|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$69.40 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$69.40
|
| Rate for Payer: BCN Commercial |
$69.40
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$260.58
|
| Rate for Payer: Cofinity Commercial |
$212.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$272.70
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.55
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$257.55
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$190.89
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.24
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$190.89 |
| Max. Negotiated Rate |
$272.70 |
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.95
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$212.10
|
| Rate for Payer: Cofinity Commercial |
$260.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.40
|
| Rate for Payer: Healthscope Commercial |
$272.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.55
|
| Rate for Payer: PHP Commercial |
$257.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health SBD |
$190.89
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$21,922.00 |
| Rate for Payer: Aetna Commercial |
$161.51
|
| Rate for Payer: Aetna Medicare |
$125.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.56
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$120.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$120.53
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$161.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.53
|
| Rate for Payer: Healthscope Commercial |
$222.98
|
| Rate for Payer: Healthscope Commercial |
$192.85
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.56
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,922.00
|
| Rate for Payer: Nomi Health Commercial |
$144.64
|
| Rate for Payer: PACE SWMI |
$120.53
|
| Rate for Payer: PHP Medicare Advantage |
$120.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.93
|
| Rate for Payer: Priority Health Medicare |
$120.53
|
| Rate for Payer: Priority Health Narrow Network |
$196.93
|
| Rate for Payer: Priority Health SBD |
$196.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.53
|
| Rate for Payer: UHC Exchange |
$168.10
|
| Rate for Payer: UHC Medicare Advantage |
$120.53
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$25,144.00 |
| Rate for Payer: Aetna Commercial |
$184.73
|
| Rate for Payer: Aetna Medicare |
$143.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.52
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS MAPPO |
$137.86
|
| Rate for Payer: BCBS Trust/PPO |
$423.70
|
| Rate for Payer: BCN Commercial |
$242.88
|
| Rate for Payer: BCN Medicare Advantage |
$137.86
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$198.52
|
| Rate for Payer: Cofinity Commercial |
$184.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.86
|
| Rate for Payer: Healthscope Commercial |
$255.04
|
| Rate for Payer: Healthscope Commercial |
$220.58
|
| Rate for Payer: Mclaren Medicaid |
$95.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.75
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,144.00
|
| Rate for Payer: Nomi Health Commercial |
$165.43
|
| Rate for Payer: PACE SWMI |
$137.86
|
| Rate for Payer: PHP Medicare Advantage |
$137.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.44
|
| Rate for Payer: Priority Health Medicare |
$137.86
|
| Rate for Payer: Priority Health Narrow Network |
$226.44
|
| Rate for Payer: Priority Health SBD |
$226.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.86
|
| Rate for Payer: UHC Exchange |
$183.98
|
| Rate for Payer: UHC Medicare Advantage |
$137.86
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$21,058.00 |
| Rate for Payer: Aetna Commercial |
$156.27
|
| Rate for Payer: Aetna Medicare |
$121.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.93
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCBS MAPPO |
$116.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.77
|
| Rate for Payer: BCN Commercial |
$179.35
|
| Rate for Payer: BCN Medicare Advantage |
$116.62
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$167.93
|
| Rate for Payer: Cofinity Commercial |
$156.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.62
|
| Rate for Payer: Healthscope Commercial |
$215.75
|
| Rate for Payer: Healthscope Commercial |
$186.59
|
| Rate for Payer: Mclaren Medicaid |
$80.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.45
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,058.00
|
| Rate for Payer: Nomi Health Commercial |
$139.94
|
| Rate for Payer: PACE SWMI |
$116.62
|
| Rate for Payer: PHP Medicare Advantage |
$116.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.83
|
| Rate for Payer: Priority Health Medicare |
$116.62
|
| Rate for Payer: Priority Health Narrow Network |
$190.83
|
| Rate for Payer: Priority Health SBD |
$190.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.62
|
| Rate for Payer: UHC Exchange |
$155.80
|
| Rate for Payer: UHC Medicare Advantage |
$116.62
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$54,524.00 |
| Rate for Payer: Aetna Commercial |
$400.58
|
| Rate for Payer: Aetna Medicare |
$310.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.47
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$298.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,163.99
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$298.94
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$430.47
|
| Rate for Payer: Cofinity Commercial |
$400.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.94
|
| Rate for Payer: Healthscope Commercial |
$553.04
|
| Rate for Payer: Healthscope Commercial |
$478.30
|
| Rate for Payer: Mclaren Medicaid |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.89
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,524.00
|
| Rate for Payer: Nomi Health Commercial |
$358.73
|
| Rate for Payer: PACE SWMI |
$298.94
|
| Rate for Payer: PHP Medicare Advantage |
$298.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.92
|
| Rate for Payer: Priority Health Medicare |
$298.94
|
| Rate for Payer: Priority Health Narrow Network |
$483.92
|
| Rate for Payer: Priority Health SBD |
$483.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.94
|
| Rate for Payer: UHC Exchange |
$414.86
|
| Rate for Payer: UHC Medicare Advantage |
$298.94
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$326.53 |
| Max. Negotiated Rate |
$88,126.00 |
| Rate for Payer: Aetna Commercial |
$646.35
|
| Rate for Payer: Aetna Medicare |
$501.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.58
|
| Rate for Payer: BCBS Complete |
$342.86
|
| Rate for Payer: BCBS MAPPO |
$482.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,467.23
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$482.35
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$694.58
|
| Rate for Payer: Cofinity Commercial |
$646.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.35
|
| Rate for Payer: Healthscope Commercial |
$892.35
|
| Rate for Payer: Healthscope Commercial |
$771.76
|
| Rate for Payer: Mclaren Medicaid |
$326.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.47
|
| Rate for Payer: Meridian Medicaid |
$342.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88,126.00
|
| Rate for Payer: Nomi Health Commercial |
$578.82
|
| Rate for Payer: PACE SWMI |
$482.35
|
| Rate for Payer: PHP Medicare Advantage |
$482.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.91
|
| Rate for Payer: Priority Health Medicare |
$482.35
|
| Rate for Payer: Priority Health Narrow Network |
$769.91
|
| Rate for Payer: Priority Health SBD |
$769.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$482.35
|
| Rate for Payer: UHC Exchange |
$662.78
|
| Rate for Payer: UHC Medicare Advantage |
$482.35
|
| Rate for Payer: UHCCP Medicaid |
$326.53
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$46,453.00 |
| Rate for Payer: Aetna Commercial |
$341.28
|
| Rate for Payer: Aetna Medicare |
$264.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.75
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$254.69
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$254.69
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cofinity Commercial |
$366.75
|
| Rate for Payer: Cofinity Commercial |
$341.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.69
|
| Rate for Payer: Healthscope Commercial |
$471.18
|
| Rate for Payer: Healthscope Commercial |
$407.50
|
| Rate for Payer: Mclaren Medicaid |
$175.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,453.00
|
| Rate for Payer: Nomi Health Commercial |
$305.63
|
| Rate for Payer: PACE SWMI |
$254.69
|
| Rate for Payer: PHP Medicare Advantage |
$254.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.72
|
| Rate for Payer: Priority Health Medicare |
$254.69
|
| Rate for Payer: Priority Health Narrow Network |
$414.72
|
| Rate for Payer: Priority Health SBD |
$414.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.69
|
| Rate for Payer: UHC Exchange |
$318.46
|
| Rate for Payer: UHC Medicare Advantage |
$254.69
|
| Rate for Payer: UHCCP Medicaid |
$175.73
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$233.87 |
| Max. Negotiated Rate |
$63,677.00 |
| Rate for Payer: Aetna Commercial |
$458.57
|
| Rate for Payer: Aetna Medicare |
$355.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.80
|
| Rate for Payer: BCBS Complete |
$245.56
|
| Rate for Payer: BCBS MAPPO |
$342.22
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$582.99
|
| Rate for Payer: BCN Medicare Advantage |
$342.22
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$458.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.22
|
| Rate for Payer: Healthscope Commercial |
$633.11
|
| Rate for Payer: Healthscope Commercial |
$547.55
|
| Rate for Payer: Mclaren Medicaid |
$233.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.33
|
| Rate for Payer: Meridian Medicaid |
$245.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,677.00
|
| Rate for Payer: Nomi Health Commercial |
$410.66
|
| Rate for Payer: PACE SWMI |
$342.22
|
| Rate for Payer: PHP Medicare Advantage |
$342.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.26
|
| Rate for Payer: Priority Health Medicare |
$342.22
|
| Rate for Payer: Priority Health Narrow Network |
$560.26
|
| Rate for Payer: Priority Health SBD |
$560.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.22
|
| Rate for Payer: UHC Exchange |
$468.71
|
| Rate for Payer: UHC Medicare Advantage |
$342.22
|
| Rate for Payer: UHCCP Medicaid |
$233.87
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$68,992.00 |
| Rate for Payer: Aetna Commercial |
$505.18
|
| Rate for Payer: Aetna Medicare |
$392.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.88
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$377.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$377.00
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$542.88
|
| Rate for Payer: Cofinity Commercial |
$505.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.00
|
| Rate for Payer: Healthscope Commercial |
$697.45
|
| Rate for Payer: Healthscope Commercial |
$603.20
|
| Rate for Payer: Mclaren Medicaid |
$256.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.85
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,992.00
|
| Rate for Payer: Nomi Health Commercial |
$452.40
|
| Rate for Payer: PACE SWMI |
$377.00
|
| Rate for Payer: PHP Medicare Advantage |
$377.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.57
|
| Rate for Payer: Priority Health Medicare |
$377.00
|
| Rate for Payer: Priority Health Narrow Network |
$606.57
|
| Rate for Payer: Priority Health SBD |
$606.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$506.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$377.00
|
| Rate for Payer: UHC Exchange |
$506.26
|
| Rate for Payer: UHC Medicare Advantage |
$377.00
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$1,958.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$134,206.00 |
| Rate for Payer: Aetna Commercial |
$967.49
|
| Rate for Payer: Aetna Medicare |
$750.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.49
|
| Rate for Payer: BCBS Complete |
$509.47
|
| Rate for Payer: BCBS MAPPO |
$722.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,221.50
|
| Rate for Payer: BCN Commercial |
$1,107.84
|
| Rate for Payer: BCN Medicare Advantage |
$722.01
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$967.49
|
| Rate for Payer: Cofinity Commercial |
$1,039.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.01
|
| Rate for Payer: Healthscope Commercial |
$1,335.72
|
| Rate for Payer: Healthscope Commercial |
$1,155.22
|
| Rate for Payer: Mclaren Medicaid |
$485.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.11
|
| Rate for Payer: Meridian Medicaid |
$509.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,206.00
|
| Rate for Payer: Nomi Health Commercial |
$866.41
|
| Rate for Payer: PACE SWMI |
$722.01
|
| Rate for Payer: PHP Medicare Advantage |
$722.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.12
|
| Rate for Payer: Priority Health Medicare |
$722.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.12
|
| Rate for Payer: Priority Health SBD |
$1,155.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.01
|
| Rate for Payer: UHC Exchange |
$796.17
|
| Rate for Payer: UHC Medicare Advantage |
$722.01
|
| Rate for Payer: UHCCP Medicaid |
$485.21
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$738.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$32,699.00 |
| Rate for Payer: Aetna Commercial |
$236.66
|
| Rate for Payer: Aetna Medicare |
$183.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.32
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$176.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$262.42
|
| Rate for Payer: BCN Medicare Advantage |
$176.61
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cofinity Commercial |
$254.32
|
| Rate for Payer: Cofinity Commercial |
$236.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.61
|
| Rate for Payer: Healthscope Commercial |
$326.73
|
| Rate for Payer: Healthscope Commercial |
$282.58
|
| Rate for Payer: Mclaren Medicaid |
$114.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.44
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,699.00
|
| Rate for Payer: Nomi Health Commercial |
$211.93
|
| Rate for Payer: PACE SWMI |
$176.61
|
| Rate for Payer: PHP Medicare Advantage |
$176.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.25
|
| Rate for Payer: Priority Health Medicare |
$176.61
|
| Rate for Payer: Priority Health Narrow Network |
$273.25
|
| Rate for Payer: Priority Health SBD |
$273.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.61
|
| Rate for Payer: UHC Exchange |
$549.22
|
| Rate for Payer: UHC Medicare Advantage |
$176.61
|
| Rate for Payer: UHCCP Medicaid |
$114.81
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$129.43 |
| Max. Negotiated Rate |
$55,879.00 |
| Rate for Payer: Aetna Commercial |
$411.23
|
| Rate for Payer: Aetna Medicare |
$319.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.92
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$306.89
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$529.24
|
| Rate for Payer: BCN Medicare Advantage |
$306.89
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$441.92
|
| Rate for Payer: Cofinity Commercial |
$411.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.89
|
| Rate for Payer: Healthscope Commercial |
$567.75
|
| Rate for Payer: Healthscope Commercial |
$491.02
|
| Rate for Payer: Mclaren Medicaid |
$211.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.23
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,879.00
|
| Rate for Payer: Nomi Health Commercial |
$368.27
|
| Rate for Payer: PACE SWMI |
$306.89
|
| Rate for Payer: PHP Medicare Advantage |
$306.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$501.22
|
| Rate for Payer: Priority Health Medicare |
$306.89
|
| Rate for Payer: Priority Health Narrow Network |
$501.22
|
| Rate for Payer: Priority Health SBD |
$501.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.89
|
| Rate for Payer: UHC Exchange |
$326.91
|
| Rate for Payer: UHC Medicare Advantage |
$306.89
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$52,769.00 |
| Rate for Payer: Aetna Commercial |
$387.11
|
| Rate for Payer: Aetna Medicare |
$300.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.00
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$288.89
|
| Rate for Payer: BCBS Trust/PPO |
$112.00
|
| Rate for Payer: BCN Commercial |
$502.36
|
| Rate for Payer: BCN Medicare Advantage |
$288.89
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cofinity Commercial |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$387.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.89
|
| Rate for Payer: Healthscope Commercial |
$534.45
|
| Rate for Payer: Healthscope Commercial |
$462.22
|
| Rate for Payer: Mclaren Medicaid |
$198.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.33
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,769.00
|
| Rate for Payer: Nomi Health Commercial |
$346.67
|
| Rate for Payer: PACE SWMI |
$288.89
|
| Rate for Payer: PHP Medicare Advantage |
$288.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.19
|
| Rate for Payer: Priority Health Medicare |
$288.89
|
| Rate for Payer: Priority Health Narrow Network |
$470.19
|
| Rate for Payer: Priority Health SBD |
$470.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.89
|
| Rate for Payer: UHC Exchange |
$328.10
|
| Rate for Payer: UHC Medicare Advantage |
$288.89
|
| Rate for Payer: UHCCP Medicaid |
$198.94
|
|
|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,288.00
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$300.76 |
| Max. Negotiated Rate |
$80,843.00 |
| Rate for Payer: Aetna Commercial |
$590.83
|
| Rate for Payer: Aetna Medicare |
$458.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.92
|
| Rate for Payer: BCBS Complete |
$315.80
|
| Rate for Payer: BCBS MAPPO |
$440.92
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$754.03
|
| Rate for Payer: BCN Medicare Advantage |
$440.92
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cofinity Commercial |
$634.92
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.92
|
| Rate for Payer: Healthscope Commercial |
$815.70
|
| Rate for Payer: Healthscope Commercial |
$705.47
|
| Rate for Payer: Mclaren Medicaid |
$300.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.97
|
| Rate for Payer: Meridian Medicaid |
$315.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,843.00
|
| Rate for Payer: Nomi Health Commercial |
$529.10
|
| Rate for Payer: PACE SWMI |
$440.92
|
| Rate for Payer: PHP Medicare Advantage |
$440.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$837.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$713.93
|
| Rate for Payer: Priority Health Medicare |
$440.92
|
| Rate for Payer: Priority Health Narrow Network |
$713.93
|
| Rate for Payer: Priority Health SBD |
$713.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.92
|
| Rate for Payer: UHC Exchange |
$585.61
|
| Rate for Payer: UHC Medicare Advantage |
$440.92
|
| Rate for Payer: UHCCP Medicaid |
$300.76
|
|
|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$299.69 |
| Max. Negotiated Rate |
$80,176.00 |
| Rate for Payer: Aetna Commercial |
$586.68
|
| Rate for Payer: Aetna Medicare |
$455.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.46
|
| Rate for Payer: BCBS Complete |
$314.67
|
| Rate for Payer: BCBS MAPPO |
$437.82
|
| Rate for Payer: BCBS Trust/PPO |
$716.37
|
| Rate for Payer: BCN Commercial |
$723.24
|
| Rate for Payer: BCN Medicare Advantage |
$437.82
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cofinity Commercial |
$630.46
|
| Rate for Payer: Cofinity Commercial |
$586.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.82
|
| Rate for Payer: Healthscope Commercial |
$809.97
|
| Rate for Payer: Healthscope Commercial |
$700.51
|
| Rate for Payer: Mclaren Medicaid |
$299.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.71
|
| Rate for Payer: Meridian Medicaid |
$314.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,176.00
|
| Rate for Payer: Nomi Health Commercial |
$525.38
|
| Rate for Payer: PACE SWMI |
$437.82
|
| Rate for Payer: PHP Medicare Advantage |
$437.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.84
|
| Rate for Payer: Priority Health Medicare |
$437.82
|
| Rate for Payer: Priority Health Narrow Network |
$708.84
|
| Rate for Payer: Priority Health SBD |
$708.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$437.82
|
| Rate for Payer: UHC Exchange |
$521.87
|
| Rate for Payer: UHC Medicare Advantage |
$437.82
|
| Rate for Payer: UHCCP Medicaid |
$299.69
|
|
|
PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 27238
|
| Min. Negotiated Rate |
$309.06 |
| Max. Negotiated Rate |
$83,176.00 |
| Rate for Payer: Aetna Commercial |
$608.31
|
| Rate for Payer: Aetna Medicare |
$472.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.70
|
| Rate for Payer: BCBS Complete |
$324.51
|
| Rate for Payer: BCBS MAPPO |
$453.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$693.93
|
| Rate for Payer: BCN Medicare Advantage |
$453.96
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$653.70
|
| Rate for Payer: Cofinity Commercial |
$608.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.96
|
| Rate for Payer: Healthscope Commercial |
$839.83
|
| Rate for Payer: Healthscope Commercial |
$726.34
|
| Rate for Payer: Mclaren Medicaid |
$309.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.66
|
| Rate for Payer: Meridian Medicaid |
$324.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83,176.00
|
| Rate for Payer: Nomi Health Commercial |
$544.75
|
| Rate for Payer: PACE SWMI |
$453.96
|
| Rate for Payer: PHP Medicare Advantage |
$453.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.25
|
| Rate for Payer: Priority Health Medicare |
$453.96
|
| Rate for Payer: Priority Health Narrow Network |
$732.25
|
| Rate for Payer: Priority Health SBD |
$732.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.96
|
| Rate for Payer: UHC Exchange |
$543.23
|
| Rate for Payer: UHC Medicare Advantage |
$453.96
|
| Rate for Payer: UHCCP Medicaid |
$309.06
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 28665
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$21,922.00 |
| Rate for Payer: Aetna Commercial |
$161.16
|
| Rate for Payer: Aetna Medicare |
$125.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.19
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$120.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.32
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$120.27
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$173.19
|
| Rate for Payer: Cofinity Commercial |
$161.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.27
|
| Rate for Payer: Healthscope Commercial |
$222.50
|
| Rate for Payer: Healthscope Commercial |
$192.43
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.28
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,922.00
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: PACE SWMI |
$120.27
|
| Rate for Payer: PHP Medicare Advantage |
$120.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.40
|
| Rate for Payer: Priority Health Medicare |
$120.27
|
| Rate for Payer: Priority Health Narrow Network |
$195.40
|
| Rate for Payer: Priority Health SBD |
$195.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.27
|
| Rate for Payer: UHC Exchange |
$185.53
|
| Rate for Payer: UHC Medicare Advantage |
$120.27
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 28660
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$16,475.00 |
| Rate for Payer: Aetna Commercial |
$121.67
|
| Rate for Payer: Aetna Medicare |
$94.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.75
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$90.80
|
| Rate for Payer: BCBS Trust/PPO |
$766.04
|
| Rate for Payer: BCN Commercial |
$183.74
|
| Rate for Payer: BCN Medicare Advantage |
$90.80
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$130.75
|
| Rate for Payer: Cofinity Commercial |
$121.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.80
|
| Rate for Payer: Healthscope Commercial |
$167.98
|
| Rate for Payer: Healthscope Commercial |
$145.28
|
| Rate for Payer: Mclaren Medicaid |
$61.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.34
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,475.00
|
| Rate for Payer: Nomi Health Commercial |
$108.96
|
| Rate for Payer: PACE SWMI |
$90.80
|
| Rate for Payer: PHP Medicare Advantage |
$90.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.55
|
| Rate for Payer: Priority Health Medicare |
$90.80
|
| Rate for Payer: Priority Health Narrow Network |
$146.55
|
| Rate for Payer: Priority Health SBD |
$146.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.80
|
| Rate for Payer: UHC Exchange |
$169.77
|
| Rate for Payer: UHC Medicare Advantage |
$90.80
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 27240
|
| Min. Negotiated Rate |
$620.90 |
| Max. Negotiated Rate |
$169,933.00 |
| Rate for Payer: Aetna Commercial |
$1,236.67
|
| Rate for Payer: Aetna Medicare |
$959.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.96
|
| Rate for Payer: BCBS Complete |
$651.94
|
| Rate for Payer: BCBS MAPPO |
$922.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.47
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| Rate for Payer: BCN Medicare Advantage |
$922.89
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$1,328.96
|
| Rate for Payer: Cofinity Commercial |
$1,236.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.89
|
| Rate for Payer: Healthscope Commercial |
$1,707.35
|
| Rate for Payer: Healthscope Commercial |
$1,476.62
|
| Rate for Payer: Mclaren Medicaid |
$620.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.03
|
| Rate for Payer: Meridian Medicaid |
$651.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169,933.00
|
| Rate for Payer: Nomi Health Commercial |
$1,107.47
|
| Rate for Payer: PACE SWMI |
$922.89
|
| Rate for Payer: PHP Medicare Advantage |
$922.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,466.54
|
| Rate for Payer: Priority Health Medicare |
$922.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.54
|
| Rate for Payer: Priority Health SBD |
$1,466.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$922.89
|
| Rate for Payer: UHC Exchange |
$1,010.00
|
| Rate for Payer: UHC Medicare Advantage |
$922.89
|
| Rate for Payer: UHCCP Medicaid |
$620.90
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ REQ ANES
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 26775
|
| Min. Negotiated Rate |
$238.13 |
| Max. Negotiated Rate |
$63,477.00 |
| Rate for Payer: Aetna Commercial |
$464.79
|
| Rate for Payer: Aetna Medicare |
$360.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.48
|
| Rate for Payer: BCBS Complete |
$250.04
|
| Rate for Payer: BCBS MAPPO |
$346.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$594.23
|
| Rate for Payer: BCN Medicare Advantage |
$346.86
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$499.48
|
| Rate for Payer: Cofinity Commercial |
$464.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.86
|
| Rate for Payer: Healthscope Commercial |
$641.69
|
| Rate for Payer: Healthscope Commercial |
$554.98
|
| Rate for Payer: Mclaren Medicaid |
$238.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.20
|
| Rate for Payer: Meridian Medicaid |
$250.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,477.00
|
| Rate for Payer: Nomi Health Commercial |
$416.23
|
| Rate for Payer: PACE SWMI |
$346.86
|
| Rate for Payer: PHP Medicare Advantage |
$346.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.33
|
| Rate for Payer: Priority Health Medicare |
$346.86
|
| Rate for Payer: Priority Health Narrow Network |
$564.33
|
| Rate for Payer: Priority Health SBD |
$564.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.86
|
| Rate for Payer: UHC Exchange |
$399.16
|
| Rate for Payer: UHC Medicare Advantage |
$346.86
|
| Rate for Payer: UHCCP Medicaid |
$238.13
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$178.07 |
| Max. Negotiated Rate |
$47,158.00 |
| Rate for Payer: Aetna Commercial |
$349.42
|
| Rate for Payer: Aetna Medicare |
$271.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.49
|
| Rate for Payer: BCBS Complete |
$186.97
|
| Rate for Payer: BCBS MAPPO |
$260.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.16
|
| Rate for Payer: BCN Commercial |
$433.46
|
| Rate for Payer: BCN Medicare Advantage |
$260.76
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cofinity Commercial |
$375.49
|
| Rate for Payer: Cofinity Commercial |
$349.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.76
|
| Rate for Payer: Healthscope Commercial |
$482.41
|
| Rate for Payer: Healthscope Commercial |
$417.22
|
| Rate for Payer: Mclaren Medicaid |
$178.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.80
|
| Rate for Payer: Meridian Medicaid |
$186.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,158.00
|
| Rate for Payer: Nomi Health Commercial |
$312.91
|
| Rate for Payer: PACE SWMI |
$260.76
|
| Rate for Payer: PHP Medicare Advantage |
$260.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.81
|
| Rate for Payer: Priority Health Medicare |
$260.76
|
| Rate for Payer: Priority Health Narrow Network |
$419.81
|
| Rate for Payer: Priority Health SBD |
$419.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.76
|
| Rate for Payer: UHC Exchange |
$316.09
|
| Rate for Payer: UHC Medicare Advantage |
$260.76
|
| Rate for Payer: UHCCP Medicaid |
$178.07
|
|
|
PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX
|
Professional
|
Both
|
$1,195.00
|
|
|
Service Code
|
HCPCS 21440
|
| Min. Negotiated Rate |
$382.76 |
| Max. Negotiated Rate |
$94,649.00 |
| Rate for Payer: Aetna Commercial |
$726.94
|
| Rate for Payer: Aetna Medicare |
$564.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.19
|
| Rate for Payer: BCBS Complete |
$401.90
|
| Rate for Payer: BCBS MAPPO |
$542.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,978.97
|
| Rate for Payer: BCN Commercial |
$1,012.05
|
| Rate for Payer: BCN Medicare Advantage |
$542.49
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$781.19
|
| Rate for Payer: Cofinity Commercial |
$726.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.49
|
| Rate for Payer: Healthscope Commercial |
$867.98
|
| Rate for Payer: Healthscope Commercial |
$1,003.61
|
| Rate for Payer: Mclaren Medicaid |
$382.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.61
|
| Rate for Payer: Meridian Medicaid |
$401.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,649.00
|
| Rate for Payer: Nomi Health Commercial |
$650.99
|
| Rate for Payer: PACE SWMI |
$542.49
|
| Rate for Payer: PHP Medicare Advantage |
$542.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$382.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$542.49
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: Priority Health SBD |
$927.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.49
|
| Rate for Payer: UHC Exchange |
$436.15
|
| Rate for Payer: UHC Medicare Advantage |
$542.49
|
| Rate for Payer: UHCCP Medicaid |
$382.76
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$207.46 |
| Max. Negotiated Rate |
$54,585.00 |
| Rate for Payer: Aetna Commercial |
$403.57
|
| Rate for Payer: Aetna Medicare |
$313.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.68
|
| Rate for Payer: BCBS Complete |
$217.83
|
| Rate for Payer: BCBS MAPPO |
$301.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,919.55
|
| Rate for Payer: BCN Commercial |
$400.52
|
| Rate for Payer: BCN Medicare Advantage |
$301.17
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$433.68
|
| Rate for Payer: Cofinity Commercial |
$403.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.17
|
| Rate for Payer: Healthscope Commercial |
$557.16
|
| Rate for Payer: Healthscope Commercial |
$481.87
|
| Rate for Payer: Mclaren Medicaid |
$207.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.23
|
| Rate for Payer: Meridian Medicaid |
$217.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,585.00
|
| Rate for Payer: Nomi Health Commercial |
$361.40
|
| Rate for Payer: PACE SWMI |
$301.17
|
| Rate for Payer: PHP Medicare Advantage |
$301.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.53
|
| Rate for Payer: Priority Health Medicare |
$301.17
|
| Rate for Payer: Priority Health Narrow Network |
$489.53
|
| Rate for Payer: Priority Health SBD |
$489.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.17
|
| Rate for Payer: UHC Exchange |
$349.02
|
| Rate for Payer: UHC Medicare Advantage |
$301.17
|
| Rate for Payer: UHCCP Medicaid |
$207.46
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$53,185.00 |
| Rate for Payer: Aetna Commercial |
$390.07
|
| Rate for Payer: Aetna Medicare |
$302.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.18
|
| Rate for Payer: BCBS Complete |
$210.45
|
| Rate for Payer: BCBS MAPPO |
$291.10
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$497.47
|
| Rate for Payer: BCN Medicare Advantage |
$291.10
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$419.18
|
| Rate for Payer: Cofinity Commercial |
$390.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.10
|
| Rate for Payer: Healthscope Commercial |
$538.54
|
| Rate for Payer: Healthscope Commercial |
$465.76
|
| Rate for Payer: Mclaren Medicaid |
$200.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.66
|
| Rate for Payer: Meridian Medicaid |
$210.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,185.00
|
| Rate for Payer: Nomi Health Commercial |
$349.32
|
| Rate for Payer: PACE SWMI |
$291.10
|
| Rate for Payer: PHP Medicare Advantage |
$291.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.75
|
| Rate for Payer: Priority Health Medicare |
$291.10
|
| Rate for Payer: Priority Health Narrow Network |
$473.75
|
| Rate for Payer: Priority Health SBD |
$473.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.10
|
| Rate for Payer: UHC Exchange |
$365.59
|
| Rate for Payer: UHC Medicare Advantage |
$291.10
|
| Rate for Payer: UHCCP Medicaid |
$200.43
|
|
