|
PR TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC
|
Professional
|
Both
|
$3,809.00
|
|
|
Service Code
|
HCPCS 35301
|
| Min. Negotiated Rate |
$654.12 |
| Max. Negotiated Rate |
$2,856.75 |
| Rate for Payer: Aetna Commercial |
$1,387.06
|
| Rate for Payer: Aetna Medicare |
$1,076.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,387.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,490.57
|
| Rate for Payer: BCBS Complete |
$686.83
|
| Rate for Payer: BCBS MAPPO |
$1,035.12
|
| Rate for Payer: BCN Commercial |
$1,649.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.12
|
| Rate for Payer: Cash Price |
$3,047.20
|
| Rate for Payer: Cash Price |
$3,047.20
|
| Rate for Payer: Cofinity Commercial |
$1,387.06
|
| Rate for Payer: Cofinity Commercial |
$1,490.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,086.88
|
| Rate for Payer: Meridian Medicaid |
$686.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,138.63
|
| Rate for Payer: Nomi Health Commercial |
$1,242.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,856.75
|
| Rate for Payer: PACE SWMI |
$1,035.12
|
| Rate for Payer: PHP Commercial |
$1,449.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,773.63
|
| Rate for Payer: Priority Health Medicare |
$1,035.12
|
| Rate for Payer: Priority Health SBD |
$1,773.63
|
| Rate for Payer: Priority Health Tiered Network |
$1,773.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,035.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,030.06
|
| Rate for Payer: UHC Core |
$2,030.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,035.12
|
| Rate for Payer: UHC Exchange |
$2,030.06
|
| Rate for Payer: UHC Medicaid |
$654.12
|
| Rate for Payer: UHCCP Medicaid |
$654.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,752.14
|
|
|
PR TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
|
Professional
|
Both
|
$4,876.00
|
|
|
Service Code
|
HCPCS 35331
|
| Min. Negotiated Rate |
$810.47 |
| Max. Negotiated Rate |
$3,657.00 |
| Rate for Payer: Aetna Commercial |
$1,726.80
|
| Rate for Payer: Aetna Medicare |
$1,340.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,726.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.67
|
| Rate for Payer: BCBS Complete |
$850.99
|
| Rate for Payer: BCBS MAPPO |
$1,288.66
|
| Rate for Payer: BCN Commercial |
$2,113.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,288.66
|
| Rate for Payer: Cash Price |
$3,900.80
|
| Rate for Payer: Cash Price |
$3,900.80
|
| Rate for Payer: Cofinity Commercial |
$1,726.80
|
| Rate for Payer: Cofinity Commercial |
$1,855.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,288.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,353.09
|
| Rate for Payer: Meridian Medicaid |
$850.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,417.53
|
| Rate for Payer: Nomi Health Commercial |
$1,546.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,657.00
|
| Rate for Payer: PACE SWMI |
$1,288.66
|
| Rate for Payer: PHP Commercial |
$1,804.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,288.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$810.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,273.27
|
| Rate for Payer: Priority Health Medicare |
$1,288.66
|
| Rate for Payer: Priority Health SBD |
$2,273.27
|
| Rate for Payer: Priority Health Tiered Network |
$2,273.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,288.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,609.18
|
| Rate for Payer: UHC Core |
$2,609.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,288.66
|
| Rate for Payer: UHC Exchange |
$2,609.18
|
| Rate for Payer: UHC Medicaid |
$810.47
|
| Rate for Payer: UHCCP Medicaid |
$810.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,242.96
|
|
|
PR TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 35363
|
| Min. Negotiated Rate |
$941.25 |
| Max. Negotiated Rate |
$2,925.22 |
| Rate for Payer: Aetna Commercial |
$2,006.58
|
| Rate for Payer: Aetna Medicare |
$1,557.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,006.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,156.33
|
| Rate for Payer: BCBS Complete |
$988.31
|
| Rate for Payer: BCBS MAPPO |
$1,497.45
|
| Rate for Payer: BCN Commercial |
$2,373.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,497.45
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cofinity Commercial |
$2,006.58
|
| Rate for Payer: Cofinity Commercial |
$2,156.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,497.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,572.32
|
| Rate for Payer: Meridian Medicaid |
$988.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,647.19
|
| Rate for Payer: Nomi Health Commercial |
$1,796.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,580.75
|
| Rate for Payer: PACE SWMI |
$1,497.45
|
| Rate for Payer: PHP Commercial |
$2,096.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,497.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$941.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,552.81
|
| Rate for Payer: Priority Health Medicare |
$1,497.45
|
| Rate for Payer: Priority Health SBD |
$2,552.81
|
| Rate for Payer: Priority Health Tiered Network |
$2,552.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,497.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,925.22
|
| Rate for Payer: UHC Core |
$2,925.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,497.45
|
| Rate for Payer: UHC Exchange |
$2,925.22
|
| Rate for Payer: UHC Medicaid |
$941.25
|
| Rate for Payer: UHCCP Medicaid |
$941.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,582.86
|
|
|
PR TEAEC W/WO PATCH GRAFT COMMON FEMORAL
|
Professional
|
Both
|
$1,804.00
|
|
|
Service Code
|
HCPCS 35371
|
| Min. Negotiated Rate |
$471.80 |
| Max. Negotiated Rate |
$1,465.55 |
| Rate for Payer: Aetna Commercial |
$999.99
|
| Rate for Payer: Aetna Medicare |
$776.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.99
|
| Rate for Payer: BCBS Complete |
$495.39
|
| Rate for Payer: BCBS MAPPO |
$746.26
|
| Rate for Payer: BCN Commercial |
$1,189.68
|
| Rate for Payer: BCN Medicare Advantage |
$746.26
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cofinity Commercial |
$1,074.61
|
| Rate for Payer: Cofinity Commercial |
$999.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.57
|
| Rate for Payer: Meridian Medicaid |
$495.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$820.89
|
| Rate for Payer: Nomi Health Commercial |
$895.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,353.00
|
| Rate for Payer: PACE SWMI |
$746.26
|
| Rate for Payer: PHP Commercial |
$1,044.76
|
| Rate for Payer: PHP Medicare Advantage |
$746.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,279.35
|
| Rate for Payer: Priority Health Medicare |
$746.26
|
| Rate for Payer: Priority Health SBD |
$1,279.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,279.35
|
| Rate for Payer: Railroad Medicare Medicare |
$746.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,465.55
|
| Rate for Payer: UHC Core |
$1,465.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$746.26
|
| Rate for Payer: UHC Exchange |
$1,465.55
|
| Rate for Payer: UHC Medicaid |
$471.80
|
| Rate for Payer: UHCCP Medicaid |
$471.80
|
| Rate for Payer: UMR Bronson Commercial |
$829.84
|
|
|
PR TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL
|
Professional
|
Both
|
$3,886.00
|
|
|
Service Code
|
HCPCS 35372
|
| Min. Negotiated Rate |
$564.66 |
| Max. Negotiated Rate |
$2,914.50 |
| Rate for Payer: Aetna Commercial |
$1,198.51
|
| Rate for Payer: Aetna Medicare |
$930.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.95
|
| Rate for Payer: BCBS Complete |
$592.89
|
| Rate for Payer: BCBS MAPPO |
$894.41
|
| Rate for Payer: BCN Commercial |
$1,423.72
|
| Rate for Payer: BCN Medicare Advantage |
$894.41
|
| Rate for Payer: Cash Price |
$3,108.80
|
| Rate for Payer: Cash Price |
$3,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,198.51
|
| Rate for Payer: Cofinity Commercial |
$1,287.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.13
|
| Rate for Payer: Meridian Medicaid |
$592.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$983.85
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,914.50
|
| Rate for Payer: PACE SWMI |
$894.41
|
| Rate for Payer: PHP Commercial |
$1,252.17
|
| Rate for Payer: PHP Medicare Advantage |
$894.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,531.04
|
| Rate for Payer: Priority Health Medicare |
$894.41
|
| Rate for Payer: Priority Health SBD |
$1,531.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,531.04
|
| Rate for Payer: Railroad Medicare Medicare |
$894.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,757.17
|
| Rate for Payer: UHC Core |
$1,757.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$894.41
|
| Rate for Payer: UHC Exchange |
$1,757.17
|
| Rate for Payer: UHC Medicaid |
$564.66
|
| Rate for Payer: UHCCP Medicaid |
$564.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,787.56
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIAC
|
Professional
|
Both
|
$2,604.00
|
|
|
Service Code
|
HCPCS 35351
|
| Min. Negotiated Rate |
$745.93 |
| Max. Negotiated Rate |
$2,305.88 |
| Rate for Payer: Aetna Commercial |
$1,584.00
|
| Rate for Payer: Aetna Medicare |
$1,229.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,584.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,702.21
|
| Rate for Payer: BCBS Complete |
$783.23
|
| Rate for Payer: BCBS MAPPO |
$1,182.09
|
| Rate for Payer: BCN Commercial |
$1,879.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.09
|
| Rate for Payer: Cash Price |
$2,083.20
|
| Rate for Payer: Cash Price |
$2,083.20
|
| Rate for Payer: Cofinity Commercial |
$1,584.00
|
| Rate for Payer: Cofinity Commercial |
$1,702.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.19
|
| Rate for Payer: Meridian Medicaid |
$783.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,300.30
|
| Rate for Payer: Nomi Health Commercial |
$1,418.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,953.00
|
| Rate for Payer: PACE SWMI |
$1,182.09
|
| Rate for Payer: PHP Commercial |
$1,654.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.57
|
| Rate for Payer: Priority Health Medicare |
$1,182.09
|
| Rate for Payer: Priority Health SBD |
$2,021.57
|
| Rate for Payer: Priority Health Tiered Network |
$2,021.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,182.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,305.88
|
| Rate for Payer: UHC Core |
$2,305.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,182.09
|
| Rate for Payer: UHC Exchange |
$2,305.88
|
| Rate for Payer: UHC Medicaid |
$745.93
|
| Rate for Payer: UHCCP Medicaid |
$745.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,197.84
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIOFEMORAL
|
Professional
|
Both
|
$2,115.00
|
|
|
Service Code
|
HCPCS 35355
|
| Min. Negotiated Rate |
$594.70 |
| Max. Negotiated Rate |
$1,854.18 |
| Rate for Payer: Aetna Commercial |
$1,263.95
|
| Rate for Payer: Aetna Medicare |
$980.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,263.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.28
|
| Rate for Payer: BCBS Complete |
$624.43
|
| Rate for Payer: BCBS MAPPO |
$943.25
|
| Rate for Payer: BCN Commercial |
$1,501.41
|
| Rate for Payer: BCN Medicare Advantage |
$943.25
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cofinity Commercial |
$1,263.95
|
| Rate for Payer: Cofinity Commercial |
$1,358.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$990.41
|
| Rate for Payer: Meridian Medicaid |
$624.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,037.58
|
| Rate for Payer: Nomi Health Commercial |
$1,131.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,586.25
|
| Rate for Payer: PACE SWMI |
$943.25
|
| Rate for Payer: PHP Commercial |
$1,320.55
|
| Rate for Payer: PHP Medicare Advantage |
$943.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,614.58
|
| Rate for Payer: Priority Health Medicare |
$943.25
|
| Rate for Payer: Priority Health SBD |
$1,614.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,614.58
|
| Rate for Payer: Railroad Medicare Medicare |
$943.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,854.18
|
| Rate for Payer: UHC Core |
$1,854.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$943.25
|
| Rate for Payer: UHC Exchange |
$1,854.18
|
| Rate for Payer: UHC Medicaid |
$594.70
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
| Rate for Payer: UMR Bronson Commercial |
$972.90
|
|
|
PR TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL
|
Professional
|
Both
|
$4,643.00
|
|
|
Service Code
|
HCPCS 35341
|
| Min. Negotiated Rate |
$793.21 |
| Max. Negotiated Rate |
$3,482.25 |
| Rate for Payer: Aetna Commercial |
$1,683.70
|
| Rate for Payer: Aetna Medicare |
$1,306.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,683.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.35
|
| Rate for Payer: BCBS Complete |
$832.87
|
| Rate for Payer: BCBS MAPPO |
$1,256.49
|
| Rate for Payer: BCN Commercial |
$2,009.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.49
|
| Rate for Payer: Cash Price |
$3,714.40
|
| Rate for Payer: Cash Price |
$3,714.40
|
| Rate for Payer: Cofinity Commercial |
$1,683.70
|
| Rate for Payer: Cofinity Commercial |
$1,809.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.31
|
| Rate for Payer: Meridian Medicaid |
$832.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,382.14
|
| Rate for Payer: Nomi Health Commercial |
$1,507.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,482.25
|
| Rate for Payer: PACE SWMI |
$1,256.49
|
| Rate for Payer: PHP Commercial |
$1,759.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,161.33
|
| Rate for Payer: Priority Health Medicare |
$1,256.49
|
| Rate for Payer: Priority Health SBD |
$2,161.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,161.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,256.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,470.10
|
| Rate for Payer: UHC Core |
$2,470.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,256.49
|
| Rate for Payer: UHC Exchange |
$2,470.10
|
| Rate for Payer: UHC Medicaid |
$793.21
|
| Rate for Payer: UHCCP Medicaid |
$793.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,135.78
|
|
|
PR TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL
|
Professional
|
Both
|
$3,971.00
|
|
|
Service Code
|
HCPCS 35321
|
| Min. Negotiated Rate |
$526.75 |
| Max. Negotiated Rate |
$2,978.25 |
| Rate for Payer: Aetna Commercial |
$1,113.58
|
| Rate for Payer: Aetna Medicare |
$864.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.68
|
| Rate for Payer: BCBS Complete |
$553.09
|
| Rate for Payer: BCBS MAPPO |
$831.03
|
| Rate for Payer: BCN Commercial |
$1,329.11
|
| Rate for Payer: BCN Medicare Advantage |
$831.03
|
| Rate for Payer: Cash Price |
$3,176.80
|
| Rate for Payer: Cash Price |
$3,176.80
|
| Rate for Payer: Cofinity Commercial |
$1,113.58
|
| Rate for Payer: Cofinity Commercial |
$1,196.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$831.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.58
|
| Rate for Payer: Meridian Medicaid |
$553.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$914.13
|
| Rate for Payer: Nomi Health Commercial |
$997.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,978.25
|
| Rate for Payer: PACE SWMI |
$831.03
|
| Rate for Payer: PHP Commercial |
$1,163.44
|
| Rate for Payer: PHP Medicare Advantage |
$831.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,429.29
|
| Rate for Payer: Priority Health Medicare |
$831.03
|
| Rate for Payer: Priority Health SBD |
$1,429.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,429.29
|
| Rate for Payer: Railroad Medicare Medicare |
$831.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,599.81
|
| Rate for Payer: UHC Core |
$1,599.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$831.03
|
| Rate for Payer: UHC Exchange |
$1,599.81
|
| Rate for Payer: UHC Medicaid |
$526.75
|
| Rate for Payer: UHCCP Medicaid |
$526.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,826.66
|
|
|
PR TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC
|
Professional
|
Both
|
$2,931.00
|
|
|
Service Code
|
HCPCS 35311
|
| Min. Negotiated Rate |
$932.30 |
| Max. Negotiated Rate |
$2,779.67 |
| Rate for Payer: Aetna Commercial |
$1,961.67
|
| Rate for Payer: Aetna Medicare |
$1,522.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,961.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,108.06
|
| Rate for Payer: BCBS Complete |
$978.91
|
| Rate for Payer: BCBS MAPPO |
$1,463.93
|
| Rate for Payer: BCN Commercial |
$2,276.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,463.93
|
| Rate for Payer: Cash Price |
$2,344.80
|
| Rate for Payer: Cash Price |
$2,344.80
|
| Rate for Payer: Cofinity Commercial |
$1,961.67
|
| Rate for Payer: Cofinity Commercial |
$2,108.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,463.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,537.13
|
| Rate for Payer: Meridian Medicaid |
$978.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,610.32
|
| Rate for Payer: Nomi Health Commercial |
$1,756.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,198.25
|
| Rate for Payer: PACE SWMI |
$1,463.93
|
| Rate for Payer: PHP Commercial |
$2,049.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,463.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$932.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,448.37
|
| Rate for Payer: Priority Health Medicare |
$1,463.93
|
| Rate for Payer: Priority Health SBD |
$2,448.37
|
| Rate for Payer: Priority Health Tiered Network |
$2,448.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,463.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.67
|
| Rate for Payer: UHC Core |
$2,779.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,463.93
|
| Rate for Payer: UHC Exchange |
$2,779.67
|
| Rate for Payer: UHC Medicaid |
$932.30
|
| Rate for Payer: UHCCP Medicaid |
$932.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,348.26
|
|
|
PR TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 99366
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$41.24
|
| Rate for Payer: Aetna Medicare |
$48.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.24
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52.86
|
| Rate for Payer: Priority Health SBD |
$52.86
|
| Rate for Payer: Priority Health Tiered Network |
$52.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.12
|
| Rate for Payer: UHC Core |
$61.12
|
| Rate for Payer: UHC Exchange |
$61.12
|
| Rate for Payer: UMR Bronson Commercial |
$44.62
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 99368
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$53.09 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.09
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46.59
|
| Rate for Payer: Priority Health SBD |
$46.59
|
| Rate for Payer: Priority Health Tiered Network |
$46.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.09
|
| Rate for Payer: UHC Core |
$53.09
|
| Rate for Payer: UHC Exchange |
$53.09
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 99367
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$146.64 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCN Commercial |
$146.64
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| 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 |
$72.68
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 98967
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Aetna Commercial |
$26.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$19.89
|
| Rate for Payer: BCN Commercial |
$26.84
|
| Rate for Payer: BCN Medicare Advantage |
$19.89
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$28.64
|
| Rate for Payer: Cofinity Commercial |
$26.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.88
|
| Rate for Payer: Nomi Health Commercial |
$23.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$19.89
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: PHP Medicare Advantage |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.23
|
| Rate for Payer: Priority Health Medicare |
$19.89
|
| Rate for Payer: Priority Health SBD |
$31.23
|
| Rate for Payer: Priority Health Tiered Network |
$31.23
|
| Rate for Payer: Railroad Medicare Medicare |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.05
|
| Rate for Payer: UHC Core |
$42.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.89
|
| Rate for Payer: UHC Exchange |
$42.05
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 98968
|
| Min. Negotiated Rate |
$28.85 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$30.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.54
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$28.85
|
| Rate for Payer: BCN Commercial |
$40.84
|
| Rate for Payer: BCN Medicare Advantage |
$28.85
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$41.54
|
| Rate for Payer: Cofinity Commercial |
$38.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.73
|
| Rate for Payer: Nomi Health Commercial |
$34.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$28.85
|
| Rate for Payer: PHP Commercial |
$40.39
|
| Rate for Payer: PHP Medicare Advantage |
$28.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.63
|
| Rate for Payer: Priority Health Medicare |
$28.85
|
| Rate for Payer: Priority Health SBD |
$43.63
|
| Rate for Payer: Priority Health Tiered Network |
$43.63
|
| Rate for Payer: Railroad Medicare Medicare |
$28.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.48
|
| Rate for Payer: UHC Core |
$62.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.85
|
| Rate for Payer: UHC Exchange |
$62.48
|
| Rate for Payer: UMR Bronson Commercial |
$38.64
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 98966
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$13.73
|
| Rate for Payer: Aetna Medicare |
$10.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.76
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$13.24
|
| Rate for Payer: BCN Medicare Advantage |
$10.25
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$14.76
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: PACE SWMI |
$10.25
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Medicare Advantage |
$10.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.07
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: Priority Health Tiered Network |
$16.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.01
|
| Rate for Payer: UHC Core |
$21.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.25
|
| Rate for Payer: UHC Exchange |
$21.01
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
|
|
PR TEMPORARY CLOSURE EYELIDS SUTURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 67875
|
| Min. Negotiated Rate |
$78.73 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna Commercial |
$105.50
|
| Rate for Payer: Aetna Medicare |
$81.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.37
|
| Rate for Payer: BCBS Complete |
$156.80
|
| Rate for Payer: BCBS MAPPO |
$78.73
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$78.73
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$113.37
|
| Rate for Payer: Cofinity Commercial |
$105.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.60
|
| Rate for Payer: Nomi Health Commercial |
$94.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$78.73
|
| Rate for Payer: PHP Commercial |
$110.22
|
| Rate for Payer: PHP Medicare Advantage |
$78.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.82
|
| Rate for Payer: Priority Health Medicare |
$78.73
|
| Rate for Payer: Priority Health SBD |
$166.82
|
| Rate for Payer: Priority Health Tiered Network |
$166.82
|
| Rate for Payer: Railroad Medicare Medicare |
$78.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.06
|
| Rate for Payer: UHC Core |
$164.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.73
|
| Rate for Payer: UHC Exchange |
$164.06
|
| Rate for Payer: UMR Bronson Commercial |
$180.32
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$299.69 |
| Max. Negotiated Rate |
$880.98 |
| Rate for Payer: Aetna Commercial |
$612.19
|
| Rate for Payer: Aetna Medicare |
$475.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.88
|
| Rate for Payer: BCBS Complete |
$314.67
|
| Rate for Payer: BCBS MAPPO |
$456.86
|
| Rate for Payer: BCN Commercial |
$770.87
|
| Rate for Payer: BCN Medicare Advantage |
$456.86
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cofinity Commercial |
$612.19
|
| Rate for Payer: Cofinity Commercial |
$657.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.70
|
| Rate for Payer: Meridian Medicaid |
$314.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.55
|
| Rate for Payer: Nomi Health Commercial |
$548.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$859.50
|
| Rate for Payer: PACE SWMI |
$456.86
|
| Rate for Payer: PHP Commercial |
$639.60
|
| Rate for Payer: PHP Medicare Advantage |
$456.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$824.04
|
| Rate for Payer: Priority Health Medicare |
$456.86
|
| Rate for Payer: Priority Health SBD |
$824.04
|
| Rate for Payer: Priority Health Tiered Network |
$824.04
|
| Rate for Payer: Railroad Medicare Medicare |
$456.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.98
|
| Rate for Payer: UHC Core |
$880.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$456.86
|
| Rate for Payer: UHC Exchange |
$880.98
|
| Rate for Payer: UHC Medicaid |
$299.69
|
| Rate for Payer: UHCCP Medicaid |
$299.69
|
| Rate for Payer: UMR Bronson Commercial |
$527.16
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,060.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$1,007.51 |
| Rate for Payer: Aetna Commercial |
$704.14
|
| Rate for Payer: Aetna Medicare |
$546.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$756.69
|
| Rate for Payer: BCBS Complete |
$362.09
|
| Rate for Payer: BCBS MAPPO |
$525.48
|
| Rate for Payer: BCN Commercial |
$891.38
|
| Rate for Payer: BCN Medicare Advantage |
$525.48
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cofinity Commercial |
$704.14
|
| Rate for Payer: Cofinity Commercial |
$756.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.75
|
| Rate for Payer: Meridian Medicaid |
$362.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$578.03
|
| Rate for Payer: Nomi Health Commercial |
$630.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$795.00
|
| Rate for Payer: PACE SWMI |
$525.48
|
| Rate for Payer: PHP Commercial |
$735.67
|
| Rate for Payer: PHP Medicare Advantage |
$525.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$952.86
|
| Rate for Payer: Priority Health Medicare |
$525.48
|
| Rate for Payer: Priority Health SBD |
$952.86
|
| Rate for Payer: Priority Health Tiered Network |
$952.86
|
| Rate for Payer: Railroad Medicare Medicare |
$525.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.51
|
| Rate for Payer: UHC Core |
$1,007.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$525.48
|
| Rate for Payer: UHC Exchange |
$1,007.51
|
| Rate for Payer: UHC Medicaid |
$344.85
|
| Rate for Payer: UHCCP Medicaid |
$344.85
|
| Rate for Payer: UMR Bronson Commercial |
$487.60
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,215.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$911.25 |
| Rate for Payer: Aetna Commercial |
$369.24
|
| Rate for Payer: Aetna Medicare |
$286.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.79
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$275.55
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$275.55
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$369.24
|
| Rate for Payer: Cofinity Commercial |
$396.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.33
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$303.11
|
| Rate for Payer: Nomi Health Commercial |
$330.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PACE SWMI |
$275.55
|
| Rate for Payer: PHP Commercial |
$385.77
|
| Rate for Payer: PHP Medicare Advantage |
$275.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$484.41
|
| Rate for Payer: Priority Health Medicare |
$275.55
|
| Rate for Payer: Priority Health SBD |
$484.41
|
| Rate for Payer: Priority Health Tiered Network |
$484.41
|
| Rate for Payer: Railroad Medicare Medicare |
$275.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.03
|
| Rate for Payer: UHC Core |
$497.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.55
|
| Rate for Payer: UHC Exchange |
$497.03
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
| Rate for Payer: UMR Bronson Commercial |
$558.90
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,215.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$534.60 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna American Axle |
$789.75
|
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.75
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Advantage |
$850.50
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$850.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,032.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: Priority Health SBD |
$765.45
|
| Rate for Payer: UMR Bronson Commercial |
$534.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.25
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,215.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$911.25 |
| Rate for Payer: Aetna Commercial |
$369.24
|
| Rate for Payer: Aetna Medicare |
$286.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.79
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$275.55
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$275.55
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$369.24
|
| Rate for Payer: Cofinity Commercial |
$396.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.33
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$303.11
|
| Rate for Payer: Nomi Health Commercial |
$330.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PACE SWMI |
$275.55
|
| Rate for Payer: PHP Commercial |
$385.77
|
| Rate for Payer: PHP Medicare Advantage |
$275.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$484.41
|
| Rate for Payer: Priority Health Medicare |
$275.55
|
| Rate for Payer: Priority Health SBD |
$484.41
|
| Rate for Payer: Priority Health Tiered Network |
$484.41
|
| Rate for Payer: Railroad Medicare Medicare |
$275.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.03
|
| Rate for Payer: UHC Core |
$497.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.55
|
| Rate for Payer: UHC Exchange |
$497.03
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
| Rate for Payer: UMR Bronson Commercial |
$558.90
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,215.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$449.55 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna American Axle |
$789.75
|
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,857.88
|
| Rate for Payer: BCN Commercial |
$1,857.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Advantage |
$850.50
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$850.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.25
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,032.75
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health SBD |
$765.45
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: UMR Bronson Commercial |
$449.55
|
| Rate for Payer: VA VA |
$1,602.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.25
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,462.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,458.03 |
| Rate for Payer: Aetna Commercial |
$1,068.96
|
| Rate for Payer: Aetna Medicare |
$829.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,068.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,148.73
|
| Rate for Payer: BCBS Complete |
$559.12
|
| Rate for Payer: BCBS MAPPO |
$797.73
|
| Rate for Payer: BCN Commercial |
$1,311.19
|
| Rate for Payer: BCN Medicare Advantage |
$797.73
|
| Rate for Payer: Cash Price |
$1,169.60
|
| Rate for Payer: Cash Price |
$1,169.60
|
| Rate for Payer: Cofinity Commercial |
$1,068.96
|
| Rate for Payer: Cofinity Commercial |
$1,148.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$797.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.62
|
| Rate for Payer: Meridian Medicaid |
$559.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$877.50
|
| Rate for Payer: Nomi Health Commercial |
$957.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.50
|
| Rate for Payer: PACE SWMI |
$797.73
|
| Rate for Payer: PHP Commercial |
$1,116.82
|
| Rate for Payer: PHP Medicare Advantage |
$797.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,401.61
|
| Rate for Payer: Priority Health Medicare |
$797.73
|
| Rate for Payer: Priority Health SBD |
$1,401.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,401.61
|
| Rate for Payer: Railroad Medicare Medicare |
$797.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,458.03
|
| Rate for Payer: UHC Core |
$1,458.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$797.73
|
| Rate for Payer: UHC Exchange |
$1,458.03
|
| Rate for Payer: UHC Medicaid |
$532.50
|
| Rate for Payer: UHCCP Medicaid |
$532.50
|
| Rate for Payer: UMR Bronson Commercial |
$672.52
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$372.11 |
| Max. Negotiated Rate |
$1,069.53 |
| Rate for Payer: Aetna Commercial |
$760.22
|
| Rate for Payer: Aetna Medicare |
$590.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.96
|
| Rate for Payer: BCBS Complete |
$390.72
|
| Rate for Payer: BCBS MAPPO |
$567.33
|
| Rate for Payer: BCN Commercial |
$929.23
|
| Rate for Payer: BCN Medicare Advantage |
$567.33
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$760.22
|
| Rate for Payer: Cofinity Commercial |
$816.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.70
|
| Rate for Payer: Meridian Medicaid |
$390.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$624.06
|
| Rate for Payer: Nomi Health Commercial |
$680.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PACE SWMI |
$567.33
|
| Rate for Payer: PHP Commercial |
$794.26
|
| Rate for Payer: PHP Medicare Advantage |
$567.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$993.33
|
| Rate for Payer: Priority Health Medicare |
$567.33
|
| Rate for Payer: Priority Health SBD |
$993.33
|
| Rate for Payer: Priority Health Tiered Network |
$993.33
|
| Rate for Payer: Railroad Medicare Medicare |
$567.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.53
|
| Rate for Payer: UHC Core |
$1,069.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$567.33
|
| Rate for Payer: UHC Exchange |
$1,069.53
|
| Rate for Payer: UHC Medicaid |
$372.11
|
| Rate for Payer: UHCCP Medicaid |
$372.11
|
| Rate for Payer: UMR Bronson Commercial |
$517.50
|
|
