|
PR OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ
|
Professional
|
Both
|
$3,183.00
|
|
|
Service Code
|
HCPCS 27848
|
| Min. Negotiated Rate |
$509.07 |
| Max. Negotiated Rate |
$2,228.10 |
| Rate for Payer: Aetna Commercial |
$1,037.86
|
| Rate for Payer: Aetna Medicare |
$805.50
|
| Rate for Payer: BCBS Complete |
$534.52
|
| Rate for Payer: BCBS MAPPO |
$774.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.99
|
| Rate for Payer: BCN Commercial |
$1,152.30
|
| Rate for Payer: BCN Medicare Advantage |
$774.52
|
| Rate for Payer: Cash Price |
$2,546.40
|
| Rate for Payer: Cash Price |
$2,546.40
|
| Rate for Payer: Cofinity Commercial |
$1,115.31
|
| Rate for Payer: Cofinity Commercial |
$1,037.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.52
|
| Rate for Payer: Mclaren Medicaid |
$509.07
|
| Rate for Payer: Meridian Medicaid |
$534.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$813.25
|
| Rate for Payer: PACE SWMI |
$774.52
|
| Rate for Payer: PHP Medicare Advantage |
$774.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,228.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,204.11
|
| Rate for Payer: Priority Health Medicare |
$774.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,204.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$774.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.52
|
| Rate for Payer: UHC Medicare Advantage |
$797.76
|
|
|
PR OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR
|
Professional
|
Both
|
$3,073.00
|
|
|
Service Code
|
HCPCS 27217
|
| Min. Negotiated Rate |
$537.61 |
| Max. Negotiated Rate |
$2,151.10 |
| Rate for Payer: Aetna Commercial |
$1,119.55
|
| Rate for Payer: BCBS Complete |
$564.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,869.65
|
| Rate for Payer: BCN Commercial |
$1,224.63
|
| Rate for Payer: Cash Price |
$2,458.40
|
| Rate for Payer: Cash Price |
$2,458.40
|
| Rate for Payer: Mclaren Medicaid |
$537.61
|
| Rate for Payer: Meridian Medicaid |
$564.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,151.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,279.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,279.68
|
|
|
PR OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ
|
Professional
|
Both
|
$3,175.00
|
|
|
Service Code
|
HCPCS 26686
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$2,222.50 |
| Rate for Payer: Aetna Commercial |
$825.16
|
| Rate for Payer: Aetna Medicare |
$640.42
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS MAPPO |
$615.79
|
| Rate for Payer: BCBS Trust/PPO |
$75.56
|
| Rate for Payer: BCN Commercial |
$921.16
|
| Rate for Payer: BCN Medicare Advantage |
$615.79
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cofinity Commercial |
$825.16
|
| Rate for Payer: Cofinity Commercial |
$886.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.79
|
| Rate for Payer: Mclaren Medicaid |
$405.13
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.58
|
| Rate for Payer: PACE SWMI |
$615.79
|
| Rate for Payer: PHP Medicare Advantage |
$615.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,222.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.57
|
| Rate for Payer: Priority Health Medicare |
$615.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$962.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$615.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.79
|
| Rate for Payer: UHC Medicare Advantage |
$634.26
|
|
|
PR OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION
|
Professional
|
Both
|
$2,413.00
|
|
|
Service Code
|
HCPCS 21470
|
| Min. Negotiated Rate |
$745.07 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$1,520.52
|
| Rate for Payer: Aetna Medicare |
$1,180.11
|
| Rate for Payer: BCBS Complete |
$782.32
|
| Rate for Payer: BCBS MAPPO |
$1,134.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$1,692.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,134.72
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cofinity Commercial |
$1,634.00
|
| Rate for Payer: Cofinity Commercial |
$1,520.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,134.72
|
| Rate for Payer: Mclaren Medicaid |
$745.07
|
| Rate for Payer: Meridian Medicaid |
$782.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,191.46
|
| Rate for Payer: PACE SWMI |
$1,134.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,134.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,689.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,768.38
|
| Rate for Payer: Priority Health Medicare |
$1,134.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,768.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,134.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,134.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,168.76
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG
|
Professional
|
Both
|
$2,373.00
|
|
|
Service Code
|
HCPCS 25608
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$1,661.10 |
| Rate for Payer: Aetna Commercial |
$1,093.64
|
| Rate for Payer: Aetna Medicare |
$848.80
|
| Rate for Payer: BCBS Complete |
$564.27
|
| Rate for Payer: BCBS MAPPO |
$816.15
|
| Rate for Payer: BCBS Trust/PPO |
$25.36
|
| Rate for Payer: BCN Commercial |
$1,220.23
|
| Rate for Payer: BCN Medicare Advantage |
$816.15
|
| Rate for Payer: Cash Price |
$1,898.40
|
| Rate for Payer: Cash Price |
$1,898.40
|
| Rate for Payer: Cofinity Commercial |
$1,175.26
|
| Rate for Payer: Cofinity Commercial |
$1,093.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.15
|
| Rate for Payer: Mclaren Medicaid |
$537.40
|
| Rate for Payer: Meridian Medicaid |
$564.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$856.96
|
| Rate for Payer: PACE SWMI |
$816.15
|
| Rate for Payer: PHP Medicare Advantage |
$816.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,275.09
|
| Rate for Payer: Priority Health Medicare |
$816.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$816.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.15
|
| Rate for Payer: UHC Medicare Advantage |
$840.63
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG
|
Professional
|
Both
|
$2,901.00
|
|
|
Service Code
|
HCPCS 25609
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$2,030.70 |
| Rate for Payer: Aetna Commercial |
$1,388.27
|
| Rate for Payer: Aetna Medicare |
$1,077.46
|
| Rate for Payer: BCBS Complete |
$714.34
|
| Rate for Payer: BCBS MAPPO |
$1,036.02
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$1,547.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.02
|
| Rate for Payer: Cash Price |
$2,320.80
|
| Rate for Payer: Cash Price |
$2,320.80
|
| Rate for Payer: Cofinity Commercial |
$1,388.27
|
| Rate for Payer: Cofinity Commercial |
$1,491.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.02
|
| Rate for Payer: Mclaren Medicaid |
$680.32
|
| Rate for Payer: Meridian Medicaid |
$714.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,087.82
|
| Rate for Payer: PACE SWMI |
$1,036.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,030.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,616.72
|
| Rate for Payer: Priority Health Medicare |
$1,036.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,616.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,036.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,036.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,067.10
|
|
|
PR OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP
|
Facility
|
IP
|
$1,906.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$1,162.47 |
| Max. Negotiated Rate |
$1,715.40 |
| Rate for Payer: Aetna Commercial |
$1,620.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,472.96
|
| Rate for Payer: BCN Commercial |
$1,472.96
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cofinity Commercial |
$1,639.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,524.80
|
| Rate for Payer: Healthscope Commercial |
$1,715.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,429.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,620.10
|
| Rate for Payer: PHP Commercial |
$1,620.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,658.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,162.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,677.28
|
| Rate for Payer: UHC Core |
$1,591.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,429.50
|
|
|
PR OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP
|
Professional
|
Both
|
$1,906.00
|
|
|
Service Code
|
HCPCS 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$1,334.20 |
| Rate for Payer: Aetna Commercial |
$977.89
|
| Rate for Payer: Aetna Medicare |
$758.96
|
| Rate for Payer: BCBS Complete |
$505.45
|
| Rate for Payer: BCBS MAPPO |
$729.77
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$729.77
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cofinity Commercial |
$1,050.87
|
| Rate for Payer: Cofinity Commercial |
$977.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.77
|
| Rate for Payer: Mclaren Medicaid |
$481.38
|
| Rate for Payer: Meridian Medicaid |
$505.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.26
|
| Rate for Payer: PACE SWMI |
$729.77
|
| Rate for Payer: PHP Medicare Advantage |
$729.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$729.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,142.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$729.77
|
| Rate for Payer: UHC Medicare Advantage |
$751.66
|
|
|
PR OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP
|
Professional
|
Both
|
$1,906.00
|
|
|
Service Code
|
HCPCS 25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$1,334.20 |
| Rate for Payer: Aetna Commercial |
$977.89
|
| Rate for Payer: Aetna Medicare |
$758.96
|
| Rate for Payer: BCBS Complete |
$505.45
|
| Rate for Payer: BCBS MAPPO |
$729.77
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$729.77
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cofinity Commercial |
$977.89
|
| Rate for Payer: Cofinity Commercial |
$1,050.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.77
|
| Rate for Payer: Mclaren Medicaid |
$481.38
|
| Rate for Payer: Meridian Medicaid |
$505.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.26
|
| Rate for Payer: PACE SWMI |
$729.77
|
| Rate for Payer: PHP Medicare Advantage |
$729.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$729.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,142.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$729.77
|
| Rate for Payer: UHC Medicare Advantage |
$751.66
|
|
|
PR OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP
|
Facility
|
OP
|
$1,906.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$452.68 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$1,620.10
|
| Rate for Payer: Aetna Medicare |
$495.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.62
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$476.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.92
|
| Rate for Payer: BCN Commercial |
$1,481.92
|
| Rate for Payer: BCN Medicare Advantage |
$476.50
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cofinity Commercial |
$1,639.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,524.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.50
|
| Rate for Payer: Healthscope Commercial |
$1,715.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,429.50
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,620.10
|
| Rate for Payer: PACE Senior Care Partners |
$452.68
|
| Rate for Payer: PACE SWMI |
$476.50
|
| Rate for Payer: PHP Commercial |
$1,620.10
|
| Rate for Payer: PHP Medicare Advantage |
$476.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,658.22
|
| Rate for Payer: Priority Health Medicare |
$476.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,162.47
|
| Rate for Payer: Railroad Medicare Medicare |
$476.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,677.28
|
| Rate for Payer: UHC Core |
$1,591.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.50
|
| Rate for Payer: UHC Medicare Advantage |
$490.80
|
| Rate for Payer: VA VA |
$476.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,429.50
|
|
|
PR OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT
|
Professional
|
Both
|
$3,659.00
|
|
|
Service Code
|
HCPCS 27236
|
| Min. Negotiated Rate |
$766.59 |
| Max. Negotiated Rate |
$2,561.30 |
| Rate for Payer: Aetna Commercial |
$1,574.14
|
| Rate for Payer: Aetna Medicare |
$1,221.72
|
| Rate for Payer: BCBS Complete |
$804.92
|
| Rate for Payer: BCBS MAPPO |
$1,174.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,920.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,174.73
|
| Rate for Payer: Cash Price |
$2,927.20
|
| Rate for Payer: Cash Price |
$2,927.20
|
| Rate for Payer: Cofinity Commercial |
$1,691.61
|
| Rate for Payer: Cofinity Commercial |
$1,574.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,174.73
|
| Rate for Payer: Mclaren Medicaid |
$766.59
|
| Rate for Payer: Meridian Medicaid |
$804.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,233.47
|
| Rate for Payer: PACE SWMI |
$1,174.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,174.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$766.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,561.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,823.02
|
| Rate for Payer: Priority Health Medicare |
$1,174.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,823.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,174.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,174.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,209.97
|
|
|
PR OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW
|
Professional
|
Both
|
$4,132.00
|
|
|
Service Code
|
HCPCS 27506
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$2,892.40 |
| Rate for Payer: Aetna Commercial |
$1,765.62
|
| Rate for Payer: Aetna Medicare |
$1,370.34
|
| Rate for Payer: BCBS Complete |
$902.20
|
| Rate for Payer: BCBS MAPPO |
$1,317.63
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,154.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.63
|
| Rate for Payer: Cash Price |
$3,305.60
|
| Rate for Payer: Cash Price |
$3,305.60
|
| Rate for Payer: Cofinity Commercial |
$1,897.39
|
| Rate for Payer: Cofinity Commercial |
$1,765.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.63
|
| Rate for Payer: Mclaren Medicaid |
$859.24
|
| Rate for Payer: Meridian Medicaid |
$902.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,383.51
|
| Rate for Payer: PACE SWMI |
$1,317.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,045.15
|
| Rate for Payer: Priority Health Medicare |
$1,317.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,317.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,357.16
|
|
|
PR OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,773.00
|
|
|
Service Code
|
HCPCS 27507
|
| Min. Negotiated Rate |
$621.11 |
| Max. Negotiated Rate |
$2,641.10 |
| Rate for Payer: Aetna Commercial |
$1,279.42
|
| Rate for Payer: Aetna Medicare |
$992.98
|
| Rate for Payer: BCBS Complete |
$652.17
|
| Rate for Payer: BCBS MAPPO |
$954.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.62
|
| Rate for Payer: BCN Commercial |
$1,416.67
|
| Rate for Payer: BCN Medicare Advantage |
$954.79
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cofinity Commercial |
$1,374.90
|
| Rate for Payer: Cofinity Commercial |
$1,279.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.79
|
| Rate for Payer: Mclaren Medicaid |
$621.11
|
| Rate for Payer: Meridian Medicaid |
$652.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,002.53
|
| Rate for Payer: PACE SWMI |
$954.79
|
| Rate for Payer: PHP Medicare Advantage |
$954.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,480.37
|
| Rate for Payer: Priority Health Medicare |
$954.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,480.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$954.79
|
| Rate for Payer: UHC Medicare Advantage |
$983.43
|
|
|
PR OPTX GREATER HUMERAL TUBEROSITY FX W/INT FIXJ
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 23630
|
| Min. Negotiated Rate |
$265.21 |
| Max. Negotiated Rate |
$1,201.57 |
| Rate for Payer: Aetna Commercial |
$1,031.60
|
| Rate for Payer: Aetna Medicare |
$800.64
|
| Rate for Payer: BCBS Complete |
$531.39
|
| Rate for Payer: BCBS MAPPO |
$769.85
|
| Rate for Payer: BCBS Trust/PPO |
$265.21
|
| Rate for Payer: BCN Commercial |
$1,149.86
|
| Rate for Payer: BCN Medicare Advantage |
$769.85
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cofinity Commercial |
$1,108.58
|
| Rate for Payer: Cofinity Commercial |
$1,031.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.85
|
| Rate for Payer: Mclaren Medicaid |
$506.09
|
| Rate for Payer: Meridian Medicaid |
$531.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$808.34
|
| Rate for Payer: PACE SWMI |
$769.85
|
| Rate for Payer: PHP Medicare Advantage |
$769.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$506.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,201.57
|
| Rate for Payer: Priority Health Medicare |
$769.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,201.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$769.85
|
| Rate for Payer: UHC Medicare Advantage |
$792.95
|
|
|
PR OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD
|
Professional
|
Both
|
$3,476.00
|
|
|
Service Code
|
HCPCS 27254
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$2,549.58 |
| Rate for Payer: Aetna Commercial |
$1,678.97
|
| Rate for Payer: Aetna Medicare |
$1,303.08
|
| Rate for Payer: BCBS Complete |
$856.80
|
| Rate for Payer: BCBS MAPPO |
$1,252.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.58
|
| Rate for Payer: BCN Commercial |
$1,859.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,252.96
|
| Rate for Payer: Cash Price |
$2,780.80
|
| Rate for Payer: Cash Price |
$2,780.80
|
| Rate for Payer: Cofinity Commercial |
$1,804.26
|
| Rate for Payer: Cofinity Commercial |
$1,678.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,252.96
|
| Rate for Payer: Mclaren Medicaid |
$816.00
|
| Rate for Payer: Meridian Medicaid |
$856.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,315.61
|
| Rate for Payer: PACE SWMI |
$1,252.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,252.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,433.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,943.03
|
| Rate for Payer: Priority Health Medicare |
$1,252.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,943.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,252.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,252.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,290.55
|
|
|
PR OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 27253
|
| Min. Negotiated Rate |
$604.92 |
| Max. Negotiated Rate |
$2,442.33 |
| Rate for Payer: Aetna Commercial |
$1,242.58
|
| Rate for Payer: Aetna Medicare |
$964.39
|
| Rate for Payer: BCBS Complete |
$635.17
|
| Rate for Payer: BCBS MAPPO |
$927.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,442.33
|
| Rate for Payer: BCN Commercial |
$1,379.05
|
| Rate for Payer: BCN Medicare Advantage |
$927.30
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cofinity Commercial |
$1,335.31
|
| Rate for Payer: Cofinity Commercial |
$1,242.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$927.30
|
| Rate for Payer: Mclaren Medicaid |
$604.92
|
| Rate for Payer: Meridian Medicaid |
$635.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$973.66
|
| Rate for Payer: PACE SWMI |
$927.30
|
| Rate for Payer: PHP Medicare Advantage |
$927.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,613.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,441.06
|
| Rate for Payer: Priority Health Medicare |
$927.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,441.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$927.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$927.30
|
| Rate for Payer: UHC Medicare Advantage |
$955.12
|
|
|
PR OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE
|
Professional
|
Both
|
$3,031.00
|
|
|
Service Code
|
HCPCS 24515
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$2,121.70 |
| Rate for Payer: Aetna Commercial |
$1,164.03
|
| Rate for Payer: Aetna Medicare |
$903.43
|
| Rate for Payer: BCBS Complete |
$597.60
|
| Rate for Payer: BCBS MAPPO |
$868.68
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$868.68
|
| Rate for Payer: Cash Price |
$2,424.80
|
| Rate for Payer: Cash Price |
$2,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,250.90
|
| Rate for Payer: Cofinity Commercial |
$1,164.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.68
|
| Rate for Payer: Mclaren Medicaid |
$569.14
|
| Rate for Payer: Meridian Medicaid |
$597.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$912.11
|
| Rate for Payer: PACE SWMI |
$868.68
|
| Rate for Payer: PHP Medicare Advantage |
$868.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,121.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.25
|
| Rate for Payer: Priority Health Medicare |
$868.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,354.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.68
|
| Rate for Payer: UHC Medicare Advantage |
$894.74
|
|
|
PR OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD
|
Professional
|
Both
|
$2,582.00
|
|
|
Service Code
|
HCPCS 27215
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$1,807.40 |
| Rate for Payer: Aetna Commercial |
$803.86
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.81
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: Cash Price |
$2,065.60
|
| Rate for Payer: Cash Price |
$2,065.60
|
| Rate for Payer: Mclaren Medicaid |
$387.02
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$921.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$921.22
|
|
|
PR OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN
|
Professional
|
Both
|
$2,014.00
|
|
|
Service Code
|
HCPCS 21347
|
| Min. Negotiated Rate |
$86.11 |
| Max. Negotiated Rate |
$1,596.80 |
| Rate for Payer: Aetna Commercial |
$1,362.70
|
| Rate for Payer: Aetna Medicare |
$1,057.62
|
| Rate for Payer: BCBS Complete |
$697.79
|
| Rate for Payer: BCBS MAPPO |
$1,016.94
|
| Rate for Payer: BCBS Trust/PPO |
$86.11
|
| Rate for Payer: BCN Commercial |
$1,528.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.94
|
| Rate for Payer: Cash Price |
$1,611.20
|
| Rate for Payer: Cash Price |
$1,611.20
|
| Rate for Payer: Cofinity Commercial |
$1,464.39
|
| Rate for Payer: Cofinity Commercial |
$1,362.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.94
|
| Rate for Payer: Mclaren Medicaid |
$664.56
|
| Rate for Payer: Meridian Medicaid |
$697.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,067.79
|
| Rate for Payer: PACE SWMI |
$1,016.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,596.80
|
| Rate for Payer: Priority Health Medicare |
$1,016.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,596.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,047.45
|
|
|
PR OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 21390
|
| Min. Negotiated Rate |
$514.18 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$1,050.76
|
| Rate for Payer: Aetna Medicare |
$815.52
|
| Rate for Payer: BCBS Complete |
$539.89
|
| Rate for Payer: BCBS MAPPO |
$784.15
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,174.29
|
| Rate for Payer: BCN Medicare Advantage |
$784.15
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,050.76
|
| Rate for Payer: Cofinity Commercial |
$1,129.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.15
|
| Rate for Payer: Mclaren Medicaid |
$514.18
|
| Rate for Payer: Meridian Medicaid |
$539.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$823.36
|
| Rate for Payer: PACE SWMI |
$784.15
|
| Rate for Payer: PHP Medicare Advantage |
$784.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,106.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,227.09
|
| Rate for Payer: Priority Health Medicare |
$784.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,227.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$784.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$784.15
|
| Rate for Payer: UHC Medicare Advantage |
$807.67
|
|
|
PR OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 27566
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$1,369.56 |
| Rate for Payer: Aetna Commercial |
$1,179.95
|
| Rate for Payer: Aetna Medicare |
$915.78
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: BCBS MAPPO |
$880.56
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$1,310.63
|
| Rate for Payer: BCN Medicare Advantage |
$880.56
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,268.01
|
| Rate for Payer: Cofinity Commercial |
$1,179.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$880.56
|
| Rate for Payer: Mclaren Medicaid |
$576.38
|
| Rate for Payer: Meridian Medicaid |
$605.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$924.59
|
| Rate for Payer: PACE SWMI |
$880.56
|
| Rate for Payer: PHP Medicare Advantage |
$880.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,094.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,369.56
|
| Rate for Payer: Priority Health Medicare |
$880.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,369.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$880.56
|
| Rate for Payer: UHC Medicare Advantage |
$906.98
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$487.56 |
| Max. Negotiated Rate |
$1,722.00 |
| Rate for Payer: Aetna Commercial |
$996.30
|
| Rate for Payer: Aetna Medicare |
$773.25
|
| Rate for Payer: BCBS Complete |
$511.94
|
| Rate for Payer: BCBS MAPPO |
$743.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$1,221.43
|
| Rate for Payer: BCN Medicare Advantage |
$743.51
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$1,070.65
|
| Rate for Payer: Cofinity Commercial |
$996.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$743.51
|
| Rate for Payer: Mclaren Medicaid |
$487.56
|
| Rate for Payer: Meridian Medicaid |
$511.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$780.69
|
| Rate for Payer: PACE SWMI |
$743.51
|
| Rate for Payer: PHP Medicare Advantage |
$743.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,159.18
|
| Rate for Payer: Priority Health Medicare |
$743.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,159.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$743.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$743.51
|
| Rate for Payer: UHC Medicare Advantage |
$765.82
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 27524
|
| Min. Negotiated Rate |
$487.56 |
| Max. Negotiated Rate |
$1,722.00 |
| Rate for Payer: Aetna Commercial |
$996.30
|
| Rate for Payer: Aetna Medicare |
$773.25
|
| Rate for Payer: BCBS Complete |
$511.94
|
| Rate for Payer: BCBS MAPPO |
$743.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$1,221.43
|
| Rate for Payer: BCN Medicare Advantage |
$743.51
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$996.30
|
| Rate for Payer: Cofinity Commercial |
$1,070.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$743.51
|
| Rate for Payer: Mclaren Medicaid |
$487.56
|
| Rate for Payer: Meridian Medicaid |
$511.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$780.69
|
| Rate for Payer: PACE SWMI |
$743.51
|
| Rate for Payer: PHP Medicare Advantage |
$743.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,159.18
|
| Rate for Payer: Priority Health Medicare |
$743.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,159.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$743.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$743.51
|
| Rate for Payer: UHC Medicare Advantage |
$765.82
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Facility
|
OP
|
$2,460.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$584.25 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$2,091.00
|
| Rate for Payer: Aetna Medicare |
$639.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.75
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$615.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,912.65
|
| Rate for Payer: BCN Commercial |
$1,912.65
|
| Rate for Payer: BCN Medicare Advantage |
$615.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$2,115.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,968.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.00
|
| Rate for Payer: Healthscope Commercial |
$2,214.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,845.00
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,091.00
|
| Rate for Payer: PACE Senior Care Partners |
$584.25
|
| Rate for Payer: PACE SWMI |
$615.00
|
| Rate for Payer: PHP Commercial |
$2,091.00
|
| Rate for Payer: PHP Medicare Advantage |
$615.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,140.20
|
| Rate for Payer: Priority Health Medicare |
$615.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,500.35
|
| Rate for Payer: Railroad Medicare Medicare |
$615.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,164.80
|
| Rate for Payer: UHC Core |
$2,054.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.00
|
| Rate for Payer: UHC Medicare Advantage |
$633.45
|
| Rate for Payer: VA VA |
$615.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,845.00
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Facility
|
IP
|
$2,460.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$1,500.35 |
| Max. Negotiated Rate |
$2,214.00 |
| Rate for Payer: Aetna Commercial |
$2,091.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.09
|
| Rate for Payer: BCN Commercial |
$1,901.09
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$2,115.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,968.00
|
| Rate for Payer: Healthscope Commercial |
$2,214.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,845.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,091.00
|
| Rate for Payer: PHP Commercial |
$2,091.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,140.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,500.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,164.80
|
| Rate for Payer: UHC Core |
$2,054.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,845.00
|
|
