|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3+ FRAG
|
Professional
|
Both
|
$2,959.00
|
|
|
Service Code
|
HCPCS 25609
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$186,484.00 |
| Rate for Payer: Aetna Commercial |
$1,361.44
|
| Rate for Payer: Aetna Medicare |
$1,056.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.04
|
| Rate for Payer: BCBS Complete |
$721.94
|
| Rate for Payer: BCBS MAPPO |
$1,016.00
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$1,547.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.00
|
| Rate for Payer: Cash Price |
$2,367.20
|
| Rate for Payer: Cash Price |
$2,367.20
|
| Rate for Payer: Cofinity Commercial |
$1,463.04
|
| Rate for Payer: Cofinity Commercial |
$1,361.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.00
|
| Rate for Payer: Healthscope Commercial |
$1,879.60
|
| Rate for Payer: Healthscope Commercial |
$1,625.60
|
| Rate for Payer: Mclaren Medicaid |
$687.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.80
|
| Rate for Payer: Meridian Medicaid |
$721.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186,484.00
|
| Rate for Payer: Nomi Health Commercial |
$1,219.20
|
| Rate for Payer: PACE SWMI |
$1,016.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,923.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,625.30
|
| Rate for Payer: Priority Health Medicare |
$1,016.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,625.30
|
| Rate for Payer: Priority Health SBD |
$1,625.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.00
|
| Rate for Payer: UHC Exchange |
$1,120.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,016.00
|
| Rate for Payer: UHCCP Medicaid |
$687.56
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$131,359.00 |
| Rate for Payer: Aetna Commercial |
$961.40
|
| Rate for Payer: Aetna Medicare |
$746.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.40
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$717.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$717.46
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$961.40
|
| Rate for Payer: Cofinity Commercial |
$1,033.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.46
|
| Rate for Payer: Healthscope Commercial |
$1,327.30
|
| Rate for Payer: Healthscope Commercial |
$1,147.94
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.33
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,359.00
|
| Rate for Payer: Nomi Health Commercial |
$860.95
|
| Rate for Payer: PACE SWMI |
$717.46
|
| Rate for Payer: PHP Medicare Advantage |
$717.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$717.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.03
|
| Rate for Payer: Priority Health SBD |
$1,150.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.46
|
| Rate for Payer: UHC Exchange |
$759.79
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$131,359.00 |
| Rate for Payer: Aetna Commercial |
$961.40
|
| Rate for Payer: Aetna Medicare |
$746.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.40
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$717.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$717.46
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$961.40
|
| Rate for Payer: Cofinity Commercial |
$1,033.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.46
|
| Rate for Payer: Healthscope Commercial |
$1,327.30
|
| Rate for Payer: Healthscope Commercial |
$1,147.94
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.33
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,359.00
|
| Rate for Payer: Nomi Health Commercial |
$860.95
|
| Rate for Payer: PACE SWMI |
$717.46
|
| Rate for Payer: PHP Medicare Advantage |
$717.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$717.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.03
|
| Rate for Payer: Priority Health SBD |
$1,150.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.46
|
| Rate for Payer: UHC Exchange |
$759.79
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Facility
|
IP
|
$1,944.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$1,224.72 |
| Max. Negotiated Rate |
$1,749.60 |
| Rate for Payer: Aetna Commercial |
$1,652.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,263.60
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,671.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,360.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,555.20
|
| Rate for Payer: Healthscope Commercial |
$1,749.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,652.40
|
| Rate for Payer: PHP Commercial |
$1,652.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health SBD |
$1,224.72
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Facility
|
OP
|
$1,944.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$789.87 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Commercial |
$1,652.40
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,263.60
|
| 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 |
$2,975.03
|
| Rate for Payer: BCN Commercial |
$2,975.03
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,671.84
|
| Rate for Payer: Cofinity Commercial |
$1,360.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,360.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,555.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$1,749.60
|
| 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 |
$1,652.40
|
| 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 |
$1,652.40
|
| 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 |
$1,263.60
|
| 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 |
$1,224.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.87
|
| 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 OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 27236
|
| Min. Negotiated Rate |
$772.13 |
| Max. Negotiated Rate |
$211,451.00 |
| Rate for Payer: Aetna Commercial |
$1,539.53
|
| Rate for Payer: Aetna Medicare |
$1,194.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,539.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.42
|
| Rate for Payer: BCBS Complete |
$810.74
|
| Rate for Payer: BCBS MAPPO |
$1,148.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,920.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,148.90
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,654.42
|
| Rate for Payer: Cofinity Commercial |
$1,539.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,148.90
|
| Rate for Payer: Healthscope Commercial |
$2,125.46
|
| Rate for Payer: Healthscope Commercial |
$1,838.24
|
| Rate for Payer: Mclaren Medicaid |
$772.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,206.34
|
| Rate for Payer: Meridian Medicaid |
$810.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211,451.00
|
| Rate for Payer: Nomi Health Commercial |
$1,378.68
|
| Rate for Payer: PACE SWMI |
$1,148.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,148.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,831.39
|
| Rate for Payer: Priority Health Medicare |
$1,148.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,831.39
|
| Rate for Payer: Priority Health SBD |
$1,831.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,250.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,148.90
|
| Rate for Payer: UHC Exchange |
$1,250.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.90
|
| Rate for Payer: UHCCP Medicaid |
$772.13
|
|
|
PR OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW
|
Professional
|
Both
|
$4,215.00
|
|
|
Service Code
|
HCPCS 27506
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$237,173.00 |
| Rate for Payer: Aetna Commercial |
$1,726.52
|
| Rate for Payer: Aetna Medicare |
$1,339.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,726.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.37
|
| Rate for Payer: BCBS Complete |
$909.36
|
| Rate for Payer: BCBS MAPPO |
$1,288.45
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,154.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,288.45
|
| Rate for Payer: Cash Price |
$3,372.00
|
| Rate for Payer: Cash Price |
$3,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,855.37
|
| Rate for Payer: Cofinity Commercial |
$1,726.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,288.45
|
| Rate for Payer: Healthscope Commercial |
$2,383.63
|
| Rate for Payer: Healthscope Commercial |
$2,061.52
|
| Rate for Payer: Mclaren Medicaid |
$866.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,352.87
|
| Rate for Payer: Meridian Medicaid |
$909.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237,173.00
|
| Rate for Payer: Nomi Health Commercial |
$1,546.14
|
| Rate for Payer: PACE SWMI |
$1,288.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,288.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.75
|
| Rate for Payer: Priority Health Medicare |
$1,288.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.75
|
| Rate for Payer: Priority Health SBD |
$2,052.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,532.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,288.45
|
| Rate for Payer: UHC Exchange |
$1,532.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,288.45
|
| Rate for Payer: UHCCP Medicaid |
$866.06
|
|
|
PR OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27507
|
| Min. Negotiated Rate |
$626.65 |
| Max. Negotiated Rate |
$171,862.00 |
| Rate for Payer: Aetna Commercial |
$1,250.94
|
| Rate for Payer: Aetna Medicare |
$970.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.30
|
| Rate for Payer: BCBS Complete |
$657.98
|
| Rate for Payer: BCBS MAPPO |
$933.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.62
|
| Rate for Payer: BCN Commercial |
$1,416.67
|
| Rate for Payer: BCN Medicare Advantage |
$933.54
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,344.30
|
| Rate for Payer: Cofinity Commercial |
$1,250.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.54
|
| Rate for Payer: Healthscope Commercial |
$1,727.05
|
| Rate for Payer: Healthscope Commercial |
$1,493.66
|
| Rate for Payer: Mclaren Medicaid |
$626.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.22
|
| Rate for Payer: Meridian Medicaid |
$657.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171,862.00
|
| Rate for Payer: Nomi Health Commercial |
$1,120.25
|
| Rate for Payer: PACE SWMI |
$933.54
|
| Rate for Payer: PHP Medicare Advantage |
$933.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,483.83
|
| Rate for Payer: Priority Health Medicare |
$933.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,483.83
|
| Rate for Payer: Priority Health SBD |
$1,483.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,278.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.54
|
| Rate for Payer: UHC Exchange |
$1,278.44
|
| Rate for Payer: UHC Medicare Advantage |
$933.54
|
| Rate for Payer: UHCCP Medicaid |
$626.65
|
|
|
PR OPTX GREATER HUMERAL TUBEROSITY FX W/INT FIXJ
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 23630
|
| Min. Negotiated Rate |
$265.21 |
| Max. Negotiated Rate |
$138,573.00 |
| Rate for Payer: Aetna Commercial |
$1,011.63
|
| Rate for Payer: Aetna Medicare |
$785.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,087.13
|
| Rate for Payer: BCBS Complete |
$536.31
|
| Rate for Payer: BCBS MAPPO |
$754.95
|
| Rate for Payer: BCBS Trust/PPO |
$265.21
|
| Rate for Payer: BCN Commercial |
$1,149.86
|
| Rate for Payer: BCN Medicare Advantage |
$754.95
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$1,087.13
|
| Rate for Payer: Cofinity Commercial |
$1,011.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.95
|
| Rate for Payer: Healthscope Commercial |
$1,396.66
|
| Rate for Payer: Healthscope Commercial |
$1,207.92
|
| Rate for Payer: Mclaren Medicaid |
$510.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$792.70
|
| Rate for Payer: Meridian Medicaid |
$536.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138,573.00
|
| Rate for Payer: Nomi Health Commercial |
$905.94
|
| Rate for Payer: PACE SWMI |
$754.95
|
| Rate for Payer: PHP Medicare Advantage |
$754.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.05
|
| Rate for Payer: Priority Health Medicare |
$754.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.05
|
| Rate for Payer: Priority Health SBD |
$1,209.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$754.95
|
| Rate for Payer: UHC Exchange |
$651.33
|
| Rate for Payer: UHC Medicare Advantage |
$754.95
|
| Rate for Payer: UHCCP Medicaid |
$510.77
|
|
|
PR OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD
|
Professional
|
Both
|
$3,546.00
|
|
|
Service Code
|
HCPCS 27254
|
| Min. Negotiated Rate |
$821.97 |
| Max. Negotiated Rate |
$225,533.00 |
| Rate for Payer: Aetna Commercial |
$1,640.68
|
| Rate for Payer: Aetna Medicare |
$1,273.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,640.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,763.12
|
| Rate for Payer: BCBS Complete |
$863.07
|
| Rate for Payer: BCBS MAPPO |
$1,224.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.58
|
| Rate for Payer: BCN Commercial |
$1,859.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,224.39
|
| Rate for Payer: Cash Price |
$2,836.80
|
| Rate for Payer: Cash Price |
$2,836.80
|
| Rate for Payer: Cofinity Commercial |
$1,763.12
|
| Rate for Payer: Cofinity Commercial |
$1,640.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,224.39
|
| Rate for Payer: Healthscope Commercial |
$2,265.12
|
| Rate for Payer: Healthscope Commercial |
$1,959.02
|
| Rate for Payer: Mclaren Medicaid |
$821.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,285.61
|
| Rate for Payer: Meridian Medicaid |
$863.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225,533.00
|
| Rate for Payer: Nomi Health Commercial |
$1,469.27
|
| Rate for Payer: PACE SWMI |
$1,224.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,224.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,304.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,949.44
|
| Rate for Payer: Priority Health Medicare |
$1,224.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,949.44
|
| Rate for Payer: Priority Health SBD |
$1,949.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,592.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,224.39
|
| Rate for Payer: UHC Exchange |
$1,592.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,224.39
|
| Rate for Payer: UHCCP Medicaid |
$821.97
|
|
|
PR OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ
|
Professional
|
Both
|
$2,351.00
|
|
|
Service Code
|
HCPCS 27253
|
| Min. Negotiated Rate |
$609.82 |
| Max. Negotiated Rate |
$166,914.00 |
| Rate for Payer: Aetna Commercial |
$1,214.46
|
| Rate for Payer: Aetna Medicare |
$942.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.09
|
| Rate for Payer: BCBS Complete |
$640.31
|
| Rate for Payer: BCBS MAPPO |
$906.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,442.33
|
| Rate for Payer: BCN Commercial |
$1,379.05
|
| Rate for Payer: BCN Medicare Advantage |
$906.31
|
| Rate for Payer: Cash Price |
$1,880.80
|
| Rate for Payer: Cash Price |
$1,880.80
|
| Rate for Payer: Cofinity Commercial |
$1,305.09
|
| Rate for Payer: Cofinity Commercial |
$1,214.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.31
|
| Rate for Payer: Healthscope Commercial |
$1,676.67
|
| Rate for Payer: Healthscope Commercial |
$1,450.10
|
| Rate for Payer: Mclaren Medicaid |
$609.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.63
|
| Rate for Payer: Meridian Medicaid |
$640.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166,914.00
|
| Rate for Payer: Nomi Health Commercial |
$1,087.57
|
| Rate for Payer: PACE SWMI |
$906.31
|
| Rate for Payer: PHP Medicare Advantage |
$906.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,445.17
|
| Rate for Payer: Priority Health Medicare |
$906.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,445.17
|
| Rate for Payer: Priority Health SBD |
$1,445.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.31
|
| Rate for Payer: UHC Exchange |
$1,203.54
|
| Rate for Payer: UHC Medicare Advantage |
$906.31
|
| Rate for Payer: UHCCP Medicaid |
$609.82
|
|
|
PR OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE
|
Professional
|
Both
|
$3,092.00
|
|
|
Service Code
|
HCPCS 24515
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$156,362.00 |
| Rate for Payer: Aetna Commercial |
$1,137.89
|
| Rate for Payer: Aetna Medicare |
$883.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,137.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.80
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$849.17
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$849.17
|
| Rate for Payer: Cash Price |
$2,473.60
|
| Rate for Payer: Cash Price |
$2,473.60
|
| Rate for Payer: Cofinity Commercial |
$1,222.80
|
| Rate for Payer: Cofinity Commercial |
$1,137.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.17
|
| Rate for Payer: Healthscope Commercial |
$1,570.96
|
| Rate for Payer: Healthscope Commercial |
$1,358.67
|
| Rate for Payer: Mclaren Medicaid |
$573.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.63
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156,362.00
|
| Rate for Payer: Nomi Health Commercial |
$1,019.00
|
| Rate for Payer: PACE SWMI |
$849.17
|
| Rate for Payer: PHP Medicare Advantage |
$849.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,009.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,359.67
|
| Rate for Payer: Priority Health Medicare |
$849.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.67
|
| Rate for Payer: Priority Health SBD |
$1,359.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.17
|
| Rate for Payer: UHC Exchange |
$1,055.73
|
| Rate for Payer: UHC Medicare Advantage |
$849.17
|
| Rate for Payer: UHCCP Medicaid |
$573.82
|
|
|
PR OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS 27215
|
| Min. Negotiated Rate |
$387.66 |
| Max. Negotiated Rate |
$106,985.00 |
| Rate for Payer: Aetna Commercial |
$803.86
|
| Rate for Payer: Aetna Medicare |
$1,317.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.86
|
| Rate for Payer: BCBS Complete |
$407.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.81
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Mclaren Medicaid |
$387.66
|
| Rate for Payer: Meridian Medicaid |
$407.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,985.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.59
|
| Rate for Payer: Priority Health Narrow Network |
$924.59
|
| Rate for Payer: Priority Health SBD |
$924.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,008.33
|
| Rate for Payer: UHC Exchange |
$1,008.33
|
| Rate for Payer: UHCCP Medicaid |
$387.66
|
|
|
PR OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN
|
Professional
|
Both
|
$2,054.00
|
|
|
Service Code
|
HCPCS 21347
|
| Min. Negotiated Rate |
$86.11 |
| Max. Negotiated Rate |
$183,049.00 |
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: Aetna Medicare |
$1,018.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,312.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,410.72
|
| Rate for Payer: BCBS Complete |
$701.37
|
| Rate for Payer: BCBS MAPPO |
$979.67
|
| Rate for Payer: BCBS Trust/PPO |
$86.11
|
| Rate for Payer: BCN Commercial |
$1,528.09
|
| Rate for Payer: BCN Medicare Advantage |
$979.67
|
| Rate for Payer: Cash Price |
$1,643.20
|
| Rate for Payer: Cash Price |
$1,643.20
|
| Rate for Payer: Cofinity Commercial |
$1,410.72
|
| Rate for Payer: Cofinity Commercial |
$1,312.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.67
|
| Rate for Payer: Healthscope Commercial |
$1,812.39
|
| Rate for Payer: Healthscope Commercial |
$1,567.47
|
| Rate for Payer: Mclaren Medicaid |
$667.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.65
|
| Rate for Payer: Meridian Medicaid |
$701.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183,049.00
|
| Rate for Payer: Nomi Health Commercial |
$1,175.60
|
| Rate for Payer: PACE SWMI |
$979.67
|
| Rate for Payer: PHP Medicare Advantage |
$979.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,587.65
|
| Rate for Payer: Priority Health Medicare |
$979.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,587.65
|
| Rate for Payer: Priority Health SBD |
$1,587.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.67
|
| Rate for Payer: UHC Exchange |
$1,091.04
|
| Rate for Payer: UHC Medicare Advantage |
$979.67
|
| Rate for Payer: UHCCP Medicaid |
$667.97
|
|
|
PR OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC
|
Professional
|
Both
|
$1,613.00
|
|
|
Service Code
|
HCPCS 21390
|
| Min. Negotiated Rate |
$513.97 |
| Max. Negotiated Rate |
$141,147.00 |
| Rate for Payer: Aetna Commercial |
$1,012.60
|
| Rate for Payer: Aetna Medicare |
$785.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.16
|
| Rate for Payer: BCBS Complete |
$539.67
|
| Rate for Payer: BCBS MAPPO |
$755.67
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,174.29
|
| Rate for Payer: BCN Medicare Advantage |
$755.67
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cofinity Commercial |
$1,088.16
|
| Rate for Payer: Cofinity Commercial |
$1,012.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.67
|
| Rate for Payer: Healthscope Commercial |
$1,397.99
|
| Rate for Payer: Healthscope Commercial |
$1,209.07
|
| Rate for Payer: Mclaren Medicaid |
$513.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$793.45
|
| Rate for Payer: Meridian Medicaid |
$539.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,147.00
|
| Rate for Payer: Nomi Health Commercial |
$906.80
|
| Rate for Payer: PACE SWMI |
$755.67
|
| Rate for Payer: PHP Medicare Advantage |
$755.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,048.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.39
|
| Rate for Payer: Priority Health Medicare |
$755.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,228.39
|
| Rate for Payer: Priority Health SBD |
$1,228.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$929.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$755.67
|
| Rate for Payer: UHC Exchange |
$929.58
|
| Rate for Payer: UHC Medicare Advantage |
$755.67
|
| Rate for Payer: UHCCP Medicaid |
$513.97
|
|
|
PR OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 27566
|
| Min. Negotiated Rate |
$581.06 |
| Max. Negotiated Rate |
$158,501.00 |
| Rate for Payer: Aetna Commercial |
$1,155.75
|
| Rate for Payer: Aetna Medicare |
$897.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.00
|
| Rate for Payer: BCBS Complete |
$610.11
|
| Rate for Payer: BCBS MAPPO |
$862.50
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$1,310.63
|
| Rate for Payer: BCN Medicare Advantage |
$862.50
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,242.00
|
| Rate for Payer: Cofinity Commercial |
$1,155.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.50
|
| Rate for Payer: Healthscope Commercial |
$1,595.62
|
| Rate for Payer: Healthscope Commercial |
$1,380.00
|
| Rate for Payer: Mclaren Medicaid |
$581.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.62
|
| Rate for Payer: Meridian Medicaid |
$610.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158,501.00
|
| Rate for Payer: Nomi Health Commercial |
$1,035.00
|
| Rate for Payer: PACE SWMI |
$862.50
|
| Rate for Payer: PHP Medicare Advantage |
$862.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,376.98
|
| Rate for Payer: Priority Health Medicare |
$862.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,376.98
|
| Rate for Payer: Priority Health SBD |
$1,376.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.50
|
| Rate for Payer: UHC Exchange |
$1,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$862.50
|
| Rate for Payer: UHCCP Medicaid |
$581.06
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Facility
|
IP
|
$2,509.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$1,580.67 |
| Max. Negotiated Rate |
$2,258.10 |
| Rate for Payer: Aetna Commercial |
$2,132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.85
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,756.30
|
| Rate for Payer: Cofinity Commercial |
$2,157.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,756.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.20
|
| Rate for Payer: Healthscope Commercial |
$2,258.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.65
|
| Rate for Payer: PHP Commercial |
$2,132.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health SBD |
$1,580.67
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Facility
|
OP
|
$2,509.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$804.24 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Commercial |
$2,132.65
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.85
|
| 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 |
$3,723.91
|
| Rate for Payer: BCN Commercial |
$3,723.91
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$2,157.74
|
| Rate for Payer: Cofinity Commercial |
$1,756.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,756.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,258.10
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.65
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$2,132.65
|
| 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 |
$1,630.85
|
| 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 |
$1,580.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.24
|
| 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 OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 27524
|
| Min. Negotiated Rate |
$491.82 |
| Max. Negotiated Rate |
$133,832.00 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$757.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,048.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.60
|
| Rate for Payer: BCBS Complete |
$516.41
|
| Rate for Payer: BCBS MAPPO |
$728.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$1,221.43
|
| Rate for Payer: BCN Medicare Advantage |
$728.06
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$975.60
|
| Rate for Payer: Cofinity Commercial |
$1,048.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.06
|
| Rate for Payer: Healthscope Commercial |
$1,346.91
|
| Rate for Payer: Healthscope Commercial |
$1,164.90
|
| Rate for Payer: Mclaren Medicaid |
$491.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.46
|
| Rate for Payer: Meridian Medicaid |
$516.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133,832.00
|
| Rate for Payer: Nomi Health Commercial |
$873.67
|
| Rate for Payer: PACE SWMI |
$728.06
|
| Rate for Payer: PHP Medicare Advantage |
$728.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,164.78
|
| Rate for Payer: Priority Health Medicare |
$728.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,164.78
|
| Rate for Payer: Priority Health SBD |
$1,164.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.06
|
| Rate for Payer: UHC Exchange |
$873.92
|
| Rate for Payer: UHC Medicare Advantage |
$728.06
|
| Rate for Payer: UHCCP Medicaid |
$491.82
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$491.82 |
| Max. Negotiated Rate |
$133,832.00 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$757.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,048.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.60
|
| Rate for Payer: BCBS Complete |
$516.41
|
| Rate for Payer: BCBS MAPPO |
$728.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$1,221.43
|
| Rate for Payer: BCN Medicare Advantage |
$728.06
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$975.60
|
| Rate for Payer: Cofinity Commercial |
$1,048.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.06
|
| Rate for Payer: Healthscope Commercial |
$1,346.91
|
| Rate for Payer: Healthscope Commercial |
$1,164.90
|
| Rate for Payer: Mclaren Medicaid |
$491.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.46
|
| Rate for Payer: Meridian Medicaid |
$516.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133,832.00
|
| Rate for Payer: Nomi Health Commercial |
$873.67
|
| Rate for Payer: PACE SWMI |
$728.06
|
| Rate for Payer: PHP Medicare Advantage |
$728.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,164.78
|
| Rate for Payer: Priority Health Medicare |
$728.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,164.78
|
| Rate for Payer: Priority Health SBD |
$1,164.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.06
|
| Rate for Payer: UHC Exchange |
$873.92
|
| Rate for Payer: UHC Medicare Advantage |
$728.06
|
| Rate for Payer: UHCCP Medicaid |
$491.82
|
|
|
PR OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO
|
Professional
|
Both
|
$1,947.00
|
|
|
Service Code
|
HCPCS 24586
|
| Min. Negotiated Rate |
$194.94 |
| Max. Negotiated Rate |
$192,829.00 |
| Rate for Payer: Aetna Commercial |
$1,398.52
|
| Rate for Payer: Aetna Medicare |
$1,085.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,398.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.88
|
| Rate for Payer: BCBS Complete |
$737.82
|
| Rate for Payer: BCBS MAPPO |
$1,043.67
|
| Rate for Payer: BCBS Trust/PPO |
$194.94
|
| Rate for Payer: BCN Commercial |
$1,593.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,043.67
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cofinity Commercial |
$1,502.88
|
| Rate for Payer: Cofinity Commercial |
$1,398.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,043.67
|
| Rate for Payer: Healthscope Commercial |
$1,930.79
|
| Rate for Payer: Healthscope Commercial |
$1,669.87
|
| Rate for Payer: Mclaren Medicaid |
$702.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,095.85
|
| Rate for Payer: Meridian Medicaid |
$737.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192,829.00
|
| Rate for Payer: Nomi Health Commercial |
$1,252.40
|
| Rate for Payer: PACE SWMI |
$1,043.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,043.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$702.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,265.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,670.59
|
| Rate for Payer: Priority Health Medicare |
$1,043.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,670.59
|
| Rate for Payer: Priority Health SBD |
$1,670.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,220.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,043.67
|
| Rate for Payer: UHC Exchange |
$1,220.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.67
|
| Rate for Payer: UHCCP Medicaid |
$702.69
|
|
|
PR OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD
|
Professional
|
Both
|
$3,919.00
|
|
|
Service Code
|
HCPCS 27218
|
| Min. Negotiated Rate |
$738.90 |
| Max. Negotiated Rate |
$204,444.00 |
| Rate for Payer: Aetna Commercial |
$1,541.82
|
| Rate for Payer: Aetna Medicare |
$1,959.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.82
|
| Rate for Payer: BCBS Complete |
$775.84
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$1,679.59
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Mclaren Medicaid |
$738.90
|
| Rate for Payer: Meridian Medicaid |
$775.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204,444.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.14
|
| Rate for Payer: Priority Health SBD |
$1,760.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,718.92
|
| Rate for Payer: UHC Exchange |
$1,718.92
|
| Rate for Payer: UHCCP Medicaid |
$738.90
|
|
|
PR OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 24587
|
| Min. Negotiated Rate |
$435.85 |
| Max. Negotiated Rate |
$193,259.00 |
| Rate for Payer: Aetna Commercial |
$1,405.55
|
| Rate for Payer: Aetna Medicare |
$1,090.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,405.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,510.44
|
| Rate for Payer: BCBS Complete |
$740.95
|
| Rate for Payer: BCBS MAPPO |
$1,048.92
|
| Rate for Payer: BCBS Trust/PPO |
$435.85
|
| Rate for Payer: BCN Commercial |
$1,596.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.92
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,510.44
|
| Rate for Payer: Cofinity Commercial |
$1,405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.92
|
| Rate for Payer: Healthscope Commercial |
$1,940.50
|
| Rate for Payer: Healthscope Commercial |
$1,678.27
|
| Rate for Payer: Mclaren Medicaid |
$705.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,101.37
|
| Rate for Payer: Meridian Medicaid |
$740.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193,259.00
|
| Rate for Payer: Nomi Health Commercial |
$1,258.70
|
| Rate for Payer: PACE SWMI |
$1,048.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.15
|
| Rate for Payer: Priority Health Medicare |
$1,048.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,674.15
|
| Rate for Payer: Priority Health SBD |
$1,674.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,213.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.92
|
| Rate for Payer: UHC Exchange |
$1,213.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.92
|
| Rate for Payer: UHCCP Medicaid |
$705.67
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 23615
|
| Hospital Charge Code |
23615
|
| Min. Negotiated Rate |
$333.89 |
| Max. Negotiated Rate |
$156,758.00 |
| Rate for Payer: Aetna Commercial |
$1,142.08
|
| Rate for Payer: Aetna Medicare |
$886.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,227.31
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCBS MAPPO |
$852.30
|
| Rate for Payer: BCBS Trust/PPO |
$333.89
|
| Rate for Payer: BCN Commercial |
$1,298.41
|
| Rate for Payer: BCN Medicare Advantage |
$852.30
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cofinity Commercial |
$1,227.31
|
| Rate for Payer: Cofinity Commercial |
$1,142.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.30
|
| Rate for Payer: Healthscope Commercial |
$1,576.76
|
| Rate for Payer: Healthscope Commercial |
$1,363.68
|
| Rate for Payer: Mclaren Medicaid |
$575.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$894.92
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156,758.00
|
| Rate for Payer: Nomi Health Commercial |
$1,022.76
|
| Rate for Payer: PACE SWMI |
$852.30
|
| Rate for Payer: PHP Medicare Advantage |
$852.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,363.23
|
| Rate for Payer: Priority Health Medicare |
$852.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,363.23
|
| Rate for Payer: Priority Health SBD |
$1,363.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,000.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$852.30
|
| Rate for Payer: UHC Exchange |
$1,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$852.30
|
| Rate for Payer: UHCCP Medicaid |
$575.53
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Facility
|
OP
|
$3,192.00
|
|
|
Service Code
|
CPT 23615
|
| Hospital Charge Code |
23615
|
| Min. Negotiated Rate |
$941.80 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Commercial |
$2,713.20
|
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,074.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,339.88
|
| Rate for Payer: BCN Commercial |
$4,339.88
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cofinity Commercial |
$2,234.40
|
| Rate for Payer: Cofinity Commercial |
$2,745.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,234.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,553.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Healthscope Commercial |
$2,872.80
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,713.20
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Commercial |
$2,713.20
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Priority Health SBD |
$2,010.96
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.80
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$7,097.54
|
| Rate for Payer: VA VA |
$12,606.65
|
|
