|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Facility
|
OP
|
$1,903.00
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$584.78 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna American Axle |
$1,236.95
|
| Rate for Payer: Aetna Commercial |
$1,617.55
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.95
|
| 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 |
$5,332.45
|
| Rate for Payer: BCN Commercial |
$5,332.45
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,332.10
|
| Rate for Payer: Cofinity Commercial |
$1,636.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,332.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$1,712.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,332.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.25
|
| 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 |
$1,617.55
|
| 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 |
$1,617.55
|
| 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 |
$1,236.95
|
| 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 |
$1,198.89
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.26
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$584.78
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$704.11
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.25
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Facility
|
IP
|
$1,903.00
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$837.32 |
| Max. Negotiated Rate |
$1,712.70 |
| Rate for Payer: Aetna American Axle |
$1,236.95
|
| Rate for Payer: Aetna Commercial |
$1,617.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.95
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,332.10
|
| Rate for Payer: Cofinity Commercial |
$1,636.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,332.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.40
|
| Rate for Payer: Healthscope Commercial |
$1,712.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,332.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.55
|
| Rate for Payer: PHP Commercial |
$1,617.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health SBD |
$1,198.89
|
| Rate for Payer: UMR Bronson Commercial |
$837.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.25
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27385
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$395.97 |
| Max. Negotiated Rate |
$1,236.95 |
| Rate for Payer: Aetna Commercial |
$776.34
|
| Rate for Payer: Aetna Medicare |
$602.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.28
|
| Rate for Payer: BCBS Complete |
$415.77
|
| Rate for Payer: BCBS MAPPO |
$579.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$579.36
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$834.28
|
| Rate for Payer: Cofinity Commercial |
$776.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.33
|
| Rate for Payer: Meridian Medicaid |
$415.77
|
| Rate for Payer: Nomi Health Commercial |
$695.23
|
| Rate for Payer: PACE SWMI |
$579.36
|
| Rate for Payer: PHP Commercial |
$811.10
|
| Rate for Payer: PHP Medicare Advantage |
$579.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$942.92
|
| Rate for Payer: Priority Health Medicare |
$579.36
|
| Rate for Payer: Priority Health Narrow Network |
$942.92
|
| Rate for Payer: Priority Health SBD |
$942.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.36
|
| Rate for Payer: UHC Medicare Advantage |
$579.36
|
| Rate for Payer: UHCCP Medicaid |
$395.97
|
| Rate for Payer: UMR Bronson Commercial |
$875.38
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27385
|
| Min. Negotiated Rate |
$395.97 |
| Max. Negotiated Rate |
$1,236.95 |
| Rate for Payer: Aetna Commercial |
$776.34
|
| Rate for Payer: Aetna Medicare |
$602.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.28
|
| Rate for Payer: BCBS Complete |
$415.77
|
| Rate for Payer: BCBS MAPPO |
$579.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$579.36
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$776.34
|
| Rate for Payer: Cofinity Commercial |
$834.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.33
|
| Rate for Payer: Meridian Medicaid |
$415.77
|
| Rate for Payer: Nomi Health Commercial |
$695.23
|
| Rate for Payer: PACE SWMI |
$579.36
|
| Rate for Payer: PHP Commercial |
$811.10
|
| Rate for Payer: PHP Medicare Advantage |
$579.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$942.92
|
| Rate for Payer: Priority Health Medicare |
$579.36
|
| Rate for Payer: Priority Health Narrow Network |
$942.92
|
| Rate for Payer: Priority Health SBD |
$942.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.36
|
| Rate for Payer: UHC Medicare Advantage |
$579.36
|
| Rate for Payer: UHCCP Medicaid |
$395.97
|
| Rate for Payer: UMR Bronson Commercial |
$875.38
|
|
|
PR SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$5,688.00
|
|
|
Service Code
|
HCPCS 33322
|
| Min. Negotiated Rate |
$484.45 |
| Max. Negotiated Rate |
$3,697.20 |
| Rate for Payer: Aetna Commercial |
$1,783.42
|
| Rate for Payer: Aetna Medicare |
$1,384.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,783.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,916.51
|
| Rate for Payer: BCBS Complete |
$919.20
|
| Rate for Payer: BCBS MAPPO |
$1,330.91
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,990.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,330.91
|
| Rate for Payer: Cash Price |
$4,550.40
|
| Rate for Payer: Cash Price |
$4,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,783.42
|
| Rate for Payer: Cofinity Commercial |
$1,916.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,330.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,397.46
|
| Rate for Payer: Meridian Medicaid |
$919.20
|
| Rate for Payer: Nomi Health Commercial |
$1,597.09
|
| Rate for Payer: PACE SWMI |
$1,330.91
|
| Rate for Payer: PHP Commercial |
$1,863.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,330.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$875.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,697.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,194.30
|
| Rate for Payer: Priority Health Medicare |
$1,330.91
|
| Rate for Payer: Priority Health Narrow Network |
$2,194.30
|
| Rate for Payer: Priority Health SBD |
$2,194.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,330.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,330.91
|
| Rate for Payer: UHCCP Medicaid |
$875.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,616.48
|
|
|
PR SUTURE/REPAIR TESTICULAR INJURY
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 54670
|
| Min. Negotiated Rate |
$264.12 |
| Max. Negotiated Rate |
$2,909.88 |
| Rate for Payer: Aetna Commercial |
$524.49
|
| Rate for Payer: Aetna Medicare |
$407.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.63
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$391.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,909.88
|
| Rate for Payer: BCN Commercial |
$593.26
|
| Rate for Payer: BCN Medicare Advantage |
$391.41
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$524.49
|
| Rate for Payer: Cofinity Commercial |
$563.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.98
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Nomi Health Commercial |
$469.69
|
| Rate for Payer: PACE SWMI |
$391.41
|
| Rate for Payer: PHP Commercial |
$547.97
|
| Rate for Payer: PHP Medicare Advantage |
$391.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$656.16
|
| Rate for Payer: Priority Health Medicare |
$391.41
|
| Rate for Payer: Priority Health Narrow Network |
$656.16
|
| Rate for Payer: Priority Health SBD |
$656.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.41
|
| Rate for Payer: UHC Medicare Advantage |
$391.41
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
| Rate for Payer: UMR Bronson Commercial |
$577.76
|
|
|
PR SUTURE SCIATIC NERVE
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 64858
|
| Min. Negotiated Rate |
$255.70 |
| Max. Negotiated Rate |
$2,009.84 |
| Rate for Payer: Aetna Commercial |
$1,515.92
|
| Rate for Payer: Aetna Medicare |
$1,176.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.04
|
| Rate for Payer: BCBS Complete |
$796.19
|
| Rate for Payer: BCBS MAPPO |
$1,131.28
|
| Rate for Payer: BCBS Trust/PPO |
$255.70
|
| Rate for Payer: BCN Commercial |
$1,715.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,131.28
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,515.92
|
| Rate for Payer: Cofinity Commercial |
$1,629.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,131.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.84
|
| Rate for Payer: Meridian Medicaid |
$796.19
|
| Rate for Payer: Nomi Health Commercial |
$1,357.54
|
| Rate for Payer: PACE SWMI |
$1,131.28
|
| Rate for Payer: PHP Commercial |
$1,583.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,131.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$758.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,009.84
|
| Rate for Payer: Priority Health Medicare |
$1,131.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,009.84
|
| Rate for Payer: Priority Health SBD |
$2,009.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,131.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,131.28
|
| Rate for Payer: UHCCP Medicaid |
$758.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,150.00
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY CERVICAL
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 31800
|
| Min. Negotiated Rate |
$451.56 |
| Max. Negotiated Rate |
$1,267.39 |
| Rate for Payer: Aetna Commercial |
$881.96
|
| Rate for Payer: Aetna Medicare |
$684.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.78
|
| Rate for Payer: BCBS Complete |
$474.14
|
| Rate for Payer: BCBS MAPPO |
$658.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.39
|
| Rate for Payer: BCN Commercial |
$1,045.28
|
| Rate for Payer: BCN Medicare Advantage |
$658.18
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$881.96
|
| Rate for Payer: Cofinity Commercial |
$947.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.09
|
| Rate for Payer: Meridian Medicaid |
$474.14
|
| Rate for Payer: Nomi Health Commercial |
$789.82
|
| Rate for Payer: PACE SWMI |
$658.18
|
| Rate for Payer: PHP Commercial |
$921.45
|
| Rate for Payer: PHP Medicare Advantage |
$658.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.72
|
| Rate for Payer: Priority Health Medicare |
$658.18
|
| Rate for Payer: Priority Health Narrow Network |
$986.72
|
| Rate for Payer: Priority Health SBD |
$986.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.18
|
| Rate for Payer: UHC Medicare Advantage |
$658.18
|
| Rate for Payer: UHCCP Medicaid |
$451.56
|
| Rate for Payer: UMR Bronson Commercial |
$730.94
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC
|
Professional
|
Both
|
$1,671.00
|
|
|
Service Code
|
HCPCS 31805
|
| Min. Negotiated Rate |
$520.79 |
| Max. Negotiated Rate |
$1,619.77 |
| Rate for Payer: Aetna Commercial |
$1,054.47
|
| Rate for Payer: Aetna Medicare |
$818.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,054.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.16
|
| Rate for Payer: BCBS Complete |
$546.83
|
| Rate for Payer: BCBS MAPPO |
$786.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,619.77
|
| Rate for Payer: BCN Commercial |
$1,181.62
|
| Rate for Payer: BCN Medicare Advantage |
$786.92
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cofinity Commercial |
$1,133.16
|
| Rate for Payer: Cofinity Commercial |
$1,054.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$786.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.27
|
| Rate for Payer: Meridian Medicaid |
$546.83
|
| Rate for Payer: Nomi Health Commercial |
$944.30
|
| Rate for Payer: PACE SWMI |
$786.92
|
| Rate for Payer: PHP Commercial |
$1,101.69
|
| Rate for Payer: PHP Medicare Advantage |
$786.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.54
|
| Rate for Payer: Priority Health Medicare |
$786.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.54
|
| Rate for Payer: Priority Health SBD |
$1,128.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$786.92
|
| Rate for Payer: UHC Medicare Advantage |
$786.92
|
| Rate for Payer: UHCCP Medicaid |
$520.79
|
| Rate for Payer: UMR Bronson Commercial |
$768.66
|
|
|
PR SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 99058
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$773.43 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.30
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS Trust/PPO |
$773.43
|
| Rate for Payer: BCN Commercial |
$42.19
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.94
|
| Rate for Payer: Priority Health Narrow Network |
$28.94
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
PR SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 99051
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$556.30 |
| Rate for Payer: Aetna Commercial |
$20.02
|
| Rate for Payer: Aetna Medicare |
$30.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.02
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.43
|
| Rate for Payer: Priority Health Narrow Network |
$24.43
|
| Rate for Payer: Priority Health SBD |
$24.43
|
| Rate for Payer: UMR Bronson Commercial |
$27.60
|
|
|
PR SYMPATHECTOMY CERVICAL
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 64802
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$1,478.09 |
| Rate for Payer: Aetna Commercial |
$1,121.46
|
| Rate for Payer: Aetna Medicare |
$870.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,205.15
|
| Rate for Payer: BCBS Complete |
$585.07
|
| Rate for Payer: BCBS MAPPO |
$836.91
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$1,254.44
|
| Rate for Payer: BCN Medicare Advantage |
$836.91
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,205.15
|
| Rate for Payer: Cofinity Commercial |
$1,121.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$836.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$878.76
|
| Rate for Payer: Meridian Medicaid |
$585.07
|
| Rate for Payer: Nomi Health Commercial |
$1,004.29
|
| Rate for Payer: PACE SWMI |
$836.91
|
| Rate for Payer: PHP Commercial |
$1,171.67
|
| Rate for Payer: PHP Medicare Advantage |
$836.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,478.09
|
| Rate for Payer: Priority Health Medicare |
$836.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,478.09
|
| Rate for Payer: Priority Health SBD |
$1,478.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$836.91
|
| Rate for Payer: UHC Medicare Advantage |
$836.91
|
| Rate for Payer: UHCCP Medicaid |
$557.21
|
| Rate for Payer: UMR Bronson Commercial |
$795.34
|
|
|
PR SYMPATHECTOMY LUMBAR
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 64818
|
| Min. Negotiated Rate |
$146.74 |
| Max. Negotiated Rate |
$1,337.62 |
| Rate for Payer: Aetna Commercial |
$1,006.61
|
| Rate for Payer: Aetna Medicare |
$781.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,081.73
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS MAPPO |
$751.20
|
| Rate for Payer: BCBS Trust/PPO |
$668.83
|
| Rate for Payer: BCN Commercial |
$1,141.55
|
| Rate for Payer: BCN Medicare Advantage |
$751.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$1,006.61
|
| Rate for Payer: Cofinity Commercial |
$1,081.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.76
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Nomi Health Commercial |
$901.44
|
| Rate for Payer: PACE SWMI |
$751.20
|
| Rate for Payer: PHP Commercial |
$1,051.68
|
| Rate for Payer: PHP Medicare Advantage |
$751.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.62
|
| Rate for Payer: Priority Health Medicare |
$751.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,337.62
|
| Rate for Payer: Priority Health SBD |
$1,337.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.20
|
| Rate for Payer: UHC Medicare Advantage |
$751.20
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
| Rate for Payer: UMR Bronson Commercial |
$146.74
|
|
|
PR SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI
|
Professional
|
Both
|
$2,168.00
|
|
|
Service Code
|
HCPCS 50540
|
| Min. Negotiated Rate |
$730.80 |
| Max. Negotiated Rate |
$2,068.29 |
| Rate for Payer: Aetna Commercial |
$1,465.14
|
| Rate for Payer: Aetna Medicare |
$1,137.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,574.48
|
| Rate for Payer: BCBS Complete |
$767.34
|
| Rate for Payer: BCBS MAPPO |
$1,093.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.29
|
| Rate for Payer: BCN Commercial |
$1,647.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,093.39
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cofinity Commercial |
$1,465.14
|
| Rate for Payer: Cofinity Commercial |
$1,574.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,093.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,148.06
|
| Rate for Payer: Meridian Medicaid |
$767.34
|
| Rate for Payer: Nomi Health Commercial |
$1,312.07
|
| Rate for Payer: PACE SWMI |
$1,093.39
|
| Rate for Payer: PHP Commercial |
$1,530.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,093.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$730.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,816.16
|
| Rate for Payer: Priority Health Medicare |
$1,093.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,816.16
|
| Rate for Payer: Priority Health SBD |
$1,816.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,093.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,093.39
|
| Rate for Payer: UHCCP Medicaid |
$730.80
|
| Rate for Payer: UMR Bronson Commercial |
$997.28
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 98015
|
| Min. Negotiated Rate |
$142.00 |
| Max. Negotiated Rate |
$230.75 |
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: UMR Bronson Commercial |
$163.30
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 98013
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna Medicare |
$81.00
|
| Rate for Payer: BCBS Complete |
$64.80
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
| Rate for Payer: UMR Bronson Commercial |
$74.52
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 98014
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$156.65 |
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: UMR Bronson Commercial |
$110.86
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 98012
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$57.85 |
| Rate for Payer: Aetna Medicare |
$44.50
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: UMR Bronson Commercial |
$40.94
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
HCPCS 98011
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$282.75 |
| Rate for Payer: Aetna Medicare |
$217.50
|
| Rate for Payer: BCBS Complete |
$174.00
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.75
|
| Rate for Payer: UMR Bronson Commercial |
$200.10
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 98009
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$134.55 |
| Rate for Payer: Aetna Medicare |
$103.50
|
| Rate for Payer: BCBS Complete |
$82.80
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.55
|
| Rate for Payer: UMR Bronson Commercial |
$95.22
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 98010
|
| Min. Negotiated Rate |
$132.80 |
| Max. Negotiated Rate |
$215.80 |
| Rate for Payer: Aetna Medicare |
$166.00
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 98008
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VISIT EST LOW MDM 20 MIN
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 98005
|
| Min. Negotiated Rate |
$77.60 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VISIT EST MOD MDM 30 MIN
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 98006
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$170.95 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.95
|
| Rate for Payer: UMR Bronson Commercial |
$120.98
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VISIT EST SF MDM 10 MIN
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 98004
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$72.15 |
| Rate for Payer: Aetna Medicare |
$55.50
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: UMR Bronson Commercial |
$51.06
|
|
