|
PR REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH
|
Professional
|
Both
|
$1,309.00
|
|
|
Service Code
|
HCPCS 26418
|
| Min. Negotiated Rate |
$523.60 |
| Max. Negotiated Rate |
$850.85 |
| Rate for Payer: Aetna Commercial |
$772.68
|
| Rate for Payer: Aetna Medicare |
$599.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.68
|
| Rate for Payer: BCBS Complete |
$523.60
|
| Rate for Payer: BCBS MAPPO |
$576.63
|
| Rate for Payer: BCN Medicare Advantage |
$576.63
|
| Rate for Payer: Cash Price |
$1,047.20
|
| Rate for Payer: Cash Price |
$1,047.20
|
| Rate for Payer: Cofinity Commercial |
$830.35
|
| Rate for Payer: Cofinity Commercial |
$772.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.46
|
| Rate for Payer: Nomi Health Commercial |
$691.96
|
| Rate for Payer: PACE SWMI |
$576.63
|
| Rate for Payer: PHP Commercial |
$807.28
|
| Rate for Payer: PHP Medicare Advantage |
$576.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.85
|
| Rate for Payer: Priority Health Medicare |
$576.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$576.63
|
| Rate for Payer: UHC Medicare Advantage |
$576.63
|
| Rate for Payer: UMR Bronson Commercial |
$602.14
|
|
|
PR REPAIR EXTENSOR TENDON HAND W/GRAFT EACH
|
Professional
|
Both
|
$1,933.00
|
|
|
Service Code
|
HCPCS 26412
|
| Min. Negotiated Rate |
$665.88 |
| Max. Negotiated Rate |
$1,256.45 |
| Rate for Payer: Aetna Commercial |
$892.28
|
| Rate for Payer: Aetna Medicare |
$692.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$892.28
|
| Rate for Payer: BCBS Complete |
$773.20
|
| Rate for Payer: BCBS MAPPO |
$665.88
|
| Rate for Payer: BCN Medicare Advantage |
$665.88
|
| Rate for Payer: Cash Price |
$1,546.40
|
| Rate for Payer: Cash Price |
$1,546.40
|
| Rate for Payer: Cofinity Commercial |
$958.87
|
| Rate for Payer: Cofinity Commercial |
$892.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.17
|
| Rate for Payer: Nomi Health Commercial |
$799.06
|
| Rate for Payer: PACE SWMI |
$665.88
|
| Rate for Payer: PHP Commercial |
$932.23
|
| Rate for Payer: PHP Medicare Advantage |
$665.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.45
|
| Rate for Payer: Priority Health Medicare |
$665.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.88
|
| Rate for Payer: UHC Medicare Advantage |
$665.88
|
| Rate for Payer: UMR Bronson Commercial |
$889.18
|
|
|
PR REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH
|
Professional
|
Both
|
$1,257.00
|
|
|
Service Code
|
HCPCS 26410
|
| Min. Negotiated Rate |
$502.80 |
| Max. Negotiated Rate |
$817.05 |
| Rate for Payer: Aetna Commercial |
$745.98
|
| Rate for Payer: Aetna Medicare |
$578.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.98
|
| Rate for Payer: BCBS Complete |
$502.80
|
| Rate for Payer: BCBS MAPPO |
$556.70
|
| Rate for Payer: BCN Medicare Advantage |
$556.70
|
| Rate for Payer: Cash Price |
$1,005.60
|
| Rate for Payer: Cash Price |
$1,005.60
|
| Rate for Payer: Cofinity Commercial |
$801.65
|
| Rate for Payer: Cofinity Commercial |
$745.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.53
|
| Rate for Payer: Nomi Health Commercial |
$668.04
|
| Rate for Payer: PACE SWMI |
$556.70
|
| Rate for Payer: PHP Commercial |
$779.38
|
| Rate for Payer: PHP Medicare Advantage |
$556.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.05
|
| Rate for Payer: Priority Health Medicare |
$556.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$556.70
|
| Rate for Payer: UHC Medicare Advantage |
$556.70
|
| Rate for Payer: UMR Bronson Commercial |
$578.22
|
|
|
PR REPAIR FASCIAL DEFECT LEG
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 27656
|
| Min. Negotiated Rate |
$324.14 |
| Max. Negotiated Rate |
$601.25 |
| Rate for Payer: Aetna Commercial |
$434.35
|
| Rate for Payer: Aetna Medicare |
$337.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.35
|
| Rate for Payer: BCBS Complete |
$370.00
|
| Rate for Payer: BCBS MAPPO |
$324.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.14
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cofinity Commercial |
$466.76
|
| Rate for Payer: Cofinity Commercial |
$434.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.35
|
| Rate for Payer: Nomi Health Commercial |
$388.97
|
| Rate for Payer: PACE SWMI |
$324.14
|
| Rate for Payer: PHP Commercial |
$453.80
|
| Rate for Payer: PHP Medicare Advantage |
$324.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.25
|
| Rate for Payer: Priority Health Medicare |
$324.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.14
|
| Rate for Payer: UHC Medicare Advantage |
$324.14
|
| Rate for Payer: UMR Bronson Commercial |
$425.50
|
|
|
PR REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION
|
Professional
|
Both
|
$4,033.00
|
|
|
Service Code
|
HCPCS 27726
|
| Min. Negotiated Rate |
$924.08 |
| Max. Negotiated Rate |
$2,621.45 |
| Rate for Payer: Aetna Commercial |
$1,238.27
|
| Rate for Payer: Aetna Medicare |
$961.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,238.27
|
| Rate for Payer: BCBS Complete |
$1,613.20
|
| Rate for Payer: BCBS MAPPO |
$924.08
|
| Rate for Payer: BCN Medicare Advantage |
$924.08
|
| Rate for Payer: Cash Price |
$3,226.40
|
| Rate for Payer: Cash Price |
$3,226.40
|
| Rate for Payer: Cofinity Commercial |
$1,330.68
|
| Rate for Payer: Cofinity Commercial |
$1,238.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$924.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$970.28
|
| Rate for Payer: Nomi Health Commercial |
$1,108.90
|
| Rate for Payer: PACE SWMI |
$924.08
|
| Rate for Payer: PHP Commercial |
$1,293.71
|
| Rate for Payer: PHP Medicare Advantage |
$924.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,621.45
|
| Rate for Payer: Priority Health Medicare |
$924.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$924.08
|
| Rate for Payer: UHC Medicare Advantage |
$924.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,855.18
|
|
|
PR REPAIR FIRST ABDOMINAL WALL HERNIA
|
Professional
|
Both
|
$2,106.00
|
|
|
Service Code
|
HCPCS 49560
|
| Min. Negotiated Rate |
$842.40 |
| Max. Negotiated Rate |
$1,368.90 |
| Rate for Payer: Aetna Medicare |
$1,053.00
|
| Rate for Payer: BCBS Complete |
$842.40
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.90
|
| Rate for Payer: UMR Bronson Commercial |
$968.76
|
|
|
PR REPAIR FISTULA OROMAXILLARY
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 30580
|
| Min. Negotiated Rate |
$440.14 |
| Max. Negotiated Rate |
$963.95 |
| Rate for Payer: Aetna Commercial |
$589.79
|
| Rate for Payer: Aetna Medicare |
$457.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.80
|
| Rate for Payer: BCBS Complete |
$593.20
|
| Rate for Payer: BCBS MAPPO |
$440.14
|
| Rate for Payer: BCN Medicare Advantage |
$440.14
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$589.79
|
| Rate for Payer: Cofinity Commercial |
$633.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.15
|
| Rate for Payer: Nomi Health Commercial |
$528.17
|
| Rate for Payer: PACE SWMI |
$440.14
|
| Rate for Payer: PHP Commercial |
$616.20
|
| Rate for Payer: PHP Medicare Advantage |
$440.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.95
|
| Rate for Payer: Priority Health Medicare |
$440.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.14
|
| Rate for Payer: UHC Medicare Advantage |
$440.14
|
| Rate for Payer: UMR Bronson Commercial |
$682.18
|
|
|
PR REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27658
|
| Min. Negotiated Rate |
$356.27 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$477.40
|
| Rate for Payer: Aetna Medicare |
$370.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.40
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$356.27
|
| Rate for Payer: BCN Medicare Advantage |
$356.27
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$513.03
|
| Rate for Payer: Cofinity Commercial |
$477.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.08
|
| Rate for Payer: Nomi Health Commercial |
$427.52
|
| Rate for Payer: PACE SWMI |
$356.27
|
| Rate for Payer: PHP Commercial |
$498.78
|
| Rate for Payer: PHP Medicare Advantage |
$356.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$356.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.27
|
| Rate for Payer: UHC Medicare Advantage |
$356.27
|
| Rate for Payer: UMR Bronson Commercial |
$598.46
|
|
|
PR REPAIR INCOMPLETE CIRCUMCISION
|
Professional
|
Both
|
$409.00
|
|
|
Service Code
|
HCPCS 54163
|
| Min. Negotiated Rate |
$163.60 |
| Max. Negotiated Rate |
$301.25 |
| Rate for Payer: Aetna Commercial |
$280.33
|
| Rate for Payer: Aetna Medicare |
$217.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.33
|
| Rate for Payer: BCBS Complete |
$163.60
|
| Rate for Payer: BCBS MAPPO |
$209.20
|
| Rate for Payer: BCN Medicare Advantage |
$209.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cofinity Commercial |
$301.25
|
| Rate for Payer: Cofinity Commercial |
$280.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.66
|
| Rate for Payer: Nomi Health Commercial |
$251.04
|
| Rate for Payer: PACE SWMI |
$209.20
|
| Rate for Payer: PHP Commercial |
$292.88
|
| Rate for Payer: PHP Medicare Advantage |
$209.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.85
|
| Rate for Payer: Priority Health Medicare |
$209.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.20
|
| Rate for Payer: UHC Medicare Advantage |
$209.20
|
| Rate for Payer: UMR Bronson Commercial |
$188.14
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM
|
Professional
|
Both
|
$1,017.00
|
|
|
Service Code
|
HCPCS 12055
|
| Min. Negotiated Rate |
$287.77 |
| Max. Negotiated Rate |
$661.05 |
| Rate for Payer: Aetna Commercial |
$385.61
|
| Rate for Payer: Aetna Medicare |
$299.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.61
|
| Rate for Payer: BCBS Complete |
$406.80
|
| Rate for Payer: BCBS MAPPO |
$287.77
|
| Rate for Payer: BCN Medicare Advantage |
$287.77
|
| Rate for Payer: Cash Price |
$813.60
|
| Rate for Payer: Cash Price |
$813.60
|
| Rate for Payer: Cofinity Commercial |
$414.39
|
| Rate for Payer: Cofinity Commercial |
$385.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.16
|
| Rate for Payer: Nomi Health Commercial |
$345.32
|
| Rate for Payer: PACE SWMI |
$287.77
|
| Rate for Payer: PHP Commercial |
$402.88
|
| Rate for Payer: PHP Medicare Advantage |
$287.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$661.05
|
| Rate for Payer: Priority Health Medicare |
$287.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.77
|
| Rate for Payer: UHC Medicare Advantage |
$287.77
|
| Rate for Payer: UMR Bronson Commercial |
$467.82
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<
|
Facility
|
OP
|
$445.00
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
12051
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$164.65 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$289.25
|
| Rate for Payer: Aetna Commercial |
$378.25
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$311.50
|
| Rate for Payer: Cofinity Commercial |
$382.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$400.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.75
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.25
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$378.25
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$280.35
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$164.65
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.75
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 12051
|
| Min. Negotiated Rate |
$159.45 |
| Max. Negotiated Rate |
$289.25 |
| Rate for Payer: Aetna Commercial |
$213.66
|
| Rate for Payer: Aetna Medicare |
$165.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.66
|
| Rate for Payer: BCBS Complete |
$178.00
|
| Rate for Payer: BCBS MAPPO |
$159.45
|
| Rate for Payer: BCN Medicare Advantage |
$159.45
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$229.61
|
| Rate for Payer: Cofinity Commercial |
$213.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.42
|
| Rate for Payer: Nomi Health Commercial |
$191.34
|
| Rate for Payer: PACE SWMI |
$159.45
|
| Rate for Payer: PHP Commercial |
$223.23
|
| Rate for Payer: PHP Medicare Advantage |
$159.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health Medicare |
$159.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.45
|
| Rate for Payer: UHC Medicare Advantage |
$159.45
|
| Rate for Payer: UMR Bronson Commercial |
$204.70
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 12051
|
| Hospital Charge Code |
12051
|
| Min. Negotiated Rate |
$159.45 |
| Max. Negotiated Rate |
$289.25 |
| Rate for Payer: Aetna Commercial |
$213.66
|
| Rate for Payer: Aetna Medicare |
$165.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.66
|
| Rate for Payer: BCBS Complete |
$178.00
|
| Rate for Payer: BCBS MAPPO |
$159.45
|
| Rate for Payer: BCN Medicare Advantage |
$159.45
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$213.66
|
| Rate for Payer: Cofinity Commercial |
$229.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.42
|
| Rate for Payer: Nomi Health Commercial |
$191.34
|
| Rate for Payer: PACE SWMI |
$159.45
|
| Rate for Payer: PHP Commercial |
$223.23
|
| Rate for Payer: PHP Medicare Advantage |
$159.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health Medicare |
$159.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.45
|
| Rate for Payer: UHC Medicare Advantage |
$159.45
|
| Rate for Payer: UMR Bronson Commercial |
$204.70
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<
|
Facility
|
IP
|
$445.00
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
12051
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$195.80 |
| Max. Negotiated Rate |
$400.50 |
| Rate for Payer: Aetna American Axle |
$289.25
|
| Rate for Payer: Aetna Commercial |
$378.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.25
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$311.50
|
| Rate for Payer: Cofinity Commercial |
$382.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.00
|
| Rate for Payer: Healthscope Commercial |
$400.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.25
|
| Rate for Payer: PHP Commercial |
$378.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health SBD |
$280.35
|
| Rate for Payer: UMR Bronson Commercial |
$195.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.75
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM
|
Professional
|
Both
|
$560.00
|
|
|
Service Code
|
HCPCS 12052
|
| Min. Negotiated Rate |
$188.62 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: Aetna Commercial |
$252.75
|
| Rate for Payer: Aetna Medicare |
$196.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.75
|
| Rate for Payer: BCBS Complete |
$224.00
|
| Rate for Payer: BCBS MAPPO |
$188.62
|
| Rate for Payer: BCN Medicare Advantage |
$188.62
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$271.61
|
| Rate for Payer: Cofinity Commercial |
$252.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.05
|
| Rate for Payer: Nomi Health Commercial |
$226.34
|
| Rate for Payer: PACE SWMI |
$188.62
|
| Rate for Payer: PHP Commercial |
$264.07
|
| Rate for Payer: PHP Medicare Advantage |
$188.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
| Rate for Payer: Priority Health Medicare |
$188.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.62
|
| Rate for Payer: UHC Medicare Advantage |
$188.62
|
| Rate for Payer: UMR Bronson Commercial |
$257.60
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM
|
Professional
|
Both
|
$560.00
|
|
|
Service Code
|
HCPCS 12052
|
| Hospital Charge Code |
12052
|
| Min. Negotiated Rate |
$188.62 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: Aetna Commercial |
$252.75
|
| Rate for Payer: Aetna Medicare |
$196.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.75
|
| Rate for Payer: BCBS Complete |
$224.00
|
| Rate for Payer: BCBS MAPPO |
$188.62
|
| Rate for Payer: BCN Medicare Advantage |
$188.62
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$252.75
|
| Rate for Payer: Cofinity Commercial |
$271.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.05
|
| Rate for Payer: Nomi Health Commercial |
$226.34
|
| Rate for Payer: PACE SWMI |
$188.62
|
| Rate for Payer: PHP Commercial |
$264.07
|
| Rate for Payer: PHP Medicare Advantage |
$188.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
| Rate for Payer: Priority Health Medicare |
$188.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.62
|
| Rate for Payer: UHC Medicare Advantage |
$188.62
|
| Rate for Payer: UMR Bronson Commercial |
$257.60
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
12052
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$207.20 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$364.00
|
| Rate for Payer: Aetna Commercial |
$476.00
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$481.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$392.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$504.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.00
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.00
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$476.00
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$352.80
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$207.20
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.00
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
12052
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Aetna American Axle |
$364.00
|
| Rate for Payer: Aetna Commercial |
$476.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.00
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$481.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$392.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.00
|
| Rate for Payer: Healthscope Commercial |
$504.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.00
|
| Rate for Payer: PHP Commercial |
$476.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
| Rate for Payer: Priority Health SBD |
$352.80
|
| Rate for Payer: UMR Bronson Commercial |
$246.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.00
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
12053
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$278.96 |
| Max. Negotiated Rate |
$570.60 |
| Rate for Payer: Aetna American Axle |
$412.10
|
| Rate for Payer: Aetna Commercial |
$538.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.10
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$443.80
|
| Rate for Payer: Cofinity Commercial |
$545.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$443.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.20
|
| Rate for Payer: Healthscope Commercial |
$570.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$443.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$538.90
|
| Rate for Payer: PHP Commercial |
$538.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.10
|
| Rate for Payer: Priority Health SBD |
$399.42
|
| Rate for Payer: UMR Bronson Commercial |
$278.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.50
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 12053
|
| Hospital Charge Code |
12053
|
| Min. Negotiated Rate |
$203.68 |
| Max. Negotiated Rate |
$412.10 |
| Rate for Payer: Aetna Commercial |
$272.93
|
| Rate for Payer: Aetna Medicare |
$211.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.93
|
| Rate for Payer: BCBS Complete |
$253.60
|
| Rate for Payer: BCBS MAPPO |
$203.68
|
| Rate for Payer: BCN Medicare Advantage |
$203.68
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$272.93
|
| Rate for Payer: Cofinity Commercial |
$293.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.86
|
| Rate for Payer: Nomi Health Commercial |
$244.42
|
| Rate for Payer: PACE SWMI |
$203.68
|
| Rate for Payer: PHP Commercial |
$285.15
|
| Rate for Payer: PHP Medicare Advantage |
$203.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.10
|
| Rate for Payer: Priority Health Medicare |
$203.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.68
|
| Rate for Payer: UHC Medicare Advantage |
$203.68
|
| Rate for Payer: UMR Bronson Commercial |
$291.64
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM
|
Facility
|
OP
|
$634.00
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
12053
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$412.10
|
| Rate for Payer: Aetna Commercial |
$538.90
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$443.80
|
| Rate for Payer: Cofinity Commercial |
$545.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$443.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$570.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$443.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.50
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$538.90
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$538.90
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.10
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$399.42
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$234.58
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.50
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 12053
|
| Min. Negotiated Rate |
$203.68 |
| Max. Negotiated Rate |
$412.10 |
| Rate for Payer: Aetna Commercial |
$272.93
|
| Rate for Payer: Aetna Medicare |
$211.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.93
|
| Rate for Payer: BCBS Complete |
$253.60
|
| Rate for Payer: BCBS MAPPO |
$203.68
|
| Rate for Payer: BCN Medicare Advantage |
$203.68
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$293.30
|
| Rate for Payer: Cofinity Commercial |
$272.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.86
|
| Rate for Payer: Nomi Health Commercial |
$244.42
|
| Rate for Payer: PACE SWMI |
$203.68
|
| Rate for Payer: PHP Commercial |
$285.15
|
| Rate for Payer: PHP Medicare Advantage |
$203.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.10
|
| Rate for Payer: Priority Health Medicare |
$203.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.68
|
| Rate for Payer: UHC Medicare Advantage |
$203.68
|
| Rate for Payer: UMR Bronson Commercial |
$291.64
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 12054
|
| Min. Negotiated Rate |
$209.77 |
| Max. Negotiated Rate |
$517.40 |
| Rate for Payer: Aetna Commercial |
$281.09
|
| Rate for Payer: Aetna Medicare |
$218.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.09
|
| Rate for Payer: BCBS Complete |
$318.40
|
| Rate for Payer: BCBS MAPPO |
$209.77
|
| Rate for Payer: BCN Medicare Advantage |
$209.77
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$302.07
|
| Rate for Payer: Cofinity Commercial |
$281.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.26
|
| Rate for Payer: Nomi Health Commercial |
$251.72
|
| Rate for Payer: PACE SWMI |
$209.77
|
| Rate for Payer: PHP Commercial |
$293.68
|
| Rate for Payer: PHP Medicare Advantage |
$209.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.40
|
| Rate for Payer: Priority Health Medicare |
$209.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.77
|
| Rate for Payer: UHC Medicare Advantage |
$209.77
|
| Rate for Payer: UMR Bronson Commercial |
$366.16
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
CPT 12054
|
| Hospital Charge Code |
12054
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$350.24 |
| Max. Negotiated Rate |
$716.40 |
| Rate for Payer: Aetna American Axle |
$517.40
|
| Rate for Payer: Aetna Commercial |
$676.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.40
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$557.20
|
| Rate for Payer: Cofinity Commercial |
$684.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$557.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.80
|
| Rate for Payer: Healthscope Commercial |
$716.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$557.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$597.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.60
|
| Rate for Payer: PHP Commercial |
$676.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.40
|
| Rate for Payer: Priority Health SBD |
$501.48
|
| Rate for Payer: UMR Bronson Commercial |
$350.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$597.00
|
|
|
PR REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
CPT 12054
|
| Hospital Charge Code |
12054
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$517.40
|
| Rate for Payer: Aetna Commercial |
$676.60
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$557.20
|
| Rate for Payer: Cofinity Commercial |
$684.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$557.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$716.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$557.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$597.00
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.60
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$676.60
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.40
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$501.48
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$294.52
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$597.00
|
|
