|
PR TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 26440
|
| Min. Negotiated Rate |
$475.60 |
| Max. Negotiated Rate |
$866.62 |
| Rate for Payer: Aetna Commercial |
$806.44
|
| Rate for Payer: Aetna Medicare |
$625.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$866.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.44
|
| Rate for Payer: BCBS Complete |
$475.60
|
| Rate for Payer: BCBS MAPPO |
$601.82
|
| Rate for Payer: BCN Medicare Advantage |
$601.82
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$866.62
|
| Rate for Payer: Cofinity Commercial |
$806.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$631.91
|
| Rate for Payer: Nomi Health Commercial |
$722.18
|
| Rate for Payer: PACE SWMI |
$601.82
|
| Rate for Payer: PHP Commercial |
$842.55
|
| Rate for Payer: PHP Medicare Advantage |
$601.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health Medicare |
$601.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$601.82
|
| Rate for Payer: UHC Medicare Advantage |
$601.82
|
| Rate for Payer: UMR Bronson Commercial |
$546.94
|
|
|
PR TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27680
|
| Min. Negotiated Rate |
$407.46 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$546.00
|
| Rate for Payer: Aetna Medicare |
$423.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.00
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$407.46
|
| Rate for Payer: BCN Medicare Advantage |
$407.46
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$586.74
|
| Rate for Payer: Cofinity Commercial |
$546.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.83
|
| Rate for Payer: Nomi Health Commercial |
$488.95
|
| Rate for Payer: PACE SWMI |
$407.46
|
| Rate for Payer: PHP Commercial |
$570.44
|
| Rate for Payer: PHP Medicare Advantage |
$407.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$407.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.46
|
| Rate for Payer: UHC Medicare Advantage |
$407.46
|
| Rate for Payer: UMR Bronson Commercial |
$598.46
|
|
|
PR TENOLYSIS TRICEPS
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 24332
|
| Min. Negotiated Rate |
$567.60 |
| Max. Negotiated Rate |
$922.35 |
| Rate for Payer: Aetna Commercial |
$800.46
|
| Rate for Payer: Aetna Medicare |
$621.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.46
|
| Rate for Payer: BCBS Complete |
$567.60
|
| Rate for Payer: BCBS MAPPO |
$597.36
|
| Rate for Payer: BCN Medicare Advantage |
$597.36
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cofinity Commercial |
$860.20
|
| Rate for Payer: Cofinity Commercial |
$800.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.23
|
| Rate for Payer: Nomi Health Commercial |
$716.83
|
| Rate for Payer: PACE SWMI |
$597.36
|
| Rate for Payer: PHP Commercial |
$836.30
|
| Rate for Payer: PHP Medicare Advantage |
$597.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health Medicare |
$597.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.36
|
| Rate for Payer: UHC Medicare Advantage |
$597.36
|
| Rate for Payer: UMR Bronson Commercial |
$652.74
|
|
|
PR TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX
|
Professional
|
Both
|
$2,879.00
|
|
|
Service Code
|
HCPCS 27006
|
| Min. Negotiated Rate |
$685.56 |
| Max. Negotiated Rate |
$1,871.35 |
| Rate for Payer: Aetna Commercial |
$918.65
|
| Rate for Payer: Aetna Medicare |
$712.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.65
|
| Rate for Payer: BCBS Complete |
$1,151.60
|
| Rate for Payer: BCBS MAPPO |
$685.56
|
| Rate for Payer: BCN Medicare Advantage |
$685.56
|
| Rate for Payer: Cash Price |
$2,303.20
|
| Rate for Payer: Cash Price |
$2,303.20
|
| Rate for Payer: Cofinity Commercial |
$987.21
|
| Rate for Payer: Cofinity Commercial |
$918.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.84
|
| Rate for Payer: Nomi Health Commercial |
$822.67
|
| Rate for Payer: PACE SWMI |
$685.56
|
| Rate for Payer: PHP Commercial |
$959.78
|
| Rate for Payer: PHP Medicare Advantage |
$685.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,871.35
|
| Rate for Payer: Priority Health Medicare |
$685.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.56
|
| Rate for Payer: UHC Medicare Advantage |
$685.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,324.34
|
|
|
PR TENOTOMY ADDUCTOR HIP OPEN
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 27001
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$750.54 |
| Rate for Payer: Aetna Commercial |
$698.42
|
| Rate for Payer: Aetna Medicare |
$542.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.42
|
| Rate for Payer: BCBS Complete |
$423.20
|
| Rate for Payer: BCBS MAPPO |
$521.21
|
| Rate for Payer: BCN Medicare Advantage |
$521.21
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cofinity Commercial |
$750.54
|
| Rate for Payer: Cofinity Commercial |
$698.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$521.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$547.27
|
| Rate for Payer: Nomi Health Commercial |
$625.45
|
| Rate for Payer: PACE SWMI |
$521.21
|
| Rate for Payer: PHP Commercial |
$729.69
|
| Rate for Payer: PHP Medicare Advantage |
$521.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$687.70
|
| Rate for Payer: Priority Health Medicare |
$521.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$521.21
|
| Rate for Payer: UHC Medicare Advantage |
$521.21
|
| Rate for Payer: UMR Bronson Commercial |
$486.68
|
|
|
PR TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 27000
|
| Min. Negotiated Rate |
$334.00 |
| Max. Negotiated Rate |
$542.75 |
| Rate for Payer: Aetna Commercial |
$499.53
|
| Rate for Payer: Aetna Medicare |
$387.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.53
|
| Rate for Payer: BCBS Complete |
$334.00
|
| Rate for Payer: BCBS MAPPO |
$372.78
|
| Rate for Payer: BCN Medicare Advantage |
$372.78
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$536.80
|
| Rate for Payer: Cofinity Commercial |
$499.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.42
|
| Rate for Payer: Nomi Health Commercial |
$447.34
|
| Rate for Payer: PACE SWMI |
$372.78
|
| Rate for Payer: PHP Commercial |
$521.89
|
| Rate for Payer: PHP Medicare Advantage |
$372.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.75
|
| Rate for Payer: Priority Health Medicare |
$372.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.78
|
| Rate for Payer: UHC Medicare Advantage |
$372.78
|
| Rate for Payer: UMR Bronson Commercial |
$384.10
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS
|
Professional
|
Both
|
$1,273.00
|
|
|
Service Code
|
HCPCS 24357
|
| Min. Negotiated Rate |
$396.76 |
| Max. Negotiated Rate |
$827.45 |
| Rate for Payer: Aetna Commercial |
$531.66
|
| Rate for Payer: Aetna Medicare |
$412.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.66
|
| Rate for Payer: BCBS Complete |
$509.20
|
| Rate for Payer: BCBS MAPPO |
$396.76
|
| Rate for Payer: BCN Medicare Advantage |
$396.76
|
| Rate for Payer: Cash Price |
$1,018.40
|
| Rate for Payer: Cash Price |
$1,018.40
|
| Rate for Payer: Cofinity Commercial |
$571.33
|
| Rate for Payer: Cofinity Commercial |
$531.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.60
|
| Rate for Payer: Nomi Health Commercial |
$476.11
|
| Rate for Payer: PACE SWMI |
$396.76
|
| Rate for Payer: PHP Commercial |
$555.46
|
| Rate for Payer: PHP Medicare Advantage |
$396.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.45
|
| Rate for Payer: Priority Health Medicare |
$396.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.76
|
| Rate for Payer: UHC Medicare Advantage |
$396.76
|
| Rate for Payer: UMR Bronson Commercial |
$585.58
|
|
|
PR TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 26460
|
| Min. Negotiated Rate |
$396.40 |
| Max. Negotiated Rate |
$644.15 |
| Rate for Payer: Aetna Commercial |
$563.35
|
| Rate for Payer: Aetna Medicare |
$437.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.35
|
| Rate for Payer: BCBS Complete |
$396.40
|
| Rate for Payer: BCBS MAPPO |
$420.41
|
| Rate for Payer: BCN Medicare Advantage |
$420.41
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$605.39
|
| Rate for Payer: Cofinity Commercial |
$563.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.43
|
| Rate for Payer: Nomi Health Commercial |
$504.49
|
| Rate for Payer: PACE SWMI |
$420.41
|
| Rate for Payer: PHP Commercial |
$588.57
|
| Rate for Payer: PHP Medicare Advantage |
$420.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.15
|
| Rate for Payer: Priority Health Medicare |
$420.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.41
|
| Rate for Payer: UHC Medicare Advantage |
$420.41
|
| Rate for Payer: UMR Bronson Commercial |
$455.86
|
|
|
PR TENOTOMY FLEXOR FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 26455
|
| Min. Negotiated Rate |
$396.40 |
| Max. Negotiated Rate |
$644.15 |
| Rate for Payer: Aetna Commercial |
$576.56
|
| Rate for Payer: Aetna Medicare |
$447.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.56
|
| Rate for Payer: BCBS Complete |
$396.40
|
| Rate for Payer: BCBS MAPPO |
$430.27
|
| Rate for Payer: BCN Medicare Advantage |
$430.27
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$619.59
|
| Rate for Payer: Cofinity Commercial |
$576.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.78
|
| Rate for Payer: Nomi Health Commercial |
$516.32
|
| Rate for Payer: PACE SWMI |
$430.27
|
| Rate for Payer: PHP Commercial |
$602.38
|
| Rate for Payer: PHP Medicare Advantage |
$430.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.15
|
| Rate for Payer: Priority Health Medicare |
$430.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.27
|
| Rate for Payer: UHC Medicare Advantage |
$430.27
|
| Rate for Payer: UMR Bronson Commercial |
$455.86
|
|
|
PR TENOTOMY FLEXOR PALM OPEN EACH TENDON
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 26450
|
| Min. Negotiated Rate |
$433.31 |
| Max. Negotiated Rate |
$732.55 |
| Rate for Payer: Aetna Commercial |
$580.64
|
| Rate for Payer: Aetna Medicare |
$450.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.64
|
| Rate for Payer: BCBS Complete |
$450.80
|
| Rate for Payer: BCBS MAPPO |
$433.31
|
| Rate for Payer: BCN Medicare Advantage |
$433.31
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$623.97
|
| Rate for Payer: Cofinity Commercial |
$580.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.98
|
| Rate for Payer: Nomi Health Commercial |
$519.97
|
| Rate for Payer: PACE SWMI |
$433.31
|
| Rate for Payer: PHP Commercial |
$606.63
|
| Rate for Payer: PHP Medicare Advantage |
$433.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health Medicare |
$433.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.31
|
| Rate for Payer: UHC Medicare Advantage |
$433.31
|
| Rate for Payer: UMR Bronson Commercial |
$518.42
|
|
|
PR TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 27005
|
| Min. Negotiated Rate |
$564.40 |
| Max. Negotiated Rate |
$1,005.51 |
| Rate for Payer: Aetna Commercial |
$935.68
|
| Rate for Payer: Aetna Medicare |
$726.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,005.51
|
| Rate for Payer: BCBS Complete |
$564.40
|
| Rate for Payer: BCBS MAPPO |
$698.27
|
| Rate for Payer: BCN Medicare Advantage |
$698.27
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$935.68
|
| Rate for Payer: Cofinity Commercial |
$1,005.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.18
|
| Rate for Payer: Nomi Health Commercial |
$837.92
|
| Rate for Payer: PACE SWMI |
$698.27
|
| Rate for Payer: PHP Commercial |
$977.58
|
| Rate for Payer: PHP Medicare Advantage |
$698.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health Medicare |
$698.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.27
|
| Rate for Payer: UHC Medicare Advantage |
$698.27
|
| Rate for Payer: UMR Bronson Commercial |
$649.06
|
|
|
PR TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 24310
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$656.38 |
| Rate for Payer: Aetna Commercial |
$610.80
|
| Rate for Payer: Aetna Medicare |
$474.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.80
|
| Rate for Payer: BCBS Complete |
$362.40
|
| Rate for Payer: BCBS MAPPO |
$455.82
|
| Rate for Payer: BCN Medicare Advantage |
$455.82
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$656.38
|
| Rate for Payer: Cofinity Commercial |
$610.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.61
|
| Rate for Payer: Nomi Health Commercial |
$546.98
|
| Rate for Payer: PACE SWMI |
$455.82
|
| Rate for Payer: PHP Commercial |
$638.15
|
| Rate for Payer: PHP Medicare Advantage |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.90
|
| Rate for Payer: Priority Health Medicare |
$455.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.82
|
| Rate for Payer: UHC Medicare Advantage |
$455.82
|
| Rate for Payer: UMR Bronson Commercial |
$416.76
|
|
|
PR TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 28234
|
| Min. Negotiated Rate |
$257.82 |
| Max. Negotiated Rate |
$431.60 |
| Rate for Payer: Aetna Commercial |
$345.48
|
| Rate for Payer: Aetna Medicare |
$268.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.48
|
| Rate for Payer: BCBS Complete |
$265.60
|
| Rate for Payer: BCBS MAPPO |
$257.82
|
| Rate for Payer: BCN Medicare Advantage |
$257.82
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Cofinity Commercial |
$345.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.71
|
| Rate for Payer: Nomi Health Commercial |
$309.38
|
| Rate for Payer: PACE SWMI |
$257.82
|
| Rate for Payer: PHP Commercial |
$360.95
|
| Rate for Payer: PHP Medicare Advantage |
$257.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health Medicare |
$257.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.82
|
| Rate for Payer: UHC Medicare Advantage |
$257.82
|
| Rate for Payer: UMR Bronson Commercial |
$305.44
|
|
|
PR TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 27391
|
| Min. Negotiated Rate |
$461.20 |
| Max. Negotiated Rate |
$808.01 |
| Rate for Payer: Aetna Commercial |
$751.90
|
| Rate for Payer: Aetna Medicare |
$583.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.90
|
| Rate for Payer: BCBS Complete |
$461.20
|
| Rate for Payer: BCBS MAPPO |
$561.12
|
| Rate for Payer: BCN Medicare Advantage |
$561.12
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$808.01
|
| Rate for Payer: Cofinity Commercial |
$751.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.18
|
| Rate for Payer: Nomi Health Commercial |
$673.34
|
| Rate for Payer: PACE SWMI |
$561.12
|
| Rate for Payer: PHP Commercial |
$785.57
|
| Rate for Payer: PHP Medicare Advantage |
$561.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health Medicare |
$561.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.12
|
| Rate for Payer: UHC Medicare Advantage |
$561.12
|
| Rate for Payer: UMR Bronson Commercial |
$530.38
|
|
|
PR TENOTOMY PERCUTANEOUS TOE SINGLE TENDON
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 28010
|
| Min. Negotiated Rate |
$157.60 |
| Max. Negotiated Rate |
$286.52 |
| Rate for Payer: Aetna Commercial |
$266.62
|
| Rate for Payer: Aetna Medicare |
$206.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.62
|
| Rate for Payer: BCBS Complete |
$157.60
|
| Rate for Payer: BCBS MAPPO |
$198.97
|
| Rate for Payer: BCN Medicare Advantage |
$198.97
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$286.52
|
| Rate for Payer: Cofinity Commercial |
$266.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.92
|
| Rate for Payer: Nomi Health Commercial |
$238.76
|
| Rate for Payer: PACE SWMI |
$198.97
|
| Rate for Payer: PHP Commercial |
$278.56
|
| Rate for Payer: PHP Medicare Advantage |
$198.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$198.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.97
|
| Rate for Payer: UHC Medicare Advantage |
$198.97
|
| Rate for Payer: UMR Bronson Commercial |
$181.24
|
|
|
PR TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 27606
|
| Min. Negotiated Rate |
$260.78 |
| Max. Negotiated Rate |
$563.55 |
| Rate for Payer: Aetna Commercial |
$349.45
|
| Rate for Payer: Aetna Medicare |
$271.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.45
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS MAPPO |
$260.78
|
| Rate for Payer: BCN Medicare Advantage |
$260.78
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$375.52
|
| Rate for Payer: Cofinity Commercial |
$349.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.82
|
| Rate for Payer: Nomi Health Commercial |
$312.94
|
| Rate for Payer: PACE SWMI |
$260.78
|
| Rate for Payer: PHP Commercial |
$365.09
|
| Rate for Payer: PHP Medicare Advantage |
$260.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health Medicare |
$260.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.78
|
| Rate for Payer: UHC Medicare Advantage |
$260.78
|
| Rate for Payer: UMR Bronson Commercial |
$398.82
|
|
|
PR TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 27605
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$495.30 |
| Rate for Payer: Aetna Commercial |
$234.50
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.50
|
| Rate for Payer: BCBS Complete |
$304.80
|
| Rate for Payer: BCBS MAPPO |
$175.00
|
| Rate for Payer: BCN Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cofinity Commercial |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$234.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.75
|
| Rate for Payer: Nomi Health Commercial |
$210.00
|
| Rate for Payer: PACE SWMI |
$175.00
|
| Rate for Payer: PHP Commercial |
$245.00
|
| Rate for Payer: PHP Medicare Advantage |
$175.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
| Rate for Payer: Priority Health Medicare |
$175.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.00
|
| Rate for Payer: UHC Medicare Advantage |
$175.00
|
| Rate for Payer: UMR Bronson Commercial |
$350.52
|
|
|
PR TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX
|
Professional
|
Both
|
$1,181.00
|
|
|
Service Code
|
HCPCS 27306
|
| Min. Negotiated Rate |
$329.65 |
| Max. Negotiated Rate |
$767.65 |
| Rate for Payer: Aetna Commercial |
$441.73
|
| Rate for Payer: Aetna Medicare |
$342.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.73
|
| Rate for Payer: BCBS Complete |
$472.40
|
| Rate for Payer: BCBS MAPPO |
$329.65
|
| Rate for Payer: BCN Medicare Advantage |
$329.65
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cofinity Commercial |
$474.70
|
| Rate for Payer: Cofinity Commercial |
$441.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.13
|
| Rate for Payer: Nomi Health Commercial |
$395.58
|
| Rate for Payer: PACE SWMI |
$329.65
|
| Rate for Payer: PHP Commercial |
$461.51
|
| Rate for Payer: PHP Medicare Advantage |
$329.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.65
|
| Rate for Payer: Priority Health Medicare |
$329.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.65
|
| Rate for Payer: UHC Medicare Advantage |
$329.65
|
| Rate for Payer: UMR Bronson Commercial |
$543.26
|
|
|
PR TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 27307
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$568.32 |
| Rate for Payer: Aetna Commercial |
$528.86
|
| Rate for Payer: Aetna Medicare |
$410.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.86
|
| Rate for Payer: BCBS Complete |
$338.00
|
| Rate for Payer: BCBS MAPPO |
$394.67
|
| Rate for Payer: BCN Medicare Advantage |
$394.67
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$568.32
|
| Rate for Payer: Cofinity Commercial |
$528.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.40
|
| Rate for Payer: Nomi Health Commercial |
$473.60
|
| Rate for Payer: PACE SWMI |
$394.67
|
| Rate for Payer: PHP Commercial |
$552.54
|
| Rate for Payer: PHP Medicare Advantage |
$394.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: Priority Health Medicare |
$394.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.67
|
| Rate for Payer: UHC Medicare Advantage |
$394.67
|
| Rate for Payer: UMR Bronson Commercial |
$388.70
|
|
|
PR TENOTOMY SHOULDER AREA 1 TENDON
|
Professional
|
Both
|
$1,732.00
|
|
|
Service Code
|
HCPCS 23405
|
| Min. Negotiated Rate |
$591.84 |
| Max. Negotiated Rate |
$1,125.80 |
| Rate for Payer: Aetna Commercial |
$793.07
|
| Rate for Payer: Aetna Medicare |
$615.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.07
|
| Rate for Payer: BCBS Complete |
$692.80
|
| Rate for Payer: BCBS MAPPO |
$591.84
|
| Rate for Payer: BCN Medicare Advantage |
$591.84
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cofinity Commercial |
$852.25
|
| Rate for Payer: Cofinity Commercial |
$793.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.43
|
| Rate for Payer: Nomi Health Commercial |
$710.21
|
| Rate for Payer: PACE SWMI |
$591.84
|
| Rate for Payer: PHP Commercial |
$828.58
|
| Rate for Payer: PHP Medicare Advantage |
$591.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.80
|
| Rate for Payer: Priority Health Medicare |
$591.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.84
|
| Rate for Payer: UHC Medicare Advantage |
$591.84
|
| Rate for Payer: UMR Bronson Commercial |
$796.72
|
|
|
PR TERBUTALINE SULFATE INJ
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J3105
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Medicare |
$7.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.64
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$7.39
|
| Rate for Payer: BCN Medicare Advantage |
$7.39
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$10.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.76
|
| Rate for Payer: Nomi Health Commercial |
$8.87
|
| Rate for Payer: PACE SWMI |
$7.39
|
| Rate for Payer: PHP Commercial |
$10.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$7.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.39
|
| Rate for Payer: UHC Medicare Advantage |
$7.39
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
PR TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION
|
Professional
|
Both
|
$439.00
|
|
|
Service Code
|
HCPCS 95923
|
| Min. Negotiated Rate |
$107.04 |
| Max. Negotiated Rate |
$285.35 |
| Rate for Payer: Aetna Commercial |
$143.43
|
| Rate for Payer: Aetna Medicare |
$111.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.43
|
| Rate for Payer: BCBS Complete |
$175.60
|
| Rate for Payer: BCBS MAPPO |
$107.04
|
| Rate for Payer: BCN Medicare Advantage |
$107.04
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cofinity Commercial |
$154.14
|
| Rate for Payer: Cofinity Commercial |
$143.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.39
|
| Rate for Payer: Nomi Health Commercial |
$128.45
|
| Rate for Payer: PACE SWMI |
$107.04
|
| Rate for Payer: PHP Commercial |
$149.86
|
| Rate for Payer: PHP Medicare Advantage |
$107.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.35
|
| Rate for Payer: Priority Health Medicare |
$107.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.04
|
| Rate for Payer: UHC Medicare Advantage |
$107.04
|
| Rate for Payer: UMR Bronson Commercial |
$201.94
|
|
|
PR TESTOSTERONE CYPIONAT 100 MG
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1070
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR TESTOSTERONE CYPIONAT 200 MG
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J1080
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR TESTOSTERONE CYPIONATE 1 ML
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J1060
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Medicare |
$3.00
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
| Rate for Payer: UMR Bronson Commercial |
$2.76
|
|
