|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$132.91 |
| Max. Negotiated Rate |
$324.71 |
| Rate for Payer: Aetna Commercial |
$265.41
|
| Rate for Payer: Aetna Medicare |
$205.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.22
|
| Rate for Payer: BCBS Complete |
$139.56
|
| Rate for Payer: BCBS MAPPO |
$198.07
|
| Rate for Payer: BCN Commercial |
$303.77
|
| Rate for Payer: BCN Medicare Advantage |
$198.07
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$265.41
|
| Rate for Payer: Cofinity Commercial |
$285.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.97
|
| Rate for Payer: Meridian Medicaid |
$139.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.88
|
| Rate for Payer: Nomi Health Commercial |
$237.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$198.07
|
| Rate for Payer: PHP Commercial |
$277.30
|
| Rate for Payer: PHP Medicare Advantage |
$198.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$324.71
|
| Rate for Payer: Priority Health Medicare |
$198.07
|
| Rate for Payer: Priority Health SBD |
$324.71
|
| Rate for Payer: Priority Health Tiered Network |
$324.71
|
| Rate for Payer: Railroad Medicare Medicare |
$198.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.80
|
| Rate for Payer: UHC Core |
$318.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.07
|
| Rate for Payer: UHC Exchange |
$318.80
|
| Rate for Payer: UHC Medicaid |
$132.91
|
| Rate for Payer: UHCCP Medicaid |
$132.91
|
| Rate for Payer: UMR Bronson Commercial |
$195.04
|
|
|
PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ
|
Professional
|
Both
|
$777.00
|
|
|
Service Code
|
HCPCS 25600
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$582.75 |
| Rate for Payer: Aetna Commercial |
$434.31
|
| Rate for Payer: Aetna Medicare |
$337.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.72
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$324.11
|
| Rate for Payer: BCN Commercial |
$405.66
|
| Rate for Payer: BCN Medicare Advantage |
$324.11
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cofinity Commercial |
$434.31
|
| Rate for Payer: Cofinity Commercial |
$466.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.32
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$356.52
|
| Rate for Payer: Nomi Health Commercial |
$388.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.75
|
| Rate for Payer: PACE SWMI |
$324.11
|
| Rate for Payer: PHP Commercial |
$453.75
|
| Rate for Payer: PHP Medicare Advantage |
$324.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$324.11
|
| Rate for Payer: Priority Health SBD |
$549.90
|
| Rate for Payer: Priority Health Tiered Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$324.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.15
|
| Rate for Payer: UHC Core |
$538.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$324.11
|
| Rate for Payer: UHC Exchange |
$538.15
|
| Rate for Payer: UHC Medicaid |
$218.11
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
| Rate for Payer: UMR Bronson Commercial |
$357.42
|
|
|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MNPJ
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$709.15
|
| Rate for Payer: Aetna Medicare |
$550.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.08
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCBS MAPPO |
$529.22
|
| Rate for Payer: BCN Commercial |
$793.28
|
| Rate for Payer: BCN Medicare Advantage |
$529.22
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Commercial |
$709.15
|
| Rate for Payer: Cofinity Commercial |
$762.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.68
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.14
|
| Rate for Payer: Nomi Health Commercial |
$635.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,072.50
|
| Rate for Payer: PACE SWMI |
$529.22
|
| Rate for Payer: PHP Commercial |
$740.91
|
| Rate for Payer: PHP Medicare Advantage |
$529.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$848.00
|
| Rate for Payer: Priority Health Medicare |
$529.22
|
| Rate for Payer: Priority Health SBD |
$848.00
|
| Rate for Payer: Priority Health Tiered Network |
$848.00
|
| Rate for Payer: Railroad Medicare Medicare |
$529.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.27
|
| Rate for Payer: UHC Core |
$886.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.22
|
| Rate for Payer: UHC Exchange |
$886.27
|
| Rate for Payer: UHC Medicaid |
$350.39
|
| Rate for Payer: UHCCP Medicaid |
$350.39
|
| Rate for Payer: UMR Bronson Commercial |
$657.80
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$346.13 |
| Max. Negotiated Rate |
$879.40 |
| Rate for Payer: Aetna Commercial |
$687.47
|
| Rate for Payer: Aetna Medicare |
$533.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.78
|
| Rate for Payer: BCBS Complete |
$363.44
|
| Rate for Payer: BCBS MAPPO |
$513.04
|
| Rate for Payer: BCN Commercial |
$822.67
|
| Rate for Payer: BCN Medicare Advantage |
$513.04
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cofinity Commercial |
$687.47
|
| Rate for Payer: Cofinity Commercial |
$738.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.69
|
| Rate for Payer: Meridian Medicaid |
$363.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$564.34
|
| Rate for Payer: Nomi Health Commercial |
$615.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.50
|
| Rate for Payer: PACE SWMI |
$513.04
|
| Rate for Payer: PHP Commercial |
$718.26
|
| Rate for Payer: PHP Medicare Advantage |
$513.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$879.40
|
| Rate for Payer: Priority Health Medicare |
$513.04
|
| Rate for Payer: Priority Health SBD |
$879.40
|
| Rate for Payer: Priority Health Tiered Network |
$879.40
|
| Rate for Payer: Railroad Medicare Medicare |
$513.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.75
|
| Rate for Payer: UHC Core |
$870.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$513.04
|
| Rate for Payer: UHC Exchange |
$870.75
|
| Rate for Payer: UHC Medicaid |
$346.13
|
| Rate for Payer: UHCCP Medicaid |
$346.13
|
| Rate for Payer: UMR Bronson Commercial |
$495.88
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ
|
Professional
|
Both
|
$1,460.00
|
|
|
Service Code
|
HCPCS 27510
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,190.86 |
| Rate for Payer: Aetna Commercial |
$880.81
|
| Rate for Payer: Aetna Medicare |
$683.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$946.54
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS MAPPO |
$657.32
|
| Rate for Payer: BCN Commercial |
$1,038.29
|
| Rate for Payer: BCN Medicare Advantage |
$657.32
|
| Rate for Payer: Cash Price |
$1,168.00
|
| Rate for Payer: Cash Price |
$1,168.00
|
| Rate for Payer: Cofinity Commercial |
$880.81
|
| Rate for Payer: Cofinity Commercial |
$946.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.19
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$723.05
|
| Rate for Payer: Nomi Health Commercial |
$788.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.00
|
| Rate for Payer: PACE SWMI |
$657.32
|
| Rate for Payer: PHP Commercial |
$920.25
|
| Rate for Payer: PHP Medicare Advantage |
$657.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,109.90
|
| Rate for Payer: Priority Health Medicare |
$657.32
|
| Rate for Payer: Priority Health SBD |
$1,109.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,109.90
|
| Rate for Payer: Railroad Medicare Medicare |
$657.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.86
|
| Rate for Payer: UHC Core |
$1,190.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$657.32
|
| Rate for Payer: UHC Exchange |
$1,190.86
|
| Rate for Payer: UHC Medicaid |
$428.98
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
| Rate for Payer: UMR Bronson Commercial |
$671.60
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 27508
|
| Min. Negotiated Rate |
$311.62 |
| Max. Negotiated Rate |
$861.02 |
| Rate for Payer: Aetna Commercial |
$633.77
|
| Rate for Payer: Aetna Medicare |
$491.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.06
|
| Rate for Payer: BCBS Complete |
$327.20
|
| Rate for Payer: BCBS MAPPO |
$472.96
|
| Rate for Payer: BCN Commercial |
$770.37
|
| Rate for Payer: BCN Medicare Advantage |
$472.96
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$633.77
|
| Rate for Payer: Cofinity Commercial |
$681.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.61
|
| Rate for Payer: Meridian Medicaid |
$327.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$520.26
|
| Rate for Payer: Nomi Health Commercial |
$567.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$849.75
|
| Rate for Payer: PACE SWMI |
$472.96
|
| Rate for Payer: PHP Commercial |
$662.14
|
| Rate for Payer: PHP Medicare Advantage |
$472.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$823.51
|
| Rate for Payer: Priority Health Medicare |
$472.96
|
| Rate for Payer: Priority Health SBD |
$823.51
|
| Rate for Payer: Priority Health Tiered Network |
$823.51
|
| Rate for Payer: Railroad Medicare Medicare |
$472.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.02
|
| Rate for Payer: UHC Core |
$861.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$472.96
|
| Rate for Payer: UHC Exchange |
$861.02
|
| Rate for Payer: UHC Medicaid |
$311.62
|
| Rate for Payer: UHCCP Medicaid |
$311.62
|
| Rate for Payer: UMR Bronson Commercial |
$521.18
|
|
|
PR CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 27232
|
| Min. Negotiated Rate |
$444.32 |
| Max. Negotiated Rate |
$1,317.09 |
| Rate for Payer: Aetna Commercial |
$921.18
|
| Rate for Payer: Aetna Medicare |
$714.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.93
|
| Rate for Payer: BCBS Complete |
$466.54
|
| Rate for Payer: BCBS MAPPO |
$687.45
|
| Rate for Payer: BCN Commercial |
$1,107.01
|
| Rate for Payer: BCN Medicare Advantage |
$687.45
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cofinity Commercial |
$921.18
|
| Rate for Payer: Cofinity Commercial |
$989.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.82
|
| Rate for Payer: Meridian Medicaid |
$466.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$756.20
|
| Rate for Payer: Nomi Health Commercial |
$824.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,060.50
|
| Rate for Payer: PACE SWMI |
$687.45
|
| Rate for Payer: PHP Commercial |
$962.43
|
| Rate for Payer: PHP Medicare Advantage |
$687.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.36
|
| Rate for Payer: Priority Health Medicare |
$687.45
|
| Rate for Payer: Priority Health SBD |
$1,183.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,183.36
|
| Rate for Payer: Railroad Medicare Medicare |
$687.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.09
|
| Rate for Payer: UHC Core |
$1,317.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$687.45
|
| Rate for Payer: UHC Exchange |
$1,317.09
|
| Rate for Payer: UHC Medicaid |
$444.32
|
| Rate for Payer: UHCCP Medicaid |
$444.32
|
| Rate for Payer: UMR Bronson Commercial |
$650.44
|
|
|
PR CLTX FEM FX PROX END NCK W/O MANJ
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 27230
|
| Min. Negotiated Rate |
$301.61 |
| Max. Negotiated Rate |
$823.00 |
| Rate for Payer: Aetna Commercial |
$612.46
|
| Rate for Payer: Aetna Medicare |
$475.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.17
|
| Rate for Payer: BCBS Complete |
$316.69
|
| Rate for Payer: BCBS MAPPO |
$457.06
|
| Rate for Payer: BCN Commercial |
$738.00
|
| Rate for Payer: BCN Medicare Advantage |
$457.06
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$612.46
|
| Rate for Payer: Cofinity Commercial |
$658.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.91
|
| Rate for Payer: Meridian Medicaid |
$316.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.77
|
| Rate for Payer: Nomi Health Commercial |
$548.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$771.75
|
| Rate for Payer: PACE SWMI |
$457.06
|
| Rate for Payer: PHP Commercial |
$639.88
|
| Rate for Payer: PHP Medicare Advantage |
$457.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$788.92
|
| Rate for Payer: Priority Health Medicare |
$457.06
|
| Rate for Payer: Priority Health SBD |
$788.92
|
| Rate for Payer: Priority Health Tiered Network |
$788.92
|
| Rate for Payer: Railroad Medicare Medicare |
$457.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$823.00
|
| Rate for Payer: UHC Core |
$823.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.06
|
| Rate for Payer: UHC Exchange |
$823.00
|
| Rate for Payer: UHC Medicaid |
$301.61
|
| Rate for Payer: UHCCP Medicaid |
$301.61
|
| Rate for Payer: UMR Bronson Commercial |
$473.34
|
|
|
PR CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ
|
Professional
|
Both
|
$1,887.00
|
|
|
Service Code
|
HCPCS 27502
|
| Min. Negotiated Rate |
$479.89 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: Aetna Commercial |
$988.16
|
| Rate for Payer: Aetna Medicare |
$766.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,061.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.16
|
| Rate for Payer: BCBS Complete |
$503.88
|
| Rate for Payer: BCBS MAPPO |
$737.43
|
| Rate for Payer: BCN Commercial |
$1,146.85
|
| Rate for Payer: BCN Medicare Advantage |
$737.43
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,061.90
|
| Rate for Payer: Cofinity Commercial |
$988.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$774.30
|
| Rate for Payer: Meridian Medicaid |
$503.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$811.17
|
| Rate for Payer: Nomi Health Commercial |
$884.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,415.25
|
| Rate for Payer: PACE SWMI |
$737.43
|
| Rate for Payer: PHP Commercial |
$1,032.40
|
| Rate for Payer: PHP Medicare Advantage |
$737.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,225.95
|
| Rate for Payer: Priority Health Medicare |
$737.43
|
| Rate for Payer: Priority Health SBD |
$1,225.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,225.95
|
| Rate for Payer: Railroad Medicare Medicare |
$737.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.03
|
| Rate for Payer: UHC Core |
$1,333.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$737.43
|
| Rate for Payer: UHC Exchange |
$1,333.03
|
| Rate for Payer: UHC Medicaid |
$479.89
|
| Rate for Payer: UHCCP Medicaid |
$479.89
|
| Rate for Payer: UMR Bronson Commercial |
$868.02
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 28495
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$254.16 |
| Rate for Payer: Aetna Commercial |
$197.11
|
| Rate for Payer: Aetna Medicare |
$152.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.82
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$147.10
|
| Rate for Payer: BCN Commercial |
$234.05
|
| Rate for Payer: BCN Medicare Advantage |
$147.10
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Commercial |
$211.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.46
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.81
|
| Rate for Payer: Nomi Health Commercial |
$176.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$147.10
|
| Rate for Payer: PHP Commercial |
$205.94
|
| Rate for Payer: PHP Medicare Advantage |
$147.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$250.20
|
| Rate for Payer: Priority Health Medicare |
$147.10
|
| Rate for Payer: Priority Health SBD |
$250.20
|
| Rate for Payer: Priority Health Tiered Network |
$250.20
|
| Rate for Payer: Railroad Medicare Medicare |
$147.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.16
|
| Rate for Payer: UHC Core |
$254.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.10
|
| Rate for Payer: UHC Exchange |
$254.16
|
| Rate for Payer: UHC Medicaid |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UMR Bronson Commercial |
$108.10
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS 28490
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$167.90
|
| Rate for Payer: Aetna Medicare |
$130.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.43
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$125.30
|
| Rate for Payer: BCN Commercial |
$195.70
|
| Rate for Payer: BCN Medicare Advantage |
$125.30
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Cofinity Commercial |
$180.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.56
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.83
|
| Rate for Payer: Nomi Health Commercial |
$150.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PACE SWMI |
$125.30
|
| Rate for Payer: PHP Commercial |
$175.42
|
| Rate for Payer: PHP Medicare Advantage |
$125.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$209.20
|
| Rate for Payer: Priority Health Medicare |
$125.30
|
| Rate for Payer: Priority Health SBD |
$209.20
|
| Rate for Payer: Priority Health Tiered Network |
$209.20
|
| Rate for Payer: Railroad Medicare Medicare |
$125.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.06
|
| Rate for Payer: UHC Core |
$211.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$125.30
|
| Rate for Payer: UHC Exchange |
$211.06
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
| Rate for Payer: UMR Bronson Commercial |
$143.52
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$185.00
|
| Rate for Payer: Aetna Medicare |
$143.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.81
|
| Rate for Payer: BCBS Complete |
$97.06
|
| Rate for Payer: BCBS MAPPO |
$138.06
|
| Rate for Payer: BCN Commercial |
$223.09
|
| Rate for Payer: BCN Medicare Advantage |
$138.06
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$185.00
|
| Rate for Payer: Cofinity Commercial |
$198.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.96
|
| Rate for Payer: Meridian Medicaid |
$97.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.87
|
| Rate for Payer: Nomi Health Commercial |
$165.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: PACE SWMI |
$138.06
|
| Rate for Payer: PHP Commercial |
$193.28
|
| Rate for Payer: PHP Medicare Advantage |
$138.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$238.48
|
| Rate for Payer: Priority Health Medicare |
$138.06
|
| Rate for Payer: Priority Health SBD |
$238.48
|
| Rate for Payer: Priority Health Tiered Network |
$238.48
|
| Rate for Payer: Railroad Medicare Medicare |
$138.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.70
|
| Rate for Payer: UHC Core |
$243.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.06
|
| Rate for Payer: UHC Exchange |
$243.70
|
| Rate for Payer: UHC Medicaid |
$92.44
|
| Rate for Payer: UHCCP Medicaid |
$92.44
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$158.72
|
| Rate for Payer: Aetna Medicare |
$123.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.57
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$118.45
|
| Rate for Payer: BCN Commercial |
$189.23
|
| Rate for Payer: BCN Medicare Advantage |
$118.45
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$158.72
|
| Rate for Payer: Cofinity Commercial |
$170.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.37
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.29
|
| Rate for Payer: Nomi Health Commercial |
$142.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.75
|
| Rate for Payer: PACE SWMI |
$118.45
|
| Rate for Payer: PHP Commercial |
$165.83
|
| Rate for Payer: PHP Medicare Advantage |
$118.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.29
|
| Rate for Payer: Priority Health Medicare |
$118.45
|
| Rate for Payer: Priority Health SBD |
$202.29
|
| Rate for Payer: Priority Health Tiered Network |
$202.29
|
| Rate for Payer: Railroad Medicare Medicare |
$118.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.87
|
| Rate for Payer: UHC Core |
$202.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.45
|
| Rate for Payer: UHC Exchange |
$202.87
|
| Rate for Payer: UHC Medicaid |
$79.66
|
| Rate for Payer: UHCCP Medicaid |
$79.66
|
| Rate for Payer: UMR Bronson Commercial |
$138.46
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$673.50 |
| Rate for Payer: Aetna Commercial |
$407.47
|
| Rate for Payer: Aetna Medicare |
$316.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.88
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$304.08
|
| Rate for Payer: BCN Commercial |
$480.06
|
| Rate for Payer: BCN Medicare Advantage |
$304.08
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cofinity Commercial |
$407.47
|
| Rate for Payer: Cofinity Commercial |
$437.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.28
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.49
|
| Rate for Payer: Nomi Health Commercial |
$364.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.50
|
| Rate for Payer: PACE SWMI |
$304.08
|
| Rate for Payer: PHP Commercial |
$425.71
|
| Rate for Payer: PHP Medicare Advantage |
$304.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$513.16
|
| Rate for Payer: Priority Health Medicare |
$304.08
|
| Rate for Payer: Priority Health SBD |
$513.16
|
| Rate for Payer: Priority Health Tiered Network |
$513.16
|
| Rate for Payer: Railroad Medicare Medicare |
$304.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.60
|
| Rate for Payer: UHC Core |
$523.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.08
|
| Rate for Payer: UHC Exchange |
$523.60
|
| Rate for Payer: UHC Medicaid |
$202.56
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
| Rate for Payer: UMR Bronson Commercial |
$413.08
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$1,497.00 |
| Rate for Payer: Aetna Commercial |
$624.41
|
| Rate for Payer: Aetna Medicare |
$484.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.01
|
| Rate for Payer: BCBS Complete |
$320.71
|
| Rate for Payer: BCBS MAPPO |
$465.98
|
| Rate for Payer: BCN Commercial |
$763.41
|
| Rate for Payer: BCN Medicare Advantage |
$465.98
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$624.41
|
| Rate for Payer: Cofinity Commercial |
$671.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.28
|
| Rate for Payer: Meridian Medicaid |
$320.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.58
|
| Rate for Payer: Nomi Health Commercial |
$559.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$465.98
|
| Rate for Payer: PHP Commercial |
$652.37
|
| Rate for Payer: PHP Medicare Advantage |
$465.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$816.06
|
| Rate for Payer: Priority Health Medicare |
$465.98
|
| Rate for Payer: Priority Health SBD |
$816.06
|
| Rate for Payer: Priority Health Tiered Network |
$816.06
|
| Rate for Payer: Railroad Medicare Medicare |
$465.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.20
|
| Rate for Payer: UHC Core |
$861.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.98
|
| Rate for Payer: UHC Exchange |
$861.20
|
| Rate for Payer: UHC Medicaid |
$305.44
|
| Rate for Payer: UHCCP Medicaid |
$305.44
|
| Rate for Payer: UMR Bronson Commercial |
$918.16
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$708.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$173.17 |
| Max. Negotiated Rate |
$531.00 |
| Rate for Payer: Aetna Commercial |
$346.75
|
| Rate for Payer: Aetna Medicare |
$269.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.63
|
| Rate for Payer: BCBS Complete |
$181.83
|
| Rate for Payer: BCBS MAPPO |
$258.77
|
| Rate for Payer: BCN Commercial |
$410.84
|
| Rate for Payer: BCN Medicare Advantage |
$258.77
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cofinity Commercial |
$346.75
|
| Rate for Payer: Cofinity Commercial |
$372.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.71
|
| Rate for Payer: Meridian Medicaid |
$181.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$284.65
|
| Rate for Payer: Nomi Health Commercial |
$310.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$531.00
|
| Rate for Payer: PACE SWMI |
$258.77
|
| Rate for Payer: PHP Commercial |
$362.28
|
| Rate for Payer: PHP Medicare Advantage |
$258.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$439.17
|
| Rate for Payer: Priority Health Medicare |
$258.77
|
| Rate for Payer: Priority Health SBD |
$439.17
|
| Rate for Payer: Priority Health Tiered Network |
$439.17
|
| Rate for Payer: Railroad Medicare Medicare |
$258.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.39
|
| Rate for Payer: UHC Core |
$441.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$258.77
|
| Rate for Payer: UHC Exchange |
$441.39
|
| Rate for Payer: UHC Medicaid |
$173.17
|
| Rate for Payer: UHCCP Medicaid |
$173.17
|
| Rate for Payer: UMR Bronson Commercial |
$325.68
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$606.95 |
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.10
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCN Commercial |
$546.78
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.83
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.00
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$584.49
|
| Rate for Payer: Priority Health Medicare |
$362.57
|
| Rate for Payer: Priority Health SBD |
$584.49
|
| Rate for Payer: Priority Health Tiered Network |
$584.49
|
| Rate for Payer: Railroad Medicare Medicare |
$362.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.95
|
| Rate for Payer: UHC Core |
$606.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.57
|
| Rate for Payer: UHC Exchange |
$606.95
|
| Rate for Payer: UHC Medicaid |
$240.69
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
| Rate for Payer: UMR Bronson Commercial |
$312.80
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$923.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$692.25 |
| Rate for Payer: Aetna Commercial |
$489.86
|
| Rate for Payer: Aetna Medicare |
$380.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.42
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$365.57
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: BCN Medicare Advantage |
$365.57
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cofinity Commercial |
$489.86
|
| Rate for Payer: Cofinity Commercial |
$526.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$383.85
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.13
|
| Rate for Payer: Nomi Health Commercial |
$438.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$692.25
|
| Rate for Payer: PACE SWMI |
$365.57
|
| Rate for Payer: PHP Commercial |
$511.80
|
| Rate for Payer: PHP Medicare Advantage |
$365.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.92
|
| Rate for Payer: Priority Health Medicare |
$365.57
|
| Rate for Payer: Priority Health SBD |
$640.92
|
| Rate for Payer: Priority Health Tiered Network |
$640.92
|
| Rate for Payer: Railroad Medicare Medicare |
$365.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.62
|
| Rate for Payer: UHC Core |
$669.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$365.57
|
| Rate for Payer: UHC Exchange |
$669.62
|
| Rate for Payer: UHC Medicaid |
$240.69
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
| Rate for Payer: UMR Bronson Commercial |
$424.58
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$2,017.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$458.16 |
| Max. Negotiated Rate |
$1,512.75 |
| Rate for Payer: Aetna Commercial |
$943.64
|
| Rate for Payer: Aetna Medicare |
$732.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.64
|
| Rate for Payer: BCBS Complete |
$481.07
|
| Rate for Payer: BCBS MAPPO |
$704.21
|
| Rate for Payer: BCN Commercial |
$1,134.40
|
| Rate for Payer: BCN Medicare Advantage |
$704.21
|
| Rate for Payer: Cash Price |
$1,613.60
|
| Rate for Payer: Cash Price |
$1,613.60
|
| Rate for Payer: Cofinity Commercial |
$1,014.06
|
| Rate for Payer: Cofinity Commercial |
$943.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.42
|
| Rate for Payer: Meridian Medicaid |
$481.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$774.63
|
| Rate for Payer: Nomi Health Commercial |
$845.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,512.75
|
| Rate for Payer: PACE SWMI |
$704.21
|
| Rate for Payer: PHP Commercial |
$985.89
|
| Rate for Payer: PHP Medicare Advantage |
$704.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,212.64
|
| Rate for Payer: Priority Health Medicare |
$704.21
|
| Rate for Payer: Priority Health SBD |
$1,212.64
|
| Rate for Payer: Priority Health Tiered Network |
$1,212.64
|
| Rate for Payer: Railroad Medicare Medicare |
$704.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.05
|
| Rate for Payer: UHC Core |
$1,324.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$704.21
|
| Rate for Payer: UHC Exchange |
$1,324.05
|
| Rate for Payer: UHC Medicaid |
$458.16
|
| Rate for Payer: UHCCP Medicaid |
$458.16
|
| Rate for Payer: UMR Bronson Commercial |
$927.82
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$236.90
|
| Rate for Payer: Aetna Medicare |
$183.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.58
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCBS MAPPO |
$176.79
|
| Rate for Payer: BCN Commercial |
$268.41
|
| Rate for Payer: BCN Medicare Advantage |
$176.79
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$236.90
|
| Rate for Payer: Cofinity Commercial |
$254.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.63
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.47
|
| Rate for Payer: Nomi Health Commercial |
$212.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$570.00
|
| Rate for Payer: PACE SWMI |
$176.79
|
| Rate for Payer: PHP Commercial |
$247.51
|
| Rate for Payer: PHP Medicare Advantage |
$176.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$286.93
|
| Rate for Payer: Priority Health Medicare |
$176.79
|
| Rate for Payer: Priority Health SBD |
$286.93
|
| Rate for Payer: Priority Health Tiered Network |
$286.93
|
| Rate for Payer: Railroad Medicare Medicare |
$176.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.70
|
| Rate for Payer: UHC Core |
$330.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$176.79
|
| Rate for Payer: UHC Exchange |
$330.70
|
| Rate for Payer: UHC Medicaid |
$111.40
|
| Rate for Payer: UHCCP Medicaid |
$111.40
|
| Rate for Payer: UMR Bronson Commercial |
$349.60
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/O MNPJ
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$529.62 |
| Rate for Payer: Aetna Commercial |
$430.92
|
| Rate for Payer: Aetna Medicare |
$334.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.08
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$321.58
|
| Rate for Payer: BCN Commercial |
$494.99
|
| Rate for Payer: BCN Medicare Advantage |
$321.58
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$430.92
|
| Rate for Payer: Cofinity Commercial |
$463.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.66
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.74
|
| Rate for Payer: Nomi Health Commercial |
$385.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$524.25
|
| Rate for Payer: PACE SWMI |
$321.58
|
| Rate for Payer: PHP Commercial |
$450.21
|
| Rate for Payer: PHP Medicare Advantage |
$321.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$529.13
|
| Rate for Payer: Priority Health Medicare |
$321.58
|
| Rate for Payer: Priority Health SBD |
$529.13
|
| Rate for Payer: Priority Health Tiered Network |
$529.13
|
| Rate for Payer: Railroad Medicare Medicare |
$321.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.62
|
| Rate for Payer: UHC Core |
$529.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$321.58
|
| Rate for Payer: UHC Exchange |
$529.62
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
| Rate for Payer: UMR Bronson Commercial |
$321.54
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MNPJ
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$204.05 |
| Max. Negotiated Rate |
$633.75 |
| Rate for Payer: Aetna Commercial |
$408.79
|
| Rate for Payer: Aetna Medicare |
$317.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.30
|
| Rate for Payer: BCBS Complete |
$214.25
|
| Rate for Payer: BCBS MAPPO |
$305.07
|
| Rate for Payer: BCN Commercial |
$465.12
|
| Rate for Payer: BCN Medicare Advantage |
$305.07
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$408.79
|
| Rate for Payer: Cofinity Commercial |
$439.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.32
|
| Rate for Payer: Meridian Medicaid |
$214.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.58
|
| Rate for Payer: Nomi Health Commercial |
$366.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$633.75
|
| Rate for Payer: PACE SWMI |
$305.07
|
| Rate for Payer: PHP Commercial |
$427.10
|
| Rate for Payer: PHP Medicare Advantage |
$305.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$497.20
|
| Rate for Payer: Priority Health Medicare |
$305.07
|
| Rate for Payer: Priority Health SBD |
$497.20
|
| Rate for Payer: Priority Health Tiered Network |
$497.20
|
| Rate for Payer: Railroad Medicare Medicare |
$305.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.13
|
| Rate for Payer: UHC Core |
$502.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.07
|
| Rate for Payer: UHC Exchange |
$502.13
|
| Rate for Payer: UHC Medicaid |
$204.05
|
| Rate for Payer: UHCCP Medicaid |
$204.05
|
| Rate for Payer: UMR Bronson Commercial |
$388.70
|
|
|
PR CLTX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 24500
|
| Min. Negotiated Rate |
$222.37 |
| Max. Negotiated Rate |
$651.75 |
| Rate for Payer: Aetna Commercial |
$446.31
|
| Rate for Payer: Aetna Medicare |
$346.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.62
|
| Rate for Payer: BCBS Complete |
$233.49
|
| Rate for Payer: BCBS MAPPO |
$333.07
|
| Rate for Payer: BCN Commercial |
$526.37
|
| Rate for Payer: BCN Medicare Advantage |
$333.07
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$446.31
|
| Rate for Payer: Cofinity Commercial |
$479.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.72
|
| Rate for Payer: Meridian Medicaid |
$233.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$366.38
|
| Rate for Payer: Nomi Health Commercial |
$399.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.75
|
| Rate for Payer: PACE SWMI |
$333.07
|
| Rate for Payer: PHP Commercial |
$466.30
|
| Rate for Payer: PHP Medicare Advantage |
$333.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$562.67
|
| Rate for Payer: Priority Health Medicare |
$333.07
|
| Rate for Payer: Priority Health SBD |
$562.67
|
| Rate for Payer: Priority Health Tiered Network |
$562.67
|
| Rate for Payer: Railroad Medicare Medicare |
$333.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.13
|
| Rate for Payer: UHC Core |
$565.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$333.07
|
| Rate for Payer: UHC Exchange |
$565.13
|
| Rate for Payer: UHC Medicaid |
$222.37
|
| Rate for Payer: UHCCP Medicaid |
$222.37
|
| Rate for Payer: UMR Bronson Commercial |
$399.74
|
|
|
PR CLTX HUMERAL SHFT FX W/MNPJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$995.25 |
| Rate for Payer: Aetna Commercial |
$611.43
|
| Rate for Payer: Aetna Medicare |
$474.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.06
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCBS MAPPO |
$456.29
|
| Rate for Payer: BCN Commercial |
$703.15
|
| Rate for Payer: BCN Medicare Advantage |
$456.29
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$611.43
|
| Rate for Payer: Cofinity Commercial |
$657.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.10
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$501.92
|
| Rate for Payer: Nomi Health Commercial |
$547.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$995.25
|
| Rate for Payer: PACE SWMI |
$456.29
|
| Rate for Payer: PHP Commercial |
$638.81
|
| Rate for Payer: PHP Medicare Advantage |
$456.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.64
|
| Rate for Payer: Priority Health Medicare |
$456.29
|
| Rate for Payer: Priority Health SBD |
$751.64
|
| Rate for Payer: Priority Health Tiered Network |
$751.64
|
| Rate for Payer: Railroad Medicare Medicare |
$456.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.81
|
| Rate for Payer: UHC Core |
$777.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$456.29
|
| Rate for Payer: UHC Exchange |
$777.81
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
| Rate for Payer: UMR Bronson Commercial |
$610.42
|
|
|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$982.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$287.34 |
| Max. Negotiated Rate |
$767.18 |
| Rate for Payer: Aetna Commercial |
$580.81
|
| Rate for Payer: Aetna Medicare |
$450.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.15
|
| Rate for Payer: BCBS Complete |
$301.71
|
| Rate for Payer: BCBS MAPPO |
$433.44
|
| Rate for Payer: BCN Commercial |
$700.66
|
| Rate for Payer: BCN Medicare Advantage |
$433.44
|
| Rate for Payer: Cash Price |
$785.60
|
| Rate for Payer: Cash Price |
$785.60
|
| Rate for Payer: Cofinity Commercial |
$580.81
|
| Rate for Payer: Cofinity Commercial |
$624.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.11
|
| Rate for Payer: Meridian Medicaid |
$301.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$476.78
|
| Rate for Payer: Nomi Health Commercial |
$520.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$736.50
|
| Rate for Payer: PACE SWMI |
$433.44
|
| Rate for Payer: PHP Commercial |
$606.82
|
| Rate for Payer: PHP Medicare Advantage |
$433.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$748.99
|
| Rate for Payer: Priority Health Medicare |
$433.44
|
| Rate for Payer: Priority Health SBD |
$748.99
|
| Rate for Payer: Priority Health Tiered Network |
$748.99
|
| Rate for Payer: Railroad Medicare Medicare |
$433.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$767.18
|
| Rate for Payer: UHC Core |
$767.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$433.44
|
| Rate for Payer: UHC Exchange |
$767.18
|
| Rate for Payer: UHC Medicaid |
$287.34
|
| Rate for Payer: UHCCP Medicaid |
$287.34
|
| Rate for Payer: UMR Bronson Commercial |
$451.72
|
|
