|
PR CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 26641
|
| Min. Negotiated Rate |
$256.67 |
| Max. Negotiated Rate |
$628.93 |
| Rate for Payer: Aetna Commercial |
$501.28
|
| Rate for Payer: Aetna Medicare |
$389.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.69
|
| Rate for Payer: BCBS Complete |
$269.50
|
| Rate for Payer: BCBS MAPPO |
$374.09
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$628.93
|
| Rate for Payer: BCN Medicare Advantage |
$374.09
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$501.28
|
| Rate for Payer: Cofinity Commercial |
$538.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.79
|
| Rate for Payer: Meridian Medicaid |
$269.50
|
| Rate for Payer: Nomi Health Commercial |
$448.91
|
| Rate for Payer: PACE SWMI |
$374.09
|
| Rate for Payer: PHP Commercial |
$523.73
|
| Rate for Payer: PHP Medicare Advantage |
$374.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.57
|
| Rate for Payer: Priority Health Medicare |
$374.09
|
| Rate for Payer: Priority Health Narrow Network |
$606.57
|
| Rate for Payer: Priority Health SBD |
$606.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.09
|
| Rate for Payer: UHC Medicare Advantage |
$374.09
|
| Rate for Payer: UHCCP Medicaid |
$256.67
|
| Rate for Payer: UMR Bronson Commercial |
$345.46
|
|
|
PR CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 26645
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$661.70 |
| Rate for Payer: Aetna Commercial |
$518.15
|
| Rate for Payer: Aetna Medicare |
$402.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.82
|
| Rate for Payer: BCBS Complete |
$277.55
|
| Rate for Payer: BCBS MAPPO |
$386.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$649.45
|
| Rate for Payer: BCN Medicare Advantage |
$386.68
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cofinity Commercial |
$518.15
|
| Rate for Payer: Cofinity Commercial |
$556.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.01
|
| Rate for Payer: Meridian Medicaid |
$277.55
|
| Rate for Payer: Nomi Health Commercial |
$464.02
|
| Rate for Payer: PACE SWMI |
$386.68
|
| Rate for Payer: PHP Commercial |
$541.35
|
| Rate for Payer: PHP Medicare Advantage |
$386.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$661.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$625.38
|
| Rate for Payer: Priority Health Medicare |
$386.68
|
| Rate for Payer: Priority Health Narrow Network |
$625.38
|
| Rate for Payer: Priority Health SBD |
$625.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.68
|
| Rate for Payer: UHC Medicare Advantage |
$386.68
|
| Rate for Payer: UHCCP Medicaid |
$264.33
|
| Rate for Payer: UMR Bronson Commercial |
$468.28
|
|
|
PR CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 26670
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$524.35 |
| Rate for Payer: Aetna Commercial |
$417.83
|
| Rate for Payer: Aetna Medicare |
$324.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.01
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$311.81
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$524.35
|
| Rate for Payer: BCN Medicare Advantage |
$311.81
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cofinity Commercial |
$417.83
|
| Rate for Payer: Cofinity Commercial |
$449.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.40
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Nomi Health Commercial |
$374.17
|
| Rate for Payer: PACE SWMI |
$311.81
|
| Rate for Payer: PHP Commercial |
$436.53
|
| Rate for Payer: PHP Medicare Advantage |
$311.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.69
|
| Rate for Payer: Priority Health Medicare |
$311.81
|
| Rate for Payer: Priority Health Narrow Network |
$498.69
|
| Rate for Payer: Priority Health SBD |
$498.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.81
|
| Rate for Payer: UHC Medicare Advantage |
$311.81
|
| Rate for Payer: UHCCP Medicaid |
$212.57
|
| Rate for Payer: UMR Bronson Commercial |
$278.30
|
|
|
PR CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 26675
|
| Min. Negotiated Rate |
$46.70 |
| Max. Negotiated Rate |
$822.25 |
| Rate for Payer: Aetna Commercial |
$553.86
|
| Rate for Payer: Aetna Medicare |
$429.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.20
|
| Rate for Payer: BCBS Complete |
$296.78
|
| Rate for Payer: BCBS MAPPO |
$413.33
|
| Rate for Payer: BCBS Trust/PPO |
$46.70
|
| Rate for Payer: BCN Commercial |
$692.95
|
| Rate for Payer: BCN Medicare Advantage |
$413.33
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$553.86
|
| Rate for Payer: Cofinity Commercial |
$595.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.00
|
| Rate for Payer: Meridian Medicaid |
$296.78
|
| Rate for Payer: Nomi Health Commercial |
$496.00
|
| Rate for Payer: PACE SWMI |
$413.33
|
| Rate for Payer: PHP Commercial |
$578.66
|
| Rate for Payer: PHP Medicare Advantage |
$413.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.13
|
| Rate for Payer: Priority Health Medicare |
$413.33
|
| Rate for Payer: Priority Health Narrow Network |
$668.13
|
| Rate for Payer: Priority Health SBD |
$668.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.33
|
| Rate for Payer: UHC Medicare Advantage |
$413.33
|
| Rate for Payer: UHCCP Medicaid |
$282.65
|
| Rate for Payer: UMR Bronson Commercial |
$581.90
|
|
|
PR CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ
|
Professional
|
Both
|
$1,306.00
|
|
|
Service Code
|
HCPCS 27516
|
| Min. Negotiated Rate |
$322.91 |
| Max. Negotiated Rate |
$1,829.50 |
| Rate for Payer: Aetna Commercial |
$633.24
|
| Rate for Payer: Aetna Medicare |
$491.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.50
|
| Rate for Payer: BCBS Complete |
$339.06
|
| Rate for Payer: BCBS MAPPO |
$472.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,829.50
|
| Rate for Payer: BCN Commercial |
$773.09
|
| Rate for Payer: BCN Medicare Advantage |
$472.57
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Cofinity Commercial |
$633.24
|
| Rate for Payer: Cofinity Commercial |
$680.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.20
|
| Rate for Payer: Meridian Medicaid |
$339.06
|
| Rate for Payer: Nomi Health Commercial |
$567.08
|
| Rate for Payer: PACE SWMI |
$472.57
|
| Rate for Payer: PHP Commercial |
$661.60
|
| Rate for Payer: PHP Medicare Advantage |
$472.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.81
|
| Rate for Payer: Priority Health Medicare |
$472.57
|
| Rate for Payer: Priority Health Narrow Network |
$763.81
|
| Rate for Payer: Priority Health SBD |
$763.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.57
|
| Rate for Payer: UHC Medicare Advantage |
$472.57
|
| Rate for Payer: UHCCP Medicaid |
$322.91
|
| Rate for Payer: UMR Bronson Commercial |
$600.76
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/MANJ
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 27788
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$882.05 |
| Rate for Payer: Aetna Commercial |
$503.42
|
| Rate for Payer: Aetna Medicare |
$390.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.99
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$375.69
|
| Rate for Payer: BCBS Trust/PPO |
$677.10
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Medicare Advantage |
$375.69
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$503.42
|
| Rate for Payer: Cofinity Commercial |
$540.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.47
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Nomi Health Commercial |
$450.83
|
| Rate for Payer: PACE SWMI |
$375.69
|
| Rate for Payer: PHP Commercial |
$525.97
|
| Rate for Payer: PHP Medicare Advantage |
$375.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$608.10
|
| Rate for Payer: Priority Health Medicare |
$375.69
|
| Rate for Payer: Priority Health Narrow Network |
$608.10
|
| Rate for Payer: Priority Health SBD |
$608.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.69
|
| Rate for Payer: UHC Medicare Advantage |
$375.69
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
| Rate for Payer: UMR Bronson Commercial |
$624.22
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ
|
Professional
|
Both
|
$775.00
|
|
|
Service Code
|
HCPCS 27786
|
| Min. Negotiated Rate |
$192.34 |
| Max. Negotiated Rate |
$2,764.24 |
| Rate for Payer: Aetna Commercial |
$374.24
|
| Rate for Payer: Aetna Medicare |
$290.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.16
|
| Rate for Payer: BCBS Complete |
$201.96
|
| Rate for Payer: BCBS MAPPO |
$279.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,764.24
|
| Rate for Payer: BCN Commercial |
$378.53
|
| Rate for Payer: BCN Medicare Advantage |
$279.28
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cofinity Commercial |
$374.24
|
| Rate for Payer: Cofinity Commercial |
$402.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.24
|
| Rate for Payer: Meridian Medicaid |
$201.96
|
| Rate for Payer: Nomi Health Commercial |
$335.14
|
| Rate for Payer: PACE SWMI |
$279.28
|
| Rate for Payer: PHP Commercial |
$390.99
|
| Rate for Payer: PHP Medicare Advantage |
$279.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$503.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.45
|
| Rate for Payer: Priority Health Medicare |
$279.28
|
| Rate for Payer: Priority Health Narrow Network |
$456.45
|
| Rate for Payer: Priority Health SBD |
$456.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.28
|
| Rate for Payer: UHC Medicare Advantage |
$279.28
|
| Rate for Payer: UHCCP Medicaid |
$192.34
|
| Rate for Payer: UMR Bronson Commercial |
$356.50
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 26755
|
| Min. Negotiated Rate |
$185.95 |
| Max. Negotiated Rate |
$1,776.67 |
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna Medicare |
$282.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.65
|
| Rate for Payer: BCBS Complete |
$195.25
|
| Rate for Payer: BCBS MAPPO |
$271.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,776.67
|
| Rate for Payer: BCN Commercial |
$482.81
|
| Rate for Payer: BCN Medicare Advantage |
$271.98
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cofinity Commercial |
$364.45
|
| Rate for Payer: Cofinity Commercial |
$391.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.58
|
| Rate for Payer: Meridian Medicaid |
$195.25
|
| Rate for Payer: Nomi Health Commercial |
$326.38
|
| Rate for Payer: PACE SWMI |
$271.98
|
| Rate for Payer: PHP Commercial |
$380.77
|
| Rate for Payer: PHP Medicare Advantage |
$271.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.09
|
| Rate for Payer: Priority Health Medicare |
$271.98
|
| Rate for Payer: Priority Health Narrow Network |
$436.09
|
| Rate for Payer: Priority Health SBD |
$436.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.98
|
| Rate for Payer: UHC Medicare Advantage |
$271.98
|
| Rate for Payer: UHCCP Medicaid |
$185.95
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$945.13 |
| Rate for Payer: Aetna Commercial |
$251.91
|
| Rate for Payer: Aetna Medicare |
$195.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.71
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$187.99
|
| Rate for Payer: BCBS Trust/PPO |
$945.13
|
| Rate for Payer: BCN Commercial |
$283.92
|
| Rate for Payer: BCN Medicare Advantage |
$187.99
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$251.91
|
| Rate for Payer: Cofinity Commercial |
$270.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.39
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Nomi Health Commercial |
$225.59
|
| Rate for Payer: PACE SWMI |
$187.99
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: PHP Medicare Advantage |
$187.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.32
|
| Rate for Payer: Priority Health Medicare |
$187.99
|
| Rate for Payer: Priority Health Narrow Network |
$305.32
|
| Rate for Payer: Priority Health SBD |
$305.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.99
|
| Rate for Payer: UHC Medicare Advantage |
$187.99
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
| Rate for Payer: UMR Bronson Commercial |
$189.52
|
|
|
PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ
|
Professional
|
Both
|
$754.00
|
|
|
Service Code
|
HCPCS 25600
|
| Min. Negotiated Rate |
$220.03 |
| Max. Negotiated Rate |
$579.96 |
| Rate for Payer: Aetna Commercial |
$424.75
|
| Rate for Payer: Aetna Medicare |
$329.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.45
|
| Rate for Payer: BCBS Complete |
$231.03
|
| Rate for Payer: BCBS MAPPO |
$316.98
|
| Rate for Payer: BCBS Trust/PPO |
$579.96
|
| Rate for Payer: BCN Commercial |
$410.33
|
| Rate for Payer: BCN Medicare Advantage |
$316.98
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Cofinity Commercial |
$424.75
|
| Rate for Payer: Cofinity Commercial |
$456.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.83
|
| Rate for Payer: Meridian Medicaid |
$231.03
|
| Rate for Payer: Nomi Health Commercial |
$380.38
|
| Rate for Payer: PACE SWMI |
$316.98
|
| Rate for Payer: PHP Commercial |
$443.77
|
| Rate for Payer: PHP Medicare Advantage |
$316.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$518.03
|
| Rate for Payer: Priority Health Medicare |
$316.98
|
| Rate for Payer: Priority Health Narrow Network |
$518.03
|
| Rate for Payer: Priority Health SBD |
$518.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.98
|
| Rate for Payer: UHC Medicare Advantage |
$316.98
|
| Rate for Payer: UHCCP Medicaid |
$220.03
|
| Rate for Payer: UMR Bronson Commercial |
$346.84
|
|
|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MNPJ
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$902.20 |
| Rate for Payer: Aetna Commercial |
$667.56
|
| Rate for Payer: Aetna Medicare |
$518.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.38
|
| Rate for Payer: BCBS Complete |
$356.28
|
| Rate for Payer: BCBS MAPPO |
$498.18
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$808.76
|
| Rate for Payer: BCN Medicare Advantage |
$498.18
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$667.56
|
| Rate for Payer: Cofinity Commercial |
$717.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.09
|
| Rate for Payer: Meridian Medicaid |
$356.28
|
| Rate for Payer: Nomi Health Commercial |
$597.82
|
| Rate for Payer: PACE SWMI |
$498.18
|
| Rate for Payer: PHP Commercial |
$697.45
|
| Rate for Payer: PHP Medicare Advantage |
$498.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$805.02
|
| Rate for Payer: Priority Health Medicare |
$498.18
|
| Rate for Payer: Priority Health Narrow Network |
$805.02
|
| Rate for Payer: Priority Health SBD |
$805.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.18
|
| Rate for Payer: UHC Medicare Advantage |
$498.18
|
| Rate for Payer: UHCCP Medicaid |
$339.31
|
| Rate for Payer: UMR Bronson Commercial |
$638.48
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,047.00
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$257.28 |
| Max. Negotiated Rate |
$843.18 |
| Rate for Payer: Aetna Commercial |
$677.45
|
| Rate for Payer: Aetna Medicare |
$525.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.01
|
| Rate for Payer: BCBS Complete |
$369.47
|
| Rate for Payer: BCBS MAPPO |
$505.56
|
| Rate for Payer: BCBS Trust/PPO |
$257.28
|
| Rate for Payer: BCN Commercial |
$812.67
|
| Rate for Payer: BCN Medicare Advantage |
$505.56
|
| Rate for Payer: Cash Price |
$837.60
|
| Rate for Payer: Cash Price |
$837.60
|
| Rate for Payer: Cofinity Commercial |
$677.45
|
| Rate for Payer: Cofinity Commercial |
$728.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.84
|
| Rate for Payer: Meridian Medicaid |
$369.47
|
| Rate for Payer: Nomi Health Commercial |
$606.67
|
| Rate for Payer: PACE SWMI |
$505.56
|
| Rate for Payer: PHP Commercial |
$707.78
|
| Rate for Payer: PHP Medicare Advantage |
$505.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$843.18
|
| Rate for Payer: Priority Health Medicare |
$505.56
|
| Rate for Payer: Priority Health Narrow Network |
$843.18
|
| Rate for Payer: Priority Health SBD |
$843.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.56
|
| Rate for Payer: UHC Medicare Advantage |
$505.56
|
| Rate for Payer: UHCCP Medicaid |
$351.88
|
| Rate for Payer: UMR Bronson Commercial |
$481.62
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 27510
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,056.40 |
| Rate for Payer: Aetna Commercial |
$884.04
|
| Rate for Payer: Aetna Medicare |
$686.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.01
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$659.73
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$1,005.70
|
| Rate for Payer: BCN Medicare Advantage |
$659.73
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cofinity Commercial |
$884.04
|
| Rate for Payer: Cofinity Commercial |
$950.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.72
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Nomi Health Commercial |
$791.68
|
| Rate for Payer: PACE SWMI |
$659.73
|
| Rate for Payer: PHP Commercial |
$923.62
|
| Rate for Payer: PHP Medicare Advantage |
$659.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,056.40
|
| Rate for Payer: Priority Health Medicare |
$659.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,056.40
|
| Rate for Payer: Priority Health SBD |
$1,056.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.73
|
| Rate for Payer: UHC Medicare Advantage |
$659.73
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
| Rate for Payer: UMR Bronson Commercial |
$651.82
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 27508
|
| Min. Negotiated Rate |
$329.51 |
| Max. Negotiated Rate |
$781.39 |
| Rate for Payer: Aetna Commercial |
$648.98
|
| Rate for Payer: Aetna Medicare |
$503.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.41
|
| Rate for Payer: BCBS Complete |
$345.99
|
| Rate for Payer: BCBS MAPPO |
$484.31
|
| Rate for Payer: BCBS Trust/PPO |
$738.04
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$484.31
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$648.98
|
| Rate for Payer: Cofinity Commercial |
$697.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.53
|
| Rate for Payer: Meridian Medicaid |
$345.99
|
| Rate for Payer: Nomi Health Commercial |
$581.17
|
| Rate for Payer: PACE SWMI |
$484.31
|
| Rate for Payer: PHP Commercial |
$678.03
|
| Rate for Payer: PHP Medicare Advantage |
$484.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$715.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$780.09
|
| Rate for Payer: Priority Health Medicare |
$484.31
|
| Rate for Payer: Priority Health Narrow Network |
$780.09
|
| Rate for Payer: Priority Health SBD |
$780.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.31
|
| Rate for Payer: UHC Medicare Advantage |
$484.31
|
| Rate for Payer: UHCCP Medicaid |
$329.51
|
| Rate for Payer: UMR Bronson Commercial |
$506.00
|
|
|
PR CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,373.00
|
|
|
Service Code
|
HCPCS 27232
|
| Min. Negotiated Rate |
$473.50 |
| Max. Negotiated Rate |
$1,117.45 |
| Rate for Payer: Aetna Commercial |
$950.37
|
| Rate for Payer: Aetna Medicare |
$737.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.37
|
| Rate for Payer: BCBS Complete |
$497.18
|
| Rate for Payer: BCBS MAPPO |
$709.23
|
| Rate for Payer: BCBS Trust/PPO |
$835.77
|
| Rate for Payer: BCN Commercial |
$1,065.80
|
| Rate for Payer: BCN Medicare Advantage |
$709.23
|
| Rate for Payer: Cash Price |
$1,098.40
|
| Rate for Payer: Cash Price |
$1,098.40
|
| Rate for Payer: Cofinity Commercial |
$1,021.29
|
| Rate for Payer: Cofinity Commercial |
$950.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.69
|
| Rate for Payer: Meridian Medicaid |
$497.18
|
| Rate for Payer: Nomi Health Commercial |
$851.08
|
| Rate for Payer: PACE SWMI |
$709.23
|
| Rate for Payer: PHP Commercial |
$992.92
|
| Rate for Payer: PHP Medicare Advantage |
$709.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.45
|
| Rate for Payer: Priority Health Medicare |
$709.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.45
|
| Rate for Payer: Priority Health SBD |
$1,117.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.23
|
| Rate for Payer: UHC Medicare Advantage |
$709.23
|
| Rate for Payer: UHCCP Medicaid |
$473.50
|
| Rate for Payer: UMR Bronson Commercial |
$631.58
|
|
|
PR CLTX FEM FX PROX END NCK W/O MANJ
|
Professional
|
Both
|
$999.00
|
|
|
Service Code
|
HCPCS 27230
|
| Min. Negotiated Rate |
$315.67 |
| Max. Negotiated Rate |
$806.71 |
| Rate for Payer: Aetna Commercial |
$620.89
|
| Rate for Payer: Aetna Medicare |
$481.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.22
|
| Rate for Payer: BCBS Complete |
$331.45
|
| Rate for Payer: BCBS MAPPO |
$463.35
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$723.73
|
| Rate for Payer: BCN Medicare Advantage |
$463.35
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cofinity Commercial |
$620.89
|
| Rate for Payer: Cofinity Commercial |
$667.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.52
|
| Rate for Payer: Meridian Medicaid |
$331.45
|
| Rate for Payer: Nomi Health Commercial |
$556.02
|
| Rate for Payer: PACE SWMI |
$463.35
|
| Rate for Payer: PHP Commercial |
$648.69
|
| Rate for Payer: PHP Medicare Advantage |
$463.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$749.54
|
| Rate for Payer: Priority Health Medicare |
$463.35
|
| Rate for Payer: Priority Health Narrow Network |
$749.54
|
| Rate for Payer: Priority Health SBD |
$749.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$463.35
|
| Rate for Payer: UHC Medicare Advantage |
$463.35
|
| Rate for Payer: UHCCP Medicaid |
$315.67
|
| Rate for Payer: UMR Bronson Commercial |
$459.54
|
|
|
PR CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ
|
Professional
|
Both
|
$1,832.00
|
|
|
Service Code
|
HCPCS 27502
|
| Min. Negotiated Rate |
$490.54 |
| Max. Negotiated Rate |
$1,190.80 |
| Rate for Payer: Aetna Commercial |
$979.66
|
| Rate for Payer: Aetna Medicare |
$760.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.66
|
| Rate for Payer: BCBS Complete |
$515.07
|
| Rate for Payer: BCBS MAPPO |
$731.09
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$1,111.74
|
| Rate for Payer: BCN Medicare Advantage |
$731.09
|
| Rate for Payer: Cash Price |
$1,465.60
|
| Rate for Payer: Cash Price |
$1,465.60
|
| Rate for Payer: Cofinity Commercial |
$1,052.77
|
| Rate for Payer: Cofinity Commercial |
$979.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.64
|
| Rate for Payer: Meridian Medicaid |
$515.07
|
| Rate for Payer: Nomi Health Commercial |
$877.31
|
| Rate for Payer: PACE SWMI |
$731.09
|
| Rate for Payer: PHP Commercial |
$1,023.53
|
| Rate for Payer: PHP Medicare Advantage |
$731.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,162.75
|
| Rate for Payer: Priority Health Medicare |
$731.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,162.75
|
| Rate for Payer: Priority Health SBD |
$1,162.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.09
|
| Rate for Payer: UHC Medicare Advantage |
$731.09
|
| Rate for Payer: UHCCP Medicaid |
$490.54
|
| Rate for Payer: UMR Bronson Commercial |
$842.72
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 28495
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$413.04 |
| Rate for Payer: Aetna Commercial |
$194.11
|
| Rate for Payer: Aetna Medicare |
$150.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.60
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$144.86
|
| Rate for Payer: BCBS Trust/PPO |
$413.04
|
| Rate for Payer: BCN Commercial |
$263.88
|
| Rate for Payer: BCN Medicare Advantage |
$144.86
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$208.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.10
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Nomi Health Commercial |
$173.83
|
| Rate for Payer: PACE SWMI |
$144.86
|
| Rate for Payer: PHP Commercial |
$202.80
|
| Rate for Payer: PHP Medicare Advantage |
$144.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.10
|
| Rate for Payer: Priority Health Medicare |
$144.86
|
| Rate for Payer: Priority Health Narrow Network |
$235.10
|
| Rate for Payer: Priority Health SBD |
$235.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.86
|
| Rate for Payer: UHC Medicare Advantage |
$144.86
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
| Rate for Payer: UMR Bronson Commercial |
$104.88
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$133.32 |
| Max. Negotiated Rate |
$272.70 |
| Rate for Payer: Aetna American Axle |
$196.95
|
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.95
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$212.10
|
| Rate for Payer: Cofinity Commercial |
$260.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.40
|
| Rate for Payer: Healthscope Commercial |
$272.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.55
|
| Rate for Payer: PHP Commercial |
$257.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health SBD |
$190.89
|
| Rate for Payer: UMR Bronson Commercial |
$133.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.25
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$112.11 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$196.95
|
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$120.93
|
| Rate for Payer: BCN Commercial |
$120.93
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$260.58
|
| Rate for Payer: Cofinity Commercial |
$212.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$272.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.25
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.55
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$257.55
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$190.89
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.24
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$120.22
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$112.11
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.25
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$1,548.98 |
| Rate for Payer: BCBS MAPPO |
$120.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$120.53
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$161.51
|
| Rate for Payer: Cofinity Commercial |
$173.56
|
| Rate for Payer: Aetna Commercial |
$161.51
|
| Rate for Payer: Aetna Medicare |
$125.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.56
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.56
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$144.64
|
| Rate for Payer: PACE SWMI |
$120.53
|
| Rate for Payer: PHP Commercial |
$168.74
|
| Rate for Payer: PHP Medicare Advantage |
$120.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.93
|
| Rate for Payer: Priority Health Medicare |
$120.53
|
| Rate for Payer: Priority Health Narrow Network |
$196.93
|
| Rate for Payer: Priority Health SBD |
$196.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.53
|
| Rate for Payer: UHC Medicare Advantage |
$120.53
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
| Rate for Payer: UMR Bronson Commercial |
$139.38
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 28490
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$1,548.98 |
| Rate for Payer: Aetna Commercial |
$161.51
|
| Rate for Payer: Aetna Medicare |
$125.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.56
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$120.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$120.53
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$161.51
|
| Rate for Payer: Cofinity Commercial |
$173.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.56
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$144.64
|
| Rate for Payer: PACE SWMI |
$120.53
|
| Rate for Payer: PHP Commercial |
$168.74
|
| Rate for Payer: PHP Medicare Advantage |
$120.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.93
|
| Rate for Payer: Priority Health Medicare |
$120.53
|
| Rate for Payer: Priority Health Narrow Network |
$196.93
|
| Rate for Payer: Priority Health SBD |
$196.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.53
|
| Rate for Payer: UHC Medicare Advantage |
$120.53
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
| Rate for Payer: UMR Bronson Commercial |
$139.38
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna Commercial |
$184.73
|
| Rate for Payer: Aetna Medicare |
$143.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.52
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS MAPPO |
$137.86
|
| Rate for Payer: BCBS Trust/PPO |
$423.70
|
| Rate for Payer: BCN Commercial |
$242.88
|
| Rate for Payer: BCN Medicare Advantage |
$137.86
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$184.73
|
| Rate for Payer: Cofinity Commercial |
$198.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.75
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Nomi Health Commercial |
$165.43
|
| Rate for Payer: PACE SWMI |
$137.86
|
| Rate for Payer: PHP Commercial |
$193.00
|
| Rate for Payer: PHP Medicare Advantage |
$137.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.44
|
| Rate for Payer: Priority Health Medicare |
$137.86
|
| Rate for Payer: Priority Health Narrow Network |
$226.44
|
| Rate for Payer: Priority Health SBD |
$226.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.86
|
| Rate for Payer: UHC Medicare Advantage |
$137.86
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
| Rate for Payer: UMR Bronson Commercial |
$170.20
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$1,955.77 |
| Rate for Payer: Aetna Commercial |
$156.27
|
| Rate for Payer: Aetna Medicare |
$121.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.93
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCBS MAPPO |
$116.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.77
|
| Rate for Payer: BCN Commercial |
$179.35
|
| Rate for Payer: BCN Medicare Advantage |
$116.62
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$167.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.45
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Nomi Health Commercial |
$139.94
|
| Rate for Payer: PACE SWMI |
$116.62
|
| Rate for Payer: PHP Commercial |
$163.27
|
| Rate for Payer: PHP Medicare Advantage |
$116.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.83
|
| Rate for Payer: Priority Health Medicare |
$116.62
|
| Rate for Payer: Priority Health Narrow Network |
$190.83
|
| Rate for Payer: Priority Health SBD |
$190.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.62
|
| Rate for Payer: UHC Medicare Advantage |
$116.62
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
| Rate for Payer: UMR Bronson Commercial |
$134.32
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$3,163.99 |
| Rate for Payer: Aetna Commercial |
$400.58
|
| Rate for Payer: Aetna Medicare |
$310.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.47
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$298.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,163.99
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$298.94
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$400.58
|
| Rate for Payer: Cofinity Commercial |
$430.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.89
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Nomi Health Commercial |
$358.73
|
| Rate for Payer: PACE SWMI |
$298.94
|
| Rate for Payer: PHP Commercial |
$418.52
|
| Rate for Payer: PHP Medicare Advantage |
$298.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.92
|
| Rate for Payer: Priority Health Medicare |
$298.94
|
| Rate for Payer: Priority Health Narrow Network |
$483.92
|
| Rate for Payer: Priority Health SBD |
$483.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.94
|
| Rate for Payer: UHC Medicare Advantage |
$298.94
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$401.12
|
|
