|
PR CLTX DSTL FIBULAR FX LAT MALLS W/MANJ
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
HCPCS 27788
|
| Min. Negotiated Rate |
$264.12 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Aetna Commercial |
$533.88
|
| Rate for Payer: Aetna Medicare |
$414.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.72
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$398.42
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: BCN Medicare Advantage |
$398.42
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cofinity Commercial |
$573.72
|
| Rate for Payer: Cofinity Commercial |
$533.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.42
|
| Rate for Payer: Healthscope Commercial |
$737.08
|
| Rate for Payer: Healthscope Commercial |
$637.47
|
| Rate for Payer: Mclaren Medicaid |
$264.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.34
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.29
|
| Rate for Payer: Nomi Health Commercial |
$478.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,048.50
|
| Rate for Payer: PACE SWMI |
$398.42
|
| Rate for Payer: PHP Medicare Advantage |
$398.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.92
|
| Rate for Payer: Priority Health Medicare |
$398.42
|
| Rate for Payer: Priority Health SBD |
$640.92
|
| Rate for Payer: Priority Health Tiered Network |
$640.92
|
| Rate for Payer: Railroad Medicare Medicare |
$398.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.15
|
| Rate for Payer: UHC Core |
$667.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.42
|
| Rate for Payer: UHC Exchange |
$667.15
|
| Rate for Payer: UHC Medicaid |
$264.12
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
HCPCS 27786
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna Commercial |
$375.86
|
| Rate for Payer: Aetna Medicare |
$291.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.91
|
| Rate for Payer: BCBS Complete |
$196.59
|
| Rate for Payer: BCBS MAPPO |
$280.49
|
| Rate for Payer: BCN Commercial |
$354.61
|
| Rate for Payer: BCN Medicare Advantage |
$280.49
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$403.91
|
| Rate for Payer: Cofinity Commercial |
$375.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.49
|
| Rate for Payer: Healthscope Commercial |
$518.91
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Mclaren Medicaid |
$187.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.51
|
| Rate for Payer: Meridian Medicaid |
$196.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.50
|
| Rate for Payer: Nomi Health Commercial |
$336.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.50
|
| Rate for Payer: PACE SWMI |
$280.49
|
| Rate for Payer: PHP Medicare Advantage |
$280.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$480.69
|
| Rate for Payer: Priority Health Medicare |
$280.49
|
| Rate for Payer: Priority Health SBD |
$480.69
|
| Rate for Payer: Priority Health Tiered Network |
$480.69
|
| Rate for Payer: Railroad Medicare Medicare |
$280.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$492.99
|
| Rate for Payer: UHC Core |
$492.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.49
|
| Rate for Payer: UHC Exchange |
$492.99
|
| Rate for Payer: UHC Medicaid |
$187.23
|
| Rate for Payer: UHCCP Medicaid |
$187.23
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 26755
|
| Min. Negotiated Rate |
$190.85 |
| Max. Negotiated Rate |
$531.49 |
| Rate for Payer: Aetna Commercial |
$384.97
|
| Rate for Payer: Aetna Medicare |
$298.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.70
|
| Rate for Payer: BCBS Complete |
$200.39
|
| Rate for Payer: BCBS MAPPO |
$287.29
|
| Rate for Payer: BCN Commercial |
$434.74
|
| Rate for Payer: BCN Medicare Advantage |
$287.29
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$413.70
|
| Rate for Payer: Cofinity Commercial |
$384.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.29
|
| Rate for Payer: Healthscope Commercial |
$531.49
|
| Rate for Payer: Healthscope Commercial |
$459.66
|
| Rate for Payer: Mclaren Medicaid |
$190.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.65
|
| Rate for Payer: Meridian Medicaid |
$200.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$316.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.64
|
| Rate for Payer: Nomi Health Commercial |
$344.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.25
|
| Rate for Payer: PACE SWMI |
$287.29
|
| Rate for Payer: PHP Medicare Advantage |
$287.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$464.71
|
| Rate for Payer: Priority Health Medicare |
$287.29
|
| Rate for Payer: Priority Health SBD |
$464.71
|
| Rate for Payer: Priority Health Tiered Network |
$464.71
|
| Rate for Payer: Railroad Medicare Medicare |
$287.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.60
|
| Rate for Payer: UHC Core |
$472.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$287.29
|
| Rate for Payer: UHC Exchange |
$472.60
|
| Rate for Payer: UHC Medicaid |
$190.85
|
| Rate for Payer: UHCCP Medicaid |
$190.85
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$132.91 |
| Max. Negotiated Rate |
$366.43 |
| Rate for Payer: Aetna Commercial |
$265.41
|
| Rate for Payer: Aetna Medicare |
$205.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.22
|
| Rate for Payer: BCBS Complete |
$139.56
|
| Rate for Payer: BCBS MAPPO |
$198.07
|
| Rate for Payer: BCN Commercial |
$303.77
|
| Rate for Payer: BCN Medicare Advantage |
$198.07
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$285.22
|
| Rate for Payer: Cofinity Commercial |
$265.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.07
|
| Rate for Payer: Healthscope Commercial |
$366.43
|
| Rate for Payer: Healthscope Commercial |
$316.91
|
| Rate for Payer: Mclaren Medicaid |
$132.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.97
|
| Rate for Payer: Meridian Medicaid |
$139.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.92
|
| Rate for Payer: Nomi Health Commercial |
$237.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$198.07
|
| Rate for Payer: PHP Medicare Advantage |
$198.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$324.71
|
| Rate for Payer: Priority Health Medicare |
$198.07
|
| Rate for Payer: Priority Health SBD |
$324.71
|
| Rate for Payer: Priority Health Tiered Network |
$324.71
|
| Rate for Payer: Railroad Medicare Medicare |
$198.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.80
|
| Rate for Payer: UHC Core |
$318.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.07
|
| Rate for Payer: UHC Exchange |
$318.80
|
| Rate for Payer: UHC Medicaid |
$132.91
|
| Rate for Payer: UHCCP Medicaid |
$132.91
|
|
|
PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ
|
Professional
|
Both
|
$777.00
|
|
|
Service Code
|
HCPCS 25600
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$599.60 |
| Rate for Payer: Aetna Commercial |
$434.31
|
| Rate for Payer: Aetna Medicare |
$337.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.72
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$324.11
|
| Rate for Payer: BCN Commercial |
$405.66
|
| Rate for Payer: BCN Medicare Advantage |
$324.11
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cofinity Commercial |
$466.72
|
| Rate for Payer: Cofinity Commercial |
$434.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.11
|
| Rate for Payer: Healthscope Commercial |
$599.60
|
| Rate for Payer: Healthscope Commercial |
$518.58
|
| Rate for Payer: Mclaren Medicaid |
$218.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.32
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$356.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$575.66
|
| Rate for Payer: Nomi Health Commercial |
$388.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.75
|
| Rate for Payer: PACE SWMI |
$324.11
|
| Rate for Payer: PHP Medicare Advantage |
$324.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$324.11
|
| Rate for Payer: Priority Health SBD |
$549.90
|
| Rate for Payer: Priority Health Tiered Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$324.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.15
|
| Rate for Payer: UHC Core |
$538.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$324.11
|
| Rate for Payer: UHC Exchange |
$538.15
|
| Rate for Payer: UHC Medicaid |
$218.11
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MNPJ
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$709.15
|
| Rate for Payer: Aetna Medicare |
$550.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.08
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCBS MAPPO |
$529.22
|
| Rate for Payer: BCN Commercial |
$793.28
|
| Rate for Payer: BCN Medicare Advantage |
$529.22
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Commercial |
$762.08
|
| Rate for Payer: Cofinity Commercial |
$709.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.22
|
| Rate for Payer: Healthscope Commercial |
$979.06
|
| Rate for Payer: Healthscope Commercial |
$846.75
|
| Rate for Payer: Mclaren Medicaid |
$350.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.68
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$915.05
|
| Rate for Payer: Nomi Health Commercial |
$635.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,072.50
|
| Rate for Payer: PACE SWMI |
$529.22
|
| Rate for Payer: PHP Medicare Advantage |
$529.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$848.00
|
| Rate for Payer: Priority Health Medicare |
$529.22
|
| Rate for Payer: Priority Health SBD |
$848.00
|
| Rate for Payer: Priority Health Tiered Network |
$848.00
|
| Rate for Payer: Railroad Medicare Medicare |
$529.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.27
|
| Rate for Payer: UHC Core |
$886.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.22
|
| Rate for Payer: UHC Exchange |
$886.27
|
| Rate for Payer: UHC Medicaid |
$350.39
|
| Rate for Payer: UHCCP Medicaid |
$350.39
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$346.13 |
| Max. Negotiated Rate |
$954.43 |
| Rate for Payer: Aetna Commercial |
$687.47
|
| Rate for Payer: Aetna Medicare |
$533.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.78
|
| Rate for Payer: BCBS Complete |
$363.44
|
| Rate for Payer: BCBS MAPPO |
$513.04
|
| Rate for Payer: BCN Commercial |
$822.67
|
| Rate for Payer: BCN Medicare Advantage |
$513.04
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cofinity Commercial |
$738.78
|
| Rate for Payer: Cofinity Commercial |
$687.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.04
|
| Rate for Payer: Healthscope Commercial |
$949.12
|
| Rate for Payer: Healthscope Commercial |
$820.86
|
| Rate for Payer: Mclaren Medicaid |
$346.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.69
|
| Rate for Payer: Meridian Medicaid |
$363.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$564.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.43
|
| Rate for Payer: Nomi Health Commercial |
$615.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.50
|
| Rate for Payer: PACE SWMI |
$513.04
|
| Rate for Payer: PHP Medicare Advantage |
$513.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$879.40
|
| Rate for Payer: Priority Health Medicare |
$513.04
|
| Rate for Payer: Priority Health SBD |
$879.40
|
| Rate for Payer: Priority Health Tiered Network |
$879.40
|
| Rate for Payer: Railroad Medicare Medicare |
$513.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.75
|
| Rate for Payer: UHC Core |
$870.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$513.04
|
| Rate for Payer: UHC Exchange |
$870.75
|
| Rate for Payer: UHC Medicaid |
$346.13
|
| Rate for Payer: UHCCP Medicaid |
$346.13
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ
|
Professional
|
Both
|
$1,460.00
|
|
|
Service Code
|
HCPCS 27510
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,216.62 |
| Rate for Payer: Aetna Commercial |
$880.81
|
| Rate for Payer: Aetna Medicare |
$683.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$946.54
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS MAPPO |
$657.32
|
| Rate for Payer: BCN Commercial |
$1,038.29
|
| Rate for Payer: BCN Medicare Advantage |
$657.32
|
| Rate for Payer: Cash Price |
$1,168.00
|
| Rate for Payer: Cash Price |
$1,168.00
|
| Rate for Payer: Cofinity Commercial |
$946.54
|
| Rate for Payer: Cofinity Commercial |
$880.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.32
|
| Rate for Payer: Healthscope Commercial |
$1,216.04
|
| Rate for Payer: Healthscope Commercial |
$1,051.71
|
| Rate for Payer: Mclaren Medicaid |
$428.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.19
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$723.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,216.62
|
| Rate for Payer: Nomi Health Commercial |
$788.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.00
|
| Rate for Payer: PACE SWMI |
$657.32
|
| Rate for Payer: PHP Medicare Advantage |
$657.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,109.90
|
| Rate for Payer: Priority Health Medicare |
$657.32
|
| Rate for Payer: Priority Health SBD |
$1,109.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,109.90
|
| Rate for Payer: Railroad Medicare Medicare |
$657.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.86
|
| Rate for Payer: UHC Core |
$1,190.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$657.32
|
| Rate for Payer: UHC Exchange |
$1,190.86
|
| Rate for Payer: UHC Medicaid |
$428.98
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 27508
|
| Min. Negotiated Rate |
$311.62 |
| Max. Negotiated Rate |
$887.69 |
| Rate for Payer: Aetna Commercial |
$633.77
|
| Rate for Payer: Aetna Medicare |
$491.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.06
|
| Rate for Payer: BCBS Complete |
$327.20
|
| Rate for Payer: BCBS MAPPO |
$472.96
|
| Rate for Payer: BCN Commercial |
$770.37
|
| Rate for Payer: BCN Medicare Advantage |
$472.96
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$681.06
|
| Rate for Payer: Cofinity Commercial |
$633.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.96
|
| Rate for Payer: Healthscope Commercial |
$874.98
|
| Rate for Payer: Healthscope Commercial |
$756.74
|
| Rate for Payer: Mclaren Medicaid |
$311.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.61
|
| Rate for Payer: Meridian Medicaid |
$327.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$520.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$887.69
|
| Rate for Payer: Nomi Health Commercial |
$567.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$849.75
|
| Rate for Payer: PACE SWMI |
$472.96
|
| Rate for Payer: PHP Medicare Advantage |
$472.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$823.51
|
| Rate for Payer: Priority Health Medicare |
$472.96
|
| Rate for Payer: Priority Health SBD |
$823.51
|
| Rate for Payer: Priority Health Tiered Network |
$823.51
|
| Rate for Payer: Railroad Medicare Medicare |
$472.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.02
|
| Rate for Payer: UHC Core |
$861.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$472.96
|
| Rate for Payer: UHC Exchange |
$861.02
|
| Rate for Payer: UHC Medicaid |
$311.62
|
| Rate for Payer: UHCCP Medicaid |
$311.62
|
|
|
PR CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 27232
|
| Min. Negotiated Rate |
$444.32 |
| Max. Negotiated Rate |
$1,317.09 |
| Rate for Payer: Aetna Commercial |
$921.18
|
| Rate for Payer: Aetna Medicare |
$714.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.93
|
| Rate for Payer: BCBS Complete |
$466.54
|
| Rate for Payer: BCBS MAPPO |
$687.45
|
| Rate for Payer: BCN Commercial |
$1,107.01
|
| Rate for Payer: BCN Medicare Advantage |
$687.45
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cofinity Commercial |
$989.93
|
| Rate for Payer: Cofinity Commercial |
$921.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.45
|
| Rate for Payer: Healthscope Commercial |
$1,271.78
|
| Rate for Payer: Healthscope Commercial |
$1,099.92
|
| Rate for Payer: Mclaren Medicaid |
$444.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.82
|
| Rate for Payer: Meridian Medicaid |
$466.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$756.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,299.22
|
| Rate for Payer: Nomi Health Commercial |
$824.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,060.50
|
| Rate for Payer: PACE SWMI |
$687.45
|
| Rate for Payer: PHP Medicare Advantage |
$687.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.36
|
| Rate for Payer: Priority Health Medicare |
$687.45
|
| Rate for Payer: Priority Health SBD |
$1,183.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,183.36
|
| Rate for Payer: Railroad Medicare Medicare |
$687.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.09
|
| Rate for Payer: UHC Core |
$1,317.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$687.45
|
| Rate for Payer: UHC Exchange |
$1,317.09
|
| Rate for Payer: UHC Medicaid |
$444.32
|
| Rate for Payer: UHCCP Medicaid |
$444.32
|
|
|
PR CLTX FEM FX PROX END NCK W/O MANJ
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 27230
|
| Min. Negotiated Rate |
$301.61 |
| Max. Negotiated Rate |
$849.96 |
| Rate for Payer: Aetna Commercial |
$612.46
|
| Rate for Payer: Aetna Medicare |
$475.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.17
|
| Rate for Payer: BCBS Complete |
$316.69
|
| Rate for Payer: BCBS MAPPO |
$457.06
|
| Rate for Payer: BCN Commercial |
$738.00
|
| Rate for Payer: BCN Medicare Advantage |
$457.06
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$658.17
|
| Rate for Payer: Cofinity Commercial |
$612.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.06
|
| Rate for Payer: Healthscope Commercial |
$845.56
|
| Rate for Payer: Healthscope Commercial |
$731.30
|
| Rate for Payer: Mclaren Medicaid |
$301.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.91
|
| Rate for Payer: Meridian Medicaid |
$316.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.96
|
| Rate for Payer: Nomi Health Commercial |
$548.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$771.75
|
| Rate for Payer: PACE SWMI |
$457.06
|
| Rate for Payer: PHP Medicare Advantage |
$457.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$788.92
|
| Rate for Payer: Priority Health Medicare |
$457.06
|
| Rate for Payer: Priority Health SBD |
$788.92
|
| Rate for Payer: Priority Health Tiered Network |
$788.92
|
| Rate for Payer: Railroad Medicare Medicare |
$457.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$823.00
|
| Rate for Payer: UHC Core |
$823.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.06
|
| Rate for Payer: UHC Exchange |
$823.00
|
| Rate for Payer: UHC Medicaid |
$301.61
|
| Rate for Payer: UHCCP Medicaid |
$301.61
|
|
|
PR CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ
|
Professional
|
Both
|
$1,887.00
|
|
|
Service Code
|
HCPCS 27502
|
| Min. Negotiated Rate |
$479.89 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: Aetna Commercial |
$988.16
|
| Rate for Payer: Aetna Medicare |
$766.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,061.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.16
|
| Rate for Payer: BCBS Complete |
$503.88
|
| Rate for Payer: BCBS MAPPO |
$737.43
|
| Rate for Payer: BCN Commercial |
$1,146.85
|
| Rate for Payer: BCN Medicare Advantage |
$737.43
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$988.16
|
| Rate for Payer: Cofinity Commercial |
$1,061.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.43
|
| Rate for Payer: Healthscope Commercial |
$1,364.25
|
| Rate for Payer: Healthscope Commercial |
$1,179.89
|
| Rate for Payer: Mclaren Medicaid |
$479.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$774.30
|
| Rate for Payer: Meridian Medicaid |
$503.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$811.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.90
|
| Rate for Payer: Nomi Health Commercial |
$884.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,415.25
|
| Rate for Payer: PACE SWMI |
$737.43
|
| Rate for Payer: PHP Medicare Advantage |
$737.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,225.95
|
| Rate for Payer: Priority Health Medicare |
$737.43
|
| Rate for Payer: Priority Health SBD |
$1,225.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,225.95
|
| Rate for Payer: Railroad Medicare Medicare |
$737.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.03
|
| Rate for Payer: UHC Core |
$1,333.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$737.43
|
| Rate for Payer: UHC Exchange |
$1,333.03
|
| Rate for Payer: UHC Medicaid |
$479.89
|
| Rate for Payer: UHCCP Medicaid |
$479.89
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 28495
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$272.13 |
| Rate for Payer: Aetna Commercial |
$197.11
|
| Rate for Payer: Aetna Medicare |
$152.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.82
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$147.10
|
| Rate for Payer: BCN Commercial |
$234.05
|
| Rate for Payer: BCN Medicare Advantage |
$147.10
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$211.82
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.10
|
| Rate for Payer: Healthscope Commercial |
$272.13
|
| Rate for Payer: Healthscope Commercial |
$235.36
|
| Rate for Payer: Mclaren Medicaid |
$98.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.46
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.09
|
| Rate for Payer: Nomi Health Commercial |
$176.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$147.10
|
| Rate for Payer: PHP Medicare Advantage |
$147.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$250.20
|
| Rate for Payer: Priority Health Medicare |
$147.10
|
| Rate for Payer: Priority Health SBD |
$250.20
|
| Rate for Payer: Priority Health Tiered Network |
$250.20
|
| Rate for Payer: Railroad Medicare Medicare |
$147.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.16
|
| Rate for Payer: UHC Core |
$254.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.10
|
| Rate for Payer: UHC Exchange |
$254.16
|
| Rate for Payer: UHC Medicaid |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS 28490
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$167.90
|
| Rate for Payer: Aetna Medicare |
$130.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.43
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$125.30
|
| Rate for Payer: BCN Commercial |
$195.70
|
| Rate for Payer: BCN Medicare Advantage |
$125.30
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$180.43
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.30
|
| Rate for Payer: Healthscope Commercial |
$231.81
|
| Rate for Payer: Healthscope Commercial |
$200.48
|
| Rate for Payer: Mclaren Medicaid |
$84.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.56
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.22
|
| Rate for Payer: Nomi Health Commercial |
$150.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PACE SWMI |
$125.30
|
| Rate for Payer: PHP Medicare Advantage |
$125.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$209.20
|
| Rate for Payer: Priority Health Medicare |
$125.30
|
| Rate for Payer: Priority Health SBD |
$209.20
|
| Rate for Payer: Priority Health Tiered Network |
$209.20
|
| Rate for Payer: Railroad Medicare Medicare |
$125.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.06
|
| Rate for Payer: UHC Core |
$211.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$125.30
|
| Rate for Payer: UHC Exchange |
$211.06
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$185.00
|
| Rate for Payer: Aetna Medicare |
$143.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.81
|
| Rate for Payer: BCBS Complete |
$97.06
|
| Rate for Payer: BCBS MAPPO |
$138.06
|
| Rate for Payer: BCN Commercial |
$223.09
|
| Rate for Payer: BCN Medicare Advantage |
$138.06
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$198.81
|
| Rate for Payer: Cofinity Commercial |
$185.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.06
|
| Rate for Payer: Healthscope Commercial |
$255.41
|
| Rate for Payer: Healthscope Commercial |
$220.90
|
| Rate for Payer: Mclaren Medicaid |
$92.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.96
|
| Rate for Payer: Meridian Medicaid |
$97.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.44
|
| Rate for Payer: Nomi Health Commercial |
$165.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: PACE SWMI |
$138.06
|
| Rate for Payer: PHP Medicare Advantage |
$138.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$238.48
|
| Rate for Payer: Priority Health Medicare |
$138.06
|
| Rate for Payer: Priority Health SBD |
$238.48
|
| Rate for Payer: Priority Health Tiered Network |
$238.48
|
| Rate for Payer: Railroad Medicare Medicare |
$138.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.70
|
| Rate for Payer: UHC Core |
$243.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.06
|
| Rate for Payer: UHC Exchange |
$243.70
|
| Rate for Payer: UHC Medicaid |
$92.44
|
| Rate for Payer: UHCCP Medicaid |
$92.44
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$158.72
|
| Rate for Payer: Aetna Medicare |
$123.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.57
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$118.45
|
| Rate for Payer: BCN Commercial |
$189.23
|
| Rate for Payer: BCN Medicare Advantage |
$118.45
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$170.57
|
| Rate for Payer: Cofinity Commercial |
$158.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.45
|
| Rate for Payer: Healthscope Commercial |
$219.13
|
| Rate for Payer: Healthscope Commercial |
$189.52
|
| Rate for Payer: Mclaren Medicaid |
$79.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.37
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.58
|
| Rate for Payer: Nomi Health Commercial |
$142.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.75
|
| Rate for Payer: PACE SWMI |
$118.45
|
| Rate for Payer: PHP Medicare Advantage |
$118.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.29
|
| Rate for Payer: Priority Health Medicare |
$118.45
|
| Rate for Payer: Priority Health SBD |
$202.29
|
| Rate for Payer: Priority Health Tiered Network |
$202.29
|
| Rate for Payer: Railroad Medicare Medicare |
$118.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.87
|
| Rate for Payer: UHC Core |
$202.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.45
|
| Rate for Payer: UHC Exchange |
$202.87
|
| Rate for Payer: UHC Medicaid |
$79.66
|
| Rate for Payer: UHCCP Medicaid |
$79.66
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$673.50 |
| Rate for Payer: Aetna Commercial |
$407.47
|
| Rate for Payer: Aetna Medicare |
$316.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.88
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$304.08
|
| Rate for Payer: BCN Commercial |
$480.06
|
| Rate for Payer: BCN Medicare Advantage |
$304.08
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cofinity Commercial |
$437.88
|
| Rate for Payer: Cofinity Commercial |
$407.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.08
|
| Rate for Payer: Healthscope Commercial |
$562.55
|
| Rate for Payer: Healthscope Commercial |
$486.53
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.28
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.24
|
| Rate for Payer: Nomi Health Commercial |
$364.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.50
|
| Rate for Payer: PACE SWMI |
$304.08
|
| Rate for Payer: PHP Medicare Advantage |
$304.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$513.16
|
| Rate for Payer: Priority Health Medicare |
$304.08
|
| Rate for Payer: Priority Health SBD |
$513.16
|
| Rate for Payer: Priority Health Tiered Network |
$513.16
|
| Rate for Payer: Railroad Medicare Medicare |
$304.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.60
|
| Rate for Payer: UHC Core |
$523.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.08
|
| Rate for Payer: UHC Exchange |
$523.60
|
| Rate for Payer: UHC Medicaid |
$202.56
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$1,497.00 |
| Rate for Payer: Aetna Commercial |
$624.41
|
| Rate for Payer: Aetna Medicare |
$484.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.01
|
| Rate for Payer: BCBS Complete |
$320.71
|
| Rate for Payer: BCBS MAPPO |
$465.98
|
| Rate for Payer: BCN Commercial |
$763.41
|
| Rate for Payer: BCN Medicare Advantage |
$465.98
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$671.01
|
| Rate for Payer: Cofinity Commercial |
$624.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.98
|
| Rate for Payer: Healthscope Commercial |
$862.06
|
| Rate for Payer: Healthscope Commercial |
$745.57
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.28
|
| Rate for Payer: Meridian Medicaid |
$320.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.26
|
| Rate for Payer: Nomi Health Commercial |
$559.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$465.98
|
| Rate for Payer: PHP Medicare Advantage |
$465.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$816.06
|
| Rate for Payer: Priority Health Medicare |
$465.98
|
| Rate for Payer: Priority Health SBD |
$816.06
|
| Rate for Payer: Priority Health Tiered Network |
$816.06
|
| Rate for Payer: Railroad Medicare Medicare |
$465.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.20
|
| Rate for Payer: UHC Core |
$861.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.98
|
| Rate for Payer: UHC Exchange |
$861.20
|
| Rate for Payer: UHC Medicaid |
$305.44
|
| Rate for Payer: UHCCP Medicaid |
$305.44
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$708.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$173.17 |
| Max. Negotiated Rate |
$531.00 |
| Rate for Payer: Aetna Commercial |
$346.75
|
| Rate for Payer: Aetna Medicare |
$269.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.63
|
| Rate for Payer: BCBS Complete |
$181.83
|
| Rate for Payer: BCBS MAPPO |
$258.77
|
| Rate for Payer: BCN Commercial |
$410.84
|
| Rate for Payer: BCN Medicare Advantage |
$258.77
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cofinity Commercial |
$372.63
|
| Rate for Payer: Cofinity Commercial |
$346.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.77
|
| Rate for Payer: Healthscope Commercial |
$478.72
|
| Rate for Payer: Healthscope Commercial |
$414.03
|
| Rate for Payer: Mclaren Medicaid |
$173.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.71
|
| Rate for Payer: Meridian Medicaid |
$181.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$284.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.53
|
| Rate for Payer: Nomi Health Commercial |
$310.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$531.00
|
| Rate for Payer: PACE SWMI |
$258.77
|
| Rate for Payer: PHP Medicare Advantage |
$258.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$439.17
|
| Rate for Payer: Priority Health Medicare |
$258.77
|
| Rate for Payer: Priority Health SBD |
$439.17
|
| Rate for Payer: Priority Health Tiered Network |
$439.17
|
| Rate for Payer: Railroad Medicare Medicare |
$258.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.39
|
| Rate for Payer: UHC Core |
$441.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$258.77
|
| Rate for Payer: UHC Exchange |
$441.39
|
| Rate for Payer: UHC Medicaid |
$173.17
|
| Rate for Payer: UHCCP Medicaid |
$173.17
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$670.75 |
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.10
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCN Commercial |
$546.78
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Healthscope Commercial |
$670.75
|
| Rate for Payer: Healthscope Commercial |
$580.11
|
| Rate for Payer: Mclaren Medicaid |
$240.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$636.77
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.00
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$584.49
|
| Rate for Payer: Priority Health Medicare |
$362.57
|
| Rate for Payer: Priority Health SBD |
$584.49
|
| Rate for Payer: Priority Health Tiered Network |
$584.49
|
| Rate for Payer: Railroad Medicare Medicare |
$362.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.95
|
| Rate for Payer: UHC Core |
$606.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.57
|
| Rate for Payer: UHC Exchange |
$606.95
|
| Rate for Payer: UHC Medicaid |
$240.69
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$923.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$692.25 |
| Rate for Payer: Aetna Commercial |
$489.86
|
| Rate for Payer: Aetna Medicare |
$380.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.42
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$365.57
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: BCN Medicare Advantage |
$365.57
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cofinity Commercial |
$526.42
|
| Rate for Payer: Cofinity Commercial |
$489.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.57
|
| Rate for Payer: Healthscope Commercial |
$676.30
|
| Rate for Payer: Healthscope Commercial |
$584.91
|
| Rate for Payer: Mclaren Medicaid |
$240.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$383.85
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.92
|
| Rate for Payer: Nomi Health Commercial |
$438.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$692.25
|
| Rate for Payer: PACE SWMI |
$365.57
|
| Rate for Payer: PHP Medicare Advantage |
$365.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.92
|
| Rate for Payer: Priority Health Medicare |
$365.57
|
| Rate for Payer: Priority Health SBD |
$640.92
|
| Rate for Payer: Priority Health Tiered Network |
$640.92
|
| Rate for Payer: Railroad Medicare Medicare |
$365.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.62
|
| Rate for Payer: UHC Core |
$669.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$365.57
|
| Rate for Payer: UHC Exchange |
$669.62
|
| Rate for Payer: UHC Medicaid |
$240.69
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$2,017.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$458.16 |
| Max. Negotiated Rate |
$1,512.75 |
| Rate for Payer: Aetna Commercial |
$943.64
|
| Rate for Payer: Aetna Medicare |
$732.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.64
|
| Rate for Payer: BCBS Complete |
$481.07
|
| Rate for Payer: BCBS MAPPO |
$704.21
|
| Rate for Payer: BCN Commercial |
$1,134.40
|
| Rate for Payer: BCN Medicare Advantage |
$704.21
|
| Rate for Payer: Cash Price |
$1,613.60
|
| Rate for Payer: Cash Price |
$1,613.60
|
| Rate for Payer: Cofinity Commercial |
$943.64
|
| Rate for Payer: Cofinity Commercial |
$1,014.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.21
|
| Rate for Payer: Healthscope Commercial |
$1,302.79
|
| Rate for Payer: Healthscope Commercial |
$1,126.74
|
| Rate for Payer: Mclaren Medicaid |
$458.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.42
|
| Rate for Payer: Meridian Medicaid |
$481.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$774.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.06
|
| Rate for Payer: Nomi Health Commercial |
$845.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,512.75
|
| Rate for Payer: PACE SWMI |
$704.21
|
| Rate for Payer: PHP Medicare Advantage |
$704.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,212.64
|
| Rate for Payer: Priority Health Medicare |
$704.21
|
| Rate for Payer: Priority Health SBD |
$1,212.64
|
| Rate for Payer: Priority Health Tiered Network |
$1,212.64
|
| Rate for Payer: Railroad Medicare Medicare |
$704.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.05
|
| Rate for Payer: UHC Core |
$1,324.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$704.21
|
| Rate for Payer: UHC Exchange |
$1,324.05
|
| Rate for Payer: UHC Medicaid |
$458.16
|
| Rate for Payer: UHCCP Medicaid |
$458.16
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$236.90
|
| Rate for Payer: Aetna Medicare |
$183.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.58
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCBS MAPPO |
$176.79
|
| Rate for Payer: BCN Commercial |
$268.41
|
| Rate for Payer: BCN Medicare Advantage |
$176.79
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$254.58
|
| Rate for Payer: Cofinity Commercial |
$236.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.79
|
| Rate for Payer: Healthscope Commercial |
$327.06
|
| Rate for Payer: Healthscope Commercial |
$282.86
|
| Rate for Payer: Mclaren Medicaid |
$111.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.63
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.99
|
| Rate for Payer: Nomi Health Commercial |
$212.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$570.00
|
| Rate for Payer: PACE SWMI |
$176.79
|
| Rate for Payer: PHP Medicare Advantage |
$176.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$286.93
|
| Rate for Payer: Priority Health Medicare |
$176.79
|
| Rate for Payer: Priority Health SBD |
$286.93
|
| Rate for Payer: Priority Health Tiered Network |
$286.93
|
| Rate for Payer: Railroad Medicare Medicare |
$176.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.70
|
| Rate for Payer: UHC Core |
$330.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$176.79
|
| Rate for Payer: UHC Exchange |
$330.70
|
| Rate for Payer: UHC Medicaid |
$111.40
|
| Rate for Payer: UHCCP Medicaid |
$111.40
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/O MNPJ
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$594.92 |
| Rate for Payer: Aetna Commercial |
$430.92
|
| Rate for Payer: Aetna Medicare |
$334.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.08
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$321.58
|
| Rate for Payer: BCN Commercial |
$494.99
|
| Rate for Payer: BCN Medicare Advantage |
$321.58
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$463.08
|
| Rate for Payer: Cofinity Commercial |
$430.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.58
|
| Rate for Payer: Healthscope Commercial |
$594.92
|
| Rate for Payer: Healthscope Commercial |
$514.53
|
| Rate for Payer: Mclaren Medicaid |
$215.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.66
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.79
|
| Rate for Payer: Nomi Health Commercial |
$385.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$524.25
|
| Rate for Payer: PACE SWMI |
$321.58
|
| Rate for Payer: PHP Medicare Advantage |
$321.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$529.13
|
| Rate for Payer: Priority Health Medicare |
$321.58
|
| Rate for Payer: Priority Health SBD |
$529.13
|
| Rate for Payer: Priority Health Tiered Network |
$529.13
|
| Rate for Payer: Railroad Medicare Medicare |
$321.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.62
|
| Rate for Payer: UHC Core |
$529.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$321.58
|
| Rate for Payer: UHC Exchange |
$529.62
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MNPJ
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$204.05 |
| Max. Negotiated Rate |
$633.75 |
| Rate for Payer: Aetna Commercial |
$408.79
|
| Rate for Payer: Aetna Medicare |
$317.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.30
|
| Rate for Payer: BCBS Complete |
$214.25
|
| Rate for Payer: BCBS MAPPO |
$305.07
|
| Rate for Payer: BCN Commercial |
$465.12
|
| Rate for Payer: BCN Medicare Advantage |
$305.07
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$439.30
|
| Rate for Payer: Cofinity Commercial |
$408.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.07
|
| Rate for Payer: Healthscope Commercial |
$564.38
|
| Rate for Payer: Healthscope Commercial |
$488.11
|
| Rate for Payer: Mclaren Medicaid |
$204.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.32
|
| Rate for Payer: Meridian Medicaid |
$214.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$527.69
|
| Rate for Payer: Nomi Health Commercial |
$366.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$633.75
|
| Rate for Payer: PACE SWMI |
$305.07
|
| Rate for Payer: PHP Medicare Advantage |
$305.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$497.20
|
| Rate for Payer: Priority Health Medicare |
$305.07
|
| Rate for Payer: Priority Health SBD |
$497.20
|
| Rate for Payer: Priority Health Tiered Network |
$497.20
|
| Rate for Payer: Railroad Medicare Medicare |
$305.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.13
|
| Rate for Payer: UHC Core |
$502.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.07
|
| Rate for Payer: UHC Exchange |
$502.13
|
| Rate for Payer: UHC Medicaid |
$204.05
|
| Rate for Payer: UHCCP Medicaid |
$204.05
|
|
