|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
IP
|
$297.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$181.14 |
| Max. Negotiated Rate |
$267.30 |
| Rate for Payer: Aetna Commercial |
$252.45
|
| Rate for Payer: BCBS Trust/PPO |
$229.52
|
| Rate for Payer: BCN Commercial |
$229.52
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$255.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.60
|
| Rate for Payer: Healthscope Commercial |
$267.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$252.45
|
| Rate for Payer: PHP Commercial |
$252.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.36
|
| Rate for Payer: UHC Core |
$248.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.75
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna Commercial |
$187.18
|
| Rate for Payer: Aetna Medicare |
$145.28
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$139.69
|
| Rate for Payer: BCBS Trust/PPO |
$423.70
|
| Rate for Payer: BCN Commercial |
$242.88
|
| Rate for Payer: BCN Medicare Advantage |
$139.69
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$187.18
|
| Rate for Payer: Cofinity Commercial |
$201.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.69
|
| Rate for Payer: Mclaren Medicaid |
$94.79
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.67
|
| Rate for Payer: PACE SWMI |
$139.69
|
| Rate for Payer: PHP Medicare Advantage |
$139.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.62
|
| Rate for Payer: Priority Health Medicare |
$139.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.69
|
| Rate for Payer: UHC Medicare Advantage |
$143.88
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$79.88 |
| Max. Negotiated Rate |
$1,955.77 |
| Rate for Payer: Aetna Commercial |
$156.77
|
| Rate for Payer: Aetna Medicare |
$121.67
|
| Rate for Payer: BCBS Complete |
$83.87
|
| Rate for Payer: BCBS MAPPO |
$116.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.77
|
| Rate for Payer: BCN Commercial |
$179.35
|
| Rate for Payer: BCN Medicare Advantage |
$116.99
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$156.77
|
| Rate for Payer: Cofinity Commercial |
$168.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.99
|
| Rate for Payer: Mclaren Medicaid |
$79.88
|
| Rate for Payer: Meridian Medicaid |
$83.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.84
|
| Rate for Payer: PACE SWMI |
$116.99
|
| Rate for Payer: PHP Medicare Advantage |
$116.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.39
|
| Rate for Payer: Priority Health Medicare |
$116.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.99
|
| Rate for Payer: UHC Medicare Advantage |
$120.50
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$3,163.99 |
| Rate for Payer: Aetna Commercial |
$405.90
|
| Rate for Payer: Aetna Medicare |
$315.03
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$302.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,163.99
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$302.91
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$405.90
|
| Rate for Payer: Cofinity Commercial |
$436.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.91
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.06
|
| Rate for Payer: PACE SWMI |
$302.91
|
| Rate for Payer: PHP Medicare Advantage |
$302.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.99
|
| Rate for Payer: Priority Health Medicare |
$302.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.91
|
| Rate for Payer: UHC Medicare Advantage |
$312.00
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$322.27 |
| Max. Negotiated Rate |
$3,467.23 |
| Rate for Payer: Aetna Commercial |
$656.05
|
| Rate for Payer: Aetna Medicare |
$509.17
|
| Rate for Payer: BCBS Complete |
$338.38
|
| Rate for Payer: BCBS MAPPO |
$489.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,467.23
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$489.59
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$705.01
|
| Rate for Payer: Cofinity Commercial |
$656.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.59
|
| Rate for Payer: Mclaren Medicaid |
$322.27
|
| Rate for Payer: Meridian Medicaid |
$338.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.07
|
| Rate for Payer: PACE SWMI |
$489.59
|
| Rate for Payer: PHP Medicare Advantage |
$489.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.44
|
| Rate for Payer: Priority Health Medicare |
$489.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$764.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$489.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.59
|
| Rate for Payer: UHC Medicare Advantage |
$504.28
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$674.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$471.80 |
| Rate for Payer: Aetna Commercial |
$345.81
|
| Rate for Payer: Aetna Medicare |
$268.39
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$258.07
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$258.07
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cofinity Commercial |
$371.62
|
| Rate for Payer: Cofinity Commercial |
$345.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.07
|
| Rate for Payer: Mclaren Medicaid |
$173.60
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.97
|
| Rate for Payer: PACE SWMI |
$258.07
|
| Rate for Payer: PHP Medicare Advantage |
$258.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.55
|
| Rate for Payer: Priority Health Medicare |
$258.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.07
|
| Rate for Payer: UHC Medicare Advantage |
$265.81
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$582.99 |
| Rate for Payer: Aetna Commercial |
$474.04
|
| Rate for Payer: Aetna Medicare |
$367.91
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$353.76
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$582.99
|
| Rate for Payer: BCN Medicare Advantage |
$353.76
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$509.41
|
| Rate for Payer: Cofinity Commercial |
$474.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.76
|
| Rate for Payer: Mclaren Medicaid |
$234.51
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.45
|
| Rate for Payer: PACE SWMI |
$353.76
|
| Rate for Payer: PHP Medicare Advantage |
$353.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.12
|
| Rate for Payer: Priority Health Medicare |
$353.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.76
|
| Rate for Payer: UHC Medicare Advantage |
$364.37
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$253.90 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$513.61
|
| Rate for Payer: Aetna Medicare |
$398.62
|
| Rate for Payer: BCBS Complete |
$266.60
|
| Rate for Payer: BCBS MAPPO |
$383.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$383.29
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cofinity Commercial |
$551.94
|
| Rate for Payer: Cofinity Commercial |
$513.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.29
|
| Rate for Payer: Mclaren Medicaid |
$253.90
|
| Rate for Payer: Meridian Medicaid |
$266.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.45
|
| Rate for Payer: PACE SWMI |
$383.29
|
| Rate for Payer: PHP Medicare Advantage |
$383.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$614.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.03
|
| Rate for Payer: Priority Health Medicare |
$383.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$601.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$383.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.29
|
| Rate for Payer: UHC Medicare Advantage |
$394.79
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$1,920.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$483.51 |
| Max. Negotiated Rate |
$2,221.50 |
| Rate for Payer: Aetna Commercial |
$999.09
|
| Rate for Payer: Aetna Medicare |
$775.41
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS MAPPO |
$745.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,221.50
|
| Rate for Payer: BCN Commercial |
$1,107.84
|
| Rate for Payer: BCN Medicare Advantage |
$745.59
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cofinity Commercial |
$1,073.65
|
| Rate for Payer: Cofinity Commercial |
$999.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.59
|
| Rate for Payer: Mclaren Medicaid |
$483.51
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$782.87
|
| Rate for Payer: PACE SWMI |
$745.59
|
| Rate for Payer: PHP Medicare Advantage |
$745.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,157.64
|
| Rate for Payer: Priority Health Medicare |
$745.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,157.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$745.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$745.59
|
| Rate for Payer: UHC Medicare Advantage |
$767.96
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$724.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$114.38 |
| Max. Negotiated Rate |
$2,156.52 |
| Rate for Payer: Aetna Commercial |
$243.42
|
| Rate for Payer: Aetna Medicare |
$188.93
|
| Rate for Payer: BCBS Complete |
$120.10
|
| Rate for Payer: BCBS MAPPO |
$181.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$262.42
|
| Rate for Payer: BCN Medicare Advantage |
$181.66
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$261.59
|
| Rate for Payer: Cofinity Commercial |
$243.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.66
|
| Rate for Payer: Mclaren Medicaid |
$114.38
|
| Rate for Payer: Meridian Medicaid |
$120.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.74
|
| Rate for Payer: PACE SWMI |
$181.66
|
| Rate for Payer: PHP Medicare Advantage |
$181.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.21
|
| Rate for Payer: Priority Health Medicare |
$181.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.66
|
| Rate for Payer: UHC Medicare Advantage |
$187.11
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$666.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$129.43 |
| Max. Negotiated Rate |
$529.24 |
| Rate for Payer: Aetna Commercial |
$415.99
|
| Rate for Payer: Aetna Medicare |
$322.86
|
| Rate for Payer: BCBS Complete |
$220.30
|
| Rate for Payer: BCBS MAPPO |
$310.44
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$529.24
|
| Rate for Payer: BCN Medicare Advantage |
$310.44
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cofinity Commercial |
$415.99
|
| Rate for Payer: Cofinity Commercial |
$447.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.44
|
| Rate for Payer: Mclaren Medicaid |
$209.81
|
| Rate for Payer: Meridian Medicaid |
$220.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$325.96
|
| Rate for Payer: PACE SWMI |
$310.44
|
| Rate for Payer: PHP Medicare Advantage |
$310.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$492.78
|
| Rate for Payer: Priority Health Medicare |
$310.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.44
|
| Rate for Payer: UHC Medicare Advantage |
$319.75
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$562.80 |
| Rate for Payer: Aetna Commercial |
$392.83
|
| Rate for Payer: Aetna Medicare |
$304.89
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$293.16
|
| Rate for Payer: BCBS Trust/PPO |
$112.00
|
| Rate for Payer: BCN Commercial |
$502.36
|
| Rate for Payer: BCN Medicare Advantage |
$293.16
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$422.15
|
| Rate for Payer: Cofinity Commercial |
$392.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.16
|
| Rate for Payer: Mclaren Medicaid |
$196.81
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$307.82
|
| Rate for Payer: PACE SWMI |
$293.16
|
| Rate for Payer: PHP Medicare Advantage |
$293.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.69
|
| Rate for Payer: Priority Health Medicare |
$293.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.16
|
| Rate for Payer: UHC Medicare Advantage |
$301.95
|
|
|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$884.10 |
| Rate for Payer: Aetna Commercial |
$601.83
|
| Rate for Payer: Aetna Medicare |
$467.10
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$449.13
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$754.03
|
| Rate for Payer: BCN Medicare Advantage |
$449.13
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$646.75
|
| Rate for Payer: Cofinity Commercial |
$601.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.13
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$471.59
|
| Rate for Payer: PACE SWMI |
$449.13
|
| Rate for Payer: PHP Medicare Advantage |
$449.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$706.23
|
| Rate for Payer: Priority Health Medicare |
$449.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$706.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.13
|
| Rate for Payer: UHC Medicare Advantage |
$462.60
|
|
|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$296.71 |
| Max. Negotiated Rate |
$723.24 |
| Rate for Payer: Aetna Commercial |
$596.86
|
| Rate for Payer: Aetna Medicare |
$463.24
|
| Rate for Payer: BCBS Complete |
$311.55
|
| Rate for Payer: BCBS MAPPO |
$445.42
|
| Rate for Payer: BCBS Trust/PPO |
$716.37
|
| Rate for Payer: BCN Commercial |
$723.24
|
| Rate for Payer: BCN Medicare Advantage |
$445.42
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$641.40
|
| Rate for Payer: Cofinity Commercial |
$596.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.42
|
| Rate for Payer: Mclaren Medicaid |
$296.71
|
| Rate for Payer: Meridian Medicaid |
$311.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$467.69
|
| Rate for Payer: PACE SWMI |
$445.42
|
| Rate for Payer: PHP Medicare Advantage |
$445.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$702.15
|
| Rate for Payer: Priority Health Medicare |
$445.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$445.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.42
|
| Rate for Payer: UHC Medicare Advantage |
$458.78
|
|
|
PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ
|
Professional
|
Both
|
$933.00
|
|
|
Service Code
|
HCPCS 27238
|
| Min. Negotiated Rate |
$306.51 |
| Max. Negotiated Rate |
$1,049.20 |
| Rate for Payer: Aetna Commercial |
$619.20
|
| Rate for Payer: Aetna Medicare |
$480.57
|
| Rate for Payer: BCBS Complete |
$321.84
|
| Rate for Payer: BCBS MAPPO |
$462.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$693.93
|
| Rate for Payer: BCN Medicare Advantage |
$462.09
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cofinity Commercial |
$665.41
|
| Rate for Payer: Cofinity Commercial |
$619.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.09
|
| Rate for Payer: Mclaren Medicaid |
$306.51
|
| Rate for Payer: Meridian Medicaid |
$321.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$485.19
|
| Rate for Payer: PACE SWMI |
$462.09
|
| Rate for Payer: PHP Medicare Advantage |
$462.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.13
|
| Rate for Payer: Priority Health Medicare |
$462.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$725.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.09
|
| Rate for Payer: UHC Medicare Advantage |
$475.95
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 28665
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$1,135.32 |
| Rate for Payer: Aetna Commercial |
$163.20
|
| Rate for Payer: Aetna Medicare |
$126.66
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$121.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.32
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$121.79
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.79
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.88
|
| Rate for Payer: PACE SWMI |
$121.79
|
| Rate for Payer: PHP Medicare Advantage |
$121.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.96
|
| Rate for Payer: Priority Health Medicare |
$121.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.79
|
| Rate for Payer: UHC Medicare Advantage |
$125.44
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 28660
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$766.04 |
| Rate for Payer: Aetna Commercial |
$122.65
|
| Rate for Payer: Aetna Medicare |
$95.19
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$91.53
|
| Rate for Payer: BCBS Trust/PPO |
$766.04
|
| Rate for Payer: BCN Commercial |
$183.74
|
| Rate for Payer: BCN Medicare Advantage |
$91.53
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$122.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.53
|
| Rate for Payer: Mclaren Medicaid |
$61.34
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.11
|
| Rate for Payer: PACE SWMI |
$91.53
|
| Rate for Payer: PHP Medicare Advantage |
$91.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.98
|
| Rate for Payer: Priority Health Medicare |
$91.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.53
|
| Rate for Payer: UHC Medicare Advantage |
$94.28
|
|
|
PR CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ
|
Professional
|
Both
|
$1,946.00
|
|
|
Service Code
|
HCPCS 27240
|
| Min. Negotiated Rate |
$613.87 |
| Max. Negotiated Rate |
$1,467.10 |
| Rate for Payer: Aetna Commercial |
$1,265.05
|
| Rate for Payer: Aetna Medicare |
$981.83
|
| Rate for Payer: BCBS Complete |
$644.56
|
| Rate for Payer: BCBS MAPPO |
$944.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.47
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| Rate for Payer: BCN Medicare Advantage |
$944.07
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.46
|
| Rate for Payer: Cofinity Commercial |
$1,265.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.07
|
| Rate for Payer: Mclaren Medicaid |
$613.87
|
| Rate for Payer: Meridian Medicaid |
$644.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$991.27
|
| Rate for Payer: PACE SWMI |
$944.07
|
| Rate for Payer: PHP Medicare Advantage |
$944.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.10
|
| Rate for Payer: Priority Health Medicare |
$944.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,467.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$944.07
|
| Rate for Payer: UHC Medicare Advantage |
$972.39
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ REQ ANES
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 26775
|
| Min. Negotiated Rate |
$236.22 |
| Max. Negotiated Rate |
$2,900.37 |
| Rate for Payer: Aetna Commercial |
$472.55
|
| Rate for Payer: Aetna Medicare |
$366.76
|
| Rate for Payer: BCBS Complete |
$248.03
|
| Rate for Payer: BCBS MAPPO |
$352.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$594.23
|
| Rate for Payer: BCN Medicare Advantage |
$352.65
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$507.82
|
| Rate for Payer: Cofinity Commercial |
$472.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.65
|
| Rate for Payer: Mclaren Medicaid |
$236.22
|
| Rate for Payer: Meridian Medicaid |
$248.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.28
|
| Rate for Payer: PACE SWMI |
$352.65
|
| Rate for Payer: PHP Medicare Advantage |
$352.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.12
|
| Rate for Payer: Priority Health Medicare |
$352.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.65
|
| Rate for Payer: UHC Medicare Advantage |
$363.23
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$1,851.16 |
| Rate for Payer: Aetna Commercial |
$351.07
|
| Rate for Payer: Aetna Medicare |
$272.47
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$261.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.16
|
| Rate for Payer: BCN Commercial |
$433.46
|
| Rate for Payer: BCN Medicare Advantage |
$261.99
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cofinity Commercial |
$377.27
|
| Rate for Payer: Cofinity Commercial |
$351.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.99
|
| Rate for Payer: Mclaren Medicaid |
$175.73
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$275.09
|
| Rate for Payer: PACE SWMI |
$261.99
|
| Rate for Payer: PHP Medicare Advantage |
$261.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$412.09
|
| Rate for Payer: Priority Health Medicare |
$261.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.99
|
| Rate for Payer: UHC Medicare Advantage |
$269.85
|
|
|
PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 21440
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$2,978.97 |
| Rate for Payer: Aetna Commercial |
$704.61
|
| Rate for Payer: Aetna Medicare |
$546.86
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS MAPPO |
$525.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,978.97
|
| Rate for Payer: BCN Commercial |
$1,012.05
|
| Rate for Payer: BCN Medicare Advantage |
$525.83
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cofinity Commercial |
$704.61
|
| Rate for Payer: Cofinity Commercial |
$757.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.83
|
| Rate for Payer: Mclaren Medicaid |
$388.30
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.12
|
| Rate for Payer: PACE SWMI |
$525.83
|
| Rate for Payer: PHP Medicare Advantage |
$525.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$849.20
|
| Rate for Payer: Priority Health Medicare |
$525.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.83
|
| Rate for Payer: UHC Medicare Advantage |
$541.60
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$2,919.55 |
| Rate for Payer: Aetna Commercial |
$406.36
|
| Rate for Payer: Aetna Medicare |
$315.38
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$303.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,919.55
|
| Rate for Payer: BCN Commercial |
$400.52
|
| Rate for Payer: BCN Medicare Advantage |
$303.25
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$436.68
|
| Rate for Payer: Cofinity Commercial |
$406.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.25
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.41
|
| Rate for Payer: PACE SWMI |
$303.25
|
| Rate for Payer: PHP Medicare Advantage |
$303.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$480.52
|
| Rate for Payer: Priority Health Medicare |
$303.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.25
|
| Rate for Payer: UHC Medicare Advantage |
$312.35
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$701.00
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$497.47 |
| Rate for Payer: Aetna Commercial |
$395.93
|
| Rate for Payer: Aetna Medicare |
$307.29
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$295.47
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$497.47
|
| Rate for Payer: BCN Medicare Advantage |
$295.47
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cofinity Commercial |
$425.48
|
| Rate for Payer: Cofinity Commercial |
$395.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.47
|
| Rate for Payer: Mclaren Medicaid |
$198.30
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$310.24
|
| Rate for Payer: PACE SWMI |
$295.47
|
| Rate for Payer: PHP Medicare Advantage |
$295.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.27
|
| Rate for Payer: Priority Health Medicare |
$295.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.47
|
| Rate for Payer: UHC Medicare Advantage |
$304.33
|
|
|
PR CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 26607
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$671.66
|
| Rate for Payer: Aetna Medicare |
$521.29
|
| Rate for Payer: BCBS Complete |
$348.44
|
| Rate for Payer: BCBS MAPPO |
$501.24
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$757.45
|
| Rate for Payer: BCN Medicare Advantage |
$501.24
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$671.66
|
| Rate for Payer: Cofinity Commercial |
$721.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.24
|
| Rate for Payer: Mclaren Medicaid |
$331.85
|
| Rate for Payer: Meridian Medicaid |
$348.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$526.30
|
| Rate for Payer: PACE SWMI |
$501.24
|
| Rate for Payer: PHP Medicare Advantage |
$501.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,057.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.51
|
| Rate for Payer: Priority Health Medicare |
$501.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$791.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$501.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$501.24
|
| Rate for Payer: UHC Medicare Advantage |
$516.28
|
|
|
PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 26600
|
| Min. Negotiated Rate |
$103.55 |
| Max. Negotiated Rate |
$451.41 |
| Rate for Payer: Aetna Commercial |
$379.86
|
| Rate for Payer: Aetna Medicare |
$294.82
|
| Rate for Payer: BCBS Complete |
$201.74
|
| Rate for Payer: BCBS MAPPO |
$283.48
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCN Commercial |
$364.78
|
| Rate for Payer: BCN Medicare Advantage |
$283.48
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$379.86
|
| Rate for Payer: Cofinity Commercial |
$408.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.48
|
| Rate for Payer: Mclaren Medicaid |
$192.13
|
| Rate for Payer: Meridian Medicaid |
$201.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$297.65
|
| Rate for Payer: PACE SWMI |
$283.48
|
| Rate for Payer: PHP Medicare Advantage |
$283.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$451.41
|
| Rate for Payer: Priority Health Medicare |
$283.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$451.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.48
|
| Rate for Payer: UHC Medicare Advantage |
$291.98
|
|
