|
PR TEAEC W/WO PATCH GRAFT COMMON FEMORAL
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 35371
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,269.46 |
| Rate for Payer: Aetna Commercial |
$1,045.09
|
| Rate for Payer: Aetna Medicare |
$811.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.08
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$779.92
|
| Rate for Payer: BCBS Trust/PPO |
$666.19
|
| Rate for Payer: BCN Commercial |
$1,163.54
|
| Rate for Payer: BCN Medicare Advantage |
$779.92
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,045.09
|
| Rate for Payer: Cofinity Commercial |
$1,123.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.92
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Nomi Health Commercial |
$935.90
|
| Rate for Payer: PACE SWMI |
$779.92
|
| Rate for Payer: PHP Commercial |
$1,091.89
|
| Rate for Payer: PHP Medicare Advantage |
$779.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.46
|
| Rate for Payer: Priority Health Medicare |
$779.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.46
|
| Rate for Payer: Priority Health SBD |
$1,269.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.92
|
| Rate for Payer: UHC Medicare Advantage |
$779.92
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
| Rate for Payer: UMR Bronson Commercial |
$805.46
|
|
|
PR TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL
|
Professional
|
Both
|
$3,773.00
|
|
|
Service Code
|
HCPCS 35372
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$2,452.45 |
| Rate for Payer: Aetna Commercial |
$1,252.04
|
| Rate for Payer: Aetna Medicare |
$971.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.48
|
| Rate for Payer: BCBS Complete |
$639.42
|
| Rate for Payer: BCBS MAPPO |
$934.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.49
|
| Rate for Payer: BCN Commercial |
$1,392.25
|
| Rate for Payer: BCN Medicare Advantage |
$934.36
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cofinity Commercial |
$1,252.04
|
| Rate for Payer: Cofinity Commercial |
$1,345.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.08
|
| Rate for Payer: Meridian Medicaid |
$639.42
|
| Rate for Payer: Nomi Health Commercial |
$1,121.23
|
| Rate for Payer: PACE SWMI |
$934.36
|
| Rate for Payer: PHP Commercial |
$1,308.10
|
| Rate for Payer: PHP Medicare Advantage |
$934.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,452.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,521.01
|
| Rate for Payer: Priority Health Medicare |
$934.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,521.01
|
| Rate for Payer: Priority Health SBD |
$1,521.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.36
|
| Rate for Payer: UHC Medicare Advantage |
$934.36
|
| Rate for Payer: UHCCP Medicaid |
$608.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,735.58
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIAC
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 35351
|
| Min. Negotiated Rate |
$804.08 |
| Max. Negotiated Rate |
$2,001.79 |
| Rate for Payer: Aetna Commercial |
$1,654.38
|
| Rate for Payer: Aetna Medicare |
$1,283.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,777.84
|
| Rate for Payer: BCBS Complete |
$844.28
|
| Rate for Payer: BCBS MAPPO |
$1,234.61
|
| Rate for Payer: BCBS Trust/PPO |
$942.49
|
| Rate for Payer: BCN Commercial |
$1,831.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,234.61
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cofinity Commercial |
$1,654.38
|
| Rate for Payer: Cofinity Commercial |
$1,777.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,234.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.34
|
| Rate for Payer: Meridian Medicaid |
$844.28
|
| Rate for Payer: Nomi Health Commercial |
$1,481.53
|
| Rate for Payer: PACE SWMI |
$1,234.61
|
| Rate for Payer: PHP Commercial |
$1,728.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,234.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$804.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,001.79
|
| Rate for Payer: Priority Health Medicare |
$1,234.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,001.79
|
| Rate for Payer: Priority Health SBD |
$2,001.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,234.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,234.61
|
| Rate for Payer: UHCCP Medicaid |
$804.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,162.88
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIOFEMORAL
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 35355
|
| Min. Negotiated Rate |
$642.20 |
| Max. Negotiated Rate |
$1,601.33 |
| Rate for Payer: Aetna Commercial |
$1,322.67
|
| Rate for Payer: Aetna Medicare |
$1,026.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,322.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,421.38
|
| Rate for Payer: BCBS Complete |
$674.31
|
| Rate for Payer: BCBS MAPPO |
$987.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.22
|
| Rate for Payer: BCN Commercial |
$1,466.52
|
| Rate for Payer: BCN Medicare Advantage |
$987.07
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cofinity Commercial |
$1,322.67
|
| Rate for Payer: Cofinity Commercial |
$1,421.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$987.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,036.42
|
| Rate for Payer: Meridian Medicaid |
$674.31
|
| Rate for Payer: Nomi Health Commercial |
$1,184.48
|
| Rate for Payer: PACE SWMI |
$987.07
|
| Rate for Payer: PHP Commercial |
$1,381.90
|
| Rate for Payer: PHP Medicare Advantage |
$987.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,601.33
|
| Rate for Payer: Priority Health Medicare |
$987.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,601.33
|
| Rate for Payer: Priority Health SBD |
$1,601.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$987.07
|
| Rate for Payer: UHC Medicare Advantage |
$987.07
|
| Rate for Payer: UHCCP Medicaid |
$642.20
|
| Rate for Payer: UMR Bronson Commercial |
$944.38
|
|
|
PR TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL
|
Professional
|
Both
|
$4,508.00
|
|
|
Service Code
|
HCPCS 35341
|
| Min. Negotiated Rate |
$859.67 |
| Max. Negotiated Rate |
$2,930.20 |
| Rate for Payer: Aetna Commercial |
$1,768.49
|
| Rate for Payer: Aetna Medicare |
$1,372.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,768.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,900.47
|
| Rate for Payer: BCBS Complete |
$902.65
|
| Rate for Payer: BCBS MAPPO |
$1,319.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.71
|
| Rate for Payer: BCN Commercial |
$1,972.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.77
|
| Rate for Payer: Cash Price |
$3,606.40
|
| Rate for Payer: Cash Price |
$3,606.40
|
| Rate for Payer: Cofinity Commercial |
$1,768.49
|
| Rate for Payer: Cofinity Commercial |
$1,900.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.76
|
| Rate for Payer: Meridian Medicaid |
$902.65
|
| Rate for Payer: Nomi Health Commercial |
$1,583.72
|
| Rate for Payer: PACE SWMI |
$1,319.77
|
| Rate for Payer: PHP Commercial |
$1,847.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,930.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.80
|
| Rate for Payer: Priority Health Medicare |
$1,319.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,160.80
|
| Rate for Payer: Priority Health SBD |
$2,160.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,319.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,319.77
|
| Rate for Payer: UHCCP Medicaid |
$859.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,073.68
|
|
|
PR TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL
|
Professional
|
Both
|
$3,855.00
|
|
|
Service Code
|
HCPCS 35321
|
| Min. Negotiated Rate |
$568.50 |
| Max. Negotiated Rate |
$2,505.75 |
| Rate for Payer: Aetna Commercial |
$1,164.80
|
| Rate for Payer: Aetna Medicare |
$904.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.72
|
| Rate for Payer: BCBS Complete |
$596.92
|
| Rate for Payer: BCBS MAPPO |
$869.25
|
| Rate for Payer: BCBS Trust/PPO |
$677.28
|
| Rate for Payer: BCN Commercial |
$1,280.34
|
| Rate for Payer: BCN Medicare Advantage |
$869.25
|
| Rate for Payer: Cash Price |
$3,084.00
|
| Rate for Payer: Cash Price |
$3,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,164.80
|
| Rate for Payer: Cofinity Commercial |
$1,251.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.71
|
| Rate for Payer: Meridian Medicaid |
$596.92
|
| Rate for Payer: Nomi Health Commercial |
$1,043.10
|
| Rate for Payer: PACE SWMI |
$869.25
|
| Rate for Payer: PHP Commercial |
$1,216.95
|
| Rate for Payer: PHP Medicare Advantage |
$869.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,505.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,402.95
|
| Rate for Payer: Priority Health Medicare |
$869.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.95
|
| Rate for Payer: Priority Health SBD |
$1,402.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.25
|
| Rate for Payer: UHC Medicare Advantage |
$869.25
|
| Rate for Payer: UHCCP Medicaid |
$568.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,773.30
|
|
|
PR TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC
|
Professional
|
Both
|
$2,846.00
|
|
|
Service Code
|
HCPCS 35311
|
| Min. Negotiated Rate |
$973.84 |
| Max. Negotiated Rate |
$2,421.92 |
| Rate for Payer: Aetna Commercial |
$1,989.93
|
| Rate for Payer: Aetna Medicare |
$1,544.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,989.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,138.43
|
| Rate for Payer: BCBS Complete |
$1,022.53
|
| Rate for Payer: BCBS MAPPO |
$1,485.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: BCN Commercial |
$2,224.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,485.02
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cofinity Commercial |
$2,138.43
|
| Rate for Payer: Cofinity Commercial |
$1,989.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,485.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,559.27
|
| Rate for Payer: Meridian Medicaid |
$1,022.53
|
| Rate for Payer: Nomi Health Commercial |
$1,782.02
|
| Rate for Payer: PACE SWMI |
$1,485.02
|
| Rate for Payer: PHP Commercial |
$2,079.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,485.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$973.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,849.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,421.92
|
| Rate for Payer: Priority Health Medicare |
$1,485.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,421.92
|
| Rate for Payer: Priority Health SBD |
$2,421.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,485.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.02
|
| Rate for Payer: UHCCP Medicaid |
$973.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,309.16
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 99368
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$852.68 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.09
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS Trust/PPO |
$852.68
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.67
|
| Rate for Payer: Priority Health Narrow Network |
$46.67
|
| Rate for Payer: Priority Health SBD |
$46.67
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 99367
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$232.98 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$232.98
|
| Rate for Payer: BCN Commercial |
$145.07
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.80
|
| Rate for Payer: Priority Health Narrow Network |
$71.80
|
| Rate for Payer: Priority Health SBD |
$71.80
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 98967
|
| Min. Negotiated Rate |
$21.65 |
| Max. Negotiated Rate |
$1,248.37 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare |
$22.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.01
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.37
|
| Rate for Payer: BCN Commercial |
$28.04
|
| Rate for Payer: BCN Medicare Advantage |
$21.65
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.73
|
| Rate for Payer: Nomi Health Commercial |
$25.98
|
| Rate for Payer: PACE SWMI |
$21.65
|
| Rate for Payer: PHP Commercial |
$30.31
|
| Rate for Payer: PHP Medicare Advantage |
$21.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$21.65
|
| Rate for Payer: Priority Health Narrow Network |
$29.85
|
| Rate for Payer: Priority Health SBD |
$29.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.65
|
| Rate for Payer: UHC Medicare Advantage |
$21.65
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 98968
|
| Min. Negotiated Rate |
$30.32 |
| Max. Negotiated Rate |
$1,647.77 |
| Rate for Payer: Aetna Commercial |
$40.63
|
| Rate for Payer: Aetna Medicare |
$31.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$30.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$41.49
|
| Rate for Payer: BCN Medicare Advantage |
$30.32
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.84
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: PACE SWMI |
$30.32
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$30.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.61
|
| Rate for Payer: Priority Health Medicare |
$30.32
|
| Rate for Payer: Priority Health Narrow Network |
$41.61
|
| Rate for Payer: Priority Health SBD |
$41.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.32
|
| Rate for Payer: UHC Medicare Advantage |
$30.32
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 98966
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$564.75 |
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$11.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.01
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$11.12
|
| Rate for Payer: BCBS Trust/PPO |
$564.75
|
| Rate for Payer: BCN Commercial |
$14.56
|
| Rate for Payer: BCN Medicare Advantage |
$11.12
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.68
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: PACE SWMI |
$11.12
|
| Rate for Payer: PHP Commercial |
$15.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.38
|
| Rate for Payer: Priority Health Medicare |
$11.12
|
| Rate for Payer: Priority Health Narrow Network |
$15.38
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.12
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
| Rate for Payer: UMR Bronson Commercial |
$13.34
|
|
|
PR TEMPORARY CLOSURE EYELIDS SUTURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 67875
|
| Min. Negotiated Rate |
$89.27 |
| Max. Negotiated Rate |
$266.33 |
| Rate for Payer: Aetna Commercial |
$119.62
|
| Rate for Payer: Aetna Medicare |
$92.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.55
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$89.27
|
| Rate for Payer: BCN Commercial |
$266.33
|
| Rate for Payer: BCN Medicare Advantage |
$89.27
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$128.55
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.73
|
| Rate for Payer: Nomi Health Commercial |
$107.12
|
| Rate for Payer: PACE SWMI |
$89.27
|
| Rate for Payer: PHP Commercial |
$124.98
|
| Rate for Payer: PHP Medicare Advantage |
$89.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.12
|
| Rate for Payer: Priority Health Medicare |
$89.27
|
| Rate for Payer: Priority Health Narrow Network |
$166.12
|
| Rate for Payer: Priority Health SBD |
$166.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.27
|
| Rate for Payer: UHC Medicare Advantage |
$89.27
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$329.72 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$650.99
|
| Rate for Payer: Aetna Medicare |
$505.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.57
|
| Rate for Payer: BCBS Complete |
$346.21
|
| Rate for Payer: BCBS MAPPO |
$485.81
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$741.81
|
| Rate for Payer: BCN Medicare Advantage |
$485.81
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cofinity Commercial |
$650.99
|
| Rate for Payer: Cofinity Commercial |
$699.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.10
|
| Rate for Payer: Meridian Medicaid |
$346.21
|
| Rate for Payer: Nomi Health Commercial |
$582.97
|
| Rate for Payer: PACE SWMI |
$485.81
|
| Rate for Payer: PHP Commercial |
$680.13
|
| Rate for Payer: PHP Medicare Advantage |
$485.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$779.57
|
| Rate for Payer: Priority Health Medicare |
$485.81
|
| Rate for Payer: Priority Health Narrow Network |
$779.57
|
| Rate for Payer: Priority Health SBD |
$779.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.81
|
| Rate for Payer: UHC Medicare Advantage |
$485.81
|
| Rate for Payer: UHCCP Medicaid |
$329.72
|
| Rate for Payer: UMR Bronson Commercial |
$511.98
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$148.45 |
| Max. Negotiated Rate |
$901.69 |
| Rate for Payer: Aetna Commercial |
$752.45
|
| Rate for Payer: Aetna Medicare |
$583.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.60
|
| Rate for Payer: BCBS Complete |
$400.33
|
| Rate for Payer: BCBS MAPPO |
$561.53
|
| Rate for Payer: BCBS Trust/PPO |
$148.45
|
| Rate for Payer: BCN Commercial |
$856.16
|
| Rate for Payer: BCN Medicare Advantage |
$561.53
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$752.45
|
| Rate for Payer: Cofinity Commercial |
$808.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.61
|
| Rate for Payer: Meridian Medicaid |
$400.33
|
| Rate for Payer: Nomi Health Commercial |
$673.84
|
| Rate for Payer: PACE SWMI |
$561.53
|
| Rate for Payer: PHP Commercial |
$786.14
|
| Rate for Payer: PHP Medicare Advantage |
$561.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$901.69
|
| Rate for Payer: Priority Health Medicare |
$561.53
|
| Rate for Payer: Priority Health Narrow Network |
$901.69
|
| Rate for Payer: Priority Health SBD |
$901.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.53
|
| Rate for Payer: UHC Medicare Advantage |
$561.53
|
| Rate for Payer: UHCCP Medicaid |
$381.27
|
| Rate for Payer: UMR Bronson Commercial |
$473.34
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$875.71 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.35
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Commercial |
$395.07
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.95
|
| Rate for Payer: Priority Health Medicare |
$282.19
|
| Rate for Payer: Priority Health Narrow Network |
$456.95
|
| Rate for Payer: Priority Health SBD |
$456.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
| Rate for Payer: UMR Bronson Commercial |
$542.80
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$875.71 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.35
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Commercial |
$395.07
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.95
|
| Rate for Payer: Priority Health Medicare |
$282.19
|
| Rate for Payer: Priority Health Narrow Network |
$456.95
|
| Rate for Payer: Priority Health SBD |
$456.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
| Rate for Payer: UMR Bronson Commercial |
$542.80
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$519.20 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna American Axle |
$767.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Cofinity Commercial |
$826.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$826.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health SBD |
$743.40
|
| Rate for Payer: UMR Bronson Commercial |
$519.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.00
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$282.00 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$767.00
|
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.86
|
| Rate for Payer: BCN Commercial |
$1,537.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Cofinity Commercial |
$826.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$826.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.00
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$743.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.20
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$282.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$436.60
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.00
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$560.83 |
| Max. Negotiated Rate |
$1,346.45 |
| Rate for Payer: Aetna Commercial |
$1,090.34
|
| Rate for Payer: Aetna Medicare |
$846.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.71
|
| Rate for Payer: BCBS Complete |
$588.87
|
| Rate for Payer: BCBS MAPPO |
$813.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.41
|
| Rate for Payer: BCN Commercial |
$1,293.53
|
| Rate for Payer: BCN Medicare Advantage |
$813.69
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,090.34
|
| Rate for Payer: Cofinity Commercial |
$1,171.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$854.37
|
| Rate for Payer: Meridian Medicaid |
$588.87
|
| Rate for Payer: Nomi Health Commercial |
$976.43
|
| Rate for Payer: PACE SWMI |
$813.69
|
| Rate for Payer: PHP Commercial |
$1,139.17
|
| Rate for Payer: PHP Medicare Advantage |
$813.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.45
|
| Rate for Payer: Priority Health Medicare |
$813.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,346.45
|
| Rate for Payer: Priority Health SBD |
$1,346.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.69
|
| Rate for Payer: UHC Medicare Advantage |
$813.69
|
| Rate for Payer: UHCCP Medicaid |
$560.83
|
| Rate for Payer: UMR Bronson Commercial |
$652.74
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$86.64 |
| Max. Negotiated Rate |
$927.65 |
| Rate for Payer: Aetna Commercial |
$785.71
|
| Rate for Payer: Aetna Medicare |
$609.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.34
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$586.35
|
| Rate for Payer: BCBS Trust/PPO |
$86.64
|
| Rate for Payer: BCN Commercial |
$886.46
|
| Rate for Payer: BCN Medicare Advantage |
$586.35
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$785.71
|
| Rate for Payer: Cofinity Commercial |
$844.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.67
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Nomi Health Commercial |
$703.62
|
| Rate for Payer: PACE SWMI |
$586.35
|
| Rate for Payer: PHP Commercial |
$820.89
|
| Rate for Payer: PHP Medicare Advantage |
$586.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$586.35
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: Priority Health SBD |
$927.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.35
|
| Rate for Payer: UHC Medicare Advantage |
$586.35
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
| Rate for Payer: UMR Bronson Commercial |
$502.32
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$420.46 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$813.47
|
| Rate for Payer: Aetna Medicare |
$631.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.18
|
| Rate for Payer: BCBS Complete |
$441.48
|
| Rate for Payer: BCBS MAPPO |
$607.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$972.47
|
| Rate for Payer: BCN Medicare Advantage |
$607.07
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cofinity Commercial |
$813.47
|
| Rate for Payer: Cofinity Commercial |
$874.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.42
|
| Rate for Payer: Meridian Medicaid |
$441.48
|
| Rate for Payer: Nomi Health Commercial |
$728.48
|
| Rate for Payer: PACE SWMI |
$607.07
|
| Rate for Payer: PHP Commercial |
$849.90
|
| Rate for Payer: PHP Medicare Advantage |
$607.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,011.10
|
| Rate for Payer: Priority Health Medicare |
$607.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,011.10
|
| Rate for Payer: Priority Health SBD |
$1,011.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.07
|
| Rate for Payer: UHC Medicare Advantage |
$607.07
|
| Rate for Payer: UHCCP Medicaid |
$420.46
|
| Rate for Payer: UMR Bronson Commercial |
$466.90
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
OP
|
$2,357.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$721.93 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna American Axle |
$1,532.05
|
| Rate for Payer: Aetna Commercial |
$2,003.45
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,532.05
|
| 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 |
$5,219.76
|
| Rate for Payer: BCN Commercial |
$5,219.76
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$1,649.90
|
| Rate for Payer: Cofinity Commercial |
$2,027.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,649.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,121.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,649.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,767.75
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| 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 |
$2,003.45
|
| 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 |
$2,003.45
|
| 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 |
$1,532.05
|
| 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 |
$1,484.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$794.12
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$721.93
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$872.09
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,767.75
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,357.00
|
|
|
Service Code
|
HCPCS 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$106.55 |
| Max. Negotiated Rate |
$1,532.05 |
| Rate for Payer: Aetna Commercial |
$961.62
|
| Rate for Payer: Aetna Medicare |
$746.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.62
|
| Rate for Payer: BCBS Complete |
$509.70
|
| Rate for Payer: BCBS MAPPO |
$717.63
|
| Rate for Payer: BCBS Trust/PPO |
$106.55
|
| Rate for Payer: BCN Commercial |
$1,096.11
|
| Rate for Payer: BCN Medicare Advantage |
$717.63
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$961.62
|
| Rate for Payer: Cofinity Commercial |
$1,033.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.51
|
| Rate for Payer: Meridian Medicaid |
$509.70
|
| Rate for Payer: Nomi Health Commercial |
$861.16
|
| Rate for Payer: PACE SWMI |
$717.63
|
| Rate for Payer: PHP Commercial |
$1,004.68
|
| Rate for Payer: PHP Medicare Advantage |
$717.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.56
|
| Rate for Payer: Priority Health Medicare |
$717.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.56
|
| Rate for Payer: Priority Health SBD |
$1,151.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.63
|
| Rate for Payer: UHC Medicare Advantage |
$717.63
|
| Rate for Payer: UHCCP Medicaid |
$485.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,084.22
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
IP
|
$2,357.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$1,037.08 |
| Max. Negotiated Rate |
$2,121.30 |
| Rate for Payer: Aetna American Axle |
$1,532.05
|
| Rate for Payer: Aetna Commercial |
$2,003.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,532.05
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$1,649.90
|
| Rate for Payer: Cofinity Commercial |
$2,027.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,649.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.60
|
| Rate for Payer: Healthscope Commercial |
$2,121.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,649.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,767.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,003.45
|
| Rate for Payer: PHP Commercial |
$2,003.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health SBD |
$1,484.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,037.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,767.75
|
|
