|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS
|
Professional
|
Both
|
$3,175.00
|
|
|
Service Code
|
HCPCS 64857
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$2,063.75 |
| Rate for Payer: Aetna Commercial |
$1,351.18
|
| Rate for Payer: Aetna Medicare |
$1,048.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,452.01
|
| Rate for Payer: BCBS Complete |
$710.54
|
| Rate for Payer: BCBS MAPPO |
$1,008.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,539.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.34
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,351.18
|
| Rate for Payer: Cofinity Commercial |
$1,452.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,058.76
|
| Rate for Payer: Meridian Medicaid |
$710.54
|
| Rate for Payer: Nomi Health Commercial |
$1,210.01
|
| Rate for Payer: PACE SWMI |
$1,008.34
|
| Rate for Payer: PHP Commercial |
$1,411.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,801.13
|
| Rate for Payer: Priority Health Medicare |
$1,008.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,801.13
|
| Rate for Payer: Priority Health SBD |
$1,801.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,008.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,008.34
|
| Rate for Payer: UHCCP Medicaid |
$676.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,460.50
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS
|
Professional
|
Both
|
$3,953.00
|
|
|
Service Code
|
HCPCS 64856
|
| Min. Negotiated Rate |
$183.32 |
| Max. Negotiated Rate |
$2,569.45 |
| Rate for Payer: Aetna Commercial |
$1,306.22
|
| Rate for Payer: Aetna Medicare |
$1,013.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.70
|
| Rate for Payer: BCBS Complete |
$685.49
|
| Rate for Payer: BCBS MAPPO |
$974.79
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$1,480.20
|
| Rate for Payer: BCN Medicare Advantage |
$974.79
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,306.22
|
| Rate for Payer: Cofinity Commercial |
$1,403.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,023.53
|
| Rate for Payer: Meridian Medicaid |
$685.49
|
| Rate for Payer: Nomi Health Commercial |
$1,169.75
|
| Rate for Payer: PACE SWMI |
$974.79
|
| Rate for Payer: PHP Commercial |
$1,364.71
|
| Rate for Payer: PHP Medicare Advantage |
$974.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,569.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.21
|
| Rate for Payer: Priority Health Medicare |
$974.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.21
|
| Rate for Payer: Priority Health SBD |
$1,723.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.79
|
| Rate for Payer: UHC Medicare Advantage |
$974.79
|
| Rate for Payer: UHCCP Medicaid |
$652.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,818.38
|
|
|
PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 27386
|
| Min. Negotiated Rate |
$557.00 |
| Max. Negotiated Rate |
$1,522.30 |
| Rate for Payer: Aetna Commercial |
$1,100.61
|
| Rate for Payer: Aetna Medicare |
$854.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.74
|
| Rate for Payer: BCBS Complete |
$584.85
|
| Rate for Payer: BCBS MAPPO |
$821.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.54
|
| Rate for Payer: BCN Commercial |
$1,261.27
|
| Rate for Payer: BCN Medicare Advantage |
$821.35
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$1,100.61
|
| Rate for Payer: Cofinity Commercial |
$1,182.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.42
|
| Rate for Payer: Meridian Medicaid |
$584.85
|
| Rate for Payer: Nomi Health Commercial |
$985.62
|
| Rate for Payer: PACE SWMI |
$821.35
|
| Rate for Payer: PHP Commercial |
$1,149.89
|
| Rate for Payer: PHP Medicare Advantage |
$821.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.05
|
| Rate for Payer: Priority Health Medicare |
$821.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.05
|
| Rate for Payer: Priority Health SBD |
$1,323.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.35
|
| Rate for Payer: UHC Medicare Advantage |
$821.35
|
| Rate for Payer: UHCCP Medicaid |
$557.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,077.32
|
|
|
PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP
|
Professional
|
Both
|
$2,203.00
|
|
|
Service Code
|
HCPCS 33320
|
| Min. Negotiated Rate |
$375.26 |
| Max. Negotiated Rate |
$1,682.16 |
| Rate for Payer: Aetna Commercial |
$1,376.56
|
| Rate for Payer: Aetna Medicare |
$1,068.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.28
|
| Rate for Payer: BCBS Complete |
$710.09
|
| Rate for Payer: BCBS MAPPO |
$1,027.28
|
| Rate for Payer: BCBS Trust/PPO |
$375.26
|
| Rate for Payer: BCN Commercial |
$1,538.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.28
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cofinity Commercial |
$1,376.56
|
| Rate for Payer: Cofinity Commercial |
$1,479.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.64
|
| Rate for Payer: Meridian Medicaid |
$710.09
|
| Rate for Payer: Nomi Health Commercial |
$1,232.74
|
| Rate for Payer: PACE SWMI |
$1,027.28
|
| Rate for Payer: PHP Commercial |
$1,438.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,431.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,682.16
|
| Rate for Payer: Priority Health Medicare |
$1,027.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,682.16
|
| Rate for Payer: Priority Health SBD |
$1,682.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.28
|
| Rate for Payer: UHCCP Medicaid |
$676.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,013.38
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$2,017.58 |
| Rate for Payer: Aetna Commercial |
$545.35
|
| Rate for Payer: Aetna Medicare |
$423.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.05
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$406.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.58
|
| Rate for Payer: BCN Commercial |
$870.33
|
| Rate for Payer: BCN Medicare Advantage |
$406.98
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$545.35
|
| Rate for Payer: Cofinity Commercial |
$586.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.33
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Nomi Health Commercial |
$488.38
|
| Rate for Payer: PACE SWMI |
$406.98
|
| Rate for Payer: PHP Commercial |
$569.77
|
| Rate for Payer: PHP Medicare Advantage |
$406.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.38
|
| Rate for Payer: Priority Health Medicare |
$406.98
|
| Rate for Payer: Priority Health Narrow Network |
$760.38
|
| Rate for Payer: Priority Health SBD |
$760.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.98
|
| Rate for Payer: UHC Medicare Advantage |
$406.98
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
| Rate for Payer: UMR Bronson Commercial |
$529.46
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 67930
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$668.30 |
| Rate for Payer: Aetna Commercial |
$294.24
|
| Rate for Payer: Aetna Medicare |
$228.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.20
|
| Rate for Payer: BCBS Complete |
$156.56
|
| Rate for Payer: BCBS MAPPO |
$219.58
|
| Rate for Payer: BCBS Trust/PPO |
$668.30
|
| Rate for Payer: BCN Commercial |
$539.50
|
| Rate for Payer: BCN Medicare Advantage |
$219.58
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$294.24
|
| Rate for Payer: Cofinity Commercial |
$316.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.56
|
| Rate for Payer: Meridian Medicaid |
$156.56
|
| Rate for Payer: Nomi Health Commercial |
$263.50
|
| Rate for Payer: PACE SWMI |
$219.58
|
| Rate for Payer: PHP Commercial |
$307.41
|
| Rate for Payer: PHP Medicare Advantage |
$219.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.85
|
| Rate for Payer: Priority Health Medicare |
$219.58
|
| Rate for Payer: Priority Health Narrow Network |
$408.85
|
| Rate for Payer: Priority Health SBD |
$408.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.58
|
| Rate for Payer: UHC Medicare Advantage |
$219.58
|
| Rate for Payer: UHCCP Medicaid |
$149.10
|
| Rate for Payer: UMR Bronson Commercial |
$351.90
|
|
|
PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 64834
|
| Min. Negotiated Rate |
$404.68 |
| Max. Negotiated Rate |
$1,397.50 |
| Rate for Payer: Aetna Commercial |
$961.70
|
| Rate for Payer: Aetna Medicare |
$746.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.70
|
| Rate for Payer: BCBS Complete |
$509.25
|
| Rate for Payer: BCBS MAPPO |
$717.69
|
| Rate for Payer: BCBS Trust/PPO |
$404.68
|
| Rate for Payer: BCN Commercial |
$1,077.53
|
| Rate for Payer: BCN Medicare Advantage |
$717.69
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,033.47
|
| Rate for Payer: Cofinity Commercial |
$961.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.57
|
| Rate for Payer: Meridian Medicaid |
$509.25
|
| Rate for Payer: Nomi Health Commercial |
$861.23
|
| Rate for Payer: PACE SWMI |
$717.69
|
| Rate for Payer: PHP Commercial |
$1,004.77
|
| Rate for Payer: PHP Medicare Advantage |
$717.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,280.18
|
| Rate for Payer: Priority Health Medicare |
$717.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,280.18
|
| Rate for Payer: Priority Health SBD |
$1,280.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.69
|
| Rate for Payer: UHC Medicare Advantage |
$717.69
|
| Rate for Payer: UHCCP Medicaid |
$485.00
|
| Rate for Payer: UMR Bronson Commercial |
$989.00
|
|
|
PR SUTURE 1 NERVE MEDIAN MOTOR THENAR
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 64835
|
| Min. Negotiated Rate |
$302.72 |
| Max. Negotiated Rate |
$1,486.55 |
| Rate for Payer: Aetna Commercial |
$1,055.21
|
| Rate for Payer: Aetna Medicare |
$818.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.96
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$787.47
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$1,197.26
|
| Rate for Payer: BCN Medicare Advantage |
$787.47
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,055.21
|
| Rate for Payer: Cofinity Commercial |
$1,133.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.84
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Nomi Health Commercial |
$944.96
|
| Rate for Payer: PACE SWMI |
$787.47
|
| Rate for Payer: PHP Commercial |
$1,102.46
|
| Rate for Payer: PHP Medicare Advantage |
$787.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.16
|
| Rate for Payer: Priority Health Medicare |
$787.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,404.16
|
| Rate for Payer: Priority Health SBD |
$1,404.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.47
|
| Rate for Payer: UHC Medicare Advantage |
$787.47
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.02
|
|
|
PR SUTURE 1 NERVE ULNAR MOTOR
|
Professional
|
Both
|
$1,805.00
|
|
|
Service Code
|
HCPCS 64836
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$1,404.16 |
| Rate for Payer: Aetna Commercial |
$1,055.21
|
| Rate for Payer: Aetna Medicare |
$818.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.96
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$787.47
|
| Rate for Payer: BCBS Trust/PPO |
$219.24
|
| Rate for Payer: BCN Commercial |
$1,197.26
|
| Rate for Payer: BCN Medicare Advantage |
$787.47
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cofinity Commercial |
$1,055.21
|
| Rate for Payer: Cofinity Commercial |
$1,133.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.84
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Nomi Health Commercial |
$944.96
|
| Rate for Payer: PACE SWMI |
$787.47
|
| Rate for Payer: PHP Commercial |
$1,102.46
|
| Rate for Payer: PHP Medicare Advantage |
$787.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.16
|
| Rate for Payer: Priority Health Medicare |
$787.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,404.16
|
| Rate for Payer: Priority Health SBD |
$1,404.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.47
|
| Rate for Payer: UHC Medicare Advantage |
$787.47
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
| Rate for Payer: UMR Bronson Commercial |
$830.30
|
|
|
PR SUTURE BRACHIAL PLEXUS
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 64861
|
| Min. Negotiated Rate |
$244.60 |
| Max. Negotiated Rate |
$2,643.96 |
| Rate for Payer: Aetna Commercial |
$2,023.86
|
| Rate for Payer: Aetna Medicare |
$1,570.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,023.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,174.89
|
| Rate for Payer: BCBS Complete |
$1,045.34
|
| Rate for Payer: BCBS MAPPO |
$1,510.34
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: BCN Commercial |
$2,250.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,510.34
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$2,023.86
|
| Rate for Payer: Cofinity Commercial |
$2,174.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,510.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,585.86
|
| Rate for Payer: Meridian Medicaid |
$1,045.34
|
| Rate for Payer: Nomi Health Commercial |
$1,812.41
|
| Rate for Payer: PACE SWMI |
$1,510.34
|
| Rate for Payer: PHP Commercial |
$2,114.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,510.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$995.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,643.96
|
| Rate for Payer: Priority Health Medicare |
$1,510.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,643.96
|
| Rate for Payer: Priority Health SBD |
$2,643.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,510.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,510.34
|
| Rate for Payer: UHCCP Medicaid |
$995.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,704.30
|
|
|
PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 64831
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$1,290.25 |
| Rate for Payer: Aetna Commercial |
$895.43
|
| Rate for Payer: Aetna Medicare |
$694.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.25
|
| Rate for Payer: BCBS Complete |
$476.15
|
| Rate for Payer: BCBS MAPPO |
$668.23
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,019.87
|
| Rate for Payer: BCN Medicare Advantage |
$668.23
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$895.43
|
| Rate for Payer: Cofinity Commercial |
$962.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.64
|
| Rate for Payer: Meridian Medicaid |
$476.15
|
| Rate for Payer: Nomi Health Commercial |
$801.88
|
| Rate for Payer: PACE SWMI |
$668.23
|
| Rate for Payer: PHP Commercial |
$935.52
|
| Rate for Payer: PHP Medicare Advantage |
$668.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,197.14
|
| Rate for Payer: Priority Health Medicare |
$668.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,197.14
|
| Rate for Payer: Priority Health SBD |
$1,197.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.23
|
| Rate for Payer: UHC Medicare Advantage |
$668.23
|
| Rate for Payer: UHCCP Medicaid |
$453.48
|
| Rate for Payer: UMR Bronson Commercial |
$913.10
|
|
|
PR SUTURE EACH ADDITIONAL NERVE HAND/FOOT
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 64837
|
| Min. Negotiated Rate |
$206.57 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$466.68
|
| Rate for Payer: Aetna Medicare |
$362.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.51
|
| Rate for Payer: BCBS Complete |
$242.43
|
| Rate for Payer: BCBS MAPPO |
$348.27
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$525.33
|
| Rate for Payer: BCN Medicare Advantage |
$348.27
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cofinity Commercial |
$466.68
|
| Rate for Payer: Cofinity Commercial |
$501.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.68
|
| Rate for Payer: Meridian Medicaid |
$242.43
|
| Rate for Payer: Nomi Health Commercial |
$417.92
|
| Rate for Payer: PACE SWMI |
$348.27
|
| Rate for Payer: PHP Commercial |
$487.58
|
| Rate for Payer: PHP Medicare Advantage |
$348.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.51
|
| Rate for Payer: Priority Health Medicare |
$348.27
|
| Rate for Payer: Priority Health Narrow Network |
$612.51
|
| Rate for Payer: Priority Health SBD |
$612.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.27
|
| Rate for Payer: UHC Medicare Advantage |
$348.27
|
| Rate for Payer: UHCCP Medicaid |
$230.89
|
| Rate for Payer: UMR Bronson Commercial |
$603.06
|
|
|
PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE
|
Professional
|
Both
|
$1,633.00
|
|
|
Service Code
|
HCPCS 64859
|
| Min. Negotiated Rate |
$156.77 |
| Max. Negotiated Rate |
$1,061.45 |
| Rate for Payer: Aetna Commercial |
$316.79
|
| Rate for Payer: Aetna Medicare |
$245.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.43
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$236.41
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$357.23
|
| Rate for Payer: BCN Medicare Advantage |
$236.41
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cofinity Commercial |
$316.79
|
| Rate for Payer: Cofinity Commercial |
$340.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.23
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Nomi Health Commercial |
$283.69
|
| Rate for Payer: PACE SWMI |
$236.41
|
| Rate for Payer: PHP Commercial |
$330.97
|
| Rate for Payer: PHP Medicare Advantage |
$236.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,061.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.29
|
| Rate for Payer: Priority Health Medicare |
$236.41
|
| Rate for Payer: Priority Health Narrow Network |
$416.29
|
| Rate for Payer: Priority Health SBD |
$416.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.41
|
| Rate for Payer: UHC Medicare Advantage |
$236.41
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
| Rate for Payer: UMR Bronson Commercial |
$751.18
|
|
|
PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY
|
Professional
|
Both
|
$3,048.00
|
|
|
Service Code
|
HCPCS 47900
|
| Min. Negotiated Rate |
$886.08 |
| Max. Negotiated Rate |
$3,830.18 |
| Rate for Payer: Aetna Commercial |
$1,794.29
|
| Rate for Payer: Aetna Medicare |
$1,392.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,794.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,928.19
|
| Rate for Payer: BCBS Complete |
$930.38
|
| Rate for Payer: BCBS MAPPO |
$1,339.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,830.18
|
| Rate for Payer: BCN Commercial |
$2,015.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,339.02
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cofinity Commercial |
$1,794.29
|
| Rate for Payer: Cofinity Commercial |
$1,928.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,339.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,405.97
|
| Rate for Payer: Meridian Medicaid |
$930.38
|
| Rate for Payer: Nomi Health Commercial |
$1,606.82
|
| Rate for Payer: PACE SWMI |
$1,339.02
|
| Rate for Payer: PHP Commercial |
$1,874.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,339.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,469.89
|
| Rate for Payer: Priority Health Medicare |
$1,339.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,469.89
|
| Rate for Payer: Priority Health SBD |
$2,469.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,339.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.02
|
| Rate for Payer: UHCCP Medicaid |
$886.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,402.08
|
|
|
PR SUTURE FACIAL NERVE EXTRACRANIAL
|
Professional
|
Both
|
$2,429.00
|
|
|
Service Code
|
HCPCS 64864
|
| Min. Negotiated Rate |
$305.89 |
| Max. Negotiated Rate |
$1,578.85 |
| Rate for Payer: Aetna Commercial |
$1,103.32
|
| Rate for Payer: Aetna Medicare |
$856.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.65
|
| Rate for Payer: BCBS Complete |
$581.27
|
| Rate for Payer: BCBS MAPPO |
$823.37
|
| Rate for Payer: BCBS Trust/PPO |
$305.89
|
| Rate for Payer: BCN Commercial |
$1,260.78
|
| Rate for Payer: BCN Medicare Advantage |
$823.37
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cofinity Commercial |
$1,103.32
|
| Rate for Payer: Cofinity Commercial |
$1,185.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$864.54
|
| Rate for Payer: Meridian Medicaid |
$581.27
|
| Rate for Payer: Nomi Health Commercial |
$988.04
|
| Rate for Payer: PACE SWMI |
$823.37
|
| Rate for Payer: PHP Commercial |
$1,152.72
|
| Rate for Payer: PHP Medicare Advantage |
$823.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,466.71
|
| Rate for Payer: Priority Health Medicare |
$823.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.71
|
| Rate for Payer: Priority Health SBD |
$1,466.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$823.37
|
| Rate for Payer: UHC Medicare Advantage |
$823.37
|
| Rate for Payer: UHCCP Medicaid |
$553.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,117.34
|
|
|
PR SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT
|
Professional
|
Both
|
$3,037.00
|
|
|
Service Code
|
HCPCS 64865
|
| Min. Negotiated Rate |
$354.49 |
| Max. Negotiated Rate |
$1,974.05 |
| Rate for Payer: Aetna Commercial |
$1,371.62
|
| Rate for Payer: Aetna Medicare |
$1,064.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.98
|
| Rate for Payer: BCBS Complete |
$726.86
|
| Rate for Payer: BCBS MAPPO |
$1,023.60
|
| Rate for Payer: BCBS Trust/PPO |
$354.49
|
| Rate for Payer: BCN Commercial |
$1,592.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,371.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.78
|
| Rate for Payer: Meridian Medicaid |
$726.86
|
| Rate for Payer: Nomi Health Commercial |
$1,228.32
|
| Rate for Payer: PACE SWMI |
$1,023.60
|
| Rate for Payer: PHP Commercial |
$1,433.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,853.44
|
| Rate for Payer: Priority Health Medicare |
$1,023.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,853.44
|
| Rate for Payer: Priority Health SBD |
$1,853.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,023.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,023.60
|
| Rate for Payer: UHCCP Medicaid |
$692.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,397.02
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$682.44 |
| Max. Negotiated Rate |
$1,395.90 |
| Rate for Payer: Aetna American Axle |
$1,008.15
|
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.15
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,085.70
|
| Rate for Payer: Cofinity Commercial |
$1,333.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,085.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.80
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,085.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health SBD |
$977.13
|
| Rate for Payer: UMR Bronson Commercial |
$682.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.25
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$2,533.73 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.17
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,533.73
|
| Rate for Payer: BCN Commercial |
$923.11
|
| Rate for Payer: BCN Medicare Advantage |
$595.26
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$857.17
|
| Rate for Payer: Cofinity Commercial |
$797.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Nomi Health Commercial |
$714.31
|
| Rate for Payer: PACE SWMI |
$595.26
|
| Rate for Payer: PHP Commercial |
$833.36
|
| Rate for Payer: PHP Medicare Advantage |
$595.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.33
|
| Rate for Payer: Priority Health Medicare |
$595.26
|
| Rate for Payer: Priority Health Narrow Network |
$966.33
|
| Rate for Payer: Priority Health SBD |
$966.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
| Rate for Payer: UMR Bronson Commercial |
$713.46
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$2,533.73 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.17
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,533.73
|
| Rate for Payer: BCN Commercial |
$923.11
|
| Rate for Payer: BCN Medicare Advantage |
$595.26
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$797.65
|
| Rate for Payer: Cofinity Commercial |
$857.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Nomi Health Commercial |
$714.31
|
| Rate for Payer: PACE SWMI |
$595.26
|
| Rate for Payer: PHP Commercial |
$833.36
|
| Rate for Payer: PHP Medicare Advantage |
$595.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.33
|
| Rate for Payer: Priority Health Medicare |
$595.26
|
| Rate for Payer: Priority Health Narrow Network |
$966.33
|
| Rate for Payer: Priority Health SBD |
$966.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
| Rate for Payer: UMR Bronson Commercial |
$713.46
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$573.87 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna American Axle |
$1,008.15
|
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,949.61
|
| Rate for Payer: BCN Commercial |
$4,949.61
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,333.86
|
| Rate for Payer: Cofinity Commercial |
$1,085.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,085.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,085.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.25
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$977.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.25
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$601.14
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$573.87
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.25
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,979.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$330.19 |
| Max. Negotiated Rate |
$1,342.93 |
| Rate for Payer: Aetna Commercial |
$972.67
|
| Rate for Payer: Aetna Medicare |
$754.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.67
|
| Rate for Payer: BCBS Complete |
$506.57
|
| Rate for Payer: BCBS MAPPO |
$725.87
|
| Rate for Payer: BCBS Trust/PPO |
$330.19
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| Rate for Payer: BCN Medicare Advantage |
$725.87
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cofinity Commercial |
$1,045.25
|
| Rate for Payer: Cofinity Commercial |
$972.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.16
|
| Rate for Payer: Meridian Medicaid |
$506.57
|
| Rate for Payer: Nomi Health Commercial |
$871.04
|
| Rate for Payer: PACE SWMI |
$725.87
|
| Rate for Payer: PHP Commercial |
$1,016.22
|
| Rate for Payer: PHP Medicare Advantage |
$725.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.93
|
| Rate for Payer: Priority Health Medicare |
$725.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,342.93
|
| Rate for Payer: Priority Health SBD |
$1,342.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$725.87
|
| Rate for Payer: UHC Medicare Advantage |
$725.87
|
| Rate for Payer: UHCCP Medicaid |
$482.45
|
| Rate for Payer: UMR Bronson Commercial |
$910.34
|
|
|
PR SUTURE NERVE REQ SECONDARY/DELAYED SUTURE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 64872
|
| Min. Negotiated Rate |
$73.49 |
| Max. Negotiated Rate |
$213.43 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: Aetna Medicare |
$115.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.52
|
| Rate for Payer: BCBS Complete |
$77.16
|
| Rate for Payer: BCBS MAPPO |
$110.78
|
| Rate for Payer: BCBS Trust/PPO |
$213.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$110.78
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$148.45
|
| Rate for Payer: Cofinity Commercial |
$159.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.32
|
| Rate for Payer: Meridian Medicaid |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$132.94
|
| Rate for Payer: PACE SWMI |
$110.78
|
| Rate for Payer: PHP Commercial |
$155.09
|
| Rate for Payer: PHP Medicare Advantage |
$110.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.50
|
| Rate for Payer: Priority Health Medicare |
$110.78
|
| Rate for Payer: Priority Health Narrow Network |
$194.50
|
| Rate for Payer: Priority Health SBD |
$194.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.78
|
| Rate for Payer: UHC Medicare Advantage |
$110.78
|
| Rate for Payer: UHCCP Medicaid |
$73.49
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
|
|
PR SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 64874
|
| Min. Negotiated Rate |
$109.91 |
| Max. Negotiated Rate |
$303.24 |
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Aetna Commercial |
$222.17
|
| Rate for Payer: Aetna Medicare |
$172.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.75
|
| Rate for Payer: BCBS Complete |
$115.41
|
| Rate for Payer: BCBS MAPPO |
$165.80
|
| Rate for Payer: BCBS Trust/PPO |
$303.24
|
| Rate for Payer: BCN Commercial |
$249.71
|
| Rate for Payer: BCN Medicare Advantage |
$165.80
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$222.17
|
| Rate for Payer: Cofinity Commercial |
$238.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.09
|
| Rate for Payer: Meridian Medicaid |
$115.41
|
| Rate for Payer: Nomi Health Commercial |
$198.96
|
| Rate for Payer: PACE SWMI |
$165.80
|
| Rate for Payer: PHP Commercial |
$232.12
|
| Rate for Payer: PHP Medicare Advantage |
$165.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.74
|
| Rate for Payer: Priority Health Medicare |
$165.80
|
| Rate for Payer: Priority Health Narrow Network |
$291.74
|
| Rate for Payer: Priority Health SBD |
$291.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.80
|
| Rate for Payer: UHC Medicare Advantage |
$165.80
|
| Rate for Payer: UHCCP Medicaid |
$109.91
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
|
|
PR SUTURE PHARYNX WOUND/INJURY
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 42900
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$1,110.49 |
| Rate for Payer: Aetna Commercial |
$425.21
|
| Rate for Payer: Aetna Medicare |
$330.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.94
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$317.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.49
|
| Rate for Payer: BCN Commercial |
$485.75
|
| Rate for Payer: BCN Medicare Advantage |
$317.32
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$425.21
|
| Rate for Payer: Cofinity Commercial |
$456.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.19
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Nomi Health Commercial |
$380.78
|
| Rate for Payer: PACE SWMI |
$317.32
|
| Rate for Payer: PHP Commercial |
$444.25
|
| Rate for Payer: PHP Medicare Advantage |
$317.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.60
|
| Rate for Payer: Priority Health Medicare |
$317.32
|
| Rate for Payer: Priority Health Narrow Network |
$596.60
|
| Rate for Payer: Priority Health SBD |
$596.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.32
|
| Rate for Payer: UHC Medicare Advantage |
$317.32
|
| Rate for Payer: UHCCP Medicaid |
$213.64
|
| Rate for Payer: UMR Bronson Commercial |
$286.58
|
|
|
PR SUTURE POSTERIOR TIBIAL NERVE
|
Professional
|
Both
|
$1,979.00
|
|
|
Service Code
|
HCPCS 64840
|
| Min. Negotiated Rate |
$247.24 |
| Max. Negotiated Rate |
$1,651.55 |
| Rate for Payer: Aetna Commercial |
$1,243.64
|
| Rate for Payer: Aetna Medicare |
$965.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,243.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.45
|
| Rate for Payer: BCBS Complete |
$655.29
|
| Rate for Payer: BCBS MAPPO |
$928.09
|
| Rate for Payer: BCBS Trust/PPO |
$247.24
|
| Rate for Payer: BCN Commercial |
$1,409.35
|
| Rate for Payer: BCN Medicare Advantage |
$928.09
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cofinity Commercial |
$1,243.64
|
| Rate for Payer: Cofinity Commercial |
$1,336.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$928.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.49
|
| Rate for Payer: Meridian Medicaid |
$655.29
|
| Rate for Payer: Nomi Health Commercial |
$1,113.71
|
| Rate for Payer: PACE SWMI |
$928.09
|
| Rate for Payer: PHP Commercial |
$1,299.33
|
| Rate for Payer: PHP Medicare Advantage |
$928.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.55
|
| Rate for Payer: Priority Health Medicare |
$928.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,651.55
|
| Rate for Payer: Priority Health SBD |
$1,651.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$928.09
|
| Rate for Payer: UHC Medicare Advantage |
$928.09
|
| Rate for Payer: UHCCP Medicaid |
$624.09
|
| Rate for Payer: UMR Bronson Commercial |
$910.34
|
|
