|
PR OPEN CLOSURE MAJOR BRONCHIAL FISTULA
|
Professional
|
Both
|
$4,688.00
|
|
|
Service Code
|
HCPCS 32815
|
| Min. Negotiated Rate |
$1,282.18 |
| Max. Negotiated Rate |
$3,819.66 |
| Rate for Payer: Aetna Commercial |
$3,626.68
|
| Rate for Payer: BCBS Complete |
$1,848.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.18
|
| Rate for Payer: Cash Price |
$3,750.40
|
| Rate for Payer: Cash Price |
$3,750.40
|
| Rate for Payer: Mclaren Medicaid |
$1,760.02
|
| Rate for Payer: Meridian Medicaid |
$1,848.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,760.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,281.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,819.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,819.66
|
| Rate for Payer: Priority Health SBD |
$3,819.66
|
|
|
PR OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 35600
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$1,077.73 |
| Rate for Payer: Aetna Commercial |
$345.32
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.73
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Mclaren Medicaid |
$115.87
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$883.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.32
|
| Rate for Payer: Priority Health Narrow Network |
$288.32
|
| Rate for Payer: Priority Health SBD |
$288.32
|
|
|
PR OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 64568
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,330.00 |
| Rate for Payer: Aetna Commercial |
$795.28
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS Trust/PPO |
$462.79
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Mclaren Medicaid |
$388.30
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.20
|
| Rate for Payer: Priority Health SBD |
$1,019.20
|
|
|
PR OPEN IMPLANTATION NEA PERIPHERAL NERVE
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 64575
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$428.44
|
| Rate for Payer: BCBS Complete |
$212.02
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Mclaren Medicaid |
$201.92
|
| Rate for Payer: Meridian Medicaid |
$212.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$518.67
|
| Rate for Payer: Priority Health Narrow Network |
$518.67
|
| Rate for Payer: Priority Health SBD |
$518.67
|
|
|
PR OPEN IMPLANTATION NEA SACRAL NERVE
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
HCPCS 64581
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,101.31 |
| Rate for Payer: Aetna Commercial |
$851.71
|
| Rate for Payer: BCBS Complete |
$438.81
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Mclaren Medicaid |
$417.91
|
| Rate for Payer: Meridian Medicaid |
$438.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,040.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,101.31
|
| Rate for Payer: Priority Health SBD |
$1,101.31
|
|
|
PR OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 64582
|
| Min. Negotiated Rate |
$368.23 |
| Max. Negotiated Rate |
$1,458.03 |
| Rate for Payer: Aetna Commercial |
$1,116.01
|
| Rate for Payer: BCBS Complete |
$562.03
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Mclaren Medicaid |
$535.27
|
| Rate for Payer: Meridian Medicaid |
$562.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,458.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,458.03
|
| Rate for Payer: Priority Health SBD |
$1,458.03
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
HCPCS 37239
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$1,127.39 |
| Rate for Payer: Aetna Commercial |
$204.11
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.39
|
| Rate for Payer: Cash Price |
$501.60
|
| Rate for Payer: Cash Price |
$501.60
|
| Rate for Payer: Mclaren Medicaid |
$93.29
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.47
|
| Rate for Payer: Priority Health Narrow Network |
$232.47
|
| Rate for Payer: Priority Health SBD |
$232.47
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 37237
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$1,781.43 |
| Rate for Payer: Aetna Commercial |
$283.76
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.43
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Mclaren Medicaid |
$131.00
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.02
|
| Rate for Payer: Priority Health Narrow Network |
$325.02
|
| Rate for Payer: Priority Health SBD |
$325.02
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL
|
Professional
|
Both
|
$1,187.00
|
|
|
Service Code
|
HCPCS 37236
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$1,359.84 |
| Rate for Payer: Aetna Commercial |
$595.20
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.84
|
| Rate for Payer: Cash Price |
$949.60
|
| Rate for Payer: Cash Price |
$949.60
|
| Rate for Payer: Mclaren Medicaid |
$273.49
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.10
|
| Rate for Payer: Priority Health Narrow Network |
$684.10
|
| Rate for Payer: Priority Health SBD |
$684.10
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 37238
|
| Min. Negotiated Rate |
$190.42 |
| Max. Negotiated Rate |
$2,106.33 |
| Rate for Payer: Aetna Commercial |
$412.29
|
| Rate for Payer: BCBS Complete |
$199.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.33
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Mclaren Medicaid |
$190.42
|
| Rate for Payer: Meridian Medicaid |
$199.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.45
|
| Rate for Payer: Priority Health Narrow Network |
$473.45
|
| Rate for Payer: Priority Health SBD |
$473.45
|
|
|
PR OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 25525
|
| Min. Negotiated Rate |
$512.90 |
| Max. Negotiated Rate |
$1,769.60 |
| Rate for Payer: Aetna Commercial |
$1,049.63
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.84
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Mclaren Medicaid |
$512.90
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,769.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,218.93
|
| Rate for Payer: Priority Health SBD |
$1,218.93
|
|
|
PR OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 25526
|
| Min. Negotiated Rate |
$618.77 |
| Max. Negotiated Rate |
$2,041.90 |
| Rate for Payer: Aetna Commercial |
$1,274.50
|
| Rate for Payer: BCBS Complete |
$649.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.05
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Mclaren Medicaid |
$618.77
|
| Rate for Payer: Meridian Medicaid |
$649.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,041.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,470.16
|
| Rate for Payer: Priority Health SBD |
$1,470.16
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF ACUTE
|
Professional
|
Both
|
$2,565.00
|
|
|
Service Code
|
HCPCS 23410
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,795.50 |
| Rate for Payer: Aetna Commercial |
$1,094.22
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Mclaren Medicaid |
$529.52
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.79
|
| Rate for Payer: Priority Health SBD |
$1,260.79
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,058.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$78.96 |
| Max. Negotiated Rate |
$2,140.60 |
| Rate for Payer: Aetna Commercial |
$1,137.14
|
| Rate for Payer: BCBS Complete |
$577.91
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: Cash Price |
$2,446.40
|
| Rate for Payer: Cash Price |
$2,446.40
|
| Rate for Payer: Mclaren Medicaid |
$550.39
|
| Rate for Payer: Meridian Medicaid |
$577.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$550.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,309.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,309.31
|
| Rate for Payer: Priority Health SBD |
$1,309.31
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
IP
|
$2,946.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$1,855.98 |
| Max. Negotiated Rate |
$2,651.40 |
| Rate for Payer: Aetna Commercial |
$2,504.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,914.90
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$2,533.56
|
| Rate for Payer: Cofinity Commercial |
$2,062.20
|
| Rate for Payer: Healthscope Commercial |
$2,651.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,504.10
|
| Rate for Payer: PHP Commercial |
$2,504.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health SBD |
$1,855.98
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 27814
|
| Min. Negotiated Rate |
$493.95 |
| Max. Negotiated Rate |
$2,062.20 |
| Rate for Payer: Aetna Commercial |
$1,021.13
|
| Rate for Payer: BCBS Complete |
$518.65
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Mclaren Medicaid |
$493.95
|
| Rate for Payer: Meridian Medicaid |
$518.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,175.51
|
| Rate for Payer: Priority Health SBD |
$1,175.51
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$493.95 |
| Max. Negotiated Rate |
$2,062.20 |
| Rate for Payer: Aetna Commercial |
$1,021.13
|
| Rate for Payer: BCBS Complete |
$518.65
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Mclaren Medicaid |
$493.95
|
| Rate for Payer: Meridian Medicaid |
$518.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,175.51
|
| Rate for Payer: Priority Health SBD |
$1,175.51
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
OP
|
$2,946.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$759.34 |
| Max. Negotiated Rate |
$19,502.65 |
| Rate for Payer: Aetna Commercial |
$2,504.10
|
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,914.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,237.29
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$2,533.56
|
| Rate for Payer: Cofinity Commercial |
$2,062.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Healthscope Commercial |
$2,651.40
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,504.10
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Commercial |
$2,504.10
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,502.65
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health Narrow Network |
$15,602.12
|
| Rate for Payer: Priority Health SBD |
$1,855.98
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$759.34
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,300.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,310.00 |
| Rate for Payer: Aetna Commercial |
$1,498.02
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Mclaren Medicaid |
$721.43
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,310.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,722.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,722.93
|
| Rate for Payer: Priority Health SBD |
$1,722.93
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,180.00
|
|
|
Service Code
|
HCPCS 28420
|
| Min. Negotiated Rate |
$372.45 |
| Max. Negotiated Rate |
$1,990.51 |
| Rate for Payer: Aetna Commercial |
$1,729.13
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS Trust/PPO |
$372.45
|
| Rate for Payer: Cash Price |
$1,744.00
|
| Rate for Payer: Cash Price |
$1,744.00
|
| Rate for Payer: Mclaren Medicaid |
$834.96
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,526.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,990.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,990.51
|
| Rate for Payer: Priority Health SBD |
$1,990.51
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,513.00
|
|
|
Service Code
|
HCPCS 27828
|
| Min. Negotiated Rate |
$853.07 |
| Max. Negotiated Rate |
$3,159.10 |
| Rate for Payer: Aetna Commercial |
$1,772.06
|
| Rate for Payer: BCBS Complete |
$895.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.07
|
| Rate for Payer: Cash Price |
$3,610.40
|
| Rate for Payer: Cash Price |
$3,610.40
|
| Rate for Payer: Mclaren Medicaid |
$853.07
|
| Rate for Payer: Meridian Medicaid |
$895.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$853.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,035.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,035.96
|
| Rate for Payer: Priority Health SBD |
$2,035.96
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,040.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$551.24 |
| Max. Negotiated Rate |
$3,384.29 |
| Rate for Payer: Aetna Commercial |
$1,135.98
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,384.29
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Mclaren Medicaid |
$551.24
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,314.42
|
| Rate for Payer: Priority Health SBD |
$1,314.42
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,276.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$721.86 |
| Max. Negotiated Rate |
$3,897.80 |
| Rate for Payer: Aetna Commercial |
$1,490.61
|
| Rate for Payer: BCBS Complete |
$757.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.80
|
| Rate for Payer: Cash Price |
$3,420.80
|
| Rate for Payer: Cash Price |
$3,420.80
|
| Rate for Payer: Mclaren Medicaid |
$721.86
|
| Rate for Payer: Meridian Medicaid |
$757.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,993.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,721.92
|
| Rate for Payer: Priority Health SBD |
$1,721.92
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$480.10 |
| Max. Negotiated Rate |
$2,101.58 |
| Rate for Payer: Aetna Commercial |
$996.94
|
| Rate for Payer: BCBS Complete |
$504.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.58
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Mclaren Medicaid |
$480.10
|
| Rate for Payer: Meridian Medicaid |
$504.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,143.34
|
| Rate for Payer: Priority Health SBD |
$1,143.34
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,802.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$378.26 |
| Max. Negotiated Rate |
$1,961.40 |
| Rate for Payer: Aetna Commercial |
$1,111.10
|
| Rate for Payer: BCBS Complete |
$567.40
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Mclaren Medicaid |
$540.38
|
| Rate for Payer: Meridian Medicaid |
$567.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,961.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,284.28
|
| Rate for Payer: Priority Health SBD |
$1,284.28
|
|
