|
PR OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO
|
Professional
|
Both
|
$1,909.00
|
|
|
Service Code
|
HCPCS 24586
|
| Min. Negotiated Rate |
$194.94 |
| Max. Negotiated Rate |
$1,664.71 |
| Rate for Payer: Aetna Commercial |
$1,435.50
|
| Rate for Payer: Aetna Medicare |
$1,114.12
|
| Rate for Payer: BCBS Complete |
$734.24
|
| Rate for Payer: BCBS MAPPO |
$1,071.27
|
| Rate for Payer: BCBS Trust/PPO |
$194.94
|
| Rate for Payer: BCN Commercial |
$1,593.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.27
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cofinity Commercial |
$1,435.50
|
| Rate for Payer: Cofinity Commercial |
$1,542.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.27
|
| Rate for Payer: Mclaren Medicaid |
$699.28
|
| Rate for Payer: Meridian Medicaid |
$734.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,124.83
|
| Rate for Payer: PACE SWMI |
$1,071.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$699.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,664.71
|
| Rate for Payer: Priority Health Medicare |
$1,071.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,664.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,071.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,103.41
|
|
|
PR OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD
|
Professional
|
Both
|
$3,842.00
|
|
|
Service Code
|
HCPCS 27218
|
| Min. Negotiated Rate |
$736.77 |
| Max. Negotiated Rate |
$2,689.40 |
| Rate for Payer: Aetna Commercial |
$1,541.82
|
| Rate for Payer: BCBS Complete |
$773.61
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$1,679.59
|
| Rate for Payer: Cash Price |
$3,073.60
|
| Rate for Payer: Cash Price |
$3,073.60
|
| Rate for Payer: Mclaren Medicaid |
$736.77
|
| Rate for Payer: Meridian Medicaid |
$773.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,689.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,755.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,755.10
|
|
|
PR OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 24587
|
| Min. Negotiated Rate |
$435.85 |
| Max. Negotiated Rate |
$1,667.79 |
| Rate for Payer: Aetna Commercial |
$1,438.70
|
| Rate for Payer: Aetna Medicare |
$1,116.61
|
| Rate for Payer: BCBS Complete |
$735.81
|
| Rate for Payer: BCBS MAPPO |
$1,073.66
|
| Rate for Payer: BCBS Trust/PPO |
$435.85
|
| Rate for Payer: BCN Commercial |
$1,596.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,073.66
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$1,546.07
|
| Rate for Payer: Cofinity Commercial |
$1,438.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,073.66
|
| Rate for Payer: Mclaren Medicaid |
$700.77
|
| Rate for Payer: Meridian Medicaid |
$735.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,127.34
|
| Rate for Payer: PACE SWMI |
$1,073.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,073.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$700.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,667.79
|
| Rate for Payer: Priority Health Medicare |
$1,073.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,667.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,073.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,073.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,105.87
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Facility
|
OP
|
$3,129.00
|
|
|
Service Code
|
CPT 23615
|
| Hospital Charge Code |
23615
|
| Min. Negotiated Rate |
$743.14 |
| Max. Negotiated Rate |
$9,065.28 |
| Rate for Payer: Aetna Commercial |
$2,659.65
|
| Rate for Payer: Aetna Medicare |
$813.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$977.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$977.81
|
| Rate for Payer: BCBS Complete |
$9,065.28
|
| Rate for Payer: BCBS MAPPO |
$782.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,432.80
|
| Rate for Payer: BCN Commercial |
$2,432.80
|
| Rate for Payer: BCN Medicare Advantage |
$782.25
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cofinity Commercial |
$2,690.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,503.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.25
|
| Rate for Payer: Healthscope Commercial |
$2,816.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.75
|
| Rate for Payer: Mclaren Medicaid |
$8,633.60
|
| Rate for Payer: Meridian Medicaid |
$9,065.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$821.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$899.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,659.65
|
| Rate for Payer: PACE Senior Care Partners |
$743.14
|
| Rate for Payer: PACE SWMI |
$782.25
|
| Rate for Payer: PHP Commercial |
$2,659.65
|
| Rate for Payer: PHP Medicare Advantage |
$782.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,633.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,190.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,722.23
|
| Rate for Payer: Priority Health Medicare |
$782.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,908.38
|
| Rate for Payer: Railroad Medicare Medicare |
$782.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,753.52
|
| Rate for Payer: UHC Core |
$2,612.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.25
|
| Rate for Payer: UHC Medicare Advantage |
$805.72
|
| Rate for Payer: VA VA |
$782.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.75
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Professional
|
Both
|
$3,129.00
|
|
|
Service Code
|
HCPCS 23615
|
| Min. Negotiated Rate |
$333.89 |
| Max. Negotiated Rate |
$2,190.30 |
| Rate for Payer: Aetna Commercial |
$1,166.98
|
| Rate for Payer: Aetna Medicare |
$905.72
|
| Rate for Payer: BCBS Complete |
$599.16
|
| Rate for Payer: BCBS MAPPO |
$870.88
|
| Rate for Payer: BCBS Trust/PPO |
$333.89
|
| Rate for Payer: BCN Commercial |
$1,298.41
|
| Rate for Payer: BCN Medicare Advantage |
$870.88
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cofinity Commercial |
$1,166.98
|
| Rate for Payer: Cofinity Commercial |
$1,254.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.88
|
| Rate for Payer: Mclaren Medicaid |
$570.63
|
| Rate for Payer: Meridian Medicaid |
$599.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$914.42
|
| Rate for Payer: PACE SWMI |
$870.88
|
| Rate for Payer: PHP Medicare Advantage |
$870.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,190.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,356.79
|
| Rate for Payer: Priority Health Medicare |
$870.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,356.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.88
|
| Rate for Payer: UHC Medicare Advantage |
$897.01
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Professional
|
Both
|
$3,129.00
|
|
|
Service Code
|
HCPCS 23615
|
| Hospital Charge Code |
23615
|
| Min. Negotiated Rate |
$333.89 |
| Max. Negotiated Rate |
$2,190.30 |
| Rate for Payer: Aetna Commercial |
$1,166.98
|
| Rate for Payer: Aetna Medicare |
$905.72
|
| Rate for Payer: BCBS Complete |
$599.16
|
| Rate for Payer: BCBS MAPPO |
$870.88
|
| Rate for Payer: BCBS Trust/PPO |
$333.89
|
| Rate for Payer: BCN Commercial |
$1,298.41
|
| Rate for Payer: BCN Medicare Advantage |
$870.88
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cofinity Commercial |
$1,166.98
|
| Rate for Payer: Cofinity Commercial |
$1,254.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.88
|
| Rate for Payer: Mclaren Medicaid |
$570.63
|
| Rate for Payer: Meridian Medicaid |
$599.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$914.42
|
| Rate for Payer: PACE SWMI |
$870.88
|
| Rate for Payer: PHP Medicare Advantage |
$870.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,190.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,356.79
|
| Rate for Payer: Priority Health Medicare |
$870.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,356.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.88
|
| Rate for Payer: UHC Medicare Advantage |
$897.01
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Facility
|
IP
|
$3,129.00
|
|
|
Service Code
|
CPT 23615
|
| Hospital Charge Code |
23615
|
| Min. Negotiated Rate |
$1,908.38 |
| Max. Negotiated Rate |
$2,816.10 |
| Rate for Payer: Aetna Commercial |
$2,659.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.09
|
| Rate for Payer: BCN Commercial |
$2,418.09
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cofinity Commercial |
$2,690.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,503.20
|
| Rate for Payer: Healthscope Commercial |
$2,816.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,659.65
|
| Rate for Payer: PHP Commercial |
$2,659.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,190.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,722.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,908.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,753.52
|
| Rate for Payer: UHC Core |
$2,612.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.75
|
|
|
PR OPTX PROX HUMRL FX W/INT FIXJ RPR TUBRST RPLCMT
|
Professional
|
Both
|
$2,330.00
|
|
|
Service Code
|
HCPCS 23616
|
| Min. Negotiated Rate |
$496.07 |
| Max. Negotiated Rate |
$1,890.42 |
| Rate for Payer: Aetna Commercial |
$1,633.02
|
| Rate for Payer: Aetna Medicare |
$1,267.42
|
| Rate for Payer: BCBS Complete |
$833.99
|
| Rate for Payer: BCBS MAPPO |
$1,218.67
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$1,809.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.67
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cofinity Commercial |
$1,754.88
|
| Rate for Payer: Cofinity Commercial |
$1,633.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.67
|
| Rate for Payer: Mclaren Medicaid |
$794.28
|
| Rate for Payer: Meridian Medicaid |
$833.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,279.60
|
| Rate for Payer: PACE SWMI |
$1,218.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,631.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,890.42
|
| Rate for Payer: Priority Health Medicare |
$1,218.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,890.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,255.23
|
|
|
PR OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ
|
Professional
|
Both
|
$3,037.00
|
|
|
Service Code
|
HCPCS 27226
|
| Min. Negotiated Rate |
$558.94 |
| Max. Negotiated Rate |
$2,125.90 |
| Rate for Payer: Aetna Commercial |
$1,395.81
|
| Rate for Payer: Aetna Medicare |
$1,083.32
|
| Rate for Payer: BCBS Complete |
$714.34
|
| Rate for Payer: BCBS MAPPO |
$1,041.65
|
| Rate for Payer: BCBS Trust/PPO |
$558.94
|
| Rate for Payer: BCN Commercial |
$1,546.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.65
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,499.98
|
| Rate for Payer: Cofinity Commercial |
$1,395.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.65
|
| Rate for Payer: Mclaren Medicaid |
$680.32
|
| Rate for Payer: Meridian Medicaid |
$714.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,093.73
|
| Rate for Payer: PACE SWMI |
$1,041.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,125.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,616.21
|
| Rate for Payer: Priority Health Medicare |
$1,041.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,616.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,041.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,041.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.90
|
|
|
PR OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT
|
Professional
|
Both
|
$5,599.00
|
|
|
Service Code
|
HCPCS 22318
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$3,919.30 |
| Rate for Payer: Aetna Commercial |
$2,219.92
|
| Rate for Payer: Aetna Medicare |
$1,722.93
|
| Rate for Payer: BCBS Complete |
$1,127.65
|
| Rate for Payer: BCBS MAPPO |
$1,656.66
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$2,682.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,656.66
|
| Rate for Payer: Cash Price |
$4,479.20
|
| Rate for Payer: Cash Price |
$4,479.20
|
| Rate for Payer: Cofinity Commercial |
$2,385.59
|
| Rate for Payer: Cofinity Commercial |
$2,219.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,656.66
|
| Rate for Payer: Mclaren Medicaid |
$1,073.95
|
| Rate for Payer: Meridian Medicaid |
$1,127.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,739.49
|
| Rate for Payer: PACE SWMI |
$1,656.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,656.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,073.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,919.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,545.59
|
| Rate for Payer: Priority Health Medicare |
$1,656.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,545.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,656.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,656.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,706.36
|
|
|
PR OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ
|
Professional
|
Both
|
$10,531.00
|
|
|
Service Code
|
HCPCS 22319
|
| Min. Negotiated Rate |
$1,190.67 |
| Max. Negotiated Rate |
$7,371.70 |
| Rate for Payer: Aetna Commercial |
$2,468.44
|
| Rate for Payer: Aetna Medicare |
$1,915.80
|
| Rate for Payer: BCBS Complete |
$1,250.20
|
| Rate for Payer: BCBS MAPPO |
$1,842.12
|
| Rate for Payer: BCBS Trust/PPO |
$5,215.40
|
| Rate for Payer: BCN Commercial |
$2,704.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,842.12
|
| Rate for Payer: Cash Price |
$8,424.80
|
| Rate for Payer: Cash Price |
$8,424.80
|
| Rate for Payer: Cofinity Commercial |
$2,652.65
|
| Rate for Payer: Cofinity Commercial |
$2,468.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,842.12
|
| Rate for Payer: Mclaren Medicaid |
$1,190.67
|
| Rate for Payer: Meridian Medicaid |
$1,250.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,934.23
|
| Rate for Payer: PACE SWMI |
$1,842.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,842.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,190.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,371.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,825.94
|
| Rate for Payer: Priority Health Medicare |
$1,842.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,825.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,842.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,842.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,897.38
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR
|
Professional
|
Both
|
$3,987.00
|
|
|
Service Code
|
HCPCS 22326
|
| Min. Negotiated Rate |
$979.59 |
| Max. Negotiated Rate |
$2,790.90 |
| Rate for Payer: Aetna Commercial |
$2,023.74
|
| Rate for Payer: Aetna Medicare |
$1,570.66
|
| Rate for Payer: BCBS Complete |
$1,028.57
|
| Rate for Payer: BCBS MAPPO |
$1,510.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.59
|
| Rate for Payer: BCN Commercial |
$2,452.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,510.25
|
| Rate for Payer: Cash Price |
$3,189.60
|
| Rate for Payer: Cash Price |
$3,189.60
|
| Rate for Payer: Cofinity Commercial |
$2,174.76
|
| Rate for Payer: Cofinity Commercial |
$2,023.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,510.25
|
| Rate for Payer: Mclaren Medicaid |
$979.59
|
| Rate for Payer: Meridian Medicaid |
$1,028.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,585.76
|
| Rate for Payer: PACE SWMI |
$1,510.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,510.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$979.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,790.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,327.03
|
| Rate for Payer: Priority Health Medicare |
$1,510.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,327.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,510.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,555.56
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA
|
Professional
|
Both
|
$1,148.00
|
|
|
Service Code
|
HCPCS 22328
|
| Min. Negotiated Rate |
$179.35 |
| Max. Negotiated Rate |
$950.50 |
| Rate for Payer: Aetna Commercial |
$378.93
|
| Rate for Payer: Aetna Medicare |
$294.09
|
| Rate for Payer: BCBS Complete |
$188.32
|
| Rate for Payer: BCBS MAPPO |
$282.78
|
| Rate for Payer: BCBS Trust/PPO |
$950.50
|
| Rate for Payer: BCN Commercial |
$453.59
|
| Rate for Payer: BCN Medicare Advantage |
$282.78
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Cofinity Commercial |
$407.20
|
| Rate for Payer: Cofinity Commercial |
$378.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.78
|
| Rate for Payer: Mclaren Medicaid |
$179.35
|
| Rate for Payer: Meridian Medicaid |
$188.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$296.92
|
| Rate for Payer: PACE SWMI |
$282.78
|
| Rate for Payer: PHP Medicare Advantage |
$282.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$803.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.48
|
| Rate for Payer: Priority Health Medicare |
$282.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.78
|
| Rate for Payer: UHC Medicare Advantage |
$291.26
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM
|
Professional
|
Both
|
$3,668.00
|
|
|
Service Code
|
HCPCS 22325
|
| Min. Negotiated Rate |
$957.44 |
| Max. Negotiated Rate |
$17,177.60 |
| Rate for Payer: Aetna Commercial |
$1,969.25
|
| Rate for Payer: Aetna Medicare |
$1,528.37
|
| Rate for Payer: BCBS Complete |
$1,005.31
|
| Rate for Payer: BCBS MAPPO |
$1,469.59
|
| Rate for Payer: BCBS Trust/PPO |
$17,177.60
|
| Rate for Payer: BCN Commercial |
$2,172.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,469.59
|
| Rate for Payer: Cash Price |
$2,934.40
|
| Rate for Payer: Cash Price |
$2,934.40
|
| Rate for Payer: Cofinity Commercial |
$2,116.21
|
| Rate for Payer: Cofinity Commercial |
$1,969.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,469.59
|
| Rate for Payer: Mclaren Medicaid |
$957.44
|
| Rate for Payer: Meridian Medicaid |
$1,005.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,543.07
|
| Rate for Payer: PACE SWMI |
$1,469.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,469.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$957.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,567.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,270.34
|
| Rate for Payer: Priority Health Medicare |
$1,469.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,270.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,469.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,469.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,513.68
|
|
|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH
|
Professional
|
Both
|
$3,828.00
|
|
|
Service Code
|
HCPCS 22327
|
| Min. Negotiated Rate |
$950.50 |
| Max. Negotiated Rate |
$2,679.60 |
| Rate for Payer: Aetna Commercial |
$2,053.39
|
| Rate for Payer: Aetna Medicare |
$1,593.68
|
| Rate for Payer: BCBS Complete |
$1,047.57
|
| Rate for Payer: BCBS MAPPO |
$1,532.38
|
| Rate for Payer: BCBS Trust/PPO |
$950.50
|
| Rate for Payer: BCN Commercial |
$2,264.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,532.38
|
| Rate for Payer: Cash Price |
$3,062.40
|
| Rate for Payer: Cash Price |
$3,062.40
|
| Rate for Payer: Cofinity Commercial |
$2,053.39
|
| Rate for Payer: Cofinity Commercial |
$2,206.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,532.38
|
| Rate for Payer: Mclaren Medicaid |
$997.69
|
| Rate for Payer: Meridian Medicaid |
$1,047.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,609.00
|
| Rate for Payer: PACE SWMI |
$1,532.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,532.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$997.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,679.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,365.84
|
| Rate for Payer: Priority Health Medicare |
$1,532.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,365.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,532.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,532.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,578.35
|
|
|
PR OPTX SHO DISLC W/FX GR HUMERAL TUBRST INT FIXJ
|
Professional
|
Both
|
$2,881.00
|
|
|
Service Code
|
HCPCS 23670
|
| Min. Negotiated Rate |
$196.12 |
| Max. Negotiated Rate |
$2,016.70 |
| Rate for Payer: Aetna Commercial |
$1,150.87
|
| Rate for Payer: Aetna Medicare |
$893.21
|
| Rate for Payer: BCBS Complete |
$592.00
|
| Rate for Payer: BCBS MAPPO |
$858.86
|
| Rate for Payer: BCBS Trust/PPO |
$196.12
|
| Rate for Payer: BCN Commercial |
$1,279.85
|
| Rate for Payer: BCN Medicare Advantage |
$858.86
|
| Rate for Payer: Cash Price |
$2,304.80
|
| Rate for Payer: Cash Price |
$2,304.80
|
| Rate for Payer: Cofinity Commercial |
$1,150.87
|
| Rate for Payer: Cofinity Commercial |
$1,236.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.86
|
| Rate for Payer: Mclaren Medicaid |
$563.81
|
| Rate for Payer: Meridian Medicaid |
$592.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$901.80
|
| Rate for Payer: PACE SWMI |
$858.86
|
| Rate for Payer: PHP Medicare Advantage |
$858.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,016.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.40
|
| Rate for Payer: Priority Health Medicare |
$858.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,337.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.86
|
| Rate for Payer: UHC Medicare Advantage |
$884.63
|
|
|
PR OPTX SHO DISLC W/SURG/ANTMCL NECK FX INT FIXJ
|
Professional
|
Both
|
$1,623.00
|
|
|
Service Code
|
HCPCS 23680
|
| Min. Negotiated Rate |
$228.81 |
| Max. Negotiated Rate |
$1,427.27 |
| Rate for Payer: Aetna Commercial |
$1,229.07
|
| Rate for Payer: Aetna Medicare |
$953.91
|
| Rate for Payer: BCBS Complete |
$623.98
|
| Rate for Payer: BCBS MAPPO |
$917.22
|
| Rate for Payer: BCBS Trust/PPO |
$228.81
|
| Rate for Payer: BCN Commercial |
$1,365.86
|
| Rate for Payer: BCN Medicare Advantage |
$917.22
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Cofinity Commercial |
$1,320.80
|
| Rate for Payer: Cofinity Commercial |
$1,229.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.22
|
| Rate for Payer: Mclaren Medicaid |
$594.27
|
| Rate for Payer: Meridian Medicaid |
$623.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$963.08
|
| Rate for Payer: PACE SWMI |
$917.22
|
| Rate for Payer: PHP Medicare Advantage |
$917.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,427.27
|
| Rate for Payer: Priority Health Medicare |
$917.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$917.22
|
| Rate for Payer: UHC Medicare Advantage |
$944.74
|
|
|
PR OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN
|
Professional
|
Both
|
$1,615.00
|
|
|
Service Code
|
HCPCS 27178
|
| Min. Negotiated Rate |
$595.12 |
| Max. Negotiated Rate |
$1,416.03 |
| Rate for Payer: Aetna Commercial |
$1,218.89
|
| Rate for Payer: Aetna Medicare |
$946.00
|
| Rate for Payer: BCBS Complete |
$624.88
|
| Rate for Payer: BCBS MAPPO |
$909.62
|
| Rate for Payer: BCBS Trust/PPO |
$969.43
|
| Rate for Payer: BCN Commercial |
$1,355.11
|
| Rate for Payer: BCN Medicare Advantage |
$909.62
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cofinity Commercial |
$1,309.85
|
| Rate for Payer: Cofinity Commercial |
$1,218.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.62
|
| Rate for Payer: Mclaren Medicaid |
$595.12
|
| Rate for Payer: Meridian Medicaid |
$624.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$955.10
|
| Rate for Payer: PACE SWMI |
$909.62
|
| Rate for Payer: PHP Medicare Advantage |
$909.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,130.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,416.03
|
| Rate for Payer: Priority Health Medicare |
$909.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,416.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$909.62
|
| Rate for Payer: UHC Medicare Advantage |
$936.91
|
|
|
PR OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 27181
|
| Min. Negotiated Rate |
$381.43 |
| Max. Negotiated Rate |
$1,714.25 |
| Rate for Payer: Aetna Commercial |
$1,478.45
|
| Rate for Payer: Aetna Medicare |
$1,147.45
|
| Rate for Payer: BCBS Complete |
$757.06
|
| Rate for Payer: BCBS MAPPO |
$1,103.32
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$1,640.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.32
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cofinity Commercial |
$1,478.45
|
| Rate for Payer: Cofinity Commercial |
$1,588.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.32
|
| Rate for Payer: Mclaren Medicaid |
$721.01
|
| Rate for Payer: Meridian Medicaid |
$757.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,158.49
|
| Rate for Payer: PACE SWMI |
$1,103.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,613.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,714.25
|
| Rate for Payer: Priority Health Medicare |
$1,103.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,714.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,103.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.42
|
|
|
PR OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT
|
Professional
|
Both
|
$1,952.00
|
|
|
Service Code
|
HCPCS 27177
|
| Min. Negotiated Rate |
$718.02 |
| Max. Negotiated Rate |
$1,708.64 |
| Rate for Payer: Aetna Commercial |
$1,473.45
|
| Rate for Payer: Aetna Medicare |
$1,143.57
|
| Rate for Payer: BCBS Complete |
$753.92
|
| Rate for Payer: BCBS MAPPO |
$1,099.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.86
|
| Rate for Payer: BCN Commercial |
$1,635.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.59
|
| Rate for Payer: Cash Price |
$1,561.60
|
| Rate for Payer: Cash Price |
$1,561.60
|
| Rate for Payer: Cofinity Commercial |
$1,583.41
|
| Rate for Payer: Cofinity Commercial |
$1,473.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.59
|
| Rate for Payer: Mclaren Medicaid |
$718.02
|
| Rate for Payer: Meridian Medicaid |
$753.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,154.57
|
| Rate for Payer: PACE SWMI |
$1,099.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,708.64
|
| Rate for Payer: Priority Health Medicare |
$1,099.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,708.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,099.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,132.58
|
|
|
PR OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM
|
Professional
|
Both
|
$1,947.00
|
|
|
Service Code
|
HCPCS 27258
|
| Min. Negotiated Rate |
$715.04 |
| Max. Negotiated Rate |
$2,598.71 |
| Rate for Payer: Aetna Commercial |
$1,468.10
|
| Rate for Payer: Aetna Medicare |
$1,139.42
|
| Rate for Payer: BCBS Complete |
$750.79
|
| Rate for Payer: BCBS MAPPO |
$1,095.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,598.71
|
| Rate for Payer: BCN Commercial |
$1,628.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,095.60
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cofinity Commercial |
$1,577.66
|
| Rate for Payer: Cofinity Commercial |
$1,468.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,095.60
|
| Rate for Payer: Mclaren Medicaid |
$715.04
|
| Rate for Payer: Meridian Medicaid |
$750.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,150.38
|
| Rate for Payer: PACE SWMI |
$1,095.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,095.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,701.48
|
| Rate for Payer: Priority Health Medicare |
$1,095.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,701.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,095.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.47
|
|
|
PR OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF
|
Professional
|
Both
|
$2,096.00
|
|
|
Service Code
|
HCPCS 23532
|
| Min. Negotiated Rate |
$407.68 |
| Max. Negotiated Rate |
$1,467.20 |
| Rate for Payer: Aetna Commercial |
$829.90
|
| Rate for Payer: Aetna Medicare |
$644.10
|
| Rate for Payer: BCBS Complete |
$428.06
|
| Rate for Payer: BCBS MAPPO |
$619.33
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$926.54
|
| Rate for Payer: BCN Medicare Advantage |
$619.33
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cofinity Commercial |
$891.84
|
| Rate for Payer: Cofinity Commercial |
$829.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.33
|
| Rate for Payer: Mclaren Medicaid |
$407.68
|
| Rate for Payer: Meridian Medicaid |
$428.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$650.30
|
| Rate for Payer: PACE SWMI |
$619.33
|
| Rate for Payer: PHP Medicare Advantage |
$619.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.19
|
| Rate for Payer: Priority Health Medicare |
$619.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$968.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.33
|
| Rate for Payer: UHC Medicare Advantage |
$637.91
|
|
|
PR OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ
|
Professional
|
Both
|
$3,036.00
|
|
|
Service Code
|
HCPCS 27536
|
| Min. Negotiated Rate |
$763.39 |
| Max. Negotiated Rate |
$2,125.20 |
| Rate for Payer: Aetna Commercial |
$1,566.97
|
| Rate for Payer: Aetna Medicare |
$1,216.16
|
| Rate for Payer: BCBS Complete |
$801.56
|
| Rate for Payer: BCBS MAPPO |
$1,169.38
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$1,737.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.38
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,683.91
|
| Rate for Payer: Cofinity Commercial |
$1,566.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.38
|
| Rate for Payer: Mclaren Medicaid |
$763.39
|
| Rate for Payer: Meridian Medicaid |
$801.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,227.85
|
| Rate for Payer: PACE SWMI |
$1,169.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,125.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,815.36
|
| Rate for Payer: Priority Health Medicare |
$1,169.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,815.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,169.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,204.46
|
|
|
PR OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,516.00
|
|
|
Service Code
|
HCPCS 27758
|
| Min. Negotiated Rate |
$578.72 |
| Max. Negotiated Rate |
$2,461.20 |
| Rate for Payer: Aetna Commercial |
$1,183.70
|
| Rate for Payer: Aetna Medicare |
$918.69
|
| Rate for Payer: BCBS Complete |
$607.66
|
| Rate for Payer: BCBS MAPPO |
$883.36
|
| Rate for Payer: BCBS Trust/PPO |
$623.39
|
| Rate for Payer: BCN Commercial |
$1,316.50
|
| Rate for Payer: BCN Medicare Advantage |
$883.36
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cofinity Commercial |
$1,272.04
|
| Rate for Payer: Cofinity Commercial |
$1,183.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$883.36
|
| Rate for Payer: Mclaren Medicaid |
$578.72
|
| Rate for Payer: Meridian Medicaid |
$607.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$927.53
|
| Rate for Payer: PACE SWMI |
$883.36
|
| Rate for Payer: PHP Medicare Advantage |
$883.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,461.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,375.69
|
| Rate for Payer: Priority Health Medicare |
$883.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,375.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$883.36
|
| Rate for Payer: UHC Medicare Advantage |
$909.86
|
|
|
PROPYLENE GLYCOL 0.6 % EYE DROPS
|
Facility
|
IP
|
$39.45
|
|
|
Service Code
|
NDC 0065-0481-11
|
| Hospital Charge Code |
106794
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$35.50 |
| Rate for Payer: Aetna Commercial |
$33.53
|
| Rate for Payer: BCBS Trust/PPO |
$30.49
|
| Rate for Payer: BCN Commercial |
$30.49
|
| Rate for Payer: Cash Price |
$31.56
|
| Rate for Payer: Cofinity Commercial |
$33.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.56
|
| Rate for Payer: Healthscope Commercial |
$35.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.53
|
| Rate for Payer: PHP Commercial |
$33.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.72
|
| Rate for Payer: UHC Core |
$32.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.59
|
|
