare |
$720.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.49
|
| Rate for Payer: UHC Core |
$1,402.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$720.57
|
| Rate for Payer: UHC Exchange |
$1,402.49
|
| Rate for Payer: UHC Medicaid |
$470.09
|
| Rate for Payer: UHCCP Medicaid |
$470.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,247.52
|
|
|
PR RPR NON-UNION MTCRPL/PHALANX
|
Professional
|
Both
|
$2,172.00
|
|
|
Service Code
|
HCPCS 26546
|
| Min. Negotiated Rate |
$633.46 |
| Max. Negotiated Rate |
$1,730.93 |
| Rate for Payer: Aetna Commercial |
$1,275.92
|
| Rate for Payer: Aetna Medicare |
$990.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,275.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.14
|
| Rate for Payer: BCBS Complete |
$665.13
|
| Rate for Payer: BCBS MAPPO |
$952.18
|
| Rate for Payer: BCN Commercial |
$1,580.09
|
| Rate for Payer: BCN Medicare Advantage |
$952.18
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cofinity Commercial |
$1,275.92
|
| Rate for Payer: Cofinity Commercial |
$1,371.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$952.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$999.79
|
| Rate for Payer: Meridian Medicaid |
$665.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,047.40
|
| Rate for Payer: Nomi Health Commercial |
$1,142.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.00
|
| Rate for Payer: PACE SWMI |
$952.18
|
| Rate for Payer: PHP Commercial |
$1,333.05
|
| Rate for Payer: PHP Medicare Advantage |
$952.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,689.07
|
| Rate for Payer: Priority Health Medicare |
$952.18
|
| Rate for Payer: Priority Health SBD |
$1,689.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,689.07
|
| Rate for Payer: Railroad Medicare Medicare |
$952.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,730.93
|
| Rate for Payer: UHC Core |
$1,730.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$952.18
|
| Rate for Payer: UHC Exchange |
$1,730.93
|
| Rate for Payer: UHC Medicaid |
$633.46
|
| Rate for Payer: UHCCP Medicaid |
$633.46
|
| Rate for Payer: UMR Bronson Commercial |
$999.12
|
|
|
PR RPR NONUNION SCAPHOID CARPAL B1 W/WO RDL STYLODC
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 25440
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$1,338.53 |
| Rate for Payer: Aetna Commercial |
$922.08
|
| Rate for Payer: Aetna Medicare |
$715.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.89
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS MAPPO |
$688.12
|
| Rate for Payer: BCN Commercial |
$1,175.24
|
| Rate for Payer: BCN Medicare Advantage |
$688.12
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cofinity Commercial |
$922.08
|
| Rate for Payer: Cofinity Commercial |
$990.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.53
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$756.93
|
| Rate for Payer: Nomi Health Commercial |
$825.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,062.75
|
| Rate for Payer: PACE SWMI |
$688.12
|
| Rate for Payer: PHP Commercial |
$963.37
|
| Rate for Payer: PHP Medicare Advantage |
$688.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,256.30
|
| Rate for Payer: Priority Health Medicare |
$688.12
|
| Rate for Payer: Priority Health SBD |
$1,256.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,256.30
|
| Rate for Payer: Railroad Medicare Medicare |
$688.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.53
|
| Rate for Payer: UHC Core |
$1,338.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.12
|
| Rate for Payer: UHC Exchange |
$1,338.53
|
| Rate for Payer: UHC Medicaid |
$449.43
|
| Rate for Payer: UHCCP Medicaid |
$449.43
|
| Rate for Payer: UMR Bronson Commercial |
$651.82
|
|
|
PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
HCPCS 30468
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$192.67
|
| Rate for Payer: Aetna Medicare |
$149.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.04
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$143.78
|
| Rate for Payer: BCN Commercial |
$253.47
|
| Rate for Payer: BCN Medicare Advantage |
$143.78
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cofinity Commercial |
$192.67
|
| Rate for Payer: Cofinity Commercial |
$207.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.97
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.16
|
| Rate for Payer: Nomi Health Commercial |
$172.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.00
|
| Rate for Payer: PACE SWMI |
$143.78
|
| Rate for Payer: PHP Commercial |
$201.29
|
| Rate for Payer: PHP Medicare Advantage |
$143.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$238.69
|
| Rate for Payer: Priority Health Medicare |
$143.78
|
| Rate for Payer: Priority Health SBD |
$238.69
|
| Rate for Payer: Priority Health Tiered Network |
$238.69
|
| Rate for Payer: Railroad Medicare Medicare |
$143.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.57
|
| Rate for Payer: UHC Core |
$302.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.78
|
| Rate for Payer: UHC Exchange |
$302.57
|
| Rate for Payer: UHC Medicaid |
$92.87
|
| Rate for Payer: UHCCP Medicaid |
$92.87
|
| Rate for Payer: UMR Bronson Commercial |
$198.72
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$869.89 |
| Max. Negotiated Rate |
$2,606.02 |
| Rate for Payer: Aetna Commercial |
$1,828.12
|
| Rate for Payer: Aetna Medicare |
$1,418.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,828.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.55
|
| Rate for Payer: BCBS Complete |
$913.38
|
| Rate for Payer: BCBS MAPPO |
$1,364.27
|
| Rate for Payer: BCN Commercial |
$2,138.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,364.27
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,828.12
|
| Rate for Payer: Cofinity Commercial |
$1,964.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,364.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,432.48
|
| Rate for Payer: Meridian Medicaid |
$913.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,500.70
|
| Rate for Payer: Nomi Health Commercial |
$1,637.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$1,364.27
|
| Rate for Payer: PHP Commercial |
$1,909.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,364.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$869.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,606.02
|
| Rate for Payer: Priority Health Medicare |
$1,364.27
|
| Rate for Payer: Priority Health SBD |
$2,606.02
|
| Rate for Payer: Priority Health Tiered Network |
$2,606.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,364.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,583.69
|
| Rate for Payer: UHC Core |
$2,583.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,364.27
|
| Rate for Payer: UHC Exchange |
$2,583.69
|
| Rate for Payer: UHC Medicaid |
$869.89
|
| Rate for Payer: UHCCP Medicaid |
$869.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.22
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$2,182.00
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$687.35 |
| Max. Negotiated Rate |
$2,090.89 |
| Rate for Payer: Aetna Commercial |
$1,440.33
|
| Rate for Payer: Aetna Medicare |
$1,117.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,547.81
|
| Rate for Payer: BCBS Complete |
$721.72
|
| Rate for Payer: BCBS MAPPO |
$1,074.87
|
| Rate for Payer: BCN Commercial |
$1,716.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,074.87
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Cofinity Commercial |
$1,440.33
|
| Rate for Payer: Cofinity Commercial |
$1,547.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,074.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,128.61
|
| Rate for Payer: Meridian Medicaid |
$721.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,182.36
|
| Rate for Payer: Nomi Health Commercial |
$1,289.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,636.50
|
| Rate for Payer: PACE SWMI |
$1,074.87
|
| Rate for Payer: PHP Commercial |
$1,504.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,074.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,090.89
|
| Rate for Payer: Priority Health Medicare |
$1,074.87
|
| Rate for Payer: Priority Health SBD |
$2,090.89
|
| Rate for Payer: Priority Health Tiered Network |
$2,090.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,074.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,066.11
|
| Rate for Payer: UHC Core |
$2,066.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,074.87
|
| Rate for Payer: UHC Exchange |
$2,066.11
|
| Rate for Payer: UHC Medicaid |
$687.35
|
| Rate for Payer: UHCCP Medicaid |
$687.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,003.72
|
|
