|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$469.67 |
| Max. Negotiated Rate |
$2,788.67 |
| Rate for Payer: Aetna Commercial |
$960.57
|
| Rate for Payer: Aetna Medicare |
$745.51
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS MAPPO |
$716.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,788.67
|
| Rate for Payer: BCN Commercial |
$1,069.23
|
| Rate for Payer: BCN Medicare Advantage |
$716.84
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$960.57
|
| Rate for Payer: Cofinity Commercial |
$1,032.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.84
|
| Rate for Payer: Mclaren Medicaid |
$469.67
|
| Rate for Payer: Meridian Medicaid |
$493.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$752.68
|
| Rate for Payer: PACE SWMI |
$716.84
|
| Rate for Payer: PHP Medicare Advantage |
$716.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.30
|
| Rate for Payer: Priority Health Medicare |
$716.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,117.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.84
|
| Rate for Payer: UHC Medicare Advantage |
$738.35
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,233.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$2,244.78 |
| Rate for Payer: Aetna Commercial |
$938.70
|
| Rate for Payer: Aetna Medicare |
$728.54
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS MAPPO |
$700.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.78
|
| Rate for Payer: BCN Commercial |
$1,046.26
|
| Rate for Payer: BCN Medicare Advantage |
$700.52
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cofinity Commercial |
$938.70
|
| Rate for Payer: Cofinity Commercial |
$1,008.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.52
|
| Rate for Payer: Mclaren Medicaid |
$463.49
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$735.55
|
| Rate for Payer: PACE SWMI |
$700.52
|
| Rate for Payer: PHP Medicare Advantage |
$700.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,093.29
|
| Rate for Payer: Priority Health Medicare |
$700.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,093.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.52
|
| Rate for Payer: UHC Medicare Advantage |
$721.54
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE
|
Professional
|
Both
|
$2,023.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$436.44 |
| Max. Negotiated Rate |
$1,416.10 |
| Rate for Payer: Aetna Commercial |
$885.91
|
| Rate for Payer: Aetna Medicare |
$687.58
|
| Rate for Payer: BCBS Complete |
$458.26
|
| Rate for Payer: BCBS MAPPO |
$661.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,387.32
|
| Rate for Payer: BCN Commercial |
$989.57
|
| Rate for Payer: BCN Medicare Advantage |
$661.13
|
| Rate for Payer: Cash Price |
$1,618.40
|
| Rate for Payer: Cash Price |
$1,618.40
|
| Rate for Payer: Cofinity Commercial |
$885.91
|
| Rate for Payer: Cofinity Commercial |
$952.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.13
|
| Rate for Payer: Mclaren Medicaid |
$436.44
|
| Rate for Payer: Meridian Medicaid |
$458.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$694.19
|
| Rate for Payer: PACE SWMI |
$661.13
|
| Rate for Payer: PHP Medicare Advantage |
$661.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.07
|
| Rate for Payer: Priority Health Medicare |
$661.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,034.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$661.13
|
| Rate for Payer: UHC Medicare Advantage |
$680.96
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,957.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$312.23 |
| Max. Negotiated Rate |
$1,369.90 |
| Rate for Payer: Aetna Commercial |
$917.79
|
| Rate for Payer: Aetna Medicare |
$712.32
|
| Rate for Payer: BCBS Complete |
$478.83
|
| Rate for Payer: BCBS MAPPO |
$684.92
|
| Rate for Payer: BCBS Trust/PPO |
$312.23
|
| Rate for Payer: BCN Commercial |
$1,291.09
|
| Rate for Payer: BCN Medicare Advantage |
$684.92
|
| Rate for Payer: Cash Price |
$1,565.60
|
| Rate for Payer: Cash Price |
$1,565.60
|
| Rate for Payer: Cofinity Commercial |
$986.28
|
| Rate for Payer: Cofinity Commercial |
$917.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.92
|
| Rate for Payer: Mclaren Medicaid |
$456.03
|
| Rate for Payer: Meridian Medicaid |
$478.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$719.17
|
| Rate for Payer: PACE SWMI |
$684.92
|
| Rate for Payer: PHP Medicare Advantage |
$684.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,065.22
|
| Rate for Payer: Priority Health Medicare |
$684.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,065.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.92
|
| Rate for Payer: UHC Medicare Advantage |
$705.47
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,080.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$588.53 |
| Max. Negotiated Rate |
$2,156.00 |
| Rate for Payer: Aetna Commercial |
$1,371.17
|
| Rate for Payer: Aetna Medicare |
$1,064.19
|
| Rate for Payer: BCBS Complete |
$708.97
|
| Rate for Payer: BCBS MAPPO |
$1,023.26
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.26
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Cofinity Commercial |
$1,473.49
|
| Rate for Payer: Cofinity Commercial |
$1,371.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.26
|
| Rate for Payer: Mclaren Medicaid |
$675.21
|
| Rate for Payer: Meridian Medicaid |
$708.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,074.42
|
| Rate for Payer: PACE SWMI |
$1,023.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,589.66
|
| Rate for Payer: Priority Health Medicare |
$1,023.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,589.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,023.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,023.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,053.96
|
|
|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,694.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$427.92 |
| Max. Negotiated Rate |
$1,269.58 |
| Rate for Payer: Aetna Commercial |
$874.77
|
| Rate for Payer: Aetna Medicare |
$678.92
|
| Rate for Payer: BCBS Complete |
$449.32
|
| Rate for Payer: BCBS MAPPO |
$652.81
|
| Rate for Payer: BCBS Trust/PPO |
$645.58
|
| Rate for Payer: BCN Commercial |
$1,269.58
|
| Rate for Payer: BCN Medicare Advantage |
$652.81
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cofinity Commercial |
$940.05
|
| Rate for Payer: Cofinity Commercial |
$874.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.81
|
| Rate for Payer: Mclaren Medicaid |
$427.92
|
| Rate for Payer: Meridian Medicaid |
$449.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$685.45
|
| Rate for Payer: PACE SWMI |
$652.81
|
| Rate for Payer: PHP Medicare Advantage |
$652.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,185.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.72
|
| Rate for Payer: Priority Health Medicare |
$652.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,017.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.81
|
| Rate for Payer: UHC Medicare Advantage |
$672.39
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,760.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$535.48 |
| Max. Negotiated Rate |
$1,778.26 |
| Rate for Payer: Aetna Commercial |
$1,084.26
|
| Rate for Payer: Aetna Medicare |
$841.52
|
| Rate for Payer: BCBS Complete |
$562.25
|
| Rate for Payer: BCBS MAPPO |
$809.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.26
|
| Rate for Payer: BCN Commercial |
$1,214.37
|
| Rate for Payer: BCN Medicare Advantage |
$809.15
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.18
|
| Rate for Payer: Cofinity Commercial |
$1,084.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.15
|
| Rate for Payer: Mclaren Medicaid |
$535.48
|
| Rate for Payer: Meridian Medicaid |
$562.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.61
|
| Rate for Payer: PACE SWMI |
$809.15
|
| Rate for Payer: PHP Medicare Advantage |
$809.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,268.97
|
| Rate for Payer: Priority Health Medicare |
$809.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,268.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$809.15
|
| Rate for Payer: UHC Medicare Advantage |
$833.42
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
IP
|
$2,297.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,400.94 |
| Max. Negotiated Rate |
$2,067.30 |
| Rate for Payer: Aetna Commercial |
$1,952.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.12
|
| Rate for Payer: BCN Commercial |
$1,775.12
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$1,975.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.60
|
| Rate for Payer: Healthscope Commercial |
$2,067.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,952.45
|
| Rate for Payer: PHP Commercial |
$1,952.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,998.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,400.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.36
|
| Rate for Payer: UHC Core |
$1,918.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.75
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,607.90 |
| Rate for Payer: Aetna Commercial |
$863.46
|
| Rate for Payer: Aetna Medicare |
$670.14
|
| Rate for Payer: BCBS Complete |
$446.63
|
| Rate for Payer: BCBS MAPPO |
$644.37
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: BCN Medicare Advantage |
$644.37
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$927.89
|
| Rate for Payer: Cofinity Commercial |
$863.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.37
|
| Rate for Payer: Mclaren Medicaid |
$425.36
|
| Rate for Payer: Meridian Medicaid |
$446.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$676.59
|
| Rate for Payer: PACE SWMI |
$644.37
|
| Rate for Payer: PHP Medicare Advantage |
$644.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.04
|
| Rate for Payer: Priority Health Medicare |
$644.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$644.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.37
|
| Rate for Payer: UHC Medicare Advantage |
$663.70
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,607.90 |
| Rate for Payer: Aetna Commercial |
$863.46
|
| Rate for Payer: Aetna Medicare |
$670.14
|
| Rate for Payer: BCBS Complete |
$446.63
|
| Rate for Payer: BCBS MAPPO |
$644.37
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: BCN Medicare Advantage |
$644.37
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$863.46
|
| Rate for Payer: Cofinity Commercial |
$927.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.37
|
| Rate for Payer: Mclaren Medicaid |
$425.36
|
| Rate for Payer: Meridian Medicaid |
$446.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$676.59
|
| Rate for Payer: PACE SWMI |
$644.37
|
| Rate for Payer: PHP Medicare Advantage |
$644.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.04
|
| Rate for Payer: Priority Health Medicare |
$644.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$644.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.37
|
| Rate for Payer: UHC Medicare Advantage |
$663.70
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
OP
|
$2,297.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$545.54 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$1,952.45
|
| Rate for Payer: Aetna Medicare |
$597.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$717.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$717.81
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$574.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,785.92
|
| Rate for Payer: BCN Commercial |
$1,785.92
|
| Rate for Payer: BCN Medicare Advantage |
$574.25
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$1,975.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.25
|
| Rate for Payer: Healthscope Commercial |
$2,067.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.75
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$602.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$660.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,952.45
|
| Rate for Payer: PACE Senior Care Partners |
$545.54
|
| Rate for Payer: PACE SWMI |
$574.25
|
| Rate for Payer: PHP Commercial |
$1,952.45
|
| Rate for Payer: PHP Medicare Advantage |
$574.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,998.39
|
| Rate for Payer: Priority Health Medicare |
$574.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,400.94
|
| Rate for Payer: Railroad Medicare Medicare |
$574.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.36
|
| Rate for Payer: UHC Core |
$1,918.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.25
|
| Rate for Payer: UHC Medicare Advantage |
$591.48
|
| Rate for Payer: VA VA |
$574.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.75
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$405.98 |
| Max. Negotiated Rate |
$1,501.43 |
| Rate for Payer: Aetna Commercial |
$824.80
|
| Rate for Payer: Aetna Medicare |
$640.14
|
| Rate for Payer: BCBS Complete |
$426.28
|
| Rate for Payer: BCBS MAPPO |
$615.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.43
|
| Rate for Payer: BCN Commercial |
$922.13
|
| Rate for Payer: BCN Medicare Advantage |
$615.52
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$886.35
|
| Rate for Payer: Cofinity Commercial |
$824.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.52
|
| Rate for Payer: Mclaren Medicaid |
$405.98
|
| Rate for Payer: Meridian Medicaid |
$426.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.30
|
| Rate for Payer: PACE SWMI |
$615.52
|
| Rate for Payer: PHP Medicare Advantage |
$615.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$963.59
|
| Rate for Payer: Priority Health Medicare |
$615.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$963.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$615.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.52
|
| Rate for Payer: UHC Medicare Advantage |
$633.99
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 1-2 RIBS
|
Professional
|
Both
|
$3,282.00
|
|
|
Service Code
|
HCPCS 0245T
|
| Min. Negotiated Rate |
$1,312.80 |
| Max. Negotiated Rate |
$2,297.40 |
| Rate for Payer: BCBS Complete |
$1,312.80
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.40
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS
|
Professional
|
Both
|
$3,617.00
|
|
|
Service Code
|
HCPCS 0246T
|
| Min. Negotiated Rate |
$1,446.80 |
| Max. Negotiated Rate |
$2,531.90 |
| Rate for Payer: BCBS Complete |
$1,446.80
|
| Rate for Payer: Cash Price |
$2,893.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,531.90
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS
|
Professional
|
Both
|
$4,000.00
|
|
|
Service Code
|
HCPCS 0247T
|
| Min. Negotiated Rate |
$1,600.00 |
| Max. Negotiated Rate |
$2,800.00 |
| Rate for Payer: BCBS Complete |
$1,600.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,800.00
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS
|
Professional
|
Both
|
$4,617.00
|
|
|
Service Code
|
HCPCS 0248T
|
| Min. Negotiated Rate |
$1,846.80 |
| Max. Negotiated Rate |
$3,231.90 |
| Rate for Payer: BCBS Complete |
$1,846.80
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,231.90
|
|
|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,689.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$372.11 |
| Max. Negotiated Rate |
$1,882.30 |
| Rate for Payer: Aetna Commercial |
$758.02
|
| Rate for Payer: Aetna Medicare |
$588.32
|
| Rate for Payer: BCBS Complete |
$390.72
|
| Rate for Payer: BCBS MAPPO |
$565.69
|
| Rate for Payer: BCBS Trust/PPO |
$528.83
|
| Rate for Payer: BCN Commercial |
$846.39
|
| Rate for Payer: BCN Medicare Advantage |
$565.69
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Cofinity Commercial |
$758.02
|
| Rate for Payer: Cofinity Commercial |
$814.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.69
|
| Rate for Payer: Mclaren Medicaid |
$372.11
|
| Rate for Payer: Meridian Medicaid |
$390.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$593.97
|
| Rate for Payer: PACE SWMI |
$565.69
|
| Rate for Payer: PHP Medicare Advantage |
$565.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,882.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.45
|
| Rate for Payer: Priority Health Medicare |
$565.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$565.69
|
| Rate for Payer: UHC Medicare Advantage |
$582.66
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,526.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$462.42 |
| Max. Negotiated Rate |
$1,768.20 |
| Rate for Payer: Aetna Commercial |
$945.58
|
| Rate for Payer: Aetna Medicare |
$733.89
|
| Rate for Payer: BCBS Complete |
$485.54
|
| Rate for Payer: BCBS MAPPO |
$705.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: BCN Commercial |
$1,053.10
|
| Rate for Payer: BCN Medicare Advantage |
$705.66
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cofinity Commercial |
$945.58
|
| Rate for Payer: Cofinity Commercial |
$1,016.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.66
|
| Rate for Payer: Mclaren Medicaid |
$462.42
|
| Rate for Payer: Meridian Medicaid |
$485.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$740.94
|
| Rate for Payer: PACE SWMI |
$705.66
|
| Rate for Payer: PHP Medicare Advantage |
$705.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.45
|
| Rate for Payer: Priority Health Medicare |
$705.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$705.66
|
| Rate for Payer: UHC Medicare Advantage |
$726.83
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,667.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$367.62 |
| Max. Negotiated Rate |
$1,866.90 |
| Rate for Payer: Aetna Commercial |
$776.96
|
| Rate for Payer: Aetna Medicare |
$603.01
|
| Rate for Payer: BCBS Complete |
$399.88
|
| Rate for Payer: BCBS MAPPO |
$579.82
|
| Rate for Payer: BCBS Trust/PPO |
$367.62
|
| Rate for Payer: BCN Commercial |
$867.89
|
| Rate for Payer: BCN Medicare Advantage |
$579.82
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Cofinity Commercial |
$834.94
|
| Rate for Payer: Cofinity Commercial |
$776.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.82
|
| Rate for Payer: Mclaren Medicaid |
$380.84
|
| Rate for Payer: Meridian Medicaid |
$399.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$608.81
|
| Rate for Payer: PACE SWMI |
$579.82
|
| Rate for Payer: PHP Medicare Advantage |
$579.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$906.92
|
| Rate for Payer: Priority Health Medicare |
$579.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$906.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.82
|
| Rate for Payer: UHC Medicare Advantage |
$597.21
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,480.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$481.17 |
| Max. Negotiated Rate |
$1,736.00 |
| Rate for Payer: Aetna Commercial |
$980.21
|
| Rate for Payer: Aetna Medicare |
$760.76
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS MAPPO |
$731.50
|
| Rate for Payer: BCBS Trust/PPO |
$663.54
|
| Rate for Payer: BCN Commercial |
$1,095.13
|
| Rate for Payer: BCN Medicare Advantage |
$731.50
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Cofinity Commercial |
$1,053.36
|
| Rate for Payer: Cofinity Commercial |
$980.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.50
|
| Rate for Payer: Mclaren Medicaid |
$481.17
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.08
|
| Rate for Payer: PACE SWMI |
$731.50
|
| Rate for Payer: PHP Medicare Advantage |
$731.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,736.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,144.36
|
| Rate for Payer: Priority Health Medicare |
$731.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,144.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.50
|
| Rate for Payer: UHC Medicare Advantage |
$753.44
|
|
|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$372.54 |
| Max. Negotiated Rate |
$1,263.69 |
| Rate for Payer: Aetna Commercial |
$758.12
|
| Rate for Payer: Aetna Medicare |
$588.39
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$565.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.69
|
| Rate for Payer: BCN Commercial |
$846.87
|
| Rate for Payer: BCN Medicare Advantage |
$565.76
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$814.69
|
| Rate for Payer: Cofinity Commercial |
$758.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.76
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$594.05
|
| Rate for Payer: PACE SWMI |
$565.76
|
| Rate for Payer: PHP Medicare Advantage |
$565.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.96
|
| Rate for Payer: Priority Health Medicare |
$565.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$565.76
|
| Rate for Payer: UHC Medicare Advantage |
$582.73
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE
|
Professional
|
Both
|
$1,984.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$466.68 |
| Max. Negotiated Rate |
$1,388.80 |
| Rate for Payer: Aetna Commercial |
$950.92
|
| Rate for Payer: Aetna Medicare |
$738.03
|
| Rate for Payer: BCBS Complete |
$490.01
|
| Rate for Payer: BCBS MAPPO |
$709.64
|
| Rate for Payer: BCBS Trust/PPO |
$548.81
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: BCN Medicare Advantage |
$709.64
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cofinity Commercial |
$950.92
|
| Rate for Payer: Cofinity Commercial |
$1,021.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.64
|
| Rate for Payer: Mclaren Medicaid |
$466.68
|
| Rate for Payer: Meridian Medicaid |
$490.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$745.12
|
| Rate for Payer: PACE SWMI |
$709.64
|
| Rate for Payer: PHP Medicare Advantage |
$709.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,388.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.13
|
| Rate for Payer: Priority Health Medicare |
$709.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.64
|
| Rate for Payer: UHC Medicare Advantage |
$730.93
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
HCPCS 26685
|
| Min. Negotiated Rate |
$56.88 |
| Max. Negotiated Rate |
$1,547.70 |
| Rate for Payer: Aetna Commercial |
$759.42
|
| Rate for Payer: Aetna Medicare |
$589.40
|
| Rate for Payer: BCBS Complete |
$394.75
|
| Rate for Payer: BCBS MAPPO |
$566.73
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$851.77
|
| Rate for Payer: BCN Medicare Advantage |
$566.73
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cofinity Commercial |
$759.42
|
| Rate for Payer: Cofinity Commercial |
$816.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.73
|
| Rate for Payer: Mclaren Medicaid |
$375.95
|
| Rate for Payer: Meridian Medicaid |
$394.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$595.07
|
| Rate for Payer: PACE SWMI |
$566.73
|
| Rate for Payer: PHP Medicare Advantage |
$566.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$890.06
|
| Rate for Payer: Priority Health Medicare |
$566.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$890.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.73
|
| Rate for Payer: UHC Medicare Advantage |
$583.73
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,831.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$1,981.70 |
| Rate for Payer: Aetna Commercial |
$826.31
|
| Rate for Payer: Aetna Medicare |
$641.32
|
| Rate for Payer: BCBS Complete |
$428.52
|
| Rate for Payer: BCBS MAPPO |
$616.65
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: BCN Commercial |
$926.54
|
| Rate for Payer: BCN Medicare Advantage |
$616.65
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cofinity Commercial |
$826.31
|
| Rate for Payer: Cofinity Commercial |
$887.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.65
|
| Rate for Payer: Mclaren Medicaid |
$408.11
|
| Rate for Payer: Meridian Medicaid |
$428.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.48
|
| Rate for Payer: PACE SWMI |
$616.65
|
| Rate for Payer: PHP Medicare Advantage |
$616.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.19
|
| Rate for Payer: Priority Health Medicare |
$616.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$968.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.65
|
| Rate for Payer: UHC Medicare Advantage |
$635.15
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,407.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$285.26 |
| Max. Negotiated Rate |
$1,684.90 |
| Rate for Payer: Aetna Commercial |
$953.21
|
| Rate for Payer: Aetna Medicare |
$739.80
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS MAPPO |
$711.35
|
| Rate for Payer: BCBS Trust/PPO |
$285.26
|
| Rate for Payer: BCN Commercial |
$1,062.87
|
| Rate for Payer: BCN Medicare Advantage |
$711.35
|
| Rate for Payer: Cash Price |
$1,925.60
|
| Rate for Payer: Cash Price |
$1,925.60
|
| Rate for Payer: Cofinity Commercial |
$953.21
|
| Rate for Payer: Cofinity Commercial |
$1,024.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.35
|
| Rate for Payer: Mclaren Medicaid |
$467.11
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$746.92
|
| Rate for Payer: PACE SWMI |
$711.35
|
| Rate for Payer: PHP Medicare Advantage |
$711.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.67
|
| Rate for Payer: Priority Health Medicare |
$711.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,110.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.35
|
| Rate for Payer: UHC Medicare Advantage |
$732.69
|
|
