|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,155.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$948.20 |
| Max. Negotiated Rate |
$1,939.50 |
| Rate for Payer: Aetna American Axle |
$1,400.75
|
| Rate for Payer: Aetna Commercial |
$1,831.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,400.75
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cofinity Advantage |
$1,508.50
|
| Rate for Payer: Cofinity Commercial |
$1,853.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,724.00
|
| Rate for Payer: Healthscope Commercial |
$1,939.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,508.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,616.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,831.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,616.25
|
| Rate for Payer: PHP Commercial |
$1,831.75
|
| Rate for Payer: Priority Health SBD |
$1,357.65
|
| Rate for Payer: UMR Bronson Commercial |
$948.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,616.25
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,603.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$766.37 |
| Max. Negotiated Rate |
$3,452.25 |
| Rate for Payer: Aetna Commercial |
$1,608.43
|
| Rate for Payer: Aetna Medicare |
$1,248.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,608.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,728.46
|
| Rate for Payer: BCBS Complete |
$804.69
|
| Rate for Payer: BCBS MAPPO |
$1,200.32
|
| Rate for Payer: BCN Commercial |
$1,937.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,200.32
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,608.43
|
| Rate for Payer: Cofinity Commercial |
$1,728.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,200.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,260.34
|
| Rate for Payer: Meridian Medicaid |
$804.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,320.35
|
| Rate for Payer: Nomi Health Commercial |
$1,440.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,452.25
|
| Rate for Payer: PACE SWMI |
$1,200.32
|
| Rate for Payer: PHP Commercial |
$1,680.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,200.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$766.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,577.53
|
| Rate for Payer: Priority Health Medicare |
$1,200.32
|
| Rate for Payer: Priority Health SBD |
$2,577.53
|
| Rate for Payer: Priority Health Tiered Network |
$2,577.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,200.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,278.98
|
| Rate for Payer: UHC Core |
$2,278.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,200.32
|
| Rate for Payer: UHC Exchange |
$2,278.98
|
| Rate for Payer: UHC Medicaid |
$766.37
|
| Rate for Payer: UHCCP Medicaid |
$766.37
|
| Rate for Payer: UMR Bronson Commercial |
$2,117.38
|
|
|
PR RPR SINUS VALSALVA FISTULA
|
Professional
|
Both
|
$3,326.00
|
|
|
Service Code
|
HCPCS 33702
|
| Min. Negotiated Rate |
$933.37 |
| Max. Negotiated Rate |
$2,748.78 |
| Rate for Payer: Aetna Commercial |
$1,958.64
|
| Rate for Payer: Aetna Medicare |
$1,520.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,958.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,104.80
|
| Rate for Payer: BCBS Complete |
$980.04
|
| Rate for Payer: BCBS MAPPO |
$1,461.67
|
| Rate for Payer: BCN Commercial |
$2,286.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,461.67
|
| Rate for Payer: Cash Price |
$2,660.80
|
| Rate for Payer: Cash Price |
$2,660.80
|
| Rate for Payer: Cofinity Commercial |
$1,958.64
|
| Rate for Payer: Cofinity Commercial |
$2,104.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,461.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,534.75
|
| Rate for Payer: Meridian Medicaid |
$980.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,607.84
|
| Rate for Payer: Nomi Health Commercial |
$1,754.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,494.50
|
| Rate for Payer: PACE SWMI |
$1,461.67
|
| Rate for Payer: PHP Commercial |
$2,046.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,461.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$933.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,458.56
|
| Rate for Payer: Priority Health Medicare |
$1,461.67
|
| Rate for Payer: Priority Health SBD |
$2,458.56
|
| Rate for Payer: Priority Health Tiered Network |
$2,458.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,461.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,748.78
|
| Rate for Payer: UHC Core |
$2,748.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,461.67
|
| Rate for Payer: UHC Exchange |
$2,748.78
|
| Rate for Payer: UHC Medicaid |
$933.37
|
| Rate for Payer: UHCCP Medicaid |
$933.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,529.96
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$448.79 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$933.94
|
| Rate for Payer: Aetna Medicare |
$724.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.94
|
| Rate for Payer: BCBS Complete |
$471.23
|
| Rate for Payer: BCBS MAPPO |
$696.97
|
| Rate for Payer: BCN Commercial |
$1,112.00
|
| Rate for Payer: BCN Medicare Advantage |
$696.97
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$1,003.64
|
| Rate for Payer: Cofinity Commercial |
$933.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.82
|
| Rate for Payer: Meridian Medicaid |
$471.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$766.67
|
| Rate for Payer: Nomi Health Commercial |
$836.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,522.50
|
| Rate for Payer: PACE SWMI |
$696.97
|
| Rate for Payer: PHP Commercial |
$975.76
|
| Rate for Payer: PHP Medicare Advantage |
$696.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,354.89
|
| Rate for Payer: Priority Health Medicare |
$696.97
|
| Rate for Payer: Priority Health SBD |
$1,354.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,354.89
|
| Rate for Payer: Railroad Medicare Medicare |
$696.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.41
|
| Rate for Payer: UHC Core |
$1,304.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$696.97
|
| Rate for Payer: UHC Exchange |
$1,304.41
|
| Rate for Payer: UHC Medicaid |
$448.79
|
| Rate for Payer: UHCCP Medicaid |
$448.79
|
| Rate for Payer: UMR Bronson Commercial |
$933.80
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,675.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$670.00 |
| Max. Negotiated Rate |
$1,256.25 |
| Rate for Payer: Aetna Medicare |
$837.50
|
| Rate for Payer: BCBS Complete |
$670.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.25
|
| Rate for Payer: UMR Bronson Commercial |
$770.50
|
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$8,123.00
|
|
|
Service Code
|
HCPCS 38780
|
| Min. Negotiated Rate |
$624.30 |
| Max. Negotiated Rate |
$6,092.25 |
| Rate for Payer: Aetna Commercial |
$1,299.42
|
| Rate for Payer: Aetna Medicare |
$1,008.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,396.40
|
| Rate for Payer: BCBS Complete |
$655.51
|
| Rate for Payer: BCBS MAPPO |
$969.72
|
| Rate for Payer: BCN Commercial |
$1,586.56
|
| Rate for Payer: BCN Medicare Advantage |
$969.72
|
| Rate for Payer: Cash Price |
$6,498.40
|
| Rate for Payer: Cash Price |
$6,498.40
|
| Rate for Payer: Cofinity Commercial |
$1,396.40
|
| Rate for Payer: Cofinity Commercial |
$1,299.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.21
|
| Rate for Payer: Meridian Medicaid |
$655.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,066.69
|
| Rate for Payer: Nomi Health Commercial |
$1,163.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,092.25
|
| Rate for Payer: PACE SWMI |
$969.72
|
| Rate for Payer: PHP Commercial |
$1,357.61
|
| Rate for Payer: PHP Medicare Advantage |
$969.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,111.06
|
| Rate for Payer: Priority Health Medicare |
$969.72
|
| Rate for Payer: Priority Health SBD |
$2,111.06
|
| Rate for Payer: Priority Health Tiered Network |
$2,111.06
|
| Rate for Payer: Railroad Medicare Medicare |
$969.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,828.88
|
| Rate for Payer: UHC Core |
$1,828.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$969.72
|
| Rate for Payer: UHC Exchange |
$1,828.88
|
| Rate for Payer: UHC Medicaid |
$624.30
|
| Rate for Payer: UHCCP Medicaid |
$624.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,736.58
|
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 28200
|
| Min. Negotiated Rate |
$199.58 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$406.29
|
| Rate for Payer: Aetna Medicare |
$315.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.61
|
| Rate for Payer: BCBS Complete |
$209.56
|
| Rate for Payer: BCBS MAPPO |
$303.20
|
| Rate for Payer: BCN Commercial |
$497.98
|
| Rate for Payer: BCN Medicare Advantage |
$303.20
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cofinity Commercial |
$406.29
|
| Rate for Payer: Cofinity Commercial |
$436.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.36
|
| Rate for Payer: Meridian Medicaid |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.52
|
| Rate for Payer: Nomi Health Commercial |
$363.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: PACE SWMI |
$303.20
|
| Rate for Payer: PHP Commercial |
$424.48
|
| Rate for Payer: PHP Medicare Advantage |
$303.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$532.34
|
| Rate for Payer: Priority Health Medicare |
$303.20
|
| Rate for Payer: Priority Health SBD |
$532.34
|
| Rate for Payer: Priority Health Tiered Network |
$532.34
|
| Rate for Payer: Railroad Medicare Medicare |
$303.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.13
|
| Rate for Payer: UHC Core |
$564.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.20
|
| Rate for Payer: UHC Exchange |
$564.13
|
| Rate for Payer: UHC Medicaid |
$199.58
|
| Rate for Payer: UHCCP Medicaid |
$199.58
|
| Rate for Payer: UMR Bronson Commercial |
$593.86
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,292.00
|
|
|
Service Code
|
HCPCS 25263
|
| Min. Negotiated Rate |
$387.66 |
| Max. Negotiated Rate |
$1,096.57 |
| Rate for Payer: Aetna Commercial |
$790.39
|
| Rate for Payer: Aetna Medicare |
$613.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.37
|
| Rate for Payer: BCBS Complete |
$407.04
|
| Rate for Payer: BCBS MAPPO |
$589.84
|
| Rate for Payer: BCN Commercial |
$975.05
|
| Rate for Payer: BCN Medicare Advantage |
$589.84
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cofinity Commercial |
$790.39
|
| Rate for Payer: Cofinity Commercial |
$849.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.33
|
| Rate for Payer: Meridian Medicaid |
$407.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$648.82
|
| Rate for Payer: Nomi Health Commercial |
$707.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.00
|
| Rate for Payer: PACE SWMI |
$589.84
|
| Rate for Payer: PHP Commercial |
$825.78
|
| Rate for Payer: PHP Medicare Advantage |
$589.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,042.29
|
| Rate for Payer: Priority Health Medicare |
$589.84
|
| Rate for Payer: Priority Health SBD |
$1,042.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,042.29
|
| Rate for Payer: Railroad Medicare Medicare |
$589.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.57
|
| Rate for Payer: UHC Core |
$1,096.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$589.84
|
| Rate for Payer: UHC Exchange |
$1,096.57
|
| Rate for Payer: UHC Medicaid |
$387.66
|
| Rate for Payer: UHCCP Medicaid |
$387.66
|
| Rate for Payer: UMR Bronson Commercial |
$594.32
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU
|
Professional
|
Both
|
$1,752.00
|
|
|
Service Code
|
HCPCS 25260
|
| Min. Negotiated Rate |
$382.12 |
| Max. Negotiated Rate |
$1,314.00 |
| Rate for Payer: Aetna Commercial |
$778.22
|
| Rate for Payer: Aetna Medicare |
$603.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.29
|
| Rate for Payer: BCBS Complete |
$401.23
|
| Rate for Payer: BCBS MAPPO |
$580.76
|
| Rate for Payer: BCN Commercial |
$977.53
|
| Rate for Payer: BCN Medicare Advantage |
$580.76
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cofinity Commercial |
$778.22
|
| Rate for Payer: Cofinity Commercial |
$836.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$609.80
|
| Rate for Payer: Meridian Medicaid |
$401.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$638.84
|
| Rate for Payer: Nomi Health Commercial |
$696.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,314.00
|
| Rate for Payer: PACE SWMI |
$580.76
|
| Rate for Payer: PHP Commercial |
$813.06
|
| Rate for Payer: PHP Medicare Advantage |
$580.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$382.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,044.96
|
| Rate for Payer: Priority Health Medicare |
$580.76
|
| Rate for Payer: Priority Health SBD |
$1,044.96
|
| Rate for Payer: Priority Health Tiered Network |
$1,044.96
|
| Rate for Payer: Railroad Medicare Medicare |
$580.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.10
|
| Rate for Payer: UHC Core |
$1,095.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$580.76
|
| Rate for Payer: UHC Exchange |
$1,095.10
|
| Rate for Payer: UHC Medicaid |
$382.12
|
| Rate for Payer: UHCCP Medicaid |
$382.12
|
| Rate for Payer: UMR Bronson Commercial |
$805.92
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN
|
Professional
|
Both
|
$1,461.00
|
|
|
Service Code
|
HCPCS 25270
|
| Min. Negotiated Rate |
$300.33 |
| Max. Negotiated Rate |
$1,095.75 |
| Rate for Payer: Aetna Commercial |
$611.12
|
| Rate for Payer: Aetna Medicare |
$474.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.73
|
| Rate for Payer: BCBS Complete |
$315.35
|
| Rate for Payer: BCBS MAPPO |
$456.06
|
| Rate for Payer: BCN Commercial |
$762.90
|
| Rate for Payer: BCN Medicare Advantage |
$456.06
|
| Rate for Payer: Cash Price |
$1,168.80
|
| Rate for Payer: Cash Price |
$1,168.80
|
| Rate for Payer: Cofinity Commercial |
$611.12
|
| Rate for Payer: Cofinity Commercial |
$656.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.86
|
| Rate for Payer: Meridian Medicaid |
$315.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$501.67
|
| Rate for Payer: Nomi Health Commercial |
$547.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.75
|
| Rate for Payer: PACE SWMI |
$456.06
|
| Rate for Payer: PHP Commercial |
$638.48
|
| Rate for Payer: PHP Medicare Advantage |
$456.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$815.53
|
| Rate for Payer: Priority Health Medicare |
$456.06
|
| Rate for Payer: Priority Health SBD |
$815.53
|
| Rate for Payer: Priority Health Tiered Network |
$815.53
|
| Rate for Payer: Railroad Medicare Medicare |
$456.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.22
|
| Rate for Payer: UHC Core |
$854.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$456.06
|
| Rate for Payer: UHC Exchange |
$854.22
|
| Rate for Payer: UHC Medicaid |
$300.33
|
| Rate for Payer: UHCCP Medicaid |
$300.33
|
| Rate for Payer: UMR Bronson Commercial |
$672.06
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
HCPCS 25272
|
| Min. Negotiated Rate |
$341.65 |
| Max. Negotiated Rate |
$1,252.50 |
| Rate for Payer: Aetna Commercial |
$697.13
|
| Rate for Payer: Aetna Medicare |
$541.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.16
|
| Rate for Payer: BCBS Complete |
$358.73
|
| Rate for Payer: BCBS MAPPO |
$520.25
|
| Rate for Payer: BCN Commercial |
$861.01
|
| Rate for Payer: BCN Medicare Advantage |
$520.25
|
| Rate for Payer: Cash Price |
$1,336.00
|
| Rate for Payer: Cash Price |
$1,336.00
|
| Rate for Payer: Cofinity Commercial |
$697.13
|
| Rate for Payer: Cofinity Commercial |
$749.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$546.26
|
| Rate for Payer: Meridian Medicaid |
$358.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$572.27
|
| Rate for Payer: Nomi Health Commercial |
$624.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,252.50
|
| Rate for Payer: PACE SWMI |
$520.25
|
| Rate for Payer: PHP Commercial |
$728.35
|
| Rate for Payer: PHP Medicare Advantage |
$520.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$920.39
|
| Rate for Payer: Priority Health Medicare |
$520.25
|
| Rate for Payer: Priority Health SBD |
$920.39
|
| Rate for Payer: Priority Health Tiered Network |
$920.39
|
| Rate for Payer: Railroad Medicare Medicare |
$520.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$970.49
|
| Rate for Payer: UHC Core |
$970.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$520.25
|
| Rate for Payer: UHC Exchange |
$970.49
|
| Rate for Payer: UHC Medicaid |
$341.65
|
| Rate for Payer: UHCCP Medicaid |
$341.65
|
| Rate for Payer: UMR Bronson Commercial |
$768.20
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN
|
Professional
|
Both
|
$2,371.00
|
|
|
Service Code
|
HCPCS 25274
|
| Min. Negotiated Rate |
$392.77 |
| Max. Negotiated Rate |
$1,778.25 |
| Rate for Payer: Aetna Commercial |
$803.33
|
| Rate for Payer: Aetna Medicare |
$623.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.28
|
| Rate for Payer: BCBS Complete |
$412.41
|
| Rate for Payer: BCBS MAPPO |
$599.50
|
| Rate for Payer: BCN Commercial |
$1,021.86
|
| Rate for Payer: BCN Medicare Advantage |
$599.50
|
| Rate for Payer: Cash Price |
$1,896.80
|
| Rate for Payer: Cash Price |
$1,896.80
|
| Rate for Payer: Cofinity Commercial |
$803.33
|
| Rate for Payer: Cofinity Commercial |
$863.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.48
|
| Rate for Payer: Meridian Medicaid |
$412.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$659.45
|
| Rate for Payer: Nomi Health Commercial |
$719.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,778.25
|
| Rate for Payer: PACE SWMI |
$599.50
|
| Rate for Payer: PHP Commercial |
$839.30
|
| Rate for Payer: PHP Medicare Advantage |
$599.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,092.34
|
| Rate for Payer: Priority Health Medicare |
$599.50
|
| Rate for Payer: Priority Health SBD |
$1,092.34
|
| Rate for Payer: Priority Health Tiered Network |
$1,092.34
|
| Rate for Payer: Railroad Medicare Medicare |
$599.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.84
|
| Rate for Payer: UHC Core |
$1,158.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$599.50
|
| Rate for Payer: UHC Exchange |
$1,158.84
|
| Rate for Payer: UHC Medicaid |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$392.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,090.66
|
|
|
PR RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT
|
Professional
|
Both
|
$2,086.00
|
|
|
Service Code
|
HCPCS 25275
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$1,564.50 |
| Rate for Payer: Aetna Commercial |
$813.41
|
| Rate for Payer: Aetna Medicare |
$631.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.11
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS MAPPO |
$607.02
|
| Rate for Payer: BCN Commercial |
$1,032.31
|
| Rate for Payer: BCN Medicare Advantage |
$607.02
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cofinity Commercial |
$813.41
|
| Rate for Payer: Cofinity Commercial |
$874.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.37
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$667.72
|
| Rate for Payer: Nomi Health Commercial |
$728.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,564.50
|
| Rate for Payer: PACE SWMI |
$607.02
|
| Rate for Payer: PHP Commercial |
$849.83
|
| Rate for Payer: PHP Medicare Advantage |
$607.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,103.51
|
| Rate for Payer: Priority Health Medicare |
$607.02
|
| Rate for Payer: Priority Health SBD |
$1,103.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,103.51
|
| Rate for Payer: Railroad Medicare Medicare |
$607.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.28
|
| Rate for Payer: UHC Core |
$1,169.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$607.02
|
| Rate for Payer: UHC Exchange |
$1,169.28
|
| Rate for Payer: UHC Medicaid |
$397.88
|
| Rate for Payer: UHCCP Medicaid |
$397.88
|
| Rate for Payer: UMR Bronson Commercial |
$959.56
|
|
|
PR RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 28210
|
| Min. Negotiated Rate |
$253.47 |
| Max. Negotiated Rate |
$732.02 |
| Rate for Payer: Aetna Commercial |
$518.58
|
| Rate for Payer: Aetna Medicare |
$402.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.28
|
| Rate for Payer: BCBS Complete |
$266.14
|
| Rate for Payer: BCBS MAPPO |
$387.00
|
| Rate for Payer: BCN Commercial |
$638.41
|
| Rate for Payer: BCN Medicare Advantage |
$387.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cofinity Commercial |
$518.58
|
| Rate for Payer: Cofinity Commercial |
$557.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.35
|
| Rate for Payer: Meridian Medicaid |
$266.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.70
|
| Rate for Payer: Nomi Health Commercial |
$464.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$731.25
|
| Rate for Payer: PACE SWMI |
$387.00
|
| Rate for Payer: PHP Commercial |
$541.80
|
| Rate for Payer: PHP Medicare Advantage |
$387.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$682.44
|
| Rate for Payer: Priority Health Medicare |
$387.00
|
| Rate for Payer: Priority Health SBD |
$682.44
|
| Rate for Payer: Priority Health Tiered Network |
$682.44
|
| Rate for Payer: Railroad Medicare Medicare |
$387.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.02
|
| Rate for Payer: UHC Core |
$732.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.00
|
| Rate for Payer: UHC Exchange |
$732.02
|
| Rate for Payer: UHC Medicaid |
$253.47
|
| Rate for Payer: UHCCP Medicaid |
$253.47
|
| Rate for Payer: UMR Bronson Commercial |
$448.50
|
|
|
PR RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS
|
Professional
|
Both
|
$8,951.00
|
|
|
Service Code
|
HCPCS 33877
|
| Min. Negotiated Rate |
$2,099.54 |
| Max. Negotiated Rate |
$6,713.25 |
| Rate for Payer: Aetna Commercial |
$4,454.88
|
| Rate for Payer: Aetna Medicare |
$3,457.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,454.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,787.34
|
| Rate for Payer: BCBS Complete |
$2,204.52
|
| Rate for Payer: BCBS MAPPO |
$3,324.54
|
| Rate for Payer: BCN Commercial |
$5,272.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,324.54
|
| Rate for Payer: Cash Price |
$7,160.80
|
| Rate for Payer: Cash Price |
$7,160.80
|
| Rate for Payer: Cofinity Commercial |
$4,454.88
|
| Rate for Payer: Cofinity Commercial |
$4,787.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,324.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,490.77
|
| Rate for Payer: Meridian Medicaid |
$2,204.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,656.99
|
| Rate for Payer: Nomi Health Commercial |
$3,989.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,713.25
|
| Rate for Payer: PACE SWMI |
$3,324.54
|
| Rate for Payer: PHP Commercial |
$4,654.36
|
| Rate for Payer: PHP Medicare Advantage |
$3,324.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,099.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,669.50
|
| Rate for Payer: Priority Health Medicare |
$3,324.54
|
| Rate for Payer: Priority Health SBD |
$5,669.50
|
| Rate for Payer: Priority Health Tiered Network |
$5,669.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,324.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,496.60
|
| Rate for Payer: UHC Core |
$6,496.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,324.54
|
| Rate for Payer: UHC Exchange |
$6,496.60
|
| Rate for Payer: UHC Medicaid |
$2,099.54
|
| Rate for Payer: UHCCP Medicaid |
$2,099.54
|
| Rate for Payer: UMR Bronson Commercial |
$4,117.46
|
|
|
PR RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE
|
Professional
|
Both
|
$649.00
|
|
|
Service Code
|
HCPCS 55060
|
| Min. Negotiated Rate |
$225.78 |
| Max. Negotiated Rate |
$667.05 |
| Rate for Payer: Aetna Commercial |
$464.15
|
| Rate for Payer: Aetna Medicare |
$360.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.79
|
| Rate for Payer: BCBS Complete |
$237.07
|
| Rate for Payer: BCBS MAPPO |
$346.38
|
| Rate for Payer: BCN Commercial |
$573.68
|
| Rate for Payer: BCN Medicare Advantage |
$346.38
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Cofinity Commercial |
$464.15
|
| Rate for Payer: Cofinity Commercial |
$498.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.70
|
| Rate for Payer: Meridian Medicaid |
$237.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$381.02
|
| Rate for Payer: Nomi Health Commercial |
$415.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.75
|
| Rate for Payer: PACE SWMI |
$346.38
|
| Rate for Payer: PHP Commercial |
$484.93
|
| Rate for Payer: PHP Medicare Advantage |
$346.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$624.91
|
| Rate for Payer: Priority Health Medicare |
$346.38
|
| Rate for Payer: Priority Health SBD |
$624.91
|
| Rate for Payer: Priority Health Tiered Network |
$624.91
|
| Rate for Payer: Railroad Medicare Medicare |
$346.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.05
|
| Rate for Payer: UHC Core |
$667.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$346.38
|
| Rate for Payer: UHC Exchange |
$667.05
|
| Rate for Payer: UHC Medicaid |
$225.78
|
| Rate for Payer: UHCCP Medicaid |
$225.78
|
| Rate for Payer: UMR Bronson Commercial |
$298.54
|
|
|
PR RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 36575
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$345.75 |
| Rate for Payer: Aetna Commercial |
$39.57
|
| Rate for Payer: Aetna Medicare |
$30.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.52
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.53
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$29.53
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$39.57
|
| Rate for Payer: Cofinity Commercial |
$42.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.01
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.48
|
| Rate for Payer: Nomi Health Commercial |
$35.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.75
|
| Rate for Payer: PACE SWMI |
$29.53
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: PHP Medicare Advantage |
$29.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.01
|
| Rate for Payer: Priority Health Medicare |
$29.53
|
| Rate for Payer: Priority Health SBD |
$53.01
|
| Rate for Payer: Priority Health Tiered Network |
$53.01
|
| Rate for Payer: Railroad Medicare Medicare |
$29.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$62.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.53
|
| Rate for Payer: UHC Exchange |
$62.08
|
| Rate for Payer: UHC Medicaid |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
| Rate for Payer: UMR Bronson Commercial |
$212.06
|
|
|
PR RPR UMBILICAL HERNIA < 5 YRS INCARCERATED
|
Professional
|
Both
|
$1,507.00
|
|
|
Service Code
|
HCPCS 49582
|
| Min. Negotiated Rate |
$602.80 |
| Max. Negotiated Rate |
$1,130.25 |
| Rate for Payer: Aetna Medicare |
$753.50
|
| Rate for Payer: BCBS Complete |
$602.80
|
| Rate for Payer: Cash Price |
$1,205.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,130.25
|
| Rate for Payer: UMR Bronson Commercial |
$693.22
|
|
|
PR RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,306.00
|
|
|
Service Code
|
HCPCS 49580
|
| Min. Negotiated Rate |
$522.40 |
| Max. Negotiated Rate |
$979.50 |
| Rate for Payer: Aetna Medicare |
$653.00
|
| Rate for Payer: BCBS Complete |
$522.40
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$979.50
|
| Rate for Payer: UMR Bronson Commercial |
$600.76
|
|
|
PR RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,736.00
|
|
|
Service Code
|
HCPCS 49587
|
| Min. Negotiated Rate |
$694.40 |
| Max. Negotiated Rate |
$1,302.00 |
| Rate for Payer: Aetna Medicare |
$868.00
|
| Rate for Payer: BCBS Complete |
$694.40
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,302.00
|
| Rate for Payer: UMR Bronson Commercial |
$798.56
|
|
|
PR RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,507.00
|
|
|
Service Code
|
HCPCS 49585
|
| Min. Negotiated Rate |
$602.80 |
| Max. Negotiated Rate |
$1,130.25 |
| Rate for Payer: Aetna Medicare |
$753.50
|
| Rate for Payer: BCBS Complete |
$602.80
|
| Rate for Payer: Cash Price |
$1,205.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,130.25
|
| Rate for Payer: UMR Bronson Commercial |
$693.22
|
|
|
PR RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC
|
Professional
|
Both
|
$8,282.00
|
|
|
Service Code
|
HCPCS 33414
|
| Min. Negotiated Rate |
$1,273.31 |
| Max. Negotiated Rate |
$6,211.50 |
| Rate for Payer: Aetna Commercial |
$2,686.07
|
| Rate for Payer: Aetna Medicare |
$2,084.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,686.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,886.52
|
| Rate for Payer: BCBS Complete |
$1,336.98
|
| Rate for Payer: BCBS MAPPO |
$2,004.53
|
| Rate for Payer: BCN Commercial |
$3,154.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,004.53
|
| Rate for Payer: Cash Price |
$6,625.60
|
| Rate for Payer: Cash Price |
$6,625.60
|
| Rate for Payer: Cofinity Commercial |
$2,886.52
|
| Rate for Payer: Cofinity Commercial |
$2,686.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,004.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,104.76
|
| Rate for Payer: Meridian Medicaid |
$1,336.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,204.98
|
| Rate for Payer: Nomi Health Commercial |
$2,405.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,211.50
|
| Rate for Payer: PACE SWMI |
$2,004.53
|
| Rate for Payer: PHP Commercial |
$2,806.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,004.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,273.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,392.49
|
| Rate for Payer: Priority Health Medicare |
$2,004.53
|
| Rate for Payer: Priority Health SBD |
$3,392.49
|
| Rate for Payer: Priority Health Tiered Network |
$3,392.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,004.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,833.71
|
| Rate for Payer: UHC Core |
$3,833.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,004.53
|
| Rate for Payer: UHC Exchange |
$3,833.71
|
| Rate for Payer: UHC Medicaid |
$1,273.31
|
| Rate for Payer: UHCCP Medicaid |
$1,273.31
|
| Rate for Payer: UMR Bronson Commercial |
$3,809.72
|
|
|
PR RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER
|
Professional
|
Both
|
$2,908.00
|
|
|
Service Code
|
HCPCS 26428
|
| Min. Negotiated Rate |
$503.32 |
| Max. Negotiated Rate |
$2,181.00 |
| Rate for Payer: Aetna Commercial |
$1,008.40
|
| Rate for Payer: Aetna Medicare |
$782.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.66
|
| Rate for Payer: BCBS Complete |
$528.49
|
| Rate for Payer: BCBS MAPPO |
$752.54
|
| Rate for Payer: BCN Commercial |
$1,200.63
|
| Rate for Payer: BCN Medicare Advantage |
$752.54
|
| Rate for Payer: Cash Price |
$2,326.40
|
| Rate for Payer: Cash Price |
$2,326.40
|
| Rate for Payer: Cofinity Commercial |
$1,008.40
|
| Rate for Payer: Cofinity Commercial |
$1,083.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.17
|
| Rate for Payer: Meridian Medicaid |
$528.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$827.79
|
| Rate for Payer: Nomi Health Commercial |
$903.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.00
|
| Rate for Payer: PACE SWMI |
$752.54
|
| Rate for Payer: PHP Commercial |
$1,053.56
|
| Rate for Payer: PHP Medicare Advantage |
$752.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$503.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,283.44
|
| Rate for Payer: Priority Health Medicare |
$752.54
|
| Rate for Payer: Priority Health SBD |
$1,283.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,283.44
|
| Rate for Payer: Railroad Medicare Medicare |
$752.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.75
|
| Rate for Payer: UHC Core |
$1,318.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$752.54
|
| Rate for Payer: UHC Exchange |
$1,318.75
|
| Rate for Payer: UHC Medicaid |
$503.32
|
| Rate for Payer: UHCCP Medicaid |
$503.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,337.68
|
|
|
PR RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26426
|
| Min. Negotiated Rate |
$303.53 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$617.61
|
| Rate for Payer: Aetna Medicare |
$479.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.70
|
| Rate for Payer: BCBS Complete |
$318.71
|
| Rate for Payer: BCBS MAPPO |
$460.90
|
| Rate for Payer: BCN Commercial |
$777.35
|
| Rate for Payer: BCN Medicare Advantage |
$460.90
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$617.61
|
| Rate for Payer: Cofinity Commercial |
$663.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.94
|
| Rate for Payer: Meridian Medicaid |
$318.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$506.99
|
| Rate for Payer: Nomi Health Commercial |
$553.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$460.90
|
| Rate for Payer: PHP Commercial |
$645.26
|
| Rate for Payer: PHP Medicare Advantage |
$460.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$830.97
|
| Rate for Payer: Priority Health Medicare |
$460.90
|
| Rate for Payer: Priority Health SBD |
$830.97
|
| Rate for Payer: Priority Health Tiered Network |
$830.97
|
| Rate for Payer: Railroad Medicare Medicare |
$460.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.64
|
| Rate for Payer: UHC Core |
$870.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$460.90
|
| Rate for Payer: UHC Exchange |
$870.64
|
| Rate for Payer: UHC Medicaid |
$303.53
|
| Rate for Payer: UHCCP Medicaid |
$303.53
|
| Rate for Payer: UMR Bronson Commercial |
$939.32
|
|
|
PR RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 33226
|
| Min. Negotiated Rate |
$269.87 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$570.12
|
| Rate for Payer: Aetna Medicare |
$442.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.66
|
| Rate for Payer: BCBS Complete |
$283.36
|
| Rate for Payer: BCBS MAPPO |
$425.46
|
| Rate for Payer: BCN Commercial |
$717.09
|
| Rate for Payer: BCN Medicare Advantage |
$425.46
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$570.12
|
| Rate for Payer: Cofinity Commercial |
$612.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.73
|
| Rate for Payer: Meridian Medicaid |
$283.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.01
|
| Rate for Payer: Nomi Health Commercial |
$510.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$425.46
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: PHP Medicare Advantage |
$425.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$771.14
|
| Rate for Payer: Priority Health Medicare |
$425.46
|
| Rate for Payer: Priority Health SBD |
$771.14
|
| Rate for Payer: Priority Health Tiered Network |
$771.14
|
| Rate for Payer: Railroad Medicare Medicare |
$425.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.90
|
| Rate for Payer: UHC Core |
$883.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$425.46
|
| Rate for Payer: UHC Exchange |
$883.90
|
| Rate for Payer: UHC Medicaid |
$269.87
|
| Rate for Payer: UHCCP Medicaid |
$269.87
|
| Rate for Payer: UMR Bronson Commercial |
$614.56
|
|
