|
PR OPTX GREATER HUMERAL TUBEROSITY FX W/INT FIXJ
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 23630
|
| Min. Negotiated Rate |
$468.17 |
| Max. Negotiated Rate |
$1,385.73 |
| Rate for Payer: Aetna Commercial |
$958.72
|
| Rate for Payer: Aetna Medicare |
$744.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,030.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.72
|
| Rate for Payer: BCBS Complete |
$491.58
|
| Rate for Payer: BCBS MAPPO |
$715.46
|
| Rate for Payer: BCN Commercial |
$1,194.15
|
| Rate for Payer: BCN Medicare Advantage |
$715.46
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Commercial |
$958.72
|
| Rate for Payer: Cofinity Commercial |
$1,030.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.46
|
| Rate for Payer: Healthscope Commercial |
$1,323.60
|
| Rate for Payer: Healthscope Commercial |
$1,144.74
|
| Rate for Payer: Mclaren Medicaid |
$468.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.23
|
| Rate for Payer: Meridian Medicaid |
$491.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$787.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,385.73
|
| Rate for Payer: Nomi Health Commercial |
$858.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,072.50
|
| Rate for Payer: PACE SWMI |
$715.46
|
| Rate for Payer: PHP Medicare Advantage |
$715.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,276.52
|
| Rate for Payer: Priority Health Medicare |
$715.46
|
| Rate for Payer: Priority Health SBD |
$1,276.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,276.52
|
| Rate for Payer: Railroad Medicare Medicare |
$715.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,359.31
|
| Rate for Payer: UHC Core |
$1,359.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$715.46
|
| Rate for Payer: UHC Exchange |
$1,359.31
|
| Rate for Payer: UHC Medicaid |
$468.17
|
| Rate for Payer: UHCCP Medicaid |
$468.17
|
|
|
PR OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD
|
Professional
|
Both
|
$3,652.00
|
|
|
Service Code
|
HCPCS 27254
|
| Min. Negotiated Rate |
$737.83 |
| Max. Negotiated Rate |
$2,739.00 |
| Rate for Payer: Aetna Commercial |
$1,525.42
|
| Rate for Payer: Aetna Medicare |
$1,183.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,525.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.25
|
| Rate for Payer: BCBS Complete |
$774.72
|
| Rate for Payer: BCBS MAPPO |
$1,138.37
|
| Rate for Payer: BCN Commercial |
$1,921.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.37
|
| Rate for Payer: Cash Price |
$2,921.60
|
| Rate for Payer: Cash Price |
$2,921.60
|
| Rate for Payer: Cofinity Commercial |
$1,639.25
|
| Rate for Payer: Cofinity Commercial |
$1,525.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.37
|
| Rate for Payer: Healthscope Commercial |
$2,105.98
|
| Rate for Payer: Healthscope Commercial |
$1,821.39
|
| Rate for Payer: Mclaren Medicaid |
$737.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,195.29
|
| Rate for Payer: Meridian Medicaid |
$774.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,252.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,255.33
|
| Rate for Payer: Nomi Health Commercial |
$1,366.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,739.00
|
| Rate for Payer: PACE SWMI |
$1,138.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$737.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,054.25
|
| Rate for Payer: Priority Health Medicare |
$1,138.37
|
| Rate for Payer: Priority Health SBD |
$2,054.25
|
| Rate for Payer: Priority Health Tiered Network |
$2,054.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,235.97
|
| Rate for Payer: UHC Core |
$2,235.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,138.37
|
| Rate for Payer: UHC Exchange |
$2,235.97
|
| Rate for Payer: UHC Medicaid |
$737.83
|
| Rate for Payer: UHCCP Medicaid |
$737.83
|
|
|
PR OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ
|
Professional
|
Both
|
$2,422.00
|
|
|
Service Code
|
HCPCS 27253
|
| Min. Negotiated Rate |
$554.65 |
| Max. Negotiated Rate |
$1,816.50 |
| Rate for Payer: Aetna Commercial |
$1,142.99
|
| Rate for Payer: Aetna Medicare |
$887.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,228.29
|
| Rate for Payer: BCBS Complete |
$582.38
|
| Rate for Payer: BCBS MAPPO |
$852.98
|
| Rate for Payer: BCN Commercial |
$1,425.72
|
| Rate for Payer: BCN Medicare Advantage |
$852.98
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cofinity Commercial |
$1,228.29
|
| Rate for Payer: Cofinity Commercial |
$1,142.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.98
|
| Rate for Payer: Healthscope Commercial |
$1,578.01
|
| Rate for Payer: Healthscope Commercial |
$1,364.77
|
| Rate for Payer: Mclaren Medicaid |
$554.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.63
|
| Rate for Payer: Meridian Medicaid |
$582.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$938.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.14
|
| Rate for Payer: Nomi Health Commercial |
$1,023.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,816.50
|
| Rate for Payer: PACE SWMI |
$852.98
|
| Rate for Payer: PHP Medicare Advantage |
$852.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,524.05
|
| Rate for Payer: Priority Health Medicare |
$852.98
|
| Rate for Payer: Priority Health SBD |
$1,524.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,524.05
|
| Rate for Payer: Railroad Medicare Medicare |
$852.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,650.79
|
| Rate for Payer: UHC Core |
$1,650.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$852.98
|
| Rate for Payer: UHC Exchange |
$1,650.79
|
| Rate for Payer: UHC Medicaid |
$554.65
|
| Rate for Payer: UHCCP Medicaid |
$554.65
|
|
|
PR OPTX HUMERAL SHFT FX PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,185.00
|
|
|
Service Code
|
HCPCS 24515
|
| Min. Negotiated Rate |
$524.41 |
| Max. Negotiated Rate |
$2,388.75 |
| Rate for Payer: Aetna Commercial |
$1,075.95
|
| Rate for Payer: Aetna Medicare |
$835.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,156.25
|
| Rate for Payer: BCBS Complete |
$550.63
|
| Rate for Payer: BCBS MAPPO |
$802.95
|
| Rate for Payer: BCN Commercial |
$1,341.56
|
| Rate for Payer: BCN Medicare Advantage |
$802.95
|
| Rate for Payer: Cash Price |
$2,548.00
|
| Rate for Payer: Cash Price |
$2,548.00
|
| Rate for Payer: Cofinity Commercial |
$1,156.25
|
| Rate for Payer: Cofinity Commercial |
$1,075.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.95
|
| Rate for Payer: Healthscope Commercial |
$1,485.46
|
| Rate for Payer: Healthscope Commercial |
$1,284.72
|
| Rate for Payer: Mclaren Medicaid |
$524.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.10
|
| Rate for Payer: Meridian Medicaid |
$550.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,563.62
|
| Rate for Payer: Nomi Health Commercial |
$963.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,388.75
|
| Rate for Payer: PACE SWMI |
$802.95
|
| Rate for Payer: PHP Medicare Advantage |
$802.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$524.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,434.08
|
| Rate for Payer: Priority Health Medicare |
$802.95
|
| Rate for Payer: Priority Health SBD |
$1,434.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,434.08
|
| Rate for Payer: Railroad Medicare Medicare |
$802.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,534.80
|
| Rate for Payer: UHC Core |
$1,534.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.95
|
| Rate for Payer: UHC Exchange |
$1,534.80
|
| Rate for Payer: UHC Medicaid |
$524.41
|
| Rate for Payer: UHCCP Medicaid |
$524.41
|
|
|
PR OPTX HUMERAL SPRCNYLR/TRANSCNDYLR FRACTURE W/XTN
|
Professional
|
Both
|
$4,101.00
|
|
|
Service Code
|
HCPCS 24546
|
| Min. Negotiated Rate |
$608.12 |
| Max. Negotiated Rate |
$3,075.75 |
| Rate for Payer: Aetna Commercial |
$1,252.27
|
| Rate for Payer: Aetna Medicare |
$971.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.72
|
| Rate for Payer: BCBS Complete |
$638.53
|
| Rate for Payer: BCBS MAPPO |
$934.53
|
| Rate for Payer: BCN Commercial |
$1,577.61
|
| Rate for Payer: BCN Medicare Advantage |
$934.53
|
| Rate for Payer: Cash Price |
$3,280.80
|
| Rate for Payer: Cash Price |
$3,280.80
|
| Rate for Payer: Cofinity Commercial |
$1,345.72
|
| Rate for Payer: Cofinity Commercial |
$1,252.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.53
|
| Rate for Payer: Healthscope Commercial |
$1,728.88
|
| Rate for Payer: Healthscope Commercial |
$1,495.25
|
| Rate for Payer: Mclaren Medicaid |
$608.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.26
|
| Rate for Payer: Meridian Medicaid |
$638.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,027.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,839.62
|
| Rate for Payer: Nomi Health Commercial |
$1,121.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,075.75
|
| Rate for Payer: PACE SWMI |
$934.53
|
| Rate for Payer: PHP Medicare Advantage |
$934.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,686.42
|
| Rate for Payer: Priority Health Medicare |
$934.53
|
| Rate for Payer: Priority Health SBD |
$1,686.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,686.42
|
| Rate for Payer: Railroad Medicare Medicare |
$934.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,817.38
|
| Rate for Payer: UHC Core |
$1,817.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$934.53
|
| Rate for Payer: UHC Exchange |
$1,817.38
|
| Rate for Payer: UHC Medicaid |
$608.12
|
| Rate for Payer: UHCCP Medicaid |
$608.12
|
|
|
PR OPTX HUMERAL SPRCNYLR/TRANSCNDYLR FX W/O XTN
|
Professional
|
Both
|
$3,136.00
|
|
|
Service Code
|
HCPCS 24545
|
| Min. Negotiated Rate |
$548.69 |
| Max. Negotiated Rate |
$2,352.00 |
| Rate for Payer: Aetna Commercial |
$1,128.37
|
| Rate for Payer: Aetna Medicare |
$875.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,128.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.58
|
| Rate for Payer: BCBS Complete |
$576.12
|
| Rate for Payer: BCBS MAPPO |
$842.07
|
| Rate for Payer: BCN Commercial |
$1,414.26
|
| Rate for Payer: BCN Medicare Advantage |
$842.07
|
| Rate for Payer: Cash Price |
$2,508.80
|
| Rate for Payer: Cash Price |
$2,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,212.58
|
| Rate for Payer: Cofinity Commercial |
$1,128.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.07
|
| Rate for Payer: Healthscope Commercial |
$1,557.83
|
| Rate for Payer: Healthscope Commercial |
$1,347.31
|
| Rate for Payer: Mclaren Medicaid |
$548.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.17
|
| Rate for Payer: Meridian Medicaid |
$576.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$926.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.29
|
| Rate for Payer: Nomi Health Commercial |
$1,010.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,352.00
|
| Rate for Payer: PACE SWMI |
$842.07
|
| Rate for Payer: PHP Medicare Advantage |
$842.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,511.81
|
| Rate for Payer: Priority Health Medicare |
$842.07
|
| Rate for Payer: Priority Health SBD |
$1,511.81
|
| Rate for Payer: Priority Health Tiered Network |
$1,511.81
|
| Rate for Payer: Railroad Medicare Medicare |
$842.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,625.87
|
| Rate for Payer: UHC Core |
$1,625.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$842.07
|
| Rate for Payer: UHC Exchange |
$1,625.87
|
| Rate for Payer: UHC Medicaid |
$548.69
|
| Rate for Payer: UHCCP Medicaid |
$548.69
|
|
|
PR OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS 27215
|
| Min. Negotiated Rate |
$345.06 |
| Max. Negotiated Rate |
$2,034.75 |
| Rate for Payer: Aetna Commercial |
$803.86
|
| Rate for Payer: Aetna Medicare |
$1,356.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.86
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCN Commercial |
$906.32
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Mclaren Medicaid |
$345.06
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,069.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,034.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$968.84
|
| Rate for Payer: Priority Health SBD |
$968.84
|
| Rate for Payer: Priority Health Tiered Network |
$968.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,062.18
|
| Rate for Payer: UHC Core |
$1,062.18
|
| Rate for Payer: UHC Exchange |
$1,062.18
|
| Rate for Payer: UHC Medicaid |
$345.06
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
|
|
PR OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN
|
Professional
|
Both
|
$2,116.00
|
|
|
Service Code
|
HCPCS 21347
|
| Min. Negotiated Rate |
$598.96 |
| Max. Negotiated Rate |
$1,830.49 |
| Rate for Payer: Aetna Commercial |
$1,219.00
|
| Rate for Payer: Aetna Medicare |
$946.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.00
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$909.70
|
| Rate for Payer: BCN Commercial |
$1,561.67
|
| Rate for Payer: BCN Medicare Advantage |
$909.70
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cofinity Commercial |
$1,309.97
|
| Rate for Payer: Cofinity Commercial |
$1,219.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.70
|
| Rate for Payer: Healthscope Commercial |
$1,682.94
|
| Rate for Payer: Healthscope Commercial |
$1,455.52
|
| Rate for Payer: Mclaren Medicaid |
$598.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.18
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,000.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.49
|
| Rate for Payer: Nomi Health Commercial |
$1,091.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.00
|
| Rate for Payer: PACE SWMI |
$909.70
|
| Rate for Payer: PHP Medicare Advantage |
$909.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,669.39
|
| Rate for Payer: Priority Health Medicare |
$909.70
|
| Rate for Payer: Priority Health SBD |
$1,669.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,669.39
|
| Rate for Payer: Railroad Medicare Medicare |
$909.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,752.28
|
| Rate for Payer: UHC Core |
$1,752.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$909.70
|
| Rate for Payer: UHC Exchange |
$1,752.28
|
| Rate for Payer: UHC Medicaid |
$598.96
|
| Rate for Payer: UHCCP Medicaid |
$598.96
|
|
|
PR OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC
|
Professional
|
Both
|
$1,661.00
|
|
|
Service Code
|
HCPCS 21390
|
| Min. Negotiated Rate |
$451.77 |
| Max. Negotiated Rate |
$1,411.47 |
| Rate for Payer: Aetna Commercial |
$923.55
|
| Rate for Payer: Aetna Medicare |
$716.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.48
|
| Rate for Payer: BCBS Complete |
$474.36
|
| Rate for Payer: BCBS MAPPO |
$689.22
|
| Rate for Payer: BCN Commercial |
$1,201.62
|
| Rate for Payer: BCN Medicare Advantage |
$689.22
|
| Rate for Payer: Cash Price |
$1,328.80
|
| Rate for Payer: Cash Price |
$1,328.80
|
| Rate for Payer: Cofinity Commercial |
$992.48
|
| Rate for Payer: Cofinity Commercial |
$923.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.22
|
| Rate for Payer: Healthscope Commercial |
$1,275.06
|
| Rate for Payer: Healthscope Commercial |
$1,102.75
|
| Rate for Payer: Mclaren Medicaid |
$451.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.68
|
| Rate for Payer: Meridian Medicaid |
$474.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$758.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,411.47
|
| Rate for Payer: Nomi Health Commercial |
$827.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,245.75
|
| Rate for Payer: PACE SWMI |
$689.22
|
| Rate for Payer: PHP Medicare Advantage |
$689.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,284.51
|
| Rate for Payer: Priority Health Medicare |
$689.22
|
| Rate for Payer: Priority Health SBD |
$1,284.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,284.51
|
| Rate for Payer: Railroad Medicare Medicare |
$689.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.20
|
| Rate for Payer: UHC Core |
$1,387.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$689.22
|
| Rate for Payer: UHC Exchange |
$1,387.20
|
| Rate for Payer: UHC Medicaid |
$451.77
|
| Rate for Payer: UHCCP Medicaid |
$451.77
|
|
|
PR OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY
|
Professional
|
Both
|
$1,643.00
|
|
|
Service Code
|
HCPCS 27566
|
| Min. Negotiated Rate |
$527.18 |
| Max. Negotiated Rate |
$1,585.01 |
| Rate for Payer: Aetna Commercial |
$1,085.04
|
| Rate for Payer: Aetna Medicare |
$842.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,085.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,166.01
|
| Rate for Payer: BCBS Complete |
$553.54
|
| Rate for Payer: BCBS MAPPO |
$809.73
|
| Rate for Payer: BCN Commercial |
$1,358.49
|
| Rate for Payer: BCN Medicare Advantage |
$809.73
|
| Rate for Payer: Cash Price |
$1,314.40
|
| Rate for Payer: Cash Price |
$1,314.40
|
| Rate for Payer: Cofinity Commercial |
$1,166.01
|
| Rate for Payer: Cofinity Commercial |
$1,085.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.73
|
| Rate for Payer: Healthscope Commercial |
$1,498.00
|
| Rate for Payer: Healthscope Commercial |
$1,295.57
|
| Rate for Payer: Mclaren Medicaid |
$527.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$850.22
|
| Rate for Payer: Meridian Medicaid |
$553.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$890.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,585.01
|
| Rate for Payer: Nomi Health Commercial |
$971.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,232.25
|
| Rate for Payer: PACE SWMI |
$809.73
|
| Rate for Payer: PHP Medicare Advantage |
$809.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$527.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,452.19
|
| Rate for Payer: Priority Health Medicare |
$809.73
|
| Rate for Payer: Priority Health SBD |
$1,452.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,452.19
|
| Rate for Payer: Railroad Medicare Medicare |
$809.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.82
|
| Rate for Payer: UHC Core |
$1,564.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$809.73
|
| Rate for Payer: UHC Exchange |
$1,564.82
|
| Rate for Payer: UHC Medicaid |
$527.18
|
| Rate for Payer: UHCCP Medicaid |
$527.18
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,584.00
|
|
|
Service Code
|
HCPCS 27524
|
| Min. Negotiated Rate |
$449.64 |
| Max. Negotiated Rate |
$1,938.00 |
| Rate for Payer: Aetna Commercial |
$922.39
|
| Rate for Payer: Aetna Medicare |
$715.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.22
|
| Rate for Payer: BCBS Complete |
$472.12
|
| Rate for Payer: BCBS MAPPO |
$688.35
|
| Rate for Payer: BCN Commercial |
$1,263.19
|
| Rate for Payer: BCN Medicare Advantage |
$688.35
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cofinity Commercial |
$991.22
|
| Rate for Payer: Cofinity Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.35
|
| Rate for Payer: Healthscope Commercial |
$1,273.45
|
| Rate for Payer: Healthscope Commercial |
$1,101.36
|
| Rate for Payer: Mclaren Medicaid |
$449.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.77
|
| Rate for Payer: Meridian Medicaid |
$472.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$757.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,338.32
|
| Rate for Payer: Nomi Health Commercial |
$826.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.00
|
| Rate for Payer: PACE SWMI |
$688.35
|
| Rate for Payer: PHP Medicare Advantage |
$688.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,229.14
|
| Rate for Payer: Priority Health Medicare |
$688.35
|
| Rate for Payer: Priority Health SBD |
$1,229.14
|
| Rate for Payer: Priority Health Tiered Network |
$1,229.14
|
| Rate for Payer: Railroad Medicare Medicare |
$688.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,314.57
|
| Rate for Payer: UHC Core |
$1,314.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.35
|
| Rate for Payer: UHC Exchange |
$1,314.57
|
| Rate for Payer: UHC Medicaid |
$449.64
|
| Rate for Payer: UHCCP Medicaid |
$449.64
|
|
|
PR OPTX PERIARTICULAR FRACTURE&/DISLOCATION ELBOW
|
Professional
|
Both
|
$2,005.00
|
|
|
Service Code
|
HCPCS 24586
|
| Min. Negotiated Rate |
$630.91 |
| Max. Negotiated Rate |
$1,928.29 |
| Rate for Payer: Aetna Commercial |
$1,300.66
|
| Rate for Payer: Aetna Medicare |
$1,009.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.72
|
| Rate for Payer: BCBS Complete |
$662.46
|
| Rate for Payer: BCBS MAPPO |
$970.64
|
| Rate for Payer: BCN Commercial |
$1,642.84
|
| Rate for Payer: BCN Medicare Advantage |
$970.64
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cofinity Commercial |
$1,397.72
|
| Rate for Payer: Cofinity Commercial |
$1,300.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.64
|
| Rate for Payer: Healthscope Commercial |
$1,795.68
|
| Rate for Payer: Healthscope Commercial |
$1,553.02
|
| Rate for Payer: Mclaren Medicaid |
$630.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,019.17
|
| Rate for Payer: Meridian Medicaid |
$662.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,067.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,928.29
|
| Rate for Payer: Nomi Health Commercial |
$1,164.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,503.75
|
| Rate for Payer: PACE SWMI |
$970.64
|
| Rate for Payer: PHP Medicare Advantage |
$970.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,756.15
|
| Rate for Payer: Priority Health Medicare |
$970.64
|
| Rate for Payer: Priority Health SBD |
$1,756.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,756.15
|
| Rate for Payer: Railroad Medicare Medicare |
$970.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,905.02
|
| Rate for Payer: UHC Core |
$1,905.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$970.64
|
| Rate for Payer: UHC Exchange |
$1,905.02
|
| Rate for Payer: UHC Medicaid |
$630.91
|
| Rate for Payer: UHCCP Medicaid |
$630.91
|
|
|
PR OPTX PERIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHRP
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 24587
|
| Min. Negotiated Rate |
$637.30 |
| Max. Negotiated Rate |
$1,932.59 |
| Rate for Payer: Aetna Commercial |
$1,314.20
|
| Rate for Payer: Aetna Medicare |
$1,019.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.28
|
| Rate for Payer: BCBS Complete |
$669.16
|
| Rate for Payer: BCBS MAPPO |
$980.75
|
| Rate for Payer: BCN Commercial |
$1,649.81
|
| Rate for Payer: BCN Medicare Advantage |
$980.75
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$1,412.28
|
| Rate for Payer: Cofinity Commercial |
$1,314.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$980.75
|
| Rate for Payer: Healthscope Commercial |
$1,814.39
|
| Rate for Payer: Healthscope Commercial |
$1,569.20
|
| Rate for Payer: Mclaren Medicaid |
$637.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,029.79
|
| Rate for Payer: Meridian Medicaid |
$669.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,078.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.59
|
| Rate for Payer: Nomi Health Commercial |
$1,176.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$980.75
|
| Rate for Payer: PHP Medicare Advantage |
$980.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,763.60
|
| Rate for Payer: Priority Health Medicare |
$980.75
|
| Rate for Payer: Priority Health SBD |
$1,763.60
|
| Rate for Payer: Priority Health Tiered Network |
$1,763.60
|
| Rate for Payer: Railroad Medicare Medicare |
$980.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,906.61
|
| Rate for Payer: UHC Core |
$1,906.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$980.75
|
| Rate for Payer: UHC Exchange |
$1,906.61
|
| Rate for Payer: UHC Medicaid |
$637.30
|
| Rate for Payer: UHCCP Medicaid |
$637.30
|
|
|
PR OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD
|
Professional
|
Both
|
$4,037.00
|
|
|
Service Code
|
HCPCS 27218
|
| Min. Negotiated Rate |
$651.78 |
| Max. Negotiated Rate |
$3,027.75 |
| Rate for Payer: Aetna Commercial |
$1,541.82
|
| Rate for Payer: Aetna Medicare |
$2,018.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.82
|
| Rate for Payer: BCBS Complete |
$684.37
|
| Rate for Payer: BCN Commercial |
$1,727.50
|
| Rate for Payer: Cash Price |
$3,229.60
|
| Rate for Payer: Cash Price |
$3,229.60
|
| Rate for Payer: Mclaren Medicaid |
$651.78
|
| Rate for Payer: Meridian Medicaid |
$684.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,044.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,027.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$651.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,846.64
|
| Rate for Payer: Priority Health SBD |
$1,846.64
|
| Rate for Payer: Priority Health Tiered Network |
$1,846.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,043.65
|
| Rate for Payer: UHC Core |
$2,043.65
|
| Rate for Payer: UHC Exchange |
$2,043.65
|
| Rate for Payer: UHC Medicaid |
$651.78
|
| Rate for Payer: UHCCP Medicaid |
$651.78
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Professional
|
Both
|
$3,288.00
|
|
|
Service Code
|
HCPCS 23615
|
| Min. Negotiated Rate |
$525.26 |
| Max. Negotiated Rate |
$2,466.00 |
| Rate for Payer: Aetna Commercial |
$1,078.45
|
| Rate for Payer: Aetna Medicare |
$837.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.45
|
| Rate for Payer: BCBS Complete |
$551.52
|
| Rate for Payer: BCBS MAPPO |
$804.81
|
| Rate for Payer: BCN Commercial |
$1,345.55
|
| Rate for Payer: BCN Medicare Advantage |
$804.81
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$1,158.93
|
| Rate for Payer: Cofinity Commercial |
$1,078.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.81
|
| Rate for Payer: Healthscope Commercial |
$1,488.90
|
| Rate for Payer: Healthscope Commercial |
$1,287.70
|
| Rate for Payer: Mclaren Medicaid |
$525.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.05
|
| Rate for Payer: Meridian Medicaid |
$551.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$885.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,567.58
|
| Rate for Payer: Nomi Health Commercial |
$965.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.00
|
| Rate for Payer: PACE SWMI |
$804.81
|
| Rate for Payer: PHP Medicare Advantage |
$804.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,438.35
|
| Rate for Payer: Priority Health Medicare |
$804.81
|
| Rate for Payer: Priority Health SBD |
$1,438.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,438.35
|
| Rate for Payer: Railroad Medicare Medicare |
$804.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,543.40
|
| Rate for Payer: UHC Core |
$1,543.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$804.81
|
| Rate for Payer: UHC Exchange |
$1,543.40
|
| Rate for Payer: UHC Medicaid |
$525.26
|
| Rate for Payer: UHCCP Medicaid |
$525.26
|
|
|
PR OPTX PROX HUMRL FX W/INT FIXJ RPR TUBRST RPLCMT
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 23616
|
| Min. Negotiated Rate |
$715.25 |
| Max. Negotiated Rate |
$2,193.61 |
| Rate for Payer: Aetna Commercial |
$1,477.70
|
| Rate for Payer: Aetna Medicare |
$1,146.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,477.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.97
|
| Rate for Payer: BCBS Complete |
$751.01
|
| Rate for Payer: BCBS MAPPO |
$1,102.76
|
| Rate for Payer: BCN Commercial |
$1,866.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,102.76
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,587.97
|
| Rate for Payer: Cofinity Commercial |
$1,477.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,102.76
|
| Rate for Payer: Healthscope Commercial |
$2,040.11
|
| Rate for Payer: Healthscope Commercial |
$1,764.42
|
| Rate for Payer: Mclaren Medicaid |
$715.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,157.90
|
| Rate for Payer: Meridian Medicaid |
$751.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,213.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,193.61
|
| Rate for Payer: Nomi Health Commercial |
$1,323.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.00
|
| Rate for Payer: PACE SWMI |
$1,102.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,102.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,995.70
|
| Rate for Payer: Priority Health Medicare |
$1,102.76
|
| Rate for Payer: Priority Health SBD |
$1,995.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,995.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,102.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,171.54
|
| Rate for Payer: UHC Core |
$2,171.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,102.76
|
| Rate for Payer: UHC Exchange |
$2,171.54
|
| Rate for Payer: UHC Medicaid |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$715.25
|
|
|
PR OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 27226
|
| Min. Negotiated Rate |
$616.85 |
| Max. Negotiated Rate |
$2,393.25 |
| Rate for Payer: Aetna Commercial |
$1,273.83
|
| Rate for Payer: Aetna Medicare |
$988.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.89
|
| Rate for Payer: BCBS Complete |
$647.69
|
| Rate for Payer: BCBS MAPPO |
$950.62
|
| Rate for Payer: BCN Commercial |
$1,594.54
|
| Rate for Payer: BCN Medicare Advantage |
$950.62
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cofinity Commercial |
$1,368.89
|
| Rate for Payer: Cofinity Commercial |
$1,273.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.62
|
| Rate for Payer: Healthscope Commercial |
$1,758.65
|
| Rate for Payer: Healthscope Commercial |
$1,520.99
|
| Rate for Payer: Mclaren Medicaid |
$616.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$998.15
|
| Rate for Payer: Meridian Medicaid |
$647.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,045.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.97
|
| Rate for Payer: Nomi Health Commercial |
$1,140.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,393.25
|
| Rate for Payer: PACE SWMI |
$950.62
|
| Rate for Payer: PHP Medicare Advantage |
$950.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,704.51
|
| Rate for Payer: Priority Health Medicare |
$950.62
|
| Rate for Payer: Priority Health SBD |
$1,704.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,704.51
|
| Rate for Payer: Railroad Medicare Medicare |
$950.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,853.55
|
| Rate for Payer: UHC Core |
$1,853.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$950.62
|
| Rate for Payer: UHC Exchange |
$1,853.55
|
| Rate for Payer: UHC Medicaid |
$616.85
|
| Rate for Payer: UHCCP Medicaid |
$616.85
|
|
|
PR OPTX RADIAL HEAD/NECK FRACTURE PROSTHETIC RPLCMT
|
Professional
|
Both
|
$2,992.00
|
|
|
Service Code
|
HCPCS 24666
|
| Min. Negotiated Rate |
$436.86 |
| Max. Negotiated Rate |
$2,244.00 |
| Rate for Payer: Aetna Commercial |
$894.38
|
| Rate for Payer: Aetna Medicare |
$694.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.13
|
| Rate for Payer: BCBS Complete |
$458.70
|
| Rate for Payer: BCBS MAPPO |
$667.45
|
| Rate for Payer: BCN Commercial |
$1,120.46
|
| Rate for Payer: BCN Medicare Advantage |
$667.45
|
| Rate for Payer: Cash Price |
$2,393.60
|
| Rate for Payer: Cash Price |
$2,393.60
|
| Rate for Payer: Cofinity Commercial |
$961.13
|
| Rate for Payer: Cofinity Commercial |
$894.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.45
|
| Rate for Payer: Healthscope Commercial |
$1,234.78
|
| Rate for Payer: Healthscope Commercial |
$1,067.92
|
| Rate for Payer: Mclaren Medicaid |
$436.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.82
|
| Rate for Payer: Meridian Medicaid |
$458.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$734.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.47
|
| Rate for Payer: Nomi Health Commercial |
$800.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,244.00
|
| Rate for Payer: PACE SWMI |
$667.45
|
| Rate for Payer: PHP Medicare Advantage |
$667.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,197.74
|
| Rate for Payer: Priority Health Medicare |
$667.45
|
| Rate for Payer: Priority Health SBD |
$1,197.74
|
| Rate for Payer: Priority Health Tiered Network |
$1,197.74
|
| Rate for Payer: Railroad Medicare Medicare |
$667.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,277.79
|
| Rate for Payer: UHC Core |
$1,277.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$667.45
|
| Rate for Payer: UHC Exchange |
$1,277.79
|
| Rate for Payer: UHC Medicaid |
$436.86
|
| Rate for Payer: UHCCP Medicaid |
$436.86
|
|
|
PR OPTX RADIAL&ULNAR SHFT FX W/INT FIXJ RADIUS&ULNA
|
Professional
|
Both
|
$2,616.00
|
|
|
Service Code
|
HCPCS 25575
|
| Min. Negotiated Rate |
$539.32 |
| Max. Negotiated Rate |
$1,962.00 |
| Rate for Payer: Aetna Commercial |
$1,105.29
|
| Rate for Payer: Aetna Medicare |
$857.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,187.77
|
| Rate for Payer: BCBS Complete |
$566.29
|
| Rate for Payer: BCBS MAPPO |
$824.84
|
| Rate for Payer: BCN Commercial |
$1,381.40
|
| Rate for Payer: BCN Medicare Advantage |
$824.84
|
| Rate for Payer: Cash Price |
$2,092.80
|
| Rate for Payer: Cash Price |
$2,092.80
|
| Rate for Payer: Cofinity Commercial |
$1,187.77
|
| Rate for Payer: Cofinity Commercial |
$1,105.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$824.84
|
| Rate for Payer: Healthscope Commercial |
$1,525.95
|
| Rate for Payer: Healthscope Commercial |
$1,319.74
|
| Rate for Payer: Mclaren Medicaid |
$539.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.08
|
| Rate for Payer: Meridian Medicaid |
$566.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$907.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,604.75
|
| Rate for Payer: Nomi Health Commercial |
$989.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.00
|
| Rate for Payer: PACE SWMI |
$824.84
|
| Rate for Payer: PHP Medicare Advantage |
$824.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,476.67
|
| Rate for Payer: Priority Health Medicare |
$824.84
|
| Rate for Payer: Priority Health SBD |
$1,476.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,476.67
|
| Rate for Payer: Railroad Medicare Medicare |
$824.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,571.92
|
| Rate for Payer: UHC Core |
$1,571.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$824.84
|
| Rate for Payer: UHC Exchange |
$1,571.92
|
| Rate for Payer: UHC Medicaid |
$539.32
|
| Rate for Payer: UHCCP Medicaid |
$539.32
|
|
|
PR OPTX RADIAL&ULNAR SHFT FX W/INT FIXJ RADIUS/ULNA
|
Professional
|
Both
|
$1,926.00
|
|
|
Service Code
|
HCPCS 25574
|
| Min. Negotiated Rate |
$408.75 |
| Max. Negotiated Rate |
$1,444.50 |
| Rate for Payer: Aetna Commercial |
$834.50
|
| Rate for Payer: Aetna Medicare |
$647.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.77
|
| Rate for Payer: BCBS Complete |
$429.19
|
| Rate for Payer: BCBS MAPPO |
$622.76
|
| Rate for Payer: BCN Commercial |
$1,038.29
|
| Rate for Payer: BCN Medicare Advantage |
$622.76
|
| Rate for Payer: Cash Price |
$1,540.80
|
| Rate for Payer: Cash Price |
$1,540.80
|
| Rate for Payer: Cofinity Commercial |
$896.77
|
| Rate for Payer: Cofinity Commercial |
$834.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.76
|
| Rate for Payer: Healthscope Commercial |
$996.42
|
| Rate for Payer: Healthscope Commercial |
$1,152.11
|
| Rate for Payer: Mclaren Medicaid |
$408.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$653.90
|
| Rate for Payer: Meridian Medicaid |
$429.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$747.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.50
|
| Rate for Payer: PACE SWMI |
$622.76
|
| Rate for Payer: PHP Medicare Advantage |
$622.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,109.90
|
| Rate for Payer: Priority Health Medicare |
$622.76
|
| Rate for Payer: Priority Health SBD |
$1,109.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,109.90
|
| Rate for Payer: Railroad Medicare Medicare |
$622.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.73
|
| Rate for Payer: UHC Core |
$1,171.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$622.76
|
| Rate for Payer: UHC Exchange |
$1,171.73
|
| Rate for Payer: UHC Medicaid |
$408.75
|
| Rate for Payer: UHCCP Medicaid |
$408.75
|
|
|
PR OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT
|
Professional
|
Both
|
$5,882.00
|
|
|
Service Code
|
HCPCS 22318
|
| Min. Negotiated Rate |
$1,036.03 |
| Max. Negotiated Rate |
$4,411.50 |
| Rate for Payer: Aetna Commercial |
$2,160.56
|
| Rate for Payer: Aetna Medicare |
$1,676.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,160.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.80
|
| Rate for Payer: BCBS Complete |
$1,087.83
|
| Rate for Payer: BCBS MAPPO |
$1,612.36
|
| Rate for Payer: BCN Commercial |
$2,765.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,612.36
|
| Rate for Payer: Cash Price |
$4,705.60
|
| Rate for Payer: Cash Price |
$4,705.60
|
| Rate for Payer: Cofinity Commercial |
$2,321.80
|
| Rate for Payer: Cofinity Commercial |
$2,160.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,612.36
|
| Rate for Payer: Healthscope Commercial |
$2,982.87
|
| Rate for Payer: Healthscope Commercial |
$2,579.78
|
| Rate for Payer: Mclaren Medicaid |
$1,036.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,692.98
|
| Rate for Payer: Meridian Medicaid |
$1,087.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,773.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,981.99
|
| Rate for Payer: Nomi Health Commercial |
$1,934.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,411.50
|
| Rate for Payer: PACE SWMI |
$1,612.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,612.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,036.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,690.92
|
| Rate for Payer: Priority Health Medicare |
$1,612.36
|
| Rate for Payer: Priority Health SBD |
$2,690.92
|
| Rate for Payer: Priority Health Tiered Network |
$2,690.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,612.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,883.13
|
| Rate for Payer: UHC Core |
$2,883.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,612.36
|
| Rate for Payer: UHC Exchange |
$2,883.13
|
| Rate for Payer: UHC Medicaid |
$1,036.03
|
| Rate for Payer: UHCCP Medicaid |
$1,036.03
|
|
|
PR OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ
|
Professional
|
Both
|
$11,064.00
|
|
|
Service Code
|
HCPCS 22319
|
| Min. Negotiated Rate |
$1,154.03 |
| Max. Negotiated Rate |
$8,298.00 |
| Rate for Payer: Aetna Commercial |
$2,410.98
|
| Rate for Payer: Aetna Medicare |
$1,871.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,410.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,590.91
|
| Rate for Payer: BCBS Complete |
$1,211.73
|
| Rate for Payer: BCBS MAPPO |
$1,799.24
|
| Rate for Payer: BCN Commercial |
$2,796.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,799.24
|
| Rate for Payer: Cash Price |
$8,851.20
|
| Rate for Payer: Cash Price |
$8,851.20
|
| Rate for Payer: Cofinity Commercial |
$2,590.91
|
| Rate for Payer: Cofinity Commercial |
$2,410.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,799.24
|
| Rate for Payer: Healthscope Commercial |
$3,328.59
|
| Rate for Payer: Healthscope Commercial |
$2,878.78
|
| Rate for Payer: Mclaren Medicaid |
$1,154.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,889.20
|
| Rate for Payer: Meridian Medicaid |
$1,211.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,979.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,315.82
|
| Rate for Payer: Nomi Health Commercial |
$2,159.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,298.00
|
| Rate for Payer: PACE SWMI |
$1,799.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,799.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,154.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,989.55
|
| Rate for Payer: Priority Health Medicare |
$1,799.24
|
| Rate for Payer: Priority Health SBD |
$2,989.55
|
| Rate for Payer: Priority Health Tiered Network |
$2,989.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,799.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,209.69
|
| Rate for Payer: UHC Core |
$3,209.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,799.24
|
| Rate for Payer: UHC Exchange |
$3,209.69
|
| Rate for Payer: UHC Medicaid |
$1,154.03
|
| Rate for Payer: UHCCP Medicaid |
$1,154.03
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR
|
Professional
|
Both
|
$4,189.00
|
|
|
Service Code
|
HCPCS 22326
|
| Min. Negotiated Rate |
$939.76 |
| Max. Negotiated Rate |
$3,141.75 |
| Rate for Payer: Aetna Commercial |
$1,953.84
|
| Rate for Payer: Aetna Medicare |
$1,516.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,953.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,099.65
|
| Rate for Payer: BCBS Complete |
$986.75
|
| Rate for Payer: BCBS MAPPO |
$1,458.09
|
| Rate for Payer: BCN Commercial |
$2,529.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,458.09
|
| Rate for Payer: Cash Price |
$3,351.20
|
| Rate for Payer: Cash Price |
$3,351.20
|
| Rate for Payer: Cofinity Commercial |
$2,099.65
|
| Rate for Payer: Cofinity Commercial |
$1,953.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,458.09
|
| Rate for Payer: Healthscope Commercial |
$2,697.47
|
| Rate for Payer: Healthscope Commercial |
$2,332.94
|
| Rate for Payer: Mclaren Medicaid |
$939.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,530.99
|
| Rate for Payer: Meridian Medicaid |
$986.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,603.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,718.45
|
| Rate for Payer: Nomi Health Commercial |
$1,749.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,141.75
|
| Rate for Payer: PACE SWMI |
$1,458.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,458.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$939.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,460.95
|
| Rate for Payer: Priority Health Medicare |
$1,458.09
|
| Rate for Payer: Priority Health SBD |
$2,460.95
|
| Rate for Payer: Priority Health Tiered Network |
$2,460.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,458.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,634.10
|
| Rate for Payer: UHC Core |
$2,634.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,458.09
|
| Rate for Payer: UHC Exchange |
$2,634.10
|
| Rate for Payer: UHC Medicaid |
$939.76
|
| Rate for Payer: UHCCP Medicaid |
$939.76
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 22328
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$904.50 |
| Rate for Payer: Aetna Commercial |
$341.49
|
| Rate for Payer: Aetna Medicare |
$265.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.97
|
| Rate for Payer: BCBS Complete |
$169.08
|
| Rate for Payer: BCBS MAPPO |
$254.84
|
| Rate for Payer: BCN Commercial |
$464.46
|
| Rate for Payer: BCN Medicare Advantage |
$254.84
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$366.97
|
| Rate for Payer: Cofinity Commercial |
$341.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.84
|
| Rate for Payer: Healthscope Commercial |
$471.45
|
| Rate for Payer: Healthscope Commercial |
$407.74
|
| Rate for Payer: Mclaren Medicaid |
$161.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.58
|
| Rate for Payer: Meridian Medicaid |
$169.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$280.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.00
|
| Rate for Payer: Nomi Health Commercial |
$305.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$904.50
|
| Rate for Payer: PACE SWMI |
$254.84
|
| Rate for Payer: PHP Medicare Advantage |
$254.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$451.94
|
| Rate for Payer: Priority Health Medicare |
$254.84
|
| Rate for Payer: Priority Health SBD |
$451.94
|
| Rate for Payer: Priority Health Tiered Network |
$451.94
|
| Rate for Payer: Railroad Medicare Medicare |
$254.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$501.21
|
| Rate for Payer: UHC Core |
$501.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$254.84
|
| Rate for Payer: UHC Exchange |
$501.21
|
| Rate for Payer: UHC Medicaid |
$161.03
|
| Rate for Payer: UHCCP Medicaid |
$161.03
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM
|
Professional
|
Both
|
$3,853.00
|
|
|
Service Code
|
HCPCS 22325
|
| Min. Negotiated Rate |
$921.01 |
| Max. Negotiated Rate |
$2,889.75 |
| Rate for Payer: Aetna Commercial |
$1,908.09
|
| Rate for Payer: Aetna Medicare |
$1,480.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,908.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,050.49
|
| Rate for Payer: BCBS Complete |
$967.06
|
| Rate for Payer: BCBS MAPPO |
$1,423.95
|
| Rate for Payer: BCN Commercial |
$2,259.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.95
|
| Rate for Payer: Cash Price |
$3,082.40
|
| Rate for Payer: Cash Price |
$3,082.40
|
| Rate for Payer: Cofinity Commercial |
$2,050.49
|
| Rate for Payer: Cofinity Commercial |
$1,908.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.95
|
| Rate for Payer: Healthscope Commercial |
$2,634.31
|
| Rate for Payer: Healthscope Commercial |
$2,278.32
|
| Rate for Payer: Mclaren Medicaid |
$921.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,495.15
|
| Rate for Payer: Meridian Medicaid |
$967.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,566.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,645.26
|
| Rate for Payer: Nomi Health Commercial |
$1,708.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,889.75
|
| Rate for Payer: PACE SWMI |
$1,423.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,415.17
|
| Rate for Payer: Priority Health Medicare |
$1,423.95
|
| Rate for Payer: Priority Health SBD |
$2,415.17
|
| Rate for Payer: Priority Health Tiered Network |
$2,415.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,549.90
|
| Rate for Payer: UHC Core |
$2,549.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,423.95
|
| Rate for Payer: UHC Exchange |
$2,549.90
|
| Rate for Payer: UHC Medicaid |
$921.01
|
| Rate for Payer: UHCCP Medicaid |
$921.01
|
|
