|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$422.59 |
| Max. Negotiated Rate |
$117,506.00 |
| Rate for Payer: Aetna Commercial |
$837.11
|
| Rate for Payer: Aetna Medicare |
$649.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.58
|
| Rate for Payer: BCBS Complete |
$443.72
|
| Rate for Payer: BCBS MAPPO |
$624.71
|
| Rate for Payer: BCBS Trust/PPO |
$645.58
|
| Rate for Payer: BCN Commercial |
$1,269.58
|
| Rate for Payer: BCN Medicare Advantage |
$624.71
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$899.58
|
| Rate for Payer: Cofinity Commercial |
$837.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.71
|
| Rate for Payer: Healthscope Commercial |
$999.54
|
| Rate for Payer: Healthscope Commercial |
$1,155.71
|
| Rate for Payer: Mclaren Medicaid |
$422.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.95
|
| Rate for Payer: Meridian Medicaid |
$443.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,506.00
|
| Rate for Payer: Nomi Health Commercial |
$749.65
|
| Rate for Payer: PACE SWMI |
$624.71
|
| Rate for Payer: PHP Medicare Advantage |
$624.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,022.31
|
| Rate for Payer: Priority Health Medicare |
$624.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,022.31
|
| Rate for Payer: Priority Health SBD |
$1,022.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$788.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.71
|
| Rate for Payer: UHC Exchange |
$788.19
|
| Rate for Payer: UHC Medicare Advantage |
$624.71
|
| Rate for Payer: UHCCP Medicaid |
$422.59
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$538.04 |
| Max. Negotiated Rate |
$145,647.00 |
| Rate for Payer: Aetna Commercial |
$1,058.81
|
| Rate for Payer: Aetna Medicare |
$821.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,137.83
|
| Rate for Payer: BCBS Complete |
$564.94
|
| Rate for Payer: BCBS MAPPO |
$790.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.26
|
| Rate for Payer: BCN Commercial |
$1,214.37
|
| Rate for Payer: BCN Medicare Advantage |
$790.16
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,137.83
|
| Rate for Payer: Cofinity Commercial |
$1,058.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.16
|
| Rate for Payer: Healthscope Commercial |
$1,461.80
|
| Rate for Payer: Healthscope Commercial |
$1,264.26
|
| Rate for Payer: Mclaren Medicaid |
$538.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.67
|
| Rate for Payer: Meridian Medicaid |
$564.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145,647.00
|
| Rate for Payer: Nomi Health Commercial |
$948.19
|
| Rate for Payer: PACE SWMI |
$790.16
|
| Rate for Payer: PHP Medicare Advantage |
$790.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,279.28
|
| Rate for Payer: Priority Health Medicare |
$790.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,279.28
|
| Rate for Payer: Priority Health SBD |
$1,279.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$723.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$790.16
|
| Rate for Payer: UHC Exchange |
$723.98
|
| Rate for Payer: UHC Medicare Advantage |
$790.16
|
| Rate for Payer: UHCCP Medicaid |
$538.04
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
OP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$697.86 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Commercial |
$1,991.55
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,764.18
|
| Rate for Payer: BCN Commercial |
$3,764.18
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$1,640.10
|
| Rate for Payer: Cofinity Commercial |
$2,014.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,640.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,108.70
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$1,991.55
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$1,476.09
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.86
|
| 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 ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$115,987.00 |
| Rate for Payer: Aetna Commercial |
$846.29
|
| Rate for Payer: Aetna Medicare |
$656.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.45
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS MAPPO |
$631.56
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: BCN Medicare Advantage |
$631.56
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$909.45
|
| Rate for Payer: Cofinity Commercial |
$846.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.56
|
| Rate for Payer: Healthscope Commercial |
$1,168.39
|
| Rate for Payer: Healthscope Commercial |
$1,010.50
|
| Rate for Payer: Mclaren Medicaid |
$428.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.14
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115,987.00
|
| Rate for Payer: Nomi Health Commercial |
$757.87
|
| Rate for Payer: PACE SWMI |
$631.56
|
| Rate for Payer: PHP Medicare Advantage |
$631.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.19
|
| Rate for Payer: Priority Health Medicare |
$631.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.19
|
| Rate for Payer: Priority Health SBD |
$1,016.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$631.56
|
| Rate for Payer: UHC Exchange |
$852.87
|
| Rate for Payer: UHC Medicare Advantage |
$631.56
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
IP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,476.09 |
| Max. Negotiated Rate |
$2,108.70 |
| Rate for Payer: Aetna Commercial |
$1,991.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.95
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$1,640.10
|
| Rate for Payer: Cofinity Commercial |
$2,014.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,640.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Healthscope Commercial |
$2,108.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: PHP Commercial |
$1,991.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health SBD |
$1,476.09
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$115,987.00 |
| Rate for Payer: Aetna Commercial |
$846.29
|
| Rate for Payer: Aetna Medicare |
$656.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.45
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS MAPPO |
$631.56
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: BCN Medicare Advantage |
$631.56
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$909.45
|
| Rate for Payer: Cofinity Commercial |
$846.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.56
|
| Rate for Payer: Healthscope Commercial |
$1,168.39
|
| Rate for Payer: Healthscope Commercial |
$1,010.50
|
| Rate for Payer: Mclaren Medicaid |
$428.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.14
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115,987.00
|
| Rate for Payer: Nomi Health Commercial |
$757.87
|
| Rate for Payer: PACE SWMI |
$631.56
|
| Rate for Payer: PHP Medicare Advantage |
$631.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.19
|
| Rate for Payer: Priority Health Medicare |
$631.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.19
|
| Rate for Payer: Priority Health SBD |
$1,016.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$631.56
|
| Rate for Payer: UHC Exchange |
$852.87
|
| Rate for Payer: UHC Medicare Advantage |
$631.56
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
|
|
PR OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$411.52 |
| Max. Negotiated Rate |
$111,051.00 |
| Rate for Payer: Aetna Commercial |
$811.12
|
| Rate for Payer: Aetna Medicare |
$629.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.65
|
| Rate for Payer: BCBS Complete |
$432.10
|
| Rate for Payer: BCBS MAPPO |
$605.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
| Rate for Payer: BCN Commercial |
$925.06
|
| Rate for Payer: BCN Medicare Advantage |
$605.31
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$871.65
|
| Rate for Payer: Cofinity Commercial |
$811.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.31
|
| Rate for Payer: Healthscope Commercial |
$968.50
|
| Rate for Payer: Healthscope Commercial |
$1,119.82
|
| Rate for Payer: Mclaren Medicaid |
$411.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.58
|
| Rate for Payer: Meridian Medicaid |
$432.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,051.00
|
| Rate for Payer: Nomi Health Commercial |
$726.37
|
| Rate for Payer: PACE SWMI |
$605.31
|
| Rate for Payer: PHP Medicare Advantage |
$605.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$972.95
|
| Rate for Payer: Priority Health Medicare |
$605.31
|
| Rate for Payer: Priority Health Narrow Network |
$972.95
|
| Rate for Payer: Priority Health SBD |
$972.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$833.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.31
|
| Rate for Payer: UHC Exchange |
$833.38
|
| Rate for Payer: UHC Medicare Advantage |
$605.31
|
| Rate for Payer: UHCCP Medicaid |
$411.52
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,667.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$410.88 |
| Max. Negotiated Rate |
$110,794.00 |
| Rate for Payer: Aetna Commercial |
$810.51
|
| Rate for Payer: Aetna Medicare |
$629.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.00
|
| Rate for Payer: BCBS Complete |
$431.42
|
| Rate for Payer: BCBS MAPPO |
$604.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.43
|
| Rate for Payer: BCN Commercial |
$922.13
|
| Rate for Payer: BCN Medicare Advantage |
$604.86
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cofinity Commercial |
$871.00
|
| Rate for Payer: Cofinity Commercial |
$810.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.86
|
| Rate for Payer: Healthscope Commercial |
$967.78
|
| Rate for Payer: Healthscope Commercial |
$1,118.99
|
| Rate for Payer: Mclaren Medicaid |
$410.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.10
|
| Rate for Payer: Meridian Medicaid |
$431.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110,794.00
|
| Rate for Payer: Nomi Health Commercial |
$725.83
|
| Rate for Payer: PACE SWMI |
$604.86
|
| Rate for Payer: PHP Medicare Advantage |
$604.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$969.89
|
| Rate for Payer: Priority Health Medicare |
$604.86
|
| Rate for Payer: Priority Health Narrow Network |
$969.89
|
| Rate for Payer: Priority Health SBD |
$969.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.86
|
| Rate for Payer: UHC Exchange |
$648.30
|
| Rate for Payer: UHC Medicare Advantage |
$604.86
|
| Rate for Payer: UHCCP Medicaid |
$410.88
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 1-2 RIBS
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 0245T
|
| Min. Negotiated Rate |
$1,339.20 |
| Max. Negotiated Rate |
$2,176.20 |
| Rate for Payer: Aetna Medicare |
$1,674.00
|
| Rate for Payer: BCBS Complete |
$1,339.20
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,176.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS
|
Professional
|
Both
|
$3,689.00
|
|
|
Service Code
|
HCPCS 0246T
|
| Min. Negotiated Rate |
$1,475.60 |
| Max. Negotiated Rate |
$2,397.85 |
| Rate for Payer: Aetna Medicare |
$1,844.50
|
| Rate for Payer: BCBS Complete |
$1,475.60
|
| Rate for Payer: Cash Price |
$2,951.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,397.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.85
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS
|
Professional
|
Both
|
$4,080.00
|
|
|
Service Code
|
HCPCS 0247T
|
| Min. Negotiated Rate |
$1,632.00 |
| Max. Negotiated Rate |
$2,652.00 |
| Rate for Payer: Aetna Medicare |
$2,040.00
|
| Rate for Payer: BCBS Complete |
$1,632.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,652.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS
|
Professional
|
Both
|
$4,709.00
|
|
|
Service Code
|
HCPCS 0248T
|
| Min. Negotiated Rate |
$1,883.60 |
| Max. Negotiated Rate |
$3,060.85 |
| Rate for Payer: Aetna Medicare |
$2,354.50
|
| Rate for Payer: BCBS Complete |
$1,883.60
|
| Rate for Payer: Cash Price |
$3,767.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,060.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,060.85
|
|
|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,743.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$374.67 |
| Max. Negotiated Rate |
$101,824.00 |
| Rate for Payer: Aetna Commercial |
$740.54
|
| Rate for Payer: Aetna Medicare |
$574.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.80
|
| Rate for Payer: BCBS Complete |
$393.40
|
| Rate for Payer: BCBS MAPPO |
$552.64
|
| Rate for Payer: BCBS Trust/PPO |
$528.83
|
| Rate for Payer: BCN Commercial |
$846.39
|
| Rate for Payer: BCN Medicare Advantage |
$552.64
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cofinity Commercial |
$795.80
|
| Rate for Payer: Cofinity Commercial |
$740.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.64
|
| Rate for Payer: Healthscope Commercial |
$884.22
|
| Rate for Payer: Healthscope Commercial |
$1,022.38
|
| Rate for Payer: Mclaren Medicaid |
$374.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.27
|
| Rate for Payer: Meridian Medicaid |
$393.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101,824.00
|
| Rate for Payer: Nomi Health Commercial |
$663.17
|
| Rate for Payer: PACE SWMI |
$552.64
|
| Rate for Payer: PHP Medicare Advantage |
$552.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,782.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$888.98
|
| Rate for Payer: Priority Health Medicare |
$552.64
|
| Rate for Payer: Priority Health Narrow Network |
$888.98
|
| Rate for Payer: Priority Health SBD |
$888.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.64
|
| Rate for Payer: UHC Exchange |
$699.96
|
| Rate for Payer: UHC Medicare Advantage |
$552.64
|
| Rate for Payer: UHCCP Medicaid |
$374.67
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$466.47 |
| Max. Negotiated Rate |
$127,019.00 |
| Rate for Payer: Aetna Commercial |
$924.83
|
| Rate for Payer: Aetna Medicare |
$717.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$993.84
|
| Rate for Payer: BCBS Complete |
$489.79
|
| Rate for Payer: BCBS MAPPO |
$690.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: BCN Commercial |
$1,053.10
|
| Rate for Payer: BCN Medicare Advantage |
$690.17
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cofinity Commercial |
$993.84
|
| Rate for Payer: Cofinity Commercial |
$924.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.17
|
| Rate for Payer: Healthscope Commercial |
$1,276.81
|
| Rate for Payer: Healthscope Commercial |
$1,104.27
|
| Rate for Payer: Mclaren Medicaid |
$466.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$724.68
|
| Rate for Payer: Meridian Medicaid |
$489.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127,019.00
|
| Rate for Payer: Nomi Health Commercial |
$828.20
|
| Rate for Payer: PACE SWMI |
$690.17
|
| Rate for Payer: PHP Medicare Advantage |
$690.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,104.73
|
| Rate for Payer: Priority Health Medicare |
$690.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,104.73
|
| Rate for Payer: Priority Health SBD |
$1,104.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$690.17
|
| Rate for Payer: UHC Exchange |
$800.62
|
| Rate for Payer: UHC Medicare Advantage |
$690.17
|
| Rate for Payer: UHCCP Medicaid |
$466.47
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,720.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$367.62 |
| Max. Negotiated Rate |
$104,368.00 |
| Rate for Payer: Aetna Commercial |
$758.76
|
| Rate for Payer: Aetna Medicare |
$588.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$815.39
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS MAPPO |
$566.24
|
| Rate for Payer: BCBS Trust/PPO |
$367.62
|
| Rate for Payer: BCN Commercial |
$867.89
|
| Rate for Payer: BCN Medicare Advantage |
$566.24
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cofinity Commercial |
$815.39
|
| Rate for Payer: Cofinity Commercial |
$758.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.24
|
| Rate for Payer: Healthscope Commercial |
$905.98
|
| Rate for Payer: Healthscope Commercial |
$1,047.54
|
| Rate for Payer: Mclaren Medicaid |
$384.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.55
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104,368.00
|
| Rate for Payer: Nomi Health Commercial |
$679.49
|
| Rate for Payer: PACE SWMI |
$566.24
|
| Rate for Payer: PHP Medicare Advantage |
$566.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.84
|
| Rate for Payer: Priority Health Medicare |
$566.24
|
| Rate for Payer: Priority Health Narrow Network |
$909.84
|
| Rate for Payer: Priority Health SBD |
$909.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.24
|
| Rate for Payer: UHC Exchange |
$679.13
|
| Rate for Payer: UHC Medicare Advantage |
$566.24
|
| Rate for Payer: UHCCP Medicaid |
$384.04
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$486.28 |
| Max. Negotiated Rate |
$131,670.00 |
| Rate for Payer: Aetna Commercial |
$960.18
|
| Rate for Payer: Aetna Medicare |
$745.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.18
|
| Rate for Payer: BCBS Complete |
$510.59
|
| Rate for Payer: BCBS MAPPO |
$716.55
|
| Rate for Payer: BCBS Trust/PPO |
$663.54
|
| Rate for Payer: BCN Commercial |
$1,095.13
|
| Rate for Payer: BCN Medicare Advantage |
$716.55
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$960.18
|
| Rate for Payer: Cofinity Commercial |
$1,031.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.55
|
| Rate for Payer: Healthscope Commercial |
$1,325.62
|
| Rate for Payer: Healthscope Commercial |
$1,146.48
|
| Rate for Payer: Mclaren Medicaid |
$486.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.38
|
| Rate for Payer: Meridian Medicaid |
$510.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,670.00
|
| Rate for Payer: Nomi Health Commercial |
$859.86
|
| Rate for Payer: PACE SWMI |
$716.55
|
| Rate for Payer: PHP Medicare Advantage |
$716.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,149.51
|
| Rate for Payer: Priority Health Medicare |
$716.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.51
|
| Rate for Payer: Priority Health SBD |
$1,149.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.55
|
| Rate for Payer: UHC Exchange |
$650.56
|
| Rate for Payer: UHC Medicare Advantage |
$716.55
|
| Rate for Payer: UHCCP Medicaid |
$486.28
|
|
|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$375.95 |
| Max. Negotiated Rate |
$101,837.00 |
| Rate for Payer: Aetna Commercial |
$742.83
|
| Rate for Payer: Aetna Medicare |
$576.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.26
|
| Rate for Payer: BCBS Complete |
$394.75
|
| Rate for Payer: BCBS MAPPO |
$554.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.69
|
| Rate for Payer: BCN Commercial |
$846.87
|
| Rate for Payer: BCN Medicare Advantage |
$554.35
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cofinity Commercial |
$798.26
|
| Rate for Payer: Cofinity Commercial |
$742.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.35
|
| Rate for Payer: Healthscope Commercial |
$886.96
|
| Rate for Payer: Healthscope Commercial |
$1,025.55
|
| Rate for Payer: Mclaren Medicaid |
$375.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.07
|
| Rate for Payer: Meridian Medicaid |
$394.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101,837.00
|
| Rate for Payer: Nomi Health Commercial |
$665.22
|
| Rate for Payer: PACE SWMI |
$554.35
|
| Rate for Payer: PHP Medicare Advantage |
$554.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$890.00
|
| Rate for Payer: Priority Health Medicare |
$554.35
|
| Rate for Payer: Priority Health Narrow Network |
$890.00
|
| Rate for Payer: Priority Health SBD |
$890.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$685.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.35
|
| Rate for Payer: UHC Exchange |
$685.18
|
| Rate for Payer: UHC Medicare Advantage |
$554.35
|
| Rate for Payer: UHCCP Medicaid |
$375.95
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$471.80 |
| Max. Negotiated Rate |
$127,735.00 |
| Rate for Payer: Aetna Commercial |
$932.37
|
| Rate for Payer: Aetna Medicare |
$723.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.37
|
| Rate for Payer: BCBS Complete |
$495.39
|
| Rate for Payer: BCBS MAPPO |
$695.80
|
| Rate for Payer: BCBS Trust/PPO |
$548.81
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: BCN Medicare Advantage |
$695.80
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cofinity Commercial |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,001.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.80
|
| Rate for Payer: Healthscope Commercial |
$1,287.23
|
| Rate for Payer: Healthscope Commercial |
$1,113.28
|
| Rate for Payer: Mclaren Medicaid |
$471.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.59
|
| Rate for Payer: Meridian Medicaid |
$495.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127,735.00
|
| Rate for Payer: Nomi Health Commercial |
$834.96
|
| Rate for Payer: PACE SWMI |
$695.80
|
| Rate for Payer: PHP Medicare Advantage |
$695.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.92
|
| Rate for Payer: Priority Health Medicare |
$695.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,114.92
|
| Rate for Payer: Priority Health SBD |
$1,114.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.80
|
| Rate for Payer: UHC Exchange |
$861.15
|
| Rate for Payer: UHC Medicare Advantage |
$695.80
|
| Rate for Payer: UHCCP Medicaid |
$471.80
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,255.00
|
|
|
Service Code
|
HCPCS 26685
|
| Min. Negotiated Rate |
$56.88 |
| Max. Negotiated Rate |
$102,011.00 |
| Rate for Payer: Aetna Commercial |
$747.26
|
| Rate for Payer: Aetna Medicare |
$579.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.03
|
| Rate for Payer: BCBS Complete |
$399.88
|
| Rate for Payer: BCBS MAPPO |
$557.66
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$851.77
|
| Rate for Payer: BCN Medicare Advantage |
$557.66
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cofinity Commercial |
$803.03
|
| Rate for Payer: Cofinity Commercial |
$747.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.66
|
| Rate for Payer: Healthscope Commercial |
$892.26
|
| Rate for Payer: Healthscope Commercial |
$1,031.67
|
| Rate for Payer: Mclaren Medicaid |
$380.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.54
|
| Rate for Payer: Meridian Medicaid |
$399.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,011.00
|
| Rate for Payer: Nomi Health Commercial |
$669.19
|
| Rate for Payer: PACE SWMI |
$557.66
|
| Rate for Payer: PHP Medicare Advantage |
$557.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.13
|
| Rate for Payer: Priority Health Medicare |
$557.66
|
| Rate for Payer: Priority Health Narrow Network |
$898.13
|
| Rate for Payer: Priority Health SBD |
$898.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.66
|
| Rate for Payer: UHC Exchange |
$663.85
|
| Rate for Payer: UHC Medicare Advantage |
$557.66
|
| Rate for Payer: UHCCP Medicaid |
$380.84
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,888.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$110,997.00 |
| Rate for Payer: Aetna Commercial |
$812.23
|
| Rate for Payer: Aetna Medicare |
$630.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.84
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$606.14
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: BCN Commercial |
$926.54
|
| Rate for Payer: BCN Medicare Advantage |
$606.14
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cofinity Commercial |
$872.84
|
| Rate for Payer: Cofinity Commercial |
$812.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.14
|
| Rate for Payer: Healthscope Commercial |
$969.82
|
| Rate for Payer: Healthscope Commercial |
$1,121.36
|
| Rate for Payer: Mclaren Medicaid |
$413.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.45
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110,997.00
|
| Rate for Payer: Nomi Health Commercial |
$727.37
|
| Rate for Payer: PACE SWMI |
$606.14
|
| Rate for Payer: PHP Medicare Advantage |
$606.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,877.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.98
|
| Rate for Payer: Priority Health Medicare |
$606.14
|
| Rate for Payer: Priority Health Narrow Network |
$974.98
|
| Rate for Payer: Priority Health SBD |
$974.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.14
|
| Rate for Payer: UHC Exchange |
$703.07
|
| Rate for Payer: UHC Medicare Advantage |
$606.14
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,455.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$285.26 |
| Max. Negotiated Rate |
$128,043.00 |
| Rate for Payer: Aetna Commercial |
$932.12
|
| Rate for Payer: Aetna Medicare |
$723.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.12
|
| Rate for Payer: BCBS Complete |
$494.49
|
| Rate for Payer: BCBS MAPPO |
$695.61
|
| Rate for Payer: BCBS Trust/PPO |
$285.26
|
| Rate for Payer: BCN Commercial |
$1,062.87
|
| Rate for Payer: BCN Medicare Advantage |
$695.61
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cofinity Commercial |
$932.12
|
| Rate for Payer: Cofinity Commercial |
$1,001.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.61
|
| Rate for Payer: Healthscope Commercial |
$1,286.88
|
| Rate for Payer: Healthscope Commercial |
$1,112.98
|
| Rate for Payer: Mclaren Medicaid |
$470.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.39
|
| Rate for Payer: Meridian Medicaid |
$494.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,043.00
|
| Rate for Payer: Nomi Health Commercial |
$834.73
|
| Rate for Payer: PACE SWMI |
$695.61
|
| Rate for Payer: PHP Medicare Advantage |
$695.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,595.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.92
|
| Rate for Payer: Priority Health Medicare |
$695.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.92
|
| Rate for Payer: Priority Health SBD |
$1,115.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.61
|
| Rate for Payer: UHC Exchange |
$726.37
|
| Rate for Payer: UHC Medicare Advantage |
$695.61
|
| Rate for Payer: UHCCP Medicaid |
$470.94
|
|
|
PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 21365
|
| Min. Negotiated Rate |
$180.58 |
| Max. Negotiated Rate |
$191,525.00 |
| Rate for Payer: Aetna Commercial |
$1,387.29
|
| Rate for Payer: Aetna Medicare |
$1,076.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,387.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,490.82
|
| Rate for Payer: BCBS Complete |
$733.35
|
| Rate for Payer: BCBS MAPPO |
$1,035.29
|
| Rate for Payer: BCBS Trust/PPO |
$180.58
|
| Rate for Payer: BCN Commercial |
$1,582.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.29
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cofinity Commercial |
$1,490.82
|
| Rate for Payer: Cofinity Commercial |
$1,387.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.29
|
| Rate for Payer: Healthscope Commercial |
$1,915.29
|
| Rate for Payer: Healthscope Commercial |
$1,656.46
|
| Rate for Payer: Mclaren Medicaid |
$698.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,087.05
|
| Rate for Payer: Meridian Medicaid |
$733.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191,525.00
|
| Rate for Payer: Nomi Health Commercial |
$1,242.35
|
| Rate for Payer: PACE SWMI |
$1,035.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.72
|
| Rate for Payer: Priority Health Medicare |
$1,035.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,648.72
|
| Rate for Payer: Priority Health SBD |
$1,648.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,035.29
|
| Rate for Payer: UHC Exchange |
$1,317.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,035.29
|
| Rate for Payer: UHCCP Medicaid |
$698.43
|
|
|
PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$3,475.00
|
|
|
Service Code
|
HCPCS 21344
|
| Min. Negotiated Rate |
$118.87 |
| Max. Negotiated Rate |
$247,288.00 |
| Rate for Payer: Aetna Commercial |
$1,774.20
|
| Rate for Payer: Aetna Medicare |
$1,376.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,906.60
|
| Rate for Payer: BCBS Complete |
$937.77
|
| Rate for Payer: BCBS MAPPO |
$1,324.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$2,044.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.03
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cofinity Commercial |
$1,906.60
|
| Rate for Payer: Cofinity Commercial |
$1,774.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.03
|
| Rate for Payer: Healthscope Commercial |
$2,449.46
|
| Rate for Payer: Healthscope Commercial |
$2,118.45
|
| Rate for Payer: Mclaren Medicaid |
$893.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,390.23
|
| Rate for Payer: Meridian Medicaid |
$937.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247,288.00
|
| Rate for Payer: Nomi Health Commercial |
$1,588.84
|
| Rate for Payer: PACE SWMI |
$1,324.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,258.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,129.07
|
| Rate for Payer: Priority Health Medicare |
$1,324.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,129.07
|
| Rate for Payer: Priority Health SBD |
$2,129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,620.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,324.03
|
| Rate for Payer: UHC Exchange |
$1,620.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,324.03
|
| Rate for Payer: UHCCP Medicaid |
$893.11
|
|
|
PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR
|
Professional
|
Both
|
$3,013.00
|
|
|
Service Code
|
HCPCS 21433
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$306,776.00 |
| Rate for Payer: Aetna Commercial |
$2,222.50
|
| Rate for Payer: Aetna Medicare |
$1,724.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,222.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,388.36
|
| Rate for Payer: BCBS Complete |
$1,170.36
|
| Rate for Payer: BCBS MAPPO |
$1,658.58
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,530.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,658.58
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cofinity Commercial |
$2,388.36
|
| Rate for Payer: Cofinity Commercial |
$2,222.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,658.58
|
| Rate for Payer: Healthscope Commercial |
$3,068.37
|
| Rate for Payer: Healthscope Commercial |
$2,653.73
|
| Rate for Payer: Mclaren Medicaid |
$1,114.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,741.51
|
| Rate for Payer: Meridian Medicaid |
$1,170.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306,776.00
|
| Rate for Payer: Nomi Health Commercial |
$1,990.30
|
| Rate for Payer: PACE SWMI |
$1,658.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,658.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,114.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,958.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,638.95
|
| Rate for Payer: Priority Health Medicare |
$1,658.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,638.95
|
| Rate for Payer: Priority Health SBD |
$2,638.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,000.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,658.58
|
| Rate for Payer: UHC Exchange |
$2,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,658.58
|
| Rate for Payer: UHCCP Medicaid |
$1,114.63
|
|
|
PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$2,453.00
|
|
|
Service Code
|
HCPCS 21343
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$191,581.00 |
| Rate for Payer: Aetna Commercial |
$1,374.30
|
| Rate for Payer: Aetna Medicare |
$1,066.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,476.86
|
| Rate for Payer: BCBS Complete |
$733.79
|
| Rate for Payer: BCBS MAPPO |
$1,025.60
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cofinity Commercial |
$1,476.86
|
| Rate for Payer: Cofinity Commercial |
$1,374.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.60
|
| Rate for Payer: Healthscope Commercial |
$1,897.36
|
| Rate for Payer: Healthscope Commercial |
$1,640.96
|
| Rate for Payer: Mclaren Medicaid |
$698.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,076.88
|
| Rate for Payer: Meridian Medicaid |
$733.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191,581.00
|
| Rate for Payer: Nomi Health Commercial |
$1,230.72
|
| Rate for Payer: PACE SWMI |
$1,025.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,667.03
|
| Rate for Payer: Priority Health Medicare |
$1,025.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,667.03
|
| Rate for Payer: Priority Health SBD |
$1,667.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,066.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,025.60
|
| Rate for Payer: UHC Exchange |
$1,066.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.60
|
| Rate for Payer: UHCCP Medicaid |
$698.85
|
|
