|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$381.20 |
| Max. Negotiated Rate |
$630.46 |
| Rate for Payer: Aetna Commercial |
$586.68
|
| Rate for Payer: Aetna Medicare |
$455.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.68
|
| Rate for Payer: BCBS Complete |
$381.20
|
| Rate for Payer: BCBS MAPPO |
$437.82
|
| Rate for Payer: BCN Medicare Advantage |
$437.82
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cofinity Commercial |
$630.46
|
| Rate for Payer: Cofinity Commercial |
$586.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.71
|
| Rate for Payer: Nomi Health Commercial |
$525.38
|
| Rate for Payer: PACE SWMI |
$437.82
|
| Rate for Payer: PHP Commercial |
$612.95
|
| Rate for Payer: PHP Medicare Advantage |
$437.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.45
|
| Rate for Payer: Priority Health Medicare |
$437.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$437.82
|
| Rate for Payer: UHC Medicare Advantage |
$437.82
|
| Rate for Payer: UMR Bronson Commercial |
$438.38
|
|
|
PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 27238
|
| Min. Negotiated Rate |
$380.80 |
| Max. Negotiated Rate |
$653.70 |
| Rate for Payer: Aetna Commercial |
$608.31
|
| Rate for Payer: Aetna Medicare |
$472.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.31
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$453.96
|
| Rate for Payer: BCN Medicare Advantage |
$453.96
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$653.70
|
| Rate for Payer: Cofinity Commercial |
$608.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.66
|
| Rate for Payer: Nomi Health Commercial |
$544.75
|
| Rate for Payer: PACE SWMI |
$453.96
|
| Rate for Payer: PHP Commercial |
$635.54
|
| Rate for Payer: PHP Medicare Advantage |
$453.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$453.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.96
|
| Rate for Payer: UHC Medicare Advantage |
$453.96
|
| Rate for Payer: UMR Bronson Commercial |
$437.92
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 28665
|
| Min. Negotiated Rate |
$108.80 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: Aetna Commercial |
$161.16
|
| Rate for Payer: Aetna Medicare |
$125.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.16
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$120.27
|
| Rate for Payer: BCN Medicare Advantage |
$120.27
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$173.19
|
| Rate for Payer: Cofinity Commercial |
$161.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.28
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: PACE SWMI |
$120.27
|
| Rate for Payer: PHP Commercial |
$168.38
|
| Rate for Payer: PHP Medicare Advantage |
$120.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Medicare |
$120.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.27
|
| Rate for Payer: UHC Medicare Advantage |
$120.27
|
| Rate for Payer: UMR Bronson Commercial |
$125.12
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 28660
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Commercial |
$121.67
|
| Rate for Payer: Aetna Medicare |
$94.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.67
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: BCBS MAPPO |
$90.80
|
| Rate for Payer: BCN Medicare Advantage |
$90.80
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$130.75
|
| Rate for Payer: Cofinity Commercial |
$121.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.34
|
| Rate for Payer: Nomi Health Commercial |
$108.96
|
| Rate for Payer: PACE SWMI |
$90.80
|
| Rate for Payer: PHP Commercial |
$127.12
|
| Rate for Payer: PHP Medicare Advantage |
$90.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health Medicare |
$90.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.80
|
| Rate for Payer: UHC Medicare Advantage |
$90.80
|
| Rate for Payer: UMR Bronson Commercial |
$107.64
|
|
|
PR CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 27240
|
| Min. Negotiated Rate |
$794.00 |
| Max. Negotiated Rate |
$1,328.96 |
| Rate for Payer: Aetna Commercial |
$1,236.67
|
| Rate for Payer: Aetna Medicare |
$959.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.67
|
| Rate for Payer: BCBS Complete |
$794.00
|
| Rate for Payer: BCBS MAPPO |
$922.89
|
| Rate for Payer: BCN Medicare Advantage |
$922.89
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$1,328.96
|
| Rate for Payer: Cofinity Commercial |
$1,236.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.03
|
| Rate for Payer: Nomi Health Commercial |
$1,107.47
|
| Rate for Payer: PACE SWMI |
$922.89
|
| Rate for Payer: PHP Commercial |
$1,292.05
|
| Rate for Payer: PHP Medicare Advantage |
$922.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health Medicare |
$922.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$922.89
|
| Rate for Payer: UHC Medicare Advantage |
$922.89
|
| Rate for Payer: UMR Bronson Commercial |
$913.10
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ REQ ANES
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 26775
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$536.25 |
| Rate for Payer: Aetna Commercial |
$464.79
|
| Rate for Payer: Aetna Medicare |
$360.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.79
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS MAPPO |
$346.86
|
| Rate for Payer: BCN Medicare Advantage |
$346.86
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$499.48
|
| Rate for Payer: Cofinity Commercial |
$464.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.20
|
| Rate for Payer: Nomi Health Commercial |
$416.23
|
| Rate for Payer: PACE SWMI |
$346.86
|
| Rate for Payer: PHP Commercial |
$485.60
|
| Rate for Payer: PHP Medicare Advantage |
$346.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health Medicare |
$346.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.86
|
| Rate for Payer: UHC Medicare Advantage |
$346.86
|
| Rate for Payer: UMR Bronson Commercial |
$379.50
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$223.20 |
| Max. Negotiated Rate |
$375.49 |
| Rate for Payer: Aetna Commercial |
$349.42
|
| Rate for Payer: Aetna Medicare |
$271.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.42
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$260.76
|
| Rate for Payer: BCN Medicare Advantage |
$260.76
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cofinity Commercial |
$375.49
|
| Rate for Payer: Cofinity Commercial |
$349.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.80
|
| Rate for Payer: Nomi Health Commercial |
$312.91
|
| Rate for Payer: PACE SWMI |
$260.76
|
| Rate for Payer: PHP Commercial |
$365.06
|
| Rate for Payer: PHP Medicare Advantage |
$260.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.70
|
| Rate for Payer: Priority Health Medicare |
$260.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.76
|
| Rate for Payer: UHC Medicare Advantage |
$260.76
|
| Rate for Payer: UMR Bronson Commercial |
$256.68
|
|
|
PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX
|
Professional
|
Both
|
$1,195.00
|
|
|
Service Code
|
HCPCS 21440
|
| Min. Negotiated Rate |
$478.00 |
| Max. Negotiated Rate |
$781.19 |
| Rate for Payer: Aetna Commercial |
$726.94
|
| Rate for Payer: Aetna Medicare |
$564.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.94
|
| Rate for Payer: BCBS Complete |
$478.00
|
| Rate for Payer: BCBS MAPPO |
$542.49
|
| Rate for Payer: BCN Medicare Advantage |
$542.49
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$781.19
|
| Rate for Payer: Cofinity Commercial |
$726.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.61
|
| Rate for Payer: Nomi Health Commercial |
$650.99
|
| Rate for Payer: PACE SWMI |
$542.49
|
| Rate for Payer: PHP Commercial |
$759.49
|
| Rate for Payer: PHP Medicare Advantage |
$542.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health Medicare |
$542.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.49
|
| Rate for Payer: UHC Medicare Advantage |
$542.49
|
| Rate for Payer: UMR Bronson Commercial |
$549.70
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$301.17 |
| Max. Negotiated Rate |
$566.80 |
| Rate for Payer: Aetna Commercial |
$403.57
|
| Rate for Payer: Aetna Medicare |
$313.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.57
|
| Rate for Payer: BCBS Complete |
$348.80
|
| Rate for Payer: BCBS MAPPO |
$301.17
|
| Rate for Payer: BCN Medicare Advantage |
$301.17
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$433.68
|
| Rate for Payer: Cofinity Commercial |
$403.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.23
|
| Rate for Payer: Nomi Health Commercial |
$361.40
|
| Rate for Payer: PACE SWMI |
$301.17
|
| Rate for Payer: PHP Commercial |
$421.64
|
| Rate for Payer: PHP Medicare Advantage |
$301.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health Medicare |
$301.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.17
|
| Rate for Payer: UHC Medicare Advantage |
$301.17
|
| Rate for Payer: UMR Bronson Commercial |
$401.12
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$464.75 |
| Rate for Payer: Aetna Commercial |
$390.07
|
| Rate for Payer: Aetna Medicare |
$302.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.07
|
| Rate for Payer: BCBS Complete |
$286.00
|
| Rate for Payer: BCBS MAPPO |
$291.10
|
| Rate for Payer: BCN Medicare Advantage |
$291.10
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$419.18
|
| Rate for Payer: Cofinity Commercial |
$390.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.65
|
| Rate for Payer: Nomi Health Commercial |
$349.32
|
| Rate for Payer: PACE SWMI |
$291.10
|
| Rate for Payer: PHP Commercial |
$407.54
|
| Rate for Payer: PHP Medicare Advantage |
$291.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.75
|
| Rate for Payer: Priority Health Medicare |
$291.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.10
|
| Rate for Payer: UHC Medicare Advantage |
$291.10
|
| Rate for Payer: UMR Bronson Commercial |
$328.90
|
|
|
PR CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26607
|
| Min. Negotiated Rate |
$484.75 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$649.57
|
| Rate for Payer: Aetna Medicare |
$504.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.57
|
| Rate for Payer: BCBS Complete |
$616.00
|
| Rate for Payer: BCBS MAPPO |
$484.75
|
| Rate for Payer: BCN Medicare Advantage |
$484.75
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$698.04
|
| Rate for Payer: Cofinity Commercial |
$649.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.99
|
| Rate for Payer: Nomi Health Commercial |
$581.70
|
| Rate for Payer: PACE SWMI |
$484.75
|
| Rate for Payer: PHP Commercial |
$678.65
|
| Rate for Payer: PHP Medicare Advantage |
$484.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health Medicare |
$484.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.75
|
| Rate for Payer: UHC Medicare Advantage |
$484.75
|
| Rate for Payer: UMR Bronson Commercial |
$708.40
|
|
|
PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 26600
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$405.14 |
| Rate for Payer: Aetna Commercial |
$377.01
|
| Rate for Payer: Aetna Medicare |
$292.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.01
|
| Rate for Payer: BCBS Complete |
$220.00
|
| Rate for Payer: BCBS MAPPO |
$281.35
|
| Rate for Payer: BCN Medicare Advantage |
$281.35
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cofinity Commercial |
$405.14
|
| Rate for Payer: Cofinity Commercial |
$377.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$295.42
|
| Rate for Payer: Nomi Health Commercial |
$337.62
|
| Rate for Payer: PACE SWMI |
$281.35
|
| Rate for Payer: PHP Commercial |
$393.89
|
| Rate for Payer: PHP Medicare Advantage |
$281.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health Medicare |
$281.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.35
|
| Rate for Payer: UHC Medicare Advantage |
$281.35
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 26705
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$558.04 |
| Rate for Payer: Aetna Commercial |
$519.29
|
| Rate for Payer: Aetna Medicare |
$403.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.29
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS MAPPO |
$387.53
|
| Rate for Payer: BCN Medicare Advantage |
$387.53
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$558.04
|
| Rate for Payer: Cofinity Commercial |
$519.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.91
|
| Rate for Payer: Nomi Health Commercial |
$465.04
|
| Rate for Payer: PACE SWMI |
$387.53
|
| Rate for Payer: PHP Commercial |
$542.54
|
| Rate for Payer: PHP Medicare Advantage |
$387.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health Medicare |
$387.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.53
|
| Rate for Payer: UHC Medicare Advantage |
$387.53
|
| Rate for Payer: UMR Bronson Commercial |
$379.50
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 26700
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$446.10 |
| Rate for Payer: Aetna Commercial |
$415.12
|
| Rate for Payer: Aetna Medicare |
$322.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.12
|
| Rate for Payer: BCBS Complete |
$220.00
|
| Rate for Payer: BCBS MAPPO |
$309.79
|
| Rate for Payer: BCN Medicare Advantage |
$309.79
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cofinity Commercial |
$446.10
|
| Rate for Payer: Cofinity Commercial |
$415.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.28
|
| Rate for Payer: Nomi Health Commercial |
$371.75
|
| Rate for Payer: PACE SWMI |
$309.79
|
| Rate for Payer: PHP Commercial |
$433.71
|
| Rate for Payer: PHP Medicare Advantage |
$309.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health Medicare |
$309.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.79
|
| Rate for Payer: UHC Medicare Advantage |
$309.79
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
|
|
PR CLTX METAR FX W/MANJ
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 28475
|
| Min. Negotiated Rate |
$222.28 |
| Max. Negotiated Rate |
$481.65 |
| Rate for Payer: Aetna Commercial |
$297.86
|
| Rate for Payer: Aetna Medicare |
$231.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.86
|
| Rate for Payer: BCBS Complete |
$296.40
|
| Rate for Payer: BCBS MAPPO |
$222.28
|
| Rate for Payer: BCN Medicare Advantage |
$222.28
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cofinity Commercial |
$320.08
|
| Rate for Payer: Cofinity Commercial |
$297.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.39
|
| Rate for Payer: Nomi Health Commercial |
$266.74
|
| Rate for Payer: PACE SWMI |
$222.28
|
| Rate for Payer: PHP Commercial |
$311.19
|
| Rate for Payer: PHP Medicare Advantage |
$222.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.65
|
| Rate for Payer: Priority Health Medicare |
$222.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.28
|
| Rate for Payer: UHC Medicare Advantage |
$222.28
|
| Rate for Payer: UMR Bronson Commercial |
$340.86
|
|
|
PR CLTX METATARSOPHLNGL JT DISLC REQ ANES
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 28635
|
| Min. Negotiated Rate |
$125.29 |
| Max. Negotiated Rate |
$205.40 |
| Rate for Payer: Aetna Commercial |
$167.89
|
| Rate for Payer: Aetna Medicare |
$130.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.89
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS MAPPO |
$125.29
|
| Rate for Payer: BCN Medicare Advantage |
$125.29
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$180.42
|
| Rate for Payer: Cofinity Commercial |
$167.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.55
|
| Rate for Payer: Nomi Health Commercial |
$150.35
|
| Rate for Payer: PACE SWMI |
$125.29
|
| Rate for Payer: PHP Commercial |
$175.41
|
| Rate for Payer: PHP Medicare Advantage |
$125.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$125.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.29
|
| Rate for Payer: UHC Medicare Advantage |
$125.29
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
|
PR CLTX METATARSOPHLNGL JT DISLC W/O ANES
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 28630
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$206.70 |
| Rate for Payer: Aetna Commercial |
$144.08
|
| Rate for Payer: Aetna Medicare |
$111.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.08
|
| Rate for Payer: BCBS Complete |
$127.20
|
| Rate for Payer: BCBS MAPPO |
$107.52
|
| Rate for Payer: BCN Medicare Advantage |
$107.52
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$154.83
|
| Rate for Payer: Cofinity Commercial |
$144.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.90
|
| Rate for Payer: Nomi Health Commercial |
$129.02
|
| Rate for Payer: PACE SWMI |
$107.52
|
| Rate for Payer: PHP Commercial |
$150.53
|
| Rate for Payer: PHP Medicare Advantage |
$107.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health Medicare |
$107.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.52
|
| Rate for Payer: UHC Medicare Advantage |
$107.52
|
| Rate for Payer: UMR Bronson Commercial |
$146.28
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 26725
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$464.75 |
| Rate for Payer: Aetna Commercial |
$401.29
|
| Rate for Payer: Aetna Medicare |
$311.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.29
|
| Rate for Payer: BCBS Complete |
$286.00
|
| Rate for Payer: BCBS MAPPO |
$299.47
|
| Rate for Payer: BCN Medicare Advantage |
$299.47
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$431.24
|
| Rate for Payer: Cofinity Commercial |
$401.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.44
|
| Rate for Payer: Nomi Health Commercial |
$359.36
|
| Rate for Payer: PACE SWMI |
$299.47
|
| Rate for Payer: PHP Commercial |
$419.26
|
| Rate for Payer: PHP Medicare Advantage |
$299.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.75
|
| Rate for Payer: Priority Health Medicare |
$299.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.47
|
| Rate for Payer: UHC Medicare Advantage |
$299.47
|
| Rate for Payer: UMR Bronson Commercial |
$328.90
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 26720
|
| Min. Negotiated Rate |
$164.80 |
| Max. Negotiated Rate |
$268.29 |
| Rate for Payer: Aetna Commercial |
$249.66
|
| Rate for Payer: Aetna Medicare |
$193.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.66
|
| Rate for Payer: BCBS Complete |
$164.80
|
| Rate for Payer: BCBS MAPPO |
$186.31
|
| Rate for Payer: BCN Medicare Advantage |
$186.31
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$268.29
|
| Rate for Payer: Cofinity Commercial |
$249.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.63
|
| Rate for Payer: Nomi Health Commercial |
$223.57
|
| Rate for Payer: PACE SWMI |
$186.31
|
| Rate for Payer: PHP Commercial |
$260.83
|
| Rate for Payer: PHP Medicare Advantage |
$186.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health Medicare |
$186.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.31
|
| Rate for Payer: UHC Medicare Advantage |
$186.31
|
| Rate for Payer: UMR Bronson Commercial |
$189.52
|
|
|
PR CLTX POST HIP ARTHRP DISLC REQ ANES
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 27266
|
| Min. Negotiated Rate |
$562.29 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Commercial |
$753.47
|
| Rate for Payer: Aetna Medicare |
$584.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.47
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS MAPPO |
$562.29
|
| Rate for Payer: BCN Medicare Advantage |
$562.29
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$809.70
|
| Rate for Payer: Cofinity Commercial |
$753.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.40
|
| Rate for Payer: Nomi Health Commercial |
$674.75
|
| Rate for Payer: PACE SWMI |
$562.29
|
| Rate for Payer: PHP Commercial |
$787.21
|
| Rate for Payer: PHP Medicare Advantage |
$562.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health Medicare |
$562.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$562.29
|
| Rate for Payer: UHC Medicare Advantage |
$562.29
|
| Rate for Payer: UMR Bronson Commercial |
$703.80
|
|
|
PR CLTX POST HIP ARTHRP DISLC W/O ANES
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 27265
|
| Min. Negotiated Rate |
$296.80 |
| Max. Negotiated Rate |
$587.20 |
| Rate for Payer: Aetna Commercial |
$546.43
|
| Rate for Payer: Aetna Medicare |
$424.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.43
|
| Rate for Payer: BCBS Complete |
$296.80
|
| Rate for Payer: BCBS MAPPO |
$407.78
|
| Rate for Payer: BCN Medicare Advantage |
$407.78
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$587.20
|
| Rate for Payer: Cofinity Commercial |
$546.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.17
|
| Rate for Payer: Nomi Health Commercial |
$489.34
|
| Rate for Payer: PACE SWMI |
$407.78
|
| Rate for Payer: PHP Commercial |
$570.89
|
| Rate for Payer: PHP Medicare Advantage |
$407.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.30
|
| Rate for Payer: Priority Health Medicare |
$407.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.78
|
| Rate for Payer: UHC Medicare Advantage |
$407.78
|
| Rate for Payer: UMR Bronson Commercial |
$341.32
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/MANJ
|
Professional
|
Both
|
$1,212.00
|
|
|
Service Code
|
HCPCS 27781
|
| Min. Negotiated Rate |
$393.23 |
| Max. Negotiated Rate |
$787.80 |
| Rate for Payer: Aetna Commercial |
$526.93
|
| Rate for Payer: Aetna Medicare |
$408.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.93
|
| Rate for Payer: BCBS Complete |
$484.80
|
| Rate for Payer: BCBS MAPPO |
$393.23
|
| Rate for Payer: BCN Medicare Advantage |
$393.23
|
| Rate for Payer: Cash Price |
$969.60
|
| Rate for Payer: Cash Price |
$969.60
|
| Rate for Payer: Cofinity Commercial |
$566.25
|
| Rate for Payer: Cofinity Commercial |
$526.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.89
|
| Rate for Payer: Nomi Health Commercial |
$471.88
|
| Rate for Payer: PACE SWMI |
$393.23
|
| Rate for Payer: PHP Commercial |
$550.52
|
| Rate for Payer: PHP Medicare Advantage |
$393.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.80
|
| Rate for Payer: Priority Health Medicare |
$393.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.23
|
| Rate for Payer: UHC Medicare Advantage |
$393.23
|
| Rate for Payer: UMR Bronson Commercial |
$557.52
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/O MANJ
|
Professional
|
Both
|
$666.00
|
|
|
Service Code
|
HCPCS 27780
|
| Min. Negotiated Rate |
$266.40 |
| Max. Negotiated Rate |
$432.90 |
| Rate for Payer: Aetna Commercial |
$373.73
|
| Rate for Payer: Aetna Medicare |
$290.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.73
|
| Rate for Payer: BCBS Complete |
$266.40
|
| Rate for Payer: BCBS MAPPO |
$278.90
|
| Rate for Payer: BCN Medicare Advantage |
$278.90
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cofinity Commercial |
$401.62
|
| Rate for Payer: Cofinity Commercial |
$373.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.85
|
| Rate for Payer: Nomi Health Commercial |
$334.68
|
| Rate for Payer: PACE SWMI |
$278.90
|
| Rate for Payer: PHP Commercial |
$390.46
|
| Rate for Payer: PHP Medicare Advantage |
$278.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.90
|
| Rate for Payer: Priority Health Medicare |
$278.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.90
|
| Rate for Payer: UHC Medicare Advantage |
$278.90
|
| Rate for Payer: UMR Bronson Commercial |
$306.36
|
|
|
PR CLTX PROX HUMRL FX W/MNPJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 23605
|
| Min. Negotiated Rate |
$416.69 |
| Max. Negotiated Rate |
$925.60 |
| Rate for Payer: Aetna Commercial |
$558.36
|
| Rate for Payer: Aetna Medicare |
$433.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.36
|
| Rate for Payer: BCBS Complete |
$569.60
|
| Rate for Payer: BCBS MAPPO |
$416.69
|
| Rate for Payer: BCN Medicare Advantage |
$416.69
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$600.03
|
| Rate for Payer: Cofinity Commercial |
$558.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.52
|
| Rate for Payer: Nomi Health Commercial |
$500.03
|
| Rate for Payer: PACE SWMI |
$416.69
|
| Rate for Payer: PHP Commercial |
$583.37
|
| Rate for Payer: PHP Medicare Advantage |
$416.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health Medicare |
$416.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.69
|
| Rate for Payer: UHC Medicare Advantage |
$416.69
|
| Rate for Payer: UMR Bronson Commercial |
$655.04
|
|
|
PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 23600
|
| Min. Negotiated Rate |
$309.58 |
| Max. Negotiated Rate |
$510.25 |
| Rate for Payer: Aetna Commercial |
$414.84
|
| Rate for Payer: Aetna Medicare |
$321.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.84
|
| Rate for Payer: BCBS Complete |
$314.00
|
| Rate for Payer: BCBS MAPPO |
$309.58
|
| Rate for Payer: BCN Medicare Advantage |
$309.58
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cofinity Commercial |
$445.80
|
| Rate for Payer: Cofinity Commercial |
$414.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.06
|
| Rate for Payer: Nomi Health Commercial |
$371.50
|
| Rate for Payer: PACE SWMI |
$309.58
|
| Rate for Payer: PHP Commercial |
$433.41
|
| Rate for Payer: PHP Medicare Advantage |
$309.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.25
|
| Rate for Payer: Priority Health Medicare |
$309.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.58
|
| Rate for Payer: UHC Medicare Advantage |
$309.58
|
| Rate for Payer: UMR Bronson Commercial |
$361.10
|
|
