|
PR SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 99374
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$70.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.22
|
| Rate for Payer: Priority Health SBD |
$71.22
|
| Rate for Payer: Priority Health Tiered Network |
$71.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.67
|
| Rate for Payer: UHC Core |
$80.67
|
| Rate for Payer: UHC Exchange |
$80.67
|
| Rate for Payer: UMR Bronson Commercial |
$64.40
|
|
|
PR SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 31820
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Aetna Commercial |
$391.63
|
| Rate for Payer: Aetna Medicare |
$303.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.85
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCBS MAPPO |
$292.26
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$292.26
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$391.63
|
| Rate for Payer: Cofinity Commercial |
$420.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.87
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.49
|
| Rate for Payer: Nomi Health Commercial |
$350.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$567.00
|
| Rate for Payer: PACE SWMI |
$292.26
|
| Rate for Payer: PHP Commercial |
$409.16
|
| Rate for Payer: PHP Medicare Advantage |
$292.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$470.36
|
| Rate for Payer: Priority Health Medicare |
$292.26
|
| Rate for Payer: Priority Health SBD |
$470.36
|
| Rate for Payer: Priority Health Tiered Network |
$470.36
|
| Rate for Payer: Railroad Medicare Medicare |
$292.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.91
|
| Rate for Payer: UHC Core |
$564.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$292.26
|
| Rate for Payer: UHC Exchange |
$564.91
|
| Rate for Payer: UHC Medicaid |
$191.49
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
| Rate for Payer: UMR Bronson Commercial |
$347.76
|
|
|
PR SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 31825
|
| Min. Negotiated Rate |
$274.34 |
| Max. Negotiated Rate |
$828.99 |
| Rate for Payer: Aetna Commercial |
$563.20
|
| Rate for Payer: Aetna Medicare |
$437.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.23
|
| Rate for Payer: BCBS Complete |
$288.06
|
| Rate for Payer: BCBS MAPPO |
$420.30
|
| Rate for Payer: BCN Commercial |
$732.03
|
| Rate for Payer: BCN Medicare Advantage |
$420.30
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$563.20
|
| Rate for Payer: Cofinity Commercial |
$605.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.31
|
| Rate for Payer: Meridian Medicaid |
$288.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$462.33
|
| Rate for Payer: Nomi Health Commercial |
$504.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$420.30
|
| Rate for Payer: PHP Commercial |
$588.42
|
| Rate for Payer: PHP Medicare Advantage |
$420.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$689.35
|
| Rate for Payer: Priority Health Medicare |
$420.30
|
| Rate for Payer: Priority Health SBD |
$689.35
|
| Rate for Payer: Priority Health Tiered Network |
$689.35
|
| Rate for Payer: Railroad Medicare Medicare |
$420.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$828.99
|
| Rate for Payer: UHC Core |
$828.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.30
|
| Rate for Payer: UHC Exchange |
$828.99
|
| Rate for Payer: UHC Medicaid |
$274.34
|
| Rate for Payer: UHCCP Medicaid |
$274.34
|
| Rate for Payer: UMR Bronson Commercial |
$488.52
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$3,066.00
|
|
|
Service Code
|
HCPCS 29828
|
| Min. Negotiated Rate |
$538.04 |
| Max. Negotiated Rate |
$2,299.50 |
| Rate for Payer: Aetna Commercial |
$1,107.11
|
| Rate for Payer: Aetna Medicare |
$859.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,107.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,189.73
|
| Rate for Payer: BCBS Complete |
$564.94
|
| Rate for Payer: BCBS MAPPO |
$826.20
|
| Rate for Payer: BCN Commercial |
$1,389.36
|
| Rate for Payer: BCN Medicare Advantage |
$826.20
|
| Rate for Payer: Cash Price |
$2,452.80
|
| Rate for Payer: Cash Price |
$2,452.80
|
| Rate for Payer: Cofinity Commercial |
$1,107.11
|
| Rate for Payer: Cofinity Commercial |
$1,189.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$826.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$867.51
|
| Rate for Payer: Meridian Medicaid |
$564.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$908.82
|
| Rate for Payer: Nomi Health Commercial |
$991.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,299.50
|
| Rate for Payer: PACE SWMI |
$826.20
|
| Rate for Payer: PHP Commercial |
$1,156.68
|
| Rate for Payer: PHP Medicare Advantage |
$826.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,485.20
|
| Rate for Payer: Priority Health Medicare |
$826.20
|
| Rate for Payer: Priority Health SBD |
$1,485.20
|
| Rate for Payer: Priority Health Tiered Network |
$1,485.20
|
| Rate for Payer: Railroad Medicare Medicare |
$826.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,607.33
|
| Rate for Payer: UHC Core |
$1,607.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$826.20
|
| Rate for Payer: UHC Exchange |
$1,607.33
|
| Rate for Payer: UHC Medicaid |
$538.04
|
| Rate for Payer: UHCCP Medicaid |
$538.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,410.36
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$3,333.00
|
|
|
Service Code
|
HCPCS 29806
|
| Min. Negotiated Rate |
$620.47 |
| Max. Negotiated Rate |
$2,499.75 |
| Rate for Payer: Aetna Commercial |
$1,277.02
|
| Rate for Payer: Aetna Medicare |
$991.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.32
|
| Rate for Payer: BCBS Complete |
$651.49
|
| Rate for Payer: BCBS MAPPO |
$953.00
|
| Rate for Payer: BCN Commercial |
$1,604.50
|
| Rate for Payer: BCN Medicare Advantage |
$953.00
|
| Rate for Payer: Cash Price |
$2,666.40
|
| Rate for Payer: Cash Price |
$2,666.40
|
| Rate for Payer: Cofinity Commercial |
$1,277.02
|
| Rate for Payer: Cofinity Commercial |
$1,372.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.65
|
| Rate for Payer: Meridian Medicaid |
$651.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,048.30
|
| Rate for Payer: Nomi Health Commercial |
$1,143.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,499.75
|
| Rate for Payer: PACE SWMI |
$953.00
|
| Rate for Payer: PHP Commercial |
$1,334.20
|
| Rate for Payer: PHP Medicare Advantage |
$953.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,715.15
|
| Rate for Payer: Priority Health Medicare |
$953.00
|
| Rate for Payer: Priority Health SBD |
$1,715.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,715.15
|
| Rate for Payer: Railroad Medicare Medicare |
$953.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,850.94
|
| Rate for Payer: UHC Core |
$1,850.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$953.00
|
| Rate for Payer: UHC Exchange |
$1,850.94
|
| Rate for Payer: UHC Medicaid |
$620.47
|
| Rate for Payer: UHCCP Medicaid |
$620.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,533.18
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 29821
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$1,751.25 |
| Rate for Payer: Aetna Commercial |
$726.84
|
| Rate for Payer: Aetna Medicare |
$564.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.08
|
| Rate for Payer: BCBS Complete |
$373.27
|
| Rate for Payer: BCBS MAPPO |
$542.42
|
| Rate for Payer: BCN Commercial |
$908.32
|
| Rate for Payer: BCN Medicare Advantage |
$542.42
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$726.84
|
| Rate for Payer: Cofinity Commercial |
$781.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.54
|
| Rate for Payer: Meridian Medicaid |
$373.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$596.66
|
| Rate for Payer: Nomi Health Commercial |
$650.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,751.25
|
| Rate for Payer: PACE SWMI |
$542.42
|
| Rate for Payer: PHP Commercial |
$759.39
|
| Rate for Payer: PHP Medicare Advantage |
$542.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$970.97
|
| Rate for Payer: Priority Health Medicare |
$542.42
|
| Rate for Payer: Priority Health SBD |
$970.97
|
| Rate for Payer: Priority Health Tiered Network |
$970.97
|
| Rate for Payer: Railroad Medicare Medicare |
$542.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,032.62
|
| Rate for Payer: UHC Core |
$1,032.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$542.42
|
| Rate for Payer: UHC Exchange |
$1,032.62
|
| Rate for Payer: UHC Medicaid |
$355.50
|
| Rate for Payer: UHCCP Medicaid |
$355.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.10
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$2,166.00
|
|
|
Service Code
|
HCPCS 29824
|
| Min. Negotiated Rate |
$407.47 |
| Max. Negotiated Rate |
$1,624.50 |
| Rate for Payer: Aetna Commercial |
$832.84
|
| Rate for Payer: Aetna Medicare |
$646.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.99
|
| Rate for Payer: BCBS Complete |
$427.84
|
| Rate for Payer: BCBS MAPPO |
$621.52
|
| Rate for Payer: BCN Commercial |
$1,136.26
|
| Rate for Payer: BCN Medicare Advantage |
$621.52
|
| Rate for Payer: Cash Price |
$1,732.80
|
| Rate for Payer: Cash Price |
$1,732.80
|
| Rate for Payer: Cofinity Commercial |
$832.84
|
| Rate for Payer: Cofinity Commercial |
$894.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.60
|
| Rate for Payer: Meridian Medicaid |
$427.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$683.67
|
| Rate for Payer: Nomi Health Commercial |
$745.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,624.50
|
| Rate for Payer: PACE SWMI |
$621.52
|
| Rate for Payer: PHP Commercial |
$870.13
|
| Rate for Payer: PHP Medicare Advantage |
$621.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,105.65
|
| Rate for Payer: Priority Health Medicare |
$621.52
|
| Rate for Payer: Priority Health SBD |
$1,105.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,105.65
|
| Rate for Payer: Railroad Medicare Medicare |
$621.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,175.04
|
| Rate for Payer: UHC Core |
$1,175.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$621.52
|
| Rate for Payer: UHC Exchange |
$1,175.04
|
| Rate for Payer: UHC Medicaid |
$407.47
|
| Rate for Payer: UHCCP Medicaid |
$407.47
|
| Rate for Payer: UMR Bronson Commercial |
$996.36
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,267.00
|
|
|
Service Code
|
HCPCS 29822
|
| Min. Negotiated Rate |
$329.09 |
| Max. Negotiated Rate |
$1,700.25 |
| Rate for Payer: Aetna Commercial |
$671.65
|
| Rate for Payer: Aetna Medicare |
$521.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.77
|
| Rate for Payer: BCBS Complete |
$345.54
|
| Rate for Payer: BCBS MAPPO |
$501.23
|
| Rate for Payer: BCN Commercial |
$911.42
|
| Rate for Payer: BCN Medicare Advantage |
$501.23
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cofinity Commercial |
$671.65
|
| Rate for Payer: Cofinity Commercial |
$721.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.29
|
| Rate for Payer: Meridian Medicaid |
$345.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$551.35
|
| Rate for Payer: Nomi Health Commercial |
$601.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,700.25
|
| Rate for Payer: PACE SWMI |
$501.23
|
| Rate for Payer: PHP Commercial |
$701.72
|
| Rate for Payer: PHP Medicare Advantage |
$501.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$886.85
|
| Rate for Payer: Priority Health Medicare |
$501.23
|
| Rate for Payer: Priority Health SBD |
$886.85
|
| Rate for Payer: Priority Health Tiered Network |
$886.85
|
| Rate for Payer: Railroad Medicare Medicare |
$501.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,003.81
|
| Rate for Payer: UHC Core |
$1,003.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$501.23
|
| Rate for Payer: UHC Exchange |
$1,003.81
|
| Rate for Payer: UHC Medicaid |
$329.09
|
| Rate for Payer: UHCCP Medicaid |
$329.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.82
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$1,998.00
|
|
|
Service Code
|
HCPCS 29820
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$1,498.50 |
| Rate for Payer: Aetna Commercial |
$654.19
|
| Rate for Payer: Aetna Medicare |
$507.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.01
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCBS MAPPO |
$488.20
|
| Rate for Payer: BCN Commercial |
$818.18
|
| Rate for Payer: BCN Medicare Advantage |
$488.20
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cofinity Commercial |
$654.19
|
| Rate for Payer: Cofinity Commercial |
$703.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.61
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$537.02
|
| Rate for Payer: Nomi Health Commercial |
$585.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.50
|
| Rate for Payer: PACE SWMI |
$488.20
|
| Rate for Payer: PHP Commercial |
$683.48
|
| Rate for Payer: PHP Medicare Advantage |
$488.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$874.61
|
| Rate for Payer: Priority Health Medicare |
$488.20
|
| Rate for Payer: Priority Health SBD |
$874.61
|
| Rate for Payer: Priority Health Tiered Network |
$874.61
|
| Rate for Payer: Railroad Medicare Medicare |
$488.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.16
|
| Rate for Payer: UHC Core |
$935.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$488.20
|
| Rate for Payer: UHC Exchange |
$935.16
|
| Rate for Payer: UHC Medicaid |
$319.93
|
| Rate for Payer: UHCCP Medicaid |
$319.93
|
| Rate for Payer: UMR Bronson Commercial |
$919.08
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,066.00
|
|
|
Service Code
|
HCPCS 29819
|
| Min. Negotiated Rate |
$350.81 |
| Max. Negotiated Rate |
$1,549.50 |
| Rate for Payer: Aetna Commercial |
$717.11
|
| Rate for Payer: Aetna Medicare |
$556.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.63
|
| Rate for Payer: BCBS Complete |
$368.35
|
| Rate for Payer: BCBS MAPPO |
$535.16
|
| Rate for Payer: BCN Commercial |
$896.37
|
| Rate for Payer: BCN Medicare Advantage |
$535.16
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cofinity Commercial |
$717.11
|
| Rate for Payer: Cofinity Commercial |
$770.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.92
|
| Rate for Payer: Meridian Medicaid |
$368.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$588.68
|
| Rate for Payer: Nomi Health Commercial |
$642.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,549.50
|
| Rate for Payer: PACE SWMI |
$535.16
|
| Rate for Payer: PHP Commercial |
$749.22
|
| Rate for Payer: PHP Medicare Advantage |
$535.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$958.19
|
| Rate for Payer: Priority Health Medicare |
$535.16
|
| Rate for Payer: Priority Health SBD |
$958.19
|
| Rate for Payer: Priority Health Tiered Network |
$958.19
|
| Rate for Payer: Railroad Medicare Medicare |
$535.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.12
|
| Rate for Payer: UHC Core |
$1,021.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$535.16
|
| Rate for Payer: UHC Exchange |
$1,021.12
|
| Rate for Payer: UHC Medicaid |
$350.81
|
| Rate for Payer: UHCCP Medicaid |
$350.81
|
| Rate for Payer: UMR Bronson Commercial |
$950.36
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$3,166.00
|
|
|
Service Code
|
HCPCS 29807
|
| Min. Negotiated Rate |
$607.05 |
| Max. Negotiated Rate |
$2,374.50 |
| Rate for Payer: Aetna Commercial |
$1,248.61
|
| Rate for Payer: Aetna Medicare |
$969.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.79
|
| Rate for Payer: BCBS Complete |
$637.40
|
| Rate for Payer: BCBS MAPPO |
$931.80
|
| Rate for Payer: BCN Commercial |
$1,567.14
|
| Rate for Payer: BCN Medicare Advantage |
$931.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cofinity Commercial |
$1,248.61
|
| Rate for Payer: Cofinity Commercial |
$1,341.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$978.39
|
| Rate for Payer: Meridian Medicaid |
$637.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,024.98
|
| Rate for Payer: Nomi Health Commercial |
$1,118.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.50
|
| Rate for Payer: PACE SWMI |
$931.80
|
| Rate for Payer: PHP Commercial |
$1,304.52
|
| Rate for Payer: PHP Medicare Advantage |
$931.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$607.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,675.23
|
| Rate for Payer: Priority Health Medicare |
$931.80
|
| Rate for Payer: Priority Health SBD |
$1,675.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,675.23
|
| Rate for Payer: Railroad Medicare Medicare |
$931.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,809.57
|
| Rate for Payer: UHC Core |
$1,809.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$931.80
|
| Rate for Payer: UHC Exchange |
$1,809.57
|
| Rate for Payer: UHC Medicaid |
$607.05
|
| Rate for Payer: UHCCP Medicaid |
$607.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,456.36
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$2,234.00
|
|
|
Service Code
|
HCPCS 29825
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$1,675.50 |
| Rate for Payer: Aetna Commercial |
$721.39
|
| Rate for Payer: Aetna Medicare |
$559.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.22
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$538.35
|
| Rate for Payer: BCN Commercial |
$896.86
|
| Rate for Payer: BCN Medicare Advantage |
$538.35
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cofinity Commercial |
$721.39
|
| Rate for Payer: Cofinity Commercial |
$775.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.27
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$592.18
|
| Rate for Payer: Nomi Health Commercial |
$646.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,675.50
|
| Rate for Payer: PACE SWMI |
$538.35
|
| Rate for Payer: PHP Commercial |
$753.69
|
| Rate for Payer: PHP Medicare Advantage |
$538.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$958.72
|
| Rate for Payer: Priority Health Medicare |
$538.35
|
| Rate for Payer: Priority Health SBD |
$958.72
|
| Rate for Payer: Priority Health Tiered Network |
$958.72
|
| Rate for Payer: Railroad Medicare Medicare |
$538.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.12
|
| Rate for Payer: UHC Core |
$1,021.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$538.35
|
| Rate for Payer: UHC Exchange |
$1,021.12
|
| Rate for Payer: UHC Medicaid |
$352.94
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,027.64
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,501.00
|
|
|
Service Code
|
HCPCS 29827
|
| Min. Negotiated Rate |
$622.60 |
| Max. Negotiated Rate |
$2,625.75 |
| Rate for Payer: Aetna Commercial |
$1,283.10
|
| Rate for Payer: Aetna Medicare |
$995.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,283.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,378.86
|
| Rate for Payer: BCBS Complete |
$653.73
|
| Rate for Payer: BCBS MAPPO |
$957.54
|
| Rate for Payer: BCN Commercial |
$1,616.94
|
| Rate for Payer: BCN Medicare Advantage |
$957.54
|
| Rate for Payer: Cash Price |
$2,800.80
|
| Rate for Payer: Cash Price |
$2,800.80
|
| Rate for Payer: Cofinity Commercial |
$1,283.10
|
| Rate for Payer: Cofinity Commercial |
$1,378.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$957.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,005.42
|
| Rate for Payer: Meridian Medicaid |
$653.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,053.29
|
| Rate for Payer: Nomi Health Commercial |
$1,149.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,625.75
|
| Rate for Payer: PACE SWMI |
$957.54
|
| Rate for Payer: PHP Commercial |
$1,340.56
|
| Rate for Payer: PHP Medicare Advantage |
$957.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,728.47
|
| Rate for Payer: Priority Health Medicare |
$957.54
|
| Rate for Payer: Priority Health SBD |
$1,728.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,728.47
|
| Rate for Payer: Railroad Medicare Medicare |
$957.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.97
|
| Rate for Payer: UHC Core |
$1,874.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$957.54
|
| Rate for Payer: UHC Exchange |
$1,874.97
|
| Rate for Payer: UHC Medicaid |
$622.60
|
| Rate for Payer: UHCCP Medicaid |
$622.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,610.46
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 29823
|
| Min. Negotiated Rate |
$356.35 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$729.01
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.42
|
| Rate for Payer: BCBS Complete |
$374.17
|
| Rate for Payer: BCBS MAPPO |
$544.04
|
| Rate for Payer: BCN Commercial |
$994.03
|
| Rate for Payer: BCN Medicare Advantage |
$544.04
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$729.01
|
| Rate for Payer: Cofinity Commercial |
$783.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.24
|
| Rate for Payer: Meridian Medicaid |
$374.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.44
|
| Rate for Payer: Nomi Health Commercial |
$652.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
| Rate for Payer: PACE SWMI |
$544.04
|
| Rate for Payer: PHP Commercial |
$761.66
|
| Rate for Payer: PHP Medicare Advantage |
$544.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.25
|
| Rate for Payer: Priority Health Medicare |
$544.04
|
| Rate for Payer: Priority Health SBD |
$967.25
|
| Rate for Payer: Priority Health Tiered Network |
$967.25
|
| Rate for Payer: Railroad Medicare Medicare |
$544.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.10
|
| Rate for Payer: UHC Core |
$1,093.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.04
|
| Rate for Payer: UHC Exchange |
$1,093.10
|
| Rate for Payer: UHC Medicaid |
$356.35
|
| Rate for Payer: UHCCP Medicaid |
$356.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,196.46
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 29826
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$197.64
|
| Rate for Payer: Aetna Medicare |
$153.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.39
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$147.49
|
| Rate for Payer: BCN Commercial |
$202.24
|
| Rate for Payer: BCN Medicare Advantage |
$147.49
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$197.64
|
| Rate for Payer: Cofinity Commercial |
$212.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.86
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$162.24
|
| Rate for Payer: Nomi Health Commercial |
$176.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
| Rate for Payer: PACE SWMI |
$147.49
|
| Rate for Payer: PHP Commercial |
$206.49
|
| Rate for Payer: PHP Medicare Advantage |
$147.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$274.14
|
| Rate for Payer: Priority Health Medicare |
$147.49
|
| Rate for Payer: Priority Health SBD |
$274.14
|
| Rate for Payer: Priority Health Tiered Network |
$274.14
|
| Rate for Payer: Railroad Medicare Medicare |
$147.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.18
|
| Rate for Payer: UHC Core |
$309.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.49
|
| Rate for Payer: UHC Exchange |
$309.18
|
| Rate for Payer: UHC Medicaid |
$94.15
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,196.46
|
|
|
PR SURGICAL TRAYS
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS A4550
|
| Min. Negotiated Rate |
$7.79 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Aetna Commercial |
$15.00
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.00
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.79
|
| Rate for Payer: UHC Core |
$7.79
|
| Rate for Payer: UHC Exchange |
$7.79
|
| Rate for Payer: UMR Bronson Commercial |
$16.10
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI
|
Professional
|
Both
|
$5,843.00
|
|
|
Service Code
|
HCPCS 69706
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$4,382.25 |
| Rate for Payer: Aetna Commercial |
$273.31
|
| Rate for Payer: Aetna Medicare |
$212.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.70
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$203.96
|
| Rate for Payer: BCN Commercial |
$363.03
|
| Rate for Payer: BCN Medicare Advantage |
$203.96
|
| Rate for Payer: Cash Price |
$4,674.40
|
| Rate for Payer: Cash Price |
$4,674.40
|
| Rate for Payer: Cofinity Commercial |
$273.31
|
| Rate for Payer: Cofinity Commercial |
$293.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.16
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$224.36
|
| Rate for Payer: Nomi Health Commercial |
$244.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,382.25
|
| Rate for Payer: PACE SWMI |
$203.96
|
| Rate for Payer: PHP Commercial |
$285.54
|
| Rate for Payer: PHP Medicare Advantage |
$203.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$358.71
|
| Rate for Payer: Priority Health Medicare |
$203.96
|
| Rate for Payer: Priority Health SBD |
$358.71
|
| Rate for Payer: Priority Health Tiered Network |
$358.71
|
| Rate for Payer: Railroad Medicare Medicare |
$203.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.19
|
| Rate for Payer: UHC Core |
$439.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$203.96
|
| Rate for Payer: UHC Exchange |
$439.19
|
| Rate for Payer: UHC Medicaid |
$131.00
|
| Rate for Payer: UHCCP Medicaid |
$131.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,687.78
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI
|
Professional
|
Both
|
$5,653.00
|
|
|
Service Code
|
HCPCS 69705
|
| Min. Negotiated Rate |
$94.57 |
| Max. Negotiated Rate |
$4,239.75 |
| Rate for Payer: Aetna Commercial |
$196.99
|
| Rate for Payer: Aetna Medicare |
$152.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.69
|
| Rate for Payer: BCBS Complete |
$99.30
|
| Rate for Payer: BCBS MAPPO |
$147.01
|
| Rate for Payer: BCN Commercial |
$259.95
|
| Rate for Payer: BCN Medicare Advantage |
$147.01
|
| Rate for Payer: Cash Price |
$4,522.40
|
| Rate for Payer: Cash Price |
$4,522.40
|
| Rate for Payer: Cofinity Commercial |
$196.99
|
| Rate for Payer: Cofinity Commercial |
$211.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.36
|
| Rate for Payer: Meridian Medicaid |
$99.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.71
|
| Rate for Payer: Nomi Health Commercial |
$176.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,239.75
|
| Rate for Payer: PACE SWMI |
$147.01
|
| Rate for Payer: PHP Commercial |
$205.81
|
| Rate for Payer: PHP Medicare Advantage |
$147.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$256.85
|
| Rate for Payer: Priority Health Medicare |
$147.01
|
| Rate for Payer: Priority Health SBD |
$256.85
|
| Rate for Payer: Priority Health Tiered Network |
$256.85
|
| Rate for Payer: Railroad Medicare Medicare |
$147.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.57
|
| Rate for Payer: UHC Core |
$313.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.01
|
| Rate for Payer: UHC Exchange |
$313.57
|
| Rate for Payer: UHC Medicaid |
$94.57
|
| Rate for Payer: UHCCP Medicaid |
$94.57
|
| Rate for Payer: UMR Bronson Commercial |
$2,600.38
|
|
|
PR SURG OPENING,ESOPHAGUS,ABD APPRCH
|
Professional
|
Both
|
$2,871.00
|
|
|
Service Code
|
HCPCS 43350
|
| Min. Negotiated Rate |
$1,148.40 |
| Max. Negotiated Rate |
$2,153.25 |
| Rate for Payer: Aetna Medicare |
$1,435.50
|
| Rate for Payer: BCBS Complete |
$1,148.40
|
| Rate for Payer: Cash Price |
$2,296.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,153.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.66
|
|
|
PR SURG TX ANAL FISTULA 2ND STAGE
|
Professional
|
Both
|
$999.00
|
|
|
Service Code
|
HCPCS 46285
|
| Min. Negotiated Rate |
$272.21 |
| Max. Negotiated Rate |
$788.18 |
| Rate for Payer: Aetna Commercial |
$552.36
|
| Rate for Payer: Aetna Medicare |
$428.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.58
|
| Rate for Payer: BCBS Complete |
$285.82
|
| Rate for Payer: BCBS MAPPO |
$412.21
|
| Rate for Payer: BCN Commercial |
$646.88
|
| Rate for Payer: BCN Medicare Advantage |
$412.21
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cofinity Commercial |
$593.58
|
| Rate for Payer: Cofinity Commercial |
$552.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.82
|
| Rate for Payer: Meridian Medicaid |
$285.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$453.43
|
| Rate for Payer: Nomi Health Commercial |
$494.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.25
|
| Rate for Payer: PACE SWMI |
$412.21
|
| Rate for Payer: PHP Commercial |
$577.09
|
| Rate for Payer: PHP Medicare Advantage |
$412.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$788.18
|
| Rate for Payer: Priority Health Medicare |
$412.21
|
| Rate for Payer: Priority Health SBD |
$788.18
|
| Rate for Payer: Priority Health Tiered Network |
$788.18
|
| Rate for Payer: Railroad Medicare Medicare |
$412.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.28
|
| Rate for Payer: UHC Core |
$724.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.21
|
| Rate for Payer: UHC Exchange |
$724.28
|
| Rate for Payer: UHC Medicaid |
$272.21
|
| Rate for Payer: UHCCP Medicaid |
$272.21
|
| Rate for Payer: UMR Bronson Commercial |
$459.54
|
|
|
PR SURG TX ANAL FISTULA INTERSPHINCTERIC
|
Professional
|
Both
|
$1,354.00
|
|
|
Service Code
|
HCPCS 46275
|
| Min. Negotiated Rate |
$271.15 |
| Max. Negotiated Rate |
$1,015.50 |
| Rate for Payer: Aetna Commercial |
$550.22
|
| Rate for Payer: Aetna Medicare |
$427.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$591.28
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS MAPPO |
$410.61
|
| Rate for Payer: BCN Commercial |
$642.90
|
| Rate for Payer: BCN Medicare Advantage |
$410.61
|
| Rate for Payer: Cash Price |
$1,083.20
|
| Rate for Payer: Cash Price |
$1,083.20
|
| Rate for Payer: Cofinity Commercial |
$550.22
|
| Rate for Payer: Cofinity Commercial |
$591.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.14
|
| Rate for Payer: Meridian Medicaid |
$284.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$451.67
|
| Rate for Payer: Nomi Health Commercial |
$492.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,015.50
|
| Rate for Payer: PACE SWMI |
$410.61
|
| Rate for Payer: PHP Commercial |
$574.85
|
| Rate for Payer: PHP Medicare Advantage |
$410.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$783.32
|
| Rate for Payer: Priority Health Medicare |
$410.61
|
| Rate for Payer: Priority Health SBD |
$783.32
|
| Rate for Payer: Priority Health Tiered Network |
$783.32
|
| Rate for Payer: Railroad Medicare Medicare |
$410.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.01
|
| Rate for Payer: UHC Core |
$725.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$410.61
|
| Rate for Payer: UHC Exchange |
$725.01
|
| Rate for Payer: UHC Medicaid |
$271.15
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
| Rate for Payer: UMR Bronson Commercial |
$622.84
|
|
|
PR SURG TX ANAL FISTULA SUBQ
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 46270
|
| Min. Negotiated Rate |
$260.29 |
| Max. Negotiated Rate |
$746.31 |
| Rate for Payer: Aetna Commercial |
$527.61
|
| Rate for Payer: Aetna Medicare |
$409.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.99
|
| Rate for Payer: BCBS Complete |
$273.30
|
| Rate for Payer: BCBS MAPPO |
$393.74
|
| Rate for Payer: BCN Commercial |
$612.52
|
| Rate for Payer: BCN Medicare Advantage |
$393.74
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$527.61
|
| Rate for Payer: Cofinity Commercial |
$566.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.43
|
| Rate for Payer: Meridian Medicaid |
$273.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.11
|
| Rate for Payer: Nomi Health Commercial |
$472.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.00
|
| Rate for Payer: PACE SWMI |
$393.74
|
| Rate for Payer: PHP Commercial |
$551.24
|
| Rate for Payer: PHP Medicare Advantage |
$393.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$746.31
|
| Rate for Payer: Priority Health Medicare |
$393.74
|
| Rate for Payer: Priority Health SBD |
$746.31
|
| Rate for Payer: Priority Health Tiered Network |
$746.31
|
| Rate for Payer: Railroad Medicare Medicare |
$393.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.01
|
| Rate for Payer: UHC Core |
$688.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$393.74
|
| Rate for Payer: UHC Exchange |
$688.01
|
| Rate for Payer: UHC Medicaid |
$260.29
|
| Rate for Payer: UHCCP Medicaid |
$260.29
|
| Rate for Payer: UMR Bronson Commercial |
$408.48
|
|
|
PR SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD
|
Professional
|
Both
|
$11,674.00
|
|
|
Service Code
|
HCPCS 33548
|
| Min. Negotiated Rate |
$1,770.03 |
| Max. Negotiated Rate |
$8,755.50 |
| Rate for Payer: Aetna Commercial |
$3,723.89
|
| Rate for Payer: Aetna Medicare |
$2,890.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,723.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,001.79
|
| Rate for Payer: BCBS Complete |
$1,858.53
|
| Rate for Payer: BCBS MAPPO |
$2,779.02
|
| Rate for Payer: BCN Commercial |
$4,318.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,779.02
|
| Rate for Payer: Cash Price |
$9,339.20
|
| Rate for Payer: Cash Price |
$9,339.20
|
| Rate for Payer: Cofinity Commercial |
$3,723.89
|
| Rate for Payer: Cofinity Commercial |
$4,001.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,779.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,917.97
|
| Rate for Payer: Meridian Medicaid |
$1,858.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,056.92
|
| Rate for Payer: Nomi Health Commercial |
$3,334.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,755.50
|
| Rate for Payer: PACE SWMI |
$2,779.02
|
| Rate for Payer: PHP Commercial |
$3,890.63
|
| Rate for Payer: PHP Medicare Advantage |
$2,779.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,770.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,644.52
|
| Rate for Payer: Priority Health Medicare |
$2,779.02
|
| Rate for Payer: Priority Health SBD |
$4,644.52
|
| Rate for Payer: Priority Health Tiered Network |
$4,644.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,779.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,284.15
|
| Rate for Payer: UHC Core |
$5,284.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,779.02
|
| Rate for Payer: UHC Exchange |
$5,284.15
|
| Rate for Payer: UHC Medicaid |
$1,770.03
|
| Rate for Payer: UHCCP Medicaid |
$1,770.03
|
| Rate for Payer: UMR Bronson Commercial |
$5,370.04
|
|
|
PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 64832
|
| Min. Negotiated Rate |
$179.56 |
| Max. Negotiated Rate |
$1,022.25 |
| Rate for Payer: Aetna Commercial |
$376.27
|
| Rate for Payer: Aetna Medicare |
$292.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.35
|
| Rate for Payer: BCBS Complete |
$188.54
|
| Rate for Payer: BCBS MAPPO |
$280.80
|
| Rate for Payer: BCN Commercial |
$493.00
|
| Rate for Payer: BCN Medicare Advantage |
$280.80
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$376.27
|
| Rate for Payer: Cofinity Commercial |
$404.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.84
|
| Rate for Payer: Meridian Medicaid |
$188.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.88
|
| Rate for Payer: Nomi Health Commercial |
$336.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,022.25
|
| Rate for Payer: PACE SWMI |
$280.80
|
| Rate for Payer: PHP Commercial |
$393.12
|
| Rate for Payer: PHP Medicare Advantage |
$280.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$572.61
|
| Rate for Payer: Priority Health Medicare |
$280.80
|
| Rate for Payer: Priority Health SBD |
$572.61
|
| Rate for Payer: Priority Health Tiered Network |
$572.61
|
| Rate for Payer: Railroad Medicare Medicare |
$280.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.56
|
| Rate for Payer: UHC Core |
$594.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.80
|
| Rate for Payer: UHC Exchange |
$594.56
|
| Rate for Payer: UHC Medicaid |
$179.56
|
| Rate for Payer: UHCCP Medicaid |
$179.56
|
| Rate for Payer: UMR Bronson Commercial |
$626.98
|
|
|
PR SUTR ESOPHGL WND/INJ CRV APPR
|
Professional
|
Both
|
$2,941.00
|
|
|
Service Code
|
HCPCS 43410
|
| Min. Negotiated Rate |
$575.31 |
| Max. Negotiated Rate |
$2,205.75 |
| Rate for Payer: Aetna Commercial |
$1,188.65
|
| Rate for Payer: Aetna Medicare |
$922.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.35
|
| Rate for Payer: BCBS Complete |
$604.08
|
| Rate for Payer: BCBS MAPPO |
$887.05
|
| Rate for Payer: BCN Commercial |
$1,558.68
|
| Rate for Payer: BCN Medicare Advantage |
$887.05
|
| Rate for Payer: Cash Price |
$2,352.80
|
| Rate for Payer: Cash Price |
$2,352.80
|
| Rate for Payer: Cofinity Commercial |
$1,188.65
|
| Rate for Payer: Cofinity Commercial |
$1,277.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$887.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$931.40
|
| Rate for Payer: Meridian Medicaid |
$604.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$975.75
|
| Rate for Payer: Nomi Health Commercial |
$1,064.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,205.75
|
| Rate for Payer: PACE SWMI |
$887.05
|
| Rate for Payer: PHP Commercial |
$1,241.87
|
| Rate for Payer: PHP Medicare Advantage |
$887.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,899.16
|
| Rate for Payer: Priority Health Medicare |
$887.05
|
| Rate for Payer: Priority Health SBD |
$1,899.16
|
| Rate for Payer: Priority Health Tiered Network |
$1,899.16
|
| Rate for Payer: Railroad Medicare Medicare |
$887.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,786.91
|
| Rate for Payer: UHC Core |
$1,786.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$887.05
|
| Rate for Payer: UHC Exchange |
$1,786.91
|
| Rate for Payer: UHC Medicaid |
$575.31
|
| Rate for Payer: UHCCP Medicaid |
$575.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,352.86
|
|
