|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$243.84
|
|
|
Service Code
|
NDC 51991081701
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.62 |
| Max. Negotiated Rate |
$219.46 |
| Rate for Payer: Aetna Commercial |
$207.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.50
|
| Rate for Payer: Cash Price |
$195.07
|
| Rate for Payer: Cofinity Advantage |
$170.69
|
| Rate for Payer: Cofinity Commercial |
$209.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.07
|
| Rate for Payer: Healthscope Commercial |
$219.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.88
|
| Rate for Payer: PHP Commercial |
$207.26
|
| Rate for Payer: Priority Health SBD |
$153.62
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$9.28
|
|
|
Service Code
|
NDC 60687021511
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$8.35 |
| Rate for Payer: Aetna Commercial |
$7.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.03
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Cofinity Advantage |
$6.50
|
| Rate for Payer: Cofinity Commercial |
$7.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.42
|
| Rate for Payer: Healthscope Commercial |
$8.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.96
|
| Rate for Payer: PHP Commercial |
$7.89
|
| Rate for Payer: Priority Health SBD |
$5.85
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$198.55
|
|
|
Service Code
|
NDC 00527411737
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.03 |
| Max. Negotiated Rate |
$178.69 |
| Rate for Payer: Aetna Commercial |
$168.77
|
| Rate for Payer: Aetna Medicare |
$99.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.06
|
| Rate for Payer: BCBS Complete |
$79.42
|
| Rate for Payer: Cash Price |
$158.84
|
| Rate for Payer: Cofinity Advantage |
$138.99
|
| Rate for Payer: Cofinity Commercial |
$170.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.84
|
| Rate for Payer: Healthscope Commercial |
$178.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.91
|
| Rate for Payer: PHP Commercial |
$168.77
|
| Rate for Payer: Priority Health SBD |
$125.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.06
|
| Rate for Payer: UHC Core |
$103.44
|
| Rate for Payer: UHC Exchange |
$78.03
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$8.17
|
|
|
Service Code
|
NDC 60687022611
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$7.35 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.31
|
| Rate for Payer: BCBS Complete |
$3.27
|
| Rate for Payer: Cash Price |
$6.54
|
| Rate for Payer: Cofinity Advantage |
$5.72
|
| Rate for Payer: Cofinity Commercial |
$7.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.54
|
| Rate for Payer: Healthscope Commercial |
$7.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.13
|
| Rate for Payer: PHP Commercial |
$6.94
|
| Rate for Payer: Priority Health SBD |
$5.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.31
|
| Rate for Payer: UHC Core |
$4.26
|
| Rate for Payer: UHC Exchange |
$3.21
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$816.96
|
|
|
Service Code
|
NDC 60687022601
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$514.68 |
| Max. Negotiated Rate |
$735.26 |
| Rate for Payer: Aetna Commercial |
$694.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.02
|
| Rate for Payer: Cash Price |
$653.57
|
| Rate for Payer: Cofinity Advantage |
$571.87
|
| Rate for Payer: Cofinity Commercial |
$702.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.57
|
| Rate for Payer: Healthscope Commercial |
$735.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.72
|
| Rate for Payer: PHP Commercial |
$694.42
|
| Rate for Payer: Priority Health SBD |
$514.68
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$198.55
|
|
|
Service Code
|
NDC 00527411737
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.09 |
| Max. Negotiated Rate |
$178.69 |
| Rate for Payer: Aetna Commercial |
$168.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.06
|
| Rate for Payer: Cash Price |
$158.84
|
| Rate for Payer: Cofinity Advantage |
$138.99
|
| Rate for Payer: Cofinity Commercial |
$170.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.84
|
| Rate for Payer: Healthscope Commercial |
$178.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.91
|
| Rate for Payer: PHP Commercial |
$168.77
|
| Rate for Payer: Priority Health SBD |
$125.09
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$441.75
|
|
|
Service Code
|
NDC 62559053101
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.61 |
| Max. Negotiated Rate |
$397.57 |
| Rate for Payer: Aetna Commercial |
$375.49
|
| Rate for Payer: Aetna Medicare |
$220.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.14
|
| Rate for Payer: BCBS Complete |
$176.70
|
| Rate for Payer: Cash Price |
$353.40
|
| Rate for Payer: Cofinity Advantage |
$309.23
|
| Rate for Payer: Cofinity Commercial |
$379.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.40
|
| Rate for Payer: Healthscope Commercial |
$397.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.31
|
| Rate for Payer: PHP Commercial |
$375.49
|
| Rate for Payer: Priority Health SBD |
$278.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.14
|
| Rate for Payer: UHC Core |
$230.15
|
| Rate for Payer: UHC Exchange |
$173.61
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$441.75
|
|
|
Service Code
|
NDC 62559053101
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$278.30 |
| Max. Negotiated Rate |
$397.57 |
| Rate for Payer: Aetna Commercial |
$375.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.14
|
| Rate for Payer: Cash Price |
$353.40
|
| Rate for Payer: Cofinity Advantage |
$309.23
|
| Rate for Payer: Cofinity Commercial |
$379.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.40
|
| Rate for Payer: Healthscope Commercial |
$397.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.31
|
| Rate for Payer: PHP Commercial |
$375.49
|
| Rate for Payer: Priority Health SBD |
$278.30
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$816.96
|
|
|
Service Code
|
NDC 60687022601
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$321.07 |
| Max. Negotiated Rate |
$735.26 |
| Rate for Payer: Aetna Commercial |
$694.42
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.02
|
| Rate for Payer: BCBS Complete |
$326.78
|
| Rate for Payer: Cash Price |
$653.57
|
| Rate for Payer: Cofinity Advantage |
$571.87
|
| Rate for Payer: Cofinity Commercial |
$702.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.57
|
| Rate for Payer: Healthscope Commercial |
$735.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$653.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.72
|
| Rate for Payer: PHP Commercial |
$694.42
|
| Rate for Payer: Priority Health SBD |
$514.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.02
|
| Rate for Payer: UHC Core |
$425.64
|
| Rate for Payer: UHC Exchange |
$321.07
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$8.17
|
|
|
Service Code
|
NDC 60687022611
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$7.35 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.31
|
| Rate for Payer: Cash Price |
$6.54
|
| Rate for Payer: Cofinity Advantage |
$5.72
|
| Rate for Payer: Cofinity Commercial |
$7.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.54
|
| Rate for Payer: Healthscope Commercial |
$7.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.13
|
| Rate for Payer: PHP Commercial |
$6.94
|
| Rate for Payer: Priority Health SBD |
$5.15
|
|
|
PR OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 92544
|
| Min. Negotiated Rate |
$17.06 |
| Max. Negotiated Rate |
$31.56 |
| Rate for Payer: Aetna Commercial |
$22.86
|
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$24.57
|
| Rate for Payer: Cofinity Commercial |
$22.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$31.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.94
|
| Rate for Payer: Nomi Health Commercial |
$20.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.80
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health SBD |
$24.80
|
| Rate for Payer: Priority Health Tiered Network |
$24.80
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.06
|
| Rate for Payer: UHC Exchange |
$28.01
|
|
|
PR OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF
|
Professional
|
Both
|
$3,575.00
|
|
|
Service Code
|
HCPCS 23552
|
| Min. Negotiated Rate |
$390.43 |
| Max. Negotiated Rate |
$2,681.25 |
| Rate for Payer: Aetna Commercial |
$798.85
|
| Rate for Payer: Aetna Medicare |
$620.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.47
|
| Rate for Payer: BCBS Complete |
$409.95
|
| Rate for Payer: BCBS MAPPO |
$596.16
|
| Rate for Payer: BCN Commercial |
$988.00
|
| Rate for Payer: BCN Medicare Advantage |
$596.16
|
| Rate for Payer: Cash Price |
$2,860.00
|
| Rate for Payer: Cash Price |
$2,860.00
|
| Rate for Payer: Cofinity Commercial |
$858.47
|
| Rate for Payer: Cofinity Commercial |
$798.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$596.16
|
| Rate for Payer: Healthscope Commercial |
$953.86
|
| Rate for Payer: Healthscope Commercial |
$1,102.90
|
| Rate for Payer: Mclaren Medicaid |
$390.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.97
|
| Rate for Payer: Meridian Medicaid |
$409.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$655.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,152.16
|
| Rate for Payer: Nomi Health Commercial |
$715.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,681.25
|
| Rate for Payer: PACE SWMI |
$596.16
|
| Rate for Payer: PHP Medicare Advantage |
$596.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,056.13
|
| Rate for Payer: Priority Health Medicare |
$596.16
|
| 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 |
$596.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,138.40
|
| Rate for Payer: UHC Core |
$1,138.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$596.16
|
| Rate for Payer: UHC Exchange |
$1,138.40
|
| Rate for Payer: UHC Medicaid |
$390.43
|
| Rate for Payer: UHCCP Medicaid |
$390.43
|
|
|
PR OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT
|
Professional
|
Both
|
$4,007.00
|
|
|
Service Code
|
HCPCS 27228
|
| Min. Negotiated Rate |
$1,075.01 |
| Max. Negotiated Rate |
$3,331.19 |
| Rate for Payer: Aetna Commercial |
$2,232.80
|
| Rate for Payer: Aetna Medicare |
$1,732.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,232.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.43
|
| Rate for Payer: BCBS Complete |
$1,128.76
|
| Rate for Payer: BCBS MAPPO |
$1,666.27
|
| Rate for Payer: BCN Commercial |
$2,825.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.27
|
| Rate for Payer: Cash Price |
$3,205.60
|
| Rate for Payer: Cash Price |
$3,205.60
|
| Rate for Payer: Cofinity Commercial |
$2,399.43
|
| Rate for Payer: Cofinity Commercial |
$2,232.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.27
|
| Rate for Payer: Healthscope Commercial |
$3,082.60
|
| Rate for Payer: Healthscope Commercial |
$2,666.03
|
| Rate for Payer: Mclaren Medicaid |
$1,075.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,749.58
|
| Rate for Payer: Meridian Medicaid |
$1,128.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,832.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,331.19
|
| Rate for Payer: Nomi Health Commercial |
$1,999.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,005.25
|
| Rate for Payer: PACE SWMI |
$1,666.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,019.90
|
| Rate for Payer: Priority Health Medicare |
$1,666.27
|
| Rate for Payer: Priority Health SBD |
$3,019.90
|
| Rate for Payer: Priority Health Tiered Network |
$3,019.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,666.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,310.26
|
| Rate for Payer: UHC Core |
$3,310.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,666.27
|
| Rate for Payer: UHC Exchange |
$3,310.26
|
| Rate for Payer: UHC Medicaid |
$1,075.01
|
| Rate for Payer: UHCCP Medicaid |
$1,075.01
|
|
|
PR OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT
|
Professional
|
Both
|
$4,805.00
|
|
|
Service Code
|
HCPCS 27227
|
| Min. Negotiated Rate |
$949.77 |
| Max. Negotiated Rate |
$3,603.75 |
| Rate for Payer: Aetna Commercial |
$1,969.40
|
| Rate for Payer: Aetna Medicare |
$1,528.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,116.37
|
| Rate for Payer: BCBS Complete |
$997.26
|
| Rate for Payer: BCBS MAPPO |
$1,469.70
|
| Rate for Payer: BCN Commercial |
$2,489.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,469.70
|
| Rate for Payer: Cash Price |
$3,844.00
|
| Rate for Payer: Cash Price |
$3,844.00
|
| Rate for Payer: Cofinity Commercial |
$2,116.37
|
| Rate for Payer: Cofinity Commercial |
$1,969.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,469.70
|
| Rate for Payer: Healthscope Commercial |
$2,718.95
|
| Rate for Payer: Healthscope Commercial |
$2,351.52
|
| Rate for Payer: Mclaren Medicaid |
$949.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,543.18
|
| Rate for Payer: Meridian Medicaid |
$997.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,616.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,926.12
|
| Rate for Payer: Nomi Health Commercial |
$1,763.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,603.75
|
| Rate for Payer: PACE SWMI |
$1,469.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,469.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$949.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,661.10
|
| Rate for Payer: Priority Health Medicare |
$1,469.70
|
| Rate for Payer: Priority Health SBD |
$2,661.10
|
| Rate for Payer: Priority Health Tiered Network |
$2,661.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,469.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,911.39
|
| Rate for Payer: UHC Core |
$2,911.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,469.70
|
| Rate for Payer: UHC Exchange |
$2,911.39
|
| Rate for Payer: UHC Medicaid |
$949.77
|
| Rate for Payer: UHCCP Medicaid |
$949.77
|
|
|
PR OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ
|
Professional
|
Both
|
$3,095.00
|
|
|
Service Code
|
HCPCS 27846
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$2,321.25 |
| Rate for Payer: Aetna Commercial |
$883.33
|
| Rate for Payer: Aetna Medicare |
$685.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$883.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.25
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS MAPPO |
$659.20
|
| Rate for Payer: BCN Commercial |
$1,102.03
|
| Rate for Payer: BCN Medicare Advantage |
$659.20
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cofinity Commercial |
$949.25
|
| Rate for Payer: Cofinity Commercial |
$883.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.20
|
| Rate for Payer: Healthscope Commercial |
$1,219.52
|
| Rate for Payer: Healthscope Commercial |
$1,054.72
|
| Rate for Payer: Mclaren Medicaid |
$430.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.16
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.41
|
| Rate for Payer: Nomi Health Commercial |
$791.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,321.25
|
| Rate for Payer: PACE SWMI |
$659.20
|
| Rate for Payer: PHP Medicare Advantage |
$659.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,178.04
|
| Rate for Payer: Priority Health Medicare |
$659.20
|
| Rate for Payer: Priority Health SBD |
$1,178.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,178.04
|
| Rate for Payer: Railroad Medicare Medicare |
$659.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,248.57
|
| Rate for Payer: UHC Core |
$1,248.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.20
|
| Rate for Payer: UHC Exchange |
$1,248.57
|
| Rate for Payer: UHC Medicaid |
$430.47
|
| Rate for Payer: UHCCP Medicaid |
$430.47
|
|
|
PR OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ
|
Professional
|
Both
|
$3,344.00
|
|
|
Service Code
|
HCPCS 27848
|
| Min. Negotiated Rate |
$470.52 |
| Max. Negotiated Rate |
$2,508.00 |
| Rate for Payer: Aetna Commercial |
$967.80
|
| Rate for Payer: Aetna Medicare |
$751.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.80
|
| Rate for Payer: BCBS Complete |
$494.05
|
| Rate for Payer: BCBS MAPPO |
$722.24
|
| Rate for Payer: BCN Commercial |
$1,208.60
|
| Rate for Payer: BCN Medicare Advantage |
$722.24
|
| Rate for Payer: Cash Price |
$2,675.20
|
| Rate for Payer: Cash Price |
$2,675.20
|
| Rate for Payer: Cofinity Commercial |
$967.80
|
| Rate for Payer: Cofinity Commercial |
$1,040.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.24
|
| Rate for Payer: Healthscope Commercial |
$1,336.14
|
| Rate for Payer: Healthscope Commercial |
$1,155.58
|
| Rate for Payer: Mclaren Medicaid |
$470.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.35
|
| Rate for Payer: Meridian Medicaid |
$494.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$794.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,394.14
|
| Rate for Payer: Nomi Health Commercial |
$866.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,508.00
|
| Rate for Payer: PACE SWMI |
$722.24
|
| Rate for Payer: PHP Medicare Advantage |
$722.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,291.96
|
| Rate for Payer: Priority Health Medicare |
$722.24
|
| Rate for Payer: Priority Health SBD |
$1,291.96
|
| Rate for Payer: Priority Health Tiered Network |
$1,291.96
|
| Rate for Payer: Railroad Medicare Medicare |
$722.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,398.77
|
| Rate for Payer: UHC Core |
$1,398.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$722.24
|
| Rate for Payer: UHC Exchange |
$1,398.77
|
| Rate for Payer: UHC Medicaid |
$470.52
|
| Rate for Payer: UHCCP Medicaid |
$470.52
|
|
|
PR OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR
|
Professional
|
Both
|
$3,228.00
|
|
|
Service Code
|
HCPCS 27217
|
| Min. Negotiated Rate |
$478.40 |
| Max. Negotiated Rate |
$2,421.00 |
| Rate for Payer: Aetna Commercial |
$1,119.55
|
| Rate for Payer: Aetna Medicare |
$1,614.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.55
|
| Rate for Payer: BCBS Complete |
$502.32
|
| Rate for Payer: BCN Commercial |
$1,259.40
|
| Rate for Payer: Cash Price |
$2,582.40
|
| Rate for Payer: Cash Price |
$2,582.40
|
| Rate for Payer: Mclaren Medicaid |
$478.40
|
| Rate for Payer: Meridian Medicaid |
$502.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,486.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,346.25
|
| Rate for Payer: Priority Health SBD |
$1,346.25
|
| Rate for Payer: Priority Health Tiered Network |
$1,346.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,478.83
|
| Rate for Payer: UHC Core |
$1,478.83
|
| Rate for Payer: UHC Exchange |
$1,478.83
|
| Rate for Payer: UHC Medicaid |
$478.40
|
| Rate for Payer: UHCCP Medicaid |
$478.40
|
|
|
PR OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ
|
Professional
|
Both
|
$3,336.00
|
|
|
Service Code
|
HCPCS 26686
|
| Min. Negotiated Rate |
$377.86 |
| Max. Negotiated Rate |
$2,502.00 |
| Rate for Payer: Aetna Commercial |
$772.28
|
| Rate for Payer: Aetna Medicare |
$599.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.28
|
| Rate for Payer: BCBS Complete |
$396.75
|
| Rate for Payer: BCBS MAPPO |
$576.33
|
| Rate for Payer: BCN Commercial |
$955.13
|
| Rate for Payer: BCN Medicare Advantage |
$576.33
|
| Rate for Payer: Cash Price |
$2,668.80
|
| Rate for Payer: Cash Price |
$2,668.80
|
| Rate for Payer: Cofinity Commercial |
$829.92
|
| Rate for Payer: Cofinity Commercial |
$772.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.33
|
| Rate for Payer: Healthscope Commercial |
$922.13
|
| Rate for Payer: Healthscope Commercial |
$1,066.21
|
| Rate for Payer: Mclaren Medicaid |
$377.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.15
|
| Rate for Payer: Meridian Medicaid |
$396.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$633.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,108.42
|
| Rate for Payer: Nomi Health Commercial |
$691.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,502.00
|
| Rate for Payer: PACE SWMI |
$576.33
|
| Rate for Payer: PHP Medicare Advantage |
$576.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,021.01
|
| Rate for Payer: Priority Health Medicare |
$576.33
|
| Rate for Payer: Priority Health SBD |
$1,021.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,021.01
|
| Rate for Payer: Railroad Medicare Medicare |
$576.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.46
|
| Rate for Payer: UHC Core |
$1,086.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$576.33
|
| Rate for Payer: UHC Exchange |
$1,086.46
|
| Rate for Payer: UHC Medicaid |
$377.86
|
| Rate for Payer: UHCCP Medicaid |
$377.86
|
|
|
PR OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION
|
Professional
|
Both
|
$2,535.00
|
|
|
Service Code
|
HCPCS 21470
|
| Min. Negotiated Rate |
$662.86 |
| Max. Negotiated Rate |
$2,050.03 |
| Rate for Payer: Aetna Commercial |
$1,362.99
|
| Rate for Payer: Aetna Medicare |
$1,057.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.71
|
| Rate for Payer: BCBS Complete |
$696.00
|
| Rate for Payer: BCBS MAPPO |
$1,017.16
|
| Rate for Payer: BCN Commercial |
$1,753.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.16
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cofinity Commercial |
$1,464.71
|
| Rate for Payer: Cofinity Commercial |
$1,362.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.16
|
| Rate for Payer: Healthscope Commercial |
$1,881.75
|
| Rate for Payer: Healthscope Commercial |
$1,627.46
|
| Rate for Payer: Mclaren Medicaid |
$662.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.02
|
| Rate for Payer: Meridian Medicaid |
$696.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,118.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,042.50
|
| Rate for Payer: Nomi Health Commercial |
$1,220.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,901.25
|
| Rate for Payer: PACE SWMI |
$1,017.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,874.33
|
| Rate for Payer: Priority Health Medicare |
$1,017.16
|
| Rate for Payer: Priority Health SBD |
$1,874.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,874.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,017.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,050.03
|
| Rate for Payer: UHC Core |
$2,050.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,017.16
|
| Rate for Payer: UHC Exchange |
$2,050.03
|
| Rate for Payer: UHC Medicaid |
$662.86
|
| Rate for Payer: UHCCP Medicaid |
$662.86
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG
|
Professional
|
Both
|
$2,493.00
|
|
|
Service Code
|
HCPCS 25608
|
| Min. Negotiated Rate |
$492.24 |
| Max. Negotiated Rate |
$1,869.75 |
| Rate for Payer: Aetna Commercial |
$1,007.35
|
| Rate for Payer: Aetna Medicare |
$781.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.52
|
| Rate for Payer: BCBS Complete |
$516.85
|
| Rate for Payer: BCBS MAPPO |
$751.75
|
| Rate for Payer: BCN Commercial |
$1,268.36
|
| Rate for Payer: BCN Medicare Advantage |
$751.75
|
| Rate for Payer: Cash Price |
$1,994.40
|
| Rate for Payer: Cash Price |
$1,994.40
|
| Rate for Payer: Cofinity Commercial |
$1,082.52
|
| Rate for Payer: Cofinity Commercial |
$1,007.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.75
|
| Rate for Payer: Healthscope Commercial |
$1,390.74
|
| Rate for Payer: Healthscope Commercial |
$1,202.80
|
| Rate for Payer: Mclaren Medicaid |
$492.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$789.34
|
| Rate for Payer: Meridian Medicaid |
$516.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$826.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,469.07
|
| Rate for Payer: Nomi Health Commercial |
$902.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,869.75
|
| Rate for Payer: PACE SWMI |
$751.75
|
| Rate for Payer: PHP Medicare Advantage |
$751.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,355.85
|
| Rate for Payer: Priority Health Medicare |
$751.75
|
| Rate for Payer: Priority Health SBD |
$1,355.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,355.85
|
| Rate for Payer: Railroad Medicare Medicare |
$751.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,436.42
|
| Rate for Payer: UHC Core |
$1,436.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$751.75
|
| Rate for Payer: UHC Exchange |
$1,436.42
|
| Rate for Payer: UHC Medicaid |
$492.24
|
| Rate for Payer: UHCCP Medicaid |
$492.24
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3+ FRAG
|
Professional
|
Both
|
$3,048.00
|
|
|
Service Code
|
HCPCS 25609
|
| Min. Negotiated Rate |
$617.49 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna Commercial |
$1,265.80
|
| Rate for Payer: Aetna Medicare |
$982.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,360.27
|
| Rate for Payer: BCBS Complete |
$648.36
|
| Rate for Payer: BCBS MAPPO |
$944.63
|
| Rate for Payer: BCN Commercial |
$1,607.48
|
| Rate for Payer: BCN Medicare Advantage |
$944.63
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cofinity Commercial |
$1,360.27
|
| Rate for Payer: Cofinity Commercial |
$1,265.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.63
|
| Rate for Payer: Healthscope Commercial |
$1,747.57
|
| Rate for Payer: Healthscope Commercial |
$1,511.41
|
| Rate for Payer: Mclaren Medicaid |
$617.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.86
|
| Rate for Payer: Meridian Medicaid |
$648.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.84
|
| Rate for Payer: Nomi Health Commercial |
$1,133.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,286.00
|
| Rate for Payer: PACE SWMI |
$944.63
|
| Rate for Payer: PHP Medicare Advantage |
$944.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,718.36
|
| Rate for Payer: Priority Health Medicare |
$944.63
|
| Rate for Payer: Priority Health SBD |
$1,718.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,718.36
|
| Rate for Payer: Railroad Medicare Medicare |
$944.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,829.63
|
| Rate for Payer: UHC Core |
$1,829.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$944.63
|
| Rate for Payer: UHC Exchange |
$1,829.63
|
| Rate for Payer: UHC Medicaid |
$617.49
|
| Rate for Payer: UHCCP Medicaid |
$617.49
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 25607
|
| Min. Negotiated Rate |
$444.74 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$907.69
|
| Rate for Payer: Aetna Medicare |
$704.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.43
|
| Rate for Payer: BCBS Complete |
$466.98
|
| Rate for Payer: BCBS MAPPO |
$677.38
|
| Rate for Payer: BCN Commercial |
$1,138.89
|
| Rate for Payer: BCN Medicare Advantage |
$677.38
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cofinity Commercial |
$975.43
|
| Rate for Payer: Cofinity Commercial |
$907.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.38
|
| Rate for Payer: Healthscope Commercial |
$1,253.15
|
| Rate for Payer: Healthscope Commercial |
$1,083.81
|
| Rate for Payer: Mclaren Medicaid |
$444.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$711.25
|
| Rate for Payer: Meridian Medicaid |
$466.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$745.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.59
|
| Rate for Payer: Nomi Health Commercial |
$812.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.50
|
| Rate for Payer: PACE SWMI |
$677.38
|
| Rate for Payer: PHP Medicare Advantage |
$677.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,217.43
|
| Rate for Payer: Priority Health Medicare |
$677.38
|
| Rate for Payer: Priority Health SBD |
$1,217.43
|
| Rate for Payer: Priority Health Tiered Network |
$1,217.43
|
| Rate for Payer: Railroad Medicare Medicare |
$677.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,278.64
|
| Rate for Payer: UHC Core |
$1,278.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$677.38
|
| Rate for Payer: UHC Exchange |
$1,278.64
|
| Rate for Payer: UHC Medicaid |
$444.74
|
| Rate for Payer: UHCCP Medicaid |
$444.74
|
|
|
PR OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT
|
Professional
|
Both
|
$3,844.00
|
|
|
Service Code
|
HCPCS 27236
|
| Min. Negotiated Rate |
$695.02 |
| Max. Negotiated Rate |
$2,883.00 |
| Rate for Payer: Aetna Commercial |
$1,435.13
|
| Rate for Payer: Aetna Medicare |
$1,113.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,542.23
|
| Rate for Payer: BCBS Complete |
$729.77
|
| Rate for Payer: BCBS MAPPO |
$1,070.99
|
| Rate for Payer: BCN Commercial |
$1,983.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,070.99
|
| Rate for Payer: Cash Price |
$3,075.20
|
| Rate for Payer: Cash Price |
$3,075.20
|
| Rate for Payer: Cofinity Commercial |
$1,542.23
|
| Rate for Payer: Cofinity Commercial |
$1,435.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,070.99
|
| Rate for Payer: Healthscope Commercial |
$1,981.33
|
| Rate for Payer: Healthscope Commercial |
$1,713.58
|
| Rate for Payer: Mclaren Medicaid |
$695.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,124.54
|
| Rate for Payer: Meridian Medicaid |
$729.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,178.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,114.51
|
| Rate for Payer: Nomi Health Commercial |
$1,285.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,883.00
|
| Rate for Payer: PACE SWMI |
$1,070.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,070.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,929.69
|
| Rate for Payer: Priority Health Medicare |
$1,070.99
|
| Rate for Payer: Priority Health SBD |
$1,929.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,929.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,070.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,096.23
|
| Rate for Payer: UHC Core |
$2,096.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,070.99
|
| Rate for Payer: UHC Exchange |
$2,096.23
|
| Rate for Payer: UHC Medicaid |
$695.02
|
| Rate for Payer: UHCCP Medicaid |
$695.02
|
|
|
PR OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW
|
Professional
|
Both
|
$4,341.00
|
|
|
Service Code
|
HCPCS 27506
|
| Min. Negotiated Rate |
$780.01 |
| Max. Negotiated Rate |
$3,255.75 |
| Rate for Payer: Aetna Commercial |
$1,609.98
|
| Rate for Payer: Aetna Medicare |
$1,249.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,609.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.13
|
| Rate for Payer: BCBS Complete |
$819.01
|
| Rate for Payer: BCBS MAPPO |
$1,201.48
|
| Rate for Payer: BCN Commercial |
$2,224.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.48
|
| Rate for Payer: Cash Price |
$3,472.80
|
| Rate for Payer: Cash Price |
$3,472.80
|
| Rate for Payer: Cofinity Commercial |
$1,730.13
|
| Rate for Payer: Cofinity Commercial |
$1,609.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.48
|
| Rate for Payer: Healthscope Commercial |
$2,222.74
|
| Rate for Payer: Healthscope Commercial |
$1,922.37
|
| Rate for Payer: Mclaren Medicaid |
$780.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,261.55
|
| Rate for Payer: Meridian Medicaid |
$819.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,321.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,371.73
|
| Rate for Payer: Nomi Health Commercial |
$1,441.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,255.75
|
| Rate for Payer: PACE SWMI |
$1,201.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,164.45
|
| Rate for Payer: Priority Health Medicare |
$1,201.48
|
| Rate for Payer: Priority Health SBD |
$2,164.45
|
| Rate for Payer: Priority Health Tiered Network |
$2,164.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,201.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,345.38
|
| Rate for Payer: UHC Core |
$2,345.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,201.48
|
| Rate for Payer: UHC Exchange |
$2,345.38
|
| Rate for Payer: UHC Medicaid |
$780.01
|
| Rate for Payer: UHCCP Medicaid |
$780.01
|
|
|
PR OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,963.00
|
|
|
Service Code
|
HCPCS 27507
|
| Min. Negotiated Rate |
$563.39 |
| Max. Negotiated Rate |
$2,972.25 |
| Rate for Payer: Aetna Commercial |
$1,164.73
|
| Rate for Payer: Aetna Medicare |
$903.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.65
|
| Rate for Payer: BCBS Complete |
$591.56
|
| Rate for Payer: BCBS MAPPO |
$869.20
|
| Rate for Payer: BCN Commercial |
$1,465.06
|
| Rate for Payer: BCN Medicare Advantage |
$869.20
|
| Rate for Payer: Cash Price |
$3,170.40
|
| Rate for Payer: Cash Price |
$3,170.40
|
| Rate for Payer: Cofinity Commercial |
$1,251.65
|
| Rate for Payer: Cofinity Commercial |
$1,164.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.20
|
| Rate for Payer: Healthscope Commercial |
$1,608.02
|
| Rate for Payer: Healthscope Commercial |
$1,390.72
|
| Rate for Payer: Mclaren Medicaid |
$563.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.66
|
| Rate for Payer: Meridian Medicaid |
$591.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$956.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,718.62
|
| Rate for Payer: Nomi Health Commercial |
$1,043.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,972.25
|
| Rate for Payer: PACE SWMI |
$869.20
|
| Rate for Payer: PHP Medicare Advantage |
$869.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,566.10
|
| Rate for Payer: Priority Health Medicare |
$869.20
|
| Rate for Payer: Priority Health SBD |
$1,566.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,566.10
|
| Rate for Payer: Railroad Medicare Medicare |
$869.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.18
|
| Rate for Payer: UHC Core |
$1,705.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$869.20
|
| Rate for Payer: UHC Exchange |
$1,705.18
|
| Rate for Payer: UHC Medicaid |
$563.39
|
| Rate for Payer: UHCCP Medicaid |
$563.39
|
|
