|
PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH
|
Professional
|
Both
|
$1,892.00
|
|
|
Service Code
|
HCPCS 57285
|
| Min. Negotiated Rate |
$444.53 |
| Max. Negotiated Rate |
$2,721.80 |
| Rate for Payer: Aetna Commercial |
$826.70
|
| Rate for Payer: BCBS Complete |
$466.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.80
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Meridian Medicaid |
$466.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.31
|
| Rate for Payer: Priority Health Narrow Network |
$983.31
|
| Rate for Payer: Priority Health SBD |
$983.31
|
| Rate for Payer: UMR Bronson Commercial |
$870.32
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$242.22 |
| Rate for Payer: Aetna Commercial |
$17.73
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS Trust/PPO |
$242.22
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.32
|
| Rate for Payer: Priority Health Narrow Network |
$19.32
|
| Rate for Payer: Priority Health SBD |
$19.32
|
| Rate for Payer: UMR Bronson Commercial |
$51.98
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$569.29 |
| Rate for Payer: Aetna Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$569.29
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.72
|
| Rate for Payer: Priority Health Narrow Network |
$26.72
|
| Rate for Payer: Priority Health SBD |
$26.72
|
| Rate for Payer: UMR Bronson Commercial |
$55.20
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: BCBS Complete |
$19.02
|
| Rate for Payer: BCBS Trust/PPO |
$18.83
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.53
|
| Rate for Payer: Priority Health Narrow Network |
$34.53
|
| Rate for Payer: Priority Health SBD |
$34.53
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
|
|
PR PARTIAL EXCISION BONE CLAVICLE
|
Professional
|
Both
|
$1,393.00
|
|
|
Service Code
|
HCPCS 23180
|
| Min. Negotiated Rate |
$70.89 |
| Max. Negotiated Rate |
$1,016.70 |
| Rate for Payer: Aetna Commercial |
$884.68
|
| Rate for Payer: BCBS Complete |
$449.99
|
| Rate for Payer: BCBS Trust/PPO |
$70.89
|
| Rate for Payer: Cash Price |
$1,114.40
|
| Rate for Payer: Cash Price |
$1,114.40
|
| Rate for Payer: Meridian Medicaid |
$449.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$975.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.70
|
| Rate for Payer: Priority Health SBD |
$1,016.70
|
| Rate for Payer: UMR Bronson Commercial |
$640.78
|
|
|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,338.00
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$420.89 |
| Max. Negotiated Rate |
$1,636.60 |
| Rate for Payer: Aetna Commercial |
$876.29
|
| Rate for Payer: BCBS Complete |
$441.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,539.47
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Meridian Medicaid |
$441.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$999.85
|
| Rate for Payer: Priority Health Narrow Network |
$999.85
|
| Rate for Payer: Priority Health SBD |
$999.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,075.48
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,604.45 |
| Rate for Payer: Aetna Commercial |
$938.53
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.45
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,085.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,085.13
|
| Rate for Payer: Priority Health SBD |
$1,085.13
|
| Rate for Payer: UMR Bronson Commercial |
$644.46
|
|
|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$1,425.00
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$254.64 |
| Max. Negotiated Rate |
$997.50 |
| Rate for Payer: Aetna Commercial |
$666.02
|
| Rate for Payer: BCBS Complete |
$342.40
|
| Rate for Payer: BCBS Trust/PPO |
$254.64
|
| Rate for Payer: Cash Price |
$1,140.00
|
| Rate for Payer: Cash Price |
$1,140.00
|
| Rate for Payer: Meridian Medicaid |
$342.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$997.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.66
|
| Rate for Payer: Priority Health Narrow Network |
$774.66
|
| Rate for Payer: Priority Health SBD |
$774.66
|
| Rate for Payer: UMR Bronson Commercial |
$655.50
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$408.75 |
| Max. Negotiated Rate |
$1,017.10 |
| Rate for Payer: Aetna Commercial |
$836.32
|
| Rate for Payer: BCBS Complete |
$429.19
|
| Rate for Payer: BCBS Trust/PPO |
$889.13
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Meridian Medicaid |
$429.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$972.27
|
| Rate for Payer: Priority Health Narrow Network |
$972.27
|
| Rate for Payer: Priority Health SBD |
$972.27
|
| Rate for Payer: UMR Bronson Commercial |
$668.38
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
OP
|
$1,453.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$537.61 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$944.45
|
| Rate for Payer: Aetna Commercial |
$1,235.05
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,017.10
|
| Rate for Payer: Cofinity Commercial |
$1,249.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,162.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,307.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,017.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,089.75
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,235.05
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,235.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$915.39
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$628.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$537.61
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,089.75
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$408.75 |
| Max. Negotiated Rate |
$1,017.10 |
| Rate for Payer: Aetna Commercial |
$836.32
|
| Rate for Payer: BCBS Complete |
$429.19
|
| Rate for Payer: BCBS Trust/PPO |
$889.13
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Meridian Medicaid |
$429.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$972.27
|
| Rate for Payer: Priority Health Narrow Network |
$972.27
|
| Rate for Payer: Priority Health SBD |
$972.27
|
| Rate for Payer: UMR Bronson Commercial |
$668.38
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
IP
|
$1,453.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$639.32 |
| Max. Negotiated Rate |
$1,307.70 |
| Rate for Payer: Aetna American Axle |
$944.45
|
| Rate for Payer: Aetna Commercial |
$1,235.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.45
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,017.10
|
| Rate for Payer: Cofinity Commercial |
$1,249.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,162.40
|
| Rate for Payer: Healthscope Commercial |
$1,307.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,017.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,089.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,235.05
|
| Rate for Payer: PHP Commercial |
$1,235.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health SBD |
$915.39
|
| Rate for Payer: UMR Bronson Commercial |
$639.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,089.75
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,631.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$96.79 |
| Max. Negotiated Rate |
$1,141.70 |
| Rate for Payer: Aetna Commercial |
$986.17
|
| Rate for Payer: BCBS Complete |
$504.78
|
| Rate for Payer: BCBS Trust/PPO |
$96.79
|
| Rate for Payer: Cash Price |
$1,304.80
|
| Rate for Payer: Cash Price |
$1,304.80
|
| Rate for Payer: Meridian Medicaid |
$504.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,141.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,141.30
|
| Rate for Payer: Priority Health SBD |
$1,141.30
|
| Rate for Payer: UMR Bronson Commercial |
$750.26
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,244.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$380.42 |
| Max. Negotiated Rate |
$1,570.80 |
| Rate for Payer: Aetna Commercial |
$780.47
|
| Rate for Payer: BCBS Complete |
$399.44
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Meridian Medicaid |
$399.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.85
|
| Rate for Payer: Priority Health Narrow Network |
$903.85
|
| Rate for Payer: Priority Health SBD |
$903.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,032.24
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,240.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$1,037.13 |
| Rate for Payer: Aetna Commercial |
$893.47
|
| Rate for Payer: BCBS Complete |
$458.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.63
|
| Rate for Payer: Cash Price |
$992.00
|
| Rate for Payer: Cash Price |
$992.00
|
| Rate for Payer: Meridian Medicaid |
$458.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$868.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.13
|
| Rate for Payer: Priority Health SBD |
$1,037.13
|
| Rate for Payer: UMR Bronson Commercial |
$570.40
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,249.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$319.71 |
| Max. Negotiated Rate |
$874.30 |
| Rate for Payer: Aetna Commercial |
$658.97
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS Trust/PPO |
$732.22
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.81
|
| Rate for Payer: Priority Health Narrow Network |
$757.81
|
| Rate for Payer: Priority Health SBD |
$757.81
|
| Rate for Payer: UMR Bronson Commercial |
$574.54
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$535.91 |
| Max. Negotiated Rate |
$2,231.54 |
| Rate for Payer: Aetna Commercial |
$1,110.44
|
| Rate for Payer: BCBS Complete |
$562.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,231.54
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Meridian Medicaid |
$562.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,274.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,274.08
|
| Rate for Payer: Priority Health SBD |
$1,274.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.14
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$369.13 |
| Max. Negotiated Rate |
$877.29 |
| Rate for Payer: Aetna Commercial |
$756.27
|
| Rate for Payer: BCBS Complete |
$387.59
|
| Rate for Payer: BCBS Trust/PPO |
$386.72
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Meridian Medicaid |
$387.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.29
|
| Rate for Payer: Priority Health Narrow Network |
$877.29
|
| Rate for Payer: Priority Health SBD |
$877.29
|
| Rate for Payer: UMR Bronson Commercial |
$531.76
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,164.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$2,214.80 |
| Rate for Payer: Aetna Commercial |
$1,287.18
|
| Rate for Payer: BCBS Complete |
$657.98
|
| Rate for Payer: BCBS Trust/PPO |
$50.72
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Meridian Medicaid |
$657.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,214.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,499.78
|
| Rate for Payer: Priority Health SBD |
$1,499.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,455.44
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$239.32 |
| Max. Negotiated Rate |
$872.90 |
| Rate for Payer: Aetna Commercial |
$586.97
|
| Rate for Payer: BCBS Complete |
$303.49
|
| Rate for Payer: BCBS Trust/PPO |
$239.32
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Meridian Medicaid |
$303.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.25
|
| Rate for Payer: Priority Health Narrow Network |
$683.25
|
| Rate for Payer: Priority Health SBD |
$683.25
|
| Rate for Payer: UMR Bronson Commercial |
$573.62
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$935.20 |
| Rate for Payer: Aetna Commercial |
$655.87
|
| Rate for Payer: BCBS Complete |
$337.93
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Meridian Medicaid |
$337.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$935.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.41
|
| Rate for Payer: Priority Health Narrow Network |
$762.41
|
| Rate for Payer: Priority Health SBD |
$762.41
|
| Rate for Payer: UMR Bronson Commercial |
$614.56
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,498.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$303.65 |
| Max. Negotiated Rate |
$1,361.39 |
| Rate for Payer: Aetna Commercial |
$1,180.76
|
| Rate for Payer: BCBS Complete |
$598.71
|
| Rate for Payer: BCBS Trust/PPO |
$303.65
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Meridian Medicaid |
$598.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,048.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,361.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.39
|
| Rate for Payer: Priority Health SBD |
$1,361.39
|
| Rate for Payer: UMR Bronson Commercial |
$689.08
|
|
|
PR PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE
|
Professional
|
Both
|
$1,121.00
|
|
|
Service Code
|
HCPCS 23130
|
| Min. Negotiated Rate |
$47.54 |
| Max. Negotiated Rate |
$955.43 |
| Rate for Payer: Aetna Commercial |
$821.57
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS Trust/PPO |
$47.54
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.43
|
| Rate for Payer: Priority Health Narrow Network |
$955.43
|
| Rate for Payer: Priority Health SBD |
$955.43
|
| Rate for Payer: UMR Bronson Commercial |
$515.66
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$215.98 |
| Max. Negotiated Rate |
$805.13 |
| Rate for Payer: Aetna Commercial |
$438.66
|
| Rate for Payer: BCBS Complete |
$226.78
|
| Rate for Payer: BCBS Trust/PPO |
$805.13
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Meridian Medicaid |
$226.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$507.08
|
| Rate for Payer: Priority Health Narrow Network |
$507.08
|
| Rate for Payer: Priority Health SBD |
$507.08
|
| Rate for Payer: UMR Bronson Commercial |
$412.16
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,060.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$425.15 |
| Max. Negotiated Rate |
$1,442.00 |
| Rate for Payer: Aetna Commercial |
$871.76
|
| Rate for Payer: BCBS Complete |
$446.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.24
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Meridian Medicaid |
$446.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.07
|
| Rate for Payer: Priority Health SBD |
$1,010.07
|
| Rate for Payer: UMR Bronson Commercial |
$947.60
|
|
