|
PR SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,198.00
|
|
|
Service Code
|
HCPCS 43415
|
| Min. Negotiated Rate |
$1,539.78 |
| Max. Negotiated Rate |
$4,639.88 |
| Rate for Payer: Aetna Commercial |
$3,230.85
|
| Rate for Payer: Aetna Medicare |
$2,507.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,230.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,471.96
|
| Rate for Payer: BCBS Complete |
$1,616.77
|
| Rate for Payer: BCBS MAPPO |
$2,411.08
|
| Rate for Payer: BCN Commercial |
$3,808.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,411.08
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cofinity Commercial |
$3,230.85
|
| Rate for Payer: Cofinity Commercial |
$3,471.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,411.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,531.63
|
| Rate for Payer: Meridian Medicaid |
$1,616.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,652.19
|
| Rate for Payer: Nomi Health Commercial |
$2,893.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.50
|
| Rate for Payer: PACE SWMI |
$2,411.08
|
| Rate for Payer: PHP Commercial |
$3,375.51
|
| Rate for Payer: PHP Medicare Advantage |
$2,411.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,539.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,639.88
|
| Rate for Payer: Priority Health Medicare |
$2,411.08
|
| Rate for Payer: Priority Health SBD |
$4,639.88
|
| Rate for Payer: Priority Health Tiered Network |
$4,639.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,411.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,576.83
|
| Rate for Payer: UHC Core |
$4,576.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,411.08
|
| Rate for Payer: UHC Exchange |
$4,576.83
|
| Rate for Payer: UHC Medicaid |
$1,539.78
|
| Rate for Payer: UHCCP Medicaid |
$1,539.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,931.08
|
|
|
PR SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 27381
|
| Min. Negotiated Rate |
$494.37 |
| Max. Negotiated Rate |
$1,410.01 |
| Rate for Payer: Aetna Commercial |
$1,010.45
|
| Rate for Payer: Aetna Medicare |
$784.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,085.86
|
| Rate for Payer: BCBS Complete |
$519.09
|
| Rate for Payer: BCBS MAPPO |
$754.07
|
| Rate for Payer: BCN Commercial |
$1,247.94
|
| Rate for Payer: BCN Medicare Advantage |
$754.07
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$1,010.45
|
| Rate for Payer: Cofinity Commercial |
$1,085.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$791.77
|
| Rate for Payer: Meridian Medicaid |
$519.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$829.48
|
| Rate for Payer: Nomi Health Commercial |
$904.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$754.07
|
| Rate for Payer: PHP Commercial |
$1,055.70
|
| Rate for Payer: PHP Medicare Advantage |
$754.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,334.01
|
| Rate for Payer: Priority Health Medicare |
$754.07
|
| Rate for Payer: Priority Health SBD |
$1,334.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,334.01
|
| Rate for Payer: Railroad Medicare Medicare |
$754.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,410.01
|
| Rate for Payer: UHC Core |
$1,410.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$754.07
|
| Rate for Payer: UHC Exchange |
$1,410.01
|
| Rate for Payer: UHC Medicaid |
$494.37
|
| Rate for Payer: UHCCP Medicaid |
$494.37
|
| Rate for Payer: UMR Bronson Commercial |
$751.64
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY
|
Professional
|
Both
|
$3,026.00
|
|
|
Service Code
|
HCPCS 44605
|
| Min. Negotiated Rate |
$776.60 |
| Max. Negotiated Rate |
$2,348.75 |
| Rate for Payer: Aetna Commercial |
$1,629.31
|
| Rate for Payer: Aetna Medicare |
$1,264.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,750.90
|
| Rate for Payer: BCBS Complete |
$815.43
|
| Rate for Payer: BCBS MAPPO |
$1,215.90
|
| Rate for Payer: BCN Commercial |
$1,927.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.90
|
| Rate for Payer: Cash Price |
$2,420.80
|
| Rate for Payer: Cash Price |
$2,420.80
|
| Rate for Payer: Cofinity Commercial |
$1,629.31
|
| Rate for Payer: Cofinity Commercial |
$1,750.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.69
|
| Rate for Payer: Meridian Medicaid |
$815.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,337.49
|
| Rate for Payer: Nomi Health Commercial |
$1,459.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,269.50
|
| Rate for Payer: PACE SWMI |
$1,215.90
|
| Rate for Payer: PHP Commercial |
$1,702.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$776.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,348.75
|
| Rate for Payer: Priority Health Medicare |
$1,215.90
|
| Rate for Payer: Priority Health SBD |
$2,348.75
|
| Rate for Payer: Priority Health Tiered Network |
$2,348.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,215.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,322.88
|
| Rate for Payer: UHC Core |
$2,322.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,215.90
|
| Rate for Payer: UHC Exchange |
$2,322.88
|
| Rate for Payer: UHC Medicaid |
$776.60
|
| Rate for Payer: UHCCP Medicaid |
$776.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,391.96
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY
|
Professional
|
Both
|
$3,173.00
|
|
|
Service Code
|
HCPCS 44604
|
| Min. Negotiated Rate |
$621.53 |
| Max. Negotiated Rate |
$2,379.75 |
| Rate for Payer: Aetna Commercial |
$1,302.63
|
| Rate for Payer: Aetna Medicare |
$1,010.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.84
|
| Rate for Payer: BCBS Complete |
$652.61
|
| Rate for Payer: BCBS MAPPO |
$972.11
|
| Rate for Payer: BCN Commercial |
$1,577.10
|
| Rate for Payer: BCN Medicare Advantage |
$972.11
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$1,302.63
|
| Rate for Payer: Cofinity Commercial |
$1,399.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,020.72
|
| Rate for Payer: Meridian Medicaid |
$652.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,069.32
|
| Rate for Payer: Nomi Health Commercial |
$1,166.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.75
|
| Rate for Payer: PACE SWMI |
$972.11
|
| Rate for Payer: PHP Commercial |
$1,360.95
|
| Rate for Payer: PHP Medicare Advantage |
$972.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,921.59
|
| Rate for Payer: Priority Health Medicare |
$972.11
|
| Rate for Payer: Priority Health SBD |
$1,921.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,921.59
|
| Rate for Payer: Railroad Medicare Medicare |
$972.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,886.70
|
| Rate for Payer: UHC Core |
$1,886.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$972.11
|
| Rate for Payer: UHC Exchange |
$1,886.70
|
| Rate for Payer: UHC Medicaid |
$621.53
|
| Rate for Payer: UHCCP Medicaid |
$621.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,459.58
|
|
|
PR SUTR&/LIG THORACIC DUCT CERVICAL APPROACH
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 38380
|
| Min. Negotiated Rate |
$330.58 |
| Max. Negotiated Rate |
$1,166.19 |
| Rate for Payer: Aetna Commercial |
$679.18
|
| Rate for Payer: Aetna Medicare |
$527.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.86
|
| Rate for Payer: BCBS Complete |
$347.11
|
| Rate for Payer: BCBS MAPPO |
$506.85
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$506.85
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$679.18
|
| Rate for Payer: Cofinity Commercial |
$729.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.19
|
| Rate for Payer: Meridian Medicaid |
$347.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.53
|
| Rate for Payer: Nomi Health Commercial |
$608.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$942.00
|
| Rate for Payer: PACE SWMI |
$506.85
|
| Rate for Payer: PHP Commercial |
$709.59
|
| Rate for Payer: PHP Medicare Advantage |
$506.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,166.19
|
| Rate for Payer: Priority Health Medicare |
$506.85
|
| Rate for Payer: Priority Health SBD |
$1,166.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,166.19
|
| Rate for Payer: Railroad Medicare Medicare |
$506.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$992.39
|
| Rate for Payer: UHC Core |
$992.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.85
|
| Rate for Payer: UHC Exchange |
$992.39
|
| Rate for Payer: UHC Medicaid |
$330.58
|
| Rate for Payer: UHCCP Medicaid |
$330.58
|
| Rate for Payer: UMR Bronson Commercial |
$577.76
|
|
|
PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH
|
Professional
|
Both
|
$6,105.00
|
|
|
Service Code
|
HCPCS 38381
|
| Min. Negotiated Rate |
$492.03 |
| Max. Negotiated Rate |
$4,578.75 |
| Rate for Payer: Aetna Commercial |
$1,025.80
|
| Rate for Payer: Aetna Medicare |
$796.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.35
|
| Rate for Payer: BCBS Complete |
$516.63
|
| Rate for Payer: BCBS MAPPO |
$765.52
|
| Rate for Payer: BCN Commercial |
$1,207.61
|
| Rate for Payer: BCN Medicare Advantage |
$765.52
|
| Rate for Payer: Cash Price |
$4,884.00
|
| Rate for Payer: Cash Price |
$4,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,025.80
|
| Rate for Payer: Cofinity Commercial |
$1,102.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.80
|
| Rate for Payer: Meridian Medicaid |
$516.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$842.07
|
| Rate for Payer: Nomi Health Commercial |
$918.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,578.75
|
| Rate for Payer: PACE SWMI |
$765.52
|
| Rate for Payer: PHP Commercial |
$1,071.73
|
| Rate for Payer: PHP Medicare Advantage |
$765.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,606.81
|
| Rate for Payer: Priority Health Medicare |
$765.52
|
| Rate for Payer: Priority Health SBD |
$1,606.81
|
| Rate for Payer: Priority Health Tiered Network |
$1,606.81
|
| Rate for Payer: Railroad Medicare Medicare |
$765.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,422.31
|
| Rate for Payer: UHC Core |
$1,422.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$765.52
|
| Rate for Payer: UHC Exchange |
$1,422.31
|
| Rate for Payer: UHC Medicaid |
$492.03
|
| Rate for Payer: UHCCP Medicaid |
$492.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,808.30
|
|
|
PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE
|
Professional
|
Both
|
$2,117.00
|
|
|
Service Code
|
HCPCS 69740
|
| Min. Negotiated Rate |
$649.86 |
| Max. Negotiated Rate |
$1,999.80 |
| Rate for Payer: Aetna Commercial |
$1,330.93
|
| Rate for Payer: Aetna Medicare |
$1,032.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.25
|
| Rate for Payer: BCBS Complete |
$682.35
|
| Rate for Payer: BCBS MAPPO |
$993.23
|
| Rate for Payer: BCN Commercial |
$1,731.98
|
| Rate for Payer: BCN Medicare Advantage |
$993.23
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Cofinity Commercial |
$1,330.93
|
| Rate for Payer: Cofinity Commercial |
$1,430.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.89
|
| Rate for Payer: Meridian Medicaid |
$682.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,092.55
|
| Rate for Payer: Nomi Health Commercial |
$1,191.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.75
|
| Rate for Payer: PACE SWMI |
$993.23
|
| Rate for Payer: PHP Commercial |
$1,390.52
|
| Rate for Payer: PHP Medicare Advantage |
$993.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,711.36
|
| Rate for Payer: Priority Health Medicare |
$993.23
|
| Rate for Payer: Priority Health SBD |
$1,711.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,711.36
|
| Rate for Payer: Railroad Medicare Medicare |
$993.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,999.80
|
| Rate for Payer: UHC Core |
$1,999.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$993.23
|
| Rate for Payer: UHC Exchange |
$1,999.80
|
| Rate for Payer: UHC Medicaid |
$649.86
|
| Rate for Payer: UHCCP Medicaid |
$649.86
|
| Rate for Payer: UMR Bronson Commercial |
$973.82
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS
|
Professional
|
Both
|
$3,270.00
|
|
|
Service Code
|
HCPCS 64857
|
| Min. Negotiated Rate |
$602.58 |
| Max. Negotiated Rate |
$2,452.50 |
| Rate for Payer: Aetna Commercial |
$1,247.49
|
| Rate for Payer: Aetna Medicare |
$968.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.58
|
| Rate for Payer: BCBS Complete |
$632.71
|
| Rate for Payer: BCBS MAPPO |
$930.96
|
| Rate for Payer: BCN Commercial |
$1,582.09
|
| Rate for Payer: BCN Medicare Advantage |
$930.96
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cofinity Commercial |
$1,247.49
|
| Rate for Payer: Cofinity Commercial |
$1,340.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.51
|
| Rate for Payer: Meridian Medicaid |
$632.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,024.06
|
| Rate for Payer: Nomi Health Commercial |
$1,117.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,452.50
|
| Rate for Payer: PACE SWMI |
$930.96
|
| Rate for Payer: PHP Commercial |
$1,303.34
|
| Rate for Payer: PHP Medicare Advantage |
$930.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,837.57
|
| Rate for Payer: Priority Health Medicare |
$930.96
|
| Rate for Payer: Priority Health SBD |
$1,837.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,837.57
|
| Rate for Payer: Railroad Medicare Medicare |
$930.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.45
|
| Rate for Payer: UHC Core |
$1,848.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$930.96
|
| Rate for Payer: UHC Exchange |
$1,848.45
|
| Rate for Payer: UHC Medicaid |
$602.58
|
| Rate for Payer: UHCCP Medicaid |
$602.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,504.20
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS
|
Professional
|
Both
|
$4,072.00
|
|
|
Service Code
|
HCPCS 64856
|
| Min. Negotiated Rate |
$586.39 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Aetna Commercial |
$1,215.71
|
| Rate for Payer: Aetna Medicare |
$943.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,215.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.44
|
| Rate for Payer: BCBS Complete |
$615.71
|
| Rate for Payer: BCBS MAPPO |
$907.25
|
| Rate for Payer: BCN Commercial |
$1,526.31
|
| Rate for Payer: BCN Medicare Advantage |
$907.25
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cofinity Commercial |
$1,215.71
|
| Rate for Payer: Cofinity Commercial |
$1,306.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$952.61
|
| Rate for Payer: Meridian Medicaid |
$615.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.98
|
| Rate for Payer: Nomi Health Commercial |
$1,088.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,054.00
|
| Rate for Payer: PACE SWMI |
$907.25
|
| Rate for Payer: PHP Commercial |
$1,270.15
|
| Rate for Payer: PHP Medicare Advantage |
$907.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$586.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,772.78
|
| Rate for Payer: Priority Health Medicare |
$907.25
|
| Rate for Payer: Priority Health SBD |
$1,772.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,772.78
|
| Rate for Payer: Railroad Medicare Medicare |
$907.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.71
|
| Rate for Payer: UHC Core |
$1,774.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$907.25
|
| Rate for Payer: UHC Exchange |
$1,774.71
|
| Rate for Payer: UHC Medicaid |
$586.39
|
| Rate for Payer: UHCCP Medicaid |
$586.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,873.12
|
|
|
PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,412.00
|
|
|
Service Code
|
HCPCS 27386
|
| Min. Negotiated Rate |
$514.82 |
| Max. Negotiated Rate |
$1,809.00 |
| Rate for Payer: Aetna Commercial |
$1,051.38
|
| Rate for Payer: Aetna Medicare |
$815.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.84
|
| Rate for Payer: BCBS Complete |
$540.56
|
| Rate for Payer: BCBS MAPPO |
$784.61
|
| Rate for Payer: BCN Commercial |
$1,302.22
|
| Rate for Payer: BCN Medicare Advantage |
$784.61
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cofinity Commercial |
$1,051.38
|
| Rate for Payer: Cofinity Commercial |
$1,129.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$823.84
|
| Rate for Payer: Meridian Medicaid |
$540.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$863.07
|
| Rate for Payer: Nomi Health Commercial |
$941.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.00
|
| Rate for Payer: PACE SWMI |
$784.61
|
| Rate for Payer: PHP Commercial |
$1,098.45
|
| Rate for Payer: PHP Medicare Advantage |
$784.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,392.04
|
| Rate for Payer: Priority Health Medicare |
$784.61
|
| Rate for Payer: Priority Health SBD |
$1,392.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,392.04
|
| Rate for Payer: Railroad Medicare Medicare |
$784.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,472.21
|
| Rate for Payer: UHC Core |
$1,472.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$784.61
|
| Rate for Payer: UHC Exchange |
$1,472.21
|
| Rate for Payer: UHC Medicaid |
$514.82
|
| Rate for Payer: UHCCP Medicaid |
$514.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,109.52
|
|
|
PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP
|
Professional
|
Both
|
$2,269.00
|
|
|
Service Code
|
HCPCS 33320
|
| Min. Negotiated Rate |
$648.80 |
| Max. Negotiated Rate |
$1,870.50 |
| Rate for Payer: Aetna Commercial |
$1,359.08
|
| Rate for Payer: Aetna Medicare |
$1,054.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,460.51
|
| Rate for Payer: BCBS Complete |
$681.24
|
| Rate for Payer: BCBS MAPPO |
$1,014.24
|
| Rate for Payer: BCN Commercial |
$1,581.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.24
|
| Rate for Payer: Cash Price |
$1,815.20
|
| Rate for Payer: Cash Price |
$1,815.20
|
| Rate for Payer: Cofinity Commercial |
$1,359.08
|
| Rate for Payer: Cofinity Commercial |
$1,460.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,064.95
|
| Rate for Payer: Meridian Medicaid |
$681.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,115.66
|
| Rate for Payer: Nomi Health Commercial |
$1,217.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,701.75
|
| Rate for Payer: PACE SWMI |
$1,014.24
|
| Rate for Payer: PHP Commercial |
$1,419.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,700.26
|
| Rate for Payer: Priority Health Medicare |
$1,014.24
|
| Rate for Payer: Priority Health SBD |
$1,700.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,700.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,014.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,870.50
|
| Rate for Payer: UHC Core |
$1,870.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,014.24
|
| Rate for Payer: UHC Exchange |
$1,870.50
|
| Rate for Payer: UHC Medicaid |
$648.80
|
| Rate for Payer: UHCCP Medicaid |
$648.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,043.74
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$889.50 |
| Rate for Payer: Aetna Commercial |
$480.38
|
| Rate for Payer: Aetna Medicare |
$372.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.23
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$358.49
|
| Rate for Payer: BCN Commercial |
$648.38
|
| Rate for Payer: BCN Medicare Advantage |
$358.49
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$480.38
|
| Rate for Payer: Cofinity Commercial |
$516.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.41
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$394.34
|
| Rate for Payer: Nomi Health Commercial |
$430.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.50
|
| Rate for Payer: PACE SWMI |
$358.49
|
| Rate for Payer: PHP Commercial |
$501.89
|
| Rate for Payer: PHP Medicare Advantage |
$358.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$759.46
|
| Rate for Payer: Priority Health Medicare |
$358.49
|
| Rate for Payer: Priority Health SBD |
$759.46
|
| Rate for Payer: Priority Health Tiered Network |
$759.46
|
| Rate for Payer: Railroad Medicare Medicare |
$358.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$756.17
|
| Rate for Payer: UHC Core |
$756.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$358.49
|
| Rate for Payer: UHC Exchange |
$756.17
|
| Rate for Payer: UHC Medicaid |
$234.94
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
| Rate for Payer: UMR Bronson Commercial |
$545.56
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 67930
|
| Min. Negotiated Rate |
$125.46 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$257.74
|
| Rate for Payer: Aetna Medicare |
$200.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.97
|
| Rate for Payer: BCBS Complete |
$131.73
|
| Rate for Payer: BCBS MAPPO |
$192.34
|
| Rate for Payer: BCN Commercial |
$348.59
|
| Rate for Payer: BCN Medicare Advantage |
$192.34
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$257.74
|
| Rate for Payer: Cofinity Commercial |
$276.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.96
|
| Rate for Payer: Meridian Medicaid |
$131.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$211.57
|
| Rate for Payer: Nomi Health Commercial |
$230.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$192.34
|
| Rate for Payer: PHP Commercial |
$269.28
|
| Rate for Payer: PHP Medicare Advantage |
$192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$408.32
|
| Rate for Payer: Priority Health Medicare |
$192.34
|
| Rate for Payer: Priority Health SBD |
$408.32
|
| Rate for Payer: Priority Health Tiered Network |
$408.32
|
| Rate for Payer: Railroad Medicare Medicare |
$192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.52
|
| Rate for Payer: UHC Core |
$410.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$192.34
|
| Rate for Payer: UHC Exchange |
$410.52
|
| Rate for Payer: UHC Medicaid |
$125.46
|
| Rate for Payer: UHCCP Medicaid |
$125.46
|
| Rate for Payer: UMR Bronson Commercial |
$362.48
|
|
|
PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 64834
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$1,661.25 |
| Rate for Payer: Aetna Commercial |
$866.62
|
| Rate for Payer: Aetna Medicare |
$672.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$866.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.29
|
| Rate for Payer: BCBS Complete |
$442.38
|
| Rate for Payer: BCBS MAPPO |
$646.73
|
| Rate for Payer: BCN Commercial |
$1,133.90
|
| Rate for Payer: BCN Medicare Advantage |
$646.73
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$866.62
|
| Rate for Payer: Cofinity Commercial |
$931.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.07
|
| Rate for Payer: Meridian Medicaid |
$442.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$711.40
|
| Rate for Payer: Nomi Health Commercial |
$776.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.25
|
| Rate for Payer: PACE SWMI |
$646.73
|
| Rate for Payer: PHP Commercial |
$905.42
|
| Rate for Payer: PHP Medicare Advantage |
$646.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,317.01
|
| Rate for Payer: Priority Health Medicare |
$646.73
|
| Rate for Payer: Priority Health SBD |
$1,317.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,317.01
|
| Rate for Payer: Railroad Medicare Medicare |
$646.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.28
|
| Rate for Payer: UHC Core |
$1,296.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$646.73
|
| Rate for Payer: UHC Exchange |
$1,296.28
|
| Rate for Payer: UHC Medicaid |
$421.31
|
| Rate for Payer: UHCCP Medicaid |
$421.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,018.90
|
|
|
PR SUTURE 1 NERVE MEDIAN MOTOR THENAR
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 64835
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$992.06
|
| Rate for Payer: Aetna Medicare |
$769.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.06
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$740.34
|
| Rate for Payer: BCN Commercial |
$1,239.47
|
| Rate for Payer: BCN Medicare Advantage |
$740.34
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$1,066.09
|
| Rate for Payer: Cofinity Commercial |
$992.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.36
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.37
|
| Rate for Payer: Nomi Health Commercial |
$888.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: PACE SWMI |
$740.34
|
| Rate for Payer: PHP Commercial |
$1,036.48
|
| Rate for Payer: PHP Medicare Advantage |
$740.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.62
|
| Rate for Payer: Priority Health Medicare |
$740.34
|
| Rate for Payer: Priority Health SBD |
$1,439.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,439.62
|
| Rate for Payer: Railroad Medicare Medicare |
$740.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.40
|
| Rate for Payer: UHC Core |
$1,430.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.34
|
| Rate for Payer: UHC Exchange |
$1,430.40
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,083.76
|
|
|
PR SUTURE 1 NERVE ULNAR MOTOR
|
Professional
|
Both
|
$1,859.00
|
|
|
Service Code
|
HCPCS 64836
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$1,439.62 |
| Rate for Payer: Aetna Commercial |
$992.06
|
| Rate for Payer: Aetna Medicare |
$769.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.06
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$740.34
|
| Rate for Payer: BCN Commercial |
$1,239.47
|
| Rate for Payer: BCN Medicare Advantage |
$740.34
|
| Rate for Payer: Cash Price |
$1,487.20
|
| Rate for Payer: Cash Price |
$1,487.20
|
| Rate for Payer: Cofinity Commercial |
$1,066.09
|
| Rate for Payer: Cofinity Commercial |
$992.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.36
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.37
|
| Rate for Payer: Nomi Health Commercial |
$888.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,394.25
|
| Rate for Payer: PACE SWMI |
$740.34
|
| Rate for Payer: PHP Commercial |
$1,036.48
|
| Rate for Payer: PHP Medicare Advantage |
$740.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.62
|
| Rate for Payer: Priority Health Medicare |
$740.34
|
| Rate for Payer: Priority Health SBD |
$1,439.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,439.62
|
| Rate for Payer: Railroad Medicare Medicare |
$740.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.40
|
| Rate for Payer: UHC Core |
$1,430.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.34
|
| Rate for Payer: UHC Exchange |
$1,430.40
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
| Rate for Payer: UMR Bronson Commercial |
$855.14
|
|
|
PR SUTURE BRACHIAL PLEXUS
|
Professional
|
Both
|
$3,816.00
|
|
|
Service Code
|
HCPCS 64861
|
| Min. Negotiated Rate |
$964.25 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Aetna Commercial |
$2,012.25
|
| Rate for Payer: Aetna Medicare |
$1,561.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,162.42
|
| Rate for Payer: BCBS Complete |
$1,012.46
|
| Rate for Payer: BCBS MAPPO |
$1,501.68
|
| Rate for Payer: BCN Commercial |
$2,327.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,501.68
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,012.25
|
| Rate for Payer: Cofinity Commercial |
$2,162.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,501.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,576.76
|
| Rate for Payer: Meridian Medicaid |
$1,012.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,651.85
|
| Rate for Payer: Nomi Health Commercial |
$1,802.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,862.00
|
| Rate for Payer: PACE SWMI |
$1,501.68
|
| Rate for Payer: PHP Commercial |
$2,102.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,501.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$964.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,703.43
|
| Rate for Payer: Priority Health Medicare |
$1,501.68
|
| Rate for Payer: Priority Health SBD |
$2,703.43
|
| Rate for Payer: Priority Health Tiered Network |
$2,703.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,501.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,664.72
|
| Rate for Payer: UHC Core |
$2,664.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,501.68
|
| Rate for Payer: UHC Exchange |
$2,664.72
|
| Rate for Payer: UHC Medicaid |
$964.25
|
| Rate for Payer: UHCCP Medicaid |
$964.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,755.36
|
|
|
PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$2,045.00
|
|
|
Service Code
|
HCPCS 64831
|
| Min. Negotiated Rate |
$410.45 |
| Max. Negotiated Rate |
$1,533.75 |
| Rate for Payer: Aetna Commercial |
$838.64
|
| Rate for Payer: Aetna Medicare |
$650.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.22
|
| Rate for Payer: BCBS Complete |
$430.97
|
| Rate for Payer: BCBS MAPPO |
$625.85
|
| Rate for Payer: BCN Commercial |
$1,060.21
|
| Rate for Payer: BCN Medicare Advantage |
$625.85
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cofinity Commercial |
$838.64
|
| Rate for Payer: Cofinity Commercial |
$901.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.14
|
| Rate for Payer: Meridian Medicaid |
$430.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.43
|
| Rate for Payer: Nomi Health Commercial |
$751.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.75
|
| Rate for Payer: PACE SWMI |
$625.85
|
| Rate for Payer: PHP Commercial |
$876.19
|
| Rate for Payer: PHP Medicare Advantage |
$625.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,231.41
|
| Rate for Payer: Priority Health Medicare |
$625.85
|
| Rate for Payer: Priority Health SBD |
$1,231.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,231.41
|
| Rate for Payer: Railroad Medicare Medicare |
$625.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.62
|
| Rate for Payer: UHC Core |
$1,198.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.85
|
| Rate for Payer: UHC Exchange |
$1,198.62
|
| Rate for Payer: UHC Medicaid |
$410.45
|
| Rate for Payer: UHCCP Medicaid |
$410.45
|
| Rate for Payer: UMR Bronson Commercial |
$940.70
|
|
|
PR SUTURE EACH ADDITIONAL NERVE HAND/FOOT
|
Professional
|
Both
|
$1,350.00
|
|
|
Service Code
|
HCPCS 64837
|
| Min. Negotiated Rate |
$198.73 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$324.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.69
|
| Rate for Payer: BCBS Complete |
$208.67
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCN Commercial |
$539.81
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Meridian Medicaid |
$208.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.75
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,012.50
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Commercial |
$436.23
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$626.99
|
| Rate for Payer: Priority Health Medicare |
$311.59
|
| Rate for Payer: Priority Health SBD |
$626.99
|
| Rate for Payer: Priority Health Tiered Network |
$626.99
|
| Rate for Payer: Railroad Medicare Medicare |
$311.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.32
|
| Rate for Payer: UHC Core |
$651.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.59
|
| Rate for Payer: UHC Exchange |
$651.32
|
| Rate for Payer: UHC Medicaid |
$198.73
|
| Rate for Payer: UHCCP Medicaid |
$198.73
|
| Rate for Payer: UMR Bronson Commercial |
$621.00
|
|
|
PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE
|
Professional
|
Both
|
$1,682.00
|
|
|
Service Code
|
HCPCS 64859
|
| Min. Negotiated Rate |
$135.26 |
| Max. Negotiated Rate |
$1,261.50 |
| Rate for Payer: Aetna Commercial |
$284.20
|
| Rate for Payer: Aetna Medicare |
$220.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.41
|
| Rate for Payer: BCBS Complete |
$142.02
|
| Rate for Payer: BCBS MAPPO |
$212.09
|
| Rate for Payer: BCN Commercial |
$366.51
|
| Rate for Payer: BCN Medicare Advantage |
$212.09
|
| Rate for Payer: Cash Price |
$1,345.60
|
| Rate for Payer: Cash Price |
$1,345.60
|
| Rate for Payer: Cofinity Commercial |
$284.20
|
| Rate for Payer: Cofinity Commercial |
$305.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.69
|
| Rate for Payer: Meridian Medicaid |
$142.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.30
|
| Rate for Payer: Nomi Health Commercial |
$254.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,261.50
|
| Rate for Payer: PACE SWMI |
$212.09
|
| Rate for Payer: PHP Commercial |
$296.93
|
| Rate for Payer: PHP Medicare Advantage |
$212.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$425.70
|
| Rate for Payer: Priority Health Medicare |
$212.09
|
| Rate for Payer: Priority Health SBD |
$425.70
|
| Rate for Payer: Priority Health Tiered Network |
$425.70
|
| Rate for Payer: Railroad Medicare Medicare |
$212.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.59
|
| Rate for Payer: UHC Core |
$442.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$212.09
|
| Rate for Payer: UHC Exchange |
$442.59
|
| Rate for Payer: UHC Medicaid |
$135.26
|
| Rate for Payer: UHCCP Medicaid |
$135.26
|
| Rate for Payer: UMR Bronson Commercial |
$773.72
|
|
|
PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY
|
Professional
|
Both
|
$3,139.00
|
|
|
Service Code
|
HCPCS 47900
|
| Min. Negotiated Rate |
$827.72 |
| Max. Negotiated Rate |
$2,524.10 |
| Rate for Payer: Aetna Commercial |
$1,729.70
|
| Rate for Payer: Aetna Medicare |
$1,342.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,729.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,858.78
|
| Rate for Payer: BCBS Complete |
$869.11
|
| Rate for Payer: BCBS MAPPO |
$1,290.82
|
| Rate for Payer: BCN Commercial |
$2,071.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,290.82
|
| Rate for Payer: Cash Price |
$2,511.20
|
| Rate for Payer: Cash Price |
$2,511.20
|
| Rate for Payer: Cofinity Commercial |
$1,729.70
|
| Rate for Payer: Cofinity Commercial |
$1,858.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,290.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,355.36
|
| Rate for Payer: Meridian Medicaid |
$869.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,419.90
|
| Rate for Payer: Nomi Health Commercial |
$1,548.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,354.25
|
| Rate for Payer: PACE SWMI |
$1,290.82
|
| Rate for Payer: PHP Commercial |
$1,807.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,290.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$827.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,524.10
|
| Rate for Payer: Priority Health Medicare |
$1,290.82
|
| Rate for Payer: Priority Health SBD |
$2,524.10
|
| Rate for Payer: Priority Health Tiered Network |
$2,524.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,290.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,433.48
|
| Rate for Payer: UHC Core |
$2,433.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,290.82
|
| Rate for Payer: UHC Exchange |
$2,433.48
|
| Rate for Payer: UHC Medicaid |
$827.72
|
| Rate for Payer: UHCCP Medicaid |
$827.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,443.94
|
|
|
PR SUTURE FACIAL NERVE EXTRACRANIAL
|
Professional
|
Both
|
$2,502.00
|
|
|
Service Code
|
HCPCS 64864
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$1,876.50 |
| Rate for Payer: Aetna Commercial |
$995.98
|
| Rate for Payer: Aetna Medicare |
$773.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,070.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.98
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$743.27
|
| Rate for Payer: BCN Commercial |
$1,294.26
|
| Rate for Payer: BCN Medicare Advantage |
$743.27
|
| Rate for Payer: Cash Price |
$2,001.60
|
| Rate for Payer: Cash Price |
$2,001.60
|
| Rate for Payer: Cofinity Commercial |
$1,070.31
|
| Rate for Payer: Cofinity Commercial |
$995.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$743.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$780.43
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$817.60
|
| Rate for Payer: Nomi Health Commercial |
$891.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,876.50
|
| Rate for Payer: PACE SWMI |
$743.27
|
| Rate for Payer: PHP Commercial |
$1,040.58
|
| Rate for Payer: PHP Medicare Advantage |
$743.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,503.26
|
| Rate for Payer: Priority Health Medicare |
$743.27
|
| Rate for Payer: Priority Health SBD |
$1,503.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,503.26
|
| Rate for Payer: Railroad Medicare Medicare |
$743.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,508.93
|
| Rate for Payer: UHC Core |
$1,508.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$743.27
|
| Rate for Payer: UHC Exchange |
$1,508.93
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,150.92
|
|
|
PR SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT
|
Professional
|
Both
|
$3,128.00
|
|
|
Service Code
|
HCPCS 64865
|
| Min. Negotiated Rate |
$604.49 |
| Max. Negotiated Rate |
$2,346.00 |
| Rate for Payer: Aetna Commercial |
$1,243.04
|
| Rate for Payer: Aetna Medicare |
$964.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,243.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,335.80
|
| Rate for Payer: BCBS Complete |
$634.71
|
| Rate for Payer: BCBS MAPPO |
$927.64
|
| Rate for Payer: BCN Commercial |
$1,618.44
|
| Rate for Payer: BCN Medicare Advantage |
$927.64
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cofinity Commercial |
$1,243.04
|
| Rate for Payer: Cofinity Commercial |
$1,335.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$927.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.02
|
| Rate for Payer: Meridian Medicaid |
$634.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,020.40
|
| Rate for Payer: Nomi Health Commercial |
$1,113.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,346.00
|
| Rate for Payer: PACE SWMI |
$927.64
|
| Rate for Payer: PHP Commercial |
$1,298.70
|
| Rate for Payer: PHP Medicare Advantage |
$927.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,879.78
|
| Rate for Payer: Priority Health Medicare |
$927.64
|
| Rate for Payer: Priority Health SBD |
$1,879.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,879.78
|
| Rate for Payer: Railroad Medicare Medicare |
$927.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,895.36
|
| Rate for Payer: UHC Core |
$1,895.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$927.64
|
| Rate for Payer: UHC Exchange |
$1,895.36
|
| Rate for Payer: UHC Medicaid |
$604.49
|
| Rate for Payer: UHCCP Medicaid |
$604.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,438.88
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,598.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$381.27 |
| Max. Negotiated Rate |
$1,198.50 |
| Rate for Payer: Aetna Commercial |
$774.23
|
| Rate for Payer: Aetna Medicare |
$600.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.00
|
| Rate for Payer: BCBS Complete |
$400.33
|
| Rate for Payer: BCBS MAPPO |
$577.78
|
| Rate for Payer: BCN Commercial |
$948.65
|
| Rate for Payer: BCN Medicare Advantage |
$577.78
|
| Rate for Payer: Cash Price |
$1,278.40
|
| Rate for Payer: Cash Price |
$1,278.40
|
| Rate for Payer: Cofinity Commercial |
$774.23
|
| Rate for Payer: Cofinity Commercial |
$832.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.67
|
| Rate for Payer: Meridian Medicaid |
$400.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.56
|
| Rate for Payer: Nomi Health Commercial |
$693.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.50
|
| Rate for Payer: PACE SWMI |
$577.78
|
| Rate for Payer: PHP Commercial |
$808.89
|
| Rate for Payer: PHP Medicare Advantage |
$577.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,014.08
|
| Rate for Payer: Priority Health Medicare |
$577.78
|
| Rate for Payer: Priority Health SBD |
$1,014.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,014.08
|
| Rate for Payer: Railroad Medicare Medicare |
$577.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.60
|
| Rate for Payer: UHC Core |
$1,054.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.78
|
| Rate for Payer: UHC Exchange |
$1,054.60
|
| Rate for Payer: UHC Medicaid |
$381.27
|
| Rate for Payer: UHCCP Medicaid |
$381.27
|
| Rate for Payer: UMR Bronson Commercial |
$735.08
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$452.41 |
| Max. Negotiated Rate |
$1,528.50 |
| Rate for Payer: Aetna Commercial |
$942.06
|
| Rate for Payer: Aetna Medicare |
$731.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.06
|
| Rate for Payer: BCBS Complete |
$475.03
|
| Rate for Payer: BCBS MAPPO |
$703.03
|
| Rate for Payer: BCN Commercial |
$1,127.93
|
| Rate for Payer: BCN Medicare Advantage |
$703.03
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cofinity Commercial |
$1,012.36
|
| Rate for Payer: Cofinity Commercial |
$942.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.18
|
| Rate for Payer: Meridian Medicaid |
$475.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.33
|
| Rate for Payer: Nomi Health Commercial |
$843.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,528.50
|
| Rate for Payer: PACE SWMI |
$703.03
|
| Rate for Payer: PHP Commercial |
$984.24
|
| Rate for Payer: PHP Medicare Advantage |
$703.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,374.31
|
| Rate for Payer: Priority Health Medicare |
$703.03
|
| Rate for Payer: Priority Health SBD |
$1,374.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,374.31
|
| Rate for Payer: Railroad Medicare Medicare |
$703.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.78
|
| Rate for Payer: UHC Core |
$1,324.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.03
|
| Rate for Payer: UHC Exchange |
$1,324.78
|
| Rate for Payer: UHC Medicaid |
$452.41
|
| Rate for Payer: UHCCP Medicaid |
$452.41
|
| Rate for Payer: UMR Bronson Commercial |
$937.48
|
|
