|
PR CLOSED TX KNEE DISLOCATION W/O ANESTHESIA
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 27550
|
| Min. Negotiated Rate |
$311.83 |
| Max. Negotiated Rate |
$768.20 |
| Rate for Payer: Aetna Commercial |
$615.13
|
| Rate for Payer: Aetna Medicare |
$477.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.03
|
| Rate for Payer: BCBS Complete |
$327.42
|
| Rate for Payer: BCBS MAPPO |
$459.05
|
| Rate for Payer: BCBS Trust/PPO |
$710.04
|
| Rate for Payer: BCN Commercial |
$768.20
|
| Rate for Payer: BCN Medicare Advantage |
$459.05
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$615.13
|
| Rate for Payer: Cofinity Commercial |
$661.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.00
|
| Rate for Payer: Meridian Medicaid |
$327.42
|
| Rate for Payer: Nomi Health Commercial |
$550.86
|
| Rate for Payer: PACE SWMI |
$459.05
|
| Rate for Payer: PHP Commercial |
$642.67
|
| Rate for Payer: PHP Medicare Advantage |
$459.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.35
|
| Rate for Payer: Priority Health Medicare |
$459.05
|
| Rate for Payer: Priority Health Narrow Network |
$738.35
|
| Rate for Payer: Priority Health SBD |
$738.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.05
|
| Rate for Payer: UHC Medicare Advantage |
$459.05
|
| Rate for Payer: UHCCP Medicaid |
$311.83
|
| Rate for Payer: UMR Bronson Commercial |
$388.70
|
|
|
PR CLOSED TX LUNATE DISLOCATION W/MANIPULATION
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 25690
|
| Min. Negotiated Rate |
$326.74 |
| Max. Negotiated Rate |
$2,554.86 |
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Aetna Commercial |
$640.96
|
| Rate for Payer: Aetna Medicare |
$497.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.80
|
| Rate for Payer: BCBS Complete |
$343.08
|
| Rate for Payer: BCBS MAPPO |
$478.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,554.86
|
| Rate for Payer: BCN Commercial |
$732.53
|
| Rate for Payer: BCN Medicare Advantage |
$478.33
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$640.96
|
| Rate for Payer: Cofinity Commercial |
$688.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.25
|
| Rate for Payer: Meridian Medicaid |
$343.08
|
| Rate for Payer: Nomi Health Commercial |
$574.00
|
| Rate for Payer: PACE SWMI |
$478.33
|
| Rate for Payer: PHP Commercial |
$669.66
|
| Rate for Payer: PHP Medicare Advantage |
$478.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.49
|
| Rate for Payer: Priority Health Medicare |
$478.33
|
| Rate for Payer: Priority Health Narrow Network |
$774.49
|
| Rate for Payer: Priority Health SBD |
$774.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.33
|
| Rate for Payer: UHC Medicare Advantage |
$478.33
|
| Rate for Payer: UHCCP Medicaid |
$326.74
|
| Rate for Payer: UMR Bronson Commercial |
$387.32
|
|
|
PR CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,207.00
|
|
|
Service Code
|
HCPCS 21451
|
| Min. Negotiated Rate |
$410.66 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$789.23
|
| Rate for Payer: Aetna Medicare |
$612.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.13
|
| Rate for Payer: BCBS Complete |
$431.19
|
| Rate for Payer: BCBS MAPPO |
$588.98
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,130.31
|
| Rate for Payer: BCN Medicare Advantage |
$588.98
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cofinity Commercial |
$789.23
|
| Rate for Payer: Cofinity Commercial |
$848.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.43
|
| Rate for Payer: Meridian Medicaid |
$431.19
|
| Rate for Payer: Nomi Health Commercial |
$706.78
|
| Rate for Payer: PACE SWMI |
$588.98
|
| Rate for Payer: PHP Commercial |
$824.57
|
| Rate for Payer: PHP Medicare Advantage |
$588.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$978.04
|
| Rate for Payer: Priority Health Medicare |
$588.98
|
| Rate for Payer: Priority Health Narrow Network |
$978.04
|
| Rate for Payer: Priority Health SBD |
$978.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.98
|
| Rate for Payer: UHC Medicare Advantage |
$588.98
|
| Rate for Payer: UHCCP Medicaid |
$410.66
|
| Rate for Payer: UMR Bronson Commercial |
$555.22
|
|
|
PR CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 21450
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$10,328.77 |
| Rate for Payer: Aetna Commercial |
$588.98
|
| Rate for Payer: Aetna Medicare |
$457.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.94
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$439.54
|
| Rate for Payer: BCBS Trust/PPO |
$10,328.77
|
| Rate for Payer: BCN Commercial |
$869.84
|
| Rate for Payer: BCN Medicare Advantage |
$439.54
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$588.98
|
| Rate for Payer: Cofinity Commercial |
$632.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.52
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Nomi Health Commercial |
$527.45
|
| Rate for Payer: PACE SWMI |
$439.54
|
| Rate for Payer: PHP Commercial |
$615.36
|
| Rate for Payer: PHP Medicare Advantage |
$439.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$733.78
|
| Rate for Payer: Priority Health Medicare |
$439.54
|
| Rate for Payer: Priority Health Narrow Network |
$733.78
|
| Rate for Payer: Priority Health SBD |
$733.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.54
|
| Rate for Payer: UHC Medicare Advantage |
$439.54
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
| Rate for Payer: UMR Bronson Commercial |
$538.20
|
|
|
PR CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 21453
|
| Min. Negotiated Rate |
$587.45 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$1,124.65
|
| Rate for Payer: Aetna Medicare |
$872.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,124.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,208.58
|
| Rate for Payer: BCBS Complete |
$616.82
|
| Rate for Payer: BCBS MAPPO |
$839.29
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,610.19
|
| Rate for Payer: BCN Medicare Advantage |
$839.29
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,124.65
|
| Rate for Payer: Cofinity Commercial |
$1,208.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$839.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$881.25
|
| Rate for Payer: Meridian Medicaid |
$616.82
|
| Rate for Payer: Nomi Health Commercial |
$1,007.15
|
| Rate for Payer: PACE SWMI |
$839.29
|
| Rate for Payer: PHP Commercial |
$1,175.01
|
| Rate for Payer: PHP Medicare Advantage |
$839.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$920.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,421.25
|
| Rate for Payer: Priority Health Medicare |
$839.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,421.25
|
| Rate for Payer: Priority Health SBD |
$1,421.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$839.29
|
| Rate for Payer: UHC Medicare Advantage |
$839.29
|
| Rate for Payer: UHCCP Medicaid |
$587.45
|
| Rate for Payer: UMR Bronson Commercial |
$651.36
|
|
|
PR CLOSED TX METATARSAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 28470
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$915.02 |
| Rate for Payer: Aetna Commercial |
$264.90
|
| Rate for Payer: Aetna Medicare |
$205.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.67
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$197.69
|
| Rate for Payer: BCBS Trust/PPO |
$915.02
|
| Rate for Payer: BCN Commercial |
$260.33
|
| Rate for Payer: BCN Medicare Advantage |
$197.69
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$264.90
|
| Rate for Payer: Cofinity Commercial |
$284.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.57
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Nomi Health Commercial |
$237.23
|
| Rate for Payer: PACE SWMI |
$197.69
|
| Rate for Payer: PHP Commercial |
$276.77
|
| Rate for Payer: PHP Medicare Advantage |
$197.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.65
|
| Rate for Payer: Priority Health Medicare |
$197.69
|
| Rate for Payer: Priority Health Narrow Network |
$324.65
|
| Rate for Payer: Priority Health SBD |
$324.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.69
|
| Rate for Payer: UHC Medicare Advantage |
$197.69
|
| Rate for Payer: UHCCP Medicaid |
$136.96
|
| Rate for Payer: UMR Bronson Commercial |
$247.94
|
|
|
PR CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 24620
|
| Min. Negotiated Rate |
$388.94 |
| Max. Negotiated Rate |
$1,066.00 |
| Rate for Payer: Aetna Commercial |
$765.57
|
| Rate for Payer: Aetna Medicare |
$594.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.70
|
| Rate for Payer: BCBS Complete |
$408.39
|
| Rate for Payer: BCBS MAPPO |
$571.32
|
| Rate for Payer: BCBS Trust/PPO |
$793.51
|
| Rate for Payer: BCN Commercial |
$872.29
|
| Rate for Payer: BCN Medicare Advantage |
$571.32
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cofinity Commercial |
$765.57
|
| Rate for Payer: Cofinity Commercial |
$822.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.89
|
| Rate for Payer: Meridian Medicaid |
$408.39
|
| Rate for Payer: Nomi Health Commercial |
$685.58
|
| Rate for Payer: PACE SWMI |
$571.32
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: PHP Medicare Advantage |
$571.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$920.53
|
| Rate for Payer: Priority Health Medicare |
$571.32
|
| Rate for Payer: Priority Health Narrow Network |
$920.53
|
| Rate for Payer: Priority Health SBD |
$920.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.32
|
| Rate for Payer: UHC Medicare Advantage |
$571.32
|
| Rate for Payer: UHCCP Medicaid |
$388.94
|
| Rate for Payer: UMR Bronson Commercial |
$754.40
|
|
|
PR CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 21315
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$2,948.86 |
| Rate for Payer: Aetna Commercial |
$77.00
|
| Rate for Payer: Aetna Medicare |
$59.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.74
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$57.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,948.86
|
| Rate for Payer: BCN Commercial |
$222.83
|
| Rate for Payer: BCN Medicare Advantage |
$57.46
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$82.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.33
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$68.95
|
| Rate for Payer: PACE SWMI |
$57.46
|
| Rate for Payer: PHP Commercial |
$80.44
|
| Rate for Payer: PHP Medicare Advantage |
$57.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.08
|
| Rate for Payer: Priority Health Medicare |
$57.46
|
| Rate for Payer: Priority Health Narrow Network |
$91.08
|
| Rate for Payer: Priority Health SBD |
$91.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.46
|
| Rate for Payer: UHC Medicare Advantage |
$57.46
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
| Rate for Payer: UMR Bronson Commercial |
$207.46
|
|
|
PR CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 21320
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$320.57 |
| Rate for Payer: Aetna Commercial |
$121.67
|
| Rate for Payer: Aetna Medicare |
$94.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.75
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$90.80
|
| Rate for Payer: BCBS Trust/PPO |
$140.42
|
| Rate for Payer: BCN Commercial |
$320.57
|
| Rate for Payer: BCN Medicare Advantage |
$90.80
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$121.67
|
| Rate for Payer: Cofinity Commercial |
$130.75
|
| 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: Meridian Medicaid |
$63.97
|
| 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 Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.03
|
| Rate for Payer: Priority Health Medicare |
$90.80
|
| Rate for Payer: Priority Health Narrow Network |
$145.03
|
| Rate for Payer: Priority Health SBD |
$145.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.80
|
| Rate for Payer: UHC Medicare Advantage |
$90.80
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
| Rate for Payer: UMR Bronson Commercial |
$190.90
|
|
|
PR CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 21337
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$616.71 |
| Rate for Payer: Aetna Commercial |
$383.44
|
| Rate for Payer: Aetna Medicare |
$297.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.06
|
| Rate for Payer: BCBS Complete |
$206.43
|
| Rate for Payer: BCBS MAPPO |
$286.15
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$616.71
|
| Rate for Payer: BCN Medicare Advantage |
$286.15
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$383.44
|
| Rate for Payer: Cofinity Commercial |
$412.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.46
|
| Rate for Payer: Meridian Medicaid |
$206.43
|
| Rate for Payer: Nomi Health Commercial |
$343.38
|
| Rate for Payer: PACE SWMI |
$286.15
|
| Rate for Payer: PHP Commercial |
$400.61
|
| Rate for Payer: PHP Medicare Advantage |
$286.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.10
|
| Rate for Payer: Priority Health Medicare |
$286.15
|
| Rate for Payer: Priority Health Narrow Network |
$465.10
|
| Rate for Payer: Priority Health SBD |
$465.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.15
|
| Rate for Payer: UHC Medicare Advantage |
$286.15
|
| Rate for Payer: UHCCP Medicaid |
$196.60
|
| Rate for Payer: UMR Bronson Commercial |
$302.68
|
|
|
PR CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT
|
Professional
|
Both
|
$1,328.00
|
|
|
Service Code
|
HCPCS 21421
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$684.22
|
| Rate for Payer: Aetna Medicare |
$531.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.28
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$510.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$943.64
|
| Rate for Payer: BCN Medicare Advantage |
$510.61
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cofinity Commercial |
$684.22
|
| Rate for Payer: Cofinity Commercial |
$735.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.14
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Nomi Health Commercial |
$612.73
|
| Rate for Payer: PACE SWMI |
$510.61
|
| Rate for Payer: PHP Commercial |
$714.85
|
| Rate for Payer: PHP Medicare Advantage |
$510.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$831.99
|
| Rate for Payer: Priority Health Medicare |
$510.61
|
| Rate for Payer: Priority Health Narrow Network |
$831.99
|
| Rate for Payer: Priority Health SBD |
$831.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.61
|
| Rate for Payer: UHC Medicare Advantage |
$510.61
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
| Rate for Payer: UMR Bronson Commercial |
$610.88
|
|
|
PR CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 27560
|
| Min. Negotiated Rate |
$228.12 |
| Max. Negotiated Rate |
$2,121.65 |
| Rate for Payer: Aetna Commercial |
$447.60
|
| Rate for Payer: Aetna Medicare |
$347.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.00
|
| Rate for Payer: BCBS Complete |
$239.53
|
| Rate for Payer: BCBS MAPPO |
$334.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.65
|
| Rate for Payer: BCN Commercial |
$561.98
|
| Rate for Payer: BCN Medicare Advantage |
$334.03
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$447.60
|
| Rate for Payer: Cofinity Commercial |
$481.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.73
|
| Rate for Payer: Meridian Medicaid |
$239.53
|
| Rate for Payer: Nomi Health Commercial |
$400.84
|
| Rate for Payer: PACE SWMI |
$334.03
|
| Rate for Payer: PHP Commercial |
$467.64
|
| Rate for Payer: PHP Medicare Advantage |
$334.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.43
|
| Rate for Payer: Priority Health Medicare |
$334.03
|
| Rate for Payer: Priority Health Narrow Network |
$541.43
|
| Rate for Payer: Priority Health SBD |
$541.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$334.03
|
| Rate for Payer: UHC Medicare Advantage |
$334.03
|
| Rate for Payer: UHCCP Medicaid |
$228.12
|
| Rate for Payer: UMR Bronson Commercial |
$282.44
|
|
|
PR CLOSED TX PATELLAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 27520
|
| Min. Negotiated Rate |
$49.13 |
| Max. Negotiated Rate |
$490.14 |
| Rate for Payer: Aetna Commercial |
$394.84
|
| Rate for Payer: Aetna Medicare |
$306.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.31
|
| Rate for Payer: BCBS Complete |
$213.14
|
| Rate for Payer: BCBS MAPPO |
$294.66
|
| Rate for Payer: BCBS Trust/PPO |
$49.13
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$294.66
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cofinity Commercial |
$394.84
|
| Rate for Payer: Cofinity Commercial |
$424.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.39
|
| Rate for Payer: Meridian Medicaid |
$213.14
|
| Rate for Payer: Nomi Health Commercial |
$353.59
|
| Rate for Payer: PACE SWMI |
$294.66
|
| Rate for Payer: PHP Commercial |
$412.52
|
| Rate for Payer: PHP Medicare Advantage |
$294.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.35
|
| Rate for Payer: Priority Health Medicare |
$294.66
|
| Rate for Payer: Priority Health Narrow Network |
$479.35
|
| Rate for Payer: Priority Health SBD |
$479.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.66
|
| Rate for Payer: UHC Medicare Advantage |
$294.66
|
| Rate for Payer: UHCCP Medicaid |
$202.99
|
| Rate for Payer: UMR Bronson Commercial |
$299.46
|
|
|
PR CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION
|
Professional
|
Both
|
$961.00
|
|
|
Service Code
|
HCPCS 24655
|
| Min. Negotiated Rate |
$270.94 |
| Max. Negotiated Rate |
$979.47 |
| Rate for Payer: Aetna Commercial |
$530.55
|
| Rate for Payer: Aetna Medicare |
$411.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.14
|
| Rate for Payer: BCBS Complete |
$284.49
|
| Rate for Payer: BCBS MAPPO |
$395.93
|
| Rate for Payer: BCBS Trust/PPO |
$979.47
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$395.93
|
| Rate for Payer: Cash Price |
$768.80
|
| Rate for Payer: Cash Price |
$768.80
|
| Rate for Payer: Cofinity Commercial |
$530.55
|
| Rate for Payer: Cofinity Commercial |
$570.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.73
|
| Rate for Payer: Meridian Medicaid |
$284.49
|
| Rate for Payer: Nomi Health Commercial |
$475.12
|
| Rate for Payer: PACE SWMI |
$395.93
|
| Rate for Payer: PHP Commercial |
$554.30
|
| Rate for Payer: PHP Medicare Advantage |
$395.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$644.22
|
| Rate for Payer: Priority Health Medicare |
$395.93
|
| Rate for Payer: Priority Health Narrow Network |
$644.22
|
| Rate for Payer: Priority Health SBD |
$644.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.93
|
| Rate for Payer: UHC Medicare Advantage |
$395.93
|
| Rate for Payer: UHCCP Medicaid |
$270.94
|
| Rate for Payer: UMR Bronson Commercial |
$442.06
|
|
|
PR CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION
|
Professional
|
Both
|
$645.00
|
|
|
Service Code
|
HCPCS 24650
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$1,113.13 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$252.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.39
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$242.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$320.02
|
| Rate for Payer: BCN Medicare Advantage |
$242.63
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cofinity Commercial |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$349.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.76
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Nomi Health Commercial |
$291.16
|
| Rate for Payer: PACE SWMI |
$242.63
|
| Rate for Payer: PHP Commercial |
$339.68
|
| Rate for Payer: PHP Medicare Advantage |
$242.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$393.87
|
| Rate for Payer: Priority Health Medicare |
$242.63
|
| Rate for Payer: Priority Health Narrow Network |
$393.87
|
| Rate for Payer: Priority Health SBD |
$393.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.63
|
| Rate for Payer: UHC Medicare Advantage |
$242.63
|
| Rate for Payer: UHCCP Medicaid |
$167.63
|
| Rate for Payer: UMR Bronson Commercial |
$296.70
|
|
|
PR CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,270.00
|
|
|
Service Code
|
HCPCS 25505
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$1,458.11 |
| Rate for Payer: Aetna Commercial |
$603.03
|
| Rate for Payer: Aetna Medicare |
$468.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.03
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$450.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.11
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$450.02
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cofinity Commercial |
$603.03
|
| Rate for Payer: Cofinity Commercial |
$648.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.52
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Nomi Health Commercial |
$540.02
|
| Rate for Payer: PACE SWMI |
$450.02
|
| Rate for Payer: PHP Commercial |
$630.03
|
| Rate for Payer: PHP Medicare Advantage |
$450.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$825.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$729.20
|
| Rate for Payer: Priority Health Medicare |
$450.02
|
| Rate for Payer: Priority Health Narrow Network |
$729.20
|
| Rate for Payer: Priority Health SBD |
$729.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$450.02
|
| Rate for Payer: UHC Medicare Advantage |
$450.02
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
| Rate for Payer: UMR Bronson Commercial |
$584.20
|
|
|
PR CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 25500
|
| Min. Negotiated Rate |
$175.09 |
| Max. Negotiated Rate |
$1,850.63 |
| Rate for Payer: Aetna Commercial |
$340.29
|
| Rate for Payer: Aetna Medicare |
$264.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.69
|
| Rate for Payer: BCBS Complete |
$183.84
|
| Rate for Payer: BCBS MAPPO |
$253.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.63
|
| Rate for Payer: BCN Commercial |
$429.06
|
| Rate for Payer: BCN Medicare Advantage |
$253.95
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cofinity Commercial |
$340.29
|
| Rate for Payer: Cofinity Commercial |
$365.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.65
|
| Rate for Payer: Meridian Medicaid |
$183.84
|
| Rate for Payer: Nomi Health Commercial |
$304.74
|
| Rate for Payer: PACE SWMI |
$253.95
|
| Rate for Payer: PHP Commercial |
$355.53
|
| Rate for Payer: PHP Medicare Advantage |
$253.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$412.68
|
| Rate for Payer: Priority Health Medicare |
$253.95
|
| Rate for Payer: Priority Health Narrow Network |
$412.68
|
| Rate for Payer: Priority Health SBD |
$412.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.95
|
| Rate for Payer: UHC Medicare Advantage |
$253.95
|
| Rate for Payer: UHCCP Medicaid |
$175.09
|
| Rate for Payer: UMR Bronson Commercial |
$207.46
|
|
|
PR CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MNPJ
|
Professional
|
Both
|
$1,428.00
|
|
|
Service Code
|
HCPCS 25565
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$2,806.33 |
| Rate for Payer: Aetna Commercial |
$607.62
|
| Rate for Payer: Aetna Medicare |
$471.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.97
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCBS MAPPO |
$453.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,806.33
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$453.45
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cofinity Commercial |
$607.62
|
| Rate for Payer: Cofinity Commercial |
$652.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.12
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: Nomi Health Commercial |
$544.14
|
| Rate for Payer: PACE SWMI |
$453.45
|
| Rate for Payer: PHP Commercial |
$634.83
|
| Rate for Payer: PHP Medicare Advantage |
$453.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$733.26
|
| Rate for Payer: Priority Health Medicare |
$453.45
|
| Rate for Payer: Priority Health Narrow Network |
$733.26
|
| Rate for Payer: Priority Health SBD |
$733.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.45
|
| Rate for Payer: UHC Medicare Advantage |
$453.45
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
| Rate for Payer: UMR Bronson Commercial |
$656.88
|
|
|
PR CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MNPJ
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 25560
|
| Min. Negotiated Rate |
$175.94 |
| Max. Negotiated Rate |
$1,599.69 |
| Rate for Payer: Aetna Commercial |
$341.94
|
| Rate for Payer: Aetna Medicare |
$265.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.46
|
| Rate for Payer: BCBS Complete |
$184.74
|
| Rate for Payer: BCBS MAPPO |
$255.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.69
|
| Rate for Payer: BCN Commercial |
$351.82
|
| Rate for Payer: BCN Medicare Advantage |
$255.18
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$341.94
|
| Rate for Payer: Cofinity Commercial |
$367.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.94
|
| Rate for Payer: Meridian Medicaid |
$184.74
|
| Rate for Payer: Nomi Health Commercial |
$306.22
|
| Rate for Payer: PACE SWMI |
$255.18
|
| Rate for Payer: PHP Commercial |
$357.25
|
| Rate for Payer: PHP Medicare Advantage |
$255.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.72
|
| Rate for Payer: Priority Health Medicare |
$255.18
|
| Rate for Payer: Priority Health Narrow Network |
$414.72
|
| Rate for Payer: Priority Health SBD |
$414.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.18
|
| Rate for Payer: UHC Medicare Advantage |
$255.18
|
| Rate for Payer: UHCCP Medicaid |
$175.94
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 23570
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$553.66 |
| Rate for Payer: Aetna Commercial |
$320.30
|
| Rate for Payer: Aetna Medicare |
$248.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.20
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$239.03
|
| Rate for Payer: BCBS Trust/PPO |
$553.66
|
| Rate for Payer: BCN Commercial |
$353.31
|
| Rate for Payer: BCN Medicare Advantage |
$239.03
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$320.30
|
| Rate for Payer: Cofinity Commercial |
$344.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.98
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Nomi Health Commercial |
$286.84
|
| Rate for Payer: PACE SWMI |
$239.03
|
| Rate for Payer: PHP Commercial |
$334.64
|
| Rate for Payer: PHP Medicare Advantage |
$239.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.75
|
| Rate for Payer: Priority Health Medicare |
$239.03
|
| Rate for Payer: Priority Health Narrow Network |
$387.75
|
| Rate for Payer: Priority Health SBD |
$387.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.03
|
| Rate for Payer: UHC Medicare Advantage |
$239.03
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
| Rate for Payer: UMR Bronson Commercial |
$282.44
|
|
|
PR CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 23525
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$595.21 |
| Rate for Payer: Aetna Commercial |
$476.89
|
| Rate for Payer: Aetna Medicare |
$370.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.48
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$355.89
|
| Rate for Payer: BCBS Trust/PPO |
$399.45
|
| Rate for Payer: BCN Commercial |
$595.21
|
| Rate for Payer: BCN Medicare Advantage |
$355.89
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$476.89
|
| Rate for Payer: Cofinity Commercial |
$512.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.68
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Nomi Health Commercial |
$427.07
|
| Rate for Payer: PACE SWMI |
$355.89
|
| Rate for Payer: PHP Commercial |
$498.25
|
| Rate for Payer: PHP Medicare Advantage |
$355.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.54
|
| Rate for Payer: Priority Health Medicare |
$355.89
|
| Rate for Payer: Priority Health Narrow Network |
$576.54
|
| Rate for Payer: Priority Health SBD |
$576.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.89
|
| Rate for Payer: UHC Medicare Advantage |
$355.89
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
| Rate for Payer: UMR Bronson Commercial |
$360.18
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLC W/O ANES
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 28570
|
| Min. Negotiated Rate |
$133.55 |
| Max. Negotiated Rate |
$1,383.62 |
| Rate for Payer: Aetna Commercial |
$258.69
|
| Rate for Payer: Aetna Medicare |
$200.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.99
|
| Rate for Payer: BCBS Complete |
$140.23
|
| Rate for Payer: BCBS MAPPO |
$193.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.62
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$193.05
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$258.69
|
| Rate for Payer: Cofinity Commercial |
$277.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.70
|
| Rate for Payer: Meridian Medicaid |
$140.23
|
| Rate for Payer: Nomi Health Commercial |
$231.66
|
| Rate for Payer: PACE SWMI |
$193.05
|
| Rate for Payer: PHP Commercial |
$270.27
|
| Rate for Payer: PHP Medicare Advantage |
$193.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.96
|
| Rate for Payer: Priority Health Medicare |
$193.05
|
| Rate for Payer: Priority Health Narrow Network |
$313.96
|
| Rate for Payer: Priority Health SBD |
$313.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.05
|
| Rate for Payer: UHC Medicare Advantage |
$193.05
|
| Rate for Payer: UHCCP Medicaid |
$133.55
|
| Rate for Payer: UMR Bronson Commercial |
$164.68
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28575
|
| Min. Negotiated Rate |
$227.27 |
| Max. Negotiated Rate |
$804.60 |
| Rate for Payer: Aetna Commercial |
$442.84
|
| Rate for Payer: Aetna Medicare |
$343.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$475.89
|
| Rate for Payer: BCBS Complete |
$238.63
|
| Rate for Payer: BCBS MAPPO |
$330.48
|
| Rate for Payer: BCBS Trust/PPO |
$804.60
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$330.48
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$442.84
|
| Rate for Payer: Cofinity Commercial |
$475.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.00
|
| Rate for Payer: Meridian Medicaid |
$238.63
|
| Rate for Payer: Nomi Health Commercial |
$396.58
|
| Rate for Payer: PACE SWMI |
$330.48
|
| Rate for Payer: PHP Commercial |
$462.67
|
| Rate for Payer: PHP Medicare Advantage |
$330.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.34
|
| Rate for Payer: Priority Health Medicare |
$330.48
|
| Rate for Payer: Priority Health Narrow Network |
$536.34
|
| Rate for Payer: Priority Health SBD |
$536.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.48
|
| Rate for Payer: UHC Medicare Advantage |
$330.48
|
| Rate for Payer: UHCCP Medicaid |
$227.27
|
| Rate for Payer: UMR Bronson Commercial |
$371.68
|
|
|
PR CLOSED TX TALUS FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28435
|
| Min. Negotiated Rate |
$219.82 |
| Max. Negotiated Rate |
$1,149.05 |
| Rate for Payer: Aetna Commercial |
$429.34
|
| Rate for Payer: Aetna Medicare |
$333.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.38
|
| Rate for Payer: BCBS Complete |
$230.81
|
| Rate for Payer: BCBS MAPPO |
$320.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.05
|
| Rate for Payer: BCN Commercial |
$553.67
|
| Rate for Payer: BCN Medicare Advantage |
$320.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$429.34
|
| Rate for Payer: Cofinity Commercial |
$461.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.42
|
| Rate for Payer: Meridian Medicaid |
$230.81
|
| Rate for Payer: Nomi Health Commercial |
$384.48
|
| Rate for Payer: PACE SWMI |
$320.40
|
| Rate for Payer: PHP Commercial |
$448.56
|
| Rate for Payer: PHP Medicare Advantage |
$320.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$320.40
|
| Rate for Payer: Priority Health Narrow Network |
$519.03
|
| Rate for Payer: Priority Health SBD |
$519.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.40
|
| Rate for Payer: UHC Medicare Advantage |
$320.40
|
| Rate for Payer: UHCCP Medicaid |
$219.82
|
| Rate for Payer: UMR Bronson Commercial |
$371.68
|
|
|
PR CLOSED TX TALUS FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 28430
|
| Min. Negotiated Rate |
$141.01 |
| Max. Negotiated Rate |
$540.45 |
| Rate for Payer: Aetna Commercial |
$274.06
|
| Rate for Payer: Aetna Medicare |
$212.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.51
|
| Rate for Payer: BCBS Complete |
$148.06
|
| Rate for Payer: BCBS MAPPO |
$204.52
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$358.20
|
| Rate for Payer: BCN Medicare Advantage |
$204.52
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$274.06
|
| Rate for Payer: Cofinity Commercial |
$294.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.75
|
| Rate for Payer: Meridian Medicaid |
$148.06
|
| Rate for Payer: Nomi Health Commercial |
$245.42
|
| Rate for Payer: PACE SWMI |
$204.52
|
| Rate for Payer: PHP Commercial |
$286.33
|
| Rate for Payer: PHP Medicare Advantage |
$204.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.30
|
| Rate for Payer: Priority Health Medicare |
$204.52
|
| Rate for Payer: Priority Health Narrow Network |
$333.30
|
| Rate for Payer: Priority Health SBD |
$333.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.52
|
| Rate for Payer: UHC Medicare Advantage |
$204.52
|
| Rate for Payer: UHCCP Medicaid |
$141.01
|
| Rate for Payer: UMR Bronson Commercial |
$309.58
|
|
