|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,119.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$78.96 |
| Max. Negotiated Rate |
$151,328.00 |
| Rate for Payer: Aetna Commercial |
$1,101.68
|
| Rate for Payer: Aetna Medicare |
$855.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,183.90
|
| Rate for Payer: BCBS Complete |
$582.61
|
| Rate for Payer: BCBS MAPPO |
$822.15
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$1,379.62
|
| Rate for Payer: BCN Medicare Advantage |
$822.15
|
| Rate for Payer: Cash Price |
$2,495.20
|
| Rate for Payer: Cash Price |
$2,495.20
|
| Rate for Payer: Cofinity Commercial |
$1,183.90
|
| Rate for Payer: Cofinity Commercial |
$1,101.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.15
|
| Rate for Payer: Healthscope Commercial |
$1,520.98
|
| Rate for Payer: Healthscope Commercial |
$1,315.44
|
| Rate for Payer: Mclaren Medicaid |
$554.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.26
|
| Rate for Payer: Meridian Medicaid |
$582.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151,328.00
|
| Rate for Payer: Nomi Health Commercial |
$986.58
|
| Rate for Payer: PACE SWMI |
$822.15
|
| Rate for Payer: PHP Medicare Advantage |
$822.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,027.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.90
|
| Rate for Payer: Priority Health Medicare |
$822.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,314.90
|
| Rate for Payer: Priority Health SBD |
$1,314.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.15
|
| Rate for Payer: UHC Exchange |
$1,340.15
|
| Rate for Payer: UHC Medicare Advantage |
$822.15
|
| Rate for Payer: UHCCP Medicaid |
$554.87
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$496.93 |
| Max. Negotiated Rate |
$135,706.00 |
| Rate for Payer: Aetna Commercial |
$984.90
|
| Rate for Payer: Aetna Medicare |
$764.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.90
|
| Rate for Payer: BCBS Complete |
$521.78
|
| Rate for Payer: BCBS MAPPO |
$735.00
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$735.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$984.90
|
| Rate for Payer: Cofinity Commercial |
$1,058.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.00
|
| Rate for Payer: Healthscope Commercial |
$1,359.75
|
| Rate for Payer: Healthscope Commercial |
$1,176.00
|
| Rate for Payer: Mclaren Medicaid |
$496.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.75
|
| Rate for Payer: Meridian Medicaid |
$521.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135,706.00
|
| Rate for Payer: Nomi Health Commercial |
$882.00
|
| Rate for Payer: PACE SWMI |
$735.00
|
| Rate for Payer: PHP Medicare Advantage |
$735.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,180.05
|
| Rate for Payer: Priority Health Medicare |
$735.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,180.05
|
| Rate for Payer: Priority Health SBD |
$1,180.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.00
|
| Rate for Payer: UHC Exchange |
$1,038.05
|
| Rate for Payer: UHC Medicare Advantage |
$735.00
|
| Rate for Payer: UHCCP Medicaid |
$496.93
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27814
|
| Min. Negotiated Rate |
$496.93 |
| Max. Negotiated Rate |
$135,706.00 |
| Rate for Payer: Aetna Commercial |
$984.90
|
| Rate for Payer: Aetna Medicare |
$764.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.90
|
| Rate for Payer: BCBS Complete |
$521.78
|
| Rate for Payer: BCBS MAPPO |
$735.00
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$735.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$984.90
|
| Rate for Payer: Cofinity Commercial |
$1,058.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.00
|
| Rate for Payer: Healthscope Commercial |
$1,359.75
|
| Rate for Payer: Healthscope Commercial |
$1,176.00
|
| Rate for Payer: Mclaren Medicaid |
$496.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.75
|
| Rate for Payer: Meridian Medicaid |
$521.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135,706.00
|
| Rate for Payer: Nomi Health Commercial |
$882.00
|
| Rate for Payer: PACE SWMI |
$735.00
|
| Rate for Payer: PHP Medicare Advantage |
$735.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,180.05
|
| Rate for Payer: Priority Health Medicare |
$735.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,180.05
|
| Rate for Payer: Priority Health SBD |
$1,180.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.00
|
| Rate for Payer: UHC Exchange |
$1,038.05
|
| Rate for Payer: UHC Medicare Advantage |
$735.00
|
| Rate for Payer: UHCCP Medicaid |
$496.93
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
IP
|
$3,005.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$1,893.15 |
| Max. Negotiated Rate |
$2,704.50 |
| Rate for Payer: Aetna Commercial |
$2,554.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,953.25
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$2,103.50
|
| Rate for Payer: Cofinity Commercial |
$2,584.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,103.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,404.00
|
| Rate for Payer: Healthscope Commercial |
$2,704.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,554.25
|
| Rate for Payer: PHP Commercial |
$2,554.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health SBD |
$1,893.15
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
OP
|
$3,005.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$814.23 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Commercial |
$2,554.25
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,953.25
|
| 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 |
$3,333.61
|
| Rate for Payer: BCN Commercial |
$3,333.61
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$2,103.50
|
| Rate for Payer: Cofinity Commercial |
$2,584.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,103.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,404.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,704.50
|
| 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 |
$2,554.25
|
| 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 |
$2,554.25
|
| 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 |
$1,953.25
|
| 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 |
$1,893.15
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.23
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,940.59
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,366.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$725.27 |
| Max. Negotiated Rate |
$198,943.00 |
| Rate for Payer: Aetna Commercial |
$1,437.07
|
| Rate for Payer: Aetna Medicare |
$1,115.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,544.31
|
| Rate for Payer: BCBS Complete |
$761.53
|
| Rate for Payer: BCBS MAPPO |
$1,072.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: BCN Commercial |
$1,648.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.44
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cofinity Commercial |
$1,544.31
|
| Rate for Payer: Cofinity Commercial |
$1,437.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.44
|
| Rate for Payer: Healthscope Commercial |
$1,984.01
|
| Rate for Payer: Healthscope Commercial |
$1,715.90
|
| Rate for Payer: Mclaren Medicaid |
$725.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,126.06
|
| Rate for Payer: Meridian Medicaid |
$761.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198,943.00
|
| Rate for Payer: Nomi Health Commercial |
$1,286.93
|
| Rate for Payer: PACE SWMI |
$1,072.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,187.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.51
|
| Rate for Payer: Priority Health Medicare |
$1,072.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.51
|
| Rate for Payer: Priority Health SBD |
$1,723.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,444.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,072.44
|
| Rate for Payer: UHC Exchange |
$1,444.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.44
|
| Rate for Payer: UHCCP Medicaid |
$725.27
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,224.00
|
|
|
Service Code
|
HCPCS 28420
|
| Min. Negotiated Rate |
$372.45 |
| Max. Negotiated Rate |
$229,658.00 |
| Rate for Payer: Aetna Commercial |
$1,664.70
|
| Rate for Payer: Aetna Medicare |
$1,292.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,788.93
|
| Rate for Payer: BCBS Complete |
$881.63
|
| Rate for Payer: BCBS MAPPO |
$1,242.31
|
| Rate for Payer: BCBS Trust/PPO |
$372.45
|
| Rate for Payer: BCN Commercial |
$1,904.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,242.31
|
| Rate for Payer: Cash Price |
$1,779.20
|
| Rate for Payer: Cash Price |
$1,779.20
|
| Rate for Payer: Cofinity Commercial |
$1,788.93
|
| Rate for Payer: Cofinity Commercial |
$1,664.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,242.31
|
| Rate for Payer: Healthscope Commercial |
$2,298.27
|
| Rate for Payer: Healthscope Commercial |
$1,987.70
|
| Rate for Payer: Mclaren Medicaid |
$839.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,304.43
|
| Rate for Payer: Meridian Medicaid |
$881.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229,658.00
|
| Rate for Payer: Nomi Health Commercial |
$1,490.77
|
| Rate for Payer: PACE SWMI |
$1,242.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,242.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,445.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,994.73
|
| Rate for Payer: Priority Health Medicare |
$1,242.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,994.73
|
| Rate for Payer: Priority Health SBD |
$1,994.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,490.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,242.31
|
| Rate for Payer: UHC Exchange |
$1,490.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,242.31
|
| Rate for Payer: UHCCP Medicaid |
$839.65
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,603.00
|
|
|
Service Code
|
HCPCS 27828
|
| Min. Negotiated Rate |
$855.62 |
| Max. Negotiated Rate |
$235,148.00 |
| Rate for Payer: Aetna Commercial |
$1,697.59
|
| Rate for Payer: Aetna Medicare |
$1,317.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,697.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,824.28
|
| Rate for Payer: BCBS Complete |
$898.40
|
| Rate for Payer: BCBS MAPPO |
$1,266.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.07
|
| Rate for Payer: BCN Commercial |
$1,948.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,266.86
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,824.28
|
| Rate for Payer: Cofinity Commercial |
$1,697.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,266.86
|
| Rate for Payer: Healthscope Commercial |
$2,343.69
|
| Rate for Payer: Healthscope Commercial |
$2,026.98
|
| Rate for Payer: Mclaren Medicaid |
$855.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,330.20
|
| Rate for Payer: Meridian Medicaid |
$898.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235,148.00
|
| Rate for Payer: Nomi Health Commercial |
$1,520.23
|
| Rate for Payer: PACE SWMI |
$1,266.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,266.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,991.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,037.98
|
| Rate for Payer: Priority Health Medicare |
$1,266.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,037.98
|
| Rate for Payer: Priority Health SBD |
$2,037.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,266.86
|
| Rate for Payer: UHC Exchange |
$1,614.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,266.86
|
| Rate for Payer: UHCCP Medicaid |
$855.62
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$552.52 |
| Max. Negotiated Rate |
$151,081.00 |
| Rate for Payer: Aetna Commercial |
$1,089.70
|
| Rate for Payer: Aetna Medicare |
$845.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.02
|
| Rate for Payer: BCBS Complete |
$580.15
|
| Rate for Payer: BCBS MAPPO |
$813.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,384.29
|
| Rate for Payer: BCN Commercial |
$1,257.85
|
| Rate for Payer: BCN Medicare Advantage |
$813.21
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$1,171.02
|
| Rate for Payer: Cofinity Commercial |
$1,089.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.21
|
| Rate for Payer: Healthscope Commercial |
$1,504.44
|
| Rate for Payer: Healthscope Commercial |
$1,301.14
|
| Rate for Payer: Mclaren Medicaid |
$552.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.87
|
| Rate for Payer: Meridian Medicaid |
$580.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151,081.00
|
| Rate for Payer: Nomi Health Commercial |
$975.85
|
| Rate for Payer: PACE SWMI |
$813.21
|
| Rate for Payer: PHP Medicare Advantage |
$813.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.93
|
| Rate for Payer: Priority Health Medicare |
$813.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,316.93
|
| Rate for Payer: Priority Health SBD |
$1,316.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.21
|
| Rate for Payer: UHC Exchange |
$920.10
|
| Rate for Payer: UHC Medicare Advantage |
$813.21
|
| Rate for Payer: UHCCP Medicaid |
$552.52
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,362.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$198,284.00 |
| Rate for Payer: Aetna Commercial |
$1,435.30
|
| Rate for Payer: Aetna Medicare |
$1,113.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,542.41
|
| Rate for Payer: BCBS Complete |
$761.97
|
| Rate for Payer: BCBS MAPPO |
$1,071.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.80
|
| Rate for Payer: BCN Commercial |
$1,647.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.12
|
| Rate for Payer: Cash Price |
$3,489.60
|
| Rate for Payer: Cash Price |
$3,489.60
|
| Rate for Payer: Cofinity Commercial |
$1,542.41
|
| Rate for Payer: Cofinity Commercial |
$1,435.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.12
|
| Rate for Payer: Healthscope Commercial |
$1,981.57
|
| Rate for Payer: Healthscope Commercial |
$1,713.79
|
| Rate for Payer: Mclaren Medicaid |
$725.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,124.68
|
| Rate for Payer: Meridian Medicaid |
$761.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198,284.00
|
| Rate for Payer: Nomi Health Commercial |
$1,285.34
|
| Rate for Payer: PACE SWMI |
$1,071.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,835.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,724.52
|
| Rate for Payer: Priority Health Medicare |
$1,071.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,724.52
|
| Rate for Payer: Priority Health SBD |
$1,724.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,327.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.12
|
| Rate for Payer: UHC Exchange |
$1,327.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.12
|
| Rate for Payer: UHCCP Medicaid |
$725.69
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$2,016.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$483.94 |
| Max. Negotiated Rate |
$132,433.00 |
| Rate for Payer: Aetna Commercial |
$963.47
|
| Rate for Payer: Aetna Medicare |
$747.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.47
|
| Rate for Payer: BCBS Complete |
$508.14
|
| Rate for Payer: BCBS MAPPO |
$719.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.58
|
| Rate for Payer: BCN Commercial |
$1,094.15
|
| Rate for Payer: BCN Medicare Advantage |
$719.01
|
| Rate for Payer: Cash Price |
$1,612.80
|
| Rate for Payer: Cash Price |
$1,612.80
|
| Rate for Payer: Cofinity Commercial |
$963.47
|
| Rate for Payer: Cofinity Commercial |
$1,035.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.01
|
| Rate for Payer: Healthscope Commercial |
$1,330.17
|
| Rate for Payer: Healthscope Commercial |
$1,150.42
|
| Rate for Payer: Mclaren Medicaid |
$483.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.96
|
| Rate for Payer: Meridian Medicaid |
$508.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,433.00
|
| Rate for Payer: Nomi Health Commercial |
$862.81
|
| Rate for Payer: PACE SWMI |
$719.01
|
| Rate for Payer: PHP Medicare Advantage |
$719.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,310.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.97
|
| Rate for Payer: Priority Health Medicare |
$719.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.97
|
| Rate for Payer: Priority Health SBD |
$1,146.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.01
|
| Rate for Payer: UHC Exchange |
$869.97
|
| Rate for Payer: UHC Medicare Advantage |
$719.01
|
| Rate for Payer: UHCCP Medicaid |
$483.94
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$378.26 |
| Max. Negotiated Rate |
$148,208.00 |
| Rate for Payer: Aetna Commercial |
$1,081.73
|
| Rate for Payer: Aetna Medicare |
$839.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,081.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,162.45
|
| Rate for Payer: BCBS Complete |
$573.22
|
| Rate for Payer: BCBS MAPPO |
$807.26
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$1,229.02
|
| Rate for Payer: BCN Medicare Advantage |
$807.26
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,162.45
|
| Rate for Payer: Cofinity Commercial |
$1,081.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$807.26
|
| Rate for Payer: Healthscope Commercial |
$1,493.43
|
| Rate for Payer: Healthscope Commercial |
$1,291.62
|
| Rate for Payer: Mclaren Medicaid |
$545.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$847.62
|
| Rate for Payer: Meridian Medicaid |
$573.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148,208.00
|
| Rate for Payer: Nomi Health Commercial |
$968.71
|
| Rate for Payer: PACE SWMI |
$807.26
|
| Rate for Payer: PHP Medicare Advantage |
$807.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,290.97
|
| Rate for Payer: Priority Health Medicare |
$807.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,290.97
|
| Rate for Payer: Priority Health SBD |
$1,290.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,042.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$807.26
|
| Rate for Payer: UHC Exchange |
$1,042.66
|
| Rate for Payer: UHC Medicare Advantage |
$807.26
|
| Rate for Payer: UHCCP Medicaid |
$545.92
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$979.00
|
|
|
Service Code
|
HCPCS 28675
|
| Min. Negotiated Rate |
$269.66 |
| Max. Negotiated Rate |
$72,448.00 |
| Rate for Payer: Aetna Commercial |
$529.88
|
| Rate for Payer: Aetna Medicare |
$411.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.42
|
| Rate for Payer: BCBS Complete |
$283.14
|
| Rate for Payer: BCBS MAPPO |
$395.43
|
| Rate for Payer: BCBS Trust/PPO |
$671.47
|
| Rate for Payer: BCN Commercial |
$841.50
|
| Rate for Payer: BCN Medicare Advantage |
$395.43
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cofinity Commercial |
$569.42
|
| Rate for Payer: Cofinity Commercial |
$529.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.43
|
| Rate for Payer: Healthscope Commercial |
$731.55
|
| Rate for Payer: Healthscope Commercial |
$632.69
|
| Rate for Payer: Mclaren Medicaid |
$269.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.20
|
| Rate for Payer: Meridian Medicaid |
$283.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,448.00
|
| Rate for Payer: Nomi Health Commercial |
$474.52
|
| Rate for Payer: PACE SWMI |
$395.43
|
| Rate for Payer: PHP Medicare Advantage |
$395.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.66
|
| Rate for Payer: Priority Health Medicare |
$395.43
|
| Rate for Payer: Priority Health Narrow Network |
$640.66
|
| Rate for Payer: Priority Health SBD |
$640.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$491.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.43
|
| Rate for Payer: UHC Exchange |
$491.21
|
| Rate for Payer: UHC Medicare Advantage |
$395.43
|
| Rate for Payer: UHCCP Medicaid |
$269.66
|
|
|
PR OPEN TREATMENT LUNATE DISLOCATION
|
Professional
|
Both
|
$1,904.00
|
|
|
Service Code
|
HCPCS 25695
|
| Min. Negotiated Rate |
$416.20 |
| Max. Negotiated Rate |
$112,977.00 |
| Rate for Payer: Aetna Commercial |
$824.15
|
| Rate for Payer: Aetna Medicare |
$639.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$885.66
|
| Rate for Payer: BCBS Complete |
$437.01
|
| Rate for Payer: BCBS MAPPO |
$615.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$937.77
|
| Rate for Payer: BCN Medicare Advantage |
$615.04
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Cofinity Commercial |
$885.66
|
| Rate for Payer: Cofinity Commercial |
$824.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.04
|
| Rate for Payer: Healthscope Commercial |
$984.06
|
| Rate for Payer: Healthscope Commercial |
$1,137.82
|
| Rate for Payer: Mclaren Medicaid |
$416.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.79
|
| Rate for Payer: Meridian Medicaid |
$437.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,977.00
|
| Rate for Payer: Nomi Health Commercial |
$738.05
|
| Rate for Payer: PACE SWMI |
$615.04
|
| Rate for Payer: PHP Medicare Advantage |
$615.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$985.66
|
| Rate for Payer: Priority Health Medicare |
$615.04
|
| Rate for Payer: Priority Health Narrow Network |
$985.66
|
| Rate for Payer: Priority Health SBD |
$985.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$786.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.04
|
| Rate for Payer: UHC Exchange |
$786.91
|
| Rate for Payer: UHC Medicare Advantage |
$615.04
|
| Rate for Payer: UHCCP Medicaid |
$416.20
|
|
|
PR OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE
|
Professional
|
Both
|
$1,713.00
|
|
|
Service Code
|
HCPCS 21465
|
| Min. Negotiated Rate |
$520.79 |
| Max. Negotiated Rate |
$140,234.00 |
| Rate for Payer: Aetna Commercial |
$1,030.37
|
| Rate for Payer: Aetna Medicare |
$799.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,030.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,107.26
|
| Rate for Payer: BCBS Complete |
$546.83
|
| Rate for Payer: BCBS MAPPO |
$768.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$1,159.64
|
| Rate for Payer: BCN Medicare Advantage |
$768.93
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cofinity Commercial |
$1,107.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.93
|
| Rate for Payer: Healthscope Commercial |
$1,422.52
|
| Rate for Payer: Healthscope Commercial |
$1,230.29
|
| Rate for Payer: Mclaren Medicaid |
$520.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$807.38
|
| Rate for Payer: Meridian Medicaid |
$546.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,234.00
|
| Rate for Payer: Nomi Health Commercial |
$922.72
|
| Rate for Payer: PACE SWMI |
$768.93
|
| Rate for Payer: PHP Medicare Advantage |
$768.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,217.70
|
| Rate for Payer: Priority Health Medicare |
$768.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,217.70
|
| Rate for Payer: Priority Health SBD |
$1,217.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,044.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$768.93
|
| Rate for Payer: UHC Exchange |
$1,044.52
|
| Rate for Payer: UHC Medicare Advantage |
$768.93
|
| Rate for Payer: UHCCP Medicaid |
$520.79
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 27766
|
| Min. Negotiated Rate |
$396.18 |
| Max. Negotiated Rate |
$107,573.00 |
| Rate for Payer: Aetna Commercial |
$781.58
|
| Rate for Payer: Aetna Medicare |
$606.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.91
|
| Rate for Payer: BCBS Complete |
$415.99
|
| Rate for Payer: BCBS MAPPO |
$583.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,661.86
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: BCN Medicare Advantage |
$583.27
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$839.91
|
| Rate for Payer: Cofinity Commercial |
$781.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.27
|
| Rate for Payer: Healthscope Commercial |
$933.23
|
| Rate for Payer: Healthscope Commercial |
$1,079.05
|
| Rate for Payer: Mclaren Medicaid |
$396.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.43
|
| Rate for Payer: Meridian Medicaid |
$415.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107,573.00
|
| Rate for Payer: Nomi Health Commercial |
$699.92
|
| Rate for Payer: PACE SWMI |
$583.27
|
| Rate for Payer: PHP Medicare Advantage |
$583.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$937.33
|
| Rate for Payer: Priority Health Medicare |
$583.27
|
| Rate for Payer: Priority Health Narrow Network |
$937.33
|
| Rate for Payer: Priority Health SBD |
$937.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$842.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$583.27
|
| Rate for Payer: UHC Exchange |
$842.15
|
| Rate for Payer: UHC Medicare Advantage |
$583.27
|
| Rate for Payer: UHCCP Medicaid |
$396.18
|
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$101,713.00 |
| Rate for Payer: Aetna Commercial |
$743.85
|
| Rate for Payer: Aetna Medicare |
$577.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$799.36
|
| Rate for Payer: BCBS Complete |
$397.20
|
| Rate for Payer: BCBS MAPPO |
$555.11
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$849.33
|
| Rate for Payer: BCN Medicare Advantage |
$555.11
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$799.36
|
| Rate for Payer: Cofinity Commercial |
$743.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.11
|
| Rate for Payer: Healthscope Commercial |
$888.18
|
| Rate for Payer: Healthscope Commercial |
$1,026.95
|
| Rate for Payer: Mclaren Medicaid |
$378.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.87
|
| Rate for Payer: Meridian Medicaid |
$397.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101,713.00
|
| Rate for Payer: Nomi Health Commercial |
$666.13
|
| Rate for Payer: PACE SWMI |
$555.11
|
| Rate for Payer: PHP Medicare Advantage |
$555.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.07
|
| Rate for Payer: Priority Health Medicare |
$555.11
|
| Rate for Payer: Priority Health Narrow Network |
$894.07
|
| Rate for Payer: Priority Health SBD |
$894.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$555.11
|
| Rate for Payer: UHC Exchange |
$585.47
|
| Rate for Payer: UHC Medicare Advantage |
$555.11
|
| Rate for Payer: UHCCP Medicaid |
$378.29
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$366.15 |
| Max. Negotiated Rate |
$98,795.00 |
| Rate for Payer: Aetna Commercial |
$718.49
|
| Rate for Payer: Aetna Medicare |
$557.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.11
|
| Rate for Payer: BCBS Complete |
$384.46
|
| Rate for Payer: BCBS MAPPO |
$536.19
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$824.89
|
| Rate for Payer: BCN Medicare Advantage |
$536.19
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$772.11
|
| Rate for Payer: Cofinity Commercial |
$718.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.19
|
| Rate for Payer: Healthscope Commercial |
$991.95
|
| Rate for Payer: Healthscope Commercial |
$857.90
|
| Rate for Payer: Mclaren Medicaid |
$366.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.00
|
| Rate for Payer: Meridian Medicaid |
$384.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,795.00
|
| Rate for Payer: Nomi Health Commercial |
$643.43
|
| Rate for Payer: PACE SWMI |
$536.19
|
| Rate for Payer: PHP Medicare Advantage |
$536.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.19
|
| Rate for Payer: Priority Health Medicare |
$536.19
|
| Rate for Payer: Priority Health Narrow Network |
$872.19
|
| Rate for Payer: Priority Health SBD |
$872.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.19
|
| Rate for Payer: UHC Exchange |
$618.59
|
| Rate for Payer: UHC Medicare Advantage |
$536.19
|
| Rate for Payer: UHCCP Medicaid |
$366.15
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$285.85 |
| Max. Negotiated Rate |
$77,492.00 |
| Rate for Payer: Aetna Commercial |
$552.84
|
| Rate for Payer: Aetna Medicare |
$429.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.10
|
| Rate for Payer: BCBS Complete |
$300.14
|
| Rate for Payer: BCBS MAPPO |
$412.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
| Rate for Payer: BCN Commercial |
$656.30
|
| Rate for Payer: BCN Medicare Advantage |
$412.57
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$594.10
|
| Rate for Payer: Cofinity Commercial |
$552.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.57
|
| Rate for Payer: Healthscope Commercial |
$763.25
|
| Rate for Payer: Healthscope Commercial |
$660.11
|
| Rate for Payer: Mclaren Medicaid |
$285.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.20
|
| Rate for Payer: Meridian Medicaid |
$300.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,492.00
|
| Rate for Payer: Nomi Health Commercial |
$495.08
|
| Rate for Payer: PACE SWMI |
$412.57
|
| Rate for Payer: PHP Medicare Advantage |
$412.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.42
|
| Rate for Payer: Priority Health Medicare |
$412.57
|
| Rate for Payer: Priority Health Narrow Network |
$684.42
|
| Rate for Payer: Priority Health SBD |
$684.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$412.57
|
| Rate for Payer: UHC Exchange |
$378.97
|
| Rate for Payer: UHC Medicare Advantage |
$412.57
|
| Rate for Payer: UHCCP Medicaid |
$285.85
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$110,662.00 |
| Rate for Payer: Aetna Commercial |
$804.95
|
| Rate for Payer: Aetna Medicare |
$624.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.02
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS MAPPO |
$600.71
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$921.16
|
| Rate for Payer: BCN Medicare Advantage |
$600.71
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$865.02
|
| Rate for Payer: Cofinity Commercial |
$804.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.71
|
| Rate for Payer: Healthscope Commercial |
$961.14
|
| Rate for Payer: Healthscope Commercial |
$1,111.31
|
| Rate for Payer: Mclaren Medicaid |
$408.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.75
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110,662.00
|
| Rate for Payer: Nomi Health Commercial |
$720.85
|
| Rate for Payer: PACE SWMI |
$600.71
|
| Rate for Payer: PHP Medicare Advantage |
$600.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.11
|
| Rate for Payer: Priority Health Medicare |
$600.71
|
| Rate for Payer: Priority Health Narrow Network |
$954.11
|
| Rate for Payer: Priority Health SBD |
$954.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.71
|
| Rate for Payer: UHC Exchange |
$808.18
|
| Rate for Payer: UHC Medicare Advantage |
$600.71
|
| Rate for Payer: UHCCP Medicaid |
$408.32
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$473.50 |
| Max. Negotiated Rate |
$129,031.00 |
| Rate for Payer: Aetna Commercial |
$939.17
|
| Rate for Payer: Aetna Medicare |
$728.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.17
|
| Rate for Payer: BCBS Complete |
$497.18
|
| Rate for Payer: BCBS MAPPO |
$700.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,788.67
|
| Rate for Payer: BCN Commercial |
$1,069.23
|
| Rate for Payer: BCN Medicare Advantage |
$700.87
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$939.17
|
| Rate for Payer: Cofinity Commercial |
$1,009.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.87
|
| Rate for Payer: Healthscope Commercial |
$1,121.39
|
| Rate for Payer: Healthscope Commercial |
$1,296.61
|
| Rate for Payer: Mclaren Medicaid |
$473.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.91
|
| Rate for Payer: Meridian Medicaid |
$497.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129,031.00
|
| Rate for Payer: Nomi Health Commercial |
$841.04
|
| Rate for Payer: PACE SWMI |
$700.87
|
| Rate for Payer: PHP Medicare Advantage |
$700.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,122.04
|
| Rate for Payer: Priority Health Medicare |
$700.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.04
|
| Rate for Payer: Priority Health SBD |
$1,122.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.87
|
| Rate for Payer: UHC Medicare Advantage |
$700.87
|
| Rate for Payer: UHCCP Medicaid |
$473.50
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$126,094.00 |
| Rate for Payer: Aetna Commercial |
$917.77
|
| Rate for Payer: Aetna Medicare |
$712.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.26
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS MAPPO |
$684.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.78
|
| Rate for Payer: BCN Commercial |
$1,046.26
|
| Rate for Payer: BCN Medicare Advantage |
$684.90
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$986.26
|
| Rate for Payer: Cofinity Commercial |
$917.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.90
|
| Rate for Payer: Healthscope Commercial |
$1,267.06
|
| Rate for Payer: Healthscope Commercial |
$1,095.84
|
| Rate for Payer: Mclaren Medicaid |
$463.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.14
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126,094.00
|
| Rate for Payer: Nomi Health Commercial |
$821.88
|
| Rate for Payer: PACE SWMI |
$684.90
|
| Rate for Payer: PHP Medicare Advantage |
$684.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.29
|
| Rate for Payer: Priority Health Medicare |
$684.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,107.29
|
| Rate for Payer: Priority Health SBD |
$1,107.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.90
|
| Rate for Payer: UHC Exchange |
$662.69
|
| Rate for Payer: UHC Medicare Advantage |
$684.90
|
| Rate for Payer: UHCCP Medicaid |
$463.49
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$440.27 |
| Max. Negotiated Rate |
$119,003.00 |
| Rate for Payer: Aetna Commercial |
$869.67
|
| Rate for Payer: Aetna Medicare |
$674.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.57
|
| Rate for Payer: BCBS Complete |
$462.28
|
| Rate for Payer: BCBS MAPPO |
$649.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,387.32
|
| Rate for Payer: BCN Commercial |
$989.57
|
| Rate for Payer: BCN Medicare Advantage |
$649.01
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cofinity Commercial |
$934.57
|
| Rate for Payer: Cofinity Commercial |
$869.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$649.01
|
| Rate for Payer: Healthscope Commercial |
$1,200.67
|
| Rate for Payer: Healthscope Commercial |
$1,038.42
|
| Rate for Payer: Mclaren Medicaid |
$440.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.46
|
| Rate for Payer: Meridian Medicaid |
$462.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119,003.00
|
| Rate for Payer: Nomi Health Commercial |
$778.81
|
| Rate for Payer: PACE SWMI |
$649.01
|
| Rate for Payer: PHP Medicare Advantage |
$649.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.65
|
| Rate for Payer: Priority Health Medicare |
$649.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.65
|
| Rate for Payer: Priority Health SBD |
$1,042.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$649.01
|
| Rate for Payer: UHC Exchange |
$797.36
|
| Rate for Payer: UHC Medicare Advantage |
$649.01
|
| Rate for Payer: UHCCP Medicaid |
$440.27
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$312.23 |
| Max. Negotiated Rate |
$123,286.00 |
| Rate for Payer: Aetna Commercial |
$918.80
|
| Rate for Payer: Aetna Medicare |
$713.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.36
|
| Rate for Payer: BCBS Complete |
$486.88
|
| Rate for Payer: BCBS MAPPO |
$685.67
|
| Rate for Payer: BCBS Trust/PPO |
$312.23
|
| Rate for Payer: BCN Commercial |
$1,291.09
|
| Rate for Payer: BCN Medicare Advantage |
$685.67
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$987.36
|
| Rate for Payer: Cofinity Commercial |
$918.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.67
|
| Rate for Payer: Healthscope Commercial |
$1,268.49
|
| Rate for Payer: Healthscope Commercial |
$1,097.07
|
| Rate for Payer: Mclaren Medicaid |
$463.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.95
|
| Rate for Payer: Meridian Medicaid |
$486.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123,286.00
|
| Rate for Payer: Nomi Health Commercial |
$822.80
|
| Rate for Payer: PACE SWMI |
$685.67
|
| Rate for Payer: PHP Medicare Advantage |
$685.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,089.48
|
| Rate for Payer: Priority Health Medicare |
$685.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,089.48
|
| Rate for Payer: Priority Health SBD |
$1,089.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$734.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.67
|
| Rate for Payer: UHC Exchange |
$734.62
|
| Rate for Payer: UHC Medicare Advantage |
$685.67
|
| Rate for Payer: UHCCP Medicaid |
$463.70
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,142.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$588.53 |
| Max. Negotiated Rate |
$184,187.00 |
| Rate for Payer: Aetna Commercial |
$1,347.18
|
| Rate for Payer: Aetna Medicare |
$1,045.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.72
|
| Rate for Payer: BCBS Complete |
$711.43
|
| Rate for Payer: BCBS MAPPO |
$1,005.36
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.36
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cofinity Commercial |
$1,447.72
|
| Rate for Payer: Cofinity Commercial |
$1,347.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.36
|
| Rate for Payer: Healthscope Commercial |
$1,859.92
|
| Rate for Payer: Healthscope Commercial |
$1,608.58
|
| Rate for Payer: Mclaren Medicaid |
$677.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.63
|
| Rate for Payer: Meridian Medicaid |
$711.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184,187.00
|
| Rate for Payer: Nomi Health Commercial |
$1,206.43
|
| Rate for Payer: PACE SWMI |
$1,005.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,042.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,613.08
|
| Rate for Payer: Priority Health Medicare |
$1,005.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,613.08
|
| Rate for Payer: Priority Health SBD |
$1,613.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,303.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.36
|
| Rate for Payer: UHC Exchange |
$1,303.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.36
|
| Rate for Payer: UHCCP Medicaid |
$677.55
|
|
