|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,689.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$372.11 |
| Max. Negotiated Rate |
$1,882.30 |
| Rate for Payer: Aetna Commercial |
$763.42
|
| Rate for Payer: BCBS Complete |
$390.72
|
| Rate for Payer: BCBS Trust/PPO |
$528.83
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Mclaren Medicaid |
$372.11
|
| Rate for Payer: Meridian Medicaid |
$390.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,882.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.45
|
| Rate for Payer: Priority Health Narrow Network |
$884.45
|
| Rate for Payer: Priority Health SBD |
$884.45
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,526.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$462.42 |
| Max. Negotiated Rate |
$1,768.20 |
| Rate for Payer: Aetna Commercial |
$952.27
|
| Rate for Payer: BCBS Complete |
$485.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Mclaren Medicaid |
$462.42
|
| Rate for Payer: Meridian Medicaid |
$485.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,100.45
|
| Rate for Payer: Priority Health SBD |
$1,100.45
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,667.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$367.62 |
| Max. Negotiated Rate |
$1,866.90 |
| Rate for Payer: Aetna Commercial |
$780.08
|
| Rate for Payer: BCBS Complete |
$399.88
|
| Rate for Payer: BCBS Trust/PPO |
$367.62
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Mclaren Medicaid |
$380.84
|
| Rate for Payer: Meridian Medicaid |
$399.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$906.92
|
| Rate for Payer: Priority Health Narrow Network |
$906.92
|
| Rate for Payer: Priority Health SBD |
$906.92
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,480.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$481.17 |
| Max. Negotiated Rate |
$1,736.00 |
| Rate for Payer: Aetna Commercial |
$988.24
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS Trust/PPO |
$663.54
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Mclaren Medicaid |
$481.17
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,736.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,144.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,144.36
|
| Rate for Payer: Priority Health SBD |
$1,144.36
|
|
|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$372.54 |
| Max. Negotiated Rate |
$1,263.69 |
| Rate for Payer: Aetna Commercial |
$762.34
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.69
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.96
|
| Rate for Payer: Priority Health Narrow Network |
$884.96
|
| Rate for Payer: Priority Health SBD |
$884.96
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE
|
Professional
|
Both
|
$1,984.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$466.68 |
| Max. Negotiated Rate |
$1,388.80 |
| Rate for Payer: Aetna Commercial |
$959.80
|
| Rate for Payer: BCBS Complete |
$490.01
|
| Rate for Payer: BCBS Trust/PPO |
$548.81
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Mclaren Medicaid |
$466.68
|
| Rate for Payer: Meridian Medicaid |
$490.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,388.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.13
|
| Rate for Payer: Priority Health SBD |
$1,109.13
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
HCPCS 26685
|
| Min. Negotiated Rate |
$56.88 |
| Max. Negotiated Rate |
$1,547.70 |
| Rate for Payer: Aetna Commercial |
$764.98
|
| Rate for Payer: BCBS Complete |
$394.75
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Mclaren Medicaid |
$375.95
|
| Rate for Payer: Meridian Medicaid |
$394.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$890.06
|
| Rate for Payer: Priority Health Narrow Network |
$890.06
|
| Rate for Payer: Priority Health SBD |
$890.06
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,831.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$1,981.70 |
| Rate for Payer: Aetna Commercial |
$832.65
|
| Rate for Payer: BCBS Complete |
$428.52
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Mclaren Medicaid |
$408.11
|
| Rate for Payer: Meridian Medicaid |
$428.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.19
|
| Rate for Payer: Priority Health Narrow Network |
$968.19
|
| Rate for Payer: Priority Health SBD |
$968.19
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,407.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$285.26 |
| Max. Negotiated Rate |
$1,684.90 |
| Rate for Payer: Aetna Commercial |
$959.84
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS Trust/PPO |
$285.26
|
| Rate for Payer: Cash Price |
$1,925.60
|
| Rate for Payer: Cash Price |
$1,925.60
|
| Rate for Payer: Mclaren Medicaid |
$467.11
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,110.67
|
| Rate for Payer: Priority Health SBD |
$1,110.67
|
|
|
PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG
|
Professional
|
Both
|
$1,978.00
|
|
|
Service Code
|
HCPCS 21365
|
| Min. Negotiated Rate |
$180.58 |
| Max. Negotiated Rate |
$1,654.00 |
| Rate for Payer: Aetna Commercial |
$1,448.48
|
| Rate for Payer: BCBS Complete |
$724.63
|
| Rate for Payer: BCBS Trust/PPO |
$180.58
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Mclaren Medicaid |
$690.12
|
| Rate for Payer: Meridian Medicaid |
$724.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,384.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,654.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,654.00
|
| Rate for Payer: Priority Health SBD |
$1,654.00
|
|
|
PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$3,407.00
|
|
|
Service Code
|
HCPCS 21344
|
| Min. Negotiated Rate |
$118.87 |
| Max. Negotiated Rate |
$2,384.90 |
| Rate for Payer: Aetna Commercial |
$1,845.66
|
| Rate for Payer: BCBS Complete |
$935.75
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: Cash Price |
$2,725.60
|
| Rate for Payer: Cash Price |
$2,725.60
|
| Rate for Payer: Mclaren Medicaid |
$891.19
|
| Rate for Payer: Meridian Medicaid |
$935.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$891.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,384.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,136.56
|
| Rate for Payer: Priority Health SBD |
$2,136.56
|
|
|
PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR
|
Professional
|
Both
|
$2,954.00
|
|
|
Service Code
|
HCPCS 21433
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,644.15 |
| Rate for Payer: Aetna Commercial |
$2,312.83
|
| Rate for Payer: BCBS Complete |
$1,159.85
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: Cash Price |
$2,363.20
|
| Rate for Payer: Cash Price |
$2,363.20
|
| Rate for Payer: Mclaren Medicaid |
$1,104.62
|
| Rate for Payer: Meridian Medicaid |
$1,159.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,104.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,067.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,644.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,644.15
|
| Rate for Payer: Priority Health SBD |
$2,644.15
|
|
|
PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 21343
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$1,683.50 |
| Rate for Payer: Aetna Commercial |
$1,431.81
|
| Rate for Payer: BCBS Complete |
$732.68
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Mclaren Medicaid |
$697.79
|
| Rate for Payer: Meridian Medicaid |
$732.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$697.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,683.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,670.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,670.34
|
| Rate for Payer: Priority Health SBD |
$1,670.34
|
|
|
PR OPEN TX DEPRESSED MALAR FRACTURE
|
Professional
|
Both
|
$1,017.00
|
|
|
Service Code
|
HCPCS 21360
|
| Min. Negotiated Rate |
$339.31 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$680.88
|
| Rate for Payer: BCBS Complete |
$356.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: Cash Price |
$813.60
|
| Rate for Payer: Cash Price |
$813.60
|
| Rate for Payer: Mclaren Medicaid |
$339.31
|
| Rate for Payer: Meridian Medicaid |
$356.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$805.81
|
| Rate for Payer: Priority Health Narrow Network |
$805.81
|
| Rate for Payer: Priority Health SBD |
$805.81
|
|
|
PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 21356
|
| Min. Negotiated Rate |
$259.86 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$497.11
|
| Rate for Payer: BCBS Complete |
$272.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Mclaren Medicaid |
$259.86
|
| Rate for Payer: Meridian Medicaid |
$272.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$565.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.90
|
| Rate for Payer: Priority Health Narrow Network |
$618.90
|
| Rate for Payer: Priority Health SBD |
$618.90
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,423.00
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$417.91 |
| Max. Negotiated Rate |
$2,729.34 |
| Rate for Payer: Aetna Commercial |
$860.56
|
| Rate for Payer: BCBS Complete |
$438.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,729.34
|
| Rate for Payer: Cash Price |
$1,938.40
|
| Rate for Payer: Cash Price |
$1,938.40
|
| 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 |
$1,696.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$993.22
|
| Rate for Payer: Priority Health Narrow Network |
$993.22
|
| Rate for Payer: Priority Health SBD |
$993.22
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
OP
|
$2,423.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$642.44 |
| Max. Negotiated Rate |
$19,502.65 |
| Rate for Payer: Aetna Commercial |
$2,059.55
|
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,574.95
|
| 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 |
$2,876.95
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Cash Price |
$1,938.40
|
| Rate for Payer: Cash Price |
$1,938.40
|
| Rate for Payer: Cofinity Commercial |
$2,083.78
|
| Rate for Payer: Cofinity Commercial |
$1,696.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Healthscope Commercial |
$2,180.70
|
| 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 |
$2,059.55
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Commercial |
$2,059.55
|
| 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 |
$1,696.10
|
| 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 |
$1,526.49
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$642.44
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,423.00
|
|
|
Service Code
|
HCPCS 27792
|
| Min. Negotiated Rate |
$417.91 |
| Max. Negotiated Rate |
$2,729.34 |
| Rate for Payer: Aetna Commercial |
$860.56
|
| Rate for Payer: BCBS Complete |
$438.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,729.34
|
| Rate for Payer: Cash Price |
$1,938.40
|
| Rate for Payer: Cash Price |
$1,938.40
|
| 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 |
$1,696.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$993.22
|
| Rate for Payer: Priority Health Narrow Network |
$993.22
|
| Rate for Payer: Priority Health SBD |
$993.22
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
IP
|
$2,423.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$1,526.49 |
| Max. Negotiated Rate |
$2,180.70 |
| Rate for Payer: Aetna Commercial |
$2,059.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,574.95
|
| Rate for Payer: Cash Price |
$1,938.40
|
| Rate for Payer: Cofinity Commercial |
$1,696.10
|
| Rate for Payer: Cofinity Commercial |
$2,083.78
|
| Rate for Payer: Healthscope Commercial |
$2,180.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,059.55
|
| Rate for Payer: PHP Commercial |
$2,059.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,696.10
|
| Rate for Payer: Priority Health SBD |
$1,526.49
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$329.72 |
| Max. Negotiated Rate |
$780.28 |
| Rate for Payer: Aetna Commercial |
$664.73
|
| Rate for Payer: BCBS Complete |
$346.21
|
| Rate for Payer: BCBS Trust/PPO |
$542.56
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Mclaren Medicaid |
$329.72
|
| Rate for Payer: Meridian Medicaid |
$346.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$780.28
|
| Rate for Payer: Priority Health Narrow Network |
$780.28
|
| Rate for Payer: Priority Health SBD |
$780.28
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,750.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$410.66 |
| Max. Negotiated Rate |
$1,483.99 |
| Rate for Payer: Aetna Commercial |
$841.44
|
| Rate for Payer: BCBS Complete |
$431.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.99
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Mclaren Medicaid |
$410.66
|
| Rate for Payer: Meridian Medicaid |
$431.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.32
|
| Rate for Payer: Priority Health Narrow Network |
$974.32
|
| Rate for Payer: Priority Health SBD |
$974.32
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
OP
|
$2,257.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$703.35 |
| Max. Negotiated Rate |
$19,502.65 |
| Rate for Payer: Aetna Commercial |
$1,918.45
|
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,467.05
|
| 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 |
$3,198.48
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$1,579.90
|
| Rate for Payer: Cofinity Commercial |
$1,941.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Healthscope Commercial |
$2,031.30
|
| 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 |
$1,918.45
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Commercial |
$1,918.45
|
| 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 |
$1,579.90
|
| 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 |
$1,421.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$773.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$703.35
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$457.52 |
| Max. Negotiated Rate |
$1,579.90 |
| Rate for Payer: Aetna Commercial |
$942.40
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.73
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Mclaren Medicaid |
$457.52
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,579.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,089.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,089.72
|
| Rate for Payer: Priority Health SBD |
$1,089.72
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
IP
|
$2,257.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$1,421.91 |
| Max. Negotiated Rate |
$2,031.30 |
| Rate for Payer: Aetna Commercial |
$1,918.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,467.05
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$1,579.90
|
| Rate for Payer: Cofinity Commercial |
$1,941.02
|
| Rate for Payer: Healthscope Commercial |
$2,031.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,918.45
|
| Rate for Payer: PHP Commercial |
$1,918.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,579.90
|
| Rate for Payer: Priority Health SBD |
$1,421.91
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$457.52 |
| Max. Negotiated Rate |
$1,579.90 |
| Rate for Payer: Aetna Commercial |
$942.40
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.73
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Mclaren Medicaid |
$457.52
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,579.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,089.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,089.72
|
| Rate for Payer: Priority Health SBD |
$1,089.72
|
|
