|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$310.34 |
| Max. Negotiated Rate |
$865.37 |
| Rate for Payer: Aetna Commercial |
$628.45
|
| Rate for Payer: Aetna Medicare |
$487.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$675.35
|
| Rate for Payer: BCBS Complete |
$325.86
|
| Rate for Payer: BCBS MAPPO |
$468.99
|
| Rate for Payer: BCN Commercial |
$777.85
|
| Rate for Payer: BCN Medicare Advantage |
$468.99
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$628.45
|
| Rate for Payer: Cofinity Commercial |
$675.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$492.44
|
| Rate for Payer: Meridian Medicaid |
$325.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.89
|
| Rate for Payer: Nomi Health Commercial |
$562.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$677.25
|
| Rate for Payer: PACE SWMI |
$468.99
|
| Rate for Payer: PHP Commercial |
$656.59
|
| Rate for Payer: PHP Medicare Advantage |
$468.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$831.49
|
| Rate for Payer: Priority Health Medicare |
$468.99
|
| Rate for Payer: Priority Health SBD |
$831.49
|
| Rate for Payer: Priority Health Tiered Network |
$831.49
|
| Rate for Payer: Railroad Medicare Medicare |
$468.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.37
|
| Rate for Payer: UHC Core |
$865.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$468.99
|
| Rate for Payer: UHC Exchange |
$865.37
|
| Rate for Payer: UHC Medicaid |
$310.34
|
| Rate for Payer: UHCCP Medicaid |
$310.34
|
| Rate for Payer: UMR Bronson Commercial |
$415.38
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,839.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$379.57 |
| Max. Negotiated Rate |
$1,379.25 |
| Rate for Payer: Aetna Commercial |
$775.22
|
| Rate for Payer: Aetna Medicare |
$601.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$833.07
|
| Rate for Payer: BCBS Complete |
$398.55
|
| Rate for Payer: BCBS MAPPO |
$578.52
|
| Rate for Payer: BCN Commercial |
$967.58
|
| Rate for Payer: BCN Medicare Advantage |
$578.52
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cofinity Commercial |
$775.22
|
| Rate for Payer: Cofinity Commercial |
$833.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$607.45
|
| Rate for Payer: Meridian Medicaid |
$398.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$636.37
|
| Rate for Payer: Nomi Health Commercial |
$694.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,379.25
|
| Rate for Payer: PACE SWMI |
$578.52
|
| Rate for Payer: PHP Commercial |
$809.93
|
| Rate for Payer: PHP Medicare Advantage |
$578.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,034.31
|
| Rate for Payer: Priority Health Medicare |
$578.52
|
| Rate for Payer: Priority Health SBD |
$1,034.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,034.31
|
| Rate for Payer: Railroad Medicare Medicare |
$578.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,098.90
|
| Rate for Payer: UHC Core |
$1,098.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$578.52
|
| Rate for Payer: UHC Exchange |
$1,098.90
|
| Rate for Payer: UHC Medicaid |
$379.57
|
| Rate for Payer: UHCCP Medicaid |
$379.57
|
| Rate for Payer: UMR Bronson Commercial |
$845.94
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,371.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$1,778.25 |
| Rate for Payer: Aetna Commercial |
$872.57
|
| Rate for Payer: Aetna Medicare |
$677.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.68
|
| Rate for Payer: BCBS Complete |
$450.66
|
| Rate for Payer: BCBS MAPPO |
$651.17
|
| Rate for Payer: BCN Commercial |
$1,070.66
|
| Rate for Payer: BCN Medicare Advantage |
$651.17
|
| Rate for Payer: Cash Price |
$1,896.80
|
| Rate for Payer: Cash Price |
$1,896.80
|
| Rate for Payer: Cofinity Commercial |
$872.57
|
| Rate for Payer: Cofinity Commercial |
$937.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.73
|
| Rate for Payer: Meridian Medicaid |
$450.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$716.29
|
| Rate for Payer: Nomi Health Commercial |
$781.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,778.25
|
| Rate for Payer: PACE SWMI |
$651.17
|
| Rate for Payer: PHP Commercial |
$911.64
|
| Rate for Payer: PHP Medicare Advantage |
$651.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,144.51
|
| Rate for Payer: Priority Health Medicare |
$651.17
|
| Rate for Payer: Priority Health SBD |
$1,144.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,144.51
|
| Rate for Payer: Railroad Medicare Medicare |
$651.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.12
|
| Rate for Payer: UHC Core |
$1,216.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.17
|
| Rate for Payer: UHC Exchange |
$1,216.12
|
| Rate for Payer: UHC Medicaid |
$429.20
|
| Rate for Payer: UHCCP Medicaid |
$429.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,090.66
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$4,039.00
|
|
|
Service Code
|
HCPCS 27514
|
| Min. Negotiated Rate |
$558.06 |
| Max. Negotiated Rate |
$3,029.25 |
| Rate for Payer: Aetna Commercial |
$1,155.07
|
| Rate for Payer: Aetna Medicare |
$896.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.27
|
| Rate for Payer: BCBS Complete |
$585.96
|
| Rate for Payer: BCBS MAPPO |
$861.99
|
| Rate for Payer: BCN Commercial |
$1,460.08
|
| Rate for Payer: BCN Medicare Advantage |
$861.99
|
| Rate for Payer: Cash Price |
$3,231.20
|
| Rate for Payer: Cash Price |
$3,231.20
|
| Rate for Payer: Cofinity Commercial |
$1,155.07
|
| Rate for Payer: Cofinity Commercial |
$1,241.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$861.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.09
|
| Rate for Payer: Meridian Medicaid |
$585.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$948.19
|
| Rate for Payer: Nomi Health Commercial |
$1,034.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,029.25
|
| Rate for Payer: PACE SWMI |
$861.99
|
| Rate for Payer: PHP Commercial |
$1,206.79
|
| Rate for Payer: PHP Medicare Advantage |
$861.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,560.79
|
| Rate for Payer: Priority Health Medicare |
$861.99
|
| Rate for Payer: Priority Health SBD |
$1,560.79
|
| Rate for Payer: Priority Health Tiered Network |
$1,560.79
|
| Rate for Payer: Railroad Medicare Medicare |
$861.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,701.27
|
| Rate for Payer: UHC Core |
$1,701.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$861.99
|
| Rate for Payer: UHC Exchange |
$1,701.27
|
| Rate for Payer: UHC Medicaid |
$558.06
|
| Rate for Payer: UHCCP Medicaid |
$558.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,857.94
|
|
|
PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD
|
Professional
|
Both
|
$4,037.00
|
|
|
Service Code
|
HCPCS 27269
|
| Min. Negotiated Rate |
$715.04 |
| Max. Negotiated Rate |
$3,027.75 |
| Rate for Payer: Aetna Commercial |
$1,481.12
|
| Rate for Payer: Aetna Medicare |
$1,149.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,481.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,591.65
|
| Rate for Payer: BCBS Complete |
$750.79
|
| Rate for Payer: BCBS MAPPO |
$1,105.31
|
| Rate for Payer: BCN Commercial |
$1,873.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.31
|
| Rate for Payer: Cash Price |
$3,229.60
|
| Rate for Payer: Cash Price |
$3,229.60
|
| Rate for Payer: Cofinity Commercial |
$1,481.12
|
| Rate for Payer: Cofinity Commercial |
$1,591.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,160.58
|
| Rate for Payer: Meridian Medicaid |
$750.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,215.84
|
| Rate for Payer: Nomi Health Commercial |
$1,326.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,027.75
|
| Rate for Payer: PACE SWMI |
$1,105.31
|
| Rate for Payer: PHP Commercial |
$1,547.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,003.15
|
| Rate for Payer: Priority Health Medicare |
$1,105.31
|
| Rate for Payer: Priority Health SBD |
$2,003.15
|
| Rate for Payer: Priority Health Tiered Network |
$2,003.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,105.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,188.43
|
| Rate for Payer: UHC Core |
$2,188.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,105.31
|
| Rate for Payer: UHC Exchange |
$2,188.43
|
| Rate for Payer: UHC Medicaid |
$715.04
|
| Rate for Payer: UHCCP Medicaid |
$715.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,857.02
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,963.00
|
|
|
Service Code
|
HCPCS 27511
|
| Min. Negotiated Rate |
$574.46 |
| Max. Negotiated Rate |
$2,972.25 |
| Rate for Payer: Aetna Commercial |
$1,189.50
|
| Rate for Payer: Aetna Medicare |
$923.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,189.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.27
|
| Rate for Payer: BCBS Complete |
$603.18
|
| Rate for Payer: BCBS MAPPO |
$887.69
|
| Rate for Payer: BCN Commercial |
$1,502.40
|
| Rate for Payer: BCN Medicare Advantage |
$887.69
|
| Rate for Payer: Cash Price |
$3,170.40
|
| Rate for Payer: Cash Price |
$3,170.40
|
| Rate for Payer: Cofinity Commercial |
$1,189.50
|
| Rate for Payer: Cofinity Commercial |
$1,278.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$887.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$932.07
|
| Rate for Payer: Meridian Medicaid |
$603.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$976.46
|
| Rate for Payer: Nomi Health Commercial |
$1,065.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,972.25
|
| Rate for Payer: PACE SWMI |
$887.69
|
| Rate for Payer: PHP Commercial |
$1,242.77
|
| Rate for Payer: PHP Medicare Advantage |
$887.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,606.03
|
| Rate for Payer: Priority Health Medicare |
$887.69
|
| Rate for Payer: Priority Health SBD |
$1,606.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,606.03
|
| Rate for Payer: Railroad Medicare Medicare |
$887.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,756.34
|
| Rate for Payer: UHC Core |
$1,756.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$887.69
|
| Rate for Payer: UHC Exchange |
$1,756.34
|
| Rate for Payer: UHC Medicaid |
$574.46
|
| Rate for Payer: UHCCP Medicaid |
$574.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,822.98
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$4,529.00
|
|
|
Service Code
|
HCPCS 27513
|
| Min. Negotiated Rate |
$705.88 |
| Max. Negotiated Rate |
$3,396.75 |
| Rate for Payer: Aetna Commercial |
$1,465.58
|
| Rate for Payer: Aetna Medicare |
$1,137.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,574.96
|
| Rate for Payer: BCBS Complete |
$741.17
|
| Rate for Payer: BCBS MAPPO |
$1,093.72
|
| Rate for Payer: BCN Commercial |
$1,858.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,093.72
|
| Rate for Payer: Cash Price |
$3,623.20
|
| Rate for Payer: Cash Price |
$3,623.20
|
| Rate for Payer: Cofinity Commercial |
$1,465.58
|
| Rate for Payer: Cofinity Commercial |
$1,574.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,093.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,148.41
|
| Rate for Payer: Meridian Medicaid |
$741.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,203.09
|
| Rate for Payer: Nomi Health Commercial |
$1,312.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,396.75
|
| Rate for Payer: PACE SWMI |
$1,093.72
|
| Rate for Payer: PHP Commercial |
$1,531.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,093.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,987.17
|
| Rate for Payer: Priority Health Medicare |
$1,093.72
|
| Rate for Payer: Priority Health SBD |
$1,987.17
|
| Rate for Payer: Priority Health Tiered Network |
$1,987.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,093.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,186.12
|
| Rate for Payer: UHC Core |
$2,186.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,093.72
|
| Rate for Payer: UHC Exchange |
$2,186.12
|
| Rate for Payer: UHC Medicaid |
$705.88
|
| Rate for Payer: UHCCP Medicaid |
$705.88
|
| Rate for Payer: UMR Bronson Commercial |
$2,083.34
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,479.00
|
|
|
Service Code
|
HCPCS 28505
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,109.25 |
| Rate for Payer: Aetna Commercial |
$613.18
|
| Rate for Payer: Aetna Medicare |
$475.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.94
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$457.60
|
| Rate for Payer: BCN Commercial |
$753.95
|
| Rate for Payer: BCN Medicare Advantage |
$457.60
|
| Rate for Payer: Cash Price |
$1,183.20
|
| Rate for Payer: Cash Price |
$1,183.20
|
| Rate for Payer: Cofinity Commercial |
$613.18
|
| Rate for Payer: Cofinity Commercial |
$658.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$480.48
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$503.36
|
| Rate for Payer: Nomi Health Commercial |
$549.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,109.25
|
| Rate for Payer: PACE SWMI |
$457.60
|
| Rate for Payer: PHP Commercial |
$640.64
|
| Rate for Payer: PHP Medicare Advantage |
$457.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.95
|
| Rate for Payer: Priority Health Medicare |
$457.60
|
| Rate for Payer: Priority Health SBD |
$805.95
|
| Rate for Payer: Priority Health Tiered Network |
$805.95
|
| Rate for Payer: Railroad Medicare Medicare |
$457.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.27
|
| Rate for Payer: UHC Core |
$867.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.60
|
| Rate for Payer: UHC Exchange |
$867.27
|
| Rate for Payer: UHC Medicaid |
$300.12
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
| Rate for Payer: UMR Bronson Commercial |
$680.34
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 28525
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$700.58 |
| Rate for Payer: Aetna Commercial |
$499.98
|
| Rate for Payer: Aetna Medicare |
$388.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.29
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$373.12
|
| Rate for Payer: BCN Commercial |
$613.51
|
| Rate for Payer: BCN Medicare Advantage |
$373.12
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$499.98
|
| Rate for Payer: Cofinity Commercial |
$537.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.78
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.43
|
| Rate for Payer: Nomi Health Commercial |
$447.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$475.50
|
| Rate for Payer: PACE SWMI |
$373.12
|
| Rate for Payer: PHP Commercial |
$522.37
|
| Rate for Payer: PHP Medicare Advantage |
$373.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$655.83
|
| Rate for Payer: Priority Health Medicare |
$373.12
|
| Rate for Payer: Priority Health SBD |
$655.83
|
| Rate for Payer: Priority Health Tiered Network |
$655.83
|
| Rate for Payer: Railroad Medicare Medicare |
$373.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.58
|
| Rate for Payer: UHC Core |
$700.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.12
|
| Rate for Payer: UHC Exchange |
$700.58
|
| Rate for Payer: UHC Medicaid |
$246.02
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
| Rate for Payer: UMR Bronson Commercial |
$291.64
|
|
|
PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT
|
Professional
|
Both
|
$1,207.00
|
|
|
Service Code
|
HCPCS 21407
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$1,116.09 |
| Rate for Payer: Aetna Commercial |
$752.45
|
| Rate for Payer: Aetna Medicare |
$583.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.60
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS MAPPO |
$561.53
|
| Rate for Payer: BCN Commercial |
$979.52
|
| Rate for Payer: BCN Medicare Advantage |
$561.53
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cofinity Commercial |
$752.45
|
| Rate for Payer: Cofinity Commercial |
$808.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.61
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.68
|
| Rate for Payer: Nomi Health Commercial |
$673.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$905.25
|
| Rate for Payer: PACE SWMI |
$561.53
|
| Rate for Payer: PHP Commercial |
$786.14
|
| Rate for Payer: PHP Medicare Advantage |
$561.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,047.10
|
| Rate for Payer: Priority Health Medicare |
$561.53
|
| Rate for Payer: Priority Health SBD |
$1,047.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.10
|
| Rate for Payer: Railroad Medicare Medicare |
$561.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,116.09
|
| Rate for Payer: UHC Core |
$1,116.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.53
|
| Rate for Payer: UHC Exchange |
$1,116.09
|
| Rate for Payer: UHC Medicaid |
$368.28
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
| Rate for Payer: UMR Bronson Commercial |
$555.22
|
|
|
PR OPEN TX HUMERAL EPICONDYLAR FRACTURE
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 24575
|
| Min. Negotiated Rate |
$443.04 |
| Max. Negotiated Rate |
$1,881.75 |
| Rate for Payer: Aetna Commercial |
$905.59
|
| Rate for Payer: Aetna Medicare |
$702.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$973.17
|
| Rate for Payer: BCBS Complete |
$465.19
|
| Rate for Payer: BCBS MAPPO |
$675.81
|
| Rate for Payer: BCN Commercial |
$1,124.44
|
| Rate for Payer: BCN Medicare Advantage |
$675.81
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$905.59
|
| Rate for Payer: Cofinity Commercial |
$973.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.60
|
| Rate for Payer: Meridian Medicaid |
$465.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$743.39
|
| Rate for Payer: Nomi Health Commercial |
$810.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,881.75
|
| Rate for Payer: PACE SWMI |
$675.81
|
| Rate for Payer: PHP Commercial |
$946.13
|
| Rate for Payer: PHP Medicare Advantage |
$675.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,201.99
|
| Rate for Payer: Priority Health Medicare |
$675.81
|
| Rate for Payer: Priority Health SBD |
$1,201.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,201.99
|
| Rate for Payer: Railroad Medicare Medicare |
$675.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,275.73
|
| Rate for Payer: UHC Core |
$1,275.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$675.81
|
| Rate for Payer: UHC Exchange |
$1,275.73
|
| Rate for Payer: UHC Medicaid |
$443.04
|
| Rate for Payer: UHCCP Medicaid |
$443.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,154.14
|
|
|
PR OPEN TX ILIAC SPINE UNI/BIL
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS G0412
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$2,034.75 |
| Rate for Payer: Aetna Commercial |
$879.15
|
| Rate for Payer: Aetna Medicare |
$682.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.76
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$656.08
|
| Rate for Payer: BCN Commercial |
$1,100.04
|
| Rate for Payer: BCN Medicare Advantage |
$656.08
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cofinity Commercial |
$879.15
|
| Rate for Payer: Cofinity Commercial |
$944.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$656.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.88
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$721.69
|
| Rate for Payer: Nomi Health Commercial |
$787.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,034.75
|
| Rate for Payer: PACE SWMI |
$656.08
|
| Rate for Payer: PHP Commercial |
$918.51
|
| Rate for Payer: PHP Medicare Advantage |
$656.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,175.91
|
| Rate for Payer: Priority Health Medicare |
$656.08
|
| Rate for Payer: Priority Health SBD |
$1,175.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,175.91
|
| Rate for Payer: Railroad Medicare Medicare |
$656.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,273.94
|
| Rate for Payer: UHC Core |
$1,273.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$656.08
|
| Rate for Payer: UHC Exchange |
$1,273.94
|
| Rate for Payer: UHC Medicaid |
$426.64
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,247.98
|
|
|
PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE
|
Professional
|
Both
|
$2,831.00
|
|
|
Service Code
|
HCPCS 27540
|
| Min. Negotiated Rate |
$486.28 |
| Max. Negotiated Rate |
$2,123.25 |
| Rate for Payer: Aetna Commercial |
$998.34
|
| Rate for Payer: Aetna Medicare |
$774.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,072.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.34
|
| Rate for Payer: BCBS Complete |
$510.59
|
| Rate for Payer: BCBS MAPPO |
$745.03
|
| Rate for Payer: BCN Commercial |
$1,242.47
|
| Rate for Payer: BCN Medicare Advantage |
$745.03
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,072.84
|
| Rate for Payer: Cofinity Commercial |
$998.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.28
|
| Rate for Payer: Meridian Medicaid |
$510.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$819.53
|
| Rate for Payer: Nomi Health Commercial |
$894.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,123.25
|
| Rate for Payer: PACE SWMI |
$745.03
|
| Rate for Payer: PHP Commercial |
$1,043.04
|
| Rate for Payer: PHP Medicare Advantage |
$745.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,328.17
|
| Rate for Payer: Priority Health Medicare |
$745.03
|
| Rate for Payer: Priority Health SBD |
$1,328.17
|
| Rate for Payer: Priority Health Tiered Network |
$1,328.17
|
| Rate for Payer: Railroad Medicare Medicare |
$745.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,415.87
|
| Rate for Payer: UHC Core |
$1,415.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$745.03
|
| Rate for Payer: UHC Exchange |
$1,415.87
|
| Rate for Payer: UHC Medicaid |
$486.28
|
| Rate for Payer: UHCCP Medicaid |
$486.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,302.26
|
|
|
PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26785
|
| Min. Negotiated Rate |
$334.41 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$678.71
|
| Rate for Payer: Aetna Medicare |
$526.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.36
|
| Rate for Payer: BCBS Complete |
$351.13
|
| Rate for Payer: BCBS MAPPO |
$506.50
|
| Rate for Payer: BCN Commercial |
$847.57
|
| Rate for Payer: BCN Medicare Advantage |
$506.50
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$678.71
|
| Rate for Payer: Cofinity Commercial |
$729.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.83
|
| Rate for Payer: Meridian Medicaid |
$351.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.15
|
| Rate for Payer: Nomi Health Commercial |
$607.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$506.50
|
| Rate for Payer: PHP Commercial |
$709.10
|
| Rate for Payer: PHP Medicare Advantage |
$506.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$906.03
|
| Rate for Payer: Priority Health Medicare |
$506.50
|
| Rate for Payer: Priority Health SBD |
$906.03
|
| Rate for Payer: Priority Health Tiered Network |
$906.03
|
| Rate for Payer: Railroad Medicare Medicare |
$506.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.28
|
| Rate for Payer: UHC Core |
$944.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.50
|
| Rate for Payer: UHC Exchange |
$944.28
|
| Rate for Payer: UHC Medicaid |
$334.41
|
| Rate for Payer: UHCCP Medicaid |
$334.41
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 27557
|
| Min. Negotiated Rate |
$601.51 |
| Max. Negotiated Rate |
$1,841.79 |
| Rate for Payer: Aetna Commercial |
$1,246.33
|
| Rate for Payer: Aetna Medicare |
$967.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,246.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,339.34
|
| Rate for Payer: BCBS Complete |
$631.59
|
| Rate for Payer: BCBS MAPPO |
$930.10
|
| Rate for Payer: BCN Commercial |
$1,575.62
|
| Rate for Payer: BCN Medicare Advantage |
$930.10
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,246.33
|
| Rate for Payer: Cofinity Commercial |
$1,339.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$976.61
|
| Rate for Payer: Meridian Medicaid |
$631.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,023.11
|
| Rate for Payer: Nomi Health Commercial |
$1,116.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.25
|
| Rate for Payer: PACE SWMI |
$930.10
|
| Rate for Payer: PHP Commercial |
$1,302.14
|
| Rate for Payer: PHP Medicare Advantage |
$930.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$601.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,684.28
|
| Rate for Payer: Priority Health Medicare |
$930.10
|
| Rate for Payer: Priority Health SBD |
$1,684.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,684.28
|
| Rate for Payer: Railroad Medicare Medicare |
$930.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,841.79
|
| Rate for Payer: UHC Core |
$1,841.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$930.10
|
| Rate for Payer: UHC Exchange |
$1,841.79
|
| Rate for Payer: UHC Medicaid |
$601.51
|
| Rate for Payer: UHCCP Medicaid |
$601.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,018.90
|
|
|
PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$1,828.00
|
|
|
Service Code
|
HCPCS 27556
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$1,541.29 |
| Rate for Payer: Aetna Commercial |
$1,052.52
|
| Rate for Payer: Aetna Medicare |
$816.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,131.06
|
| Rate for Payer: BCBS Complete |
$534.74
|
| Rate for Payer: BCBS MAPPO |
$785.46
|
| Rate for Payer: BCN Commercial |
$1,324.63
|
| Rate for Payer: BCN Medicare Advantage |
$785.46
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cofinity Commercial |
$1,052.52
|
| Rate for Payer: Cofinity Commercial |
$1,131.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.73
|
| Rate for Payer: Meridian Medicaid |
$534.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$864.01
|
| Rate for Payer: Nomi Health Commercial |
$942.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.00
|
| Rate for Payer: PACE SWMI |
$785.46
|
| Rate for Payer: PHP Commercial |
$1,099.64
|
| Rate for Payer: PHP Medicare Advantage |
$785.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,416.00
|
| Rate for Payer: Priority Health Medicare |
$785.46
|
| Rate for Payer: Priority Health SBD |
$1,416.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,416.00
|
| Rate for Payer: Railroad Medicare Medicare |
$785.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,541.29
|
| Rate for Payer: UHC Core |
$1,541.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$785.46
|
| Rate for Payer: UHC Exchange |
$1,541.29
|
| Rate for Payer: UHC Medicaid |
$509.28
|
| Rate for Payer: UHCCP Medicaid |
$509.28
|
| Rate for Payer: UMR Bronson Commercial |
$840.88
|
|
|
PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION
|
Professional
|
Both
|
$5,511.00
|
|
|
Service Code
|
HCPCS 27558
|
| Min. Negotiated Rate |
$680.75 |
| Max. Negotiated Rate |
$4,133.25 |
| Rate for Payer: Aetna Commercial |
$1,412.84
|
| Rate for Payer: Aetna Medicare |
$1,096.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,518.28
|
| Rate for Payer: BCBS Complete |
$714.79
|
| Rate for Payer: BCBS MAPPO |
$1,054.36
|
| Rate for Payer: BCN Commercial |
$1,790.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,054.36
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cofinity Commercial |
$1,412.84
|
| Rate for Payer: Cofinity Commercial |
$1,518.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,054.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.08
|
| Rate for Payer: Meridian Medicaid |
$714.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,159.80
|
| Rate for Payer: Nomi Health Commercial |
$1,265.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,133.25
|
| Rate for Payer: PACE SWMI |
$1,054.36
|
| Rate for Payer: PHP Commercial |
$1,476.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,054.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,914.25
|
| Rate for Payer: Priority Health Medicare |
$1,054.36
|
| Rate for Payer: Priority Health SBD |
$1,914.25
|
| Rate for Payer: Priority Health Tiered Network |
$1,914.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,054.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,101.40
|
| Rate for Payer: UHC Core |
$2,101.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,054.36
|
| Rate for Payer: UHC Exchange |
$2,101.40
|
| Rate for Payer: UHC Medicaid |
$680.75
|
| Rate for Payer: UHCCP Medicaid |
$680.75
|
| Rate for Payer: UMR Bronson Commercial |
$2,535.06
|
|
|
PR OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION
|
Professional
|
Both
|
$3,503.00
|
|
|
Service Code
|
HCPCS 21462
|
| Min. Negotiated Rate |
$705.67 |
| Max. Negotiated Rate |
$2,627.25 |
| Rate for Payer: Aetna Commercial |
$1,411.15
|
| Rate for Payer: Aetna Medicare |
$1,095.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,411.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.46
|
| Rate for Payer: BCBS Complete |
$740.95
|
| Rate for Payer: BCBS MAPPO |
$1,053.10
|
| Rate for Payer: BCN Commercial |
$1,729.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.10
|
| Rate for Payer: Cash Price |
$2,802.40
|
| Rate for Payer: Cash Price |
$2,802.40
|
| Rate for Payer: Cofinity Commercial |
$1,411.15
|
| Rate for Payer: Cofinity Commercial |
$1,516.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,105.76
|
| Rate for Payer: Meridian Medicaid |
$740.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,158.41
|
| Rate for Payer: Nomi Health Commercial |
$1,263.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,627.25
|
| Rate for Payer: PACE SWMI |
$1,053.10
|
| Rate for Payer: PHP Commercial |
$1,474.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,849.31
|
| Rate for Payer: Priority Health Medicare |
$1,053.10
|
| Rate for Payer: Priority Health SBD |
$1,849.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,849.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,053.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.65
|
| Rate for Payer: UHC Core |
$1,898.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,053.10
|
| Rate for Payer: UHC Exchange |
$1,898.65
|
| Rate for Payer: UHC Medicaid |
$705.67
|
| Rate for Payer: UHCCP Medicaid |
$705.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,611.38
|
|
|
PR OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION
|
Professional
|
Both
|
$4,316.00
|
|
|
Service Code
|
HCPCS 21461
|
| Min. Negotiated Rate |
$618.77 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Aetna Commercial |
$1,235.10
|
| Rate for Payer: Aetna Medicare |
$958.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,327.28
|
| Rate for Payer: BCBS Complete |
$649.71
|
| Rate for Payer: BCBS MAPPO |
$921.72
|
| Rate for Payer: BCN Commercial |
$1,557.19
|
| Rate for Payer: BCN Medicare Advantage |
$921.72
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cofinity Commercial |
$1,235.10
|
| Rate for Payer: Cofinity Commercial |
$1,327.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.81
|
| Rate for Payer: Meridian Medicaid |
$649.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,013.89
|
| Rate for Payer: Nomi Health Commercial |
$1,106.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,237.00
|
| Rate for Payer: PACE SWMI |
$921.72
|
| Rate for Payer: PHP Commercial |
$1,290.41
|
| Rate for Payer: PHP Medicare Advantage |
$921.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,664.60
|
| Rate for Payer: Priority Health Medicare |
$921.72
|
| Rate for Payer: Priority Health SBD |
$1,664.60
|
| Rate for Payer: Priority Health Tiered Network |
$1,664.60
|
| Rate for Payer: Railroad Medicare Medicare |
$921.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,713.80
|
| Rate for Payer: UHC Core |
$1,713.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$921.72
|
| Rate for Payer: UHC Exchange |
$1,713.80
|
| Rate for Payer: UHC Medicaid |
$618.77
|
| Rate for Payer: UHCCP Medicaid |
$618.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,985.36
|
|
|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26615
|
| Min. Negotiated Rate |
$349.32 |
| Max. Negotiated Rate |
$1,487.25 |
| Rate for Payer: Aetna Commercial |
$709.85
|
| Rate for Payer: Aetna Medicare |
$550.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.83
|
| Rate for Payer: BCBS Complete |
$366.79
|
| Rate for Payer: BCBS MAPPO |
$529.74
|
| Rate for Payer: BCN Commercial |
$887.90
|
| Rate for Payer: BCN Medicare Advantage |
$529.74
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$709.85
|
| Rate for Payer: Cofinity Commercial |
$762.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.23
|
| Rate for Payer: Meridian Medicaid |
$366.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.71
|
| Rate for Payer: Nomi Health Commercial |
$635.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,487.25
|
| Rate for Payer: PACE SWMI |
$529.74
|
| Rate for Payer: PHP Commercial |
$741.64
|
| Rate for Payer: PHP Medicare Advantage |
$529.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$949.14
|
| Rate for Payer: Priority Health Medicare |
$529.74
|
| Rate for Payer: Priority Health SBD |
$949.14
|
| Rate for Payer: Priority Health Tiered Network |
$949.14
|
| Rate for Payer: Railroad Medicare Medicare |
$529.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$995.47
|
| Rate for Payer: UHC Core |
$995.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.74
|
| Rate for Payer: UHC Exchange |
$995.47
|
| Rate for Payer: UHC Medicaid |
$349.32
|
| Rate for Payer: UHCCP Medicaid |
$349.32
|
| Rate for Payer: UMR Bronson Commercial |
$912.18
|
|
|
PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 28645
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$848.56 |
| Rate for Payer: Aetna Commercial |
$601.26
|
| Rate for Payer: Aetna Medicare |
$466.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.13
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$448.70
|
| Rate for Payer: BCN Commercial |
$740.00
|
| Rate for Payer: BCN Medicare Advantage |
$448.70
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$601.26
|
| Rate for Payer: Cofinity Commercial |
$646.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.13
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$493.57
|
| Rate for Payer: Nomi Health Commercial |
$538.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.00
|
| Rate for Payer: PACE SWMI |
$448.70
|
| Rate for Payer: PHP Commercial |
$628.18
|
| Rate for Payer: PHP Medicare Advantage |
$448.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$791.04
|
| Rate for Payer: Priority Health Medicare |
$448.70
|
| Rate for Payer: Priority Health SBD |
$791.04
|
| Rate for Payer: Priority Health Tiered Network |
$791.04
|
| Rate for Payer: Railroad Medicare Medicare |
$448.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.56
|
| Rate for Payer: UHC Core |
$848.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$448.70
|
| Rate for Payer: UHC Exchange |
$848.56
|
| Rate for Payer: UHC Medicaid |
$294.15
|
| Rate for Payer: UHCCP Medicaid |
$294.15
|
| Rate for Payer: UMR Bronson Commercial |
$491.28
|
|
|
PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$3,547.00
|
|
|
Service Code
|
HCPCS 24635
|
| Min. Negotiated Rate |
$408.11 |
| Max. Negotiated Rate |
$2,660.25 |
| Rate for Payer: Aetna Commercial |
$833.17
|
| Rate for Payer: Aetna Medicare |
$646.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$833.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.35
|
| Rate for Payer: BCBS Complete |
$428.52
|
| Rate for Payer: BCBS MAPPO |
$621.77
|
| Rate for Payer: BCN Commercial |
$1,040.28
|
| Rate for Payer: BCN Medicare Advantage |
$621.77
|
| Rate for Payer: Cash Price |
$2,837.60
|
| Rate for Payer: Cash Price |
$2,837.60
|
| Rate for Payer: Cofinity Commercial |
$833.17
|
| Rate for Payer: Cofinity Commercial |
$895.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.86
|
| Rate for Payer: Meridian Medicaid |
$428.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$683.95
|
| Rate for Payer: Nomi Health Commercial |
$746.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,660.25
|
| Rate for Payer: PACE SWMI |
$621.77
|
| Rate for Payer: PHP Commercial |
$870.48
|
| Rate for Payer: PHP Medicare Advantage |
$621.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,112.04
|
| Rate for Payer: Priority Health Medicare |
$621.77
|
| Rate for Payer: Priority Health SBD |
$1,112.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,112.04
|
| Rate for Payer: Railroad Medicare Medicare |
$621.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.31
|
| Rate for Payer: UHC Core |
$1,172.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$621.77
|
| Rate for Payer: UHC Exchange |
$1,172.31
|
| Rate for Payer: UHC Medicaid |
$408.11
|
| Rate for Payer: UHCCP Medicaid |
$408.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,631.62
|
|
|
PR OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 21330
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$629.89
|
| Rate for Payer: Aetna Medicare |
$488.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.90
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$470.07
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: BCN Medicare Advantage |
$470.07
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$629.89
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.57
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.08
|
| Rate for Payer: Nomi Health Commercial |
$564.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$470.07
|
| Rate for Payer: PHP Commercial |
$658.10
|
| Rate for Payer: PHP Medicare Advantage |
$470.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$858.65
|
| Rate for Payer: Priority Health Medicare |
$470.07
|
| Rate for Payer: Priority Health SBD |
$858.65
|
| Rate for Payer: Priority Health Tiered Network |
$858.65
|
| Rate for Payer: Railroad Medicare Medicare |
$470.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.40
|
| Rate for Payer: UHC Core |
$955.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.07
|
| Rate for Payer: UHC Exchange |
$955.40
|
| Rate for Payer: UHC Medicaid |
$312.68
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
| Rate for Payer: UMR Bronson Commercial |
$784.30
|
|
|
PR OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION
|
Professional
|
Both
|
$1,520.00
|
|
|
Service Code
|
HCPCS 21336
|
| Min. Negotiated Rate |
$371.90 |
| Max. Negotiated Rate |
$1,140.00 |
| Rate for Payer: Aetna Commercial |
$748.64
|
| Rate for Payer: Aetna Medicare |
$581.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.51
|
| Rate for Payer: BCBS Complete |
$390.50
|
| Rate for Payer: BCBS MAPPO |
$558.69
|
| Rate for Payer: BCN Commercial |
$957.12
|
| Rate for Payer: BCN Medicare Advantage |
$558.69
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cofinity Commercial |
$748.64
|
| Rate for Payer: Cofinity Commercial |
$804.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$586.62
|
| Rate for Payer: Meridian Medicaid |
$390.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$614.56
|
| Rate for Payer: Nomi Health Commercial |
$670.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.00
|
| Rate for Payer: PACE SWMI |
$558.69
|
| Rate for Payer: PHP Commercial |
$782.17
|
| Rate for Payer: PHP Medicare Advantage |
$558.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,023.13
|
| Rate for Payer: Priority Health Medicare |
$558.69
|
| Rate for Payer: Priority Health SBD |
$1,023.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,023.13
|
| Rate for Payer: Railroad Medicare Medicare |
$558.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.94
|
| Rate for Payer: UHC Core |
$1,086.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.69
|
| Rate for Payer: UHC Exchange |
$1,086.94
|
| Rate for Payer: UHC Medicaid |
$371.90
|
| Rate for Payer: UHCCP Medicaid |
$371.90
|
| Rate for Payer: UMR Bronson Commercial |
$699.20
|
|
|
PR OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 21338
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,447.50 |
| Rate for Payer: Aetna Commercial |
$802.66
|
| Rate for Payer: Aetna Medicare |
$622.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.56
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS MAPPO |
$599.00
|
| Rate for Payer: BCN Commercial |
$1,010.90
|
| Rate for Payer: BCN Medicare Advantage |
$599.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Cofinity Commercial |
$862.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.95
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$658.90
|
| Rate for Payer: Nomi Health Commercial |
$718.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,447.50
|
| Rate for Payer: PACE SWMI |
$599.00
|
| Rate for Payer: PHP Commercial |
$838.60
|
| Rate for Payer: PHP Medicare Advantage |
$599.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,080.62
|
| Rate for Payer: Priority Health Medicare |
$599.00
|
| Rate for Payer: Priority Health SBD |
$1,080.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,080.62
|
| Rate for Payer: Railroad Medicare Medicare |
$599.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,118.35
|
| Rate for Payer: UHC Core |
$1,118.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$599.00
|
| Rate for Payer: UHC Exchange |
$1,118.35
|
| Rate for Payer: UHC Medicaid |
$399.80
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
| Rate for Payer: UMR Bronson Commercial |
$887.80
|
|
