|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 98968
|
| Min. Negotiated Rate |
$30.32 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Commercial |
$40.63
|
| Rate for Payer: Aetna Medicare |
$31.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.63
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$30.32
|
| Rate for Payer: BCN Medicare Advantage |
$30.32
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.84
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: PACE SWMI |
$30.32
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$30.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$30.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.32
|
| Rate for Payer: UHC Medicare Advantage |
$30.32
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 98966
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$18.85 |
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$11.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$11.12
|
| Rate for Payer: BCN Medicare Advantage |
$11.12
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.68
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: PACE SWMI |
$11.12
|
| Rate for Payer: PHP Commercial |
$15.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$11.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.12
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
| Rate for Payer: UMR Bronson Commercial |
$13.34
|
|
|
PR TEMPORARY CLOSURE EYELIDS SUTURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 67875
|
| Min. Negotiated Rate |
$89.27 |
| Max. Negotiated Rate |
$247.65 |
| Rate for Payer: Aetna Commercial |
$119.62
|
| Rate for Payer: Aetna Medicare |
$92.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.62
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$89.27
|
| Rate for Payer: BCN Medicare Advantage |
$89.27
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$128.55
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.73
|
| Rate for Payer: Nomi Health Commercial |
$107.12
|
| Rate for Payer: PACE SWMI |
$89.27
|
| Rate for Payer: PHP Commercial |
$124.98
|
| Rate for Payer: PHP Medicare Advantage |
$89.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Medicare |
$89.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.27
|
| Rate for Payer: UHC Medicare Advantage |
$89.27
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$445.20 |
| Max. Negotiated Rate |
$723.45 |
| Rate for Payer: Aetna Commercial |
$650.99
|
| Rate for Payer: Aetna Medicare |
$505.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.99
|
| Rate for Payer: BCBS Complete |
$445.20
|
| Rate for Payer: BCBS MAPPO |
$485.81
|
| Rate for Payer: BCN Medicare Advantage |
$485.81
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cofinity Commercial |
$699.57
|
| Rate for Payer: Cofinity Commercial |
$650.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.10
|
| Rate for Payer: Nomi Health Commercial |
$582.97
|
| Rate for Payer: PACE SWMI |
$485.81
|
| Rate for Payer: PHP Commercial |
$680.13
|
| Rate for Payer: PHP Medicare Advantage |
$485.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.45
|
| Rate for Payer: Priority Health Medicare |
$485.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.81
|
| Rate for Payer: UHC Medicare Advantage |
$485.81
|
| Rate for Payer: UMR Bronson Commercial |
$511.98
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$411.60 |
| Max. Negotiated Rate |
$808.60 |
| Rate for Payer: Aetna Commercial |
$752.45
|
| Rate for Payer: Aetna Medicare |
$583.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.45
|
| Rate for Payer: BCBS Complete |
$411.60
|
| Rate for Payer: BCBS MAPPO |
$561.53
|
| Rate for Payer: BCN Medicare Advantage |
$561.53
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$808.60
|
| Rate for Payer: Cofinity Commercial |
$752.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.61
|
| Rate for Payer: Nomi Health Commercial |
$673.84
|
| Rate for Payer: PACE SWMI |
$561.53
|
| Rate for Payer: PHP Commercial |
$786.14
|
| Rate for Payer: PHP Medicare Advantage |
$561.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health Medicare |
$561.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.53
|
| Rate for Payer: UHC Medicare Advantage |
$561.53
|
| Rate for Payer: UMR Bronson Commercial |
$473.34
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$282.19 |
| Max. Negotiated Rate |
$767.00 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.13
|
| Rate for Payer: BCBS Complete |
$472.00
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Commercial |
$395.07
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health Medicare |
$282.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
| Rate for Payer: UMR Bronson Commercial |
$542.80
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$282.19 |
| Max. Negotiated Rate |
$767.00 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.13
|
| Rate for Payer: BCBS Complete |
$472.00
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Commercial |
$395.07
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health Medicare |
$282.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
| Rate for Payer: UMR Bronson Commercial |
$542.80
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$519.20 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Aetna American Axle |
$767.00
|
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Cofinity Commercial |
$826.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$826.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health SBD |
$743.40
|
| Rate for Payer: UMR Bronson Commercial |
$519.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.00
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna American Axle |
$767.00
|
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Cofinity Commercial |
$826.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$826.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.00
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health SBD |
$743.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,982.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: UMR Bronson Commercial |
$436.60
|
| Rate for Payer: VA VA |
$1,560.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.00
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$567.60 |
| Max. Negotiated Rate |
$1,171.71 |
| Rate for Payer: Aetna Commercial |
$1,090.34
|
| Rate for Payer: Aetna Medicare |
$846.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.34
|
| Rate for Payer: BCBS Complete |
$567.60
|
| Rate for Payer: BCBS MAPPO |
$813.69
|
| Rate for Payer: BCN Medicare Advantage |
$813.69
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,171.71
|
| Rate for Payer: Cofinity Commercial |
$1,090.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$854.37
|
| Rate for Payer: Nomi Health Commercial |
$976.43
|
| Rate for Payer: PACE SWMI |
$813.69
|
| Rate for Payer: PHP Commercial |
$1,139.17
|
| Rate for Payer: PHP Medicare Advantage |
$813.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health Medicare |
$813.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.69
|
| Rate for Payer: UHC Medicare Advantage |
$813.69
|
| Rate for Payer: UMR Bronson Commercial |
$652.74
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$436.80 |
| Max. Negotiated Rate |
$844.34 |
| Rate for Payer: Aetna Commercial |
$785.71
|
| Rate for Payer: Aetna Medicare |
$609.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.71
|
| Rate for Payer: BCBS Complete |
$436.80
|
| Rate for Payer: BCBS MAPPO |
$586.35
|
| Rate for Payer: BCN Medicare Advantage |
$586.35
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$844.34
|
| Rate for Payer: Cofinity Commercial |
$785.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.67
|
| Rate for Payer: Nomi Health Commercial |
$703.62
|
| Rate for Payer: PACE SWMI |
$586.35
|
| Rate for Payer: PHP Commercial |
$820.89
|
| Rate for Payer: PHP Medicare Advantage |
$586.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health Medicare |
$586.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.35
|
| Rate for Payer: UHC Medicare Advantage |
$586.35
|
| Rate for Payer: UMR Bronson Commercial |
$502.32
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$406.00 |
| Max. Negotiated Rate |
$874.18 |
| Rate for Payer: Aetna Commercial |
$813.47
|
| Rate for Payer: Aetna Medicare |
$631.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.47
|
| Rate for Payer: BCBS Complete |
$406.00
|
| Rate for Payer: BCBS MAPPO |
$607.07
|
| Rate for Payer: BCN Medicare Advantage |
$607.07
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cofinity Commercial |
$874.18
|
| Rate for Payer: Cofinity Commercial |
$813.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.42
|
| Rate for Payer: Nomi Health Commercial |
$728.48
|
| Rate for Payer: PACE SWMI |
$607.07
|
| Rate for Payer: PHP Commercial |
$849.90
|
| Rate for Payer: PHP Medicare Advantage |
$607.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.75
|
| Rate for Payer: Priority Health Medicare |
$607.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.07
|
| Rate for Payer: UHC Medicare Advantage |
$607.07
|
| Rate for Payer: UMR Bronson Commercial |
$466.90
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,357.00
|
|
|
Service Code
|
HCPCS 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$717.63 |
| Max. Negotiated Rate |
$1,532.05 |
| Rate for Payer: Aetna Commercial |
$961.62
|
| Rate for Payer: Aetna Medicare |
$746.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.39
|
| Rate for Payer: BCBS Complete |
$942.80
|
| Rate for Payer: BCBS MAPPO |
$717.63
|
| Rate for Payer: BCN Medicare Advantage |
$717.63
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$1,033.39
|
| Rate for Payer: Cofinity Commercial |
$961.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.51
|
| Rate for Payer: Nomi Health Commercial |
$861.16
|
| Rate for Payer: PACE SWMI |
$717.63
|
| Rate for Payer: PHP Commercial |
$1,004.68
|
| Rate for Payer: PHP Medicare Advantage |
$717.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health Medicare |
$717.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.63
|
| Rate for Payer: UHC Medicare Advantage |
$717.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,084.22
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,357.00
|
|
|
Service Code
|
HCPCS 23430
|
| Min. Negotiated Rate |
$717.63 |
| Max. Negotiated Rate |
$1,532.05 |
| Rate for Payer: Aetna Commercial |
$961.62
|
| Rate for Payer: Aetna Medicare |
$746.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.39
|
| Rate for Payer: BCBS Complete |
$942.80
|
| Rate for Payer: BCBS MAPPO |
$717.63
|
| Rate for Payer: BCN Medicare Advantage |
$717.63
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$961.62
|
| Rate for Payer: Cofinity Commercial |
$1,033.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.51
|
| Rate for Payer: Nomi Health Commercial |
$861.16
|
| Rate for Payer: PACE SWMI |
$717.63
|
| Rate for Payer: PHP Commercial |
$1,004.68
|
| Rate for Payer: PHP Medicare Advantage |
$717.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health Medicare |
$717.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.63
|
| Rate for Payer: UHC Medicare Advantage |
$717.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,084.22
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
OP
|
$2,357.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$872.09 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna American Axle |
$1,532.05
|
| Rate for Payer: Aetna Commercial |
$2,003.45
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,532.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$1,649.90
|
| Rate for Payer: Cofinity Commercial |
$2,027.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,649.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,121.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,649.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,767.75
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,003.45
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$2,003.45
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$1,484.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$13,314.90
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: UMR Bronson Commercial |
$872.09
|
| Rate for Payer: VA VA |
$6,967.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,767.75
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
IP
|
$2,357.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$1,037.08 |
| Max. Negotiated Rate |
$2,121.30 |
| Rate for Payer: Aetna American Axle |
$1,532.05
|
| Rate for Payer: Aetna Commercial |
$2,003.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,532.05
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$1,649.90
|
| Rate for Payer: Cofinity Commercial |
$2,027.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,649.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.60
|
| Rate for Payer: Healthscope Commercial |
$2,121.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,649.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,767.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,003.45
|
| Rate for Payer: PHP Commercial |
$2,003.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health SBD |
$1,484.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,037.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,767.75
|
|
|
PR TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26471
|
| Min. Negotiated Rate |
$617.22 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Commercial |
$827.07
|
| Rate for Payer: Aetna Medicare |
$641.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$827.07
|
| Rate for Payer: BCBS Complete |
$793.20
|
| Rate for Payer: BCBS MAPPO |
$617.22
|
| Rate for Payer: BCN Medicare Advantage |
$617.22
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$888.80
|
| Rate for Payer: Cofinity Commercial |
$827.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.08
|
| Rate for Payer: Nomi Health Commercial |
$740.66
|
| Rate for Payer: PACE SWMI |
$617.22
|
| Rate for Payer: PHP Commercial |
$864.11
|
| Rate for Payer: PHP Medicare Advantage |
$617.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health Medicare |
$617.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.22
|
| Rate for Payer: UHC Medicare Advantage |
$617.22
|
| Rate for Payer: UMR Bronson Commercial |
$912.18
|
|
|
PR TENODESIS WRIST EXTENSORS FINGERS
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 25301
|
| Min. Negotiated Rate |
$524.40 |
| Max. Negotiated Rate |
$896.28 |
| Rate for Payer: Aetna Commercial |
$834.04
|
| Rate for Payer: Aetna Medicare |
$647.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.04
|
| Rate for Payer: BCBS Complete |
$524.40
|
| Rate for Payer: BCBS MAPPO |
$622.42
|
| Rate for Payer: BCN Medicare Advantage |
$622.42
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cofinity Commercial |
$896.28
|
| Rate for Payer: Cofinity Commercial |
$834.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$653.54
|
| Rate for Payer: Nomi Health Commercial |
$746.90
|
| Rate for Payer: PACE SWMI |
$622.42
|
| Rate for Payer: PHP Commercial |
$871.39
|
| Rate for Payer: PHP Medicare Advantage |
$622.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.15
|
| Rate for Payer: Priority Health Medicare |
$622.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$622.42
|
| Rate for Payer: UHC Medicare Advantage |
$622.42
|
| Rate for Payer: UMR Bronson Commercial |
$603.06
|
|
|
PR TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA
|
Professional
|
Both
|
$1,844.00
|
|
|
Service Code
|
HCPCS 26449
|
| Min. Negotiated Rate |
$675.67 |
| Max. Negotiated Rate |
$1,198.60 |
| Rate for Payer: Aetna Commercial |
$905.40
|
| Rate for Payer: Aetna Medicare |
$702.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.40
|
| Rate for Payer: BCBS Complete |
$737.60
|
| Rate for Payer: BCBS MAPPO |
$675.67
|
| Rate for Payer: BCN Medicare Advantage |
$675.67
|
| Rate for Payer: Cash Price |
$1,475.20
|
| Rate for Payer: Cash Price |
$1,475.20
|
| Rate for Payer: Cofinity Commercial |
$972.96
|
| Rate for Payer: Cofinity Commercial |
$905.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.45
|
| Rate for Payer: Nomi Health Commercial |
$810.80
|
| Rate for Payer: PACE SWMI |
$675.67
|
| Rate for Payer: PHP Commercial |
$945.94
|
| Rate for Payer: PHP Medicare Advantage |
$675.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,198.60
|
| Rate for Payer: Priority Health Medicare |
$675.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.67
|
| Rate for Payer: UHC Medicare Advantage |
$675.67
|
| Rate for Payer: UMR Bronson Commercial |
$848.24
|
|
|
PR TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 28226
|
| Min. Negotiated Rate |
$318.40 |
| Max. Negotiated Rate |
$554.59 |
| Rate for Payer: Aetna Commercial |
$516.07
|
| Rate for Payer: Aetna Medicare |
$400.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.07
|
| Rate for Payer: BCBS Complete |
$318.40
|
| Rate for Payer: BCBS MAPPO |
$385.13
|
| Rate for Payer: BCN Medicare Advantage |
$385.13
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$554.59
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.39
|
| Rate for Payer: Nomi Health Commercial |
$462.16
|
| Rate for Payer: PACE SWMI |
$385.13
|
| Rate for Payer: PHP Commercial |
$539.18
|
| Rate for Payer: PHP Medicare Advantage |
$385.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.40
|
| Rate for Payer: Priority Health Medicare |
$385.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.13
|
| Rate for Payer: UHC Medicare Advantage |
$385.13
|
| Rate for Payer: UMR Bronson Commercial |
$366.16
|
|
|
PR TENOLYSIS EXTENSOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 28225
|
| Min. Negotiated Rate |
$253.76 |
| Max. Negotiated Rate |
$422.50 |
| Rate for Payer: Aetna Commercial |
$340.04
|
| Rate for Payer: Aetna Medicare |
$263.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.04
|
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: BCBS MAPPO |
$253.76
|
| Rate for Payer: BCN Medicare Advantage |
$253.76
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$365.41
|
| Rate for Payer: Cofinity Commercial |
$340.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.45
|
| Rate for Payer: Nomi Health Commercial |
$304.51
|
| Rate for Payer: PACE SWMI |
$253.76
|
| Rate for Payer: PHP Commercial |
$355.26
|
| Rate for Payer: PHP Medicare Advantage |
$253.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health Medicare |
$253.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.76
|
| Rate for Payer: UHC Medicare Advantage |
$253.76
|
| Rate for Payer: UMR Bronson Commercial |
$299.00
|
|
|
PR TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH
|
Professional
|
Both
|
$1,229.00
|
|
|
Service Code
|
HCPCS 26445
|
| Min. Negotiated Rate |
$491.60 |
| Max. Negotiated Rate |
$803.40 |
| Rate for Payer: Aetna Commercial |
$747.61
|
| Rate for Payer: Aetna Medicare |
$580.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.61
|
| Rate for Payer: BCBS Complete |
$491.60
|
| Rate for Payer: BCBS MAPPO |
$557.92
|
| Rate for Payer: BCN Medicare Advantage |
$557.92
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$803.40
|
| Rate for Payer: Cofinity Commercial |
$747.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.82
|
| Rate for Payer: Nomi Health Commercial |
$669.50
|
| Rate for Payer: PACE SWMI |
$557.92
|
| Rate for Payer: PHP Commercial |
$781.09
|
| Rate for Payer: PHP Medicare Advantage |
$557.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health Medicare |
$557.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.92
|
| Rate for Payer: UHC Medicare Advantage |
$557.92
|
| Rate for Payer: UMR Bronson Commercial |
$565.34
|
|
|
PR TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 28222
|
| Min. Negotiated Rate |
$334.80 |
| Max. Negotiated Rate |
$544.05 |
| Rate for Payer: Aetna Commercial |
$474.79
|
| Rate for Payer: Aetna Medicare |
$368.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.79
|
| Rate for Payer: BCBS Complete |
$334.80
|
| Rate for Payer: BCBS MAPPO |
$354.32
|
| Rate for Payer: BCN Medicare Advantage |
$354.32
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$510.22
|
| Rate for Payer: Cofinity Commercial |
$474.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$372.04
|
| Rate for Payer: Nomi Health Commercial |
$425.18
|
| Rate for Payer: PACE SWMI |
$354.32
|
| Rate for Payer: PHP Commercial |
$496.05
|
| Rate for Payer: PHP Medicare Advantage |
$354.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health Medicare |
$354.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.32
|
| Rate for Payer: UHC Medicare Advantage |
$354.32
|
| Rate for Payer: UMR Bronson Commercial |
$385.02
|
|
|
PR TENOLYSIS FLEXOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 28220
|
| Min. Negotiated Rate |
$291.77 |
| Max. Negotiated Rate |
$642.20 |
| Rate for Payer: Aetna Commercial |
$390.97
|
| Rate for Payer: Aetna Medicare |
$303.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.97
|
| Rate for Payer: BCBS Complete |
$395.20
|
| Rate for Payer: BCBS MAPPO |
$291.77
|
| Rate for Payer: BCN Medicare Advantage |
$291.77
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Commercial |
$420.15
|
| Rate for Payer: Cofinity Commercial |
$390.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.36
|
| Rate for Payer: Nomi Health Commercial |
$350.12
|
| Rate for Payer: PACE SWMI |
$291.77
|
| Rate for Payer: PHP Commercial |
$408.48
|
| Rate for Payer: PHP Medicare Advantage |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health Medicare |
$291.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.77
|
| Rate for Payer: UHC Medicare Advantage |
$291.77
|
| Rate for Payer: UMR Bronson Commercial |
$454.48
|
|
|
PR TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 26442
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$1,338.84 |
| Rate for Payer: Aetna Commercial |
$1,245.87
|
| Rate for Payer: Aetna Medicare |
$966.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,338.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,245.87
|
| Rate for Payer: BCBS Complete |
$714.00
|
| Rate for Payer: BCBS MAPPO |
$929.75
|
| Rate for Payer: BCN Medicare Advantage |
$929.75
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$1,338.84
|
| Rate for Payer: Cofinity Commercial |
$1,245.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$976.24
|
| Rate for Payer: Nomi Health Commercial |
$1,115.70
|
| Rate for Payer: PACE SWMI |
$929.75
|
| Rate for Payer: PHP Commercial |
$1,301.65
|
| Rate for Payer: PHP Medicare Advantage |
$929.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health Medicare |
$929.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$929.75
|
| Rate for Payer: UHC Medicare Advantage |
$929.75
|
| Rate for Payer: UMR Bronson Commercial |
$821.10
|
|
