|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$555.11 |
| Max. Negotiated Rate |
$1,251.25 |
| Rate for Payer: Aetna Commercial |
$743.85
|
| Rate for Payer: Aetna Medicare |
$577.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$799.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.85
|
| Rate for Payer: BCBS Complete |
$770.00
|
| Rate for Payer: BCBS MAPPO |
$555.11
|
| Rate for Payer: BCN Medicare Advantage |
$555.11
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$799.36
|
| Rate for Payer: Cofinity Commercial |
$743.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.87
|
| Rate for Payer: Nomi Health Commercial |
$666.13
|
| Rate for Payer: PACE SWMI |
$555.11
|
| Rate for Payer: PHP Commercial |
$777.15
|
| Rate for Payer: PHP Medicare Advantage |
$555.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.25
|
| Rate for Payer: Priority Health Medicare |
$555.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$555.11
|
| Rate for Payer: UHC Medicare Advantage |
$555.11
|
| Rate for Payer: UMR Bronson Commercial |
$885.50
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$536.19 |
| Max. Negotiated Rate |
$874.90 |
| Rate for Payer: Aetna Commercial |
$718.49
|
| Rate for Payer: Aetna Medicare |
$557.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.49
|
| Rate for Payer: BCBS Complete |
$538.40
|
| Rate for Payer: BCBS MAPPO |
$536.19
|
| Rate for Payer: BCN Medicare Advantage |
$536.19
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$772.11
|
| Rate for Payer: Cofinity Commercial |
$718.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.00
|
| Rate for Payer: Nomi Health Commercial |
$643.43
|
| Rate for Payer: PACE SWMI |
$536.19
|
| Rate for Payer: PHP Commercial |
$750.67
|
| Rate for Payer: PHP Medicare Advantage |
$536.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.90
|
| Rate for Payer: Priority Health Medicare |
$536.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.19
|
| Rate for Payer: UHC Medicare Advantage |
$536.19
|
| Rate for Payer: UMR Bronson Commercial |
$619.16
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$594.10 |
| Rate for Payer: Aetna Commercial |
$552.84
|
| Rate for Payer: Aetna Medicare |
$429.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.84
|
| Rate for Payer: BCBS Complete |
$336.00
|
| Rate for Payer: BCBS MAPPO |
$412.57
|
| Rate for Payer: BCN Medicare Advantage |
$412.57
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$594.10
|
| Rate for Payer: Cofinity Commercial |
$552.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.20
|
| Rate for Payer: Nomi Health Commercial |
$495.08
|
| Rate for Payer: PACE SWMI |
$412.57
|
| Rate for Payer: PHP Commercial |
$577.60
|
| Rate for Payer: PHP Medicare Advantage |
$412.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.00
|
| Rate for Payer: Priority Health Medicare |
$412.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$412.57
|
| Rate for Payer: UHC Medicare Advantage |
$412.57
|
| Rate for Payer: UMR Bronson Commercial |
$386.40
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$537.20 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Aetna Commercial |
$804.95
|
| Rate for Payer: Aetna Medicare |
$624.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.95
|
| Rate for Payer: BCBS Complete |
$537.20
|
| Rate for Payer: BCBS MAPPO |
$600.71
|
| Rate for Payer: BCN Medicare Advantage |
$600.71
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$865.02
|
| Rate for Payer: Cofinity Commercial |
$804.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.75
|
| Rate for Payer: Nomi Health Commercial |
$720.85
|
| Rate for Payer: PACE SWMI |
$600.71
|
| Rate for Payer: PHP Commercial |
$840.99
|
| Rate for Payer: PHP Medicare Advantage |
$600.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health Medicare |
$600.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.71
|
| Rate for Payer: UHC Medicare Advantage |
$600.71
|
| Rate for Payer: UMR Bronson Commercial |
$617.78
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$518.80 |
| Max. Negotiated Rate |
$1,009.25 |
| Rate for Payer: Aetna Commercial |
$939.17
|
| Rate for Payer: Aetna Medicare |
$728.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.25
|
| Rate for Payer: BCBS Complete |
$518.80
|
| Rate for Payer: BCBS MAPPO |
$700.87
|
| Rate for Payer: BCN Medicare Advantage |
$700.87
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$939.17
|
| Rate for Payer: Cofinity Commercial |
$1,009.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.91
|
| Rate for Payer: Nomi Health Commercial |
$841.04
|
| Rate for Payer: PACE SWMI |
$700.87
|
| Rate for Payer: PHP Commercial |
$981.22
|
| Rate for Payer: PHP Medicare Advantage |
$700.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health Medicare |
$700.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.87
|
| Rate for Payer: UHC Medicare Advantage |
$700.87
|
| Rate for Payer: UMR Bronson Commercial |
$596.62
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$684.90 |
| Max. Negotiated Rate |
$1,480.70 |
| Rate for Payer: Aetna Commercial |
$917.77
|
| Rate for Payer: Aetna Medicare |
$712.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.77
|
| Rate for Payer: BCBS Complete |
$911.20
|
| Rate for Payer: BCBS MAPPO |
$684.90
|
| Rate for Payer: BCN Medicare Advantage |
$684.90
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$986.26
|
| Rate for Payer: Cofinity Commercial |
$917.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.14
|
| Rate for Payer: Nomi Health Commercial |
$821.88
|
| Rate for Payer: PACE SWMI |
$684.90
|
| Rate for Payer: PHP Commercial |
$958.86
|
| Rate for Payer: PHP Medicare Advantage |
$684.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health Medicare |
$684.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.90
|
| Rate for Payer: UHC Medicare Advantage |
$684.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,047.88
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$649.01 |
| Max. Negotiated Rate |
$1,340.95 |
| Rate for Payer: Aetna Commercial |
$869.67
|
| Rate for Payer: Aetna Medicare |
$674.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.67
|
| Rate for Payer: BCBS Complete |
$825.20
|
| Rate for Payer: BCBS MAPPO |
$649.01
|
| Rate for Payer: BCN Medicare Advantage |
$649.01
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cofinity Commercial |
$934.57
|
| Rate for Payer: Cofinity Commercial |
$869.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$649.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.46
|
| Rate for Payer: Nomi Health Commercial |
$778.81
|
| Rate for Payer: PACE SWMI |
$649.01
|
| Rate for Payer: PHP Commercial |
$908.61
|
| Rate for Payer: PHP Medicare Advantage |
$649.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health Medicare |
$649.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$649.01
|
| Rate for Payer: UHC Medicare Advantage |
$649.01
|
| Rate for Payer: UMR Bronson Commercial |
$948.98
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$685.67 |
| Max. Negotiated Rate |
$1,297.40 |
| Rate for Payer: Aetna Commercial |
$918.80
|
| Rate for Payer: Aetna Medicare |
$713.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.80
|
| Rate for Payer: BCBS Complete |
$798.40
|
| Rate for Payer: BCBS MAPPO |
$685.67
|
| Rate for Payer: BCN Medicare Advantage |
$685.67
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$987.36
|
| Rate for Payer: Cofinity Commercial |
$918.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.95
|
| Rate for Payer: Nomi Health Commercial |
$822.80
|
| Rate for Payer: PACE SWMI |
$685.67
|
| Rate for Payer: PHP Commercial |
$959.94
|
| Rate for Payer: PHP Medicare Advantage |
$685.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health Medicare |
$685.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.67
|
| Rate for Payer: UHC Medicare Advantage |
$685.67
|
| Rate for Payer: UMR Bronson Commercial |
$918.16
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,142.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$1,005.36 |
| Max. Negotiated Rate |
$2,042.30 |
| Rate for Payer: Aetna Commercial |
$1,347.18
|
| Rate for Payer: Aetna Medicare |
$1,045.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.18
|
| Rate for Payer: BCBS Complete |
$1,256.80
|
| Rate for Payer: BCBS MAPPO |
$1,005.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.36
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cofinity Commercial |
$1,447.72
|
| Rate for Payer: Cofinity Commercial |
$1,347.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.63
|
| Rate for Payer: Nomi Health Commercial |
$1,206.43
|
| Rate for Payer: PACE SWMI |
$1,005.36
|
| Rate for Payer: PHP Commercial |
$1,407.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,042.30
|
| Rate for Payer: Priority Health Medicare |
$1,005.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,445.32
|
|
|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$624.71 |
| Max. Negotiated Rate |
$1,123.20 |
| Rate for Payer: Aetna Commercial |
$837.11
|
| Rate for Payer: Aetna Medicare |
$649.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.11
|
| Rate for Payer: BCBS Complete |
$691.20
|
| Rate for Payer: BCBS MAPPO |
$624.71
|
| Rate for Payer: BCN Medicare Advantage |
$624.71
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$899.58
|
| Rate for Payer: Cofinity Commercial |
$837.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.95
|
| Rate for Payer: Nomi Health Commercial |
$749.65
|
| Rate for Payer: PACE SWMI |
$624.71
|
| Rate for Payer: PHP Commercial |
$874.59
|
| Rate for Payer: PHP Medicare Advantage |
$624.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.20
|
| Rate for Payer: Priority Health Medicare |
$624.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.71
|
| Rate for Payer: UHC Medicare Advantage |
$624.71
|
| Rate for Payer: UMR Bronson Commercial |
$794.88
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$718.00 |
| Max. Negotiated Rate |
$1,166.75 |
| Rate for Payer: Aetna Commercial |
$1,058.81
|
| Rate for Payer: Aetna Medicare |
$821.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,137.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.81
|
| Rate for Payer: BCBS Complete |
$718.00
|
| Rate for Payer: BCBS MAPPO |
$790.16
|
| Rate for Payer: BCN Medicare Advantage |
$790.16
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,137.83
|
| Rate for Payer: Cofinity Commercial |
$1,058.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.67
|
| Rate for Payer: Nomi Health Commercial |
$948.19
|
| Rate for Payer: PACE SWMI |
$790.16
|
| Rate for Payer: PHP Commercial |
$1,106.22
|
| Rate for Payer: PHP Medicare Advantage |
$790.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.75
|
| Rate for Payer: Priority Health Medicare |
$790.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$790.16
|
| Rate for Payer: UHC Medicare Advantage |
$790.16
|
| Rate for Payer: UMR Bronson Commercial |
$825.70
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$631.56 |
| Max. Negotiated Rate |
$1,522.95 |
| Rate for Payer: Aetna Commercial |
$846.29
|
| Rate for Payer: Aetna Medicare |
$656.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.29
|
| Rate for Payer: BCBS Complete |
$937.20
|
| Rate for Payer: BCBS MAPPO |
$631.56
|
| Rate for Payer: BCN Medicare Advantage |
$631.56
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$909.45
|
| Rate for Payer: Cofinity Commercial |
$846.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.14
|
| Rate for Payer: Nomi Health Commercial |
$757.87
|
| Rate for Payer: PACE SWMI |
$631.56
|
| Rate for Payer: PHP Commercial |
$884.18
|
| Rate for Payer: PHP Medicare Advantage |
$631.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health Medicare |
$631.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$631.56
|
| Rate for Payer: UHC Medicare Advantage |
$631.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,077.78
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
IP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,030.92 |
| Max. Negotiated Rate |
$2,108.70 |
| Rate for Payer: Aetna American Axle |
$1,522.95
|
| Rate for Payer: Aetna Commercial |
$1,991.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.95
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$1,640.10
|
| Rate for Payer: Cofinity Commercial |
$2,014.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,640.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Healthscope Commercial |
$2,108.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,640.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,757.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: PHP Commercial |
$1,991.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health SBD |
$1,476.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,030.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,757.25
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
OP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$866.91 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna American Axle |
$1,522.95
|
| Rate for Payer: Aetna Commercial |
$1,991.55
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,014.98
|
| Rate for Payer: Cofinity Commercial |
$1,640.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,640.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,108.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,640.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,757.25
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$1,991.55
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$1,476.09
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$13,314.90
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: UMR Bronson Commercial |
$866.91
|
| Rate for Payer: VA VA |
$6,967.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,757.25
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$631.56 |
| Max. Negotiated Rate |
$1,522.95 |
| Rate for Payer: Aetna Commercial |
$846.29
|
| Rate for Payer: Aetna Medicare |
$656.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.29
|
| Rate for Payer: BCBS Complete |
$937.20
|
| Rate for Payer: BCBS MAPPO |
$631.56
|
| Rate for Payer: BCN Medicare Advantage |
$631.56
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$846.29
|
| Rate for Payer: Cofinity Commercial |
$909.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.14
|
| Rate for Payer: Nomi Health Commercial |
$757.87
|
| Rate for Payer: PACE SWMI |
$631.56
|
| Rate for Payer: PHP Commercial |
$884.18
|
| Rate for Payer: PHP Medicare Advantage |
$631.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health Medicare |
$631.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$631.56
|
| Rate for Payer: UHC Medicare Advantage |
$631.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,077.78
|
|
|
PR OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$605.31 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$811.12
|
| Rate for Payer: Aetna Medicare |
$629.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.12
|
| Rate for Payer: BCBS Complete |
$777.60
|
| Rate for Payer: BCBS MAPPO |
$605.31
|
| Rate for Payer: BCN Medicare Advantage |
$605.31
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$871.65
|
| Rate for Payer: Cofinity Commercial |
$811.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.58
|
| Rate for Payer: Nomi Health Commercial |
$726.37
|
| Rate for Payer: PACE SWMI |
$605.31
|
| Rate for Payer: PHP Commercial |
$847.43
|
| Rate for Payer: PHP Medicare Advantage |
$605.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health Medicare |
$605.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.31
|
| Rate for Payer: UHC Medicare Advantage |
$605.31
|
| Rate for Payer: UMR Bronson Commercial |
$894.24
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,667.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$604.86 |
| Max. Negotiated Rate |
$1,083.55 |
| Rate for Payer: Aetna Commercial |
$810.51
|
| Rate for Payer: Aetna Medicare |
$629.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.51
|
| Rate for Payer: BCBS Complete |
$666.80
|
| Rate for Payer: BCBS MAPPO |
$604.86
|
| Rate for Payer: BCN Medicare Advantage |
$604.86
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cofinity Commercial |
$871.00
|
| Rate for Payer: Cofinity Commercial |
$810.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.10
|
| Rate for Payer: Nomi Health Commercial |
$725.83
|
| Rate for Payer: PACE SWMI |
$604.86
|
| Rate for Payer: PHP Commercial |
$846.80
|
| Rate for Payer: PHP Medicare Advantage |
$604.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.55
|
| Rate for Payer: Priority Health Medicare |
$604.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.86
|
| Rate for Payer: UHC Medicare Advantage |
$604.86
|
| Rate for Payer: UMR Bronson Commercial |
$766.82
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 1-2 RIBS
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 0245T
|
| Min. Negotiated Rate |
$1,339.20 |
| Max. Negotiated Rate |
$2,176.20 |
| Rate for Payer: Aetna Medicare |
$1,674.00
|
| Rate for Payer: BCBS Complete |
$1,339.20
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,540.08
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS
|
Professional
|
Both
|
$3,689.00
|
|
|
Service Code
|
HCPCS 0246T
|
| Min. Negotiated Rate |
$1,475.60 |
| Max. Negotiated Rate |
$2,397.85 |
| Rate for Payer: Aetna Medicare |
$1,844.50
|
| Rate for Payer: BCBS Complete |
$1,475.60
|
| Rate for Payer: Cash Price |
$2,951.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,696.94
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS
|
Professional
|
Both
|
$4,080.00
|
|
|
Service Code
|
HCPCS 0247T
|
| Min. Negotiated Rate |
$1,632.00 |
| Max. Negotiated Rate |
$2,652.00 |
| Rate for Payer: Aetna Medicare |
$2,040.00
|
| Rate for Payer: BCBS Complete |
$1,632.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,876.80
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS
|
Professional
|
Both
|
$4,709.00
|
|
|
Service Code
|
HCPCS 0248T
|
| Min. Negotiated Rate |
$1,883.60 |
| Max. Negotiated Rate |
$3,060.85 |
| Rate for Payer: Aetna Medicare |
$2,354.50
|
| Rate for Payer: BCBS Complete |
$1,883.60
|
| Rate for Payer: Cash Price |
$3,767.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,060.85
|
| Rate for Payer: UMR Bronson Commercial |
$2,166.14
|
|
|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,743.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$552.64 |
| Max. Negotiated Rate |
$1,782.95 |
| Rate for Payer: Aetna Commercial |
$740.54
|
| Rate for Payer: Aetna Medicare |
$574.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.54
|
| Rate for Payer: BCBS Complete |
$1,097.20
|
| Rate for Payer: BCBS MAPPO |
$552.64
|
| Rate for Payer: BCN Medicare Advantage |
$552.64
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cofinity Commercial |
$740.54
|
| Rate for Payer: Cofinity Commercial |
$795.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.27
|
| Rate for Payer: Nomi Health Commercial |
$663.17
|
| Rate for Payer: PACE SWMI |
$552.64
|
| Rate for Payer: PHP Commercial |
$773.70
|
| Rate for Payer: PHP Medicare Advantage |
$552.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,782.95
|
| Rate for Payer: Priority Health Medicare |
$552.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.64
|
| Rate for Payer: UHC Medicare Advantage |
$552.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,261.78
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$690.17 |
| Max. Negotiated Rate |
$1,675.05 |
| Rate for Payer: Aetna Commercial |
$924.83
|
| Rate for Payer: Aetna Medicare |
$717.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$993.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.83
|
| Rate for Payer: BCBS Complete |
$1,030.80
|
| Rate for Payer: BCBS MAPPO |
$690.17
|
| Rate for Payer: BCN Medicare Advantage |
$690.17
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cofinity Commercial |
$993.84
|
| Rate for Payer: Cofinity Commercial |
$924.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$724.68
|
| Rate for Payer: Nomi Health Commercial |
$828.20
|
| Rate for Payer: PACE SWMI |
$690.17
|
| Rate for Payer: PHP Commercial |
$966.24
|
| Rate for Payer: PHP Medicare Advantage |
$690.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health Medicare |
$690.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$690.17
|
| Rate for Payer: UHC Medicare Advantage |
$690.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,185.42
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,720.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$566.24 |
| Max. Negotiated Rate |
$1,768.00 |
| Rate for Payer: Aetna Commercial |
$758.76
|
| Rate for Payer: Aetna Medicare |
$588.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$815.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| Rate for Payer: BCBS Complete |
$1,088.00
|
| Rate for Payer: BCBS MAPPO |
$566.24
|
| Rate for Payer: BCN Medicare Advantage |
$566.24
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cofinity Commercial |
$815.39
|
| Rate for Payer: Cofinity Commercial |
$758.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.55
|
| Rate for Payer: Nomi Health Commercial |
$679.49
|
| Rate for Payer: PACE SWMI |
$566.24
|
| Rate for Payer: PHP Commercial |
$792.74
|
| Rate for Payer: PHP Medicare Advantage |
$566.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.00
|
| Rate for Payer: Priority Health Medicare |
$566.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.24
|
| Rate for Payer: UHC Medicare Advantage |
$566.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,251.20
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$716.55 |
| Max. Negotiated Rate |
$1,644.50 |
| Rate for Payer: Aetna Commercial |
$960.18
|
| Rate for Payer: Aetna Medicare |
$745.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.83
|
| Rate for Payer: BCBS Complete |
$1,012.00
|
| Rate for Payer: BCBS MAPPO |
$716.55
|
| Rate for Payer: BCN Medicare Advantage |
$716.55
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$960.18
|
| Rate for Payer: Cofinity Commercial |
$1,031.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.38
|
| Rate for Payer: Nomi Health Commercial |
$859.86
|
| Rate for Payer: PACE SWMI |
$716.55
|
| Rate for Payer: PHP Commercial |
$1,003.17
|
| Rate for Payer: PHP Medicare Advantage |
$716.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health Medicare |
$716.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.55
|
| Rate for Payer: UHC Medicare Advantage |
$716.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,163.80
|
|
