|
PR CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 61050
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$519.32 |
| Rate for Payer: Aetna Commercial |
$105.04
|
| Rate for Payer: Aetna Medicare |
$81.53
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$78.39
|
| Rate for Payer: BCBS Trust/PPO |
$519.32
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: BCN Medicare Advantage |
$78.39
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$112.88
|
| Rate for Payer: Cofinity Commercial |
$105.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.39
|
| Rate for Payer: Mclaren Medicaid |
$50.48
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.31
|
| Rate for Payer: PACE SWMI |
$78.39
|
| Rate for Payer: PHP Medicare Advantage |
$78.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.19
|
| Rate for Payer: Priority Health Medicare |
$78.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.39
|
| Rate for Payer: UHC Medicare Advantage |
$80.74
|
|
|
PR CLAVICULECTOMY PARTIAL
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 23120
|
| Min. Negotiated Rate |
$34.34 |
| Max. Negotiated Rate |
$956.69 |
| Rate for Payer: Aetna Commercial |
$776.46
|
| Rate for Payer: Aetna Medicare |
$602.63
|
| Rate for Payer: BCBS Complete |
$402.57
|
| Rate for Payer: BCBS MAPPO |
$579.45
|
| Rate for Payer: BCBS Trust/PPO |
$34.34
|
| Rate for Payer: BCN Commercial |
$956.69
|
| Rate for Payer: BCN Medicare Advantage |
$579.45
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$834.41
|
| Rate for Payer: Cofinity Commercial |
$776.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.45
|
| Rate for Payer: Mclaren Medicaid |
$383.40
|
| Rate for Payer: Meridian Medicaid |
$402.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$608.42
|
| Rate for Payer: PACE SWMI |
$579.45
|
| Rate for Payer: PHP Medicare Advantage |
$579.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$907.93
|
| Rate for Payer: Priority Health Medicare |
$579.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$907.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.45
|
| Rate for Payer: UHC Medicare Advantage |
$596.83
|
|
|
PR CLAVICULECTOMY TOTAL
|
Professional
|
Both
|
$1,568.00
|
|
|
Service Code
|
HCPCS 23125
|
| Min. Negotiated Rate |
$44.38 |
| Max. Negotiated Rate |
$1,097.60 |
| Rate for Payer: Aetna Commercial |
$940.00
|
| Rate for Payer: Aetna Medicare |
$729.55
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS MAPPO |
$701.49
|
| Rate for Payer: BCBS Trust/PPO |
$44.38
|
| Rate for Payer: BCN Commercial |
$1,047.24
|
| Rate for Payer: BCN Medicare Advantage |
$701.49
|
| Rate for Payer: Cash Price |
$1,254.40
|
| Rate for Payer: Cash Price |
$1,254.40
|
| Rate for Payer: Cofinity Commercial |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,010.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.49
|
| Rate for Payer: Mclaren Medicaid |
$460.72
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$736.56
|
| Rate for Payer: PACE SWMI |
$701.49
|
| Rate for Payer: PHP Medicare Advantage |
$701.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,094.32
|
| Rate for Payer: Priority Health Medicare |
$701.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$701.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$701.49
|
| Rate for Payer: UHC Medicare Advantage |
$722.53
|
|
|
PR CLOSED RX PELVIC RING FX/SUBLUX
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 27193
|
| Min. Negotiated Rate |
$380.40 |
| Max. Negotiated Rate |
$665.70 |
| Rate for Payer: BCBS Complete |
$380.40
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.70
|
|
|
PR CLOSED RX PELV RING FX/SUBLUX,MANIP
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27194
|
| Min. Negotiated Rate |
$761.20 |
| Max. Negotiated Rate |
$1,332.10 |
| Rate for Payer: BCBS Complete |
$761.20
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.10
|
|
|
PR CLOSED RX RIB FRACTURE
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 21800
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$154.00 |
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
|
|
PR CLOSED TREATMENT COCCYGEAL FRACTURE
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 27200
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$1,904.52 |
| Rate for Payer: Aetna Commercial |
$249.23
|
| Rate for Payer: Aetna Medicare |
$193.43
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS MAPPO |
$185.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.52
|
| Rate for Payer: BCN Commercial |
$279.53
|
| Rate for Payer: BCN Medicare Advantage |
$185.99
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cofinity Commercial |
$267.83
|
| Rate for Payer: Cofinity Commercial |
$249.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.99
|
| Rate for Payer: Mclaren Medicaid |
$127.37
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.29
|
| Rate for Payer: PACE SWMI |
$185.99
|
| Rate for Payer: PHP Medicare Advantage |
$185.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.65
|
| Rate for Payer: Priority Health Medicare |
$185.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.99
|
| Rate for Payer: UHC Medicare Advantage |
$191.57
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 27768
|
| Min. Negotiated Rate |
$295.64 |
| Max. Negotiated Rate |
$3,241.12 |
| Rate for Payer: Aetna Commercial |
$593.57
|
| Rate for Payer: Aetna Medicare |
$460.68
|
| Rate for Payer: BCBS Complete |
$310.42
|
| Rate for Payer: BCBS MAPPO |
$442.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,241.12
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$442.96
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$637.86
|
| Rate for Payer: Cofinity Commercial |
$593.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.96
|
| Rate for Payer: Mclaren Medicaid |
$295.64
|
| Rate for Payer: Meridian Medicaid |
$310.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$465.11
|
| Rate for Payer: PACE SWMI |
$442.96
|
| Rate for Payer: PHP Medicare Advantage |
$442.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$697.55
|
| Rate for Payer: Priority Health Medicare |
$442.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$697.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$442.96
|
| Rate for Payer: UHC Medicare Advantage |
$456.25
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ
|
Professional
|
Both
|
$713.00
|
|
|
Service Code
|
HCPCS 27767
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$563.09 |
| Rate for Payer: Aetna Commercial |
$383.33
|
| Rate for Payer: Aetna Medicare |
$297.51
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS MAPPO |
$286.07
|
| Rate for Payer: BCBS Trust/PPO |
$563.09
|
| Rate for Payer: BCN Commercial |
$438.35
|
| Rate for Payer: BCN Medicare Advantage |
$286.07
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cofinity Commercial |
$411.94
|
| Rate for Payer: Cofinity Commercial |
$383.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.07
|
| Rate for Payer: Mclaren Medicaid |
$192.98
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$300.37
|
| Rate for Payer: PACE SWMI |
$286.07
|
| Rate for Payer: PHP Medicare Advantage |
$286.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$455.49
|
| Rate for Payer: Priority Health Medicare |
$286.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$455.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.07
|
| Rate for Payer: UHC Medicare Advantage |
$294.65
|
|
|
PR CLOSED TREATMENT SESAMOID FRACTURE
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 28530
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$1,243.09 |
| Rate for Payer: Aetna Commercial |
$131.07
|
| Rate for Payer: Aetna Medicare |
$101.72
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$97.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,243.09
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$97.81
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cofinity Commercial |
$140.85
|
| Rate for Payer: Cofinity Commercial |
$131.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.81
|
| Rate for Payer: Mclaren Medicaid |
$67.31
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.70
|
| Rate for Payer: PACE SWMI |
$97.81
|
| Rate for Payer: PHP Medicare Advantage |
$97.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.24
|
| Rate for Payer: Priority Health Medicare |
$97.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.81
|
| Rate for Payer: UHC Medicare Advantage |
$100.74
|
|
|
PR CLOSED TREATMENT STERNUM FRACTURE
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 21820
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$230.81 |
| Rate for Payer: Aetna Commercial |
$194.50
|
| Rate for Payer: Aetna Medicare |
$150.96
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS MAPPO |
$145.15
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$224.30
|
| Rate for Payer: BCN Medicare Advantage |
$145.15
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$209.02
|
| Rate for Payer: Cofinity Commercial |
$194.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.15
|
| Rate for Payer: Mclaren Medicaid |
$98.19
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.41
|
| Rate for Payer: PACE SWMI |
$145.15
|
| Rate for Payer: PHP Medicare Advantage |
$145.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$230.81
|
| Rate for Payer: Priority Health Medicare |
$145.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.15
|
| Rate for Payer: UHC Medicare Advantage |
$149.50
|
|
|
PR CLOSED TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 25650
|
| Min. Negotiated Rate |
$204.05 |
| Max. Negotiated Rate |
$1,117.88 |
| Rate for Payer: Aetna Commercial |
$409.18
|
| Rate for Payer: Aetna Medicare |
$317.57
|
| Rate for Payer: BCBS Complete |
$214.25
|
| Rate for Payer: BCBS MAPPO |
$305.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.88
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: BCN Medicare Advantage |
$305.36
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$439.72
|
| Rate for Payer: Cofinity Commercial |
$409.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.36
|
| Rate for Payer: Mclaren Medicaid |
$204.05
|
| Rate for Payer: Meridian Medicaid |
$214.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$320.63
|
| Rate for Payer: PACE SWMI |
$305.36
|
| Rate for Payer: PHP Medicare Advantage |
$305.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$571.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.07
|
| Rate for Payer: Priority Health Medicare |
$305.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.36
|
| Rate for Payer: UHC Medicare Advantage |
$314.52
|
|
|
PR CLOSED TREAT SPINE PROCESS FX
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 22305
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$290.50 |
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.50
|
|
|
PR CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 27840
|
| Min. Negotiated Rate |
$255.60 |
| Max. Negotiated Rate |
$1,414.69 |
| Rate for Payer: Aetna Commercial |
$515.36
|
| Rate for Payer: Aetna Medicare |
$399.98
|
| Rate for Payer: BCBS Complete |
$268.38
|
| Rate for Payer: BCBS MAPPO |
$384.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,414.69
|
| Rate for Payer: BCN Commercial |
$577.62
|
| Rate for Payer: BCN Medicare Advantage |
$384.60
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$553.82
|
| Rate for Payer: Cofinity Commercial |
$515.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.60
|
| Rate for Payer: Mclaren Medicaid |
$255.60
|
| Rate for Payer: Meridian Medicaid |
$268.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.83
|
| Rate for Payer: PACE SWMI |
$384.60
|
| Rate for Payer: PHP Medicare Advantage |
$384.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.59
|
| Rate for Payer: Priority Health Medicare |
$384.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$603.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.60
|
| Rate for Payer: UHC Medicare Advantage |
$396.14
|
|
|
PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 27810
|
| Min. Negotiated Rate |
$282.65 |
| Max. Negotiated Rate |
$2,867.08 |
| Rate for Payer: Aetna Commercial |
$570.12
|
| Rate for Payer: Aetna Medicare |
$442.48
|
| Rate for Payer: BCBS Complete |
$296.78
|
| Rate for Payer: BCBS MAPPO |
$425.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,867.08
|
| Rate for Payer: BCN Commercial |
$710.05
|
| Rate for Payer: BCN Medicare Advantage |
$425.46
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cofinity Commercial |
$570.12
|
| Rate for Payer: Cofinity Commercial |
$612.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.46
|
| Rate for Payer: Mclaren Medicaid |
$282.65
|
| Rate for Payer: Meridian Medicaid |
$296.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$446.73
|
| Rate for Payer: PACE SWMI |
$425.46
|
| Rate for Payer: PHP Medicare Advantage |
$425.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$667.43
|
| Rate for Payer: Priority Health Medicare |
$425.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$667.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.46
|
| Rate for Payer: UHC Medicare Advantage |
$438.22
|
|
|
PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
HCPCS 27808
|
| Min. Negotiated Rate |
$203.84 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna Commercial |
$405.30
|
| Rate for Payer: Aetna Medicare |
$314.56
|
| Rate for Payer: BCBS Complete |
$214.03
|
| Rate for Payer: BCBS MAPPO |
$302.46
|
| Rate for Payer: BCBS Trust/PPO |
$556.11
|
| Rate for Payer: BCN Commercial |
$503.83
|
| Rate for Payer: BCN Medicare Advantage |
$302.46
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$435.54
|
| Rate for Payer: Cofinity Commercial |
$405.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.46
|
| Rate for Payer: Mclaren Medicaid |
$203.84
|
| Rate for Payer: Meridian Medicaid |
$214.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$317.58
|
| Rate for Payer: PACE SWMI |
$302.46
|
| Rate for Payer: PHP Medicare Advantage |
$302.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$480.01
|
| Rate for Payer: Priority Health Medicare |
$302.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.46
|
| Rate for Payer: UHC Medicare Advantage |
$311.53
|
|
|
PR CLOSED TX CALCANEAL FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,141.00
|
|
|
Service Code
|
HCPCS 28405
|
| Min. Negotiated Rate |
$267.53 |
| Max. Negotiated Rate |
$1,513.05 |
| Rate for Payer: Aetna Commercial |
$537.98
|
| Rate for Payer: Aetna Medicare |
$417.54
|
| Rate for Payer: BCBS Complete |
$280.91
|
| Rate for Payer: BCBS MAPPO |
$401.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.05
|
| Rate for Payer: BCN Commercial |
$673.40
|
| Rate for Payer: BCN Medicare Advantage |
$401.48
|
| Rate for Payer: Cash Price |
$912.80
|
| Rate for Payer: Cash Price |
$912.80
|
| Rate for Payer: Cofinity Commercial |
$537.98
|
| Rate for Payer: Cofinity Commercial |
$578.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.48
|
| Rate for Payer: Mclaren Medicaid |
$267.53
|
| Rate for Payer: Meridian Medicaid |
$280.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.55
|
| Rate for Payer: PACE SWMI |
$401.48
|
| Rate for Payer: PHP Medicare Advantage |
$401.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.67
|
| Rate for Payer: Priority Health Medicare |
$401.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.48
|
| Rate for Payer: UHC Medicare Advantage |
$413.52
|
|
|
PR CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$704.00
|
|
|
Service Code
|
HCPCS 28400
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,304.90 |
| Rate for Payer: Aetna Commercial |
$302.02
|
| Rate for Payer: Aetna Medicare |
$234.41
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS MAPPO |
$225.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.90
|
| Rate for Payer: BCN Commercial |
$368.95
|
| Rate for Payer: BCN Medicare Advantage |
$225.39
|
| Rate for Payer: Cash Price |
$563.20
|
| Rate for Payer: Cash Price |
$563.20
|
| Rate for Payer: Cofinity Commercial |
$324.56
|
| Rate for Payer: Cofinity Commercial |
$302.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.39
|
| Rate for Payer: Mclaren Medicaid |
$152.30
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.66
|
| Rate for Payer: PACE SWMI |
$225.39
|
| Rate for Payer: PHP Medicare Advantage |
$225.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.97
|
| Rate for Payer: Priority Health Medicare |
$225.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$357.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.39
|
| Rate for Payer: UHC Medicare Advantage |
$232.15
|
|
|
PR CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 25624
|
| Min. Negotiated Rate |
$295.22 |
| Max. Negotiated Rate |
$939.26 |
| Rate for Payer: Aetna Commercial |
$590.73
|
| Rate for Payer: Aetna Medicare |
$458.47
|
| Rate for Payer: BCBS Complete |
$309.98
|
| Rate for Payer: BCBS MAPPO |
$440.84
|
| Rate for Payer: BCBS Trust/PPO |
$939.26
|
| Rate for Payer: BCN Commercial |
$735.95
|
| Rate for Payer: BCN Medicare Advantage |
$440.84
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cofinity Commercial |
$590.73
|
| Rate for Payer: Cofinity Commercial |
$634.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.84
|
| Rate for Payer: Mclaren Medicaid |
$295.22
|
| Rate for Payer: Meridian Medicaid |
$309.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.88
|
| Rate for Payer: PACE SWMI |
$440.84
|
| Rate for Payer: PHP Medicare Advantage |
$440.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.52
|
| Rate for Payer: Priority Health Medicare |
$440.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$696.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.84
|
| Rate for Payer: UHC Medicare Advantage |
$454.07
|
|
|
PR CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ
|
Professional
|
Both
|
$778.00
|
|
|
Service Code
|
HCPCS 25622
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$939.26 |
| Rate for Payer: Aetna Commercial |
$378.04
|
| Rate for Payer: Aetna Medicare |
$293.40
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$282.12
|
| Rate for Payer: BCBS Trust/PPO |
$939.26
|
| Rate for Payer: BCN Commercial |
$373.03
|
| Rate for Payer: BCN Medicare Advantage |
$282.12
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$378.04
|
| Rate for Payer: Cofinity Commercial |
$406.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.12
|
| Rate for Payer: Mclaren Medicaid |
$190.00
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$296.23
|
| Rate for Payer: PACE SWMI |
$282.12
|
| Rate for Payer: PHP Medicare Advantage |
$282.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.84
|
| Rate for Payer: Priority Health Medicare |
$282.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$447.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.12
|
| Rate for Payer: UHC Medicare Advantage |
$290.58
|
|
|
PR CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 25675
|
| Min. Negotiated Rate |
$273.71 |
| Max. Negotiated Rate |
$1,123.17 |
| Rate for Payer: Aetna Commercial |
$549.57
|
| Rate for Payer: Aetna Medicare |
$426.54
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$410.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,123.17
|
| Rate for Payer: BCN Commercial |
$685.13
|
| Rate for Payer: BCN Medicare Advantage |
$410.13
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cofinity Commercial |
$590.59
|
| Rate for Payer: Cofinity Commercial |
$549.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.13
|
| Rate for Payer: Mclaren Medicaid |
$273.71
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$430.64
|
| Rate for Payer: PACE SWMI |
$410.13
|
| Rate for Payer: PHP Medicare Advantage |
$410.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$644.96
|
| Rate for Payer: Priority Health Medicare |
$410.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$644.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.13
|
| Rate for Payer: UHC Medicare Advantage |
$422.43
|
|
|
PR CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 27268
|
| Min. Negotiated Rate |
$354.86 |
| Max. Negotiated Rate |
$3,411.76 |
| Rate for Payer: Aetna Commercial |
$721.71
|
| Rate for Payer: Aetna Medicare |
$560.13
|
| Rate for Payer: BCBS Complete |
$372.60
|
| Rate for Payer: BCBS MAPPO |
$538.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,411.76
|
| Rate for Payer: BCN Commercial |
$805.83
|
| Rate for Payer: BCN Medicare Advantage |
$538.59
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$775.57
|
| Rate for Payer: Cofinity Commercial |
$721.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.59
|
| Rate for Payer: Mclaren Medicaid |
$354.86
|
| Rate for Payer: Meridian Medicaid |
$372.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$565.52
|
| Rate for Payer: PACE SWMI |
$538.59
|
| Rate for Payer: PHP Medicare Advantage |
$538.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$842.06
|
| Rate for Payer: Priority Health Medicare |
$538.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.59
|
| Rate for Payer: UHC Medicare Advantage |
$554.75
|
|
|
PR CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION
|
Professional
|
Both
|
$1,257.00
|
|
|
Service Code
|
HCPCS 27500
|
| Min. Negotiated Rate |
$313.96 |
| Max. Negotiated Rate |
$2,223.09 |
| Rate for Payer: Aetna Commercial |
$639.69
|
| Rate for Payer: Aetna Medicare |
$496.48
|
| Rate for Payer: BCBS Complete |
$329.66
|
| Rate for Payer: BCBS MAPPO |
$477.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.09
|
| Rate for Payer: BCN Commercial |
$778.46
|
| Rate for Payer: BCN Medicare Advantage |
$477.38
|
| Rate for Payer: Cash Price |
$1,005.60
|
| Rate for Payer: Cash Price |
$1,005.60
|
| Rate for Payer: Cofinity Commercial |
$687.43
|
| Rate for Payer: Cofinity Commercial |
$639.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.38
|
| Rate for Payer: Mclaren Medicaid |
$313.96
|
| Rate for Payer: Meridian Medicaid |
$329.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$501.25
|
| Rate for Payer: PACE SWMI |
$477.38
|
| Rate for Payer: PHP Medicare Advantage |
$477.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$746.57
|
| Rate for Payer: Priority Health Medicare |
$477.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.38
|
| Rate for Payer: UHC Medicare Advantage |
$491.70
|
|
|
PR CLOSED TX KNEE DISLOCATION W/ANESTHESIA
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 27552
|
| Min. Negotiated Rate |
$413.43 |
| Max. Negotiated Rate |
$1,159.09 |
| Rate for Payer: Aetna Commercial |
$837.79
|
| Rate for Payer: Aetna Medicare |
$650.23
|
| Rate for Payer: BCBS Complete |
$434.10
|
| Rate for Payer: BCBS MAPPO |
$625.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.09
|
| Rate for Payer: BCN Commercial |
$936.30
|
| Rate for Payer: BCN Medicare Advantage |
$625.22
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$837.79
|
| Rate for Payer: Cofinity Commercial |
$900.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.22
|
| Rate for Payer: Mclaren Medicaid |
$413.43
|
| Rate for Payer: Meridian Medicaid |
$434.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.48
|
| Rate for Payer: PACE SWMI |
$625.22
|
| Rate for Payer: PHP Medicare Advantage |
$625.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$978.41
|
| Rate for Payer: Priority Health Medicare |
$625.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$978.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.22
|
| Rate for Payer: UHC Medicare Advantage |
$643.98
|
|
|
PR CLOSED TX KNEE DISLOCATION W/O ANESTHESIA
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 27550
|
| Min. Negotiated Rate |
$309.06 |
| Max. Negotiated Rate |
$768.20 |
| Rate for Payer: Aetna Commercial |
$629.60
|
| Rate for Payer: Aetna Medicare |
$488.64
|
| Rate for Payer: BCBS Complete |
$324.51
|
| Rate for Payer: BCBS MAPPO |
$469.85
|
| Rate for Payer: BCBS Trust/PPO |
$710.04
|
| Rate for Payer: BCN Commercial |
$768.20
|
| Rate for Payer: BCN Medicare Advantage |
$469.85
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$676.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$469.85
|
| Rate for Payer: Mclaren Medicaid |
$309.06
|
| Rate for Payer: Meridian Medicaid |
$324.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$493.34
|
| Rate for Payer: PACE SWMI |
$469.85
|
| Rate for Payer: PHP Medicare Advantage |
$469.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$579.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$736.35
|
| Rate for Payer: Priority Health Medicare |
$469.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$736.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$469.85
|
| Rate for Payer: UHC Medicare Advantage |
$483.95
|
|
