|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$326.53 |
| Max. Negotiated Rate |
$3,467.23 |
| Rate for Payer: Aetna Commercial |
$646.35
|
| Rate for Payer: Aetna Medicare |
$501.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.58
|
| Rate for Payer: BCBS Complete |
$342.86
|
| Rate for Payer: BCBS MAPPO |
$482.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,467.23
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$482.35
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$646.35
|
| Rate for Payer: Cofinity Commercial |
$694.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.47
|
| Rate for Payer: Meridian Medicaid |
$342.86
|
| Rate for Payer: Nomi Health Commercial |
$578.82
|
| Rate for Payer: PACE SWMI |
$482.35
|
| Rate for Payer: PHP Commercial |
$675.29
|
| Rate for Payer: PHP Medicare Advantage |
$482.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.91
|
| Rate for Payer: Priority Health Medicare |
$482.35
|
| Rate for Payer: Priority Health Narrow Network |
$769.91
|
| Rate for Payer: Priority Health SBD |
$769.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$482.35
|
| Rate for Payer: UHC Medicare Advantage |
$482.35
|
| Rate for Payer: UHCCP Medicaid |
$326.53
|
| Rate for Payer: UMR Bronson Commercial |
$891.48
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$446.55 |
| Rate for Payer: Aetna Commercial |
$341.28
|
| Rate for Payer: Aetna Medicare |
$264.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.75
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$254.69
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$254.69
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cofinity Commercial |
$341.28
|
| Rate for Payer: Cofinity Commercial |
$366.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Nomi Health Commercial |
$305.63
|
| Rate for Payer: PACE SWMI |
$254.69
|
| Rate for Payer: PHP Commercial |
$356.57
|
| Rate for Payer: PHP Medicare Advantage |
$254.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.72
|
| Rate for Payer: Priority Health Medicare |
$254.69
|
| Rate for Payer: Priority Health Narrow Network |
$414.72
|
| Rate for Payer: Priority Health SBD |
$414.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.69
|
| Rate for Payer: UHC Medicare Advantage |
$254.69
|
| Rate for Payer: UHCCP Medicaid |
$175.73
|
| Rate for Payer: UMR Bronson Commercial |
$316.02
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$233.87 |
| Max. Negotiated Rate |
$582.99 |
| Rate for Payer: Aetna Commercial |
$458.57
|
| Rate for Payer: Aetna Medicare |
$355.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.80
|
| Rate for Payer: BCBS Complete |
$245.56
|
| Rate for Payer: BCBS MAPPO |
$342.22
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$582.99
|
| Rate for Payer: BCN Medicare Advantage |
$342.22
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$458.57
|
| Rate for Payer: Cofinity Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.33
|
| Rate for Payer: Meridian Medicaid |
$245.56
|
| Rate for Payer: Nomi Health Commercial |
$410.66
|
| Rate for Payer: PACE SWMI |
$342.22
|
| Rate for Payer: PHP Commercial |
$479.11
|
| Rate for Payer: PHP Medicare Advantage |
$342.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.26
|
| Rate for Payer: Priority Health Medicare |
$342.22
|
| Rate for Payer: Priority Health Narrow Network |
$560.26
|
| Rate for Payer: Priority Health SBD |
$560.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.22
|
| Rate for Payer: UHC Medicare Advantage |
$342.22
|
| Rate for Payer: UHCCP Medicaid |
$233.87
|
| Rate for Payer: UMR Bronson Commercial |
$303.60
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$505.18
|
| Rate for Payer: Aetna Medicare |
$392.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.88
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$377.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$377.00
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$505.18
|
| Rate for Payer: Cofinity Commercial |
$542.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.85
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Nomi Health Commercial |
$452.40
|
| Rate for Payer: PACE SWMI |
$377.00
|
| Rate for Payer: PHP Commercial |
$527.80
|
| Rate for Payer: PHP Medicare Advantage |
$377.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.57
|
| Rate for Payer: Priority Health Medicare |
$377.00
|
| Rate for Payer: Priority Health Narrow Network |
$606.57
|
| Rate for Payer: Priority Health SBD |
$606.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$377.00
|
| Rate for Payer: UHC Medicare Advantage |
$377.00
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
| Rate for Payer: UMR Bronson Commercial |
$412.16
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$1,958.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$2,221.50 |
| Rate for Payer: Aetna Commercial |
$967.49
|
| Rate for Payer: Aetna Medicare |
$750.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.49
|
| Rate for Payer: BCBS Complete |
$509.47
|
| Rate for Payer: BCBS MAPPO |
$722.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,221.50
|
| Rate for Payer: BCN Commercial |
$1,107.84
|
| Rate for Payer: BCN Medicare Advantage |
$722.01
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,039.69
|
| Rate for Payer: Cofinity Commercial |
$967.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.11
|
| Rate for Payer: Meridian Medicaid |
$509.47
|
| Rate for Payer: Nomi Health Commercial |
$866.41
|
| Rate for Payer: PACE SWMI |
$722.01
|
| Rate for Payer: PHP Commercial |
$1,010.81
|
| Rate for Payer: PHP Medicare Advantage |
$722.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.12
|
| Rate for Payer: Priority Health Medicare |
$722.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.12
|
| Rate for Payer: Priority Health SBD |
$1,155.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.01
|
| Rate for Payer: UHC Medicare Advantage |
$722.01
|
| Rate for Payer: UHCCP Medicaid |
$485.21
|
| Rate for Payer: UMR Bronson Commercial |
$900.68
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$738.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$2,156.52 |
| Rate for Payer: Aetna Commercial |
$236.66
|
| Rate for Payer: Aetna Medicare |
$183.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.32
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$176.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$262.42
|
| Rate for Payer: BCN Medicare Advantage |
$176.61
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cofinity Commercial |
$236.66
|
| Rate for Payer: Cofinity Commercial |
$254.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.44
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Nomi Health Commercial |
$211.93
|
| Rate for Payer: PACE SWMI |
$176.61
|
| Rate for Payer: PHP Commercial |
$247.25
|
| Rate for Payer: PHP Medicare Advantage |
$176.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.25
|
| Rate for Payer: Priority Health Medicare |
$176.61
|
| Rate for Payer: Priority Health Narrow Network |
$273.25
|
| Rate for Payer: Priority Health SBD |
$273.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.61
|
| Rate for Payer: UHC Medicare Advantage |
$176.61
|
| Rate for Payer: UHCCP Medicaid |
$114.81
|
| Rate for Payer: UMR Bronson Commercial |
$339.48
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$129.43 |
| Max. Negotiated Rate |
$529.24 |
| Rate for Payer: Aetna Commercial |
$411.23
|
| Rate for Payer: Aetna Medicare |
$319.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.92
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$306.89
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$529.24
|
| Rate for Payer: BCN Medicare Advantage |
$306.89
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$411.23
|
| Rate for Payer: Cofinity Commercial |
$441.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.23
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Nomi Health Commercial |
$368.27
|
| Rate for Payer: PACE SWMI |
$306.89
|
| Rate for Payer: PHP Commercial |
$429.65
|
| Rate for Payer: PHP Medicare Advantage |
$306.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$501.22
|
| Rate for Payer: Priority Health Medicare |
$306.89
|
| Rate for Payer: Priority Health Narrow Network |
$501.22
|
| Rate for Payer: Priority Health SBD |
$501.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.89
|
| Rate for Payer: UHC Medicare Advantage |
$306.89
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
| Rate for Payer: UMR Bronson Commercial |
$312.34
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$533.00 |
| Rate for Payer: Aetna Commercial |
$387.11
|
| Rate for Payer: Aetna Medicare |
$300.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.00
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$288.89
|
| Rate for Payer: BCBS Trust/PPO |
$112.00
|
| Rate for Payer: BCN Commercial |
$502.36
|
| Rate for Payer: BCN Medicare Advantage |
$288.89
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cofinity Commercial |
$387.11
|
| Rate for Payer: Cofinity Commercial |
$416.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.33
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Nomi Health Commercial |
$346.67
|
| Rate for Payer: PACE SWMI |
$288.89
|
| Rate for Payer: PHP Commercial |
$404.45
|
| Rate for Payer: PHP Medicare Advantage |
$288.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.19
|
| Rate for Payer: Priority Health Medicare |
$288.89
|
| Rate for Payer: Priority Health Narrow Network |
$470.19
|
| Rate for Payer: Priority Health SBD |
$470.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.89
|
| Rate for Payer: UHC Medicare Advantage |
$288.89
|
| Rate for Payer: UHCCP Medicaid |
$198.94
|
| Rate for Payer: UMR Bronson Commercial |
$377.20
|
|
|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,288.00
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$300.76 |
| Max. Negotiated Rate |
$837.20 |
| Rate for Payer: Aetna Commercial |
$590.83
|
| Rate for Payer: Aetna Medicare |
$458.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.92
|
| Rate for Payer: BCBS Complete |
$315.80
|
| Rate for Payer: BCBS MAPPO |
$440.92
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$754.03
|
| Rate for Payer: BCN Medicare Advantage |
$440.92
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Cofinity Commercial |
$634.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.97
|
| Rate for Payer: Meridian Medicaid |
$315.80
|
| Rate for Payer: Nomi Health Commercial |
$529.10
|
| Rate for Payer: PACE SWMI |
$440.92
|
| Rate for Payer: PHP Commercial |
$617.29
|
| Rate for Payer: PHP Medicare Advantage |
$440.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$837.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$713.93
|
| Rate for Payer: Priority Health Medicare |
$440.92
|
| Rate for Payer: Priority Health Narrow Network |
$713.93
|
| Rate for Payer: Priority Health SBD |
$713.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.92
|
| Rate for Payer: UHC Medicare Advantage |
$440.92
|
| Rate for Payer: UHCCP Medicaid |
$300.76
|
| Rate for Payer: UMR Bronson Commercial |
$592.48
|
|
|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$299.69 |
| Max. Negotiated Rate |
$723.24 |
| Rate for Payer: Aetna Commercial |
$586.68
|
| Rate for Payer: Aetna Medicare |
$455.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.46
|
| Rate for Payer: BCBS Complete |
$314.67
|
| Rate for Payer: BCBS MAPPO |
$437.82
|
| Rate for Payer: BCBS Trust/PPO |
$716.37
|
| Rate for Payer: BCN Commercial |
$723.24
|
| 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 |
$586.68
|
| Rate for Payer: Cofinity Commercial |
$630.46
|
| 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: Meridian Medicaid |
$314.67
|
| 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 Choice Medicaid |
$299.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.84
|
| Rate for Payer: Priority Health Medicare |
$437.82
|
| Rate for Payer: Priority Health Narrow Network |
$708.84
|
| Rate for Payer: Priority Health SBD |
$708.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$437.82
|
| Rate for Payer: UHC Medicare Advantage |
$437.82
|
| Rate for Payer: UHCCP Medicaid |
$299.69
|
| 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 |
$309.06 |
| Max. Negotiated Rate |
$1,049.20 |
| Rate for Payer: Aetna Commercial |
$608.31
|
| Rate for Payer: Aetna Medicare |
$472.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.70
|
| Rate for Payer: BCBS Complete |
$324.51
|
| Rate for Payer: BCBS MAPPO |
$453.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$693.93
|
| 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 |
$608.31
|
| Rate for Payer: Cofinity Commercial |
$653.70
|
| 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: Meridian Medicaid |
$324.51
|
| 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 Choice Medicaid |
$309.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.25
|
| Rate for Payer: Priority Health Medicare |
$453.96
|
| Rate for Payer: Priority Health Narrow Network |
$732.25
|
| Rate for Payer: Priority Health SBD |
$732.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.96
|
| Rate for Payer: UHC Medicare Advantage |
$453.96
|
| Rate for Payer: UHCCP Medicaid |
$309.06
|
| 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 |
$81.79 |
| Max. Negotiated Rate |
$1,135.32 |
| Rate for Payer: Aetna Commercial |
$161.16
|
| Rate for Payer: Aetna Medicare |
$125.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.19
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$120.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.32
|
| Rate for Payer: BCN Commercial |
$217.95
|
| 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 |
$161.16
|
| Rate for Payer: Cofinity Commercial |
$173.19
|
| 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: Meridian Medicaid |
$85.88
|
| 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 Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.40
|
| Rate for Payer: Priority Health Medicare |
$120.27
|
| Rate for Payer: Priority Health Narrow Network |
$195.40
|
| Rate for Payer: Priority Health SBD |
$195.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.27
|
| Rate for Payer: UHC Medicare Advantage |
$120.27
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| 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 |
$61.56 |
| Max. Negotiated Rate |
$766.04 |
| Rate for Payer: Cash Price |
$187.20
|
| 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 |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$90.80
|
| Rate for Payer: BCBS Trust/PPO |
$766.04
|
| Rate for Payer: BCN Commercial |
$183.74
|
| Rate for Payer: BCN Medicare Advantage |
$90.80
|
| Rate for Payer: Cash Price |
$187.20
|
| 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 |
$64.64
|
| 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 |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.55
|
| Rate for Payer: Priority Health Medicare |
$90.80
|
| Rate for Payer: Priority Health Narrow Network |
$146.55
|
| Rate for Payer: Priority Health SBD |
$146.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.80
|
| Rate for Payer: UHC Medicare Advantage |
$90.80
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
| 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 |
$620.90 |
| Max. Negotiated Rate |
$1,466.54 |
| Rate for Payer: Aetna Commercial |
$1,236.67
|
| Rate for Payer: Aetna Medicare |
$959.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.96
|
| Rate for Payer: BCBS Complete |
$651.94
|
| Rate for Payer: BCBS MAPPO |
$922.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.47
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| 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 |
$1,236.67
|
| Rate for Payer: Cofinity Commercial |
$1,328.96
|
| 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: Meridian Medicaid |
$651.94
|
| 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 Choice Medicaid |
$620.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,466.54
|
| Rate for Payer: Priority Health Medicare |
$922.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.54
|
| Rate for Payer: Priority Health SBD |
$1,466.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$922.89
|
| Rate for Payer: UHC Medicare Advantage |
$922.89
|
| Rate for Payer: UHCCP Medicaid |
$620.90
|
| 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 |
$238.13 |
| Max. Negotiated Rate |
$2,900.37 |
| Rate for Payer: Aetna Commercial |
$464.79
|
| Rate for Payer: Aetna Medicare |
$360.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.48
|
| Rate for Payer: BCBS Complete |
$250.04
|
| Rate for Payer: BCBS MAPPO |
$346.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$594.23
|
| 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 |
$464.79
|
| Rate for Payer: Cofinity Commercial |
$499.48
|
| 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: Meridian Medicaid |
$250.04
|
| 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 Choice Medicaid |
$238.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.33
|
| Rate for Payer: Priority Health Medicare |
$346.86
|
| Rate for Payer: Priority Health Narrow Network |
$564.33
|
| Rate for Payer: Priority Health SBD |
$564.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.86
|
| Rate for Payer: UHC Medicare Advantage |
$346.86
|
| Rate for Payer: UHCCP Medicaid |
$238.13
|
| 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 |
$178.07 |
| Max. Negotiated Rate |
$1,851.16 |
| Rate for Payer: Aetna Commercial |
$349.42
|
| Rate for Payer: Aetna Medicare |
$271.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.49
|
| Rate for Payer: BCBS Complete |
$186.97
|
| Rate for Payer: BCBS MAPPO |
$260.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.16
|
| Rate for Payer: BCN Commercial |
$433.46
|
| 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 |
$349.42
|
| Rate for Payer: Cofinity Commercial |
$375.49
|
| 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: Meridian Medicaid |
$186.97
|
| 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 Choice Medicaid |
$178.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.81
|
| Rate for Payer: Priority Health Medicare |
$260.76
|
| Rate for Payer: Priority Health Narrow Network |
$419.81
|
| Rate for Payer: Priority Health SBD |
$419.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.76
|
| Rate for Payer: UHC Medicare Advantage |
$260.76
|
| Rate for Payer: UHCCP Medicaid |
$178.07
|
| 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 |
$382.76 |
| Max. Negotiated Rate |
$2,978.97 |
| Rate for Payer: Aetna Commercial |
$726.94
|
| Rate for Payer: Aetna Medicare |
$564.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.19
|
| Rate for Payer: BCBS Complete |
$401.90
|
| Rate for Payer: BCBS MAPPO |
$542.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,978.97
|
| Rate for Payer: BCN Commercial |
$1,012.05
|
| 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 |
$726.94
|
| Rate for Payer: Cofinity Commercial |
$781.19
|
| 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: Meridian Medicaid |
$401.90
|
| 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 Choice Medicaid |
$382.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$542.49
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: Priority Health SBD |
$927.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.49
|
| Rate for Payer: UHC Medicare Advantage |
$542.49
|
| Rate for Payer: UHCCP Medicaid |
$382.76
|
| 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 |
$207.46 |
| Max. Negotiated Rate |
$2,919.55 |
| Rate for Payer: Aetna Commercial |
$403.57
|
| Rate for Payer: Aetna Medicare |
$313.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.68
|
| Rate for Payer: BCBS Complete |
$217.83
|
| Rate for Payer: BCBS MAPPO |
$301.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,919.55
|
| Rate for Payer: BCN Commercial |
$400.52
|
| 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 |
$403.57
|
| Rate for Payer: Cofinity Commercial |
$433.68
|
| 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: Meridian Medicaid |
$217.83
|
| 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 Choice Medicaid |
$207.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.53
|
| Rate for Payer: Priority Health Medicare |
$301.17
|
| Rate for Payer: Priority Health Narrow Network |
$489.53
|
| Rate for Payer: Priority Health SBD |
$489.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.17
|
| Rate for Payer: UHC Medicare Advantage |
$301.17
|
| Rate for Payer: UHCCP Medicaid |
$207.46
|
| 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 |
$49.24 |
| Max. Negotiated Rate |
$497.47 |
| Rate for Payer: Aetna Commercial |
$390.07
|
| Rate for Payer: Aetna Medicare |
$302.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.18
|
| Rate for Payer: BCBS Complete |
$210.45
|
| Rate for Payer: BCBS MAPPO |
$291.10
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$497.47
|
| 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 |
$390.07
|
| Rate for Payer: Cofinity Commercial |
$419.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.66
|
| Rate for Payer: Meridian Medicaid |
$210.45
|
| 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 Choice Medicaid |
$200.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.75
|
| Rate for Payer: Priority Health Medicare |
$291.10
|
| Rate for Payer: Priority Health Narrow Network |
$473.75
|
| Rate for Payer: Priority Health SBD |
$473.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.10
|
| Rate for Payer: UHC Medicare Advantage |
$291.10
|
| Rate for Payer: UHCCP Medicaid |
$200.43
|
| 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 |
$49.24 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$649.56
|
| Rate for Payer: Aetna Medicare |
$504.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.04
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$484.75
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$757.45
|
| 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 |
$649.56
|
| Rate for Payer: Cofinity Commercial |
$698.04
|
| 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: Meridian Medicaid |
$348.67
|
| 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 Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$792.81
|
| Rate for Payer: Priority Health Medicare |
$484.75
|
| Rate for Payer: Priority Health Narrow Network |
$792.81
|
| Rate for Payer: Priority Health SBD |
$792.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.75
|
| Rate for Payer: UHC Medicare Advantage |
$484.75
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
| 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 |
$103.55 |
| Max. Negotiated Rate |
$458.99 |
| Rate for Payer: Aetna Commercial |
$377.01
|
| Rate for Payer: Aetna Medicare |
$292.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.14
|
| Rate for Payer: BCBS Complete |
$204.64
|
| Rate for Payer: BCBS MAPPO |
$281.35
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCN Commercial |
$364.78
|
| 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 |
$377.01
|
| Rate for Payer: Cofinity Commercial |
$405.14
|
| 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: Meridian Medicaid |
$204.64
|
| 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 Choice Medicaid |
$194.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$458.99
|
| Rate for Payer: Priority Health Medicare |
$281.35
|
| Rate for Payer: Priority Health Narrow Network |
$458.99
|
| Rate for Payer: Priority Health SBD |
$458.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.35
|
| Rate for Payer: UHC Medicare Advantage |
$281.35
|
| Rate for Payer: UHCCP Medicaid |
$194.90
|
| 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 |
$254.64 |
| Max. Negotiated Rate |
$657.27 |
| Rate for Payer: Aetna Commercial |
$519.29
|
| Rate for Payer: Aetna Medicare |
$403.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.04
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$387.53
|
| Rate for Payer: BCBS Trust/PPO |
$254.64
|
| Rate for Payer: BCN Commercial |
$657.27
|
| 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 |
$519.29
|
| Rate for Payer: Cofinity Commercial |
$558.04
|
| 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: Meridian Medicaid |
$278.89
|
| 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 Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.44
|
| Rate for Payer: Priority Health Medicare |
$387.53
|
| Rate for Payer: Priority Health Narrow Network |
$628.44
|
| Rate for Payer: Priority Health SBD |
$628.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.53
|
| Rate for Payer: UHC Medicare Advantage |
$387.53
|
| Rate for Payer: UHCCP Medicaid |
$265.61
|
| 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 |
$64.45 |
| Max. Negotiated Rate |
$512.14 |
| Rate for Payer: Aetna Commercial |
$415.12
|
| Rate for Payer: Aetna Medicare |
$322.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.10
|
| Rate for Payer: BCBS Complete |
$221.86
|
| Rate for Payer: BCBS MAPPO |
$309.79
|
| Rate for Payer: BCBS Trust/PPO |
$64.45
|
| Rate for Payer: BCN Commercial |
$512.14
|
| 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 |
$415.12
|
| Rate for Payer: Cofinity Commercial |
$446.10
|
| 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: Meridian Medicaid |
$221.86
|
| 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 Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.69
|
| Rate for Payer: Priority Health Medicare |
$309.79
|
| Rate for Payer: Priority Health Narrow Network |
$498.69
|
| Rate for Payer: Priority Health SBD |
$498.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.79
|
| Rate for Payer: UHC Medicare Advantage |
$309.79
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
| 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 |
$152.08 |
| Max. Negotiated Rate |
$1,033.88 |
| Rate for Payer: Aetna Commercial |
$297.86
|
| Rate for Payer: Aetna Medicare |
$231.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.08
|
| Rate for Payer: BCBS Complete |
$159.68
|
| Rate for Payer: BCBS MAPPO |
$222.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.88
|
| Rate for Payer: BCN Commercial |
$382.64
|
| 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 |
$297.86
|
| Rate for Payer: Cofinity Commercial |
$320.08
|
| 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: Meridian Medicaid |
$159.68
|
| 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 Choice Medicaid |
$152.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.28
|
| Rate for Payer: Priority Health Medicare |
$222.28
|
| Rate for Payer: Priority Health Narrow Network |
$360.28
|
| Rate for Payer: Priority Health SBD |
$360.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.28
|
| Rate for Payer: UHC Medicare Advantage |
$222.28
|
| Rate for Payer: UHCCP Medicaid |
$152.08
|
| 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 |
$85.20 |
| Max. Negotiated Rate |
$342.34 |
| Rate for Payer: Aetna Commercial |
$167.89
|
| Rate for Payer: Aetna Medicare |
$130.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.42
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS MAPPO |
$125.29
|
| Rate for Payer: BCBS Trust/PPO |
$342.34
|
| Rate for Payer: BCN Commercial |
$258.51
|
| 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 |
$167.89
|
| Rate for Payer: Cofinity Commercial |
$180.42
|
| 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: Meridian Medicaid |
$89.46
|
| 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 Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.02
|
| Rate for Payer: Priority Health Medicare |
$125.29
|
| Rate for Payer: Priority Health Narrow Network |
$202.02
|
| Rate for Payer: Priority Health SBD |
$202.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.29
|
| Rate for Payer: UHC Medicare Advantage |
$125.29
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
