|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,246.00
|
|
|
Service Code
|
HCPCS 27766
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$1,684.50 |
| Rate for Payer: Aetna Commercial |
$753.74
|
| Rate for Payer: Aetna Medicare |
$584.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.99
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS MAPPO |
$562.49
|
| Rate for Payer: BCN Commercial |
$926.25
|
| Rate for Payer: BCN Medicare Advantage |
$562.49
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cofinity Commercial |
$809.99
|
| Rate for Payer: Cofinity Commercial |
$753.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.49
|
| Rate for Payer: Healthscope Commercial |
$899.98
|
| Rate for Payer: Healthscope Commercial |
$1,040.61
|
| Rate for Payer: Mclaren Medicaid |
$369.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.61
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.73
|
| Rate for Payer: Nomi Health Commercial |
$674.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,684.50
|
| Rate for Payer: PACE SWMI |
$562.49
|
| Rate for Payer: PHP Medicare Advantage |
$562.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$990.12
|
| Rate for Payer: Priority Health Medicare |
$562.49
|
| Rate for Payer: Priority Health SBD |
$990.12
|
| Rate for Payer: Priority Health Tiered Network |
$990.12
|
| Rate for Payer: Railroad Medicare Medicare |
$562.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,050.06
|
| Rate for Payer: UHC Core |
$1,050.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$562.49
|
| Rate for Payer: UHC Exchange |
$1,050.06
|
| Rate for Payer: UHC Medicaid |
$369.77
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$347.62 |
| Max. Negotiated Rate |
$1,487.25 |
| Rate for Payer: PHP Medicare Advantage |
$527.11
|
| Rate for Payer: Aetna Commercial |
$706.33
|
| Rate for Payer: Aetna Medicare |
$548.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.04
|
| Rate for Payer: BCBS Complete |
$365.00
|
| Rate for Payer: BCBS MAPPO |
$527.11
|
| Rate for Payer: BCN Commercial |
$884.42
|
| Rate for Payer: BCN Medicare Advantage |
$527.11
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$759.04
|
| Rate for Payer: Cofinity Commercial |
$706.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.11
|
| Rate for Payer: Healthscope Commercial |
$975.15
|
| Rate for Payer: Healthscope Commercial |
$843.38
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.47
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.13
|
| Rate for Payer: Nomi Health Commercial |
$632.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,487.25
|
| Rate for Payer: PACE SWMI |
$527.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$945.41
|
| Rate for Payer: Priority Health Medicare |
$527.11
|
| Rate for Payer: Priority Health SBD |
$945.41
|
| Rate for Payer: Priority Health Tiered Network |
$945.41
|
| Rate for Payer: Railroad Medicare Medicare |
$527.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.51
|
| Rate for Payer: UHC Core |
$990.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.11
|
| Rate for Payer: UHC Exchange |
$990.51
|
| Rate for Payer: UHC Medicaid |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$347.62
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: Aetna Commercial |
$701.30
|
| Rate for Payer: Aetna Medicare |
$544.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.64
|
| Rate for Payer: BCBS Complete |
$362.99
|
| Rate for Payer: BCBS MAPPO |
$523.36
|
| Rate for Payer: BCN Commercial |
$856.03
|
| Rate for Payer: BCN Medicare Advantage |
$523.36
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$753.64
|
| Rate for Payer: Cofinity Commercial |
$701.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.36
|
| Rate for Payer: Healthscope Commercial |
$968.22
|
| Rate for Payer: Healthscope Commercial |
$837.38
|
| Rate for Payer: Mclaren Medicaid |
$345.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$549.53
|
| Rate for Payer: Meridian Medicaid |
$362.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$575.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.95
|
| Rate for Payer: Nomi Health Commercial |
$628.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,039.50
|
| Rate for Payer: PACE SWMI |
$523.36
|
| Rate for Payer: PHP Medicare Advantage |
$523.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$915.08
|
| Rate for Payer: Priority Health Medicare |
$523.36
|
| Rate for Payer: Priority Health SBD |
$915.08
|
| Rate for Payer: Priority Health Tiered Network |
$915.08
|
| Rate for Payer: Railroad Medicare Medicare |
$523.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.57
|
| Rate for Payer: UHC Core |
$957.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$523.36
|
| Rate for Payer: UHC Exchange |
$957.57
|
| Rate for Payer: UHC Medicaid |
$345.70
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$263.69 |
| Max. Negotiated Rate |
$774.92 |
| Rate for Payer: Aetna Commercial |
$527.48
|
| Rate for Payer: Aetna Medicare |
$409.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.84
|
| Rate for Payer: BCBS Complete |
$276.87
|
| Rate for Payer: BCBS MAPPO |
$393.64
|
| Rate for Payer: BCN Commercial |
$668.29
|
| Rate for Payer: BCN Medicare Advantage |
$393.64
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$566.84
|
| Rate for Payer: Cofinity Commercial |
$527.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.64
|
| Rate for Payer: Healthscope Commercial |
$728.23
|
| Rate for Payer: Healthscope Commercial |
$629.82
|
| Rate for Payer: Mclaren Medicaid |
$263.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.32
|
| Rate for Payer: Meridian Medicaid |
$276.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.92
|
| Rate for Payer: Nomi Health Commercial |
$472.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.75
|
| Rate for Payer: PACE SWMI |
$393.64
|
| Rate for Payer: PHP Medicare Advantage |
$393.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$714.38
|
| Rate for Payer: Priority Health Medicare |
$393.64
|
| Rate for Payer: Priority Health SBD |
$714.38
|
| Rate for Payer: Priority Health Tiered Network |
$714.38
|
| Rate for Payer: Railroad Medicare Medicare |
$393.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.61
|
| Rate for Payer: UHC Core |
$740.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$393.64
|
| Rate for Payer: UHC Exchange |
$740.61
|
| Rate for Payer: UHC Medicaid |
$263.69
|
| Rate for Payer: UHCCP Medicaid |
$263.69
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$1,112.66 |
| Rate for Payer: Aetna Commercial |
$767.18
|
| Rate for Payer: Aetna Medicare |
$595.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.43
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCBS MAPPO |
$572.52
|
| Rate for Payer: BCN Commercial |
$954.63
|
| Rate for Payer: BCN Medicare Advantage |
$572.52
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$824.43
|
| Rate for Payer: Cofinity Commercial |
$767.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.52
|
| Rate for Payer: Healthscope Commercial |
$916.03
|
| Rate for Payer: Healthscope Commercial |
$1,059.16
|
| Rate for Payer: Mclaren Medicaid |
$376.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.15
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$629.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,106.62
|
| Rate for Payer: Nomi Health Commercial |
$687.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE SWMI |
$572.52
|
| Rate for Payer: PHP Medicare Advantage |
$572.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,020.47
|
| Rate for Payer: Priority Health Medicare |
$572.52
|
| Rate for Payer: Priority Health SBD |
$1,020.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,020.47
|
| Rate for Payer: Railroad Medicare Medicare |
$572.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,112.66
|
| Rate for Payer: UHC Core |
$1,112.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$572.52
|
| Rate for Payer: UHC Exchange |
$1,112.66
|
| Rate for Payer: UHC Medicaid |
$376.37
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$430.90 |
| Max. Negotiated Rate |
$1,290.31 |
| Rate for Payer: Aetna Commercial |
$884.23
|
| Rate for Payer: Aetna Medicare |
$686.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.21
|
| Rate for Payer: BCBS Complete |
$452.44
|
| Rate for Payer: BCBS MAPPO |
$659.87
|
| Rate for Payer: BCN Commercial |
$1,107.01
|
| Rate for Payer: BCN Medicare Advantage |
$659.87
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$950.21
|
| Rate for Payer: Cofinity Commercial |
$884.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.87
|
| Rate for Payer: Healthscope Commercial |
$1,220.76
|
| Rate for Payer: Healthscope Commercial |
$1,055.79
|
| Rate for Payer: Mclaren Medicaid |
$430.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.86
|
| Rate for Payer: Meridian Medicaid |
$452.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,290.31
|
| Rate for Payer: Nomi Health Commercial |
$791.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$659.87
|
| Rate for Payer: PHP Medicare Advantage |
$659.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.36
|
| Rate for Payer: Priority Health Medicare |
$659.87
|
| 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 |
$659.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,273.85
|
| Rate for Payer: UHC Core |
$1,273.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.87
|
| Rate for Payer: UHC Exchange |
$1,273.85
|
| Rate for Payer: UHC Medicaid |
$430.90
|
| Rate for Payer: UHCCP Medicaid |
$430.90
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,346.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$1,759.50 |
| Rate for Payer: Aetna Commercial |
$878.10
|
| Rate for Payer: Aetna Medicare |
$681.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$878.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.63
|
| Rate for Payer: BCBS Complete |
$450.66
|
| Rate for Payer: BCBS MAPPO |
$655.30
|
| Rate for Payer: BCN Commercial |
$1,083.61
|
| Rate for Payer: BCN Medicare Advantage |
$655.30
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$943.63
|
| Rate for Payer: Cofinity Commercial |
$878.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.30
|
| Rate for Payer: Healthscope Commercial |
$1,212.31
|
| Rate for Payer: Healthscope Commercial |
$1,048.48
|
| Rate for Payer: Mclaren Medicaid |
$429.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.07
|
| Rate for Payer: Meridian Medicaid |
$450.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$720.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,260.94
|
| Rate for Payer: Nomi Health Commercial |
$786.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,759.50
|
| Rate for Payer: PACE SWMI |
$655.30
|
| Rate for Payer: PHP Medicare Advantage |
$655.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,158.35
|
| Rate for Payer: Priority Health Medicare |
$655.30
|
| Rate for Payer: Priority Health SBD |
$1,158.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,158.35
|
| Rate for Payer: Railroad Medicare Medicare |
$655.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.58
|
| Rate for Payer: UHC Core |
$1,239.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$655.30
|
| Rate for Payer: UHC Exchange |
$1,239.58
|
| Rate for Payer: UHC Medicaid |
$429.20
|
| Rate for Payer: UHCCP Medicaid |
$429.20
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$404.27 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna Medicare |
$640.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.44
|
| Rate for Payer: BCBS Complete |
$424.48
|
| Rate for Payer: BCBS MAPPO |
$616.28
|
| Rate for Payer: BCN Commercial |
$1,029.32
|
| Rate for Payer: BCN Medicare Advantage |
$616.28
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$887.44
|
| Rate for Payer: Cofinity Commercial |
$825.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.28
|
| Rate for Payer: Healthscope Commercial |
$986.05
|
| Rate for Payer: Healthscope Commercial |
$1,140.12
|
| Rate for Payer: Mclaren Medicaid |
$404.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.09
|
| Rate for Payer: Meridian Medicaid |
$424.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,190.03
|
| Rate for Payer: Nomi Health Commercial |
$739.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.75
|
| Rate for Payer: PACE SWMI |
$616.28
|
| Rate for Payer: PHP Medicare Advantage |
$616.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,100.32
|
| Rate for Payer: Priority Health Medicare |
$616.28
|
| Rate for Payer: Priority Health SBD |
$1,100.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,100.32
|
| Rate for Payer: Railroad Medicare Medicare |
$616.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.77
|
| Rate for Payer: UHC Core |
$1,164.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$616.28
|
| Rate for Payer: UHC Exchange |
$1,164.77
|
| Rate for Payer: UHC Medicaid |
$404.27
|
| Rate for Payer: UHCCP Medicaid |
$404.27
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$2,056.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$430.90 |
| Max. Negotiated Rate |
$1,542.00 |
| Rate for Payer: PHP Medicare Advantage |
$659.34
|
| Rate for Payer: Aetna Commercial |
$883.52
|
| Rate for Payer: Aetna Medicare |
$685.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$883.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.45
|
| Rate for Payer: BCBS Complete |
$452.44
|
| Rate for Payer: BCBS MAPPO |
$659.34
|
| Rate for Payer: BCN Commercial |
$1,084.10
|
| Rate for Payer: BCN Medicare Advantage |
$659.34
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cofinity Commercial |
$949.45
|
| Rate for Payer: Cofinity Commercial |
$883.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.34
|
| Rate for Payer: Healthscope Commercial |
$1,219.78
|
| Rate for Payer: Healthscope Commercial |
$1,054.94
|
| Rate for Payer: Mclaren Medicaid |
$430.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.31
|
| Rate for Payer: Meridian Medicaid |
$452.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,232.86
|
| Rate for Payer: Nomi Health Commercial |
$791.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: PACE SWMI |
$659.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,158.87
|
| Rate for Payer: Priority Health Medicare |
$659.34
|
| Rate for Payer: Priority Health SBD |
$1,158.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,158.87
|
| Rate for Payer: Railroad Medicare Medicare |
$659.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,193.12
|
| Rate for Payer: UHC Core |
$1,193.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.34
|
| Rate for Payer: UHC Exchange |
$1,193.12
|
| Rate for Payer: UHC Medicaid |
$430.90
|
| Rate for Payer: UHCCP Medicaid |
$430.90
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,236.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$622.60 |
| Max. Negotiated Rate |
$2,427.00 |
| Rate for Payer: Aetna Commercial |
$1,281.16
|
| Rate for Payer: Aetna Medicare |
$994.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.77
|
| Rate for Payer: BCBS Complete |
$653.73
|
| Rate for Payer: BCBS MAPPO |
$956.09
|
| Rate for Payer: BCN Commercial |
$1,584.08
|
| Rate for Payer: BCN Medicare Advantage |
$956.09
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cofinity Commercial |
$1,376.77
|
| Rate for Payer: Cofinity Commercial |
$1,281.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.09
|
| Rate for Payer: Healthscope Commercial |
$1,768.77
|
| Rate for Payer: Healthscope Commercial |
$1,529.74
|
| Rate for Payer: Mclaren Medicaid |
$622.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,003.89
|
| Rate for Payer: Meridian Medicaid |
$653.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,051.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,841.87
|
| Rate for Payer: Nomi Health Commercial |
$1,147.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,427.00
|
| Rate for Payer: PACE SWMI |
$956.09
|
| Rate for Payer: PHP Medicare Advantage |
$956.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,693.33
|
| Rate for Payer: Priority Health Medicare |
$956.09
|
| Rate for Payer: Priority Health SBD |
$1,693.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,693.33
|
| Rate for Payer: Railroad Medicare Medicare |
$956.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.14
|
| Rate for Payer: UHC Core |
$1,816.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$956.09
|
| Rate for Payer: UHC Exchange |
$1,816.14
|
| Rate for Payer: UHC Medicaid |
$622.60
|
| Rate for Payer: UHCCP Medicaid |
$622.60
|
|
|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,780.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$390.22 |
| Max. Negotiated Rate |
$1,335.00 |
| Rate for Payer: Aetna Commercial |
$799.66
|
| Rate for Payer: Aetna Medicare |
$620.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$799.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.33
|
| Rate for Payer: BCBS Complete |
$409.73
|
| Rate for Payer: BCBS MAPPO |
$596.76
|
| Rate for Payer: BCN Commercial |
$988.00
|
| Rate for Payer: BCN Medicare Advantage |
$596.76
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cofinity Commercial |
$859.33
|
| Rate for Payer: Cofinity Commercial |
$799.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$596.76
|
| Rate for Payer: Healthscope Commercial |
$954.82
|
| Rate for Payer: Healthscope Commercial |
$1,104.01
|
| Rate for Payer: Mclaren Medicaid |
$390.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.60
|
| Rate for Payer: Meridian Medicaid |
$409.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$656.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.06
|
| Rate for Payer: Nomi Health Commercial |
$716.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.00
|
| Rate for Payer: PACE SWMI |
$596.76
|
| Rate for Payer: PHP Medicare Advantage |
$596.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,056.13
|
| Rate for Payer: Priority Health Medicare |
$596.76
|
| Rate for Payer: Priority Health SBD |
$1,056.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,056.13
|
| Rate for Payer: Railroad Medicare Medicare |
$596.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,136.34
|
| Rate for Payer: UHC Core |
$1,136.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$596.76
|
| Rate for Payer: UHC Exchange |
$1,136.34
|
| Rate for Payer: UHC Medicaid |
$390.22
|
| Rate for Payer: UHCCP Medicaid |
$390.22
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$505.88 |
| Max. Negotiated Rate |
$1,456.47 |
| Rate for Payer: Aetna Commercial |
$1,028.91
|
| Rate for Payer: Aetna Medicare |
$798.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,028.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.69
|
| Rate for Payer: BCBS Complete |
$531.17
|
| Rate for Payer: BCBS MAPPO |
$767.84
|
| Rate for Payer: BCN Commercial |
$1,257.90
|
| Rate for Payer: BCN Medicare Advantage |
$767.84
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,105.69
|
| Rate for Payer: Cofinity Commercial |
$1,028.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$767.84
|
| Rate for Payer: Healthscope Commercial |
$1,420.50
|
| Rate for Payer: Healthscope Commercial |
$1,228.54
|
| Rate for Payer: Mclaren Medicaid |
$505.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$806.23
|
| Rate for Payer: Meridian Medicaid |
$531.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$844.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,456.47
|
| Rate for Payer: Nomi Health Commercial |
$921.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,386.75
|
| Rate for Payer: PACE SWMI |
$767.84
|
| Rate for Payer: PHP Medicare Advantage |
$767.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,344.66
|
| Rate for Payer: Priority Health Medicare |
$767.84
|
| Rate for Payer: Priority Health SBD |
$1,344.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,344.66
|
| Rate for Payer: Railroad Medicare Medicare |
$767.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,412.43
|
| Rate for Payer: UHC Core |
$1,412.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$767.84
|
| Rate for Payer: UHC Exchange |
$1,412.43
|
| Rate for Payer: UHC Medicaid |
$505.88
|
| Rate for Payer: UHCCP Medicaid |
$505.88
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END W/FIX
|
Professional
|
Both
|
$2,413.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$1,809.75 |
| Rate for Payer: Aetna Commercial |
$809.20
|
| Rate for Payer: Aetna Medicare |
$628.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.59
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCBS MAPPO |
$603.88
|
| Rate for Payer: BCN Commercial |
$1,002.94
|
| Rate for Payer: BCN Medicare Advantage |
$603.88
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cofinity Commercial |
$869.59
|
| Rate for Payer: Cofinity Commercial |
$809.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.88
|
| Rate for Payer: Healthscope Commercial |
$966.21
|
| Rate for Payer: Healthscope Commercial |
$1,117.18
|
| Rate for Payer: Mclaren Medicaid |
$396.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$634.07
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$664.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.87
|
| Rate for Payer: Nomi Health Commercial |
$724.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.75
|
| Rate for Payer: PACE SWMI |
$603.88
|
| Rate for Payer: PHP Medicare Advantage |
$603.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,072.11
|
| Rate for Payer: Priority Health Medicare |
$603.88
|
| Rate for Payer: Priority Health SBD |
$1,072.11
|
| Rate for Payer: Priority Health Tiered Network |
$1,072.11
|
| Rate for Payer: Railroad Medicare Medicare |
$603.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,135.68
|
| Rate for Payer: UHC Core |
$1,135.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$603.88
|
| Rate for Payer: UHC Exchange |
$1,135.68
|
| Rate for Payer: UHC Medicaid |
$396.82
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$379.35 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$772.99
|
| Rate for Payer: Aetna Medicare |
$599.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.68
|
| Rate for Payer: BCBS Complete |
$398.32
|
| Rate for Payer: BCBS MAPPO |
$576.86
|
| Rate for Payer: BCN Commercial |
$962.10
|
| Rate for Payer: BCN Medicare Advantage |
$576.86
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cofinity Commercial |
$830.68
|
| Rate for Payer: Cofinity Commercial |
$772.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.86
|
| Rate for Payer: Healthscope Commercial |
$922.98
|
| Rate for Payer: Healthscope Commercial |
$1,067.19
|
| Rate for Payer: Mclaren Medicaid |
$379.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.70
|
| Rate for Payer: Meridian Medicaid |
$398.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$634.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,110.51
|
| Rate for Payer: Nomi Health Commercial |
$692.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.50
|
| Rate for Payer: PACE SWMI |
$576.86
|
| Rate for Payer: PHP Medicare Advantage |
$576.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,028.45
|
| Rate for Payer: Priority Health Medicare |
$576.86
|
| Rate for Payer: Priority Health SBD |
$1,028.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,028.45
|
| Rate for Payer: Railroad Medicare Medicare |
$576.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.10
|
| Rate for Payer: UHC Core |
$1,081.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$576.86
|
| Rate for Payer: UHC Exchange |
$1,081.10
|
| Rate for Payer: UHC Medicaid |
$379.35
|
| Rate for Payer: UHCCP Medicaid |
$379.35
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$1,287.75 |
| Rate for Payer: Aetna Commercial |
$768.65
|
| Rate for Payer: Aetna Medicare |
$596.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$768.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.01
|
| Rate for Payer: BCBS Complete |
$395.64
|
| Rate for Payer: BCBS MAPPO |
$573.62
|
| Rate for Payer: BCN Commercial |
$960.61
|
| Rate for Payer: BCN Medicare Advantage |
$573.62
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cofinity Commercial |
$826.01
|
| Rate for Payer: Cofinity Commercial |
$768.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.62
|
| Rate for Payer: Healthscope Commercial |
$917.79
|
| Rate for Payer: Healthscope Commercial |
$1,061.20
|
| Rate for Payer: Mclaren Medicaid |
$376.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.30
|
| Rate for Payer: Meridian Medicaid |
$395.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$630.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.94
|
| Rate for Payer: Nomi Health Commercial |
$688.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,287.75
|
| Rate for Payer: PACE SWMI |
$573.62
|
| Rate for Payer: PHP Medicare Advantage |
$573.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,026.85
|
| Rate for Payer: Priority Health Medicare |
$573.62
|
| Rate for Payer: Priority Health SBD |
$1,026.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,026.85
|
| Rate for Payer: Railroad Medicare Medicare |
$573.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.22
|
| Rate for Payer: UHC Core |
$1,081.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$573.62
|
| Rate for Payer: UHC Exchange |
$1,081.22
|
| Rate for Payer: UHC Medicaid |
$376.80
|
| Rate for Payer: UHCCP Medicaid |
$376.80
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 1-2 RIBS
|
Professional
|
Both
|
$3,448.00
|
|
|
Service Code
|
HCPCS 0245T
|
| Min. Negotiated Rate |
$1,379.20 |
| Max. Negotiated Rate |
$2,586.00 |
| Rate for Payer: Aetna Medicare |
$1,724.00
|
| Rate for Payer: BCBS Complete |
$1,379.20
|
| Rate for Payer: Cash Price |
$2,758.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,241.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,586.00
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS
|
Professional
|
Both
|
$3,800.00
|
|
|
Service Code
|
HCPCS 0246T
|
| Min. Negotiated Rate |
$1,520.00 |
| Max. Negotiated Rate |
$2,850.00 |
| Rate for Payer: Aetna Medicare |
$1,900.00
|
| Rate for Payer: BCBS Complete |
$1,520.00
|
| Rate for Payer: Cash Price |
$3,040.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,470.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,850.00
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS
|
Professional
|
Both
|
$4,202.00
|
|
|
Service Code
|
HCPCS 0247T
|
| Min. Negotiated Rate |
$1,680.80 |
| Max. Negotiated Rate |
$3,151.50 |
| Rate for Payer: Aetna Medicare |
$2,101.00
|
| Rate for Payer: BCBS Complete |
$1,680.80
|
| Rate for Payer: Cash Price |
$3,361.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,731.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,151.50
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS
|
Professional
|
Both
|
$4,850.00
|
|
|
Service Code
|
HCPCS 0248T
|
| Min. Negotiated Rate |
$1,940.00 |
| Max. Negotiated Rate |
$3,637.50 |
| Rate for Payer: Aetna Medicare |
$2,425.00
|
| Rate for Payer: BCBS Complete |
$1,940.00
|
| Rate for Payer: Cash Price |
$3,880.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,152.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,637.50
|
|
|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,825.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$2,118.75 |
| Rate for Payer: BCBS Complete |
$362.09
|
| Rate for Payer: Aetna Commercial |
$704.50
|
| Rate for Payer: Aetna Medicare |
$546.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.08
|
| Rate for Payer: BCBS MAPPO |
$525.75
|
| Rate for Payer: BCN Commercial |
$875.95
|
| Rate for Payer: BCN Medicare Advantage |
$525.75
|
| Rate for Payer: Cash Price |
$2,260.00
|
| Rate for Payer: Cash Price |
$2,260.00
|
| Rate for Payer: Cofinity Commercial |
$757.08
|
| Rate for Payer: Cofinity Commercial |
$704.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.75
|
| Rate for Payer: Healthscope Commercial |
$972.64
|
| Rate for Payer: Healthscope Commercial |
$841.20
|
| Rate for Payer: Mclaren Medicaid |
$344.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.04
|
| Rate for Payer: Meridian Medicaid |
$362.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$578.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.24
|
| Rate for Payer: Nomi Health Commercial |
$630.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,118.75
|
| Rate for Payer: PACE SWMI |
$525.75
|
| Rate for Payer: PHP Medicare Advantage |
$525.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$936.36
|
| Rate for Payer: Priority Health Medicare |
$525.75
|
| Rate for Payer: Priority Health SBD |
$936.36
|
| Rate for Payer: Priority Health Tiered Network |
$936.36
|
| Rate for Payer: Railroad Medicare Medicare |
$525.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.21
|
| Rate for Payer: UHC Core |
$997.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$525.75
|
| Rate for Payer: UHC Exchange |
$997.21
|
| Rate for Payer: UHC Medicaid |
$344.85
|
| Rate for Payer: UHCCP Medicaid |
$344.85
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,654.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$423.87 |
| Max. Negotiated Rate |
$1,990.50 |
| Rate for Payer: Aetna Commercial |
$869.43
|
| Rate for Payer: Aetna Medicare |
$674.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.32
|
| Rate for Payer: BCBS Complete |
$445.06
|
| Rate for Payer: BCBS MAPPO |
$648.83
|
| Rate for Payer: BCN Commercial |
$1,090.57
|
| Rate for Payer: BCN Medicare Advantage |
$648.83
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cofinity Commercial |
$934.32
|
| Rate for Payer: Cofinity Commercial |
$869.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.83
|
| Rate for Payer: Healthscope Commercial |
$1,200.34
|
| Rate for Payer: Healthscope Commercial |
$1,038.13
|
| Rate for Payer: Mclaren Medicaid |
$423.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.27
|
| Rate for Payer: Meridian Medicaid |
$445.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$713.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,270.19
|
| Rate for Payer: Nomi Health Commercial |
$778.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,990.50
|
| Rate for Payer: PACE SWMI |
$648.83
|
| Rate for Payer: PHP Medicare Advantage |
$648.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,165.80
|
| Rate for Payer: Priority Health Medicare |
$648.83
|
| Rate for Payer: Priority Health SBD |
$1,165.80
|
| Rate for Payer: Priority Health Tiered Network |
$1,165.80
|
| Rate for Payer: Railroad Medicare Medicare |
$648.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,246.03
|
| Rate for Payer: UHC Core |
$1,246.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$648.83
|
| Rate for Payer: UHC Exchange |
$1,246.03
|
| Rate for Payer: UHC Medicaid |
$423.87
|
| Rate for Payer: UHCCP Medicaid |
$423.87
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,802.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$2,101.50 |
| Rate for Payer: Aetna Commercial |
$717.64
|
| Rate for Payer: Aetna Medicare |
$556.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.19
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS MAPPO |
$535.55
|
| Rate for Payer: BCN Commercial |
$897.86
|
| Rate for Payer: BCN Medicare Advantage |
$535.55
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Cofinity Commercial |
$771.19
|
| Rate for Payer: Cofinity Commercial |
$717.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.55
|
| Rate for Payer: Healthscope Commercial |
$990.77
|
| Rate for Payer: Healthscope Commercial |
$856.88
|
| Rate for Payer: Mclaren Medicaid |
$351.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.33
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$589.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,043.68
|
| Rate for Payer: Nomi Health Commercial |
$642.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,101.50
|
| Rate for Payer: PACE SWMI |
$535.55
|
| Rate for Payer: PHP Medicare Advantage |
$535.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$959.79
|
| Rate for Payer: Priority Health Medicare |
$535.55
|
| Rate for Payer: Priority Health SBD |
$959.79
|
| Rate for Payer: Priority Health Tiered Network |
$959.79
|
| Rate for Payer: Railroad Medicare Medicare |
$535.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.87
|
| Rate for Payer: UHC Core |
$1,016.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$535.55
|
| Rate for Payer: UHC Exchange |
$1,016.87
|
| Rate for Payer: UHC Medicaid |
$351.45
|
| Rate for Payer: UHCCP Medicaid |
$351.45
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,606.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$438.99 |
| Max. Negotiated Rate |
$1,954.50 |
| Rate for Payer: Aetna Commercial |
$897.01
|
| Rate for Payer: Aetna Medicare |
$696.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.95
|
| Rate for Payer: BCBS Complete |
$460.94
|
| Rate for Payer: BCBS MAPPO |
$669.41
|
| Rate for Payer: BCN Commercial |
$1,136.89
|
| Rate for Payer: BCN Medicare Advantage |
$669.41
|
| Rate for Payer: Cash Price |
$2,084.80
|
| Rate for Payer: Cash Price |
$2,084.80
|
| Rate for Payer: Cofinity Commercial |
$963.95
|
| Rate for Payer: Cofinity Commercial |
$897.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.41
|
| Rate for Payer: Healthscope Commercial |
$1,238.41
|
| Rate for Payer: Healthscope Commercial |
$1,071.06
|
| Rate for Payer: Mclaren Medicaid |
$438.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$702.88
|
| Rate for Payer: Meridian Medicaid |
$460.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$736.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.70
|
| Rate for Payer: Nomi Health Commercial |
$803.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.50
|
| Rate for Payer: PACE SWMI |
$669.41
|
| Rate for Payer: PHP Medicare Advantage |
$669.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,215.30
|
| Rate for Payer: Priority Health Medicare |
$669.41
|
| Rate for Payer: Priority Health SBD |
$1,215.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,215.30
|
| Rate for Payer: Railroad Medicare Medicare |
$669.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,290.05
|
| Rate for Payer: UHC Core |
$1,290.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$669.41
|
| Rate for Payer: UHC Exchange |
$1,290.05
|
| Rate for Payer: UHC Medicaid |
$438.99
|
| Rate for Payer: UHCCP Medicaid |
$438.99
|
|
|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$348.26 |
| Max. Negotiated Rate |
$1,164.75 |
| Rate for Payer: Aetna Commercial |
$711.06
|
| Rate for Payer: Aetna Medicare |
$551.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.12
|
| Rate for Payer: BCBS Complete |
$365.67
|
| Rate for Payer: BCBS MAPPO |
$530.64
|
| Rate for Payer: BCN Commercial |
$878.94
|
| Rate for Payer: BCN Medicare Advantage |
$530.64
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$764.12
|
| Rate for Payer: Cofinity Commercial |
$711.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.64
|
| Rate for Payer: Healthscope Commercial |
$981.68
|
| Rate for Payer: Healthscope Commercial |
$849.02
|
| Rate for Payer: Mclaren Medicaid |
$348.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.17
|
| Rate for Payer: Meridian Medicaid |
$365.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$583.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.37
|
| Rate for Payer: Nomi Health Commercial |
$636.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,164.75
|
| Rate for Payer: PACE SWMI |
$530.64
|
| Rate for Payer: PHP Medicare Advantage |
$530.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$939.57
|
| Rate for Payer: Priority Health Medicare |
$530.64
|
| Rate for Payer: Priority Health SBD |
$939.57
|
| Rate for Payer: Priority Health Tiered Network |
$939.57
|
| Rate for Payer: Railroad Medicare Medicare |
$530.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$991.92
|
| Rate for Payer: UHC Core |
$991.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$530.64
|
| Rate for Payer: UHC Exchange |
$991.92
|
| Rate for Payer: UHC Medicaid |
$348.26
|
| Rate for Payer: UHCCP Medicaid |
$348.26
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,563.75 |
| Rate for Payer: Aetna Commercial |
$872.61
|
| Rate for Payer: Aetna Medicare |
$677.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.73
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$651.20
|
| Rate for Payer: BCN Commercial |
$1,103.03
|
| Rate for Payer: BCN Medicare Advantage |
$651.20
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cofinity Commercial |
$937.73
|
| Rate for Payer: Cofinity Commercial |
$872.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.20
|
| Rate for Payer: Healthscope Commercial |
$1,204.72
|
| Rate for Payer: Healthscope Commercial |
$1,041.92
|
| Rate for Payer: Mclaren Medicaid |
$426.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.76
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$716.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,277.35
|
| Rate for Payer: Nomi Health Commercial |
$781.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,563.75
|
| Rate for Payer: PACE SWMI |
$651.20
|
| Rate for Payer: PHP Medicare Advantage |
$651.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,179.10
|
| Rate for Payer: Priority Health Medicare |
$651.20
|
| Rate for Payer: Priority Health SBD |
$1,179.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,179.10
|
| Rate for Payer: Railroad Medicare Medicare |
$651.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,251.84
|
| Rate for Payer: UHC Core |
$1,251.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.20
|
| Rate for Payer: UHC Exchange |
$1,251.84
|
| Rate for Payer: UHC Medicaid |
$426.64
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
|
