|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MNPJ
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$902.20 |
| Rate for Payer: Aetna Commercial |
$667.56
|
| Rate for Payer: Aetna Medicare |
$518.11
|
| Rate for Payer: BCBS Complete |
$356.28
|
| Rate for Payer: BCBS MAPPO |
$498.18
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$808.76
|
| Rate for Payer: BCN Medicare Advantage |
$498.18
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$717.38
|
| Rate for Payer: Cofinity Commercial |
$667.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.18
|
| Rate for Payer: Mclaren Medicaid |
$339.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.09
|
| Rate for Payer: Meridian Medicaid |
$356.28
|
| Rate for Payer: Nomi Health Commercial |
$597.82
|
| Rate for Payer: PACE SWMI |
$498.18
|
| Rate for Payer: PHP Medicare Advantage |
$498.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO |
$805.02
|
| Rate for Payer: Priority Health Medicare |
$503.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.18
|
| Rate for Payer: UHC Exchange |
$498.18
|
| Rate for Payer: UHC Medicare Advantage |
$498.18
|
| Rate for Payer: UHCCP Medicaid |
$339.31
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,047.00
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$257.28 |
| Max. Negotiated Rate |
$843.18 |
| Rate for Payer: Aetna Commercial |
$677.45
|
| Rate for Payer: Aetna Medicare |
$525.78
|
| Rate for Payer: BCBS Complete |
$369.47
|
| Rate for Payer: BCBS MAPPO |
$505.56
|
| Rate for Payer: BCBS Trust/PPO |
$257.28
|
| Rate for Payer: BCN Commercial |
$812.67
|
| Rate for Payer: BCN Medicare Advantage |
$505.56
|
| Rate for Payer: Cash Price |
$837.60
|
| Rate for Payer: Cash Price |
$837.60
|
| Rate for Payer: Cofinity Commercial |
$728.01
|
| Rate for Payer: Cofinity Commercial |
$677.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.56
|
| Rate for Payer: Mclaren Medicaid |
$351.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.84
|
| Rate for Payer: Meridian Medicaid |
$369.47
|
| Rate for Payer: Nomi Health Commercial |
$606.67
|
| Rate for Payer: PACE SWMI |
$505.56
|
| Rate for Payer: PHP Medicare Advantage |
$505.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.55
|
| Rate for Payer: Priority Health HMO/PPO |
$843.18
|
| Rate for Payer: Priority Health Medicare |
$510.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$843.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.56
|
| Rate for Payer: UHC Exchange |
$505.56
|
| Rate for Payer: UHC Medicare Advantage |
$505.56
|
| Rate for Payer: UHCCP Medicaid |
$351.88
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 27510
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,056.40 |
| Rate for Payer: Aetna Commercial |
$884.04
|
| Rate for Payer: Aetna Medicare |
$686.12
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$659.73
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$1,005.70
|
| Rate for Payer: BCN Medicare Advantage |
$659.73
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cofinity Commercial |
$950.01
|
| Rate for Payer: Cofinity Commercial |
$884.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.73
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.72
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Nomi Health Commercial |
$791.68
|
| Rate for Payer: PACE SWMI |
$659.73
|
| Rate for Payer: PHP Medicare Advantage |
$659.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,056.40
|
| Rate for Payer: Priority Health Medicare |
$666.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$659.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.73
|
| Rate for Payer: UHC Exchange |
$659.73
|
| Rate for Payer: UHC Medicare Advantage |
$659.73
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 27508
|
| Min. Negotiated Rate |
$329.51 |
| Max. Negotiated Rate |
$781.39 |
| Rate for Payer: Aetna Commercial |
$648.98
|
| Rate for Payer: Aetna Medicare |
$503.68
|
| Rate for Payer: BCBS Complete |
$345.99
|
| Rate for Payer: BCBS MAPPO |
$484.31
|
| Rate for Payer: BCBS Trust/PPO |
$738.04
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$484.31
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$697.41
|
| Rate for Payer: Cofinity Commercial |
$648.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.31
|
| Rate for Payer: Mclaren Medicaid |
$329.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.53
|
| Rate for Payer: Meridian Medicaid |
$345.99
|
| Rate for Payer: Nomi Health Commercial |
$581.17
|
| Rate for Payer: PACE SWMI |
$484.31
|
| Rate for Payer: PHP Medicare Advantage |
$484.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$715.00
|
| Rate for Payer: Priority Health HMO/PPO |
$780.09
|
| Rate for Payer: Priority Health Medicare |
$489.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.31
|
| Rate for Payer: UHC Exchange |
$484.31
|
| Rate for Payer: UHC Medicare Advantage |
$484.31
|
| Rate for Payer: UHCCP Medicaid |
$329.51
|
|
|
PR CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,373.00
|
|
|
Service Code
|
HCPCS 27232
|
| Min. Negotiated Rate |
$473.50 |
| Max. Negotiated Rate |
$1,117.45 |
| Rate for Payer: Aetna Commercial |
$950.37
|
| Rate for Payer: Aetna Medicare |
$737.60
|
| Rate for Payer: BCBS Complete |
$497.18
|
| Rate for Payer: BCBS MAPPO |
$709.23
|
| Rate for Payer: BCBS Trust/PPO |
$835.77
|
| Rate for Payer: BCN Commercial |
$1,065.80
|
| Rate for Payer: BCN Medicare Advantage |
$709.23
|
| Rate for Payer: Cash Price |
$1,098.40
|
| Rate for Payer: Cash Price |
$1,098.40
|
| Rate for Payer: Cofinity Commercial |
$950.37
|
| Rate for Payer: Cofinity Commercial |
$1,021.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.23
|
| Rate for Payer: Mclaren Medicaid |
$473.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.69
|
| Rate for Payer: Meridian Medicaid |
$497.18
|
| Rate for Payer: Nomi Health Commercial |
$851.08
|
| Rate for Payer: PACE SWMI |
$709.23
|
| Rate for Payer: PHP Medicare Advantage |
$709.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,117.45
|
| Rate for Payer: Priority Health Medicare |
$716.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,117.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.23
|
| Rate for Payer: UHC Exchange |
$709.23
|
| Rate for Payer: UHC Medicare Advantage |
$709.23
|
| Rate for Payer: UHCCP Medicaid |
$473.50
|
|
|
PR CLTX FEM FX PROX END NCK W/O MANJ
|
Professional
|
Both
|
$999.00
|
|
|
Service Code
|
HCPCS 27230
|
| Min. Negotiated Rate |
$315.67 |
| Max. Negotiated Rate |
$806.71 |
| Rate for Payer: Aetna Commercial |
$620.89
|
| Rate for Payer: Aetna Medicare |
$481.88
|
| Rate for Payer: BCBS Complete |
$331.45
|
| Rate for Payer: BCBS MAPPO |
$463.35
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$723.73
|
| Rate for Payer: BCN Medicare Advantage |
$463.35
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cofinity Commercial |
$667.22
|
| Rate for Payer: Cofinity Commercial |
$620.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.35
|
| Rate for Payer: Mclaren Medicaid |
$315.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.52
|
| Rate for Payer: Meridian Medicaid |
$331.45
|
| Rate for Payer: Nomi Health Commercial |
$556.02
|
| Rate for Payer: PACE SWMI |
$463.35
|
| Rate for Payer: PHP Medicare Advantage |
$463.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.35
|
| Rate for Payer: Priority Health HMO/PPO |
$749.54
|
| Rate for Payer: Priority Health Medicare |
$467.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$463.35
|
| Rate for Payer: UHC Exchange |
$463.35
|
| Rate for Payer: UHC Medicare Advantage |
$463.35
|
| Rate for Payer: UHCCP Medicaid |
$315.67
|
|
|
PR CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ
|
Professional
|
Both
|
$1,832.00
|
|
|
Service Code
|
HCPCS 27502
|
| Min. Negotiated Rate |
$490.54 |
| Max. Negotiated Rate |
$1,190.80 |
| Rate for Payer: Aetna Commercial |
$979.66
|
| Rate for Payer: Aetna Medicare |
$760.33
|
| Rate for Payer: BCBS Complete |
$515.07
|
| Rate for Payer: BCBS MAPPO |
$731.09
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$1,111.74
|
| Rate for Payer: BCN Medicare Advantage |
$731.09
|
| Rate for Payer: Cash Price |
$1,465.60
|
| Rate for Payer: Cash Price |
$1,465.60
|
| Rate for Payer: Cofinity Commercial |
$979.66
|
| Rate for Payer: Cofinity Commercial |
$1,052.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.09
|
| Rate for Payer: Mclaren Medicaid |
$490.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.64
|
| Rate for Payer: Meridian Medicaid |
$515.07
|
| Rate for Payer: Nomi Health Commercial |
$877.31
|
| Rate for Payer: PACE SWMI |
$731.09
|
| Rate for Payer: PHP Medicare Advantage |
$731.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,162.75
|
| Rate for Payer: Priority Health Medicare |
$738.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,162.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.09
|
| Rate for Payer: UHC Exchange |
$731.09
|
| Rate for Payer: UHC Medicare Advantage |
$731.09
|
| Rate for Payer: UHCCP Medicaid |
$490.54
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 28495
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$413.04 |
| Rate for Payer: Aetna Commercial |
$194.11
|
| Rate for Payer: Aetna Medicare |
$150.65
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$144.86
|
| Rate for Payer: BCBS Trust/PPO |
$413.04
|
| Rate for Payer: BCN Commercial |
$263.88
|
| Rate for Payer: BCN Medicare Advantage |
$144.86
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$208.60
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.86
|
| Rate for Payer: Mclaren Medicaid |
$100.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.10
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Nomi Health Commercial |
$173.83
|
| Rate for Payer: PACE SWMI |
$144.86
|
| Rate for Payer: PHP Medicare Advantage |
$144.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO |
$235.10
|
| Rate for Payer: Priority Health Medicare |
$146.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.86
|
| Rate for Payer: UHC Exchange |
$144.86
|
| Rate for Payer: UHC Medicare Advantage |
$144.86
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$1,548.98 |
| Rate for Payer: Aetna Commercial |
$161.51
|
| Rate for Payer: Aetna Medicare |
$125.35
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$120.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$120.53
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$161.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.53
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.56
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$144.64
|
| Rate for Payer: PACE SWMI |
$120.53
|
| Rate for Payer: PHP Medicare Advantage |
$120.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO |
$196.93
|
| Rate for Payer: Priority Health Medicare |
$121.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.53
|
| Rate for Payer: UHC Exchange |
$120.53
|
| Rate for Payer: UHC Medicare Advantage |
$120.53
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$71.96 |
| Max. Negotiated Rate |
$272.70 |
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: Aetna Medicare |
$78.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.69
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$75.75
|
| Rate for Payer: BCBS Trust/PPO |
$249.10
|
| Rate for Payer: BCN Commercial |
$235.58
|
| Rate for Payer: BCN Medicare Advantage |
$75.75
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$260.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.75
|
| Rate for Payer: Healthscope Commercial |
$272.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.25
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.54
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.55
|
| Rate for Payer: Nomi Health Commercial |
$248.46
|
| Rate for Payer: PACE Senior Care Partners |
$71.96
|
| Rate for Payer: PACE SWMI |
$75.75
|
| Rate for Payer: PHP Commercial |
$257.55
|
| Rate for Payer: PHP Medicare Advantage |
$75.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO |
$263.61
|
| Rate for Payer: Priority Health Medicare |
$76.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.01
|
| Rate for Payer: Railroad Medicare Medicare |
$75.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.64
|
| Rate for Payer: UHC Core |
$253.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.75
|
| Rate for Payer: UHC Exchange |
$75.75
|
| Rate for Payer: UHC Medicare Advantage |
$75.75
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$75.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.25
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$196.95 |
| Max. Negotiated Rate |
$272.70 |
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: BCBS Trust/PPO |
$247.34
|
| Rate for Payer: BCN Commercial |
$234.16
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$260.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.40
|
| Rate for Payer: Healthscope Commercial |
$272.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.55
|
| Rate for Payer: Nomi Health Commercial |
$248.46
|
| Rate for Payer: PHP Commercial |
$257.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO |
$263.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.64
|
| Rate for Payer: UHC Core |
$253.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.25
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 28490
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$1,548.98 |
| Rate for Payer: Aetna Commercial |
$161.51
|
| Rate for Payer: Aetna Medicare |
$125.35
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$120.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$120.53
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$161.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.53
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.56
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$144.64
|
| Rate for Payer: PACE SWMI |
$120.53
|
| Rate for Payer: PHP Medicare Advantage |
$120.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO |
$196.93
|
| Rate for Payer: Priority Health Medicare |
$121.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.53
|
| Rate for Payer: UHC Exchange |
$120.53
|
| Rate for Payer: UHC Medicare Advantage |
$120.53
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna Commercial |
$184.73
|
| Rate for Payer: Aetna Medicare |
$143.37
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS MAPPO |
$137.86
|
| Rate for Payer: BCBS Trust/PPO |
$423.70
|
| Rate for Payer: BCN Commercial |
$242.88
|
| Rate for Payer: BCN Medicare Advantage |
$137.86
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$198.52
|
| Rate for Payer: Cofinity Commercial |
$184.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.86
|
| Rate for Payer: Mclaren Medicaid |
$95.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.75
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Nomi Health Commercial |
$165.43
|
| Rate for Payer: PACE SWMI |
$137.86
|
| Rate for Payer: PHP Medicare Advantage |
$137.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health HMO/PPO |
$226.44
|
| Rate for Payer: Priority Health Medicare |
$139.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.86
|
| Rate for Payer: UHC Exchange |
$137.86
|
| Rate for Payer: UHC Medicare Advantage |
$137.86
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$1,955.77 |
| Rate for Payer: Aetna Commercial |
$156.27
|
| Rate for Payer: Aetna Medicare |
$121.28
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCBS MAPPO |
$116.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.77
|
| Rate for Payer: BCN Commercial |
$179.35
|
| Rate for Payer: BCN Medicare Advantage |
$116.62
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$167.93
|
| Rate for Payer: Cofinity Commercial |
$156.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.62
|
| Rate for Payer: Mclaren Medicaid |
$80.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.45
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Nomi Health Commercial |
$139.94
|
| Rate for Payer: PACE SWMI |
$116.62
|
| Rate for Payer: PHP Medicare Advantage |
$116.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO |
$190.83
|
| Rate for Payer: Priority Health Medicare |
$117.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.62
|
| Rate for Payer: UHC Exchange |
$116.62
|
| Rate for Payer: UHC Medicare Advantage |
$116.62
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$3,163.99 |
| Rate for Payer: Aetna Commercial |
$400.58
|
| Rate for Payer: Aetna Medicare |
$310.90
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$298.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,163.99
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$298.94
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$430.47
|
| Rate for Payer: Cofinity Commercial |
$400.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.94
|
| Rate for Payer: Mclaren Medicaid |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.89
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Nomi Health Commercial |
$358.73
|
| Rate for Payer: PACE SWMI |
$298.94
|
| Rate for Payer: PHP Medicare Advantage |
$298.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO |
$483.92
|
| Rate for Payer: Priority Health Medicare |
$301.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.94
|
| Rate for Payer: UHC Exchange |
$298.94
|
| Rate for Payer: UHC Medicare Advantage |
$298.94
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$326.53 |
| Max. Negotiated Rate |
$3,467.23 |
| Rate for Payer: Aetna Commercial |
$646.35
|
| Rate for Payer: Aetna Medicare |
$501.64
|
| Rate for Payer: BCBS Complete |
$342.86
|
| Rate for Payer: BCBS MAPPO |
$482.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,467.23
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$482.35
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$694.58
|
| Rate for Payer: Cofinity Commercial |
$646.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.35
|
| Rate for Payer: Mclaren Medicaid |
$326.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.47
|
| Rate for Payer: Meridian Medicaid |
$342.86
|
| Rate for Payer: Nomi Health Commercial |
$578.82
|
| Rate for Payer: PACE SWMI |
$482.35
|
| Rate for Payer: PHP Medicare Advantage |
$482.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$769.91
|
| Rate for Payer: Priority Health Medicare |
$487.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$769.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$482.35
|
| Rate for Payer: UHC Exchange |
$482.35
|
| Rate for Payer: UHC Medicare Advantage |
$482.35
|
| Rate for Payer: UHCCP Medicaid |
$326.53
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$446.55 |
| Rate for Payer: Aetna Commercial |
$341.28
|
| Rate for Payer: Aetna Medicare |
$264.88
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$254.69
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$254.69
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cofinity Commercial |
$366.75
|
| Rate for Payer: Cofinity Commercial |
$341.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.69
|
| Rate for Payer: Mclaren Medicaid |
$175.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Nomi Health Commercial |
$305.63
|
| Rate for Payer: PACE SWMI |
$254.69
|
| Rate for Payer: PHP Medicare Advantage |
$254.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.55
|
| Rate for Payer: Priority Health HMO/PPO |
$414.72
|
| Rate for Payer: Priority Health Medicare |
$257.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.69
|
| Rate for Payer: UHC Exchange |
$254.69
|
| Rate for Payer: UHC Medicare Advantage |
$254.69
|
| Rate for Payer: UHCCP Medicaid |
$175.73
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$233.87 |
| Max. Negotiated Rate |
$582.99 |
| Rate for Payer: Aetna Commercial |
$458.57
|
| Rate for Payer: Aetna Medicare |
$355.91
|
| Rate for Payer: BCBS Complete |
$245.56
|
| Rate for Payer: BCBS MAPPO |
$342.22
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$582.99
|
| Rate for Payer: BCN Medicare Advantage |
$342.22
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$458.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.22
|
| Rate for Payer: Mclaren Medicaid |
$233.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.33
|
| Rate for Payer: Meridian Medicaid |
$245.56
|
| Rate for Payer: Nomi Health Commercial |
$410.66
|
| Rate for Payer: PACE SWMI |
$342.22
|
| Rate for Payer: PHP Medicare Advantage |
$342.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.00
|
| Rate for Payer: Priority Health HMO/PPO |
$560.26
|
| Rate for Payer: Priority Health Medicare |
$345.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.22
|
| Rate for Payer: UHC Exchange |
$342.22
|
| Rate for Payer: UHC Medicare Advantage |
$342.22
|
| Rate for Payer: UHCCP Medicaid |
$233.87
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$505.18
|
| Rate for Payer: Aetna Medicare |
$392.08
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$377.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$377.00
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$542.88
|
| Rate for Payer: Cofinity Commercial |
$505.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.00
|
| Rate for Payer: Mclaren Medicaid |
$256.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.85
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Nomi Health Commercial |
$452.40
|
| Rate for Payer: PACE SWMI |
$377.00
|
| Rate for Payer: PHP Medicare Advantage |
$377.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.40
|
| Rate for Payer: Priority Health HMO/PPO |
$606.57
|
| Rate for Payer: Priority Health Medicare |
$380.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$606.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$377.00
|
| Rate for Payer: UHC Exchange |
$377.00
|
| Rate for Payer: UHC Medicare Advantage |
$377.00
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$1,958.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$2,221.50 |
| Rate for Payer: Aetna Commercial |
$967.49
|
| Rate for Payer: Aetna Medicare |
$750.89
|
| Rate for Payer: BCBS Complete |
$509.47
|
| Rate for Payer: BCBS MAPPO |
$722.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,221.50
|
| Rate for Payer: BCN Commercial |
$1,107.84
|
| Rate for Payer: BCN Medicare Advantage |
$722.01
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$967.49
|
| Rate for Payer: Cofinity Commercial |
$1,039.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.01
|
| Rate for Payer: Mclaren Medicaid |
$485.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.11
|
| Rate for Payer: Meridian Medicaid |
$509.47
|
| Rate for Payer: Nomi Health Commercial |
$866.41
|
| Rate for Payer: PACE SWMI |
$722.01
|
| Rate for Payer: PHP Medicare Advantage |
$722.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,155.12
|
| Rate for Payer: Priority Health Medicare |
$729.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,155.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$722.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.01
|
| Rate for Payer: UHC Exchange |
$722.01
|
| Rate for Payer: UHC Medicare Advantage |
$722.01
|
| Rate for Payer: UHCCP Medicaid |
$485.21
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$738.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$2,156.52 |
| Rate for Payer: Aetna Commercial |
$236.66
|
| Rate for Payer: Aetna Medicare |
$183.67
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$176.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$262.42
|
| Rate for Payer: BCN Medicare Advantage |
$176.61
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cofinity Commercial |
$254.32
|
| Rate for Payer: Cofinity Commercial |
$236.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.61
|
| Rate for Payer: Mclaren Medicaid |
$114.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.44
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Nomi Health Commercial |
$211.93
|
| Rate for Payer: PACE SWMI |
$176.61
|
| Rate for Payer: PHP Medicare Advantage |
$176.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.70
|
| Rate for Payer: Priority Health HMO/PPO |
$273.25
|
| Rate for Payer: Priority Health Medicare |
$178.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.61
|
| Rate for Payer: UHC Exchange |
$176.61
|
| Rate for Payer: UHC Medicare Advantage |
$176.61
|
| Rate for Payer: UHCCP Medicaid |
$114.81
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$129.43 |
| Max. Negotiated Rate |
$529.24 |
| Rate for Payer: Aetna Commercial |
$411.23
|
| Rate for Payer: Aetna Medicare |
$319.17
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$306.89
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$529.24
|
| Rate for Payer: BCN Medicare Advantage |
$306.89
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$441.92
|
| Rate for Payer: Cofinity Commercial |
$411.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.89
|
| Rate for Payer: Mclaren Medicaid |
$211.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.23
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Nomi Health Commercial |
$368.27
|
| Rate for Payer: PACE SWMI |
$306.89
|
| Rate for Payer: PHP Medicare Advantage |
$306.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.35
|
| Rate for Payer: Priority Health HMO/PPO |
$501.22
|
| Rate for Payer: Priority Health Medicare |
$309.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$501.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.89
|
| Rate for Payer: UHC Exchange |
$306.89
|
| Rate for Payer: UHC Medicare Advantage |
$306.89
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$533.00 |
| Rate for Payer: Aetna Commercial |
$387.11
|
| Rate for Payer: Aetna Medicare |
$300.45
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$288.89
|
| Rate for Payer: BCBS Trust/PPO |
$112.00
|
| Rate for Payer: BCN Commercial |
$502.36
|
| Rate for Payer: BCN Medicare Advantage |
$288.89
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cofinity Commercial |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$387.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.89
|
| Rate for Payer: Mclaren Medicaid |
$198.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.33
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Nomi Health Commercial |
$346.67
|
| Rate for Payer: PACE SWMI |
$288.89
|
| Rate for Payer: PHP Medicare Advantage |
$288.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.00
|
| Rate for Payer: Priority Health HMO/PPO |
$470.19
|
| Rate for Payer: Priority Health Medicare |
$291.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.89
|
| Rate for Payer: UHC Exchange |
$288.89
|
| Rate for Payer: UHC Medicare Advantage |
$288.89
|
| Rate for Payer: UHCCP Medicaid |
$198.94
|
|
|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,288.00
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$300.76 |
| Max. Negotiated Rate |
$837.20 |
| Rate for Payer: Aetna Commercial |
$590.83
|
| Rate for Payer: Aetna Medicare |
$458.56
|
| Rate for Payer: BCBS Complete |
$315.80
|
| Rate for Payer: BCBS MAPPO |
$440.92
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$754.03
|
| Rate for Payer: BCN Medicare Advantage |
$440.92
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cofinity Commercial |
$634.92
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.92
|
| Rate for Payer: Mclaren Medicaid |
$300.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.97
|
| Rate for Payer: Meridian Medicaid |
$315.80
|
| Rate for Payer: Nomi Health Commercial |
$529.10
|
| Rate for Payer: PACE SWMI |
$440.92
|
| Rate for Payer: PHP Medicare Advantage |
$440.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$837.20
|
| Rate for Payer: Priority Health HMO/PPO |
$713.93
|
| Rate for Payer: Priority Health Medicare |
$445.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.92
|
| Rate for Payer: UHC Exchange |
$440.92
|
| Rate for Payer: UHC Medicare Advantage |
$440.92
|
| Rate for Payer: UHCCP Medicaid |
$300.76
|
|
|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$299.69 |
| Max. Negotiated Rate |
$723.24 |
| Rate for Payer: Aetna Commercial |
$586.68
|
| Rate for Payer: Aetna Medicare |
$455.33
|
| Rate for Payer: BCBS Complete |
$314.67
|
| Rate for Payer: BCBS MAPPO |
$437.82
|
| Rate for Payer: BCBS Trust/PPO |
$716.37
|
| Rate for Payer: BCN Commercial |
$723.24
|
| Rate for Payer: BCN Medicare Advantage |
$437.82
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cofinity Commercial |
$630.46
|
| Rate for Payer: Cofinity Commercial |
$586.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.82
|
| Rate for Payer: Mclaren Medicaid |
$299.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.71
|
| Rate for Payer: Meridian Medicaid |
$314.67
|
| Rate for Payer: Nomi Health Commercial |
$525.38
|
| Rate for Payer: PACE SWMI |
$437.82
|
| Rate for Payer: PHP Medicare Advantage |
$437.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.45
|
| Rate for Payer: Priority Health HMO/PPO |
$708.84
|
| Rate for Payer: Priority Health Medicare |
$442.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$437.82
|
| Rate for Payer: UHC Exchange |
$437.82
|
| Rate for Payer: UHC Medicare Advantage |
$437.82
|
| Rate for Payer: UHCCP Medicaid |
$299.69
|
|
