|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 37238
|
| Min. Negotiated Rate |
$190.42 |
| Max. Negotiated Rate |
$5,084.69 |
| Rate for Payer: Aetna Commercial |
$401.12
|
| Rate for Payer: Aetna Medicare |
$311.31
|
| Rate for Payer: BCBS Complete |
$199.94
|
| Rate for Payer: BCBS MAPPO |
$299.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.33
|
| Rate for Payer: BCN Commercial |
$5,084.69
|
| Rate for Payer: BCN Medicare Advantage |
$299.34
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$431.05
|
| Rate for Payer: Cofinity Commercial |
$401.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.34
|
| Rate for Payer: Mclaren Medicaid |
$190.42
|
| Rate for Payer: Meridian Medicaid |
$199.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$314.31
|
| Rate for Payer: PACE SWMI |
$299.34
|
| Rate for Payer: PHP Medicare Advantage |
$299.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.45
|
| Rate for Payer: Priority Health Medicare |
$299.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.34
|
| Rate for Payer: UHC Medicare Advantage |
$308.32
|
|
|
PR OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 25525
|
| Min. Negotiated Rate |
$512.90 |
| Max. Negotiated Rate |
$1,769.60 |
| Rate for Payer: Aetna Commercial |
$1,045.36
|
| Rate for Payer: Aetna Medicare |
$811.32
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS MAPPO |
$780.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.84
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$780.12
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cofinity Commercial |
$1,123.37
|
| Rate for Payer: Cofinity Commercial |
$1,045.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.12
|
| Rate for Payer: Mclaren Medicaid |
$512.90
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$819.13
|
| Rate for Payer: PACE SWMI |
$780.12
|
| Rate for Payer: PHP Medicare Advantage |
$780.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,769.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.93
|
| Rate for Payer: Priority Health Medicare |
$780.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,218.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.12
|
| Rate for Payer: UHC Medicare Advantage |
$803.52
|
|
|
PR OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 25526
|
| Min. Negotiated Rate |
$618.77 |
| Max. Negotiated Rate |
$2,041.90 |
| Rate for Payer: Aetna Commercial |
$1,263.97
|
| Rate for Payer: Aetna Medicare |
$980.99
|
| Rate for Payer: BCBS Complete |
$649.71
|
| Rate for Payer: BCBS MAPPO |
$943.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.05
|
| Rate for Payer: BCN Commercial |
$1,406.91
|
| Rate for Payer: BCN Medicare Advantage |
$943.26
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,358.29
|
| Rate for Payer: Cofinity Commercial |
$1,263.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.26
|
| Rate for Payer: Mclaren Medicaid |
$618.77
|
| Rate for Payer: Meridian Medicaid |
$649.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$990.42
|
| Rate for Payer: PACE SWMI |
$943.26
|
| Rate for Payer: PHP Medicare Advantage |
$943.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,041.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.16
|
| Rate for Payer: Priority Health Medicare |
$943.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,470.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$943.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.26
|
| Rate for Payer: UHC Medicare Advantage |
$971.56
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF ACUTE
|
Professional
|
Both
|
$2,565.00
|
|
|
Service Code
|
HCPCS 23410
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,795.50 |
| Rate for Payer: Aetna Commercial |
$1,084.25
|
| Rate for Payer: Aetna Medicare |
$841.51
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS MAPPO |
$809.14
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$1,206.54
|
| Rate for Payer: BCN Medicare Advantage |
$809.14
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.16
|
| Rate for Payer: Cofinity Commercial |
$1,084.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.14
|
| Rate for Payer: Mclaren Medicaid |
$529.52
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.60
|
| Rate for Payer: PACE SWMI |
$809.14
|
| Rate for Payer: PHP Medicare Advantage |
$809.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.79
|
| Rate for Payer: Priority Health Medicare |
$809.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,260.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$809.14
|
| Rate for Payer: UHC Medicare Advantage |
$833.41
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,058.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$78.96 |
| Max. Negotiated Rate |
$2,140.60 |
| Rate for Payer: Aetna Commercial |
$1,126.55
|
| Rate for Payer: Aetna Medicare |
$874.34
|
| Rate for Payer: BCBS Complete |
$577.91
|
| Rate for Payer: BCBS MAPPO |
$840.71
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$1,379.62
|
| Rate for Payer: BCN Medicare Advantage |
$840.71
|
| Rate for Payer: Cash Price |
$2,446.40
|
| Rate for Payer: Cash Price |
$2,446.40
|
| Rate for Payer: Cofinity Commercial |
$1,126.55
|
| Rate for Payer: Cofinity Commercial |
$1,210.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$840.71
|
| Rate for Payer: Mclaren Medicaid |
$550.39
|
| Rate for Payer: Meridian Medicaid |
$577.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$882.75
|
| Rate for Payer: PACE SWMI |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$840.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$550.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,309.31
|
| Rate for Payer: Priority Health Medicare |
$840.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,309.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$840.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$840.71
|
| Rate for Payer: UHC Medicare Advantage |
$865.93
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
IP
|
$2,946.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$1,796.77 |
| Max. Negotiated Rate |
$2,651.40 |
| Rate for Payer: Aetna Commercial |
$2,504.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.67
|
| Rate for Payer: BCN Commercial |
$2,276.67
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$2,533.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,356.80
|
| Rate for Payer: Healthscope Commercial |
$2,651.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,209.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,504.10
|
| Rate for Payer: PHP Commercial |
$2,504.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,563.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,796.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,592.48
|
| Rate for Payer: UHC Core |
$2,459.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,209.50
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$493.95 |
| Max. Negotiated Rate |
$2,062.20 |
| Rate for Payer: Aetna Commercial |
$1,010.25
|
| Rate for Payer: Aetna Medicare |
$784.08
|
| Rate for Payer: BCBS Complete |
$518.65
|
| Rate for Payer: BCBS MAPPO |
$753.92
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$753.92
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,085.64
|
| Rate for Payer: Cofinity Commercial |
$1,010.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.92
|
| Rate for Payer: Mclaren Medicaid |
$493.95
|
| Rate for Payer: Meridian Medicaid |
$518.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$791.62
|
| Rate for Payer: PACE SWMI |
$753.92
|
| Rate for Payer: PHP Medicare Advantage |
$753.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.51
|
| Rate for Payer: Priority Health Medicare |
$753.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,175.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$753.92
|
| Rate for Payer: UHC Medicare Advantage |
$776.54
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
OP
|
$2,946.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
27814
|
| Min. Negotiated Rate |
$699.68 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$2,504.10
|
| Rate for Payer: Aetna Medicare |
$765.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.62
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$736.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,290.52
|
| Rate for Payer: BCN Commercial |
$2,290.52
|
| Rate for Payer: BCN Medicare Advantage |
$736.50
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$2,533.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,356.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.50
|
| Rate for Payer: Healthscope Commercial |
$2,651.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,209.50
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$773.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,504.10
|
| Rate for Payer: PACE Senior Care Partners |
$699.68
|
| Rate for Payer: PACE SWMI |
$736.50
|
| Rate for Payer: PHP Commercial |
$2,504.10
|
| Rate for Payer: PHP Medicare Advantage |
$736.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,563.02
|
| Rate for Payer: Priority Health Medicare |
$736.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,796.77
|
| Rate for Payer: Railroad Medicare Medicare |
$736.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,592.48
|
| Rate for Payer: UHC Core |
$2,459.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$736.50
|
| Rate for Payer: UHC Medicare Advantage |
$758.60
|
| Rate for Payer: VA VA |
$736.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,209.50
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 27814
|
| Min. Negotiated Rate |
$493.95 |
| Max. Negotiated Rate |
$2,062.20 |
| Rate for Payer: Aetna Commercial |
$1,010.25
|
| Rate for Payer: Aetna Medicare |
$784.08
|
| Rate for Payer: BCBS Complete |
$518.65
|
| Rate for Payer: BCBS MAPPO |
$753.92
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$753.92
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,085.64
|
| Rate for Payer: Cofinity Commercial |
$1,010.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.92
|
| Rate for Payer: Mclaren Medicaid |
$493.95
|
| Rate for Payer: Meridian Medicaid |
$518.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$791.62
|
| Rate for Payer: PACE SWMI |
$753.92
|
| Rate for Payer: PHP Medicare Advantage |
$753.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.51
|
| Rate for Payer: Priority Health Medicare |
$753.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,175.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$753.92
|
| Rate for Payer: UHC Medicare Advantage |
$776.54
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,300.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,310.00 |
| Rate for Payer: Aetna Commercial |
$1,481.02
|
| Rate for Payer: Aetna Medicare |
$1,149.45
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS MAPPO |
$1,105.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: BCN Commercial |
$1,648.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.24
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cofinity Commercial |
$1,591.55
|
| Rate for Payer: Cofinity Commercial |
$1,481.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.24
|
| Rate for Payer: Mclaren Medicaid |
$721.43
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,160.50
|
| Rate for Payer: PACE SWMI |
$1,105.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,310.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,722.93
|
| Rate for Payer: Priority Health Medicare |
$1,105.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,722.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,105.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,105.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,138.40
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,180.00
|
|
|
Service Code
|
HCPCS 28420
|
| Min. Negotiated Rate |
$372.45 |
| Max. Negotiated Rate |
$1,990.51 |
| Rate for Payer: Aetna Commercial |
$1,709.68
|
| Rate for Payer: Aetna Medicare |
$1,326.92
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS MAPPO |
$1,275.88
|
| Rate for Payer: BCBS Trust/PPO |
$372.45
|
| Rate for Payer: BCN Commercial |
$1,904.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.88
|
| Rate for Payer: Cash Price |
$1,744.00
|
| Rate for Payer: Cash Price |
$1,744.00
|
| Rate for Payer: Cofinity Commercial |
$1,837.27
|
| Rate for Payer: Cofinity Commercial |
$1,709.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.88
|
| Rate for Payer: Mclaren Medicaid |
$834.96
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,339.67
|
| Rate for Payer: PACE SWMI |
$1,275.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,526.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,990.51
|
| Rate for Payer: Priority Health Medicare |
$1,275.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,990.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,275.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,314.16
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,513.00
|
|
|
Service Code
|
HCPCS 27828
|
| Min. Negotiated Rate |
$853.07 |
| Max. Negotiated Rate |
$3,159.10 |
| Rate for Payer: Aetna Commercial |
$1,750.55
|
| Rate for Payer: Aetna Medicare |
$1,358.64
|
| Rate for Payer: BCBS Complete |
$895.72
|
| Rate for Payer: BCBS MAPPO |
$1,306.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.07
|
| Rate for Payer: BCN Commercial |
$1,948.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.38
|
| Rate for Payer: Cash Price |
$3,610.40
|
| Rate for Payer: Cash Price |
$3,610.40
|
| Rate for Payer: Cofinity Commercial |
$1,750.55
|
| Rate for Payer: Cofinity Commercial |
$1,881.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.38
|
| Rate for Payer: Mclaren Medicaid |
$853.07
|
| Rate for Payer: Meridian Medicaid |
$895.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.70
|
| Rate for Payer: PACE SWMI |
$1,306.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$853.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,035.96
|
| Rate for Payer: Priority Health Medicare |
$1,306.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,035.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,306.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,306.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.57
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,040.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$551.24 |
| Max. Negotiated Rate |
$3,384.29 |
| Rate for Payer: Aetna Commercial |
$1,124.72
|
| Rate for Payer: Aetna Medicare |
$872.91
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$839.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,384.29
|
| Rate for Payer: BCN Commercial |
$1,257.85
|
| Rate for Payer: BCN Medicare Advantage |
$839.34
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cofinity Commercial |
$1,124.72
|
| Rate for Payer: Cofinity Commercial |
$1,208.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$839.34
|
| Rate for Payer: Mclaren Medicaid |
$551.24
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$881.31
|
| Rate for Payer: PACE SWMI |
$839.34
|
| Rate for Payer: PHP Medicare Advantage |
$839.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.42
|
| Rate for Payer: Priority Health Medicare |
$839.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,314.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$839.34
|
| Rate for Payer: UHC Medicare Advantage |
$864.52
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,276.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$721.86 |
| Max. Negotiated Rate |
$3,897.80 |
| Rate for Payer: Aetna Commercial |
$1,476.12
|
| Rate for Payer: Aetna Medicare |
$1,145.64
|
| Rate for Payer: BCBS Complete |
$757.95
|
| Rate for Payer: BCBS MAPPO |
$1,101.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.80
|
| Rate for Payer: BCN Commercial |
$1,647.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.58
|
| Rate for Payer: Cash Price |
$3,420.80
|
| Rate for Payer: Cash Price |
$3,420.80
|
| Rate for Payer: Cofinity Commercial |
$1,476.12
|
| Rate for Payer: Cofinity Commercial |
$1,586.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.58
|
| Rate for Payer: Mclaren Medicaid |
$721.86
|
| Rate for Payer: Meridian Medicaid |
$757.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,156.66
|
| Rate for Payer: PACE SWMI |
$1,101.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,993.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.92
|
| Rate for Payer: Priority Health Medicare |
$1,101.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,721.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,101.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,134.63
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$480.10 |
| Max. Negotiated Rate |
$2,101.58 |
| Rate for Payer: Aetna Commercial |
$985.89
|
| Rate for Payer: Aetna Medicare |
$765.17
|
| Rate for Payer: BCBS Complete |
$504.10
|
| Rate for Payer: BCBS MAPPO |
$735.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.58
|
| Rate for Payer: BCN Commercial |
$1,094.15
|
| Rate for Payer: BCN Medicare Advantage |
$735.74
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$985.89
|
| Rate for Payer: Cofinity Commercial |
$1,059.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.74
|
| Rate for Payer: Mclaren Medicaid |
$480.10
|
| Rate for Payer: Meridian Medicaid |
$504.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$772.53
|
| Rate for Payer: PACE SWMI |
$735.74
|
| Rate for Payer: PHP Medicare Advantage |
$735.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.34
|
| Rate for Payer: Priority Health Medicare |
$735.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,143.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.74
|
| Rate for Payer: UHC Medicare Advantage |
$757.81
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,802.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$378.26 |
| Max. Negotiated Rate |
$1,961.40 |
| Rate for Payer: Aetna Commercial |
$1,103.33
|
| Rate for Payer: Aetna Medicare |
$856.32
|
| Rate for Payer: BCBS Complete |
$567.40
|
| Rate for Payer: BCBS MAPPO |
$823.38
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$1,229.02
|
| Rate for Payer: BCN Medicare Advantage |
$823.38
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Cofinity Commercial |
$1,185.67
|
| Rate for Payer: Cofinity Commercial |
$1,103.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.38
|
| Rate for Payer: Mclaren Medicaid |
$540.38
|
| Rate for Payer: Meridian Medicaid |
$567.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$864.55
|
| Rate for Payer: PACE SWMI |
$823.38
|
| Rate for Payer: PHP Medicare Advantage |
$823.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,961.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.28
|
| Rate for Payer: Priority Health Medicare |
$823.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,284.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$823.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$823.38
|
| Rate for Payer: UHC Medicare Advantage |
$848.08
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 28675
|
| Min. Negotiated Rate |
$268.17 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$539.34
|
| Rate for Payer: Aetna Medicare |
$418.59
|
| Rate for Payer: BCBS Complete |
$281.58
|
| Rate for Payer: BCBS MAPPO |
$402.49
|
| Rate for Payer: BCBS Trust/PPO |
$671.47
|
| Rate for Payer: BCN Commercial |
$841.50
|
| Rate for Payer: BCN Medicare Advantage |
$402.49
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$579.59
|
| Rate for Payer: Cofinity Commercial |
$539.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.49
|
| Rate for Payer: Mclaren Medicaid |
$268.17
|
| Rate for Payer: Meridian Medicaid |
$281.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$422.61
|
| Rate for Payer: PACE SWMI |
$402.49
|
| Rate for Payer: PHP Medicare Advantage |
$402.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.17
|
| Rate for Payer: Priority Health Medicare |
$402.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.49
|
| Rate for Payer: UHC Medicare Advantage |
$414.56
|
|
|
PR OPEN TREATMENT LUNATE DISLOCATION
|
Professional
|
Both
|
$1,867.00
|
|
|
Service Code
|
HCPCS 25695
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$1,306.90 |
| Rate for Payer: Aetna Commercial |
$841.05
|
| Rate for Payer: Aetna Medicare |
$652.76
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$627.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$937.77
|
| Rate for Payer: BCN Medicare Advantage |
$627.65
|
| Rate for Payer: Cash Price |
$1,493.60
|
| Rate for Payer: Cash Price |
$1,493.60
|
| Rate for Payer: Cofinity Commercial |
$841.05
|
| Rate for Payer: Cofinity Commercial |
$903.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.65
|
| Rate for Payer: Mclaren Medicaid |
$412.58
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$659.03
|
| Rate for Payer: PACE SWMI |
$627.65
|
| Rate for Payer: PHP Medicare Advantage |
$627.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$979.94
|
| Rate for Payer: Priority Health Medicare |
$627.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$979.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.65
|
| Rate for Payer: UHC Medicare Advantage |
$646.48
|
|
|
PR OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 21465
|
| Min. Negotiated Rate |
$509.71 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$1,043.97
|
| Rate for Payer: Aetna Medicare |
$810.24
|
| Rate for Payer: BCBS Complete |
$535.20
|
| Rate for Payer: BCBS MAPPO |
$779.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$1,159.64
|
| Rate for Payer: BCN Medicare Advantage |
$779.08
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cofinity Commercial |
$1,043.97
|
| Rate for Payer: Cofinity Commercial |
$1,121.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.08
|
| Rate for Payer: Mclaren Medicaid |
$509.71
|
| Rate for Payer: Meridian Medicaid |
$535.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.03
|
| Rate for Payer: PACE SWMI |
$779.08
|
| Rate for Payer: PHP Medicare Advantage |
$779.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.77
|
| Rate for Payer: Priority Health Medicare |
$779.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,211.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.08
|
| Rate for Payer: UHC Medicare Advantage |
$802.45
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 27766
|
| Min. Negotiated Rate |
$392.35 |
| Max. Negotiated Rate |
$2,661.86 |
| Rate for Payer: Aetna Commercial |
$800.82
|
| Rate for Payer: Aetna Medicare |
$621.54
|
| Rate for Payer: BCBS Complete |
$411.97
|
| Rate for Payer: BCBS MAPPO |
$597.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,661.86
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: BCN Medicare Advantage |
$597.63
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cofinity Commercial |
$860.59
|
| Rate for Payer: Cofinity Commercial |
$800.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.63
|
| Rate for Payer: Mclaren Medicaid |
$392.35
|
| Rate for Payer: Meridian Medicaid |
$411.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$627.51
|
| Rate for Payer: PACE SWMI |
$597.63
|
| Rate for Payer: PHP Medicare Advantage |
$597.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.51
|
| Rate for Payer: Priority Health Medicare |
$597.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$935.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.63
|
| Rate for Payer: UHC Medicare Advantage |
$615.56
|
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,887.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$374.24 |
| Max. Negotiated Rate |
$1,320.90 |
| Rate for Payer: Aetna Commercial |
$757.19
|
| Rate for Payer: Aetna Medicare |
$587.67
|
| Rate for Payer: BCBS Complete |
$392.95
|
| Rate for Payer: BCBS MAPPO |
$565.07
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$849.33
|
| Rate for Payer: BCN Medicare Advantage |
$565.07
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$813.70
|
| Rate for Payer: Cofinity Commercial |
$757.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.07
|
| Rate for Payer: Mclaren Medicaid |
$374.24
|
| Rate for Payer: Meridian Medicaid |
$392.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$593.32
|
| Rate for Payer: PACE SWMI |
$565.07
|
| Rate for Payer: PHP Medicare Advantage |
$565.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$887.51
|
| Rate for Payer: Priority Health Medicare |
$565.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$887.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$565.07
|
| Rate for Payer: UHC Medicare Advantage |
$582.02
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$365.08 |
| Max. Negotiated Rate |
$924.00 |
| Rate for Payer: Aetna Commercial |
$735.47
|
| Rate for Payer: Aetna Medicare |
$570.81
|
| Rate for Payer: BCBS Complete |
$383.33
|
| Rate for Payer: BCBS MAPPO |
$548.86
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$824.89
|
| Rate for Payer: BCN Medicare Advantage |
$548.86
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$790.36
|
| Rate for Payer: Cofinity Commercial |
$735.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.86
|
| Rate for Payer: Mclaren Medicaid |
$365.08
|
| Rate for Payer: Meridian Medicaid |
$383.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$576.30
|
| Rate for Payer: PACE SWMI |
$548.86
|
| Rate for Payer: PHP Medicare Advantage |
$548.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$861.98
|
| Rate for Payer: Priority Health Medicare |
$548.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$861.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.86
|
| Rate for Payer: UHC Medicare Advantage |
$565.33
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$286.49 |
| Max. Negotiated Rate |
$1,404.22 |
| Rate for Payer: Aetna Commercial |
$576.88
|
| Rate for Payer: Aetna Medicare |
$447.73
|
| Rate for Payer: BCBS Complete |
$300.81
|
| Rate for Payer: BCBS MAPPO |
$430.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
| Rate for Payer: BCN Commercial |
$656.30
|
| Rate for Payer: BCN Medicare Advantage |
$430.51
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cofinity Commercial |
$576.88
|
| Rate for Payer: Cofinity Commercial |
$619.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.51
|
| Rate for Payer: Mclaren Medicaid |
$286.49
|
| Rate for Payer: Meridian Medicaid |
$300.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$452.04
|
| Rate for Payer: PACE SWMI |
$430.51
|
| Rate for Payer: PHP Medicare Advantage |
$430.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.81
|
| Rate for Payer: Priority Health Medicare |
$430.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$685.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.51
|
| Rate for Payer: UHC Medicare Advantage |
$443.43
|
|
|
PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE
|
Professional
|
Both
|
$1,906.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$407.26 |
| Max. Negotiated Rate |
$1,334.20 |
| Rate for Payer: Aetna Commercial |
$826.71
|
| Rate for Payer: Aetna Medicare |
$641.63
|
| Rate for Payer: BCBS Complete |
$427.62
|
| Rate for Payer: BCBS MAPPO |
$616.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
| Rate for Payer: BCN Commercial |
$925.06
|
| Rate for Payer: BCN Medicare Advantage |
$616.95
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cofinity Commercial |
$826.71
|
| Rate for Payer: Cofinity Commercial |
$888.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.95
|
| Rate for Payer: Mclaren Medicaid |
$407.26
|
| Rate for Payer: Meridian Medicaid |
$427.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.80
|
| Rate for Payer: PACE SWMI |
$616.95
|
| Rate for Payer: PHP Medicare Advantage |
$616.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.65
|
| Rate for Payer: Priority Health Medicare |
$616.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$966.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.95
|
| Rate for Payer: UHC Medicare Advantage |
$635.46
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,317.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$399.38 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$823.82
|
| Rate for Payer: Aetna Medicare |
$639.38
|
| Rate for Payer: BCBS Complete |
$419.35
|
| Rate for Payer: BCBS MAPPO |
$614.79
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$921.16
|
| Rate for Payer: BCN Medicare Advantage |
$614.79
|
| Rate for Payer: Cash Price |
$1,053.60
|
| Rate for Payer: Cash Price |
$1,053.60
|
| Rate for Payer: Cofinity Commercial |
$885.30
|
| Rate for Payer: Cofinity Commercial |
$823.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.79
|
| Rate for Payer: Mclaren Medicaid |
$399.38
|
| Rate for Payer: Meridian Medicaid |
$419.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.53
|
| Rate for Payer: PACE SWMI |
$614.79
|
| Rate for Payer: PHP Medicare Advantage |
$614.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.57
|
| Rate for Payer: Priority Health Medicare |
$614.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$962.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$614.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.79
|
| Rate for Payer: UHC Medicare Advantage |
$633.23
|
|
