|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Min. Negotiated Rate |
$619.39 |
| Max. Negotiated Rate |
$1,606.15 |
| Rate for Payer: Aetna Commercial |
$829.98
|
| Rate for Payer: Aetna Medicare |
$644.17
|
| Rate for Payer: BCBS Complete |
$988.40
|
| Rate for Payer: BCBS MAPPO |
$619.39
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.36
|
| 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 Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health Medicare |
$625.58
|
| 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
|
|
|
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 |
$5,423.52 |
| 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 |
$5,423.52
|
| 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 |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.64
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| 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 |
$5,164.92
|
| 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 |
$5,164.92
|
| 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 |
$619.39 |
| Max. Negotiated Rate |
$1,606.15 |
| Rate for Payer: Aetna Commercial |
$829.98
|
| Rate for Payer: Aetna Medicare |
$644.17
|
| Rate for Payer: BCBS Complete |
$988.40
|
| Rate for Payer: BCBS MAPPO |
$619.39
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.36
|
| 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 Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health Medicare |
$625.58
|
| 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
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$350.80 |
| Max. Negotiated Rate |
$700.65 |
| Rate for Payer: Aetna Commercial |
$651.99
|
| Rate for Payer: Aetna Medicare |
$506.02
|
| Rate for Payer: BCBS Complete |
$350.80
|
| Rate for Payer: BCBS MAPPO |
$486.56
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.89
|
| 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 Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health Medicare |
$491.43
|
| 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
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$609.64 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Aetna Commercial |
$816.92
|
| Rate for Payer: Aetna Medicare |
$634.03
|
| Rate for Payer: BCBS Complete |
$714.00
|
| Rate for Payer: BCBS MAPPO |
$609.64
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.12
|
| 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 Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health Medicare |
$615.74
|
| 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
|
|
|
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 DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
OP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$546.73 |
| Max. Negotiated Rate |
$5,423.52 |
| 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 |
$5,423.52
|
| Rate for Payer: BCBS MAPPO |
$575.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,892.47
|
| Rate for Payer: BCN Commercial |
$1,789.81
|
| 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 |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.27
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$661.83
|
| 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 |
$546.73
|
| 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 |
$5,164.92
|
| 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 |
$581.25
|
| 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 |
$5,164.92
|
| 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
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$672.53 |
| 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 |
$920.80
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| 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 Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health Medicare |
$679.26
|
| 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
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$672.53 |
| 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 |
$920.80
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| 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 Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health Medicare |
$679.26
|
| 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
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$3,921.00
|
|
|
Service Code
|
HCPCS 27514
|
| Min. Negotiated Rate |
$931.19 |
| 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 |
$1,568.40
|
| Rate for Payer: BCBS MAPPO |
$931.19
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.75
|
| 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 Cigna Priority Health |
$2,548.65
|
| Rate for Payer: Priority Health Medicare |
$940.50
|
| 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
|
|
|
PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD
|
Professional
|
Both
|
$3,919.00
|
|
|
Service Code
|
HCPCS 27269
|
| Min. Negotiated Rate |
$1,195.96 |
| Max. Negotiated Rate |
$2,547.35 |
| Rate for Payer: Aetna Commercial |
$1,602.59
|
| Rate for Payer: Aetna Medicare |
$1,243.80
|
| Rate for Payer: BCBS Complete |
$1,567.60
|
| Rate for Payer: BCBS MAPPO |
$1,195.96
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,255.76
|
| 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 Cigna Priority Health |
$2,547.35
|
| Rate for Payer: Priority Health Medicare |
$1,207.92
|
| 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
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27511
|
| Min. Negotiated Rate |
$958.39 |
| 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 |
$1,539.20
|
| Rate for Payer: BCBS MAPPO |
$958.39
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.31
|
| 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 Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health Medicare |
$967.97
|
| 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
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$4,397.00
|
|
|
Service Code
|
HCPCS 27513
|
| Min. Negotiated Rate |
$1,188.41 |
| 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 |
$1,758.80
|
| Rate for Payer: BCBS MAPPO |
$1,188.41
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.83
|
| 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 Cigna Priority Health |
$2,858.05
|
| Rate for Payer: Priority Health Medicare |
$1,200.29
|
| 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
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 28505
|
| Min. Negotiated Rate |
$475.10 |
| Max. Negotiated Rate |
$933.40 |
| Rate for Payer: Aetna Commercial |
$636.63
|
| Rate for Payer: Aetna Medicare |
$494.10
|
| Rate for Payer: BCBS Complete |
$574.40
|
| Rate for Payer: BCBS MAPPO |
$475.10
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.86
|
| 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 Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health Medicare |
$479.85
|
| 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
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 28525
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$554.13 |
| Rate for Payer: Aetna Commercial |
$515.65
|
| Rate for Payer: Aetna Medicare |
$400.20
|
| Rate for Payer: BCBS Complete |
$246.40
|
| Rate for Payer: BCBS MAPPO |
$384.81
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.05
|
| 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 Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health Medicare |
$388.66
|
| 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
|
|
|
PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 21407
|
| Min. Negotiated Rate |
$468.80 |
| Max. Negotiated Rate |
$887.07 |
| Rate for Payer: Aetna Commercial |
$825.47
|
| Rate for Payer: Aetna Medicare |
$640.66
|
| Rate for Payer: BCBS Complete |
$468.80
|
| Rate for Payer: BCBS MAPPO |
$616.02
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.82
|
| 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 Cigna Priority Health |
$761.80
|
| Rate for Payer: Priority Health Medicare |
$622.18
|
| 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
|
|
|
PR OPEN TX HUMERAL EPICONDYLAR FRACTURE
|
Professional
|
Both
|
$2,436.00
|
|
|
Service Code
|
HCPCS 24575
|
| Min. Negotiated Rate |
$709.52 |
| Max. Negotiated Rate |
$1,583.40 |
| Rate for Payer: Aetna Commercial |
$950.76
|
| Rate for Payer: Aetna Medicare |
$737.90
|
| Rate for Payer: BCBS Complete |
$974.40
|
| Rate for Payer: BCBS MAPPO |
$709.52
|
| Rate for Payer: BCN Medicare Advantage |
$709.52
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cofinity Commercial |
$950.76
|
| Rate for Payer: Cofinity Commercial |
$1,021.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$745.00
|
| Rate for Payer: Nomi Health Commercial |
$851.42
|
| Rate for Payer: PACE SWMI |
$709.52
|
| Rate for Payer: PHP Medicare Advantage |
$709.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,583.40
|
| Rate for Payer: Priority Health Medicare |
$716.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.52
|
| Rate for Payer: UHC Exchange |
$709.52
|
| Rate for Payer: UHC Medicare Advantage |
$709.52
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,045.00
|
|
|
Service Code
|
HCPCS 24545
|
| Min. Negotiated Rate |
$897.03 |
| Max. Negotiated Rate |
$1,979.25 |
| Rate for Payer: Aetna Commercial |
$1,202.02
|
| Rate for Payer: Aetna Medicare |
$932.91
|
| Rate for Payer: BCBS Complete |
$1,218.00
|
| Rate for Payer: BCBS MAPPO |
$897.03
|
| Rate for Payer: BCN Medicare Advantage |
$897.03
|
| Rate for Payer: Cash Price |
$2,436.00
|
| Rate for Payer: Cash Price |
$2,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,291.72
|
| Rate for Payer: Cofinity Commercial |
$1,202.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$941.88
|
| Rate for Payer: Nomi Health Commercial |
$1,076.44
|
| Rate for Payer: PACE SWMI |
$897.03
|
| Rate for Payer: PHP Medicare Advantage |
$897.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,979.25
|
| Rate for Payer: Priority Health Medicare |
$906.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$897.03
|
| Rate for Payer: UHC Exchange |
$897.03
|
| Rate for Payer: UHC Medicare Advantage |
$897.03
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$3,982.00
|
|
|
Service Code
|
HCPCS 24546
|
| Min. Negotiated Rate |
$1,001.71 |
| Max. Negotiated Rate |
$2,588.30 |
| Rate for Payer: Aetna Commercial |
$1,342.29
|
| Rate for Payer: Aetna Medicare |
$1,041.78
|
| Rate for Payer: BCBS Complete |
$1,592.80
|
| Rate for Payer: BCBS MAPPO |
$1,001.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,001.71
|
| Rate for Payer: Cash Price |
$3,185.60
|
| Rate for Payer: Cash Price |
$3,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,442.46
|
| Rate for Payer: Cofinity Commercial |
$1,342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,051.80
|
| Rate for Payer: Nomi Health Commercial |
$1,202.05
|
| Rate for Payer: PACE SWMI |
$1,001.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,001.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.30
|
| Rate for Payer: Priority Health Medicare |
$1,011.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,001.71
|
| Rate for Payer: UHC Exchange |
$1,001.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,001.71
|
|
|
PR OPEN TX ILIAC SPINE UNI/BIL
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS G0412
|
| Min. Negotiated Rate |
$699.08 |
| Max. Negotiated Rate |
$1,712.10 |
| Rate for Payer: Aetna Commercial |
$936.77
|
| Rate for Payer: Aetna Medicare |
$727.04
|
| Rate for Payer: BCBS Complete |
$1,053.60
|
| Rate for Payer: BCBS MAPPO |
$699.08
|
| Rate for Payer: BCN Medicare Advantage |
$699.08
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cofinity Commercial |
$936.77
|
| Rate for Payer: Cofinity Commercial |
$1,006.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.03
|
| Rate for Payer: Nomi Health Commercial |
$838.90
|
| Rate for Payer: PACE SWMI |
$699.08
|
| Rate for Payer: PHP Medicare Advantage |
$699.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.10
|
| Rate for Payer: Priority Health Medicare |
$706.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.08
|
| Rate for Payer: UHC Exchange |
$699.08
|
| Rate for Payer: UHC Medicare Advantage |
$699.08
|
|
|
PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE
|
Professional
|
Both
|
$2,749.00
|
|
|
Service Code
|
HCPCS 27540
|
| Min. Negotiated Rate |
$787.24 |
| Max. Negotiated Rate |
$1,786.85 |
| Rate for Payer: Aetna Commercial |
$1,054.90
|
| Rate for Payer: Aetna Medicare |
$818.73
|
| Rate for Payer: BCBS Complete |
$1,099.60
|
| Rate for Payer: BCBS MAPPO |
$787.24
|
| Rate for Payer: BCN Medicare Advantage |
$787.24
|
| Rate for Payer: Cash Price |
$2,199.20
|
| Rate for Payer: Cash Price |
$2,199.20
|
| Rate for Payer: Cofinity Commercial |
$1,133.63
|
| Rate for Payer: Cofinity Commercial |
$1,054.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.60
|
| Rate for Payer: Nomi Health Commercial |
$944.69
|
| Rate for Payer: PACE SWMI |
$787.24
|
| Rate for Payer: PHP Medicare Advantage |
$787.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,786.85
|
| Rate for Payer: Priority Health Medicare |
$795.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$787.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.24
|
| Rate for Payer: UHC Exchange |
$787.24
|
| Rate for Payer: UHC Medicare Advantage |
$787.24
|
|
|
PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26785
|
| Min. Negotiated Rate |
$531.22 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$711.83
|
| Rate for Payer: Aetna Medicare |
$552.47
|
| Rate for Payer: BCBS Complete |
$616.00
|
| Rate for Payer: BCBS MAPPO |
$531.22
|
| Rate for Payer: BCN Medicare Advantage |
$531.22
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$764.96
|
| Rate for Payer: Cofinity Commercial |
$711.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.78
|
| Rate for Payer: Nomi Health Commercial |
$637.46
|
| Rate for Payer: PACE SWMI |
$531.22
|
| Rate for Payer: PHP Medicare Advantage |
$531.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health Medicare |
$536.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.22
|
| Rate for Payer: UHC Exchange |
$531.22
|
| Rate for Payer: UHC Medicare Advantage |
$531.22
|
|
|
PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 27557
|
| Min. Negotiated Rate |
$860.00 |
| Max. Negotiated Rate |
$1,448.05 |
| Rate for Payer: Aetna Commercial |
$1,347.49
|
| Rate for Payer: Aetna Medicare |
$1,045.81
|
| Rate for Payer: BCBS Complete |
$860.00
|
| Rate for Payer: BCBS MAPPO |
$1,005.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.59
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,448.05
|
| Rate for Payer: Cofinity Commercial |
$1,347.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.87
|
| Rate for Payer: Nomi Health Commercial |
$1,206.71
|
| Rate for Payer: PACE SWMI |
$1,005.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health Medicare |
$1,015.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.59
|
| Rate for Payer: UHC Exchange |
$1,005.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.59
|
|
|
PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 27556
|
| Min. Negotiated Rate |
$710.00 |
| Max. Negotiated Rate |
$1,214.96 |
| Rate for Payer: Aetna Commercial |
$1,130.58
|
| Rate for Payer: Aetna Medicare |
$877.47
|
| Rate for Payer: BCBS Complete |
$710.00
|
| Rate for Payer: BCBS MAPPO |
$843.72
|
| Rate for Payer: BCN Medicare Advantage |
$843.72
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cofinity Commercial |
$1,214.96
|
| Rate for Payer: Cofinity Commercial |
$1,130.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$843.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$885.91
|
| Rate for Payer: Nomi Health Commercial |
$1,012.46
|
| Rate for Payer: PACE SWMI |
$843.72
|
| Rate for Payer: PHP Medicare Advantage |
$843.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health Medicare |
$852.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$843.72
|
| Rate for Payer: UHC Exchange |
$843.72
|
| Rate for Payer: UHC Medicare Advantage |
$843.72
|
|
|
PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION
|
Professional
|
Both
|
$5,350.00
|
|
|
Service Code
|
HCPCS 27558
|
| Min. Negotiated Rate |
$1,144.46 |
| Max. Negotiated Rate |
$3,477.50 |
| Rate for Payer: Aetna Commercial |
$1,533.58
|
| Rate for Payer: Aetna Medicare |
$1,190.24
|
| Rate for Payer: BCBS Complete |
$2,140.00
|
| Rate for Payer: BCBS MAPPO |
$1,144.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,144.46
|
| Rate for Payer: Cash Price |
$4,280.00
|
| Rate for Payer: Cash Price |
$4,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,648.02
|
| Rate for Payer: Cofinity Commercial |
$1,533.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,144.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,201.68
|
| Rate for Payer: Nomi Health Commercial |
$1,373.35
|
| Rate for Payer: PACE SWMI |
$1,144.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,144.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,477.50
|
| Rate for Payer: Priority Health Medicare |
$1,155.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,144.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,144.46
|
| Rate for Payer: UHC Exchange |
$1,144.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,144.46
|
|
