|
PR TISS CLTR SKIN AGRFT T/A/L EA ADD 100 SQCM/EA 1%
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 15152
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$258.56 |
| Rate for Payer: Aetna Commercial |
$165.65
|
| Rate for Payer: Aetna Medicare |
$128.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.01
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$123.62
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$123.62
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$165.65
|
| Rate for Payer: Cofinity Commercial |
$178.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.80
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.98
|
| Rate for Payer: Nomi Health Commercial |
$148.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$123.62
|
| Rate for Payer: PHP Commercial |
$173.07
|
| Rate for Payer: PHP Medicare Advantage |
$123.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.35
|
| Rate for Payer: Priority Health Medicare |
$123.62
|
| Rate for Payer: Priority Health SBD |
$197.35
|
| Rate for Payer: Priority Health Tiered Network |
$197.35
|
| Rate for Payer: Railroad Medicare Medicare |
$123.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.56
|
| Rate for Payer: UHC Core |
$258.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.62
|
| Rate for Payer: UHC Exchange |
$258.56
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L 1ST 25 SQ CM/<
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 15150
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$1,121.67 |
| Rate for Payer: Aetna Commercial |
$814.60
|
| Rate for Payer: Aetna Medicare |
$632.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.39
|
| Rate for Payer: BCBS Complete |
$413.30
|
| Rate for Payer: BCBS MAPPO |
$607.91
|
| Rate for Payer: BCN Commercial |
$964.59
|
| Rate for Payer: BCN Medicare Advantage |
$607.91
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$814.60
|
| Rate for Payer: Cofinity Commercial |
$875.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$638.31
|
| Rate for Payer: Meridian Medicaid |
$413.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$668.70
|
| Rate for Payer: Nomi Health Commercial |
$729.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$930.75
|
| Rate for Payer: PACE SWMI |
$607.91
|
| Rate for Payer: PHP Commercial |
$851.07
|
| Rate for Payer: PHP Medicare Advantage |
$607.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$882.85
|
| Rate for Payer: Priority Health Medicare |
$607.91
|
| Rate for Payer: Priority Health SBD |
$882.85
|
| Rate for Payer: Priority Health Tiered Network |
$882.85
|
| Rate for Payer: Railroad Medicare Medicare |
$607.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.67
|
| Rate for Payer: UHC Core |
$1,121.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$607.91
|
| Rate for Payer: UHC Exchange |
$1,121.67
|
| Rate for Payer: UHC Medicaid |
$393.62
|
| Rate for Payer: UHCCP Medicaid |
$393.62
|
| Rate for Payer: UMR Bronson Commercial |
$570.86
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L ADDL 1-75 SQCM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 15151
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$197.70 |
| Rate for Payer: Aetna Commercial |
$131.75
|
| Rate for Payer: Aetna Medicare |
$102.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.58
|
| Rate for Payer: BCBS Complete |
$65.31
|
| Rate for Payer: BCBS MAPPO |
$98.32
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$98.32
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$131.75
|
| Rate for Payer: Cofinity Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.24
|
| Rate for Payer: Meridian Medicaid |
$65.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.15
|
| Rate for Payer: Nomi Health Commercial |
$117.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: PACE SWMI |
$98.32
|
| Rate for Payer: PHP Commercial |
$137.65
|
| Rate for Payer: PHP Medicare Advantage |
$98.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$148.59
|
| Rate for Payer: Priority Health Medicare |
$98.32
|
| Rate for Payer: Priority Health SBD |
$148.59
|
| Rate for Payer: Priority Health Tiered Network |
$148.59
|
| Rate for Payer: Railroad Medicare Medicare |
$98.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.70
|
| Rate for Payer: UHC Core |
$197.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.32
|
| Rate for Payer: UHC Exchange |
$197.70
|
| Rate for Payer: UHC Medicaid |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$62.20
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$684.16 |
| Max. Negotiated Rate |
$2,607.91 |
| Rate for Payer: Aetna Commercial |
$1,395.17
|
| Rate for Payer: Aetna Medicare |
$1,082.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.28
|
| Rate for Payer: BCBS Complete |
$718.37
|
| Rate for Payer: BCBS MAPPO |
$1,041.17
|
| Rate for Payer: BCN Commercial |
$1,755.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.17
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cofinity Commercial |
$1,395.17
|
| Rate for Payer: Cofinity Commercial |
$1,499.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,093.23
|
| Rate for Payer: Meridian Medicaid |
$718.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,145.29
|
| Rate for Payer: Nomi Health Commercial |
$1,249.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: PACE SWMI |
$1,041.17
|
| Rate for Payer: PHP Commercial |
$1,457.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$684.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,607.09
|
| Rate for Payer: Priority Health Medicare |
$1,041.17
|
| Rate for Payer: Priority Health SBD |
$1,607.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,607.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,041.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,607.91
|
| Rate for Payer: UHC Core |
$2,607.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,041.17
|
| Rate for Payer: UHC Exchange |
$2,607.91
|
| Rate for Payer: UHC Medicaid |
$684.16
|
| Rate for Payer: UHCCP Medicaid |
$684.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,159.66
|
|
|
PR TIXAGEV AND CILGAV INJ
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS M0220
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$150.50
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.50
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCN Commercial |
$97.45
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$3,713.00
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$819.20 |
| Max. Negotiated Rate |
$2,784.75 |
| Rate for Payer: Aetna Commercial |
$1,650.85
|
| Rate for Payer: Aetna Medicare |
$1,281.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,650.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.05
|
| Rate for Payer: BCBS Complete |
$860.16
|
| Rate for Payer: BCBS MAPPO |
$1,231.98
|
| Rate for Payer: BCN Commercial |
$2,097.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.98
|
| Rate for Payer: Cash Price |
$2,970.40
|
| Rate for Payer: Cash Price |
$2,970.40
|
| Rate for Payer: Cofinity Commercial |
$1,774.05
|
| Rate for Payer: Cofinity Commercial |
$1,650.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,293.58
|
| Rate for Payer: Meridian Medicaid |
$860.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,355.18
|
| Rate for Payer: Nomi Health Commercial |
$1,478.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,784.75
|
| Rate for Payer: PACE SWMI |
$1,231.98
|
| Rate for Payer: PHP Commercial |
$1,724.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$819.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,072.04
|
| Rate for Payer: Priority Health Medicare |
$1,231.98
|
| Rate for Payer: Priority Health SBD |
$2,072.04
|
| Rate for Payer: Priority Health Tiered Network |
$2,072.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,337.64
|
| Rate for Payer: UHC Core |
$2,337.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,231.98
|
| Rate for Payer: UHC Exchange |
$2,337.64
|
| Rate for Payer: UHC Medicaid |
$819.20
|
| Rate for Payer: UHCCP Medicaid |
$819.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,707.98
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$4,439.00
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$874.58 |
| Max. Negotiated Rate |
$3,329.25 |
| Rate for Payer: Aetna Commercial |
$1,767.04
|
| Rate for Payer: Aetna Medicare |
$1,371.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,767.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,898.91
|
| Rate for Payer: BCBS Complete |
$918.31
|
| Rate for Payer: BCBS MAPPO |
$1,318.69
|
| Rate for Payer: BCN Commercial |
$2,255.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.69
|
| Rate for Payer: Cash Price |
$3,551.20
|
| Rate for Payer: Cash Price |
$3,551.20
|
| Rate for Payer: Cofinity Commercial |
$1,767.04
|
| Rate for Payer: Cofinity Commercial |
$1,898.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.62
|
| Rate for Payer: Meridian Medicaid |
$918.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.56
|
| Rate for Payer: Nomi Health Commercial |
$1,582.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,329.25
|
| Rate for Payer: PACE SWMI |
$1,318.69
|
| Rate for Payer: PHP Commercial |
$1,846.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,229.01
|
| Rate for Payer: Priority Health Medicare |
$1,318.69
|
| Rate for Payer: Priority Health SBD |
$2,229.01
|
| Rate for Payer: Priority Health Tiered Network |
$2,229.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,318.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,519.33
|
| Rate for Payer: UHC Core |
$2,519.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,318.69
|
| Rate for Payer: UHC Exchange |
$2,519.33
|
| Rate for Payer: UHC Medicaid |
$874.58
|
| Rate for Payer: UHCCP Medicaid |
$874.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,041.94
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$4,198.00
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$693.53 |
| Max. Negotiated Rate |
$3,148.50 |
| Rate for Payer: Aetna Commercial |
$1,411.64
|
| Rate for Payer: Aetna Medicare |
$1,095.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,411.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.98
|
| Rate for Payer: BCBS Complete |
$728.21
|
| Rate for Payer: BCBS MAPPO |
$1,053.46
|
| Rate for Payer: BCN Commercial |
$1,823.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.46
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cofinity Commercial |
$1,411.64
|
| Rate for Payer: Cofinity Commercial |
$1,516.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,106.13
|
| Rate for Payer: Meridian Medicaid |
$728.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,158.81
|
| Rate for Payer: Nomi Health Commercial |
$1,264.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.50
|
| Rate for Payer: PACE SWMI |
$1,053.46
|
| Rate for Payer: PHP Commercial |
$1,474.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,801.91
|
| Rate for Payer: Priority Health Medicare |
$1,053.46
|
| Rate for Payer: Priority Health SBD |
$1,801.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,801.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,053.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,087.67
|
| Rate for Payer: UHC Core |
$2,087.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,053.46
|
| Rate for Payer: UHC Exchange |
$2,087.67
|
| Rate for Payer: UHC Medicaid |
$693.53
|
| Rate for Payer: UHCCP Medicaid |
$693.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,931.08
|
|
|
PR TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$4,049.00
|
|
|
Service Code
|
HCPCS 69641
|
| Min. Negotiated Rate |
$591.93 |
| Max. Negotiated Rate |
$3,036.75 |
| Rate for Payer: Aetna Commercial |
$1,202.42
|
| Rate for Payer: Aetna Medicare |
$933.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.16
|
| Rate for Payer: BCBS Complete |
$621.53
|
| Rate for Payer: BCBS MAPPO |
$897.33
|
| Rate for Payer: BCN Commercial |
$1,554.19
|
| Rate for Payer: BCN Medicare Advantage |
$897.33
|
| Rate for Payer: Cash Price |
$3,239.20
|
| Rate for Payer: Cash Price |
$3,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,202.42
|
| Rate for Payer: Cofinity Commercial |
$1,292.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.20
|
| Rate for Payer: Meridian Medicaid |
$621.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.06
|
| Rate for Payer: Nomi Health Commercial |
$1,076.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,036.75
|
| Rate for Payer: PACE SWMI |
$897.33
|
| Rate for Payer: PHP Commercial |
$1,256.26
|
| Rate for Payer: PHP Medicare Advantage |
$897.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,535.70
|
| Rate for Payer: Priority Health Medicare |
$897.33
|
| Rate for Payer: Priority Health SBD |
$1,535.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,535.70
|
| Rate for Payer: Railroad Medicare Medicare |
$897.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,775.98
|
| Rate for Payer: UHC Core |
$1,775.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$897.33
|
| Rate for Payer: UHC Exchange |
$1,775.98
|
| Rate for Payer: UHC Medicaid |
$591.93
|
| Rate for Payer: UHCCP Medicaid |
$591.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,862.54
|
|
|
PR TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$2,765.00
|
|
|
Service Code
|
HCPCS 69642
|
| Min. Negotiated Rate |
$755.51 |
| Max. Negotiated Rate |
$2,285.14 |
| Rate for Payer: Aetna Commercial |
$1,537.66
|
| Rate for Payer: Aetna Medicare |
$1,193.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,652.41
|
| Rate for Payer: BCBS Complete |
$793.29
|
| Rate for Payer: BCBS MAPPO |
$1,147.51
|
| Rate for Payer: BCN Commercial |
$1,993.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,147.51
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cofinity Commercial |
$1,537.66
|
| Rate for Payer: Cofinity Commercial |
$1,652.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,147.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,204.89
|
| Rate for Payer: Meridian Medicaid |
$793.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,262.26
|
| Rate for Payer: Nomi Health Commercial |
$1,377.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,073.75
|
| Rate for Payer: PACE SWMI |
$1,147.51
|
| Rate for Payer: PHP Commercial |
$1,606.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,147.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$755.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,969.69
|
| Rate for Payer: Priority Health Medicare |
$1,147.51
|
| Rate for Payer: Priority Health SBD |
$1,969.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,969.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,147.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,285.14
|
| Rate for Payer: UHC Core |
$2,285.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,147.51
|
| Rate for Payer: UHC Exchange |
$2,285.14
|
| Rate for Payer: UHC Medicaid |
$755.51
|
| Rate for Payer: UHCCP Medicaid |
$755.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,271.90
|
|
|
PR TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH
|
Professional
|
Both
|
$3,872.00
|
|
|
Service Code
|
HCPCS 0483T
|
| Min. Negotiated Rate |
$1,415.73 |
| Max. Negotiated Rate |
$2,904.00 |
| Rate for Payer: Aetna Commercial |
$1,415.73
|
| Rate for Payer: Aetna Medicare |
$1,936.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,415.73
|
| Rate for Payer: BCBS Complete |
$1,548.80
|
| Rate for Payer: BCN Commercial |
$2,635.81
|
| Rate for Payer: Cash Price |
$3,097.60
|
| Rate for Payer: Cash Price |
$3,097.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,904.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,438.91
|
| Rate for Payer: UHC Core |
$2,438.91
|
| Rate for Payer: UHC Exchange |
$2,438.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,781.12
|
|
|
PR TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 27681
|
| Min. Negotiated Rate |
$312.26 |
| Max. Negotiated Rate |
$1,340.25 |
| Rate for Payer: Aetna Commercial |
$637.80
|
| Rate for Payer: Aetna Medicare |
$495.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.40
|
| Rate for Payer: BCBS Complete |
$327.87
|
| Rate for Payer: BCBS MAPPO |
$475.97
|
| Rate for Payer: BCN Commercial |
$777.35
|
| Rate for Payer: BCN Medicare Advantage |
$475.97
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cofinity Commercial |
$637.80
|
| Rate for Payer: Cofinity Commercial |
$685.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.77
|
| Rate for Payer: Meridian Medicaid |
$327.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$523.57
|
| Rate for Payer: Nomi Health Commercial |
$571.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,340.25
|
| Rate for Payer: PACE SWMI |
$475.97
|
| Rate for Payer: PHP Commercial |
$666.36
|
| Rate for Payer: PHP Medicare Advantage |
$475.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$830.97
|
| Rate for Payer: Priority Health Medicare |
$475.97
|
| Rate for Payer: Priority Health SBD |
$830.97
|
| Rate for Payer: Priority Health Tiered Network |
$830.97
|
| Rate for Payer: Railroad Medicare Medicare |
$475.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$900.55
|
| Rate for Payer: UHC Core |
$900.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$475.97
|
| Rate for Payer: UHC Exchange |
$900.55
|
| Rate for Payer: UHC Medicaid |
$312.26
|
| Rate for Payer: UHCCP Medicaid |
$312.26
|
| Rate for Payer: UMR Bronson Commercial |
$822.02
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 25295
|
| Min. Negotiated Rate |
$316.94 |
| Max. Negotiated Rate |
$1,138.50 |
| Rate for Payer: Aetna Commercial |
$645.73
|
| Rate for Payer: Aetna Medicare |
$501.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$645.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.92
|
| Rate for Payer: BCBS Complete |
$332.79
|
| Rate for Payer: BCBS MAPPO |
$481.89
|
| Rate for Payer: BCN Commercial |
$812.21
|
| Rate for Payer: BCN Medicare Advantage |
$481.89
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$645.73
|
| Rate for Payer: Cofinity Commercial |
$693.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.98
|
| Rate for Payer: Meridian Medicaid |
$332.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$530.08
|
| Rate for Payer: Nomi Health Commercial |
$578.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,138.50
|
| Rate for Payer: PACE SWMI |
$481.89
|
| Rate for Payer: PHP Commercial |
$674.65
|
| Rate for Payer: PHP Medicare Advantage |
$481.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$868.22
|
| Rate for Payer: Priority Health Medicare |
$481.89
|
| Rate for Payer: Priority Health SBD |
$868.22
|
| Rate for Payer: Priority Health Tiered Network |
$868.22
|
| Rate for Payer: Railroad Medicare Medicare |
$481.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.75
|
| Rate for Payer: UHC Core |
$912.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$481.89
|
| Rate for Payer: UHC Exchange |
$912.75
|
| Rate for Payer: UHC Medicaid |
$316.94
|
| Rate for Payer: UHCCP Medicaid |
$316.94
|
| Rate for Payer: UMR Bronson Commercial |
$698.28
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24358
|
| Min. Negotiated Rate |
$318.86 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$649.36
|
| Rate for Payer: Aetna Medicare |
$503.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.82
|
| Rate for Payer: BCBS Complete |
$334.80
|
| Rate for Payer: BCBS MAPPO |
$484.60
|
| Rate for Payer: BCN Commercial |
$817.69
|
| Rate for Payer: BCN Medicare Advantage |
$484.60
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$649.36
|
| Rate for Payer: Cofinity Commercial |
$697.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.83
|
| Rate for Payer: Meridian Medicaid |
$334.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$533.06
|
| Rate for Payer: Nomi Health Commercial |
$581.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE SWMI |
$484.60
|
| Rate for Payer: PHP Commercial |
$678.44
|
| Rate for Payer: PHP Medicare Advantage |
$484.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$874.08
|
| Rate for Payer: Priority Health Medicare |
$484.60
|
| Rate for Payer: Priority Health SBD |
$874.08
|
| Rate for Payer: Priority Health Tiered Network |
$874.08
|
| Rate for Payer: Railroad Medicare Medicare |
$484.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$913.78
|
| Rate for Payer: UHC Core |
$913.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$484.60
|
| Rate for Payer: UHC Exchange |
$913.78
|
| Rate for Payer: UHC Medicaid |
$318.86
|
| Rate for Payer: UHCCP Medicaid |
$318.86
|
| Rate for Payer: UMR Bronson Commercial |
$737.84
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,909.00
|
|
|
Service Code
|
HCPCS 24359
|
| Min. Negotiated Rate |
$393.41 |
| Max. Negotiated Rate |
$1,431.75 |
| Rate for Payer: Aetna Commercial |
$805.67
|
| Rate for Payer: Aetna Medicare |
$625.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.80
|
| Rate for Payer: BCBS Complete |
$413.08
|
| Rate for Payer: BCBS MAPPO |
$601.25
|
| Rate for Payer: BCN Commercial |
$1,016.38
|
| Rate for Payer: BCN Medicare Advantage |
$601.25
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cofinity Commercial |
$805.67
|
| Rate for Payer: Cofinity Commercial |
$865.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$631.31
|
| Rate for Payer: Meridian Medicaid |
$413.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$661.38
|
| Rate for Payer: Nomi Health Commercial |
$721.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,431.75
|
| Rate for Payer: PACE SWMI |
$601.25
|
| Rate for Payer: PHP Commercial |
$841.75
|
| Rate for Payer: PHP Medicare Advantage |
$601.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,086.48
|
| Rate for Payer: Priority Health Medicare |
$601.25
|
| Rate for Payer: Priority Health SBD |
$1,086.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,086.48
|
| Rate for Payer: Railroad Medicare Medicare |
$601.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,153.67
|
| Rate for Payer: UHC Core |
$1,153.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$601.25
|
| Rate for Payer: UHC Exchange |
$1,153.67
|
| Rate for Payer: UHC Medicaid |
$393.41
|
| Rate for Payer: UHCCP Medicaid |
$393.41
|
| Rate for Payer: UMR Bronson Commercial |
$878.14
|
|
|
PR TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,314.00
|
|
|
Service Code
|
HCPCS 25290
|
| Min. Negotiated Rate |
$264.33 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Aetna Commercial |
$537.47
|
| Rate for Payer: Aetna Medicare |
$417.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.58
|
| Rate for Payer: BCBS Complete |
$277.55
|
| Rate for Payer: BCBS MAPPO |
$401.10
|
| Rate for Payer: BCN Commercial |
$674.76
|
| Rate for Payer: BCN Medicare Advantage |
$401.10
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cofinity Commercial |
$537.47
|
| Rate for Payer: Cofinity Commercial |
$577.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.15
|
| Rate for Payer: Meridian Medicaid |
$277.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$441.21
|
| Rate for Payer: Nomi Health Commercial |
$481.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$985.50
|
| Rate for Payer: PACE SWMI |
$401.10
|
| Rate for Payer: PHP Commercial |
$561.54
|
| Rate for Payer: PHP Medicare Advantage |
$401.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$721.31
|
| Rate for Payer: Priority Health Medicare |
$401.10
|
| Rate for Payer: Priority Health SBD |
$721.31
|
| Rate for Payer: Priority Health Tiered Network |
$721.31
|
| Rate for Payer: Railroad Medicare Medicare |
$401.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.52
|
| Rate for Payer: UHC Core |
$754.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$401.10
|
| Rate for Payer: UHC Exchange |
$754.52
|
| Rate for Payer: UHC Medicaid |
$264.33
|
| Rate for Payer: UHCCP Medicaid |
$264.33
|
| Rate for Payer: UMR Bronson Commercial |
$604.44
|
|
|
PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 99407
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$37.09 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$22.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.49
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$26.88
|
| Rate for Payer: BCN Medicare Advantage |
$21.87
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$29.31
|
| Rate for Payer: Cofinity Commercial |
$31.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.96
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.06
|
| Rate for Payer: Nomi Health Commercial |
$26.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.25
|
| Rate for Payer: PACE SWMI |
$21.87
|
| Rate for Payer: PHP Commercial |
$30.62
|
| Rate for Payer: PHP Medicare Advantage |
$21.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$21.87
|
| Rate for Payer: Priority Health SBD |
$33.15
|
| Rate for Payer: Priority Health Tiered Network |
$33.15
|
| Rate for Payer: Railroad Medicare Medicare |
$21.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.09
|
| Rate for Payer: UHC Core |
$37.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.87
|
| Rate for Payer: UHC Exchange |
$37.09
|
| Rate for Payer: UHC Medicaid |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 99406
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare |
$11.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.26
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$10.60
|
| Rate for Payer: BCN Commercial |
$12.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$14.20
|
| Rate for Payer: Cofinity Commercial |
$15.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.13
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.66
|
| Rate for Payer: Nomi Health Commercial |
$12.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$10.60
|
| Rate for Payer: PHP Commercial |
$14.84
|
| Rate for Payer: PHP Medicare Advantage |
$10.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.68
|
| Rate for Payer: Priority Health Medicare |
$10.60
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Priority Health Tiered Network |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$10.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.54
|
| Rate for Payer: UHC Core |
$17.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.60
|
| Rate for Payer: UHC Exchange |
$17.54
|
| Rate for Payer: UHC Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR TOBACCO-USE COUNSEL>10MIN
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS G0437
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32.16
|
| Rate for Payer: Priority Health SBD |
$32.16
|
| Rate for Payer: Priority Health Tiered Network |
$32.16
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
PR TOBACCO-USE COUNSEL 3-10 MIN
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS G0436
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.42
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: Priority Health Tiered Network |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$11.50
|
|
|
PR TONE DECAY TEST
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 92563
|
| Min. Negotiated Rate |
$27.14 |
| Max. Negotiated Rate |
$53.29 |
| Rate for Payer: Aetna Commercial |
$43.82
|
| Rate for Payer: Aetna Medicare |
$34.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.09
|
| Rate for Payer: BCBS MAPPO |
$32.70
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Medicare Advantage |
$32.70
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$47.09
|
| Rate for Payer: Cofinity Commercial |
$43.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.97
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$32.70
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$32.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.14
|
| Rate for Payer: Priority Health Medicare |
$32.70
|
| Rate for Payer: Priority Health SBD |
$49.14
|
| Rate for Payer: Priority Health Tiered Network |
$49.14
|
| Rate for Payer: Railroad Medicare Medicare |
$32.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.77
|
| Rate for Payer: UHC Core |
$45.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.70
|
| Rate for Payer: UHC Exchange |
$45.77
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 42820
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$340.86
|
| Rate for Payer: Aetna Medicare |
$264.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.29
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS MAPPO |
$254.37
|
| Rate for Payer: BCN Commercial |
$442.70
|
| Rate for Payer: BCN Medicare Advantage |
$254.37
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cofinity Commercial |
$340.86
|
| Rate for Payer: Cofinity Commercial |
$366.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.09
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$279.81
|
| Rate for Payer: Nomi Health Commercial |
$305.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.00
|
| Rate for Payer: PACE SWMI |
$254.37
|
| Rate for Payer: PHP Commercial |
$356.12
|
| Rate for Payer: PHP Medicare Advantage |
$254.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$539.41
|
| Rate for Payer: Priority Health Medicare |
$254.37
|
| Rate for Payer: Priority Health SBD |
$539.41
|
| Rate for Payer: Priority Health Tiered Network |
$539.41
|
| Rate for Payer: Railroad Medicare Medicare |
$254.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.13
|
| Rate for Payer: UHC Core |
$500.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$254.37
|
| Rate for Payer: UHC Exchange |
$500.13
|
| Rate for Payer: UHC Medicaid |
$166.35
|
| Rate for Payer: UHCCP Medicaid |
$166.35
|
| Rate for Payer: UMR Bronson Commercial |
$430.56
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 42821
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$562.46 |
| Rate for Payer: Aetna Commercial |
$355.49
|
| Rate for Payer: Aetna Medicare |
$275.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.02
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$265.29
|
| Rate for Payer: BCN Commercial |
$461.63
|
| Rate for Payer: BCN Medicare Advantage |
$265.29
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$355.49
|
| Rate for Payer: Cofinity Commercial |
$382.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.55
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$291.82
|
| Rate for Payer: Nomi Health Commercial |
$318.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.00
|
| Rate for Payer: PACE SWMI |
$265.29
|
| Rate for Payer: PHP Commercial |
$371.41
|
| Rate for Payer: PHP Medicare Advantage |
$265.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$562.46
|
| Rate for Payer: Priority Health Medicare |
$265.29
|
| Rate for Payer: Priority Health SBD |
$562.46
|
| Rate for Payer: Priority Health Tiered Network |
$562.46
|
| Rate for Payer: Railroad Medicare Medicare |
$265.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.72
|
| Rate for Payer: UHC Core |
$521.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$265.29
|
| Rate for Payer: UHC Exchange |
$521.72
|
| Rate for Payer: UHC Medicaid |
$173.60
|
| Rate for Payer: UHCCP Medicaid |
$173.60
|
| Rate for Payer: UMR Bronson Commercial |
$274.16
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY <AGE 12
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 42825
|
| Min. Negotiated Rate |
$155.28 |
| Max. Negotiated Rate |
$499.36 |
| Rate for Payer: Aetna Commercial |
$315.85
|
| Rate for Payer: Aetna Medicare |
$245.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.42
|
| Rate for Payer: BCBS Complete |
$163.04
|
| Rate for Payer: BCBS MAPPO |
$235.71
|
| Rate for Payer: BCN Commercial |
$409.84
|
| Rate for Payer: BCN Medicare Advantage |
$235.71
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$315.85
|
| Rate for Payer: Cofinity Commercial |
$339.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.50
|
| Rate for Payer: Meridian Medicaid |
$163.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.28
|
| Rate for Payer: Nomi Health Commercial |
$282.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
| Rate for Payer: PACE SWMI |
$235.71
|
| Rate for Payer: PHP Commercial |
$329.99
|
| Rate for Payer: PHP Medicare Advantage |
$235.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$499.36
|
| Rate for Payer: Priority Health Medicare |
$235.71
|
| Rate for Payer: Priority Health SBD |
$499.36
|
| Rate for Payer: Priority Health Tiered Network |
$499.36
|
| Rate for Payer: Railroad Medicare Medicare |
$235.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.36
|
| Rate for Payer: UHC Core |
$453.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$235.71
|
| Rate for Payer: UHC Exchange |
$453.36
|
| Rate for Payer: UHC Medicaid |
$155.28
|
| Rate for Payer: UHCCP Medicaid |
$155.28
|
| Rate for Payer: UMR Bronson Commercial |
$230.00
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 42826
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$474.49 |
| Rate for Payer: Aetna Commercial |
$300.91
|
| Rate for Payer: Aetna Medicare |
$233.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.37
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$224.56
|
| Rate for Payer: BCN Commercial |
$389.42
|
| Rate for Payer: BCN Medicare Advantage |
$224.56
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$300.91
|
| Rate for Payer: Cofinity Commercial |
$323.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.79
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$247.02
|
| Rate for Payer: Nomi Health Commercial |
$269.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.25
|
| Rate for Payer: PACE SWMI |
$224.56
|
| Rate for Payer: PHP Commercial |
$314.38
|
| Rate for Payer: PHP Medicare Advantage |
$224.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$474.49
|
| Rate for Payer: Priority Health Medicare |
$224.56
|
| Rate for Payer: Priority Health SBD |
$474.49
|
| Rate for Payer: Priority Health Tiered Network |
$474.49
|
| Rate for Payer: Railroad Medicare Medicare |
$224.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.65
|
| Rate for Payer: UHC Core |
$434.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$224.56
|
| Rate for Payer: UHC Exchange |
$434.65
|
| Rate for Payer: UHC Medicaid |
$147.61
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
| Rate for Payer: UMR Bronson Commercial |
$224.02
|
|
