|
PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 27557
|
| Min. Negotiated Rate |
$673.93 |
| Max. Negotiated Rate |
$185,494.00 |
| Rate for Payer: Aetna Commercial |
$1,347.49
|
| Rate for Payer: Aetna Medicare |
$1,045.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.05
|
| Rate for Payer: BCBS Complete |
$707.63
|
| Rate for Payer: BCBS MAPPO |
$1,005.59
|
| Rate for Payer: BCBS Trust/PPO |
$843.70
|
| Rate for Payer: BCN Commercial |
$1,527.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.59
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,448.05
|
| Rate for Payer: Cofinity Commercial |
$1,347.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.59
|
| Rate for Payer: Healthscope Commercial |
$1,860.34
|
| Rate for Payer: Healthscope Commercial |
$1,608.94
|
| Rate for Payer: Mclaren Medicaid |
$673.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.87
|
| Rate for Payer: Meridian Medicaid |
$707.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185,494.00
|
| Rate for Payer: Nomi Health Commercial |
$1,206.71
|
| Rate for Payer: PACE SWMI |
$1,005.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,599.36
|
| Rate for Payer: Priority Health Medicare |
$1,005.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,599.36
|
| Rate for Payer: Priority Health SBD |
$1,599.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,500.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.59
|
| Rate for Payer: UHC Exchange |
$1,500.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.59
|
| Rate for Payer: UHCCP Medicaid |
$673.93
|
|
|
PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 27556
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$155,738.00 |
| Rate for Payer: Aetna Commercial |
$1,130.58
|
| Rate for Payer: Aetna Medicare |
$877.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,130.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.96
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$843.72
|
| Rate for Payer: BCBS Trust/PPO |
$488.15
|
| Rate for Payer: BCN Commercial |
$1,284.24
|
| Rate for Payer: BCN Medicare Advantage |
$843.72
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cofinity Commercial |
$1,214.96
|
| Rate for Payer: Cofinity Commercial |
$1,130.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$843.72
|
| Rate for Payer: Healthscope Commercial |
$1,560.88
|
| Rate for Payer: Healthscope Commercial |
$1,349.95
|
| Rate for Payer: Mclaren Medicaid |
$566.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$885.91
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155,738.00
|
| Rate for Payer: Nomi Health Commercial |
$1,012.46
|
| Rate for Payer: PACE SWMI |
$843.72
|
| Rate for Payer: PHP Medicare Advantage |
$843.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,344.92
|
| Rate for Payer: Priority Health Medicare |
$843.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,344.92
|
| Rate for Payer: Priority Health SBD |
$1,344.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$843.72
|
| Rate for Payer: UHC Exchange |
$1,300.00
|
| Rate for Payer: UHC Medicare Advantage |
$843.72
|
| Rate for Payer: UHCCP Medicaid |
$566.58
|
|
|
PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION
|
Professional
|
Both
|
$5,350.00
|
|
|
Service Code
|
HCPCS 27558
|
| Min. Negotiated Rate |
$765.95 |
| Max. Negotiated Rate |
$211,198.00 |
| Rate for Payer: Aetna Commercial |
$1,533.58
|
| Rate for Payer: Aetna Medicare |
$1,190.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,533.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,648.02
|
| Rate for Payer: BCBS Complete |
$804.25
|
| Rate for Payer: BCBS MAPPO |
$1,144.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.88
|
| Rate for Payer: BCN Commercial |
$1,736.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,144.46
|
| Rate for Payer: Cash Price |
$4,280.00
|
| Rate for Payer: Cash Price |
$4,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,648.02
|
| Rate for Payer: Cofinity Commercial |
$1,533.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,144.46
|
| Rate for Payer: Healthscope Commercial |
$2,117.25
|
| Rate for Payer: Healthscope Commercial |
$1,831.14
|
| Rate for Payer: Mclaren Medicaid |
$765.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,201.68
|
| Rate for Payer: Meridian Medicaid |
$804.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211,198.00
|
| Rate for Payer: Nomi Health Commercial |
$1,373.35
|
| Rate for Payer: PACE SWMI |
$1,144.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,144.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,477.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,817.15
|
| Rate for Payer: Priority Health Medicare |
$1,144.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,817.15
|
| Rate for Payer: Priority Health SBD |
$1,817.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,629.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,144.46
|
| Rate for Payer: UHC Exchange |
$1,629.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,144.46
|
| Rate for Payer: UHCCP Medicaid |
$765.95
|
|
|
PR OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION
|
Professional
|
Both
|
$3,401.00
|
|
|
Service Code
|
HCPCS 21462
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$202,466.00 |
| Rate for Payer: Aetna Commercial |
$1,430.70
|
| Rate for Payer: Aetna Medicare |
$1,110.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.47
|
| Rate for Payer: BCBS Complete |
$776.96
|
| Rate for Payer: BCBS MAPPO |
$1,067.69
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,917.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,067.69
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cofinity Commercial |
$1,537.47
|
| Rate for Payer: Cofinity Commercial |
$1,430.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,067.69
|
| Rate for Payer: Healthscope Commercial |
$1,975.23
|
| Rate for Payer: Healthscope Commercial |
$1,708.30
|
| Rate for Payer: Mclaren Medicaid |
$739.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,121.07
|
| Rate for Payer: Meridian Medicaid |
$776.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202,466.00
|
| Rate for Payer: Nomi Health Commercial |
$1,281.23
|
| Rate for Payer: PACE SWMI |
$1,067.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,067.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$739.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,210.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,770.84
|
| Rate for Payer: Priority Health Medicare |
$1,067.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,770.84
|
| Rate for Payer: Priority Health SBD |
$1,770.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,067.69
|
| Rate for Payer: UHC Exchange |
$1,059.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,067.69
|
| Rate for Payer: UHCCP Medicaid |
$739.96
|
|
|
PR OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION
|
Professional
|
Both
|
$4,190.00
|
|
|
Service Code
|
HCPCS 21461
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$182,979.00 |
| Rate for Payer: Aetna Commercial |
$1,285.31
|
| Rate for Payer: Aetna Medicare |
$997.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.23
|
| Rate for Payer: BCBS Complete |
$699.35
|
| Rate for Payer: BCBS MAPPO |
$959.19
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,696.52
|
| Rate for Payer: BCN Medicare Advantage |
$959.19
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,381.23
|
| Rate for Payer: Cofinity Commercial |
$1,285.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.19
|
| Rate for Payer: Healthscope Commercial |
$1,774.50
|
| Rate for Payer: Healthscope Commercial |
$1,534.70
|
| Rate for Payer: Mclaren Medicaid |
$666.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.15
|
| Rate for Payer: Meridian Medicaid |
$699.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182,979.00
|
| Rate for Payer: Nomi Health Commercial |
$1,151.03
|
| Rate for Payer: PACE SWMI |
$959.19
|
| Rate for Payer: PHP Medicare Advantage |
$959.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,723.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,624.29
|
| Rate for Payer: Priority Health Medicare |
$959.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,624.29
|
| Rate for Payer: Priority Health SBD |
$1,624.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.19
|
| Rate for Payer: UHC Exchange |
$909.36
|
| Rate for Payer: UHC Medicare Advantage |
$959.19
|
| Rate for Payer: UHCCP Medicaid |
$666.05
|
|
|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 26615
|
| Min. Negotiated Rate |
$53.49 |
| Max. Negotiated Rate |
$102,022.00 |
| Rate for Payer: Aetna Commercial |
$746.65
|
| Rate for Payer: Aetna Medicare |
$579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.37
|
| Rate for Payer: BCBS Complete |
$398.77
|
| Rate for Payer: BCBS MAPPO |
$557.20
|
| Rate for Payer: BCBS Trust/PPO |
$53.49
|
| Rate for Payer: BCN Commercial |
$851.77
|
| Rate for Payer: BCN Medicare Advantage |
$557.20
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$802.37
|
| Rate for Payer: Cofinity Commercial |
$746.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.20
|
| Rate for Payer: Healthscope Commercial |
$891.52
|
| Rate for Payer: Healthscope Commercial |
$1,030.82
|
| Rate for Payer: Mclaren Medicaid |
$379.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.06
|
| Rate for Payer: Meridian Medicaid |
$398.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,022.00
|
| Rate for Payer: Nomi Health Commercial |
$668.64
|
| Rate for Payer: PACE SWMI |
$557.20
|
| Rate for Payer: PHP Medicare Advantage |
$557.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.12
|
| Rate for Payer: Priority Health Medicare |
$557.20
|
| Rate for Payer: Priority Health Narrow Network |
$897.12
|
| Rate for Payer: Priority Health SBD |
$897.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.20
|
| Rate for Payer: UHC Exchange |
$560.61
|
| Rate for Payer: UHC Medicare Advantage |
$557.20
|
| Rate for Payer: UHCCP Medicaid |
$379.78
|
|
|
PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 28645
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$85,282.00 |
| Rate for Payer: Aetna Commercial |
$625.02
|
| Rate for Payer: Aetna Medicare |
$485.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.66
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS MAPPO |
$466.43
|
| Rate for Payer: BCBS Trust/PPO |
$821.51
|
| Rate for Payer: BCN Commercial |
$945.59
|
| Rate for Payer: BCN Medicare Advantage |
$466.43
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cofinity Commercial |
$671.66
|
| Rate for Payer: Cofinity Commercial |
$625.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.43
|
| Rate for Payer: Healthscope Commercial |
$862.90
|
| Rate for Payer: Healthscope Commercial |
$746.29
|
| Rate for Payer: Mclaren Medicaid |
$316.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.75
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,282.00
|
| Rate for Payer: Nomi Health Commercial |
$559.72
|
| Rate for Payer: PACE SWMI |
$466.43
|
| Rate for Payer: PHP Medicare Advantage |
$466.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.59
|
| Rate for Payer: Priority Health Medicare |
$466.43
|
| Rate for Payer: Priority Health Narrow Network |
$751.59
|
| Rate for Payer: Priority Health SBD |
$751.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$445.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.43
|
| Rate for Payer: UHC Exchange |
$445.37
|
| Rate for Payer: UHC Medicare Advantage |
$466.43
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$3,444.00
|
|
|
Service Code
|
HCPCS 24635
|
| Min. Negotiated Rate |
$444.96 |
| Max. Negotiated Rate |
$120,091.00 |
| Rate for Payer: Aetna Commercial |
$878.69
|
| Rate for Payer: Aetna Medicare |
$681.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$878.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.27
|
| Rate for Payer: BCBS Complete |
$467.21
|
| Rate for Payer: BCBS MAPPO |
$655.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$998.86
|
| Rate for Payer: BCN Medicare Advantage |
$655.74
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Cofinity Commercial |
$944.27
|
| Rate for Payer: Cofinity Commercial |
$878.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.74
|
| Rate for Payer: Healthscope Commercial |
$1,213.12
|
| Rate for Payer: Healthscope Commercial |
$1,049.18
|
| Rate for Payer: Mclaren Medicaid |
$444.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.53
|
| Rate for Payer: Meridian Medicaid |
$467.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,091.00
|
| Rate for Payer: Nomi Health Commercial |
$786.89
|
| Rate for Payer: PACE SWMI |
$655.74
|
| Rate for Payer: PHP Medicare Advantage |
$655.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,238.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.77
|
| Rate for Payer: Priority Health Medicare |
$655.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,048.77
|
| Rate for Payer: Priority Health SBD |
$1,048.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,234.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$655.74
|
| Rate for Payer: UHC Exchange |
$1,234.09
|
| Rate for Payer: UHC Medicare Advantage |
$655.74
|
| Rate for Payer: UHCCP Medicaid |
$444.96
|
|
|
PR OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 21330
|
| Min. Negotiated Rate |
$343.57 |
| Max. Negotiated Rate |
$93,600.00 |
| Rate for Payer: Aetna Commercial |
$668.69
|
| Rate for Payer: Aetna Medicare |
$518.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$668.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.59
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$499.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
| Rate for Payer: BCN Commercial |
$788.24
|
| Rate for Payer: BCN Medicare Advantage |
$499.02
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$718.59
|
| Rate for Payer: Cofinity Commercial |
$668.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.02
|
| Rate for Payer: Healthscope Commercial |
$923.19
|
| Rate for Payer: Healthscope Commercial |
$798.43
|
| Rate for Payer: Mclaren Medicaid |
$343.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.97
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,600.00
|
| Rate for Payer: Nomi Health Commercial |
$598.82
|
| Rate for Payer: PACE SWMI |
$499.02
|
| Rate for Payer: PHP Medicare Advantage |
$499.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$822.33
|
| Rate for Payer: Priority Health Medicare |
$499.02
|
| Rate for Payer: Priority Health Narrow Network |
$822.33
|
| Rate for Payer: Priority Health SBD |
$822.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$499.02
|
| Rate for Payer: UHC Exchange |
$556.33
|
| Rate for Payer: UHC Medicare Advantage |
$499.02
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION
|
Professional
|
Both
|
$1,476.00
|
|
|
Service Code
|
HCPCS 21336
|
| Min. Negotiated Rate |
$409.39 |
| Max. Negotiated Rate |
$111,110.00 |
| Rate for Payer: Aetna Commercial |
$796.17
|
| Rate for Payer: Aetna Medicare |
$617.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.59
|
| Rate for Payer: BCBS Complete |
$429.86
|
| Rate for Payer: BCBS MAPPO |
$594.16
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$936.30
|
| Rate for Payer: BCN Medicare Advantage |
$594.16
|
| Rate for Payer: Cash Price |
$1,180.80
|
| Rate for Payer: Cash Price |
$1,180.80
|
| Rate for Payer: Cofinity Commercial |
$855.59
|
| Rate for Payer: Cofinity Commercial |
$796.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$594.16
|
| Rate for Payer: Healthscope Commercial |
$950.66
|
| Rate for Payer: Healthscope Commercial |
$1,099.20
|
| Rate for Payer: Mclaren Medicaid |
$409.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$623.87
|
| Rate for Payer: Meridian Medicaid |
$429.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,110.00
|
| Rate for Payer: Nomi Health Commercial |
$712.99
|
| Rate for Payer: PACE SWMI |
$594.16
|
| Rate for Payer: PHP Medicare Advantage |
$594.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$959.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$978.54
|
| Rate for Payer: Priority Health Medicare |
$594.16
|
| Rate for Payer: Priority Health Narrow Network |
$978.54
|
| Rate for Payer: Priority Health SBD |
$978.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$594.16
|
| Rate for Payer: UHC Exchange |
$504.20
|
| Rate for Payer: UHC Medicare Advantage |
$594.16
|
| Rate for Payer: UHCCP Medicaid |
$409.39
|
|
|
PR OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 21338
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$117,232.00 |
| Rate for Payer: Aetna Commercial |
$839.44
|
| Rate for Payer: Aetna Medicare |
$651.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.09
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$626.45
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$989.57
|
| Rate for Payer: BCN Medicare Advantage |
$626.45
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cofinity Commercial |
$902.09
|
| Rate for Payer: Cofinity Commercial |
$839.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.45
|
| Rate for Payer: Healthscope Commercial |
$1,158.93
|
| Rate for Payer: Healthscope Commercial |
$1,002.32
|
| Rate for Payer: Mclaren Medicaid |
$432.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.77
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,232.00
|
| Rate for Payer: Nomi Health Commercial |
$751.74
|
| Rate for Payer: PACE SWMI |
$626.45
|
| Rate for Payer: PHP Medicare Advantage |
$626.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.94
|
| Rate for Payer: Priority Health Medicare |
$626.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,029.94
|
| Rate for Payer: Priority Health SBD |
$1,029.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.45
|
| Rate for Payer: UHC Exchange |
$560.56
|
| Rate for Payer: UHC Medicare Advantage |
$626.45
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL
|
Professional
|
Both
|
$1,196.00
|
|
|
Service Code
|
HCPCS 21386
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$122,175.00 |
| Rate for Payer: Aetna Commercial |
$888.38
|
| Rate for Payer: Aetna Medicare |
$689.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.68
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$662.97
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,013.51
|
| Rate for Payer: BCN Medicare Advantage |
$662.97
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$954.68
|
| Rate for Payer: Cofinity Commercial |
$888.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$662.97
|
| Rate for Payer: Healthscope Commercial |
$1,226.49
|
| Rate for Payer: Healthscope Commercial |
$1,060.75
|
| Rate for Payer: Mclaren Medicaid |
$448.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.12
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122,175.00
|
| Rate for Payer: Nomi Health Commercial |
$795.56
|
| Rate for Payer: PACE SWMI |
$662.97
|
| Rate for Payer: PHP Medicare Advantage |
$662.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.97
|
| Rate for Payer: Priority Health Medicare |
$662.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.97
|
| Rate for Payer: Priority Health SBD |
$1,060.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$662.97
|
| Rate for Payer: UHC Exchange |
$864.43
|
| Rate for Payer: UHC Medicare Advantage |
$662.97
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
|
|
PR OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL
|
Professional
|
Both
|
$1,545.00
|
|
|
Service Code
|
HCPCS 21385
|
| Min. Negotiated Rate |
$473.29 |
| Max. Negotiated Rate |
$129,177.00 |
| Rate for Payer: Aetna Commercial |
$934.18
|
| Rate for Payer: Aetna Medicare |
$725.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.18
|
| Rate for Payer: BCBS Complete |
$496.95
|
| Rate for Payer: BCBS MAPPO |
$697.15
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$1,075.09
|
| Rate for Payer: BCN Medicare Advantage |
$697.15
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cofinity Commercial |
$934.18
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.15
|
| Rate for Payer: Healthscope Commercial |
$1,289.73
|
| Rate for Payer: Healthscope Commercial |
$1,115.44
|
| Rate for Payer: Mclaren Medicaid |
$473.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.01
|
| Rate for Payer: Meridian Medicaid |
$496.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129,177.00
|
| Rate for Payer: Nomi Health Commercial |
$836.58
|
| Rate for Payer: PACE SWMI |
$697.15
|
| Rate for Payer: PHP Medicare Advantage |
$697.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,122.54
|
| Rate for Payer: Priority Health Medicare |
$697.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.54
|
| Rate for Payer: Priority Health SBD |
$1,122.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.15
|
| Rate for Payer: UHC Exchange |
$835.23
|
| Rate for Payer: UHC Medicare Advantage |
$697.15
|
| Rate for Payer: UHCCP Medicaid |
$473.29
|
|
|
PR OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR
|
Professional
|
Both
|
$1,579.00
|
|
|
Service Code
|
HCPCS 21423
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$140,837.00 |
| Rate for Payer: Aetna Commercial |
$1,015.18
|
| Rate for Payer: Aetna Medicare |
$787.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,015.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.94
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS MAPPO |
$757.60
|
| Rate for Payer: BCBS Trust/PPO |
$24.96
|
| Rate for Payer: BCN Commercial |
$1,169.40
|
| Rate for Payer: BCN Medicare Advantage |
$757.60
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Cofinity Commercial |
$1,090.94
|
| Rate for Payer: Cofinity Commercial |
$1,015.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$757.60
|
| Rate for Payer: Healthscope Commercial |
$1,401.56
|
| Rate for Payer: Healthscope Commercial |
$1,212.16
|
| Rate for Payer: Mclaren Medicaid |
$512.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$795.48
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,837.00
|
| Rate for Payer: Nomi Health Commercial |
$909.12
|
| Rate for Payer: PACE SWMI |
$757.60
|
| Rate for Payer: PHP Medicare Advantage |
$757.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.73
|
| Rate for Payer: Priority Health Medicare |
$757.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,218.73
|
| Rate for Payer: Priority Health SBD |
$1,218.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$757.60
|
| Rate for Payer: UHC Exchange |
$834.27
|
| Rate for Payer: UHC Medicare Advantage |
$757.60
|
| Rate for Payer: UHCCP Medicaid |
$512.90
|
|
|
PR OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA
|
Professional
|
Both
|
$1,815.00
|
|
|
Service Code
|
HCPCS 26735
|
| Min. Negotiated Rate |
$391.92 |
| Max. Negotiated Rate |
$105,496.00 |
| Rate for Payer: Aetna Commercial |
$771.20
|
| Rate for Payer: Aetna Medicare |
$598.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.75
|
| Rate for Payer: BCBS Complete |
$411.52
|
| Rate for Payer: BCBS MAPPO |
$575.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.28
|
| Rate for Payer: BCN Commercial |
$880.11
|
| Rate for Payer: BCN Medicare Advantage |
$575.52
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cofinity Commercial |
$828.75
|
| Rate for Payer: Cofinity Commercial |
$771.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.52
|
| Rate for Payer: Healthscope Commercial |
$920.83
|
| Rate for Payer: Healthscope Commercial |
$1,064.71
|
| Rate for Payer: Mclaren Medicaid |
$391.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.30
|
| Rate for Payer: Meridian Medicaid |
$411.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105,496.00
|
| Rate for Payer: Nomi Health Commercial |
$690.62
|
| Rate for Payer: PACE SWMI |
$575.52
|
| Rate for Payer: PHP Medicare Advantage |
$575.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.15
|
| Rate for Payer: Priority Health Medicare |
$575.52
|
| Rate for Payer: Priority Health Narrow Network |
$927.15
|
| Rate for Payer: Priority Health SBD |
$927.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.52
|
| Rate for Payer: UHC Exchange |
$605.53
|
| Rate for Payer: UHC Medicare Advantage |
$575.52
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
|
|
PR OPEN TX POST PELVIC FXCTURE
|
Professional
|
Both
|
$2,367.00
|
|
|
Service Code
|
HCPCS G0415
|
| Min. Negotiated Rate |
$446.41 |
| Max. Negotiated Rate |
$202,997.00 |
| Rate for Payer: Aetna Commercial |
$1,776.01
|
| Rate for Payer: Aetna Medicare |
$1,378.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,776.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,908.55
|
| Rate for Payer: BCBS Complete |
$931.51
|
| Rate for Payer: BCBS MAPPO |
$1,325.38
|
| Rate for Payer: BCBS Trust/PPO |
$446.41
|
| Rate for Payer: BCN Commercial |
$2,004.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,325.38
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cofinity Commercial |
$1,908.55
|
| Rate for Payer: Cofinity Commercial |
$1,776.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,325.38
|
| Rate for Payer: Healthscope Commercial |
$2,120.61
|
| Rate for Payer: Healthscope Commercial |
$2,451.95
|
| Rate for Payer: Mclaren Medicaid |
$887.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,391.65
|
| Rate for Payer: Meridian Medicaid |
$931.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202,997.00
|
| Rate for Payer: Nomi Health Commercial |
$1,590.46
|
| Rate for Payer: PACE SWMI |
$1,325.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,325.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$887.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,095.49
|
| Rate for Payer: Priority Health Medicare |
$1,325.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,095.49
|
| Rate for Payer: Priority Health SBD |
$2,095.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,325.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,325.38
|
| Rate for Payer: UHCCP Medicaid |
$887.15
|
|
|
PR OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 27832
|
| Min. Negotiated Rate |
$496.50 |
| Max. Negotiated Rate |
$134,492.00 |
| Rate for Payer: Aetna Commercial |
$983.52
|
| Rate for Payer: Aetna Medicare |
$763.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$983.52
|
| Rate for Payer: BCBS Complete |
$521.32
|
| Rate for Payer: BCBS MAPPO |
$733.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.62
|
| Rate for Payer: BCN Commercial |
$1,116.14
|
| Rate for Payer: BCN Medicare Advantage |
$733.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$983.52
|
| Rate for Payer: Cofinity Commercial |
$1,056.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.97
|
| Rate for Payer: Healthscope Commercial |
$1,357.84
|
| Rate for Payer: Healthscope Commercial |
$1,174.35
|
| Rate for Payer: Mclaren Medicaid |
$496.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.67
|
| Rate for Payer: Meridian Medicaid |
$521.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,492.00
|
| Rate for Payer: Nomi Health Commercial |
$880.76
|
| Rate for Payer: PACE SWMI |
$733.97
|
| Rate for Payer: PHP Medicare Advantage |
$733.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,174.46
|
| Rate for Payer: Priority Health Medicare |
$733.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,174.46
|
| Rate for Payer: Priority Health SBD |
$1,174.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$622.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.97
|
| Rate for Payer: UHC Exchange |
$622.96
|
| Rate for Payer: UHC Medicare Advantage |
$733.97
|
| Rate for Payer: UHCCP Medicaid |
$496.50
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
Both
|
$2,365.00
|
|
|
Service Code
|
HCPCS 24665
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$116,563.00 |
| Rate for Payer: Aetna Commercial |
$852.45
|
| Rate for Payer: Aetna Medicare |
$661.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$916.07
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$636.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.54
|
| Rate for Payer: BCN Commercial |
$971.00
|
| Rate for Payer: BCN Medicare Advantage |
$636.16
|
| Rate for Payer: Cash Price |
$1,892.00
|
| Rate for Payer: Cash Price |
$1,892.00
|
| Rate for Payer: Cofinity Commercial |
$916.07
|
| Rate for Payer: Cofinity Commercial |
$852.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.16
|
| Rate for Payer: Healthscope Commercial |
$1,176.90
|
| Rate for Payer: Healthscope Commercial |
$1,017.86
|
| Rate for Payer: Mclaren Medicaid |
$432.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$667.97
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,563.00
|
| Rate for Payer: Nomi Health Commercial |
$763.39
|
| Rate for Payer: PACE SWMI |
$636.16
|
| Rate for Payer: PHP Medicare Advantage |
$636.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.79
|
| Rate for Payer: Priority Health Medicare |
$636.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.79
|
| Rate for Payer: Priority Health SBD |
$1,021.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.16
|
| Rate for Payer: UHC Exchange |
$804.11
|
| Rate for Payer: UHC Medicare Advantage |
$636.16
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC
|
Professional
|
Both
|
$2,905.00
|
|
|
Service Code
|
HCPCS 24666
|
| Min. Negotiated Rate |
$479.25 |
| Max. Negotiated Rate |
$130,147.00 |
| Rate for Payer: Aetna Commercial |
$948.63
|
| Rate for Payer: Aetna Medicare |
$736.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.63
|
| Rate for Payer: BCBS Complete |
$503.21
|
| Rate for Payer: BCBS MAPPO |
$707.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,044.45
|
| Rate for Payer: BCN Commercial |
$1,080.46
|
| Rate for Payer: BCN Medicare Advantage |
$707.93
|
| Rate for Payer: Cash Price |
$2,324.00
|
| Rate for Payer: Cash Price |
$2,324.00
|
| Rate for Payer: Cofinity Commercial |
$948.63
|
| Rate for Payer: Cofinity Commercial |
$1,019.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.93
|
| Rate for Payer: Healthscope Commercial |
$1,309.67
|
| Rate for Payer: Healthscope Commercial |
$1,132.69
|
| Rate for Payer: Mclaren Medicaid |
$479.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.33
|
| Rate for Payer: Meridian Medicaid |
$503.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130,147.00
|
| Rate for Payer: Nomi Health Commercial |
$849.52
|
| Rate for Payer: PACE SWMI |
$707.93
|
| Rate for Payer: PHP Medicare Advantage |
$707.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,888.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$707.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: Priority Health SBD |
$1,134.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.93
|
| Rate for Payer: UHC Exchange |
$864.53
|
| Rate for Payer: UHC Medicare Advantage |
$707.93
|
| Rate for Payer: UHCCP Medicaid |
$479.25
|
|
|
PR OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES
|
Professional
|
Both
|
$1,984.00
|
|
|
Service Code
|
HCPCS 25670
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$108,274.00 |
| Rate for Payer: Aetna Commercial |
$786.54
|
| Rate for Payer: Aetna Medicare |
$610.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.24
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS MAPPO |
$586.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.94
|
| Rate for Payer: BCN Commercial |
$899.66
|
| Rate for Payer: BCN Medicare Advantage |
$586.97
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cofinity Commercial |
$845.24
|
| Rate for Payer: Cofinity Commercial |
$786.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.97
|
| Rate for Payer: Healthscope Commercial |
$939.15
|
| Rate for Payer: Healthscope Commercial |
$1,085.89
|
| Rate for Payer: Mclaren Medicaid |
$397.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$616.32
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,274.00
|
| Rate for Payer: Nomi Health Commercial |
$704.36
|
| Rate for Payer: PACE SWMI |
$586.97
|
| Rate for Payer: PHP Medicare Advantage |
$586.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,289.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$944.45
|
| Rate for Payer: Priority Health Medicare |
$586.97
|
| Rate for Payer: Priority Health Narrow Network |
$944.45
|
| Rate for Payer: Priority Health SBD |
$944.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.97
|
| Rate for Payer: UHC Exchange |
$764.94
|
| Rate for Payer: UHC Medicare Advantage |
$586.97
|
| Rate for Payer: UHCCP Medicaid |
$397.88
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 21811
|
| Min. Negotiated Rate |
$377.01 |
| Max. Negotiated Rate |
$106,092.00 |
| Rate for Payer: Aetna Commercial |
$769.50
|
| Rate for Payer: Aetna Medicare |
$597.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.92
|
| Rate for Payer: BCBS Complete |
$395.86
|
| Rate for Payer: BCBS MAPPO |
$574.25
|
| Rate for Payer: BCBS Trust/PPO |
$6,603.85
|
| Rate for Payer: BCN Commercial |
$859.09
|
| Rate for Payer: BCN Medicare Advantage |
$574.25
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$826.92
|
| Rate for Payer: Cofinity Commercial |
$769.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.25
|
| Rate for Payer: Healthscope Commercial |
$1,062.36
|
| Rate for Payer: Healthscope Commercial |
$918.80
|
| Rate for Payer: Mclaren Medicaid |
$377.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.96
|
| Rate for Payer: Meridian Medicaid |
$395.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,092.00
|
| Rate for Payer: Nomi Health Commercial |
$689.10
|
| Rate for Payer: PACE SWMI |
$574.25
|
| Rate for Payer: PHP Medicare Advantage |
$574.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.65
|
| Rate for Payer: Priority Health Medicare |
$574.25
|
| Rate for Payer: Priority Health Narrow Network |
$898.65
|
| Rate for Payer: Priority Health SBD |
$898.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.25
|
| Rate for Payer: UHC Medicare Advantage |
$574.25
|
| Rate for Payer: UHCCP Medicaid |
$377.01
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS
|
Professional
|
Both
|
$1,763.00
|
|
|
Service Code
|
HCPCS 21812
|
| Min. Negotiated Rate |
$456.46 |
| Max. Negotiated Rate |
$128,533.00 |
| Rate for Payer: Aetna Commercial |
$930.76
|
| Rate for Payer: Aetna Medicare |
$722.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$930.76
|
| Rate for Payer: BCBS Complete |
$479.28
|
| Rate for Payer: BCBS MAPPO |
$694.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$1,041.37
|
| Rate for Payer: BCN Medicare Advantage |
$694.60
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cofinity Commercial |
$930.76
|
| Rate for Payer: Cofinity Commercial |
$1,000.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.60
|
| Rate for Payer: Healthscope Commercial |
$1,111.36
|
| Rate for Payer: Healthscope Commercial |
$1,285.01
|
| Rate for Payer: Mclaren Medicaid |
$456.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.33
|
| Rate for Payer: Meridian Medicaid |
$479.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,533.00
|
| Rate for Payer: Nomi Health Commercial |
$833.52
|
| Rate for Payer: PACE SWMI |
$694.60
|
| Rate for Payer: PHP Medicare Advantage |
$694.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,145.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.39
|
| Rate for Payer: Priority Health Medicare |
$694.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.39
|
| Rate for Payer: Priority Health SBD |
$1,084.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.60
|
| Rate for Payer: UHC Medicare Advantage |
$694.60
|
| Rate for Payer: UHCCP Medicaid |
$456.46
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 21813
|
| Min. Negotiated Rate |
$99.81 |
| Max. Negotiated Rate |
$175,869.00 |
| Rate for Payer: Aetna Commercial |
$1,278.25
|
| Rate for Payer: Aetna Medicare |
$992.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,373.64
|
| Rate for Payer: BCBS Complete |
$656.64
|
| Rate for Payer: BCBS MAPPO |
$953.92
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$1,423.52
|
| Rate for Payer: BCN Medicare Advantage |
$953.92
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$1,373.64
|
| Rate for Payer: Cofinity Commercial |
$1,278.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.92
|
| Rate for Payer: Healthscope Commercial |
$1,526.27
|
| Rate for Payer: Healthscope Commercial |
$1,764.75
|
| Rate for Payer: Mclaren Medicaid |
$625.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.62
|
| Rate for Payer: Meridian Medicaid |
$656.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,869.00
|
| Rate for Payer: Nomi Health Commercial |
$1,144.70
|
| Rate for Payer: PACE SWMI |
$953.92
|
| Rate for Payer: PHP Medicare Advantage |
$953.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$625.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,485.88
|
| Rate for Payer: Priority Health Medicare |
$953.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,485.88
|
| Rate for Payer: Priority Health SBD |
$1,485.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.92
|
| Rate for Payer: UHC Medicare Advantage |
$953.92
|
| Rate for Payer: UHCCP Medicaid |
$625.37
|
|
|
PR OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 23585
|
| Min. Negotiated Rate |
$187.20 |
| Max. Negotiated Rate |
$173,428.00 |
| Rate for Payer: Aetna Commercial |
$1,260.40
|
| Rate for Payer: Aetna Medicare |
$978.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.46
|
| Rate for Payer: BCBS Complete |
$664.91
|
| Rate for Payer: BCBS MAPPO |
$940.60
|
| Rate for Payer: BCBS Trust/PPO |
$187.20
|
| Rate for Payer: BCN Commercial |
$1,432.81
|
| Rate for Payer: BCN Medicare Advantage |
$940.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cofinity Commercial |
$1,354.46
|
| Rate for Payer: Cofinity Commercial |
$1,260.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.60
|
| Rate for Payer: Healthscope Commercial |
$1,740.11
|
| Rate for Payer: Healthscope Commercial |
$1,504.96
|
| Rate for Payer: Mclaren Medicaid |
$633.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.63
|
| Rate for Payer: Meridian Medicaid |
$664.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173,428.00
|
| Rate for Payer: Nomi Health Commercial |
$1,128.72
|
| Rate for Payer: PACE SWMI |
$940.60
|
| Rate for Payer: PHP Medicare Advantage |
$940.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,501.14
|
| Rate for Payer: Priority Health Medicare |
$940.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.14
|
| Rate for Payer: Priority Health SBD |
$1,501.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.60
|
| Rate for Payer: UHC Exchange |
$839.86
|
| Rate for Payer: UHC Medicare Advantage |
$940.60
|
| Rate for Payer: UHCCP Medicaid |
$633.25
|
|
|
PR OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 28531
|
| Min. Negotiated Rate |
$118.85 |
| Max. Negotiated Rate |
$31,538.00 |
| Rate for Payer: Aetna Commercial |
$232.64
|
| Rate for Payer: Aetna Medicare |
$180.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.00
|
| Rate for Payer: BCBS Complete |
$124.79
|
| Rate for Payer: BCBS MAPPO |
$173.61
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$478.42
|
| Rate for Payer: BCN Medicare Advantage |
$173.61
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Cofinity Commercial |
$232.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.61
|
| Rate for Payer: Healthscope Commercial |
$321.18
|
| Rate for Payer: Healthscope Commercial |
$277.78
|
| Rate for Payer: Mclaren Medicaid |
$118.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.29
|
| Rate for Payer: Meridian Medicaid |
$124.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,538.00
|
| Rate for Payer: Nomi Health Commercial |
$208.33
|
| Rate for Payer: PACE SWMI |
$173.61
|
| Rate for Payer: PHP Medicare Advantage |
$173.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.90
|
| Rate for Payer: Priority Health Medicare |
$173.61
|
| Rate for Payer: Priority Health Narrow Network |
$280.90
|
| Rate for Payer: Priority Health SBD |
$280.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.61
|
| Rate for Payer: UHC Exchange |
$564.28
|
| Rate for Payer: UHC Medicare Advantage |
$173.61
|
| Rate for Payer: UHCCP Medicaid |
$118.85
|
|
