|
PR CLOSED TX LUNATE DISLOCATION W/MANIPULATION
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 25690
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$2,554.86 |
| Rate for Payer: Aetna Commercial |
$651.76
|
| Rate for Payer: Aetna Medicare |
$505.85
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$486.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,554.86
|
| Rate for Payer: BCN Commercial |
$732.53
|
| Rate for Payer: BCN Medicare Advantage |
$486.39
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$651.76
|
| Rate for Payer: Cofinity Commercial |
$700.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.39
|
| Rate for Payer: Mclaren Medicaid |
$324.19
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$510.71
|
| Rate for Payer: PACE SWMI |
$486.39
|
| Rate for Payer: PHP Medicare Advantage |
$486.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.47
|
| Rate for Payer: Priority Health Medicare |
$486.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$765.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.39
|
| Rate for Payer: UHC Medicare Advantage |
$500.98
|
|
|
PR CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,183.00
|
|
|
Service Code
|
HCPCS 21451
|
| Min. Negotiated Rate |
$409.39 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$825.27
|
| Rate for Payer: Aetna Medicare |
$640.50
|
| Rate for Payer: BCBS Complete |
$429.86
|
| Rate for Payer: BCBS MAPPO |
$615.87
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,130.31
|
| Rate for Payer: BCN Medicare Advantage |
$615.87
|
| Rate for Payer: Cash Price |
$946.40
|
| Rate for Payer: Cash Price |
$946.40
|
| Rate for Payer: Cofinity Commercial |
$886.85
|
| Rate for Payer: Cofinity Commercial |
$825.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.87
|
| Rate for Payer: Mclaren Medicaid |
$409.39
|
| Rate for Payer: Meridian Medicaid |
$429.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.66
|
| Rate for Payer: PACE SWMI |
$615.87
|
| Rate for Payer: PHP Medicare Advantage |
$615.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$985.55
|
| Rate for Payer: Priority Health Medicare |
$615.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$985.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$615.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.87
|
| Rate for Payer: UHC Medicare Advantage |
$634.35
|
|
|
PR CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 21450
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$10,328.77 |
| Rate for Payer: Aetna Commercial |
$615.78
|
| Rate for Payer: Aetna Medicare |
$477.92
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$459.54
|
| Rate for Payer: BCBS Trust/PPO |
$10,328.77
|
| Rate for Payer: BCN Commercial |
$869.84
|
| Rate for Payer: BCN Medicare Advantage |
$459.54
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$661.74
|
| Rate for Payer: Cofinity Commercial |
$615.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.54
|
| Rate for Payer: Mclaren Medicaid |
$307.15
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$482.52
|
| Rate for Payer: PACE SWMI |
$459.54
|
| Rate for Payer: PHP Medicare Advantage |
$459.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.40
|
| Rate for Payer: Priority Health Medicare |
$459.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.54
|
| Rate for Payer: UHC Medicare Advantage |
$473.33
|
|
|
PR CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 21453
|
| Min. Negotiated Rate |
$594.91 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$1,193.44
|
| Rate for Payer: Aetna Medicare |
$926.26
|
| Rate for Payer: BCBS Complete |
$624.66
|
| Rate for Payer: BCBS MAPPO |
$890.63
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,610.19
|
| Rate for Payer: BCN Medicare Advantage |
$890.63
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$1,193.44
|
| Rate for Payer: Cofinity Commercial |
$1,282.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.63
|
| Rate for Payer: Mclaren Medicaid |
$594.91
|
| Rate for Payer: Meridian Medicaid |
$624.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$935.16
|
| Rate for Payer: PACE SWMI |
$890.63
|
| Rate for Payer: PHP Medicare Advantage |
$890.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$971.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.87
|
| Rate for Payer: Priority Health Medicare |
$890.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,431.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.63
|
| Rate for Payer: UHC Medicare Advantage |
$917.35
|
|
|
PR CLOSED TX METATARSAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$528.00
|
|
|
Service Code
|
HCPCS 28470
|
| Min. Negotiated Rate |
$135.89 |
| Max. Negotiated Rate |
$915.02 |
| Rate for Payer: Aetna Commercial |
$267.95
|
| Rate for Payer: Aetna Medicare |
$207.96
|
| Rate for Payer: BCBS Complete |
$142.68
|
| Rate for Payer: BCBS MAPPO |
$199.96
|
| Rate for Payer: BCBS Trust/PPO |
$915.02
|
| Rate for Payer: BCN Commercial |
$260.33
|
| Rate for Payer: BCN Medicare Advantage |
$199.96
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$287.94
|
| Rate for Payer: Cofinity Commercial |
$267.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.96
|
| Rate for Payer: Mclaren Medicaid |
$135.89
|
| Rate for Payer: Meridian Medicaid |
$142.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$209.96
|
| Rate for Payer: PACE SWMI |
$199.96
|
| Rate for Payer: PHP Medicare Advantage |
$199.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$369.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.14
|
| Rate for Payer: Priority Health Medicare |
$199.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.96
|
| Rate for Payer: UHC Medicare Advantage |
$205.96
|
|
|
PR CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 24620
|
| Min. Negotiated Rate |
$385.32 |
| Max. Negotiated Rate |
$1,125.60 |
| Rate for Payer: Aetna Commercial |
$778.45
|
| Rate for Payer: Aetna Medicare |
$604.17
|
| Rate for Payer: BCBS Complete |
$404.59
|
| Rate for Payer: BCBS MAPPO |
$580.93
|
| Rate for Payer: BCBS Trust/PPO |
$793.51
|
| Rate for Payer: BCN Commercial |
$872.29
|
| Rate for Payer: BCN Medicare Advantage |
$580.93
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$836.54
|
| Rate for Payer: Cofinity Commercial |
$778.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.93
|
| Rate for Payer: Mclaren Medicaid |
$385.32
|
| Rate for Payer: Meridian Medicaid |
$404.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$609.98
|
| Rate for Payer: PACE SWMI |
$580.93
|
| Rate for Payer: PHP Medicare Advantage |
$580.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$911.52
|
| Rate for Payer: Priority Health Medicare |
$580.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$911.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$580.93
|
| Rate for Payer: UHC Medicare Advantage |
$598.36
|
|
|
PR CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 21315
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$2,948.86 |
| Rate for Payer: Aetna Commercial |
$79.61
|
| Rate for Payer: Aetna Medicare |
$61.79
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,948.86
|
| Rate for Payer: BCN Commercial |
$222.83
|
| Rate for Payer: BCN Medicare Advantage |
$59.41
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$85.55
|
| Rate for Payer: Cofinity Commercial |
$79.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.41
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.38
|
| Rate for Payer: PACE SWMI |
$59.41
|
| Rate for Payer: PHP Medicare Advantage |
$59.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.92
|
| Rate for Payer: Priority Health Medicare |
$59.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.41
|
| Rate for Payer: UHC Medicare Advantage |
$61.19
|
|
|
PR CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 21320
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$320.57 |
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna Medicare |
$97.19
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$93.45
|
| Rate for Payer: BCBS Trust/PPO |
$140.42
|
| Rate for Payer: BCN Commercial |
$320.57
|
| Rate for Payer: BCN Medicare Advantage |
$93.45
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$134.57
|
| Rate for Payer: Cofinity Commercial |
$125.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.45
|
| Rate for Payer: Mclaren Medicaid |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.12
|
| Rate for Payer: PACE SWMI |
$93.45
|
| Rate for Payer: PHP Medicare Advantage |
$93.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.51
|
| Rate for Payer: Priority Health Medicare |
$93.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.45
|
| Rate for Payer: UHC Medicare Advantage |
$96.25
|
|
|
PR CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION
|
Professional
|
Both
|
$645.00
|
|
|
Service Code
|
HCPCS 21337
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$616.71 |
| Rate for Payer: Aetna Commercial |
$391.90
|
| Rate for Payer: Aetna Medicare |
$304.16
|
| Rate for Payer: BCBS Complete |
$204.41
|
| Rate for Payer: BCBS MAPPO |
$292.46
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$616.71
|
| Rate for Payer: BCN Medicare Advantage |
$292.46
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cofinity Commercial |
$421.14
|
| Rate for Payer: Cofinity Commercial |
$391.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.46
|
| Rate for Payer: Mclaren Medicaid |
$194.68
|
| Rate for Payer: Meridian Medicaid |
$204.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$307.08
|
| Rate for Payer: PACE SWMI |
$292.46
|
| Rate for Payer: PHP Medicare Advantage |
$292.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.14
|
| Rate for Payer: Priority Health Medicare |
$292.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.46
|
| Rate for Payer: UHC Medicare Advantage |
$301.23
|
|
|
PR CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT
|
Professional
|
Both
|
$1,302.00
|
|
|
Service Code
|
HCPCS 21421
|
| Min. Negotiated Rate |
$348.26 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$703.23
|
| Rate for Payer: Aetna Medicare |
$545.79
|
| Rate for Payer: BCBS Complete |
$365.67
|
| Rate for Payer: BCBS MAPPO |
$524.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$943.64
|
| Rate for Payer: BCN Medicare Advantage |
$524.80
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cofinity Commercial |
$755.71
|
| Rate for Payer: Cofinity Commercial |
$703.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.80
|
| Rate for Payer: Mclaren Medicaid |
$348.26
|
| Rate for Payer: Meridian Medicaid |
$365.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.04
|
| Rate for Payer: PACE SWMI |
$524.80
|
| Rate for Payer: PHP Medicare Advantage |
$524.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$911.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.87
|
| Rate for Payer: Priority Health Medicare |
$524.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$832.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.80
|
| Rate for Payer: UHC Medicare Advantage |
$540.54
|
|
|
PR CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 27560
|
| Min. Negotiated Rate |
$226.63 |
| Max. Negotiated Rate |
$2,121.65 |
| Rate for Payer: Aetna Commercial |
$456.82
|
| Rate for Payer: Aetna Medicare |
$354.55
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: BCBS MAPPO |
$340.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.65
|
| Rate for Payer: BCN Commercial |
$561.98
|
| Rate for Payer: BCN Medicare Advantage |
$340.91
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$456.82
|
| Rate for Payer: Cofinity Commercial |
$490.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.91
|
| Rate for Payer: Mclaren Medicaid |
$226.63
|
| Rate for Payer: Meridian Medicaid |
$237.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$357.96
|
| Rate for Payer: PACE SWMI |
$340.91
|
| Rate for Payer: PHP Medicare Advantage |
$340.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.69
|
| Rate for Payer: Priority Health Medicare |
$340.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.91
|
| Rate for Payer: UHC Medicare Advantage |
$351.14
|
|
|
PR CLOSED TX PATELLAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS 27520
|
| Min. Negotiated Rate |
$49.13 |
| Max. Negotiated Rate |
$490.14 |
| Rate for Payer: Aetna Commercial |
$400.18
|
| Rate for Payer: Aetna Medicare |
$310.59
|
| Rate for Payer: BCBS Complete |
$210.68
|
| Rate for Payer: BCBS MAPPO |
$298.64
|
| Rate for Payer: BCBS Trust/PPO |
$49.13
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$298.64
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cofinity Commercial |
$400.18
|
| Rate for Payer: Cofinity Commercial |
$430.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.64
|
| Rate for Payer: Mclaren Medicaid |
$200.65
|
| Rate for Payer: Meridian Medicaid |
$210.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$313.57
|
| Rate for Payer: PACE SWMI |
$298.64
|
| Rate for Payer: PHP Medicare Advantage |
$298.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.37
|
| Rate for Payer: Priority Health Medicare |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.64
|
| Rate for Payer: UHC Medicare Advantage |
$307.60
|
|
|
PR CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 24655
|
| Min. Negotiated Rate |
$269.66 |
| Max. Negotiated Rate |
$979.47 |
| Rate for Payer: Aetna Commercial |
$538.04
|
| Rate for Payer: Aetna Medicare |
$417.58
|
| Rate for Payer: BCBS Complete |
$283.14
|
| Rate for Payer: BCBS MAPPO |
$401.52
|
| Rate for Payer: BCBS Trust/PPO |
$979.47
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$401.52
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$578.19
|
| Rate for Payer: Cofinity Commercial |
$538.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.52
|
| Rate for Payer: Mclaren Medicaid |
$269.66
|
| Rate for Payer: Meridian Medicaid |
$283.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.60
|
| Rate for Payer: PACE SWMI |
$401.52
|
| Rate for Payer: PHP Medicare Advantage |
$401.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.69
|
| Rate for Payer: Priority Health Medicare |
$401.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$632.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.52
|
| Rate for Payer: UHC Medicare Advantage |
$413.57
|
|
|
PR CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 24650
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$1,113.13 |
| Rate for Payer: Aetna Commercial |
$326.20
|
| Rate for Payer: Aetna Medicare |
$253.17
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$243.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$320.02
|
| Rate for Payer: BCN Medicare Advantage |
$243.43
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$350.54
|
| Rate for Payer: Cofinity Commercial |
$326.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.43
|
| Rate for Payer: Mclaren Medicaid |
$164.86
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$255.60
|
| Rate for Payer: PACE SWMI |
$243.43
|
| Rate for Payer: PHP Medicare Advantage |
$243.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.07
|
| Rate for Payer: Priority Health Medicare |
$243.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$387.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.43
|
| Rate for Payer: UHC Medicare Advantage |
$250.73
|
|
|
PR CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 25505
|
| Min. Negotiated Rate |
$305.23 |
| Max. Negotiated Rate |
$1,458.11 |
| Rate for Payer: Aetna Commercial |
$613.67
|
| Rate for Payer: Aetna Medicare |
$476.28
|
| Rate for Payer: BCBS Complete |
$320.49
|
| Rate for Payer: BCBS MAPPO |
$457.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.11
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$457.96
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cofinity Commercial |
$659.46
|
| Rate for Payer: Cofinity Commercial |
$613.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.96
|
| Rate for Payer: Mclaren Medicaid |
$305.23
|
| Rate for Payer: Meridian Medicaid |
$320.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$480.86
|
| Rate for Payer: PACE SWMI |
$457.96
|
| Rate for Payer: PHP Medicare Advantage |
$457.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Medicare |
$457.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$720.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$457.96
|
| Rate for Payer: UHC Medicare Advantage |
$471.70
|
|
|
PR CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 25500
|
| Min. Negotiated Rate |
$172.74 |
| Max. Negotiated Rate |
$1,850.63 |
| Rate for Payer: Aetna Commercial |
$342.64
|
| Rate for Payer: Aetna Medicare |
$265.93
|
| Rate for Payer: BCBS Complete |
$181.38
|
| Rate for Payer: BCBS MAPPO |
$255.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.63
|
| Rate for Payer: BCN Commercial |
$429.06
|
| Rate for Payer: BCN Medicare Advantage |
$255.70
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$368.21
|
| Rate for Payer: Cofinity Commercial |
$342.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.70
|
| Rate for Payer: Mclaren Medicaid |
$172.74
|
| Rate for Payer: Meridian Medicaid |
$181.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$268.48
|
| Rate for Payer: PACE SWMI |
$255.70
|
| Rate for Payer: PHP Medicare Advantage |
$255.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.45
|
| Rate for Payer: Priority Health Medicare |
$255.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$405.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.70
|
| Rate for Payer: UHC Medicare Advantage |
$263.37
|
|
|
PR CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ
|
Professional
|
Both
|
$1,400.00
|
|
|
Service Code
|
HCPCS 25565
|
| Min. Negotiated Rate |
$306.93 |
| Max. Negotiated Rate |
$2,806.33 |
| Rate for Payer: Aetna Commercial |
$622.79
|
| Rate for Payer: Aetna Medicare |
$483.36
|
| Rate for Payer: BCBS Complete |
$322.28
|
| Rate for Payer: BCBS MAPPO |
$464.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,806.33
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$464.77
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cofinity Commercial |
$622.79
|
| Rate for Payer: Cofinity Commercial |
$669.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.77
|
| Rate for Payer: Mclaren Medicaid |
$306.93
|
| Rate for Payer: Meridian Medicaid |
$322.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$488.01
|
| Rate for Payer: PACE SWMI |
$464.77
|
| Rate for Payer: PHP Medicare Advantage |
$464.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$728.70
|
| Rate for Payer: Priority Health Medicare |
$464.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$728.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.77
|
| Rate for Payer: UHC Medicare Advantage |
$478.71
|
|
|
PR CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 25560
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$1,599.69 |
| Rate for Payer: Aetna Commercial |
$344.74
|
| Rate for Payer: Aetna Medicare |
$267.56
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$257.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.69
|
| Rate for Payer: BCN Commercial |
$351.82
|
| Rate for Payer: BCN Medicare Advantage |
$257.27
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$344.74
|
| Rate for Payer: Cofinity Commercial |
$370.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.27
|
| Rate for Payer: Mclaren Medicaid |
$173.60
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.13
|
| Rate for Payer: PACE SWMI |
$257.27
|
| Rate for Payer: PHP Medicare Advantage |
$257.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.01
|
| Rate for Payer: Priority Health Medicare |
$257.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$408.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.27
|
| Rate for Payer: UHC Medicare Advantage |
$264.99
|
|
|
PR CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 23570
|
| Min. Negotiated Rate |
$162.31 |
| Max. Negotiated Rate |
$553.66 |
| Rate for Payer: Aetna Commercial |
$321.44
|
| Rate for Payer: Aetna Medicare |
$249.48
|
| Rate for Payer: BCBS Complete |
$170.43
|
| Rate for Payer: BCBS MAPPO |
$239.88
|
| Rate for Payer: BCBS Trust/PPO |
$553.66
|
| Rate for Payer: BCN Commercial |
$353.31
|
| Rate for Payer: BCN Medicare Advantage |
$239.88
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$345.43
|
| Rate for Payer: Cofinity Commercial |
$321.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.88
|
| Rate for Payer: Mclaren Medicaid |
$162.31
|
| Rate for Payer: Meridian Medicaid |
$170.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.87
|
| Rate for Payer: PACE SWMI |
$239.88
|
| Rate for Payer: PHP Medicare Advantage |
$239.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$380.95
|
| Rate for Payer: Priority Health Medicare |
$239.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$380.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.88
|
| Rate for Payer: UHC Medicare Advantage |
$247.08
|
|
|
PR CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION
|
Professional
|
Both
|
$768.00
|
|
|
Service Code
|
HCPCS 23525
|
| Min. Negotiated Rate |
$241.33 |
| Max. Negotiated Rate |
$595.21 |
| Rate for Payer: Aetna Commercial |
$481.77
|
| Rate for Payer: Aetna Medicare |
$373.91
|
| Rate for Payer: BCBS Complete |
$253.40
|
| Rate for Payer: BCBS MAPPO |
$359.53
|
| Rate for Payer: BCBS Trust/PPO |
$399.45
|
| Rate for Payer: BCN Commercial |
$595.21
|
| Rate for Payer: BCN Medicare Advantage |
$359.53
|
| Rate for Payer: Cash Price |
$614.40
|
| Rate for Payer: Cash Price |
$614.40
|
| Rate for Payer: Cofinity Commercial |
$517.72
|
| Rate for Payer: Cofinity Commercial |
$481.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.53
|
| Rate for Payer: Mclaren Medicaid |
$241.33
|
| Rate for Payer: Meridian Medicaid |
$253.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$377.51
|
| Rate for Payer: PACE SWMI |
$359.53
|
| Rate for Payer: PHP Medicare Advantage |
$359.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$568.86
|
| Rate for Payer: Priority Health Medicare |
$359.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$568.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$359.53
|
| Rate for Payer: UHC Medicare Advantage |
$370.32
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLC W/O ANES
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 28570
|
| Min. Negotiated Rate |
$131.42 |
| Max. Negotiated Rate |
$1,383.62 |
| Rate for Payer: Aetna Commercial |
$258.77
|
| Rate for Payer: Aetna Medicare |
$200.83
|
| Rate for Payer: BCBS Complete |
$137.99
|
| Rate for Payer: BCBS MAPPO |
$193.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.62
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$193.11
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$278.08
|
| Rate for Payer: Cofinity Commercial |
$258.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.11
|
| Rate for Payer: Mclaren Medicaid |
$131.42
|
| Rate for Payer: Meridian Medicaid |
$137.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.77
|
| Rate for Payer: PACE SWMI |
$193.11
|
| Rate for Payer: PHP Medicare Advantage |
$193.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.41
|
| Rate for Payer: Priority Health Medicare |
$193.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.11
|
| Rate for Payer: UHC Medicare Advantage |
$198.90
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 28575
|
| Min. Negotiated Rate |
$224.50 |
| Max. Negotiated Rate |
$804.60 |
| Rate for Payer: Aetna Commercial |
$448.40
|
| Rate for Payer: Aetna Medicare |
$348.02
|
| Rate for Payer: BCBS Complete |
$235.72
|
| Rate for Payer: BCBS MAPPO |
$334.63
|
| Rate for Payer: BCBS Trust/PPO |
$804.60
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$334.63
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$481.87
|
| Rate for Payer: Cofinity Commercial |
$448.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.63
|
| Rate for Payer: Mclaren Medicaid |
$224.50
|
| Rate for Payer: Meridian Medicaid |
$235.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$351.36
|
| Rate for Payer: PACE SWMI |
$334.63
|
| Rate for Payer: PHP Medicare Advantage |
$334.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.54
|
| Rate for Payer: Priority Health Medicare |
$334.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$334.63
|
| Rate for Payer: UHC Medicare Advantage |
$344.67
|
|
|
PR CLOSED TX TALUS FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 28435
|
| Min. Negotiated Rate |
$217.26 |
| Max. Negotiated Rate |
$1,149.05 |
| Rate for Payer: Aetna Commercial |
$434.62
|
| Rate for Payer: Aetna Medicare |
$337.31
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS MAPPO |
$324.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.05
|
| Rate for Payer: BCN Commercial |
$553.67
|
| Rate for Payer: BCN Medicare Advantage |
$324.34
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$467.05
|
| Rate for Payer: Cofinity Commercial |
$434.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.34
|
| Rate for Payer: Mclaren Medicaid |
$217.26
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$340.56
|
| Rate for Payer: PACE SWMI |
$324.34
|
| Rate for Payer: PHP Medicare Advantage |
$324.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$512.18
|
| Rate for Payer: Priority Health Medicare |
$324.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.34
|
| Rate for Payer: UHC Medicare Advantage |
$334.07
|
|
|
PR CLOSED TX TALUS FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 28430
|
| Min. Negotiated Rate |
$139.52 |
| Max. Negotiated Rate |
$540.45 |
| Rate for Payer: Aetna Commercial |
$277.58
|
| Rate for Payer: Aetna Medicare |
$215.44
|
| Rate for Payer: BCBS Complete |
$146.50
|
| Rate for Payer: BCBS MAPPO |
$207.15
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$358.20
|
| Rate for Payer: BCN Medicare Advantage |
$207.15
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$277.58
|
| Rate for Payer: Cofinity Commercial |
$298.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.15
|
| Rate for Payer: Mclaren Medicaid |
$139.52
|
| Rate for Payer: Meridian Medicaid |
$146.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.51
|
| Rate for Payer: PACE SWMI |
$207.15
|
| Rate for Payer: PHP Medicare Advantage |
$207.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.34
|
| Rate for Payer: Priority Health Medicare |
$207.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.15
|
| Rate for Payer: UHC Medicare Advantage |
$213.36
|
|
|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 28605
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$2,031.31 |
| Rate for Payer: Aetna Commercial |
$401.57
|
| Rate for Payer: Aetna Medicare |
$311.67
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$299.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.31
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$299.68
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$401.57
|
| Rate for Payer: Cofinity Commercial |
$431.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.68
|
| Rate for Payer: Mclaren Medicaid |
$202.35
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$314.66
|
| Rate for Payer: PACE SWMI |
$299.68
|
| Rate for Payer: PHP Medicare Advantage |
$299.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.93
|
| Rate for Payer: Priority Health Medicare |
$299.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$475.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.68
|
| Rate for Payer: UHC Medicare Advantage |
$308.67
|
|
