|
PR TREATMENT CLOSED ELBOW DISLOCATION REQ ANES
|
Professional
|
Both
|
$1,351.00
|
|
|
Service Code
|
HCPCS 24605
|
| Min. Negotiated Rate |
$305.66 |
| Max. Negotiated Rate |
$1,013.25 |
| Rate for Payer: Aetna Commercial |
$619.40
|
| Rate for Payer: Aetna Medicare |
$480.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.63
|
| Rate for Payer: BCBS Complete |
$320.94
|
| Rate for Payer: BCBS MAPPO |
$462.24
|
| Rate for Payer: BCN Commercial |
$737.51
|
| Rate for Payer: BCN Medicare Advantage |
$462.24
|
| Rate for Payer: Cash Price |
$1,080.80
|
| Rate for Payer: Cash Price |
$1,080.80
|
| Rate for Payer: Cofinity Commercial |
$665.63
|
| Rate for Payer: Cofinity Commercial |
$619.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$485.35
|
| Rate for Payer: Meridian Medicaid |
$320.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$508.46
|
| Rate for Payer: Nomi Health Commercial |
$554.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,013.25
|
| Rate for Payer: PACE SWMI |
$462.24
|
| Rate for Payer: PHP Commercial |
$647.14
|
| Rate for Payer: PHP Medicare Advantage |
$462.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$788.37
|
| Rate for Payer: Priority Health Medicare |
$462.24
|
| Rate for Payer: Priority Health SBD |
$788.37
|
| Rate for Payer: Priority Health Tiered Network |
$788.37
|
| Rate for Payer: Railroad Medicare Medicare |
$462.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$819.59
|
| Rate for Payer: UHC Core |
$819.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$462.24
|
| Rate for Payer: UHC Exchange |
$819.59
|
| Rate for Payer: UHC Medicaid |
$305.66
|
| Rate for Payer: UHCCP Medicaid |
$305.66
|
| Rate for Payer: UMR Bronson Commercial |
$621.46
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION W/O ANES
|
Professional
|
Both
|
$773.00
|
|
|
Service Code
|
HCPCS 24600
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$585.74 |
| Rate for Payer: Aetna Commercial |
$518.45
|
| Rate for Payer: Aetna Medicare |
$402.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.14
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$386.90
|
| Rate for Payer: BCN Commercial |
$536.82
|
| Rate for Payer: BCN Medicare Advantage |
$386.90
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$518.45
|
| Rate for Payer: Cofinity Commercial |
$557.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.25
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.59
|
| Rate for Payer: Nomi Health Commercial |
$464.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$579.75
|
| Rate for Payer: PACE SWMI |
$386.90
|
| Rate for Payer: PHP Commercial |
$541.66
|
| Rate for Payer: PHP Medicare Advantage |
$386.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$573.86
|
| Rate for Payer: Priority Health Medicare |
$386.90
|
| Rate for Payer: Priority Health SBD |
$573.86
|
| Rate for Payer: Priority Health Tiered Network |
$573.86
|
| Rate for Payer: Railroad Medicare Medicare |
$386.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.74
|
| Rate for Payer: UHC Core |
$585.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$386.90
|
| Rate for Payer: UHC Exchange |
$585.74
|
| Rate for Payer: UHC Medicaid |
$256.45
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
| Rate for Payer: UMR Bronson Commercial |
$355.58
|
|
|
PR TRIAMCINOLONE ACET INJ NOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J3301
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$1.21
|
| Rate for Payer: Aetna Medicare |
$0.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.30
|
| Rate for Payer: BCBS MAPPO |
$0.90
|
| Rate for Payer: BCBS Trust/PPO |
$0.35
|
| Rate for Payer: BCN Commercial |
$0.46
|
| Rate for Payer: BCN Medicare Advantage |
$0.90
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$1.21
|
| Rate for Payer: Cofinity Commercial |
$1.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$1.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$0.90
|
| Rate for Payer: PHP Commercial |
$1.26
|
| Rate for Payer: PHP Medicare Advantage |
$0.90
|
| Rate for Payer: Priority Health Medicare |
$0.90
|
| Rate for Payer: Railroad Medicare Medicare |
$0.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.74
|
| Rate for Payer: UHC Core |
$0.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.90
|
| Rate for Payer: UHC Exchange |
$0.74
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR TRIMETHOBENZAMIDE HCL INJ
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS J3250
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$76.67
|
| Rate for Payer: Aetna Medicare |
$59.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.40
|
| Rate for Payer: BCBS MAPPO |
$57.22
|
| Rate for Payer: BCBS Trust/PPO |
$58.68
|
| Rate for Payer: BCN Commercial |
$50.98
|
| Rate for Payer: BCN Medicare Advantage |
$57.22
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$76.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.94
|
| Rate for Payer: Nomi Health Commercial |
$68.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE SWMI |
$57.22
|
| Rate for Payer: PHP Commercial |
$80.11
|
| Rate for Payer: PHP Medicare Advantage |
$57.22
|
| Rate for Payer: Priority Health Medicare |
$57.22
|
| Rate for Payer: Railroad Medicare Medicare |
$57.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.60
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.22
|
| Rate for Payer: UHC Exchange |
$57.60
|
| Rate for Payer: UMR Bronson Commercial |
$11.50
|
|
|
PR TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 11719
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$8.94
|
| Rate for Payer: Aetna Medicare |
$6.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.60
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$6.67
|
| Rate for Payer: BCN Commercial |
$8.64
|
| Rate for Payer: BCN Medicare Advantage |
$6.67
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.34
|
| Rate for Payer: Nomi Health Commercial |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$6.67
|
| Rate for Payer: PHP Commercial |
$9.34
|
| Rate for Payer: PHP Medicare Advantage |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.03
|
| Rate for Payer: Priority Health Medicare |
$6.67
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$10.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.61
|
| Rate for Payer: UHC Core |
$13.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.67
|
| Rate for Payer: UHC Exchange |
$13.61
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Aetna Commercial |
$8.94
|
| Rate for Payer: Aetna Medicare |
$6.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.60
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$6.67
|
| Rate for Payer: BCN Commercial |
$10.96
|
| Rate for Payer: BCN Medicare Advantage |
$6.67
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.34
|
| Rate for Payer: Nomi Health Commercial |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: PACE SWMI |
$6.67
|
| Rate for Payer: PHP Commercial |
$9.34
|
| Rate for Payer: PHP Medicare Advantage |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.03
|
| Rate for Payer: Priority Health Medicare |
$6.67
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$10.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.61
|
| Rate for Payer: UHC Core |
$13.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.67
|
| Rate for Payer: UHC Exchange |
$13.61
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 37246
|
| Min. Negotiated Rate |
$196.60 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$416.71
|
| Rate for Payer: Aetna Medicare |
$323.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.81
|
| Rate for Payer: BCBS Complete |
$206.43
|
| Rate for Payer: BCBS MAPPO |
$310.98
|
| Rate for Payer: BCN Commercial |
$507.94
|
| Rate for Payer: BCN Medicare Advantage |
$310.98
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$416.71
|
| Rate for Payer: Cofinity Commercial |
$447.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.53
|
| Rate for Payer: Meridian Medicaid |
$206.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.08
|
| Rate for Payer: Nomi Health Commercial |
$373.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$310.98
|
| Rate for Payer: PHP Commercial |
$435.37
|
| Rate for Payer: PHP Medicare Advantage |
$310.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$546.22
|
| Rate for Payer: Priority Health Medicare |
$310.98
|
| Rate for Payer: Priority Health SBD |
$546.22
|
| Rate for Payer: Priority Health Tiered Network |
$546.22
|
| Rate for Payer: Railroad Medicare Medicare |
$310.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.90
|
| Rate for Payer: UHC Core |
$624.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.98
|
| Rate for Payer: UHC Exchange |
$624.90
|
| Rate for Payer: UHC Medicaid |
$196.60
|
| Rate for Payer: UHCCP Medicaid |
$196.60
|
| Rate for Payer: UMR Bronson Commercial |
$520.26
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART
|
Professional
|
Both
|
$861.00
|
|
|
Service Code
|
HCPCS 37247
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Aetna Commercial |
$205.19
|
| Rate for Payer: Aetna Medicare |
$159.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.51
|
| Rate for Payer: BCBS Complete |
$101.77
|
| Rate for Payer: BCBS MAPPO |
$153.13
|
| Rate for Payer: BCN Commercial |
$253.47
|
| Rate for Payer: BCN Medicare Advantage |
$153.13
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cofinity Commercial |
$205.19
|
| Rate for Payer: Cofinity Commercial |
$220.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.79
|
| Rate for Payer: Meridian Medicaid |
$101.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.44
|
| Rate for Payer: Nomi Health Commercial |
$183.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.75
|
| Rate for Payer: PACE SWMI |
$153.13
|
| Rate for Payer: PHP Commercial |
$214.38
|
| Rate for Payer: PHP Medicare Advantage |
$153.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$272.57
|
| Rate for Payer: Priority Health Medicare |
$153.13
|
| Rate for Payer: Priority Health SBD |
$272.57
|
| Rate for Payer: Priority Health Tiered Network |
$272.57
|
| Rate for Payer: Railroad Medicare Medicare |
$153.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.25
|
| Rate for Payer: UHC Core |
$307.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$153.13
|
| Rate for Payer: UHC Exchange |
$307.25
|
| Rate for Payer: UHC Medicaid |
$96.92
|
| Rate for Payer: UHCCP Medicaid |
$96.92
|
| Rate for Payer: UMR Bronson Commercial |
$396.06
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN
|
Professional
|
Both
|
$972.00
|
|
|
Service Code
|
HCPCS 37248
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Aetna Commercial |
$350.10
|
| Rate for Payer: Aetna Medicare |
$271.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.23
|
| Rate for Payer: BCBS Complete |
$174.23
|
| Rate for Payer: BCBS MAPPO |
$261.27
|
| Rate for Payer: BCN Commercial |
$432.25
|
| Rate for Payer: BCN Medicare Advantage |
$261.27
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cofinity Commercial |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$274.33
|
| Rate for Payer: Meridian Medicaid |
$174.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$287.40
|
| Rate for Payer: Nomi Health Commercial |
$313.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.00
|
| Rate for Payer: PACE SWMI |
$261.27
|
| Rate for Payer: PHP Commercial |
$365.78
|
| Rate for Payer: PHP Medicare Advantage |
$261.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$464.83
|
| Rate for Payer: Priority Health Medicare |
$261.27
|
| Rate for Payer: Priority Health SBD |
$464.83
|
| Rate for Payer: Priority Health Tiered Network |
$464.83
|
| Rate for Payer: Railroad Medicare Medicare |
$261.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$532.79
|
| Rate for Payer: UHC Core |
$532.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$261.27
|
| Rate for Payer: UHC Exchange |
$532.79
|
| Rate for Payer: UHC Medicaid |
$165.93
|
| Rate for Payer: UHCCP Medicaid |
$165.93
|
| Rate for Payer: UMR Bronson Commercial |
$447.12
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 37249
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$357.75 |
| Rate for Payer: Aetna Commercial |
$173.42
|
| Rate for Payer: Aetna Medicare |
$134.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.36
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$129.42
|
| Rate for Payer: BCN Commercial |
$213.64
|
| Rate for Payer: BCN Medicare Advantage |
$129.42
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$173.42
|
| Rate for Payer: Cofinity Commercial |
$186.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.89
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$142.36
|
| Rate for Payer: Nomi Health Commercial |
$155.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$357.75
|
| Rate for Payer: PACE SWMI |
$129.42
|
| Rate for Payer: PHP Commercial |
$181.19
|
| Rate for Payer: PHP Medicare Advantage |
$129.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$229.74
|
| Rate for Payer: Priority Health Medicare |
$129.42
|
| Rate for Payer: Priority Health SBD |
$229.74
|
| Rate for Payer: Priority Health Tiered Network |
$229.74
|
| Rate for Payer: Railroad Medicare Medicare |
$129.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.80
|
| Rate for Payer: UHC Core |
$261.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$129.42
|
| Rate for Payer: UHC Exchange |
$261.80
|
| Rate for Payer: UHC Medicaid |
$81.79
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$219.42
|
|
|
PR TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 36907
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$262.37 |
| Rate for Payer: Aetna Commercial |
$171.85
|
| Rate for Payer: Aetna Medicare |
$133.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.68
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$128.25
|
| Rate for Payer: BCN Commercial |
$214.13
|
| Rate for Payer: BCN Medicare Advantage |
$128.25
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$171.85
|
| Rate for Payer: Cofinity Commercial |
$184.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.66
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.07
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.50
|
| Rate for Payer: PACE SWMI |
$128.25
|
| Rate for Payer: PHP Commercial |
$179.55
|
| Rate for Payer: PHP Medicare Advantage |
$128.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$230.27
|
| Rate for Payer: Priority Health Medicare |
$128.25
|
| Rate for Payer: Priority Health SBD |
$230.27
|
| Rate for Payer: Priority Health Tiered Network |
$230.27
|
| Rate for Payer: Railroad Medicare Medicare |
$128.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.37
|
| Rate for Payer: UHC Core |
$262.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.25
|
| Rate for Payer: UHC Exchange |
$262.37
|
| Rate for Payer: UHC Medicaid |
$81.37
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
| Rate for Payer: UMR Bronson Commercial |
$153.64
|
|
|
PR TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL
|
Professional
|
Both
|
$10,116.00
|
|
|
Service Code
|
HCPCS 0237T
|
| Min. Negotiated Rate |
$248.53 |
| Max. Negotiated Rate |
$10,603.43 |
| Rate for Payer: Aetna Commercial |
$4,395.81
|
| Rate for Payer: Aetna Medicare |
$5,058.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,395.81
|
| Rate for Payer: BCBS Complete |
$260.96
|
| Rate for Payer: BCN Commercial |
$10,603.43
|
| Rate for Payer: Cash Price |
$8,092.80
|
| Rate for Payer: Cash Price |
$8,092.80
|
| Rate for Payer: Meridian Medicaid |
$260.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,587.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,548.58
|
| Rate for Payer: Priority Health SBD |
$1,548.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,548.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,480.08
|
| Rate for Payer: UHC Core |
$1,480.08
|
| Rate for Payer: UHC Exchange |
$1,480.08
|
| Rate for Payer: UHC Medicaid |
$248.53
|
| Rate for Payer: UHCCP Medicaid |
$248.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,653.36
|
|
|
PR TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL
|
Professional
|
Both
|
$9,019.00
|
|
|
Service Code
|
HCPCS 61597
|
| Min. Negotiated Rate |
$1,891.23 |
| Max. Negotiated Rate |
$6,764.25 |
| Rate for Payer: Aetna Commercial |
$3,945.74
|
| Rate for Payer: Aetna Medicare |
$3,062.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,945.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,240.20
|
| Rate for Payer: BCBS Complete |
$1,985.79
|
| Rate for Payer: BCBS MAPPO |
$2,944.58
|
| Rate for Payer: BCN Commercial |
$6,096.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,944.58
|
| Rate for Payer: Cash Price |
$7,215.20
|
| Rate for Payer: Cash Price |
$7,215.20
|
| Rate for Payer: Cofinity Commercial |
$4,240.20
|
| Rate for Payer: Cofinity Commercial |
$3,945.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,944.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,091.81
|
| Rate for Payer: Meridian Medicaid |
$1,985.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,239.04
|
| Rate for Payer: Nomi Health Commercial |
$3,533.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.25
|
| Rate for Payer: PACE SWMI |
$2,944.58
|
| Rate for Payer: PHP Commercial |
$4,122.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,944.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,891.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,125.75
|
| Rate for Payer: Priority Health Medicare |
$2,944.58
|
| Rate for Payer: Priority Health SBD |
$5,125.75
|
| Rate for Payer: Priority Health Tiered Network |
$5,125.75
|
| Rate for Payer: Railroad Medicare Medicare |
$2,944.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,176.22
|
| Rate for Payer: UHC Core |
$5,176.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,944.58
|
| Rate for Payer: UHC Exchange |
$5,176.22
|
| Rate for Payer: UHC Medicaid |
$1,891.23
|
| Rate for Payer: UHCCP Medicaid |
$1,891.23
|
| Rate for Payer: UMR Bronson Commercial |
$4,148.74
|
|
|
PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 38207
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$354.75 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare |
$236.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.89
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.47
|
| Rate for Payer: Priority Health SBD |
$87.47
|
| Rate for Payer: Priority Health Tiered Network |
$87.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.44
|
| Rate for Payer: UHC Core |
$80.44
|
| Rate for Payer: UHC Exchange |
$80.44
|
| Rate for Payer: UHC Medicaid |
$24.28
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
| Rate for Payer: UMR Bronson Commercial |
$217.58
|
|
|
PR TR PARASPI MUSC HIP FASC/TDN XTN GRF
|
Professional
|
Both
|
$6,507.00
|
|
|
Service Code
|
HCPCS 27105
|
| Min. Negotiated Rate |
$518.23 |
| Max. Negotiated Rate |
$4,880.25 |
| Rate for Payer: Aetna Commercial |
$1,064.09
|
| Rate for Payer: Aetna Medicare |
$825.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,064.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.50
|
| Rate for Payer: BCBS Complete |
$544.14
|
| Rate for Payer: BCBS MAPPO |
$794.10
|
| Rate for Payer: BCN Commercial |
$1,326.12
|
| Rate for Payer: BCN Medicare Advantage |
$794.10
|
| Rate for Payer: Cash Price |
$5,205.60
|
| Rate for Payer: Cash Price |
$5,205.60
|
| Rate for Payer: Cofinity Commercial |
$1,143.50
|
| Rate for Payer: Cofinity Commercial |
$1,064.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$794.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$833.80
|
| Rate for Payer: Meridian Medicaid |
$544.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$873.51
|
| Rate for Payer: Nomi Health Commercial |
$952.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,880.25
|
| Rate for Payer: PACE SWMI |
$794.10
|
| Rate for Payer: PHP Commercial |
$1,111.74
|
| Rate for Payer: PHP Medicare Advantage |
$794.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,417.59
|
| Rate for Payer: Priority Health Medicare |
$794.10
|
| Rate for Payer: Priority Health SBD |
$1,417.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,417.59
|
| Rate for Payer: Railroad Medicare Medicare |
$794.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,516.67
|
| Rate for Payer: UHC Core |
$1,516.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$794.10
|
| Rate for Payer: UHC Exchange |
$1,516.67
|
| Rate for Payer: UHC Medicaid |
$518.23
|
| Rate for Payer: UHCCP Medicaid |
$518.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,993.22
|
|
|
PR TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 35695
|
| Min. Negotiated Rate |
$595.97 |
| Max. Negotiated Rate |
$1,843.03 |
| Rate for Payer: Aetna Commercial |
$1,267.67
|
| Rate for Payer: Aetna Medicare |
$983.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.27
|
| Rate for Payer: BCBS Complete |
$625.77
|
| Rate for Payer: BCBS MAPPO |
$946.02
|
| Rate for Payer: BCN Commercial |
$1,502.40
|
| Rate for Payer: BCN Medicare Advantage |
$946.02
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cofinity Commercial |
$1,267.67
|
| Rate for Payer: Cofinity Commercial |
$1,362.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.32
|
| Rate for Payer: Meridian Medicaid |
$625.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,040.62
|
| Rate for Payer: Nomi Health Commercial |
$1,135.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,603.50
|
| Rate for Payer: PACE SWMI |
$946.02
|
| Rate for Payer: PHP Commercial |
$1,324.43
|
| Rate for Payer: PHP Medicare Advantage |
$946.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,615.64
|
| Rate for Payer: Priority Health Medicare |
$946.02
|
| Rate for Payer: Priority Health SBD |
$1,615.64
|
| Rate for Payer: Priority Health Tiered Network |
$1,615.64
|
| Rate for Payer: Railroad Medicare Medicare |
$946.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,843.03
|
| Rate for Payer: UHC Core |
$1,843.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$946.02
|
| Rate for Payer: UHC Exchange |
$1,843.03
|
| Rate for Payer: UHC Medicaid |
$595.97
|
| Rate for Payer: UHCCP Medicaid |
$595.97
|
| Rate for Payer: UMR Bronson Commercial |
$983.48
|
|
|
PR TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 35694
|
| Min. Negotiated Rate |
$574.67 |
| Max. Negotiated Rate |
$1,775.24 |
| Rate for Payer: Aetna Commercial |
$1,222.11
|
| Rate for Payer: Aetna Medicare |
$948.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.31
|
| Rate for Payer: BCBS Complete |
$603.40
|
| Rate for Payer: BCBS MAPPO |
$912.02
|
| Rate for Payer: BCN Commercial |
$1,448.13
|
| Rate for Payer: BCN Medicare Advantage |
$912.02
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$1,222.11
|
| Rate for Payer: Cofinity Commercial |
$1,313.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$957.62
|
| Rate for Payer: Meridian Medicaid |
$603.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,003.22
|
| Rate for Payer: Nomi Health Commercial |
$1,094.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,654.50
|
| Rate for Payer: PACE SWMI |
$912.02
|
| Rate for Payer: PHP Commercial |
$1,276.83
|
| Rate for Payer: PHP Medicare Advantage |
$912.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,557.29
|
| Rate for Payer: Priority Health Medicare |
$912.02
|
| Rate for Payer: Priority Health SBD |
$1,557.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,557.29
|
| Rate for Payer: Railroad Medicare Medicare |
$912.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,775.24
|
| Rate for Payer: UHC Core |
$1,775.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$912.02
|
| Rate for Payer: UHC Exchange |
$1,775.24
|
| Rate for Payer: UHC Medicaid |
$574.67
|
| Rate for Payer: UHCCP Medicaid |
$574.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,014.76
|
|
|
PR TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART
|
Professional
|
Both
|
$4,703.00
|
|
|
Service Code
|
HCPCS 35691
|
| Min. Negotiated Rate |
$550.39 |
| Max. Negotiated Rate |
$3,527.25 |
| Rate for Payer: Aetna Commercial |
$1,170.07
|
| Rate for Payer: Aetna Medicare |
$908.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,257.39
|
| Rate for Payer: BCBS Complete |
$577.91
|
| Rate for Payer: BCBS MAPPO |
$873.19
|
| Rate for Payer: BCN Commercial |
$1,385.89
|
| Rate for Payer: BCN Medicare Advantage |
$873.19
|
| Rate for Payer: Cash Price |
$3,762.40
|
| Rate for Payer: Cash Price |
$3,762.40
|
| Rate for Payer: Cofinity Commercial |
$1,170.07
|
| Rate for Payer: Cofinity Commercial |
$1,257.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$916.85
|
| Rate for Payer: Meridian Medicaid |
$577.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$960.51
|
| Rate for Payer: Nomi Health Commercial |
$1,047.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,527.25
|
| Rate for Payer: PACE SWMI |
$873.19
|
| Rate for Payer: PHP Commercial |
$1,222.47
|
| Rate for Payer: PHP Medicare Advantage |
$873.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$550.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,490.33
|
| Rate for Payer: Priority Health Medicare |
$873.19
|
| Rate for Payer: Priority Health SBD |
$1,490.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,490.33
|
| Rate for Payer: Railroad Medicare Medicare |
$873.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.81
|
| Rate for Payer: UHC Core |
$1,698.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$873.19
|
| Rate for Payer: UHC Exchange |
$1,698.81
|
| Rate for Payer: UHC Medicaid |
$550.39
|
| Rate for Payer: UHCCP Medicaid |
$550.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,163.38
|
|
|
PR TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART
|
Professional
|
Both
|
$1,809.00
|
|
|
Service Code
|
HCPCS 35693
|
| Min. Negotiated Rate |
$489.47 |
| Max. Negotiated Rate |
$1,493.81 |
| Rate for Payer: Aetna Commercial |
$1,036.57
|
| Rate for Payer: Aetna Medicare |
$804.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,036.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.93
|
| Rate for Payer: BCBS Complete |
$513.94
|
| Rate for Payer: BCBS MAPPO |
$773.56
|
| Rate for Payer: BCN Commercial |
$1,230.01
|
| Rate for Payer: BCN Medicare Advantage |
$773.56
|
| Rate for Payer: Cash Price |
$1,447.20
|
| Rate for Payer: Cash Price |
$1,447.20
|
| Rate for Payer: Cofinity Commercial |
$1,036.57
|
| Rate for Payer: Cofinity Commercial |
$1,113.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$773.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.24
|
| Rate for Payer: Meridian Medicaid |
$513.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$850.92
|
| Rate for Payer: Nomi Health Commercial |
$928.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,356.75
|
| Rate for Payer: PACE SWMI |
$773.56
|
| Rate for Payer: PHP Commercial |
$1,082.98
|
| Rate for Payer: PHP Medicare Advantage |
$773.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,322.73
|
| Rate for Payer: Priority Health Medicare |
$773.56
|
| Rate for Payer: Priority Health SBD |
$1,322.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,322.73
|
| Rate for Payer: Railroad Medicare Medicare |
$773.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,493.81
|
| Rate for Payer: UHC Core |
$1,493.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$773.56
|
| Rate for Payer: UHC Exchange |
$1,493.81
|
| Rate for Payer: UHC Medicaid |
$489.47
|
| Rate for Payer: UHCCP Medicaid |
$489.47
|
| Rate for Payer: UMR Bronson Commercial |
$832.14
|
|
|
PR TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 26497
|
| Min. Negotiated Rate |
$561.04 |
| Max. Negotiated Rate |
$2,143.50 |
| Rate for Payer: Aetna Commercial |
$1,133.13
|
| Rate for Payer: Aetna Medicare |
$879.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,217.69
|
| Rate for Payer: BCBS Complete |
$589.09
|
| Rate for Payer: BCBS MAPPO |
$845.62
|
| Rate for Payer: BCN Commercial |
$1,365.96
|
| Rate for Payer: BCN Medicare Advantage |
$845.62
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,133.13
|
| Rate for Payer: Cofinity Commercial |
$1,217.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$845.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$887.90
|
| Rate for Payer: Meridian Medicaid |
$589.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$930.18
|
| Rate for Payer: Nomi Health Commercial |
$1,014.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,143.50
|
| Rate for Payer: PACE SWMI |
$845.62
|
| Rate for Payer: PHP Commercial |
$1,183.87
|
| Rate for Payer: PHP Medicare Advantage |
$845.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,460.17
|
| Rate for Payer: Priority Health Medicare |
$845.62
|
| Rate for Payer: Priority Health SBD |
$1,460.17
|
| Rate for Payer: Priority Health Tiered Network |
$1,460.17
|
| Rate for Payer: Railroad Medicare Medicare |
$845.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,514.83
|
| Rate for Payer: UHC Core |
$1,514.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$845.62
|
| Rate for Payer: UHC Exchange |
$1,514.83
|
| Rate for Payer: UHC Medicaid |
$561.04
|
| Rate for Payer: UHCCP Medicaid |
$561.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,314.68
|
|
|
PR TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND
|
Professional
|
Both
|
$5,783.00
|
|
|
Service Code
|
HCPCS 26551
|
| Min. Negotiated Rate |
$1,897.40 |
| Max. Negotiated Rate |
$5,778.44 |
| Rate for Payer: Aetna Commercial |
$3,921.80
|
| Rate for Payer: Aetna Medicare |
$3,043.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,921.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,214.48
|
| Rate for Payer: BCBS Complete |
$1,992.27
|
| Rate for Payer: BCBS MAPPO |
$2,926.72
|
| Rate for Payer: BCN Commercial |
$4,936.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,926.72
|
| Rate for Payer: Cash Price |
$4,626.40
|
| Rate for Payer: Cash Price |
$4,626.40
|
| Rate for Payer: Cofinity Commercial |
$3,921.80
|
| Rate for Payer: Cofinity Commercial |
$4,214.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,926.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,073.06
|
| Rate for Payer: Meridian Medicaid |
$1,992.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,219.39
|
| Rate for Payer: Nomi Health Commercial |
$3,512.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,337.25
|
| Rate for Payer: PACE SWMI |
$2,926.72
|
| Rate for Payer: PHP Commercial |
$4,097.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,926.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,897.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,277.49
|
| Rate for Payer: Priority Health Medicare |
$2,926.72
|
| Rate for Payer: Priority Health SBD |
$5,277.49
|
| Rate for Payer: Priority Health Tiered Network |
$5,277.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,926.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,778.44
|
| Rate for Payer: UHC Core |
$5,778.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,926.72
|
| Rate for Payer: UHC Exchange |
$5,778.44
|
| Rate for Payer: UHC Medicaid |
$1,897.40
|
| Rate for Payer: UHCCP Medicaid |
$1,897.40
|
| Rate for Payer: UMR Bronson Commercial |
$2,660.18
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP
|
Professional
|
Both
|
$2,904.00
|
|
|
Service Code
|
HCPCS 27691
|
| Min. Negotiated Rate |
$447.94 |
| Max. Negotiated Rate |
$2,178.00 |
| Rate for Payer: Aetna Commercial |
$916.21
|
| Rate for Payer: Aetna Medicare |
$711.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$916.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.59
|
| Rate for Payer: BCBS Complete |
$470.34
|
| Rate for Payer: BCBS MAPPO |
$683.74
|
| Rate for Payer: BCN Commercial |
$1,131.91
|
| Rate for Payer: BCN Medicare Advantage |
$683.74
|
| Rate for Payer: Cash Price |
$2,323.20
|
| Rate for Payer: Cash Price |
$2,323.20
|
| Rate for Payer: Cofinity Commercial |
$916.21
|
| Rate for Payer: Cofinity Commercial |
$984.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$717.93
|
| Rate for Payer: Meridian Medicaid |
$470.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.11
|
| Rate for Payer: Nomi Health Commercial |
$820.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,178.00
|
| Rate for Payer: PACE SWMI |
$683.74
|
| Rate for Payer: PHP Commercial |
$957.24
|
| Rate for Payer: PHP Medicare Advantage |
$683.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,209.99
|
| Rate for Payer: Priority Health Medicare |
$683.74
|
| Rate for Payer: Priority Health SBD |
$1,209.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,209.99
|
| Rate for Payer: Railroad Medicare Medicare |
$683.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.01
|
| Rate for Payer: UHC Core |
$1,298.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.74
|
| Rate for Payer: UHC Exchange |
$1,298.01
|
| Rate for Payer: UHC Medicaid |
$447.94
|
| Rate for Payer: UHCCP Medicaid |
$447.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,335.84
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 27692
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$119.98
|
| Rate for Payer: Aetna Medicare |
$93.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.94
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS MAPPO |
$89.54
|
| Rate for Payer: BCN Commercial |
$152.88
|
| Rate for Payer: BCN Medicare Advantage |
$89.54
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$119.98
|
| Rate for Payer: Cofinity Commercial |
$128.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.02
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.49
|
| Rate for Payer: Nomi Health Commercial |
$107.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: PACE SWMI |
$89.54
|
| Rate for Payer: PHP Commercial |
$125.36
|
| Rate for Payer: PHP Medicare Advantage |
$89.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$163.42
|
| Rate for Payer: Priority Health Medicare |
$89.54
|
| Rate for Payer: Priority Health SBD |
$163.42
|
| Rate for Payer: Priority Health Tiered Network |
$163.42
|
| Rate for Payer: Railroad Medicare Medicare |
$89.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.61
|
| Rate for Payer: UHC Core |
$184.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.54
|
| Rate for Payer: UHC Exchange |
$184.61
|
| Rate for Payer: UHC Medicaid |
$57.08
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
| Rate for Payer: UMR Bronson Commercial |
$241.50
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 27690
|
| Min. Negotiated Rate |
$387.87 |
| Max. Negotiated Rate |
$1,541.25 |
| Rate for Payer: Aetna Commercial |
$792.07
|
| Rate for Payer: Aetna Medicare |
$614.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.18
|
| Rate for Payer: BCBS Complete |
$407.26
|
| Rate for Payer: BCBS MAPPO |
$591.10
|
| Rate for Payer: BCN Commercial |
$974.05
|
| Rate for Payer: BCN Medicare Advantage |
$591.10
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$792.07
|
| Rate for Payer: Cofinity Commercial |
$851.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.65
|
| Rate for Payer: Meridian Medicaid |
$407.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$650.21
|
| Rate for Payer: Nomi Health Commercial |
$709.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,541.25
|
| Rate for Payer: PACE SWMI |
$591.10
|
| Rate for Payer: PHP Commercial |
$827.54
|
| Rate for Payer: PHP Medicare Advantage |
$591.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,041.24
|
| Rate for Payer: Priority Health Medicare |
$591.10
|
| Rate for Payer: Priority Health SBD |
$1,041.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,041.24
|
| Rate for Payer: Railroad Medicare Medicare |
$591.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,113.57
|
| Rate for Payer: UHC Core |
$1,113.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$591.10
|
| Rate for Payer: UHC Exchange |
$1,113.57
|
| Rate for Payer: UHC Medicaid |
$387.87
|
| Rate for Payer: UHCCP Medicaid |
$387.87
|
| Rate for Payer: UMR Bronson Commercial |
$945.30
|
|
|
PR TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$2,124.00
|
|
|
Service Code
|
HCPCS 26480
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$1,593.00 |
| Rate for Payer: Aetna Commercial |
$867.50
|
| Rate for Payer: Aetna Medicare |
$673.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.24
|
| Rate for Payer: BCBS Complete |
$447.30
|
| Rate for Payer: BCBS MAPPO |
$647.39
|
| Rate for Payer: BCN Commercial |
$1,094.06
|
| Rate for Payer: BCN Medicare Advantage |
$647.39
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cofinity Commercial |
$867.50
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.76
|
| Rate for Payer: Meridian Medicaid |
$447.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.13
|
| Rate for Payer: Nomi Health Commercial |
$776.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.00
|
| Rate for Payer: PACE SWMI |
$647.39
|
| Rate for Payer: PHP Commercial |
$906.35
|
| Rate for Payer: PHP Medicare Advantage |
$647.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,169.52
|
| Rate for Payer: Priority Health Medicare |
$647.39
|
| Rate for Payer: Priority Health SBD |
$1,169.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,169.52
|
| Rate for Payer: Railroad Medicare Medicare |
$647.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,302.29
|
| Rate for Payer: UHC Core |
$1,302.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$647.39
|
| Rate for Payer: UHC Exchange |
$1,302.29
|
| Rate for Payer: UHC Medicaid |
$426.00
|
| Rate for Payer: UHCCP Medicaid |
$426.00
|
| Rate for Payer: UMR Bronson Commercial |
$977.04
|
|
