|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,888.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$1,877.20 |
| Rate for Payer: Aetna Commercial |
$812.23
|
| Rate for Payer: Aetna Medicare |
$630.39
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$606.14
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: BCN Commercial |
$926.54
|
| Rate for Payer: BCN Medicare Advantage |
$606.14
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cofinity Commercial |
$872.84
|
| Rate for Payer: Cofinity Commercial |
$812.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.14
|
| Rate for Payer: Mclaren Medicaid |
$413.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.45
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Nomi Health Commercial |
$727.37
|
| Rate for Payer: PACE SWMI |
$606.14
|
| Rate for Payer: PHP Medicare Advantage |
$606.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,877.20
|
| Rate for Payer: Priority Health HMO/PPO |
$974.98
|
| Rate for Payer: Priority Health Medicare |
$612.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$974.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.14
|
| Rate for Payer: UHC Exchange |
$606.14
|
| Rate for Payer: UHC Medicare Advantage |
$606.14
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,455.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$285.26 |
| Max. Negotiated Rate |
$1,595.75 |
| Rate for Payer: Aetna Commercial |
$932.12
|
| Rate for Payer: Aetna Medicare |
$723.43
|
| Rate for Payer: BCBS Complete |
$494.49
|
| Rate for Payer: BCBS MAPPO |
$695.61
|
| Rate for Payer: BCBS Trust/PPO |
$285.26
|
| Rate for Payer: BCN Commercial |
$1,062.87
|
| Rate for Payer: BCN Medicare Advantage |
$695.61
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cofinity Commercial |
$932.12
|
| Rate for Payer: Cofinity Commercial |
$1,001.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.61
|
| Rate for Payer: Mclaren Medicaid |
$470.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.39
|
| Rate for Payer: Meridian Medicaid |
$494.49
|
| Rate for Payer: Nomi Health Commercial |
$834.73
|
| Rate for Payer: PACE SWMI |
$695.61
|
| Rate for Payer: PHP Medicare Advantage |
$695.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,595.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,115.92
|
| Rate for Payer: Priority Health Medicare |
$702.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.61
|
| Rate for Payer: UHC Exchange |
$695.61
|
| Rate for Payer: UHC Medicare Advantage |
$695.61
|
| Rate for Payer: UHCCP Medicaid |
$470.94
|
|
|
PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 21365
|
| Min. Negotiated Rate |
$180.58 |
| Max. Negotiated Rate |
$1,648.72 |
| Rate for Payer: Aetna Commercial |
$1,387.29
|
| Rate for Payer: Aetna Medicare |
$1,076.70
|
| Rate for Payer: BCBS Complete |
$733.35
|
| Rate for Payer: BCBS MAPPO |
$1,035.29
|
| Rate for Payer: BCBS Trust/PPO |
$180.58
|
| Rate for Payer: BCN Commercial |
$1,582.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.29
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cofinity Commercial |
$1,490.82
|
| Rate for Payer: Cofinity Commercial |
$1,387.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.29
|
| Rate for Payer: Mclaren Medicaid |
$698.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,087.05
|
| Rate for Payer: Meridian Medicaid |
$733.35
|
| Rate for Payer: Nomi Health Commercial |
$1,242.35
|
| Rate for Payer: PACE SWMI |
$1,035.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,648.72
|
| Rate for Payer: Priority Health Medicare |
$1,045.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,648.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,035.29
|
| Rate for Payer: UHC Exchange |
$1,035.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,035.29
|
| Rate for Payer: UHCCP Medicaid |
$698.43
|
|
|
PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$3,475.00
|
|
|
Service Code
|
HCPCS 21344
|
| Min. Negotiated Rate |
$118.87 |
| Max. Negotiated Rate |
$2,258.75 |
| Rate for Payer: Aetna Commercial |
$1,774.20
|
| Rate for Payer: Aetna Medicare |
$1,376.99
|
| Rate for Payer: BCBS Complete |
$937.77
|
| Rate for Payer: BCBS MAPPO |
$1,324.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$2,044.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.03
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cofinity Commercial |
$1,906.60
|
| Rate for Payer: Cofinity Commercial |
$1,774.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.03
|
| Rate for Payer: Mclaren Medicaid |
$893.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,390.23
|
| Rate for Payer: Meridian Medicaid |
$937.77
|
| Rate for Payer: Nomi Health Commercial |
$1,588.84
|
| Rate for Payer: PACE SWMI |
$1,324.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,258.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,129.07
|
| Rate for Payer: Priority Health Medicare |
$1,337.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,324.03
|
| Rate for Payer: UHC Exchange |
$1,324.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,324.03
|
| Rate for Payer: UHCCP Medicaid |
$893.11
|
|
|
PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR
|
Professional
|
Both
|
$3,013.00
|
|
|
Service Code
|
HCPCS 21433
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,638.95 |
| Rate for Payer: Aetna Commercial |
$2,222.50
|
| Rate for Payer: Aetna Medicare |
$1,724.92
|
| Rate for Payer: BCBS Complete |
$1,170.36
|
| Rate for Payer: BCBS MAPPO |
$1,658.58
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,530.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,658.58
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cofinity Commercial |
$2,388.36
|
| Rate for Payer: Cofinity Commercial |
$2,222.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,658.58
|
| Rate for Payer: Mclaren Medicaid |
$1,114.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,741.51
|
| Rate for Payer: Meridian Medicaid |
$1,170.36
|
| Rate for Payer: Nomi Health Commercial |
$1,990.30
|
| Rate for Payer: PACE SWMI |
$1,658.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,658.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,114.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,958.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,638.95
|
| Rate for Payer: Priority Health Medicare |
$1,675.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,638.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,658.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,658.58
|
| Rate for Payer: UHC Exchange |
$1,658.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,658.58
|
| Rate for Payer: UHCCP Medicaid |
$1,114.63
|
|
|
PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$2,453.00
|
|
|
Service Code
|
HCPCS 21343
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$1,667.03 |
| Rate for Payer: Aetna Commercial |
$1,374.30
|
| Rate for Payer: Aetna Medicare |
$1,066.62
|
| Rate for Payer: BCBS Complete |
$733.79
|
| Rate for Payer: BCBS MAPPO |
$1,025.60
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cofinity Commercial |
$1,476.86
|
| Rate for Payer: Cofinity Commercial |
$1,374.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.60
|
| Rate for Payer: Mclaren Medicaid |
$698.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,076.88
|
| Rate for Payer: Meridian Medicaid |
$733.79
|
| Rate for Payer: Nomi Health Commercial |
$1,230.72
|
| Rate for Payer: PACE SWMI |
$1,025.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,667.03
|
| Rate for Payer: Priority Health Medicare |
$1,035.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,667.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,025.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,025.60
|
| Rate for Payer: UHC Exchange |
$1,025.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.60
|
| Rate for Payer: UHCCP Medicaid |
$698.85
|
|
|
PR OPEN TX DEPRESSED MALAR FRACTURE
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 21360
|
| Min. Negotiated Rate |
$340.16 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$670.15
|
| Rate for Payer: Aetna Medicare |
$520.11
|
| Rate for Payer: BCBS Complete |
$357.17
|
| Rate for Payer: BCBS MAPPO |
$500.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$771.14
|
| Rate for Payer: BCN Medicare Advantage |
$500.11
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cofinity Commercial |
$720.16
|
| Rate for Payer: Cofinity Commercial |
$670.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.11
|
| Rate for Payer: Mclaren Medicaid |
$340.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.12
|
| Rate for Payer: Meridian Medicaid |
$357.17
|
| Rate for Payer: Nomi Health Commercial |
$600.13
|
| Rate for Payer: PACE SWMI |
$500.11
|
| Rate for Payer: PHP Medicare Advantage |
$500.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO |
$810.62
|
| Rate for Payer: Priority Health Medicare |
$505.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$810.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.11
|
| Rate for Payer: UHC Exchange |
$500.11
|
| Rate for Payer: UHC Medicare Advantage |
$500.11
|
| Rate for Payer: UHCCP Medicaid |
$340.16
|
|
|
PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
HCPCS 21356
|
| Min. Negotiated Rate |
$261.56 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$513.53
|
| Rate for Payer: Aetna Medicare |
$398.56
|
| Rate for Payer: BCBS Complete |
$274.64
|
| Rate for Payer: BCBS MAPPO |
$383.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$801.92
|
| Rate for Payer: BCN Medicare Advantage |
$383.23
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cofinity Commercial |
$551.85
|
| Rate for Payer: Cofinity Commercial |
$513.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.23
|
| Rate for Payer: Mclaren Medicaid |
$261.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.39
|
| Rate for Payer: Meridian Medicaid |
$274.64
|
| Rate for Payer: Nomi Health Commercial |
$459.88
|
| Rate for Payer: PACE SWMI |
$383.23
|
| Rate for Payer: PHP Medicare Advantage |
$383.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$535.60
|
| Rate for Payer: Priority Health HMO/PPO |
$620.81
|
| Rate for Payer: Priority Health Medicare |
$387.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$620.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$383.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.23
|
| Rate for Payer: UHC Exchange |
$383.23
|
| Rate for Payer: UHC Medicare Advantage |
$383.23
|
| Rate for Payer: UHCCP Medicaid |
$261.56
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
IP
|
$2,471.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$1,606.15 |
| Max. Negotiated Rate |
$2,223.90 |
| Rate for Payer: Aetna Commercial |
$2,100.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.08
|
| Rate for Payer: BCN Commercial |
$1,909.59
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$2,125.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.80
|
| Rate for Payer: Healthscope Commercial |
$2,223.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,853.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,100.35
|
| Rate for Payer: Nomi Health Commercial |
$2,026.22
|
| Rate for Payer: PHP Commercial |
$2,100.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,149.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,655.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,174.48
|
| Rate for Payer: UHC Core |
$2,063.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,853.25
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
OP
|
$2,471.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$586.86 |
| Max. Negotiated Rate |
$5,313.85 |
| Rate for Payer: Aetna Commercial |
$2,100.35
|
| Rate for Payer: Aetna Medicare |
$642.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$772.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$772.19
|
| Rate for Payer: BCBS Complete |
$5,313.85
|
| Rate for Payer: BCBS MAPPO |
$617.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.41
|
| Rate for Payer: BCN Commercial |
$1,921.20
|
| Rate for Payer: BCN Medicare Advantage |
$617.75
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$2,125.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.75
|
| Rate for Payer: Healthscope Commercial |
$2,223.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,853.25
|
| Rate for Payer: Mclaren Medicaid |
$5,060.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.64
|
| Rate for Payer: Meridian Medicaid |
$5,313.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$710.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,100.35
|
| Rate for Payer: Nomi Health Commercial |
$2,026.22
|
| Rate for Payer: PACE Senior Care Partners |
$586.86
|
| Rate for Payer: PACE SWMI |
$617.75
|
| Rate for Payer: PHP Commercial |
$2,100.35
|
| Rate for Payer: PHP Medicare Advantage |
$617.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,060.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,149.77
|
| Rate for Payer: Priority Health Medicare |
$623.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,655.57
|
| Rate for Payer: Railroad Medicare Medicare |
$617.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,174.48
|
| Rate for Payer: UHC Core |
$2,063.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.75
|
| Rate for Payer: UHC Exchange |
$617.75
|
| Rate for Payer: UHC Medicare Advantage |
$617.75
|
| Rate for Payer: UHCCP Medicaid |
$5,060.48
|
| Rate for Payer: VA VA |
$617.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,853.25
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$2,729.34 |
| Rate for Payer: Aetna Commercial |
$829.98
|
| Rate for Payer: Aetna Medicare |
$644.17
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$619.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,729.34
|
| Rate for Payer: BCN Commercial |
$1,046.55
|
| Rate for Payer: BCN Medicare Advantage |
$619.39
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$891.92
|
| Rate for Payer: Cofinity Commercial |
$829.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.39
|
| Rate for Payer: Mclaren Medicaid |
$419.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.36
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Nomi Health Commercial |
$743.27
|
| Rate for Payer: PACE SWMI |
$619.39
|
| Rate for Payer: PHP Medicare Advantage |
$619.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO |
$998.38
|
| Rate for Payer: Priority Health Medicare |
$625.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$998.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.39
|
| Rate for Payer: UHC Exchange |
$619.39
|
| Rate for Payer: UHC Medicare Advantage |
$619.39
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$2,729.34 |
| Rate for Payer: Aetna Commercial |
$829.98
|
| Rate for Payer: Aetna Medicare |
$644.17
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$619.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,729.34
|
| Rate for Payer: BCN Commercial |
$1,046.55
|
| Rate for Payer: BCN Medicare Advantage |
$619.39
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$891.92
|
| Rate for Payer: Cofinity Commercial |
$829.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.39
|
| Rate for Payer: Mclaren Medicaid |
$419.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.36
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Nomi Health Commercial |
$743.27
|
| Rate for Payer: PACE SWMI |
$619.39
|
| Rate for Payer: PHP Medicare Advantage |
$619.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO |
$998.38
|
| Rate for Payer: Priority Health Medicare |
$625.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$998.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.39
|
| Rate for Payer: UHC Exchange |
$619.39
|
| Rate for Payer: UHC Medicare Advantage |
$619.39
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$787.72 |
| Rate for Payer: Aetna Commercial |
$651.99
|
| Rate for Payer: Aetna Medicare |
$506.02
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$486.56
|
| Rate for Payer: BCBS Trust/PPO |
$542.56
|
| Rate for Payer: BCN Commercial |
$746.70
|
| Rate for Payer: BCN Medicare Advantage |
$486.56
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$700.65
|
| Rate for Payer: Cofinity Commercial |
$651.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.56
|
| Rate for Payer: Mclaren Medicaid |
$332.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.89
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$583.87
|
| Rate for Payer: PACE SWMI |
$486.56
|
| Rate for Payer: PHP Medicare Advantage |
$486.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health HMO/PPO |
$787.72
|
| Rate for Payer: Priority Health Medicare |
$491.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.56
|
| Rate for Payer: UHC Exchange |
$486.56
|
| Rate for Payer: UHC Medicare Advantage |
$486.56
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$413.86 |
| Max. Negotiated Rate |
$1,483.99 |
| Rate for Payer: Aetna Commercial |
$816.92
|
| Rate for Payer: Aetna Medicare |
$634.03
|
| Rate for Payer: BCBS Complete |
$434.55
|
| Rate for Payer: BCBS MAPPO |
$609.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.99
|
| Rate for Payer: BCN Commercial |
$932.40
|
| Rate for Payer: BCN Medicare Advantage |
$609.64
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$877.88
|
| Rate for Payer: Cofinity Commercial |
$816.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.64
|
| Rate for Payer: Mclaren Medicaid |
$413.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.12
|
| Rate for Payer: Meridian Medicaid |
$434.55
|
| Rate for Payer: Nomi Health Commercial |
$731.57
|
| Rate for Payer: PACE SWMI |
$609.64
|
| Rate for Payer: PHP Medicare Advantage |
$609.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health HMO/PPO |
$981.08
|
| Rate for Payer: Priority Health Medicare |
$615.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$609.64
|
| Rate for Payer: UHC Exchange |
$609.64
|
| Rate for Payer: UHC Medicare Advantage |
$609.64
|
| Rate for Payer: UHCCP Medicaid |
$413.86
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
OP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$546.72 |
| Max. Negotiated Rate |
$5,313.85 |
| Rate for Payer: Aetna Commercial |
$1,956.70
|
| Rate for Payer: Aetna Medicare |
$598.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$719.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$719.38
|
| Rate for Payer: BCBS Complete |
$5,313.85
|
| Rate for Payer: BCBS MAPPO |
$575.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,892.47
|
| Rate for Payer: BCN Commercial |
$1,789.80
|
| Rate for Payer: BCN Medicare Advantage |
$575.50
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$1,979.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,841.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.50
|
| Rate for Payer: Healthscope Commercial |
$2,071.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,726.50
|
| Rate for Payer: Mclaren Medicaid |
$5,060.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.28
|
| Rate for Payer: Meridian Medicaid |
$5,313.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$661.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,956.70
|
| Rate for Payer: Nomi Health Commercial |
$1,887.64
|
| Rate for Payer: PACE Senior Care Partners |
$546.72
|
| Rate for Payer: PACE SWMI |
$575.50
|
| Rate for Payer: PHP Commercial |
$1,956.70
|
| Rate for Payer: PHP Medicare Advantage |
$575.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,060.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO |
$2,002.74
|
| Rate for Payer: Priority Health Medicare |
$581.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.34
|
| Rate for Payer: Railroad Medicare Medicare |
$575.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,025.76
|
| Rate for Payer: UHC Core |
$1,922.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.50
|
| Rate for Payer: UHC Exchange |
$575.50
|
| Rate for Payer: UHC Medicare Advantage |
$575.50
|
| Rate for Payer: UHCCP Medicaid |
$5,060.48
|
| Rate for Payer: VA VA |
$575.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,726.50
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$901.19
|
| Rate for Payer: Aetna Medicare |
$699.43
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.73
|
| Rate for Payer: BCN Commercial |
$1,042.84
|
| Rate for Payer: BCN Medicare Advantage |
$672.53
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$968.44
|
| Rate for Payer: Cofinity Commercial |
$901.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.53
|
| Rate for Payer: Mclaren Medicaid |
$457.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Nomi Health Commercial |
$807.04
|
| Rate for Payer: PACE SWMI |
$672.53
|
| Rate for Payer: PHP Medicare Advantage |
$672.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,093.04
|
| Rate for Payer: Priority Health Medicare |
$679.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,093.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.53
|
| Rate for Payer: UHC Exchange |
$672.53
|
| Rate for Payer: UHC Medicare Advantage |
$672.53
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$901.19
|
| Rate for Payer: Aetna Medicare |
$699.43
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.73
|
| Rate for Payer: BCN Commercial |
$1,042.84
|
| Rate for Payer: BCN Medicare Advantage |
$672.53
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$968.44
|
| Rate for Payer: Cofinity Commercial |
$901.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.53
|
| Rate for Payer: Mclaren Medicaid |
$457.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Nomi Health Commercial |
$807.04
|
| Rate for Payer: PACE SWMI |
$672.53
|
| Rate for Payer: PHP Medicare Advantage |
$672.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,093.04
|
| Rate for Payer: Priority Health Medicare |
$679.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,093.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.53
|
| Rate for Payer: UHC Exchange |
$672.53
|
| Rate for Payer: UHC Medicare Advantage |
$672.53
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
IP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$1,496.30 |
| Max. Negotiated Rate |
$2,071.80 |
| Rate for Payer: Aetna Commercial |
$1,956.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,879.12
|
| Rate for Payer: BCN Commercial |
$1,778.99
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$1,979.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,841.60
|
| Rate for Payer: Healthscope Commercial |
$2,071.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,726.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,956.70
|
| Rate for Payer: Nomi Health Commercial |
$1,887.64
|
| Rate for Payer: PHP Commercial |
$1,956.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO |
$2,002.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,025.76
|
| Rate for Payer: UHC Core |
$1,922.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,726.50
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$3,921.00
|
|
|
Service Code
|
HCPCS 27514
|
| Min. Negotiated Rate |
$624.52 |
| Max. Negotiated Rate |
$2,548.65 |
| Rate for Payer: Aetna Commercial |
$1,247.79
|
| Rate for Payer: Aetna Medicare |
$968.44
|
| Rate for Payer: BCBS Complete |
$655.75
|
| Rate for Payer: BCBS MAPPO |
$931.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$1,412.77
|
| Rate for Payer: BCN Medicare Advantage |
$931.19
|
| Rate for Payer: Cash Price |
$3,136.80
|
| Rate for Payer: Cash Price |
$3,136.80
|
| Rate for Payer: Cofinity Commercial |
$1,340.91
|
| Rate for Payer: Cofinity Commercial |
$1,247.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.19
|
| Rate for Payer: Mclaren Medicaid |
$624.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.75
|
| Rate for Payer: Meridian Medicaid |
$655.75
|
| Rate for Payer: Nomi Health Commercial |
$1,117.43
|
| Rate for Payer: PACE SWMI |
$931.19
|
| Rate for Payer: PHP Medicare Advantage |
$931.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,479.77
|
| Rate for Payer: Priority Health Medicare |
$940.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,479.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$931.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.19
|
| Rate for Payer: UHC Exchange |
$931.19
|
| Rate for Payer: UHC Medicare Advantage |
$931.19
|
| Rate for Payer: UHCCP Medicaid |
$624.52
|
|
|
PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD
|
Professional
|
Both
|
$3,919.00
|
|
|
Service Code
|
HCPCS 27269
|
| Min. Negotiated Rate |
$801.52 |
| Max. Negotiated Rate |
$4,086.40 |
| Rate for Payer: Aetna Commercial |
$1,602.59
|
| Rate for Payer: Aetna Medicare |
$1,243.80
|
| Rate for Payer: BCBS Complete |
$841.60
|
| Rate for Payer: BCBS MAPPO |
$1,195.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,086.40
|
| Rate for Payer: BCN Commercial |
$1,812.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.96
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,722.18
|
| Rate for Payer: Cofinity Commercial |
$1,602.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.96
|
| Rate for Payer: Mclaren Medicaid |
$801.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,255.76
|
| Rate for Payer: Meridian Medicaid |
$841.60
|
| Rate for Payer: Nomi Health Commercial |
$1,435.15
|
| Rate for Payer: PACE SWMI |
$1,195.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,898.04
|
| Rate for Payer: Priority Health Medicare |
$1,207.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,898.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,195.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,195.96
|
| Rate for Payer: UHC Exchange |
$1,195.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,195.96
|
| Rate for Payer: UHCCP Medicaid |
$801.52
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27511
|
| Min. Negotiated Rate |
$642.62 |
| Max. Negotiated Rate |
$2,501.20 |
| Rate for Payer: Aetna Commercial |
$1,284.24
|
| Rate for Payer: Aetna Medicare |
$996.73
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$958.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,679.99
|
| Rate for Payer: BCN Commercial |
$1,457.24
|
| Rate for Payer: BCN Medicare Advantage |
$958.39
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,380.08
|
| Rate for Payer: Cofinity Commercial |
$1,284.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.39
|
| Rate for Payer: Mclaren Medicaid |
$642.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.31
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Nomi Health Commercial |
$1,150.07
|
| Rate for Payer: PACE SWMI |
$958.39
|
| Rate for Payer: PHP Medicare Advantage |
$958.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,526.07
|
| Rate for Payer: Priority Health Medicare |
$967.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,526.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.39
|
| Rate for Payer: UHC Exchange |
$958.39
|
| Rate for Payer: UHC Medicare Advantage |
$958.39
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$4,397.00
|
|
|
Service Code
|
HCPCS 27513
|
| Min. Negotiated Rate |
$795.13 |
| Max. Negotiated Rate |
$2,858.05 |
| Rate for Payer: Aetna Commercial |
$1,592.47
|
| Rate for Payer: Aetna Medicare |
$1,235.95
|
| Rate for Payer: BCBS Complete |
$834.89
|
| Rate for Payer: BCBS MAPPO |
$1,188.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.86
|
| Rate for Payer: BCN Commercial |
$1,805.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,188.41
|
| Rate for Payer: Cash Price |
$3,517.60
|
| Rate for Payer: Cash Price |
$3,517.60
|
| Rate for Payer: Cofinity Commercial |
$1,711.31
|
| Rate for Payer: Cofinity Commercial |
$1,592.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,188.41
|
| Rate for Payer: Mclaren Medicaid |
$795.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.83
|
| Rate for Payer: Meridian Medicaid |
$834.89
|
| Rate for Payer: Nomi Health Commercial |
$1,426.09
|
| Rate for Payer: PACE SWMI |
$1,188.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,188.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,887.36
|
| Rate for Payer: Priority Health Medicare |
$1,200.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,887.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,188.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,188.41
|
| Rate for Payer: UHC Exchange |
$1,188.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,188.41
|
| Rate for Payer: UHCCP Medicaid |
$795.13
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 28505
|
| Min. Negotiated Rate |
$322.48 |
| Max. Negotiated Rate |
$1,403.69 |
| Rate for Payer: Aetna Commercial |
$636.63
|
| Rate for Payer: Aetna Medicare |
$494.10
|
| Rate for Payer: BCBS Complete |
$338.60
|
| Rate for Payer: BCBS MAPPO |
$475.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,403.69
|
| Rate for Payer: BCN Commercial |
$951.46
|
| Rate for Payer: BCN Medicare Advantage |
$475.10
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$684.14
|
| Rate for Payer: Cofinity Commercial |
$636.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.10
|
| Rate for Payer: Mclaren Medicaid |
$322.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.86
|
| Rate for Payer: Meridian Medicaid |
$338.60
|
| Rate for Payer: Nomi Health Commercial |
$570.12
|
| Rate for Payer: PACE SWMI |
$475.10
|
| Rate for Payer: PHP Medicare Advantage |
$475.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health HMO/PPO |
$765.84
|
| Rate for Payer: Priority Health Medicare |
$479.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$765.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.10
|
| Rate for Payer: UHC Exchange |
$475.10
|
| Rate for Payer: UHC Medicare Advantage |
$475.10
|
| Rate for Payer: UHCCP Medicaid |
$322.48
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 28525
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$828.31 |
| Rate for Payer: Aetna Commercial |
$515.65
|
| Rate for Payer: Aetna Medicare |
$400.20
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$384.81
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: BCN Commercial |
$828.31
|
| Rate for Payer: BCN Medicare Advantage |
$384.81
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$554.13
|
| Rate for Payer: Cofinity Commercial |
$515.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.81
|
| Rate for Payer: Mclaren Medicaid |
$262.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.05
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Nomi Health Commercial |
$461.77
|
| Rate for Payer: PACE SWMI |
$384.81
|
| Rate for Payer: PHP Medicare Advantage |
$384.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health HMO/PPO |
$630.48
|
| Rate for Payer: Priority Health Medicare |
$388.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$630.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.81
|
| Rate for Payer: UHC Exchange |
$384.81
|
| Rate for Payer: UHC Medicare Advantage |
$384.81
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 21407
|
| Min. Negotiated Rate |
$418.97 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$825.47
|
| Rate for Payer: Aetna Medicare |
$640.66
|
| Rate for Payer: BCBS Complete |
$439.92
|
| Rate for Payer: BCBS MAPPO |
$616.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$945.10
|
| Rate for Payer: BCN Medicare Advantage |
$616.02
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cofinity Commercial |
$887.07
|
| Rate for Payer: Cofinity Commercial |
$825.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.02
|
| Rate for Payer: Mclaren Medicaid |
$418.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.82
|
| Rate for Payer: Meridian Medicaid |
$439.92
|
| Rate for Payer: Nomi Health Commercial |
$739.22
|
| Rate for Payer: PACE SWMI |
$616.02
|
| Rate for Payer: PHP Medicare Advantage |
$616.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.80
|
| Rate for Payer: Priority Health HMO/PPO |
$983.11
|
| Rate for Payer: Priority Health Medicare |
$622.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.02
|
| Rate for Payer: UHC Exchange |
$616.02
|
| Rate for Payer: UHC Medicare Advantage |
$616.02
|
| Rate for Payer: UHCCP Medicaid |
$418.97
|
|
