|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 37236
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$935.25 |
| Rate for Payer: Aetna Commercial |
$529.54
|
| Rate for Payer: Aetna Medicare |
$410.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.06
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$395.18
|
| Rate for Payer: BCN Commercial |
$641.40
|
| Rate for Payer: BCN Medicare Advantage |
$395.18
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cofinity Commercial |
$529.54
|
| Rate for Payer: Cofinity Commercial |
$569.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.94
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$434.70
|
| Rate for Payer: Nomi Health Commercial |
$474.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.25
|
| Rate for Payer: PACE SWMI |
$395.18
|
| Rate for Payer: PHP Commercial |
$553.25
|
| Rate for Payer: PHP Medicare Advantage |
$395.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$689.74
|
| Rate for Payer: Priority Health Medicare |
$395.18
|
| Rate for Payer: Priority Health SBD |
$689.74
|
| Rate for Payer: Priority Health Tiered Network |
$689.74
|
| Rate for Payer: Railroad Medicare Medicare |
$395.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.13
|
| Rate for Payer: UHC Core |
$799.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$395.18
|
| Rate for Payer: UHC Exchange |
$799.13
|
| Rate for Payer: UHC Medicaid |
$248.78
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
| Rate for Payer: UMR Bronson Commercial |
$573.62
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST
|
Professional
|
Both
|
$1,324.00
|
|
|
Service Code
|
HCPCS 37238
|
| Min. Negotiated Rate |
$172.74 |
| Max. Negotiated Rate |
$993.00 |
| Rate for Payer: Aetna Commercial |
$366.33
|
| Rate for Payer: Aetna Medicare |
$284.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.67
|
| Rate for Payer: BCBS Complete |
$181.38
|
| Rate for Payer: BCBS MAPPO |
$273.38
|
| Rate for Payer: BCN Commercial |
$447.18
|
| Rate for Payer: BCN Medicare Advantage |
$273.38
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cofinity Commercial |
$366.33
|
| Rate for Payer: Cofinity Commercial |
$393.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.05
|
| Rate for Payer: Meridian Medicaid |
$181.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.72
|
| Rate for Payer: Nomi Health Commercial |
$328.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$993.00
|
| Rate for Payer: PACE SWMI |
$273.38
|
| Rate for Payer: PHP Commercial |
$382.73
|
| Rate for Payer: PHP Medicare Advantage |
$273.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$480.89
|
| Rate for Payer: Priority Health Medicare |
$273.38
|
| Rate for Payer: Priority Health SBD |
$480.89
|
| Rate for Payer: Priority Health Tiered Network |
$480.89
|
| Rate for Payer: Railroad Medicare Medicare |
$273.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.17
|
| Rate for Payer: UHC Core |
$548.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$273.38
|
| Rate for Payer: UHC Exchange |
$548.17
|
| Rate for Payer: UHC Medicaid |
$172.74
|
| Rate for Payer: UHCCP Medicaid |
$172.74
|
| Rate for Payer: UMR Bronson Commercial |
$609.04
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF ACUTE
|
Professional
|
Both
|
$2,694.00
|
|
|
Service Code
|
HCPCS 23410
|
| Min. Negotiated Rate |
$487.77 |
| Max. Negotiated Rate |
$2,020.50 |
| Rate for Payer: Aetna Commercial |
$1,001.26
|
| Rate for Payer: Aetna Medicare |
$777.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.98
|
| Rate for Payer: BCBS Complete |
$512.16
|
| Rate for Payer: BCBS MAPPO |
$747.21
|
| Rate for Payer: BCN Commercial |
$1,248.44
|
| Rate for Payer: BCN Medicare Advantage |
$747.21
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cofinity Commercial |
$1,001.26
|
| Rate for Payer: Cofinity Commercial |
$1,075.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.57
|
| Rate for Payer: Meridian Medicaid |
$512.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.93
|
| Rate for Payer: Nomi Health Commercial |
$896.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,020.50
|
| Rate for Payer: PACE SWMI |
$747.21
|
| Rate for Payer: PHP Commercial |
$1,046.09
|
| Rate for Payer: PHP Medicare Advantage |
$747.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,334.55
|
| Rate for Payer: Priority Health Medicare |
$747.21
|
| Rate for Payer: Priority Health SBD |
$1,334.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,334.55
|
| Rate for Payer: Railroad Medicare Medicare |
$747.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,433.06
|
| Rate for Payer: UHC Core |
$1,433.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$747.21
|
| Rate for Payer: UHC Exchange |
$1,433.06
|
| Rate for Payer: UHC Medicaid |
$487.77
|
| Rate for Payer: UHCCP Medicaid |
$487.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,239.24
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,213.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$504.81 |
| Max. Negotiated Rate |
$2,409.75 |
| Rate for Payer: Aetna Commercial |
$1,037.04
|
| Rate for Payer: Aetna Medicare |
$804.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,037.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,114.43
|
| Rate for Payer: BCBS Complete |
$530.05
|
| Rate for Payer: BCBS MAPPO |
$773.91
|
| Rate for Payer: BCN Commercial |
$1,425.12
|
| Rate for Payer: BCN Medicare Advantage |
$773.91
|
| Rate for Payer: Cash Price |
$2,570.40
|
| Rate for Payer: Cash Price |
$2,570.40
|
| Rate for Payer: Cofinity Commercial |
$1,037.04
|
| Rate for Payer: Cofinity Commercial |
$1,114.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$773.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.61
|
| Rate for Payer: Meridian Medicaid |
$530.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$851.30
|
| Rate for Payer: Nomi Health Commercial |
$928.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,409.75
|
| Rate for Payer: PACE SWMI |
$773.91
|
| Rate for Payer: PHP Commercial |
$1,083.47
|
| Rate for Payer: PHP Medicare Advantage |
$773.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,386.72
|
| Rate for Payer: Priority Health Medicare |
$773.91
|
| Rate for Payer: Priority Health SBD |
$1,386.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,386.72
|
| Rate for Payer: Railroad Medicare Medicare |
$773.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,490.64
|
| Rate for Payer: UHC Core |
$1,490.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$773.91
|
| Rate for Payer: UHC Exchange |
$1,490.64
|
| Rate for Payer: UHC Medicaid |
$504.81
|
| Rate for Payer: UHCCP Medicaid |
$504.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,477.98
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$3,095.00
|
|
|
Service Code
|
HCPCS 27814
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,321.25 |
| Rate for Payer: Aetna Commercial |
$934.09
|
| Rate for Payer: Aetna Medicare |
$724.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.09
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$697.08
|
| Rate for Payer: BCN Commercial |
$1,161.79
|
| Rate for Payer: BCN Medicare Advantage |
$697.08
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cofinity Commercial |
$1,003.80
|
| Rate for Payer: Cofinity Commercial |
$934.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.93
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$766.79
|
| Rate for Payer: Nomi Health Commercial |
$836.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,321.25
|
| Rate for Payer: PACE SWMI |
$697.08
|
| Rate for Payer: PHP Commercial |
$975.91
|
| Rate for Payer: PHP Medicare Advantage |
$697.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,241.91
|
| Rate for Payer: Priority Health Medicare |
$697.08
|
| Rate for Payer: Priority Health SBD |
$1,241.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,241.91
|
| Rate for Payer: Railroad Medicare Medicare |
$697.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.69
|
| Rate for Payer: UHC Core |
$1,338.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$697.08
|
| Rate for Payer: UHC Exchange |
$1,338.69
|
| Rate for Payer: UHC Medicaid |
$455.61
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,423.70
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,467.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$668.82 |
| Max. Negotiated Rate |
$2,600.25 |
| Rate for Payer: Aetna Commercial |
$1,370.79
|
| Rate for Payer: Aetna Medicare |
$1,063.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,370.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.09
|
| Rate for Payer: BCBS Complete |
$702.26
|
| Rate for Payer: BCBS MAPPO |
$1,022.98
|
| Rate for Payer: BCN Commercial |
$1,695.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,022.98
|
| Rate for Payer: Cash Price |
$2,773.60
|
| Rate for Payer: Cash Price |
$2,773.60
|
| Rate for Payer: Cofinity Commercial |
$1,370.79
|
| Rate for Payer: Cofinity Commercial |
$1,473.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.13
|
| Rate for Payer: Meridian Medicaid |
$702.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.28
|
| Rate for Payer: Nomi Health Commercial |
$1,227.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,600.25
|
| Rate for Payer: PACE SWMI |
$1,022.98
|
| Rate for Payer: PHP Commercial |
$1,432.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,022.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,812.58
|
| Rate for Payer: Priority Health Medicare |
$1,022.98
|
| Rate for Payer: Priority Health SBD |
$1,812.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,812.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,022.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,954.99
|
| Rate for Payer: UHC Core |
$1,954.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,022.98
|
| Rate for Payer: UHC Exchange |
$1,954.99
|
| Rate for Payer: UHC Medicaid |
$668.82
|
| Rate for Payer: UHCCP Medicaid |
$668.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,594.82
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,291.00
|
|
|
Service Code
|
HCPCS 28420
|
| Min. Negotiated Rate |
$770.85 |
| Max. Negotiated Rate |
$2,243.47 |
| Rate for Payer: Aetna Commercial |
$1,580.45
|
| Rate for Payer: Aetna Medicare |
$1,226.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,580.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,698.39
|
| Rate for Payer: BCBS Complete |
$809.39
|
| Rate for Payer: BCBS MAPPO |
$1,179.44
|
| Rate for Payer: BCN Commercial |
$1,963.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,179.44
|
| Rate for Payer: Cash Price |
$1,832.80
|
| Rate for Payer: Cash Price |
$1,832.80
|
| Rate for Payer: Cofinity Commercial |
$1,580.45
|
| Rate for Payer: Cofinity Commercial |
$1,698.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,179.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,238.41
|
| Rate for Payer: Meridian Medicaid |
$809.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,297.38
|
| Rate for Payer: Nomi Health Commercial |
$1,415.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,718.25
|
| Rate for Payer: PACE SWMI |
$1,179.44
|
| Rate for Payer: PHP Commercial |
$1,651.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,179.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,098.44
|
| Rate for Payer: Priority Health Medicare |
$1,179.44
|
| Rate for Payer: Priority Health SBD |
$2,098.44
|
| Rate for Payer: Priority Health Tiered Network |
$2,098.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,179.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,243.47
|
| Rate for Payer: UHC Core |
$2,243.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,179.44
|
| Rate for Payer: UHC Exchange |
$2,243.47
|
| Rate for Payer: UHC Medicaid |
$770.85
|
| Rate for Payer: UHCCP Medicaid |
$770.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,053.86
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,741.00
|
|
|
Service Code
|
HCPCS 27828
|
| Min. Negotiated Rate |
$784.48 |
| Max. Negotiated Rate |
$3,555.75 |
| Rate for Payer: Aetna Commercial |
$1,610.16
|
| Rate for Payer: Aetna Medicare |
$1,249.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,610.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.32
|
| Rate for Payer: BCBS Complete |
$823.70
|
| Rate for Payer: BCBS MAPPO |
$1,201.61
|
| Rate for Payer: BCN Commercial |
$2,000.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.61
|
| Rate for Payer: Cash Price |
$3,792.80
|
| Rate for Payer: Cash Price |
$3,792.80
|
| Rate for Payer: Cofinity Commercial |
$1,610.16
|
| Rate for Payer: Cofinity Commercial |
$1,730.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,261.69
|
| Rate for Payer: Meridian Medicaid |
$823.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,321.77
|
| Rate for Payer: Nomi Health Commercial |
$1,441.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,555.75
|
| Rate for Payer: PACE SWMI |
$1,201.61
|
| Rate for Payer: PHP Commercial |
$1,682.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$784.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,138.36
|
| Rate for Payer: Priority Health Medicare |
$1,201.61
|
| Rate for Payer: Priority Health SBD |
$2,138.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,138.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,201.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,306.04
|
| Rate for Payer: UHC Core |
$2,306.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,201.61
|
| Rate for Payer: UHC Exchange |
$2,306.04
|
| Rate for Payer: UHC Medicaid |
$784.48
|
| Rate for Payer: UHCCP Medicaid |
$784.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,180.86
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,194.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$518.44 |
| Max. Negotiated Rate |
$2,395.50 |
| Rate for Payer: Aetna Commercial |
$1,056.95
|
| Rate for Payer: Aetna Medicare |
$820.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,135.83
|
| Rate for Payer: BCBS Complete |
$544.36
|
| Rate for Payer: BCBS MAPPO |
$788.77
|
| Rate for Payer: BCN Commercial |
$1,291.76
|
| Rate for Payer: BCN Medicare Advantage |
$788.77
|
| Rate for Payer: Cash Price |
$2,555.20
|
| Rate for Payer: Cash Price |
$2,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.95
|
| Rate for Payer: Cofinity Commercial |
$1,135.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$828.21
|
| Rate for Payer: Meridian Medicaid |
$544.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$867.65
|
| Rate for Payer: Nomi Health Commercial |
$946.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,395.50
|
| Rate for Payer: PACE SWMI |
$788.77
|
| Rate for Payer: PHP Commercial |
$1,104.28
|
| Rate for Payer: PHP Medicare Advantage |
$788.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,380.86
|
| Rate for Payer: Priority Health Medicare |
$788.77
|
| Rate for Payer: Priority Health SBD |
$1,380.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,380.86
|
| Rate for Payer: Railroad Medicare Medicare |
$788.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,480.39
|
| Rate for Payer: UHC Core |
$1,480.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$788.77
|
| Rate for Payer: UHC Exchange |
$1,480.39
|
| Rate for Payer: UHC Medicaid |
$518.44
|
| Rate for Payer: UHCCP Medicaid |
$518.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,469.24
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,493.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$671.59 |
| Max. Negotiated Rate |
$3,369.75 |
| Rate for Payer: Aetna Commercial |
$1,372.99
|
| Rate for Payer: Aetna Medicare |
$1,065.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,475.45
|
| Rate for Payer: BCBS Complete |
$705.17
|
| Rate for Payer: BCBS MAPPO |
$1,024.62
|
| Rate for Payer: BCN Commercial |
$1,696.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,024.62
|
| Rate for Payer: Cash Price |
$3,594.40
|
| Rate for Payer: Cash Price |
$3,594.40
|
| Rate for Payer: Cofinity Commercial |
$1,372.99
|
| Rate for Payer: Cofinity Commercial |
$1,475.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,024.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,075.85
|
| Rate for Payer: Meridian Medicaid |
$705.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,127.08
|
| Rate for Payer: Nomi Health Commercial |
$1,229.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,369.75
|
| Rate for Payer: PACE SWMI |
$1,024.62
|
| Rate for Payer: PHP Commercial |
$1,434.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,024.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,813.65
|
| Rate for Payer: Priority Health Medicare |
$1,024.62
|
| Rate for Payer: Priority Health SBD |
$1,813.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,813.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,024.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,935.45
|
| Rate for Payer: UHC Core |
$1,935.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,024.62
|
| Rate for Payer: UHC Exchange |
$1,935.45
|
| Rate for Payer: UHC Medicaid |
$671.59
|
| Rate for Payer: UHCCP Medicaid |
$671.59
|
| Rate for Payer: UMR Bronson Commercial |
$2,066.78
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$2,076.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$437.29 |
| Max. Negotiated Rate |
$1,557.00 |
| Rate for Payer: Aetna Commercial |
$901.22
|
| Rate for Payer: Aetna Medicare |
$699.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.47
|
| Rate for Payer: BCBS Complete |
$459.15
|
| Rate for Payer: BCBS MAPPO |
$672.55
|
| Rate for Payer: BCN Commercial |
$1,131.42
|
| Rate for Payer: BCN Medicare Advantage |
$672.55
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cofinity Commercial |
$901.22
|
| Rate for Payer: Cofinity Commercial |
$968.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.18
|
| Rate for Payer: Meridian Medicaid |
$459.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.80
|
| Rate for Payer: Nomi Health Commercial |
$807.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.00
|
| Rate for Payer: PACE SWMI |
$672.55
|
| Rate for Payer: PHP Commercial |
$941.57
|
| Rate for Payer: PHP Medicare Advantage |
$672.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,209.44
|
| Rate for Payer: Priority Health Medicare |
$672.55
|
| Rate for Payer: Priority Health SBD |
$1,209.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,209.44
|
| Rate for Payer: Railroad Medicare Medicare |
$672.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.15
|
| Rate for Payer: UHC Core |
$1,308.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.55
|
| Rate for Payer: UHC Exchange |
$1,308.15
|
| Rate for Payer: UHC Medicaid |
$437.29
|
| Rate for Payer: UHCCP Medicaid |
$437.29
|
| Rate for Payer: UMR Bronson Commercial |
$954.96
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,944.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$497.57 |
| Max. Negotiated Rate |
$2,208.00 |
| Rate for Payer: Aetna Commercial |
$1,020.22
|
| Rate for Payer: Aetna Medicare |
$791.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.36
|
| Rate for Payer: BCBS Complete |
$522.45
|
| Rate for Payer: BCBS MAPPO |
$761.36
|
| Rate for Payer: BCN Commercial |
$1,276.32
|
| Rate for Payer: BCN Medicare Advantage |
$761.36
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cofinity Commercial |
$1,020.22
|
| Rate for Payer: Cofinity Commercial |
$1,096.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.43
|
| Rate for Payer: Meridian Medicaid |
$522.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$837.50
|
| Rate for Payer: Nomi Health Commercial |
$913.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.00
|
| Rate for Payer: PACE SWMI |
$761.36
|
| Rate for Payer: PHP Commercial |
$1,065.90
|
| Rate for Payer: PHP Medicare Advantage |
$761.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,364.35
|
| Rate for Payer: Priority Health Medicare |
$761.36
|
| Rate for Payer: Priority Health SBD |
$1,364.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,364.35
|
| Rate for Payer: Railroad Medicare Medicare |
$761.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,451.51
|
| Rate for Payer: UHC Core |
$1,451.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.36
|
| Rate for Payer: UHC Exchange |
$1,451.51
|
| Rate for Payer: UHC Medicaid |
$497.57
|
| Rate for Payer: UHCCP Medicaid |
$497.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,354.24
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,008.00
|
|
|
Service Code
|
HCPCS 28675
|
| Min. Negotiated Rate |
$251.34 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$510.30
|
| Rate for Payer: Aetna Medicare |
$396.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.38
|
| Rate for Payer: BCBS Complete |
$263.91
|
| Rate for Payer: BCBS MAPPO |
$380.82
|
| Rate for Payer: BCN Commercial |
$630.44
|
| Rate for Payer: BCN Medicare Advantage |
$380.82
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cofinity Commercial |
$510.30
|
| Rate for Payer: Cofinity Commercial |
$548.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.86
|
| Rate for Payer: Meridian Medicaid |
$263.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.90
|
| Rate for Payer: Nomi Health Commercial |
$456.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$756.00
|
| Rate for Payer: PACE SWMI |
$380.82
|
| Rate for Payer: PHP Commercial |
$533.15
|
| Rate for Payer: PHP Medicare Advantage |
$380.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$673.93
|
| Rate for Payer: Priority Health Medicare |
$380.82
|
| Rate for Payer: Priority Health SBD |
$673.93
|
| Rate for Payer: Priority Health Tiered Network |
$673.93
|
| Rate for Payer: Railroad Medicare Medicare |
$380.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$701.10
|
| Rate for Payer: UHC Core |
$701.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.82
|
| Rate for Payer: UHC Exchange |
$701.10
|
| Rate for Payer: UHC Medicaid |
$251.34
|
| Rate for Payer: UHCCP Medicaid |
$251.34
|
| Rate for Payer: UMR Bronson Commercial |
$463.68
|
|
|
PR OPEN TREATMENT LUNATE DISLOCATION
|
Professional
|
Both
|
$1,961.00
|
|
|
Service Code
|
HCPCS 25695
|
| Min. Negotiated Rate |
$383.19 |
| Max. Negotiated Rate |
$1,470.75 |
| Rate for Payer: Aetna Commercial |
$784.46
|
| Rate for Payer: Aetna Medicare |
$608.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$784.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.00
|
| Rate for Payer: BCBS Complete |
$402.35
|
| Rate for Payer: BCBS MAPPO |
$585.42
|
| Rate for Payer: BCN Commercial |
$973.05
|
| Rate for Payer: BCN Medicare Advantage |
$585.42
|
| Rate for Payer: Cash Price |
$1,568.80
|
| Rate for Payer: Cash Price |
$1,568.80
|
| Rate for Payer: Cofinity Commercial |
$784.46
|
| Rate for Payer: Cofinity Commercial |
$843.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.69
|
| Rate for Payer: Meridian Medicaid |
$402.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$643.96
|
| Rate for Payer: Nomi Health Commercial |
$702.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,470.75
|
| Rate for Payer: PACE SWMI |
$585.42
|
| Rate for Payer: PHP Commercial |
$819.59
|
| Rate for Payer: PHP Medicare Advantage |
$585.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,040.17
|
| Rate for Payer: Priority Health Medicare |
$585.42
|
| Rate for Payer: Priority Health SBD |
$1,040.17
|
| Rate for Payer: Priority Health Tiered Network |
$1,040.17
|
| Rate for Payer: Railroad Medicare Medicare |
$585.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,105.82
|
| Rate for Payer: UHC Core |
$1,105.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$585.42
|
| Rate for Payer: UHC Exchange |
$1,105.82
|
| Rate for Payer: UHC Medicaid |
$383.19
|
| Rate for Payer: UHCCP Medicaid |
$383.19
|
| Rate for Payer: UMR Bronson Commercial |
$902.06
|
|
|
PR OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE
|
Professional
|
Both
|
$1,764.00
|
|
|
Service Code
|
HCPCS 21465
|
| Min. Negotiated Rate |
$461.57 |
| Max. Negotiated Rate |
$1,460.68 |
| Rate for Payer: Aetna Commercial |
$949.43
|
| Rate for Payer: Aetna Medicare |
$736.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.43
|
| Rate for Payer: BCBS Complete |
$484.65
|
| Rate for Payer: BCBS MAPPO |
$708.53
|
| Rate for Payer: BCN Commercial |
$1,217.57
|
| Rate for Payer: BCN Medicare Advantage |
$708.53
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cofinity Commercial |
$1,020.28
|
| Rate for Payer: Cofinity Commercial |
$949.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.96
|
| Rate for Payer: Meridian Medicaid |
$484.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$779.38
|
| Rate for Payer: Nomi Health Commercial |
$850.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,323.00
|
| Rate for Payer: PACE SWMI |
$708.53
|
| Rate for Payer: PHP Commercial |
$991.94
|
| Rate for Payer: PHP Medicare Advantage |
$708.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,301.54
|
| Rate for Payer: Priority Health Medicare |
$708.53
|
| Rate for Payer: Priority Health SBD |
$1,301.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,301.54
|
| Rate for Payer: Railroad Medicare Medicare |
$708.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,460.68
|
| Rate for Payer: UHC Core |
$1,460.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$708.53
|
| Rate for Payer: UHC Exchange |
$1,460.68
|
| Rate for Payer: UHC Medicaid |
$461.57
|
| Rate for Payer: UHCCP Medicaid |
$461.57
|
| Rate for Payer: UMR Bronson Commercial |
$811.44
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,246.00
|
|
|
Service Code
|
HCPCS 27766
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$1,684.50 |
| Rate for Payer: Aetna Commercial |
$753.74
|
| Rate for Payer: Aetna Medicare |
$584.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.99
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS MAPPO |
$562.49
|
| Rate for Payer: BCN Commercial |
$926.25
|
| Rate for Payer: BCN Medicare Advantage |
$562.49
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cofinity Commercial |
$753.74
|
| Rate for Payer: Cofinity Commercial |
$809.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.61
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.74
|
| Rate for Payer: Nomi Health Commercial |
$674.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,684.50
|
| Rate for Payer: PACE SWMI |
$562.49
|
| Rate for Payer: PHP Commercial |
$787.49
|
| Rate for Payer: PHP Medicare Advantage |
$562.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$990.12
|
| Rate for Payer: Priority Health Medicare |
$562.49
|
| Rate for Payer: Priority Health SBD |
$990.12
|
| Rate for Payer: Priority Health Tiered Network |
$990.12
|
| Rate for Payer: Railroad Medicare Medicare |
$562.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,050.06
|
| Rate for Payer: UHC Core |
$1,050.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$562.49
|
| Rate for Payer: UHC Exchange |
$1,050.06
|
| Rate for Payer: UHC Medicaid |
$369.77
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,033.16
|
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$347.62 |
| Max. Negotiated Rate |
$1,487.25 |
| Rate for Payer: Aetna Commercial |
$706.33
|
| Rate for Payer: Aetna Medicare |
$548.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.04
|
| Rate for Payer: BCBS Complete |
$365.00
|
| Rate for Payer: BCBS MAPPO |
$527.11
|
| Rate for Payer: BCN Commercial |
$884.42
|
| Rate for Payer: BCN Medicare Advantage |
$527.11
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$706.33
|
| Rate for Payer: Cofinity Commercial |
$759.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.47
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.82
|
| Rate for Payer: Nomi Health Commercial |
$632.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,487.25
|
| Rate for Payer: PACE SWMI |
$527.11
|
| Rate for Payer: PHP Commercial |
$737.95
|
| Rate for Payer: PHP Medicare Advantage |
$527.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$945.41
|
| Rate for Payer: Priority Health Medicare |
$527.11
|
| Rate for Payer: Priority Health SBD |
$945.41
|
| Rate for Payer: Priority Health Tiered Network |
$945.41
|
| Rate for Payer: Railroad Medicare Medicare |
$527.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.51
|
| Rate for Payer: UHC Core |
$990.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.11
|
| Rate for Payer: UHC Exchange |
$990.51
|
| Rate for Payer: UHC Medicaid |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$347.62
|
| Rate for Payer: UMR Bronson Commercial |
$912.18
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: Aetna Commercial |
$701.30
|
| Rate for Payer: Aetna Medicare |
$544.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.64
|
| Rate for Payer: BCBS Complete |
$362.99
|
| Rate for Payer: BCBS MAPPO |
$523.36
|
| Rate for Payer: BCN Commercial |
$856.03
|
| Rate for Payer: BCN Medicare Advantage |
$523.36
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$701.30
|
| Rate for Payer: Cofinity Commercial |
$753.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$549.53
|
| Rate for Payer: Meridian Medicaid |
$362.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$575.70
|
| Rate for Payer: Nomi Health Commercial |
$628.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,039.50
|
| Rate for Payer: PACE SWMI |
$523.36
|
| Rate for Payer: PHP Commercial |
$732.70
|
| Rate for Payer: PHP Medicare Advantage |
$523.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$915.08
|
| Rate for Payer: Priority Health Medicare |
$523.36
|
| Rate for Payer: Priority Health SBD |
$915.08
|
| Rate for Payer: Priority Health Tiered Network |
$915.08
|
| Rate for Payer: Railroad Medicare Medicare |
$523.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.57
|
| Rate for Payer: UHC Core |
$957.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$523.36
|
| Rate for Payer: UHC Exchange |
$957.57
|
| Rate for Payer: UHC Medicaid |
$345.70
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
| Rate for Payer: UMR Bronson Commercial |
$637.56
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$263.69 |
| Max. Negotiated Rate |
$740.61 |
| Rate for Payer: Aetna Commercial |
$527.48
|
| Rate for Payer: Aetna Medicare |
$409.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.84
|
| Rate for Payer: BCBS Complete |
$276.87
|
| Rate for Payer: BCBS MAPPO |
$393.64
|
| Rate for Payer: BCN Commercial |
$668.29
|
| Rate for Payer: BCN Medicare Advantage |
$393.64
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$527.48
|
| Rate for Payer: Cofinity Commercial |
$566.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.32
|
| Rate for Payer: Meridian Medicaid |
$276.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.00
|
| Rate for Payer: Nomi Health Commercial |
$472.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.75
|
| Rate for Payer: PACE SWMI |
$393.64
|
| Rate for Payer: PHP Commercial |
$551.10
|
| Rate for Payer: PHP Medicare Advantage |
$393.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$714.38
|
| Rate for Payer: Priority Health Medicare |
$393.64
|
| Rate for Payer: Priority Health SBD |
$714.38
|
| Rate for Payer: Priority Health Tiered Network |
$714.38
|
| Rate for Payer: Railroad Medicare Medicare |
$393.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.61
|
| Rate for Payer: UHC Core |
$740.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$393.64
|
| Rate for Payer: UHC Exchange |
$740.61
|
| Rate for Payer: UHC Medicaid |
$263.69
|
| Rate for Payer: UHCCP Medicaid |
$263.69
|
| Rate for Payer: UMR Bronson Commercial |
$397.90
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$1,112.66 |
| Rate for Payer: Aetna Commercial |
$767.18
|
| Rate for Payer: Aetna Medicare |
$595.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.43
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCBS MAPPO |
$572.52
|
| Rate for Payer: BCN Commercial |
$954.63
|
| Rate for Payer: BCN Medicare Advantage |
$572.52
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$767.18
|
| Rate for Payer: Cofinity Commercial |
$824.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.15
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$629.77
|
| Rate for Payer: Nomi Health Commercial |
$687.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE SWMI |
$572.52
|
| Rate for Payer: PHP Commercial |
$801.53
|
| Rate for Payer: PHP Medicare Advantage |
$572.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,020.47
|
| Rate for Payer: Priority Health Medicare |
$572.52
|
| Rate for Payer: Priority Health SBD |
$1,020.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,020.47
|
| Rate for Payer: Railroad Medicare Medicare |
$572.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,112.66
|
| Rate for Payer: UHC Core |
$1,112.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$572.52
|
| Rate for Payer: UHC Exchange |
$1,112.66
|
| Rate for Payer: UHC Medicaid |
$376.37
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
| Rate for Payer: UMR Bronson Commercial |
$636.18
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$430.90 |
| Max. Negotiated Rate |
$1,273.85 |
| Rate for Payer: Aetna Commercial |
$884.23
|
| Rate for Payer: Aetna Medicare |
$686.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.21
|
| Rate for Payer: BCBS Complete |
$452.44
|
| Rate for Payer: BCBS MAPPO |
$659.87
|
| Rate for Payer: BCN Commercial |
$1,107.01
|
| Rate for Payer: BCN Medicare Advantage |
$659.87
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$884.23
|
| Rate for Payer: Cofinity Commercial |
$950.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.86
|
| Rate for Payer: Meridian Medicaid |
$452.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.86
|
| Rate for Payer: Nomi Health Commercial |
$791.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$659.87
|
| Rate for Payer: PHP Commercial |
$923.82
|
| Rate for Payer: PHP Medicare Advantage |
$659.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.36
|
| Rate for Payer: Priority Health Medicare |
$659.87
|
| Rate for Payer: Priority Health SBD |
$1,183.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,183.36
|
| Rate for Payer: Railroad Medicare Medicare |
$659.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,273.85
|
| Rate for Payer: UHC Core |
$1,273.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.87
|
| Rate for Payer: UHC Exchange |
$1,273.85
|
| Rate for Payer: UHC Medicaid |
$430.90
|
| Rate for Payer: UHCCP Medicaid |
$430.90
|
| Rate for Payer: UMR Bronson Commercial |
$614.56
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,346.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$1,759.50 |
| Rate for Payer: Aetna Commercial |
$878.10
|
| Rate for Payer: Aetna Medicare |
$681.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$878.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.63
|
| Rate for Payer: BCBS Complete |
$450.66
|
| Rate for Payer: BCBS MAPPO |
$655.30
|
| Rate for Payer: BCN Commercial |
$1,083.61
|
| Rate for Payer: BCN Medicare Advantage |
$655.30
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$878.10
|
| Rate for Payer: Cofinity Commercial |
$943.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.07
|
| Rate for Payer: Meridian Medicaid |
$450.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$720.83
|
| Rate for Payer: Nomi Health Commercial |
$786.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,759.50
|
| Rate for Payer: PACE SWMI |
$655.30
|
| Rate for Payer: PHP Commercial |
$917.42
|
| Rate for Payer: PHP Medicare Advantage |
$655.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,158.35
|
| Rate for Payer: Priority Health Medicare |
$655.30
|
| Rate for Payer: Priority Health SBD |
$1,158.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,158.35
|
| Rate for Payer: Railroad Medicare Medicare |
$655.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.58
|
| Rate for Payer: UHC Core |
$1,239.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$655.30
|
| Rate for Payer: UHC Exchange |
$1,239.58
|
| Rate for Payer: UHC Medicaid |
$429.20
|
| Rate for Payer: UHCCP Medicaid |
$429.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,079.16
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$404.27 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna Medicare |
$640.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.44
|
| Rate for Payer: BCBS Complete |
$424.48
|
| Rate for Payer: BCBS MAPPO |
$616.28
|
| Rate for Payer: BCN Commercial |
$1,029.32
|
| Rate for Payer: BCN Medicare Advantage |
$616.28
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$825.82
|
| Rate for Payer: Cofinity Commercial |
$887.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.09
|
| Rate for Payer: Meridian Medicaid |
$424.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.91
|
| Rate for Payer: Nomi Health Commercial |
$739.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.75
|
| Rate for Payer: PACE SWMI |
$616.28
|
| Rate for Payer: PHP Commercial |
$862.79
|
| Rate for Payer: PHP Medicare Advantage |
$616.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,100.32
|
| Rate for Payer: Priority Health Medicare |
$616.28
|
| Rate for Payer: Priority Health SBD |
$1,100.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,100.32
|
| Rate for Payer: Railroad Medicare Medicare |
$616.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.77
|
| Rate for Payer: UHC Core |
$1,164.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$616.28
|
| Rate for Payer: UHC Exchange |
$1,164.77
|
| Rate for Payer: UHC Medicaid |
$404.27
|
| Rate for Payer: UHCCP Medicaid |
$404.27
|
| Rate for Payer: UMR Bronson Commercial |
$977.50
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$2,056.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$430.90 |
| Max. Negotiated Rate |
$1,542.00 |
| Rate for Payer: Aetna Commercial |
$883.52
|
| Rate for Payer: Aetna Medicare |
$685.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$883.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.45
|
| Rate for Payer: BCBS Complete |
$452.44
|
| Rate for Payer: BCBS MAPPO |
$659.34
|
| Rate for Payer: BCN Commercial |
$1,084.10
|
| Rate for Payer: BCN Medicare Advantage |
$659.34
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cofinity Commercial |
$883.52
|
| Rate for Payer: Cofinity Commercial |
$949.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.31
|
| Rate for Payer: Meridian Medicaid |
$452.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.27
|
| Rate for Payer: Nomi Health Commercial |
$791.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: PACE SWMI |
$659.34
|
| Rate for Payer: PHP Commercial |
$923.08
|
| Rate for Payer: PHP Medicare Advantage |
$659.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,158.87
|
| Rate for Payer: Priority Health Medicare |
$659.34
|
| Rate for Payer: Priority Health SBD |
$1,158.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,158.87
|
| Rate for Payer: Railroad Medicare Medicare |
$659.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,193.12
|
| Rate for Payer: UHC Core |
$1,193.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.34
|
| Rate for Payer: UHC Exchange |
$1,193.12
|
| Rate for Payer: UHC Medicaid |
$430.90
|
| Rate for Payer: UHCCP Medicaid |
$430.90
|
| Rate for Payer: UMR Bronson Commercial |
$945.76
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,236.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$622.60 |
| Max. Negotiated Rate |
$2,427.00 |
| Rate for Payer: Aetna Commercial |
$1,281.16
|
| Rate for Payer: Aetna Medicare |
$994.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.77
|
| Rate for Payer: BCBS Complete |
$653.73
|
| Rate for Payer: BCBS MAPPO |
$956.09
|
| Rate for Payer: BCN Commercial |
$1,584.08
|
| Rate for Payer: BCN Medicare Advantage |
$956.09
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cofinity Commercial |
$1,281.16
|
| Rate for Payer: Cofinity Commercial |
$1,376.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,003.89
|
| Rate for Payer: Meridian Medicaid |
$653.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,051.70
|
| Rate for Payer: Nomi Health Commercial |
$1,147.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,427.00
|
| Rate for Payer: PACE SWMI |
$956.09
|
| Rate for Payer: PHP Commercial |
$1,338.53
|
| Rate for Payer: PHP Medicare Advantage |
$956.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,693.33
|
| Rate for Payer: Priority Health Medicare |
$956.09
|
| Rate for Payer: Priority Health SBD |
$1,693.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,693.33
|
| Rate for Payer: Railroad Medicare Medicare |
$956.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.14
|
| Rate for Payer: UHC Core |
$1,816.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$956.09
|
| Rate for Payer: UHC Exchange |
$1,816.14
|
| Rate for Payer: UHC Medicaid |
$622.60
|
| Rate for Payer: UHCCP Medicaid |
$622.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,488.56
|
|
