|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG
|
Professional
|
Both
|
$2,420.00
|
|
|
Service Code
|
HCPCS 25608
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$1,573.00 |
| Rate for Payer: Aetna Commercial |
$1,072.74
|
| Rate for Payer: Aetna Medicare |
$832.57
|
| Rate for Payer: BCBS Complete |
$569.64
|
| Rate for Payer: BCBS MAPPO |
$800.55
|
| Rate for Payer: BCBS Trust/PPO |
$25.36
|
| Rate for Payer: BCN Commercial |
$1,220.23
|
| Rate for Payer: BCN Medicare Advantage |
$800.55
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cofinity Commercial |
$1,152.79
|
| Rate for Payer: Cofinity Commercial |
$1,072.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.55
|
| Rate for Payer: Mclaren Medicaid |
$542.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.58
|
| Rate for Payer: Meridian Medicaid |
$569.64
|
| Rate for Payer: Nomi Health Commercial |
$960.66
|
| Rate for Payer: PACE SWMI |
$800.55
|
| Rate for Payer: PHP Medicare Advantage |
$800.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,573.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,283.85
|
| Rate for Payer: Priority Health Medicare |
$808.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.55
|
| Rate for Payer: UHC Exchange |
$800.55
|
| Rate for Payer: UHC Medicare Advantage |
$800.55
|
| Rate for Payer: UHCCP Medicaid |
$542.51
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3+ FRAG
|
Professional
|
Both
|
$2,959.00
|
|
|
Service Code
|
HCPCS 25609
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$1,923.35 |
| Rate for Payer: Aetna Commercial |
$1,361.44
|
| Rate for Payer: Aetna Medicare |
$1,056.64
|
| Rate for Payer: BCBS Complete |
$721.94
|
| Rate for Payer: BCBS MAPPO |
$1,016.00
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$1,547.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.00
|
| Rate for Payer: Cash Price |
$2,367.20
|
| Rate for Payer: Cash Price |
$2,367.20
|
| Rate for Payer: Cofinity Commercial |
$1,463.04
|
| Rate for Payer: Cofinity Commercial |
$1,361.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.00
|
| Rate for Payer: Mclaren Medicaid |
$687.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.80
|
| Rate for Payer: Meridian Medicaid |
$721.94
|
| Rate for Payer: Nomi Health Commercial |
$1,219.20
|
| Rate for Payer: PACE SWMI |
$1,016.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,923.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,625.30
|
| Rate for Payer: Priority Health Medicare |
$1,026.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,625.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.00
|
| Rate for Payer: UHC Exchange |
$1,016.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,016.00
|
| Rate for Payer: UHCCP Medicaid |
$687.56
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Facility
|
IP
|
$1,944.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$1,263.60 |
| Max. Negotiated Rate |
$1,749.60 |
| Rate for Payer: Aetna Commercial |
$1,652.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.89
|
| Rate for Payer: BCN Commercial |
$1,502.32
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,671.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,555.20
|
| Rate for Payer: Healthscope Commercial |
$1,749.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,458.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,652.40
|
| Rate for Payer: Nomi Health Commercial |
$1,594.08
|
| Rate for Payer: PHP Commercial |
$1,652.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,691.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,302.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,710.72
|
| Rate for Payer: UHC Core |
$1,623.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,458.00
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$961.40
|
| Rate for Payer: Aetna Medicare |
$746.16
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$717.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$717.46
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$961.40
|
| Rate for Payer: Cofinity Commercial |
$1,033.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.46
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.33
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Nomi Health Commercial |
$860.95
|
| Rate for Payer: PACE SWMI |
$717.46
|
| Rate for Payer: PHP Medicare Advantage |
$717.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$724.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.46
|
| Rate for Payer: UHC Exchange |
$717.46
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$961.40
|
| Rate for Payer: Aetna Medicare |
$746.16
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$717.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$717.46
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$961.40
|
| Rate for Payer: Cofinity Commercial |
$1,033.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.46
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.33
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Nomi Health Commercial |
$860.95
|
| Rate for Payer: PACE SWMI |
$717.46
|
| Rate for Payer: PHP Medicare Advantage |
$717.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$724.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.46
|
| Rate for Payer: UHC Exchange |
$717.46
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Facility
|
OP
|
$1,944.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$461.70 |
| Max. Negotiated Rate |
$5,313.85 |
| Rate for Payer: Aetna Commercial |
$1,652.40
|
| Rate for Payer: Aetna Medicare |
$505.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$607.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$607.50
|
| Rate for Payer: BCBS Complete |
$5,313.85
|
| Rate for Payer: BCBS MAPPO |
$486.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.16
|
| Rate for Payer: BCN Commercial |
$1,511.46
|
| Rate for Payer: BCN Medicare Advantage |
$486.00
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,671.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,555.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.00
|
| Rate for Payer: Healthscope Commercial |
$1,749.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,458.00
|
| Rate for Payer: Mclaren Medicaid |
$5,060.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.30
|
| Rate for Payer: Meridian Medicaid |
$5,313.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$558.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,652.40
|
| Rate for Payer: Nomi Health Commercial |
$1,594.08
|
| Rate for Payer: PACE Senior Care Partners |
$461.70
|
| Rate for Payer: PACE SWMI |
$486.00
|
| Rate for Payer: PHP Commercial |
$1,652.40
|
| Rate for Payer: PHP Medicare Advantage |
$486.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,060.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,691.28
|
| Rate for Payer: Priority Health Medicare |
$490.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,302.48
|
| Rate for Payer: Railroad Medicare Medicare |
$486.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,710.72
|
| Rate for Payer: UHC Core |
$1,623.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.00
|
| Rate for Payer: UHC Exchange |
$486.00
|
| Rate for Payer: UHC Medicare Advantage |
$486.00
|
| Rate for Payer: UHCCP Medicaid |
$5,060.48
|
| Rate for Payer: VA VA |
$486.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,458.00
|
|
|
PR OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 27236
|
| Min. Negotiated Rate |
$772.13 |
| Max. Negotiated Rate |
$2,425.80 |
| Rate for Payer: Aetna Commercial |
$1,539.53
|
| Rate for Payer: Aetna Medicare |
$1,194.86
|
| Rate for Payer: BCBS Complete |
$810.74
|
| Rate for Payer: BCBS MAPPO |
$1,148.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,920.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,148.90
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,654.42
|
| Rate for Payer: Cofinity Commercial |
$1,539.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,148.90
|
| Rate for Payer: Mclaren Medicaid |
$772.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,206.34
|
| Rate for Payer: Meridian Medicaid |
$810.74
|
| Rate for Payer: Nomi Health Commercial |
$1,378.68
|
| Rate for Payer: PACE SWMI |
$1,148.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,148.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,831.39
|
| Rate for Payer: Priority Health Medicare |
$1,160.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,831.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,148.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,148.90
|
| Rate for Payer: UHC Exchange |
$1,148.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.90
|
| Rate for Payer: UHCCP Medicaid |
$772.13
|
|
|
PR OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW
|
Professional
|
Both
|
$4,215.00
|
|
|
Service Code
|
HCPCS 27506
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$2,739.75 |
| Rate for Payer: Aetna Commercial |
$1,726.52
|
| Rate for Payer: Aetna Medicare |
$1,339.99
|
| Rate for Payer: BCBS Complete |
$909.36
|
| Rate for Payer: BCBS MAPPO |
$1,288.45
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,154.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,288.45
|
| Rate for Payer: Cash Price |
$3,372.00
|
| Rate for Payer: Cash Price |
$3,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,855.37
|
| Rate for Payer: Cofinity Commercial |
$1,726.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,288.45
|
| Rate for Payer: Mclaren Medicaid |
$866.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,352.87
|
| Rate for Payer: Meridian Medicaid |
$909.36
|
| Rate for Payer: Nomi Health Commercial |
$1,546.14
|
| Rate for Payer: PACE SWMI |
$1,288.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,288.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,052.75
|
| Rate for Payer: Priority Health Medicare |
$1,301.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,052.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,288.45
|
| Rate for Payer: UHC Exchange |
$1,288.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,288.45
|
| Rate for Payer: UHCCP Medicaid |
$866.06
|
|
|
PR OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27507
|
| Min. Negotiated Rate |
$626.65 |
| Max. Negotiated Rate |
$2,501.20 |
| Rate for Payer: Aetna Commercial |
$1,250.94
|
| Rate for Payer: Aetna Medicare |
$970.88
|
| Rate for Payer: BCBS Complete |
$657.98
|
| Rate for Payer: BCBS MAPPO |
$933.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.62
|
| Rate for Payer: BCN Commercial |
$1,416.67
|
| Rate for Payer: BCN Medicare Advantage |
$933.54
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,344.30
|
| Rate for Payer: Cofinity Commercial |
$1,250.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.54
|
| Rate for Payer: Mclaren Medicaid |
$626.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.22
|
| Rate for Payer: Meridian Medicaid |
$657.98
|
| Rate for Payer: Nomi Health Commercial |
$1,120.25
|
| Rate for Payer: PACE SWMI |
$933.54
|
| Rate for Payer: PHP Medicare Advantage |
$933.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,483.83
|
| Rate for Payer: Priority Health Medicare |
$942.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,483.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$933.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.54
|
| Rate for Payer: UHC Exchange |
$933.54
|
| Rate for Payer: UHC Medicare Advantage |
$933.54
|
| Rate for Payer: UHCCP Medicaid |
$626.65
|
|
|
PR OPTX GREATER HUMERAL TUBEROSITY FX W/INT FIXJ
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 23630
|
| Min. Negotiated Rate |
$265.21 |
| Max. Negotiated Rate |
$1,209.05 |
| Rate for Payer: Aetna Commercial |
$1,011.63
|
| Rate for Payer: Aetna Medicare |
$785.15
|
| Rate for Payer: BCBS Complete |
$536.31
|
| Rate for Payer: BCBS MAPPO |
$754.95
|
| Rate for Payer: BCBS Trust/PPO |
$265.21
|
| Rate for Payer: BCN Commercial |
$1,149.86
|
| Rate for Payer: BCN Medicare Advantage |
$754.95
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$1,087.13
|
| Rate for Payer: Cofinity Commercial |
$1,011.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.95
|
| Rate for Payer: Mclaren Medicaid |
$510.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$792.70
|
| Rate for Payer: Meridian Medicaid |
$536.31
|
| Rate for Payer: Nomi Health Commercial |
$905.94
|
| Rate for Payer: PACE SWMI |
$754.95
|
| Rate for Payer: PHP Medicare Advantage |
$754.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,209.05
|
| Rate for Payer: Priority Health Medicare |
$762.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,209.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$754.95
|
| Rate for Payer: UHC Exchange |
$754.95
|
| Rate for Payer: UHC Medicare Advantage |
$754.95
|
| Rate for Payer: UHCCP Medicaid |
$510.77
|
|
|
PR OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD
|
Professional
|
Both
|
$3,546.00
|
|
|
Service Code
|
HCPCS 27254
|
| Min. Negotiated Rate |
$821.97 |
| Max. Negotiated Rate |
$2,549.58 |
| Rate for Payer: Aetna Commercial |
$1,640.68
|
| Rate for Payer: Aetna Medicare |
$1,273.37
|
| Rate for Payer: BCBS Complete |
$863.07
|
| Rate for Payer: BCBS MAPPO |
$1,224.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.58
|
| Rate for Payer: BCN Commercial |
$1,859.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,224.39
|
| Rate for Payer: Cash Price |
$2,836.80
|
| Rate for Payer: Cash Price |
$2,836.80
|
| Rate for Payer: Cofinity Commercial |
$1,763.12
|
| Rate for Payer: Cofinity Commercial |
$1,640.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,224.39
|
| Rate for Payer: Mclaren Medicaid |
$821.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,285.61
|
| Rate for Payer: Meridian Medicaid |
$863.07
|
| Rate for Payer: Nomi Health Commercial |
$1,469.27
|
| Rate for Payer: PACE SWMI |
$1,224.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,224.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,304.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,949.44
|
| Rate for Payer: Priority Health Medicare |
$1,236.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,949.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,224.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,224.39
|
| Rate for Payer: UHC Exchange |
$1,224.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,224.39
|
| Rate for Payer: UHCCP Medicaid |
$821.97
|
|
|
PR OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ
|
Professional
|
Both
|
$2,351.00
|
|
|
Service Code
|
HCPCS 27253
|
| Min. Negotiated Rate |
$609.82 |
| Max. Negotiated Rate |
$2,442.33 |
| Rate for Payer: Aetna Commercial |
$1,214.46
|
| Rate for Payer: Aetna Medicare |
$942.56
|
| Rate for Payer: BCBS Complete |
$640.31
|
| Rate for Payer: BCBS MAPPO |
$906.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,442.33
|
| Rate for Payer: BCN Commercial |
$1,379.05
|
| Rate for Payer: BCN Medicare Advantage |
$906.31
|
| Rate for Payer: Cash Price |
$1,880.80
|
| Rate for Payer: Cash Price |
$1,880.80
|
| Rate for Payer: Cofinity Commercial |
$1,305.09
|
| Rate for Payer: Cofinity Commercial |
$1,214.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.31
|
| Rate for Payer: Mclaren Medicaid |
$609.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.63
|
| Rate for Payer: Meridian Medicaid |
$640.31
|
| Rate for Payer: Nomi Health Commercial |
$1,087.57
|
| Rate for Payer: PACE SWMI |
$906.31
|
| Rate for Payer: PHP Medicare Advantage |
$906.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,445.17
|
| Rate for Payer: Priority Health Medicare |
$915.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,445.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$906.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.31
|
| Rate for Payer: UHC Exchange |
$906.31
|
| Rate for Payer: UHC Medicare Advantage |
$906.31
|
| Rate for Payer: UHCCP Medicaid |
$609.82
|
|
|
PR OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE
|
Professional
|
Both
|
$3,092.00
|
|
|
Service Code
|
HCPCS 24515
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$2,009.80 |
| Rate for Payer: Aetna Commercial |
$1,137.89
|
| Rate for Payer: Aetna Medicare |
$883.14
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$849.17
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$849.17
|
| Rate for Payer: Cash Price |
$2,473.60
|
| Rate for Payer: Cash Price |
$2,473.60
|
| Rate for Payer: Cofinity Commercial |
$1,222.80
|
| Rate for Payer: Cofinity Commercial |
$1,137.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.17
|
| Rate for Payer: Mclaren Medicaid |
$573.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.63
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Nomi Health Commercial |
$1,019.00
|
| Rate for Payer: PACE SWMI |
$849.17
|
| Rate for Payer: PHP Medicare Advantage |
$849.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,009.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,359.67
|
| Rate for Payer: Priority Health Medicare |
$857.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,359.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$849.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.17
|
| Rate for Payer: UHC Exchange |
$849.17
|
| Rate for Payer: UHC Medicare Advantage |
$849.17
|
| Rate for Payer: UHCCP Medicaid |
$573.82
|
|
|
PR OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS 27215
|
| Min. Negotiated Rate |
$387.66 |
| Max. Negotiated Rate |
$1,741.81 |
| Rate for Payer: Aetna Commercial |
$803.86
|
| Rate for Payer: Aetna Medicare |
$1,317.00
|
| Rate for Payer: BCBS Complete |
$407.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.81
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Mclaren Medicaid |
$387.66
|
| Rate for Payer: Meridian Medicaid |
$407.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.10
|
| Rate for Payer: Priority Health HMO/PPO |
$924.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.59
|
| Rate for Payer: UHCCP Medicaid |
$387.66
|
|
|
PR OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN
|
Professional
|
Both
|
$2,054.00
|
|
|
Service Code
|
HCPCS 21347
|
| Min. Negotiated Rate |
$86.11 |
| Max. Negotiated Rate |
$1,587.65 |
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: Aetna Medicare |
$1,018.86
|
| Rate for Payer: BCBS Complete |
$701.37
|
| Rate for Payer: BCBS MAPPO |
$979.67
|
| Rate for Payer: BCBS Trust/PPO |
$86.11
|
| Rate for Payer: BCN Commercial |
$1,528.09
|
| Rate for Payer: BCN Medicare Advantage |
$979.67
|
| Rate for Payer: Cash Price |
$1,643.20
|
| Rate for Payer: Cash Price |
$1,643.20
|
| Rate for Payer: Cofinity Commercial |
$1,410.72
|
| Rate for Payer: Cofinity Commercial |
$1,312.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.67
|
| Rate for Payer: Mclaren Medicaid |
$667.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.65
|
| Rate for Payer: Meridian Medicaid |
$701.37
|
| Rate for Payer: Nomi Health Commercial |
$1,175.60
|
| Rate for Payer: PACE SWMI |
$979.67
|
| Rate for Payer: PHP Medicare Advantage |
$979.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,587.65
|
| Rate for Payer: Priority Health Medicare |
$989.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,587.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$979.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.67
|
| Rate for Payer: UHC Exchange |
$979.67
|
| Rate for Payer: UHC Medicare Advantage |
$979.67
|
| Rate for Payer: UHCCP Medicaid |
$667.97
|
|
|
PR OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC
|
Professional
|
Both
|
$1,613.00
|
|
|
Service Code
|
HCPCS 21390
|
| Min. Negotiated Rate |
$513.97 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$1,012.60
|
| Rate for Payer: Aetna Medicare |
$785.90
|
| Rate for Payer: BCBS Complete |
$539.67
|
| Rate for Payer: BCBS MAPPO |
$755.67
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,174.29
|
| Rate for Payer: BCN Medicare Advantage |
$755.67
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cofinity Commercial |
$1,088.16
|
| Rate for Payer: Cofinity Commercial |
$1,012.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.67
|
| Rate for Payer: Mclaren Medicaid |
$513.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$793.45
|
| Rate for Payer: Meridian Medicaid |
$539.67
|
| Rate for Payer: Nomi Health Commercial |
$906.80
|
| Rate for Payer: PACE SWMI |
$755.67
|
| Rate for Payer: PHP Medicare Advantage |
$755.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,048.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,228.39
|
| Rate for Payer: Priority Health Medicare |
$763.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,228.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$755.67
|
| Rate for Payer: UHC Exchange |
$755.67
|
| Rate for Payer: UHC Medicare Advantage |
$755.67
|
| Rate for Payer: UHCCP Medicaid |
$513.97
|
|
|
PR OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 27566
|
| Min. Negotiated Rate |
$581.06 |
| Max. Negotiated Rate |
$1,376.98 |
| Rate for Payer: Aetna Commercial |
$1,155.75
|
| Rate for Payer: Aetna Medicare |
$897.00
|
| Rate for Payer: BCBS Complete |
$610.11
|
| Rate for Payer: BCBS MAPPO |
$862.50
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$1,310.63
|
| Rate for Payer: BCN Medicare Advantage |
$862.50
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,242.00
|
| Rate for Payer: Cofinity Commercial |
$1,155.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.50
|
| Rate for Payer: Mclaren Medicaid |
$581.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.62
|
| Rate for Payer: Meridian Medicaid |
$610.11
|
| Rate for Payer: Nomi Health Commercial |
$1,035.00
|
| Rate for Payer: PACE SWMI |
$862.50
|
| Rate for Payer: PHP Medicare Advantage |
$862.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,376.98
|
| Rate for Payer: Priority Health Medicare |
$871.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,376.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.50
|
| Rate for Payer: UHC Exchange |
$862.50
|
| Rate for Payer: UHC Medicare Advantage |
$862.50
|
| Rate for Payer: UHCCP Medicaid |
$581.06
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Facility
|
IP
|
$2,509.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$1,630.85 |
| Max. Negotiated Rate |
$2,258.10 |
| Rate for Payer: Aetna Commercial |
$2,132.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,048.10
|
| Rate for Payer: BCN Commercial |
$1,938.96
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$2,157.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.20
|
| Rate for Payer: Healthscope Commercial |
$2,258.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.65
|
| Rate for Payer: Nomi Health Commercial |
$2,057.38
|
| Rate for Payer: PHP Commercial |
$2,132.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,182.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,681.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,207.92
|
| Rate for Payer: UHC Core |
$2,095.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,881.75
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 27524
|
| Min. Negotiated Rate |
$491.82 |
| Max. Negotiated Rate |
$1,630.85 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$757.18
|
| Rate for Payer: BCBS Complete |
$516.41
|
| Rate for Payer: BCBS MAPPO |
$728.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$1,221.43
|
| Rate for Payer: BCN Medicare Advantage |
$728.06
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$975.60
|
| Rate for Payer: Cofinity Commercial |
$1,048.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.06
|
| Rate for Payer: Mclaren Medicaid |
$491.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.46
|
| Rate for Payer: Meridian Medicaid |
$516.41
|
| Rate for Payer: Nomi Health Commercial |
$873.67
|
| Rate for Payer: PACE SWMI |
$728.06
|
| Rate for Payer: PHP Medicare Advantage |
$728.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,164.78
|
| Rate for Payer: Priority Health Medicare |
$735.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,164.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.06
|
| Rate for Payer: UHC Exchange |
$728.06
|
| Rate for Payer: UHC Medicare Advantage |
$728.06
|
| Rate for Payer: UHCCP Medicaid |
$491.82
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Facility
|
OP
|
$2,509.00
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$595.89 |
| Max. Negotiated Rate |
$5,313.85 |
| Rate for Payer: Aetna Commercial |
$2,132.65
|
| Rate for Payer: Aetna Medicare |
$652.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$784.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$784.06
|
| Rate for Payer: BCBS Complete |
$5,313.85
|
| Rate for Payer: BCBS MAPPO |
$627.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,062.65
|
| Rate for Payer: BCN Commercial |
$1,950.75
|
| Rate for Payer: BCN Medicare Advantage |
$627.25
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$2,157.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.25
|
| Rate for Payer: Healthscope Commercial |
$2,258.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.75
|
| Rate for Payer: Mclaren Medicaid |
$5,060.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.61
|
| Rate for Payer: Meridian Medicaid |
$5,313.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.65
|
| Rate for Payer: Nomi Health Commercial |
$2,057.38
|
| Rate for Payer: PACE Senior Care Partners |
$595.89
|
| Rate for Payer: PACE SWMI |
$627.25
|
| Rate for Payer: PHP Commercial |
$2,132.65
|
| Rate for Payer: PHP Medicare Advantage |
$627.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,060.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,182.83
|
| Rate for Payer: Priority Health Medicare |
$633.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,681.03
|
| Rate for Payer: Railroad Medicare Medicare |
$627.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,207.92
|
| Rate for Payer: UHC Core |
$2,095.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.25
|
| Rate for Payer: UHC Exchange |
$627.25
|
| Rate for Payer: UHC Medicare Advantage |
$627.25
|
| Rate for Payer: UHCCP Medicaid |
$5,060.48
|
| Rate for Payer: VA VA |
$627.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,881.75
|
|
|
PR OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 27524
|
| Hospital Charge Code |
27524
|
| Min. Negotiated Rate |
$491.82 |
| Max. Negotiated Rate |
$1,630.85 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$757.18
|
| Rate for Payer: BCBS Complete |
$516.41
|
| Rate for Payer: BCBS MAPPO |
$728.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$1,221.43
|
| Rate for Payer: BCN Medicare Advantage |
$728.06
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$975.60
|
| Rate for Payer: Cofinity Commercial |
$1,048.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.06
|
| Rate for Payer: Mclaren Medicaid |
$491.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.46
|
| Rate for Payer: Meridian Medicaid |
$516.41
|
| Rate for Payer: Nomi Health Commercial |
$873.67
|
| Rate for Payer: PACE SWMI |
$728.06
|
| Rate for Payer: PHP Medicare Advantage |
$728.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,164.78
|
| Rate for Payer: Priority Health Medicare |
$735.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,164.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.06
|
| Rate for Payer: UHC Exchange |
$728.06
|
| Rate for Payer: UHC Medicare Advantage |
$728.06
|
| Rate for Payer: UHCCP Medicaid |
$491.82
|
|
|
PR OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO
|
Professional
|
Both
|
$1,947.00
|
|
|
Service Code
|
HCPCS 24586
|
| Min. Negotiated Rate |
$194.94 |
| Max. Negotiated Rate |
$1,670.59 |
| Rate for Payer: Aetna Commercial |
$1,398.52
|
| Rate for Payer: Aetna Medicare |
$1,085.42
|
| Rate for Payer: BCBS Complete |
$737.82
|
| Rate for Payer: BCBS MAPPO |
$1,043.67
|
| Rate for Payer: BCBS Trust/PPO |
$194.94
|
| Rate for Payer: BCN Commercial |
$1,593.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,043.67
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cofinity Commercial |
$1,502.88
|
| Rate for Payer: Cofinity Commercial |
$1,398.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,043.67
|
| Rate for Payer: Mclaren Medicaid |
$702.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,095.85
|
| Rate for Payer: Meridian Medicaid |
$737.82
|
| Rate for Payer: Nomi Health Commercial |
$1,252.40
|
| Rate for Payer: PACE SWMI |
$1,043.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,043.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$702.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,265.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,670.59
|
| Rate for Payer: Priority Health Medicare |
$1,054.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,670.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,043.67
|
| Rate for Payer: UHC Exchange |
$1,043.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.67
|
| Rate for Payer: UHCCP Medicaid |
$702.69
|
|
|
PR OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD
|
Professional
|
Both
|
$3,919.00
|
|
|
Service Code
|
HCPCS 27218
|
| Min. Negotiated Rate |
$738.90 |
| Max. Negotiated Rate |
$2,547.35 |
| Rate for Payer: Aetna Commercial |
$1,541.82
|
| Rate for Payer: Aetna Medicare |
$1,959.50
|
| Rate for Payer: BCBS Complete |
$775.84
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$1,679.59
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Mclaren Medicaid |
$738.90
|
| Rate for Payer: Meridian Medicaid |
$775.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,760.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,760.14
|
| Rate for Payer: UHCCP Medicaid |
$738.90
|
|
|
PR OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 24587
|
| Min. Negotiated Rate |
$435.85 |
| Max. Negotiated Rate |
$1,674.15 |
| Rate for Payer: Aetna Commercial |
$1,405.55
|
| Rate for Payer: Aetna Medicare |
$1,090.88
|
| Rate for Payer: BCBS Complete |
$740.95
|
| Rate for Payer: BCBS MAPPO |
$1,048.92
|
| Rate for Payer: BCBS Trust/PPO |
$435.85
|
| Rate for Payer: BCN Commercial |
$1,596.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.92
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,510.44
|
| Rate for Payer: Cofinity Commercial |
$1,405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.92
|
| Rate for Payer: Mclaren Medicaid |
$705.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,101.37
|
| Rate for Payer: Meridian Medicaid |
$740.95
|
| Rate for Payer: Nomi Health Commercial |
$1,258.70
|
| Rate for Payer: PACE SWMI |
$1,048.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,674.15
|
| Rate for Payer: Priority Health Medicare |
$1,059.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,674.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,048.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.92
|
| Rate for Payer: UHC Exchange |
$1,048.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.92
|
| Rate for Payer: UHCCP Medicaid |
$705.67
|
|
|
PR OPTX PROX HUMERAL FX W/INT FIXJ RPR TUBEROSITY
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 23615
|
| Hospital Charge Code |
23615
|
| Min. Negotiated Rate |
$333.89 |
| Max. Negotiated Rate |
$2,074.80 |
| Rate for Payer: Aetna Commercial |
$1,142.08
|
| Rate for Payer: Aetna Medicare |
$886.39
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCBS MAPPO |
$852.30
|
| Rate for Payer: BCBS Trust/PPO |
$333.89
|
| Rate for Payer: BCN Commercial |
$1,298.41
|
| Rate for Payer: BCN Medicare Advantage |
$852.30
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cofinity Commercial |
$1,227.31
|
| Rate for Payer: Cofinity Commercial |
$1,142.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.30
|
| Rate for Payer: Mclaren Medicaid |
$575.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$894.92
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Nomi Health Commercial |
$1,022.76
|
| Rate for Payer: PACE SWMI |
$852.30
|
| Rate for Payer: PHP Medicare Advantage |
$852.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,363.23
|
| Rate for Payer: Priority Health Medicare |
$860.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,363.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$852.30
|
| Rate for Payer: UHC Exchange |
$852.30
|
| Rate for Payer: UHC Medicare Advantage |
$852.30
|
| Rate for Payer: UHCCP Medicaid |
$575.53
|
|
