|
PR CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT
|
Professional
|
Both
|
$1,328.00
|
|
|
Service Code
|
HCPCS 21421
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$684.22
|
| Rate for Payer: Aetna Medicare |
$531.03
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$510.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$943.64
|
| Rate for Payer: BCN Medicare Advantage |
$510.61
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cofinity Commercial |
$735.28
|
| Rate for Payer: Cofinity Commercial |
$684.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.61
|
| Rate for Payer: Mclaren Medicaid |
$352.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.14
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Nomi Health Commercial |
$612.73
|
| Rate for Payer: PACE SWMI |
$510.61
|
| Rate for Payer: PHP Medicare Advantage |
$510.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.20
|
| Rate for Payer: Priority Health HMO/PPO |
$831.99
|
| Rate for Payer: Priority Health Medicare |
$515.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$831.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.61
|
| Rate for Payer: UHC Exchange |
$510.61
|
| Rate for Payer: UHC Medicare Advantage |
$510.61
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
|
|
PR CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 27560
|
| Min. Negotiated Rate |
$228.12 |
| Max. Negotiated Rate |
$2,121.65 |
| Rate for Payer: Aetna Commercial |
$447.60
|
| Rate for Payer: Aetna Medicare |
$347.39
|
| Rate for Payer: BCBS Complete |
$239.53
|
| Rate for Payer: BCBS MAPPO |
$334.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.65
|
| Rate for Payer: BCN Commercial |
$561.98
|
| Rate for Payer: BCN Medicare Advantage |
$334.03
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$481.00
|
| Rate for Payer: Cofinity Commercial |
$447.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.03
|
| Rate for Payer: Mclaren Medicaid |
$228.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.73
|
| Rate for Payer: Meridian Medicaid |
$239.53
|
| Rate for Payer: Nomi Health Commercial |
$400.84
|
| Rate for Payer: PACE SWMI |
$334.03
|
| Rate for Payer: PHP Medicare Advantage |
$334.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO |
$541.43
|
| Rate for Payer: Priority Health Medicare |
$337.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$541.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$334.03
|
| Rate for Payer: UHC Exchange |
$334.03
|
| Rate for Payer: UHC Medicare Advantage |
$334.03
|
| Rate for Payer: UHCCP Medicaid |
$228.12
|
|
|
PR CLOSED TX PATELLAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 27520
|
| Min. Negotiated Rate |
$49.13 |
| Max. Negotiated Rate |
$490.14 |
| Rate for Payer: Aetna Commercial |
$394.84
|
| Rate for Payer: Aetna Medicare |
$306.45
|
| Rate for Payer: BCBS Complete |
$213.14
|
| Rate for Payer: BCBS MAPPO |
$294.66
|
| Rate for Payer: BCBS Trust/PPO |
$49.13
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$294.66
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cofinity Commercial |
$424.31
|
| Rate for Payer: Cofinity Commercial |
$394.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.66
|
| Rate for Payer: Mclaren Medicaid |
$202.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.39
|
| Rate for Payer: Meridian Medicaid |
$213.14
|
| Rate for Payer: Nomi Health Commercial |
$353.59
|
| Rate for Payer: PACE SWMI |
$294.66
|
| Rate for Payer: PHP Medicare Advantage |
$294.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.15
|
| Rate for Payer: Priority Health HMO/PPO |
$479.35
|
| Rate for Payer: Priority Health Medicare |
$297.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$479.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.66
|
| Rate for Payer: UHC Exchange |
$294.66
|
| Rate for Payer: UHC Medicare Advantage |
$294.66
|
| Rate for Payer: UHCCP Medicaid |
$202.99
|
|
|
PR CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION
|
Professional
|
Both
|
$961.00
|
|
|
Service Code
|
HCPCS 24655
|
| Min. Negotiated Rate |
$270.94 |
| Max. Negotiated Rate |
$979.47 |
| Rate for Payer: Aetna Commercial |
$530.55
|
| Rate for Payer: Aetna Medicare |
$411.77
|
| Rate for Payer: BCBS Complete |
$284.49
|
| Rate for Payer: BCBS MAPPO |
$395.93
|
| Rate for Payer: BCBS Trust/PPO |
$979.47
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$395.93
|
| Rate for Payer: Cash Price |
$768.80
|
| Rate for Payer: Cash Price |
$768.80
|
| Rate for Payer: Cofinity Commercial |
$570.14
|
| Rate for Payer: Cofinity Commercial |
$530.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.93
|
| Rate for Payer: Mclaren Medicaid |
$270.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.73
|
| Rate for Payer: Meridian Medicaid |
$284.49
|
| Rate for Payer: Nomi Health Commercial |
$475.12
|
| Rate for Payer: PACE SWMI |
$395.93
|
| Rate for Payer: PHP Medicare Advantage |
$395.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.65
|
| Rate for Payer: Priority Health HMO/PPO |
$644.22
|
| Rate for Payer: Priority Health Medicare |
$399.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$644.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.93
|
| Rate for Payer: UHC Exchange |
$395.93
|
| Rate for Payer: UHC Medicare Advantage |
$395.93
|
| Rate for Payer: UHCCP Medicaid |
$270.94
|
|
|
PR CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION
|
Professional
|
Both
|
$645.00
|
|
|
Service Code
|
HCPCS 24650
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$1,113.13 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$252.34
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$242.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$320.02
|
| Rate for Payer: BCN Medicare Advantage |
$242.63
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cofinity Commercial |
$349.39
|
| Rate for Payer: Cofinity Commercial |
$325.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.63
|
| Rate for Payer: Mclaren Medicaid |
$167.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.76
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Nomi Health Commercial |
$291.16
|
| Rate for Payer: PACE SWMI |
$242.63
|
| Rate for Payer: PHP Medicare Advantage |
$242.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.25
|
| Rate for Payer: Priority Health HMO/PPO |
$393.87
|
| Rate for Payer: Priority Health Medicare |
$245.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$393.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.63
|
| Rate for Payer: UHC Exchange |
$242.63
|
| Rate for Payer: UHC Medicare Advantage |
$242.63
|
| Rate for Payer: UHCCP Medicaid |
$167.63
|
|
|
PR CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,270.00
|
|
|
Service Code
|
HCPCS 25505
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$1,458.11 |
| Rate for Payer: Aetna Commercial |
$603.03
|
| Rate for Payer: Aetna Medicare |
$468.02
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$450.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.11
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$450.02
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cofinity Commercial |
$648.03
|
| Rate for Payer: Cofinity Commercial |
$603.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.02
|
| Rate for Payer: Mclaren Medicaid |
$307.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.52
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Nomi Health Commercial |
$540.02
|
| Rate for Payer: PACE SWMI |
$450.02
|
| Rate for Payer: PHP Medicare Advantage |
$450.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$825.50
|
| Rate for Payer: Priority Health HMO/PPO |
$729.20
|
| Rate for Payer: Priority Health Medicare |
$454.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$729.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$450.02
|
| Rate for Payer: UHC Exchange |
$450.02
|
| Rate for Payer: UHC Medicare Advantage |
$450.02
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
|
|
PR CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 25500
|
| Min. Negotiated Rate |
$175.09 |
| Max. Negotiated Rate |
$1,850.63 |
| Rate for Payer: Aetna Commercial |
$340.29
|
| Rate for Payer: Aetna Medicare |
$264.11
|
| Rate for Payer: BCBS Complete |
$183.84
|
| Rate for Payer: BCBS MAPPO |
$253.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.63
|
| Rate for Payer: BCN Commercial |
$429.06
|
| Rate for Payer: BCN Medicare Advantage |
$253.95
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cofinity Commercial |
$365.69
|
| Rate for Payer: Cofinity Commercial |
$340.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.95
|
| Rate for Payer: Mclaren Medicaid |
$175.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.65
|
| Rate for Payer: Meridian Medicaid |
$183.84
|
| Rate for Payer: Nomi Health Commercial |
$304.74
|
| Rate for Payer: PACE SWMI |
$253.95
|
| Rate for Payer: PHP Medicare Advantage |
$253.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.15
|
| Rate for Payer: Priority Health HMO/PPO |
$412.68
|
| Rate for Payer: Priority Health Medicare |
$256.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.95
|
| Rate for Payer: UHC Exchange |
$253.95
|
| Rate for Payer: UHC Medicare Advantage |
$253.95
|
| Rate for Payer: UHCCP Medicaid |
$175.09
|
|
|
PR CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MNPJ
|
Professional
|
Both
|
$1,428.00
|
|
|
Service Code
|
HCPCS 25565
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$2,806.33 |
| Rate for Payer: Aetna Commercial |
$607.62
|
| Rate for Payer: Aetna Medicare |
$471.59
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCBS MAPPO |
$453.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,806.33
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$453.45
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cofinity Commercial |
$652.97
|
| Rate for Payer: Cofinity Commercial |
$607.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.45
|
| Rate for Payer: Mclaren Medicaid |
$308.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.12
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: Nomi Health Commercial |
$544.14
|
| Rate for Payer: PACE SWMI |
$453.45
|
| Rate for Payer: PHP Medicare Advantage |
$453.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.20
|
| Rate for Payer: Priority Health HMO/PPO |
$733.26
|
| Rate for Payer: Priority Health Medicare |
$457.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.45
|
| Rate for Payer: UHC Exchange |
$453.45
|
| Rate for Payer: UHC Medicare Advantage |
$453.45
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
|
|
PR CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MNPJ
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 25560
|
| Min. Negotiated Rate |
$175.94 |
| Max. Negotiated Rate |
$1,599.69 |
| Rate for Payer: Aetna Commercial |
$341.94
|
| Rate for Payer: Aetna Medicare |
$265.39
|
| Rate for Payer: BCBS Complete |
$184.74
|
| Rate for Payer: BCBS MAPPO |
$255.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.69
|
| Rate for Payer: BCN Commercial |
$351.82
|
| Rate for Payer: BCN Medicare Advantage |
$255.18
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$367.46
|
| Rate for Payer: Cofinity Commercial |
$341.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.18
|
| Rate for Payer: Mclaren Medicaid |
$175.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.94
|
| Rate for Payer: Meridian Medicaid |
$184.74
|
| Rate for Payer: Nomi Health Commercial |
$306.22
|
| Rate for Payer: PACE SWMI |
$255.18
|
| Rate for Payer: PHP Medicare Advantage |
$255.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$414.72
|
| Rate for Payer: Priority Health Medicare |
$257.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.18
|
| Rate for Payer: UHC Exchange |
$255.18
|
| Rate for Payer: UHC Medicare Advantage |
$255.18
|
| Rate for Payer: UHCCP Medicaid |
$175.94
|
|
|
PR CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 23570
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$553.66 |
| Rate for Payer: Aetna Commercial |
$320.30
|
| Rate for Payer: Aetna Medicare |
$248.59
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$239.03
|
| Rate for Payer: BCBS Trust/PPO |
$553.66
|
| Rate for Payer: BCN Commercial |
$353.31
|
| Rate for Payer: BCN Medicare Advantage |
$239.03
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$344.20
|
| Rate for Payer: Cofinity Commercial |
$320.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.03
|
| Rate for Payer: Mclaren Medicaid |
$164.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.98
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Nomi Health Commercial |
$286.84
|
| Rate for Payer: PACE SWMI |
$239.03
|
| Rate for Payer: PHP Medicare Advantage |
$239.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO |
$387.75
|
| Rate for Payer: Priority Health Medicare |
$241.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$387.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.03
|
| Rate for Payer: UHC Exchange |
$239.03
|
| Rate for Payer: UHC Medicare Advantage |
$239.03
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
|
|
PR CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 23525
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$595.21 |
| Rate for Payer: Aetna Commercial |
$476.89
|
| Rate for Payer: Aetna Medicare |
$370.13
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$355.89
|
| Rate for Payer: BCBS Trust/PPO |
$399.45
|
| Rate for Payer: BCN Commercial |
$595.21
|
| Rate for Payer: BCN Medicare Advantage |
$355.89
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$512.48
|
| Rate for Payer: Cofinity Commercial |
$476.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.89
|
| Rate for Payer: Mclaren Medicaid |
$244.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.68
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Nomi Health Commercial |
$427.07
|
| Rate for Payer: PACE SWMI |
$355.89
|
| Rate for Payer: PHP Medicare Advantage |
$355.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health HMO/PPO |
$576.54
|
| Rate for Payer: Priority Health Medicare |
$359.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$576.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.89
|
| Rate for Payer: UHC Exchange |
$355.89
|
| Rate for Payer: UHC Medicare Advantage |
$355.89
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLC W/O ANES
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 28570
|
| Min. Negotiated Rate |
$133.55 |
| Max. Negotiated Rate |
$1,383.62 |
| Rate for Payer: Aetna Commercial |
$258.69
|
| Rate for Payer: Aetna Medicare |
$200.77
|
| Rate for Payer: BCBS Complete |
$140.23
|
| Rate for Payer: BCBS MAPPO |
$193.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.62
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$193.05
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$277.99
|
| Rate for Payer: Cofinity Commercial |
$258.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.05
|
| Rate for Payer: Mclaren Medicaid |
$133.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.70
|
| Rate for Payer: Meridian Medicaid |
$140.23
|
| Rate for Payer: Nomi Health Commercial |
$231.66
|
| Rate for Payer: PACE SWMI |
$193.05
|
| Rate for Payer: PHP Medicare Advantage |
$193.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO |
$313.96
|
| Rate for Payer: Priority Health Medicare |
$194.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$313.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.05
|
| Rate for Payer: UHC Exchange |
$193.05
|
| Rate for Payer: UHC Medicare Advantage |
$193.05
|
| Rate for Payer: UHCCP Medicaid |
$133.55
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28575
|
| Min. Negotiated Rate |
$227.27 |
| Max. Negotiated Rate |
$804.60 |
| Rate for Payer: Aetna Commercial |
$442.84
|
| Rate for Payer: Aetna Medicare |
$343.70
|
| Rate for Payer: BCBS Complete |
$238.63
|
| Rate for Payer: BCBS MAPPO |
$330.48
|
| Rate for Payer: BCBS Trust/PPO |
$804.60
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$330.48
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$475.89
|
| Rate for Payer: Cofinity Commercial |
$442.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.48
|
| Rate for Payer: Mclaren Medicaid |
$227.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.00
|
| Rate for Payer: Meridian Medicaid |
$238.63
|
| Rate for Payer: Nomi Health Commercial |
$396.58
|
| Rate for Payer: PACE SWMI |
$330.48
|
| Rate for Payer: PHP Medicare Advantage |
$330.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO |
$536.34
|
| Rate for Payer: Priority Health Medicare |
$333.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.48
|
| Rate for Payer: UHC Exchange |
$330.48
|
| Rate for Payer: UHC Medicare Advantage |
$330.48
|
| Rate for Payer: UHCCP Medicaid |
$227.27
|
|
|
PR CLOSED TX TALUS FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28435
|
| Min. Negotiated Rate |
$219.82 |
| Max. Negotiated Rate |
$1,149.05 |
| Rate for Payer: Aetna Commercial |
$429.34
|
| Rate for Payer: Aetna Medicare |
$333.22
|
| Rate for Payer: BCBS Complete |
$230.81
|
| Rate for Payer: BCBS MAPPO |
$320.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.05
|
| Rate for Payer: BCN Commercial |
$553.67
|
| Rate for Payer: BCN Medicare Advantage |
$320.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$461.38
|
| Rate for Payer: Cofinity Commercial |
$429.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.40
|
| Rate for Payer: Mclaren Medicaid |
$219.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.42
|
| Rate for Payer: Meridian Medicaid |
$230.81
|
| Rate for Payer: Nomi Health Commercial |
$384.48
|
| Rate for Payer: PACE SWMI |
$320.40
|
| Rate for Payer: PHP Medicare Advantage |
$320.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$323.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.40
|
| Rate for Payer: UHC Exchange |
$320.40
|
| Rate for Payer: UHC Medicare Advantage |
$320.40
|
| Rate for Payer: UHCCP Medicaid |
$219.82
|
|
|
PR CLOSED TX TALUS FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 28430
|
| Min. Negotiated Rate |
$141.01 |
| Max. Negotiated Rate |
$540.45 |
| Rate for Payer: Aetna Commercial |
$274.06
|
| Rate for Payer: Aetna Medicare |
$212.70
|
| Rate for Payer: BCBS Complete |
$148.06
|
| Rate for Payer: BCBS MAPPO |
$204.52
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$358.20
|
| Rate for Payer: BCN Medicare Advantage |
$204.52
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$294.51
|
| Rate for Payer: Cofinity Commercial |
$274.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.52
|
| Rate for Payer: Mclaren Medicaid |
$141.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.75
|
| Rate for Payer: Meridian Medicaid |
$148.06
|
| Rate for Payer: Nomi Health Commercial |
$245.42
|
| Rate for Payer: PACE SWMI |
$204.52
|
| Rate for Payer: PHP Medicare Advantage |
$204.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO |
$333.30
|
| Rate for Payer: Priority Health Medicare |
$206.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.52
|
| Rate for Payer: UHC Exchange |
$204.52
|
| Rate for Payer: UHC Medicare Advantage |
$204.52
|
| Rate for Payer: UHCCP Medicaid |
$141.01
|
|
|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28605
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$2,031.31 |
| Rate for Payer: Aetna Commercial |
$398.61
|
| Rate for Payer: Aetna Medicare |
$309.37
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$297.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.31
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$297.47
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$428.36
|
| Rate for Payer: Cofinity Commercial |
$398.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.47
|
| Rate for Payer: Mclaren Medicaid |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.34
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Nomi Health Commercial |
$356.96
|
| Rate for Payer: PACE SWMI |
$297.47
|
| Rate for Payer: PHP Medicare Advantage |
$297.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$300.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.47
|
| Rate for Payer: UHC Exchange |
$297.47
|
| Rate for Payer: UHC Medicare Advantage |
$297.47
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 28600
|
| Min. Negotiated Rate |
$124.39 |
| Max. Negotiated Rate |
$1,628.75 |
| Rate for Payer: Aetna Commercial |
$241.45
|
| Rate for Payer: Aetna Medicare |
$187.40
|
| Rate for Payer: BCBS Complete |
$130.61
|
| Rate for Payer: BCBS MAPPO |
$180.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.75
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$180.19
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$259.47
|
| Rate for Payer: Cofinity Commercial |
$241.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.19
|
| Rate for Payer: Mclaren Medicaid |
$124.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.20
|
| Rate for Payer: Meridian Medicaid |
$130.61
|
| Rate for Payer: Nomi Health Commercial |
$216.23
|
| Rate for Payer: PACE SWMI |
$180.19
|
| Rate for Payer: PHP Medicare Advantage |
$180.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO |
$251.88
|
| Rate for Payer: Priority Health Medicare |
$181.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.19
|
| Rate for Payer: UHC Exchange |
$180.19
|
| Rate for Payer: UHC Medicare Advantage |
$180.19
|
| Rate for Payer: UHCCP Medicaid |
$124.39
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ
|
Professional
|
Both
|
$1,088.00
|
|
|
Service Code
|
HCPCS 21485
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,428.40 |
| Rate for Payer: Aetna Commercial |
$937.80
|
| Rate for Payer: Aetna Medicare |
$727.84
|
| Rate for Payer: BCBS Complete |
$517.52
|
| Rate for Payer: BCBS MAPPO |
$699.85
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,428.40
|
| Rate for Payer: BCN Medicare Advantage |
$699.85
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$937.80
|
| Rate for Payer: Cofinity Commercial |
$1,007.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.85
|
| Rate for Payer: Mclaren Medicaid |
$492.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.84
|
| Rate for Payer: Meridian Medicaid |
$517.52
|
| Rate for Payer: Nomi Health Commercial |
$839.82
|
| Rate for Payer: PACE SWMI |
$699.85
|
| Rate for Payer: PHP Medicare Advantage |
$699.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,194.30
|
| Rate for Payer: Priority Health Medicare |
$706.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,194.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.85
|
| Rate for Payer: UHC Exchange |
$699.85
|
| Rate for Payer: UHC Medicare Advantage |
$699.85
|
| Rate for Payer: UHCCP Medicaid |
$492.88
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 21480
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$32.08
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$30.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$30.85
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$41.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.85
|
| Rate for Payer: Mclaren Medicaid |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.39
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$37.02
|
| Rate for Payer: PACE SWMI |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$30.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health HMO/PPO |
$47.33
|
| Rate for Payer: Priority Health Medicare |
$31.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.85
|
| Rate for Payer: UHC Exchange |
$30.85
|
| Rate for Payer: UHC Medicare Advantage |
$30.85
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 24675
|
| Min. Negotiated Rate |
$277.97 |
| Max. Negotiated Rate |
$1,365.66 |
| Rate for Payer: Aetna Commercial |
$545.37
|
| Rate for Payer: Aetna Medicare |
$423.27
|
| Rate for Payer: BCBS Complete |
$291.87
|
| Rate for Payer: BCBS MAPPO |
$406.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: BCN Commercial |
$690.01
|
| Rate for Payer: BCN Medicare Advantage |
$406.99
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cofinity Commercial |
$586.07
|
| Rate for Payer: Cofinity Commercial |
$545.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.99
|
| Rate for Payer: Mclaren Medicaid |
$277.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.34
|
| Rate for Payer: Meridian Medicaid |
$291.87
|
| Rate for Payer: Nomi Health Commercial |
$488.39
|
| Rate for Payer: PACE SWMI |
$406.99
|
| Rate for Payer: PHP Medicare Advantage |
$406.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.75
|
| Rate for Payer: Priority Health HMO/PPO |
$659.99
|
| Rate for Payer: Priority Health Medicare |
$411.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.99
|
| Rate for Payer: UHC Exchange |
$406.99
|
| Rate for Payer: UHC Medicare Advantage |
$406.99
|
| Rate for Payer: UHCCP Medicaid |
$277.97
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ
|
Professional
|
Both
|
$797.00
|
|
|
Service Code
|
HCPCS 24670
|
| Min. Negotiated Rate |
$181.05 |
| Max. Negotiated Rate |
$1,283.24 |
| Rate for Payer: Aetna Commercial |
$352.03
|
| Rate for Payer: Aetna Medicare |
$273.22
|
| Rate for Payer: BCBS Complete |
$190.10
|
| Rate for Payer: BCBS MAPPO |
$262.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.24
|
| Rate for Payer: BCN Commercial |
$441.27
|
| Rate for Payer: BCN Medicare Advantage |
$262.71
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cofinity Commercial |
$378.30
|
| Rate for Payer: Cofinity Commercial |
$352.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.71
|
| Rate for Payer: Mclaren Medicaid |
$181.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.85
|
| Rate for Payer: Meridian Medicaid |
$190.10
|
| Rate for Payer: Nomi Health Commercial |
$315.25
|
| Rate for Payer: PACE SWMI |
$262.71
|
| Rate for Payer: PHP Medicare Advantage |
$262.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.05
|
| Rate for Payer: Priority Health HMO/PPO |
$427.45
|
| Rate for Payer: Priority Health Medicare |
$265.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.71
|
| Rate for Payer: UHC Exchange |
$262.71
|
| Rate for Payer: UHC Medicare Advantage |
$262.71
|
| Rate for Payer: UHCCP Medicaid |
$181.05
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 25535
|
| Min. Negotiated Rate |
$304.38 |
| Max. Negotiated Rate |
$1,028.60 |
| Rate for Payer: Aetna Commercial |
$596.76
|
| Rate for Payer: Aetna Medicare |
$463.15
|
| Rate for Payer: BCBS Complete |
$319.60
|
| Rate for Payer: BCBS MAPPO |
$445.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$445.34
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$641.29
|
| Rate for Payer: Cofinity Commercial |
$596.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.34
|
| Rate for Payer: Mclaren Medicaid |
$304.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.61
|
| Rate for Payer: Meridian Medicaid |
$319.60
|
| Rate for Payer: Nomi Health Commercial |
$534.41
|
| Rate for Payer: PACE SWMI |
$445.34
|
| Rate for Payer: PHP Medicare Advantage |
$445.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.50
|
| Rate for Payer: Priority Health HMO/PPO |
$722.58
|
| Rate for Payer: Priority Health Medicare |
$449.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$722.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$445.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.34
|
| Rate for Payer: UHC Exchange |
$445.34
|
| Rate for Payer: UHC Medicare Advantage |
$445.34
|
| Rate for Payer: UHCCP Medicaid |
$304.38
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$655.00
|
|
|
Service Code
|
HCPCS 25530
|
| Min. Negotiated Rate |
$165.71 |
| Max. Negotiated Rate |
$1,133.73 |
| Rate for Payer: Aetna Commercial |
$320.85
|
| Rate for Payer: Aetna Medicare |
$249.02
|
| Rate for Payer: BCBS Complete |
$174.00
|
| Rate for Payer: BCBS MAPPO |
$239.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.73
|
| Rate for Payer: BCN Commercial |
$398.76
|
| Rate for Payer: BCN Medicare Advantage |
$239.44
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cofinity Commercial |
$344.79
|
| Rate for Payer: Cofinity Commercial |
$320.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.44
|
| Rate for Payer: Mclaren Medicaid |
$165.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.41
|
| Rate for Payer: Meridian Medicaid |
$174.00
|
| Rate for Payer: Nomi Health Commercial |
$287.33
|
| Rate for Payer: PACE SWMI |
$239.44
|
| Rate for Payer: PHP Medicare Advantage |
$239.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.75
|
| Rate for Payer: Priority Health HMO/PPO |
$389.28
|
| Rate for Payer: Priority Health Medicare |
$241.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.44
|
| Rate for Payer: UHC Exchange |
$239.44
|
| Rate for Payer: UHC Medicare Advantage |
$239.44
|
| Rate for Payer: UHCCP Medicaid |
$165.71
|
|
|
PR CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 21750
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,388.14 |
| Rate for Payer: Aetna Commercial |
$875.98
|
| Rate for Payer: Aetna Medicare |
$679.87
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$653.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$653.72
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cofinity Commercial |
$941.36
|
| Rate for Payer: Cofinity Commercial |
$875.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.72
|
| Rate for Payer: Mclaren Medicaid |
$432.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.41
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Nomi Health Commercial |
$784.46
|
| Rate for Payer: PACE SWMI |
$653.72
|
| Rate for Payer: PHP Medicare Advantage |
$653.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,027.38
|
| Rate for Payer: Priority Health Medicare |
$660.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,027.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$653.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.72
|
| Rate for Payer: UHC Exchange |
$653.72
|
| Rate for Payer: UHC Medicare Advantage |
$653.72
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR CLOSURE CYSTOSTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 51880
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,691.09 |
| Rate for Payer: Aetna Commercial |
$596.06
|
| Rate for Payer: Aetna Medicare |
$462.61
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$444.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.09
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$444.82
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cofinity Commercial |
$640.54
|
| Rate for Payer: Cofinity Commercial |
$596.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.82
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.06
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Nomi Health Commercial |
$533.78
|
| Rate for Payer: PACE SWMI |
$444.82
|
| Rate for Payer: PHP Medicare Advantage |
$444.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.00
|
| Rate for Payer: Priority Health HMO/PPO |
$745.65
|
| Rate for Payer: Priority Health Medicare |
$449.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$745.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$444.82
|
| Rate for Payer: UHC Exchange |
$444.82
|
| Rate for Payer: UHC Medicare Advantage |
$444.82
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
