|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$787.72 |
| Rate for Payer: Aetna Commercial |
$651.99
|
| Rate for Payer: Aetna Medicare |
$506.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.65
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$486.56
|
| Rate for Payer: BCBS Trust/PPO |
$542.56
|
| Rate for Payer: BCN Commercial |
$746.70
|
| Rate for Payer: BCN Medicare Advantage |
$486.56
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$651.99
|
| Rate for Payer: Cofinity Commercial |
$700.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.89
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$583.87
|
| Rate for Payer: PACE SWMI |
$486.56
|
| Rate for Payer: PHP Commercial |
$681.18
|
| Rate for Payer: PHP Medicare Advantage |
$486.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$787.72
|
| Rate for Payer: Priority Health Medicare |
$486.56
|
| Rate for Payer: Priority Health Narrow Network |
$787.72
|
| Rate for Payer: Priority Health SBD |
$787.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.56
|
| Rate for Payer: UHC Medicare Advantage |
$486.56
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
| Rate for Payer: UMR Bronson Commercial |
$403.42
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$413.86 |
| Max. Negotiated Rate |
$1,483.99 |
| Rate for Payer: Aetna Commercial |
$816.92
|
| Rate for Payer: Aetna Medicare |
$634.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$877.88
|
| Rate for Payer: BCBS Complete |
$434.55
|
| Rate for Payer: BCBS MAPPO |
$609.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.99
|
| Rate for Payer: BCN Commercial |
$932.40
|
| Rate for Payer: BCN Medicare Advantage |
$609.64
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$816.92
|
| Rate for Payer: Cofinity Commercial |
$877.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.12
|
| Rate for Payer: Meridian Medicaid |
$434.55
|
| Rate for Payer: Nomi Health Commercial |
$731.57
|
| Rate for Payer: PACE SWMI |
$609.64
|
| Rate for Payer: PHP Commercial |
$853.50
|
| Rate for Payer: PHP Medicare Advantage |
$609.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.08
|
| Rate for Payer: Priority Health Medicare |
$609.64
|
| Rate for Payer: Priority Health Narrow Network |
$981.08
|
| Rate for Payer: Priority Health SBD |
$981.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$609.64
|
| Rate for Payer: UHC Medicare Advantage |
$609.64
|
| Rate for Payer: UHCCP Medicaid |
$413.86
|
| Rate for Payer: UMR Bronson Commercial |
$821.10
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
OP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$680.46 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: Aetna American Axle |
$1,496.30
|
| Rate for Payer: Aetna Commercial |
$1,956.70
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,496.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,738.95
|
| Rate for Payer: BCN Commercial |
$5,738.95
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$1,611.40
|
| Rate for Payer: Cofinity Commercial |
$1,979.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,611.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,841.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,071.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,611.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,726.50
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,956.70
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$1,956.70
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$1,450.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.51
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$680.46
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$851.74
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,726.50
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$901.19
|
| Rate for Payer: Aetna Medicare |
$699.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.44
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.73
|
| Rate for Payer: BCN Commercial |
$1,042.84
|
| Rate for Payer: BCN Medicare Advantage |
$672.53
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$901.19
|
| Rate for Payer: Cofinity Commercial |
$968.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Nomi Health Commercial |
$807.04
|
| Rate for Payer: PACE SWMI |
$672.53
|
| Rate for Payer: PHP Commercial |
$941.54
|
| Rate for Payer: PHP Medicare Advantage |
$672.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,093.04
|
| Rate for Payer: Priority Health Medicare |
$672.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,093.04
|
| Rate for Payer: Priority Health SBD |
$1,093.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.53
|
| Rate for Payer: UHC Medicare Advantage |
$672.53
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,058.92
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
IP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$1,012.88 |
| Max. Negotiated Rate |
$2,071.80 |
| Rate for Payer: Aetna American Axle |
$1,496.30
|
| Rate for Payer: Aetna Commercial |
$1,956.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,496.30
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$1,611.40
|
| Rate for Payer: Cofinity Commercial |
$1,979.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,611.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,841.60
|
| Rate for Payer: Healthscope Commercial |
$2,071.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,611.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,726.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,956.70
|
| Rate for Payer: PHP Commercial |
$1,956.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health SBD |
$1,450.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,726.50
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$901.19
|
| Rate for Payer: Aetna Medicare |
$699.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.44
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.73
|
| Rate for Payer: BCN Commercial |
$1,042.84
|
| Rate for Payer: BCN Medicare Advantage |
$672.53
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$901.19
|
| Rate for Payer: Cofinity Commercial |
$968.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Nomi Health Commercial |
$807.04
|
| Rate for Payer: PACE SWMI |
$672.53
|
| Rate for Payer: PHP Commercial |
$941.54
|
| Rate for Payer: PHP Medicare Advantage |
$672.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,093.04
|
| Rate for Payer: Priority Health Medicare |
$672.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,093.04
|
| Rate for Payer: Priority Health SBD |
$1,093.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.53
|
| Rate for Payer: UHC Medicare Advantage |
$672.53
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,058.92
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$3,921.00
|
|
|
Service Code
|
HCPCS 27514
|
| Min. Negotiated Rate |
$624.52 |
| Max. Negotiated Rate |
$2,548.65 |
| Rate for Payer: Aetna Commercial |
$1,247.79
|
| Rate for Payer: Aetna Medicare |
$968.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.91
|
| Rate for Payer: BCBS Complete |
$655.75
|
| Rate for Payer: BCBS MAPPO |
$931.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$1,412.77
|
| Rate for Payer: BCN Medicare Advantage |
$931.19
|
| Rate for Payer: Cash Price |
$3,136.80
|
| Rate for Payer: Cash Price |
$3,136.80
|
| Rate for Payer: Cofinity Commercial |
$1,247.79
|
| Rate for Payer: Cofinity Commercial |
$1,340.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.75
|
| Rate for Payer: Meridian Medicaid |
$655.75
|
| Rate for Payer: Nomi Health Commercial |
$1,117.43
|
| Rate for Payer: PACE SWMI |
$931.19
|
| Rate for Payer: PHP Commercial |
$1,303.67
|
| Rate for Payer: PHP Medicare Advantage |
$931.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,479.77
|
| Rate for Payer: Priority Health Medicare |
$931.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,479.77
|
| Rate for Payer: Priority Health SBD |
$1,479.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.19
|
| Rate for Payer: UHC Medicare Advantage |
$931.19
|
| Rate for Payer: UHCCP Medicaid |
$624.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,803.66
|
|
|
PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD
|
Professional
|
Both
|
$3,919.00
|
|
|
Service Code
|
HCPCS 27269
|
| Min. Negotiated Rate |
$801.52 |
| Max. Negotiated Rate |
$4,086.40 |
| Rate for Payer: Aetna Commercial |
$1,602.59
|
| Rate for Payer: Aetna Medicare |
$1,243.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,602.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,722.18
|
| Rate for Payer: BCBS Complete |
$841.60
|
| Rate for Payer: BCBS MAPPO |
$1,195.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,086.40
|
| Rate for Payer: BCN Commercial |
$1,812.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.96
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,602.59
|
| Rate for Payer: Cofinity Commercial |
$1,722.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,255.76
|
| Rate for Payer: Meridian Medicaid |
$841.60
|
| Rate for Payer: Nomi Health Commercial |
$1,435.15
|
| Rate for Payer: PACE SWMI |
$1,195.96
|
| Rate for Payer: PHP Commercial |
$1,674.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,898.04
|
| Rate for Payer: Priority Health Medicare |
$1,195.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,898.04
|
| Rate for Payer: Priority Health SBD |
$1,898.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,195.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,195.96
|
| Rate for Payer: UHCCP Medicaid |
$801.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,802.74
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27511
|
| Min. Negotiated Rate |
$642.62 |
| Max. Negotiated Rate |
$2,501.20 |
| Rate for Payer: Aetna Commercial |
$1,284.24
|
| Rate for Payer: Aetna Medicare |
$996.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,380.08
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$958.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,679.99
|
| Rate for Payer: BCN Commercial |
$1,457.24
|
| Rate for Payer: BCN Medicare Advantage |
$958.39
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,284.24
|
| Rate for Payer: Cofinity Commercial |
$1,380.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.31
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Nomi Health Commercial |
$1,150.07
|
| Rate for Payer: PACE SWMI |
$958.39
|
| Rate for Payer: PHP Commercial |
$1,341.75
|
| Rate for Payer: PHP Medicare Advantage |
$958.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,526.07
|
| Rate for Payer: Priority Health Medicare |
$958.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,526.07
|
| Rate for Payer: Priority Health SBD |
$1,526.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.39
|
| Rate for Payer: UHC Medicare Advantage |
$958.39
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,770.08
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$4,397.00
|
|
|
Service Code
|
HCPCS 27513
|
| Min. Negotiated Rate |
$795.13 |
| Max. Negotiated Rate |
$2,858.05 |
| Rate for Payer: Aetna Commercial |
$1,592.47
|
| Rate for Payer: Aetna Medicare |
$1,235.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,592.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,711.31
|
| Rate for Payer: BCBS Complete |
$834.89
|
| Rate for Payer: BCBS MAPPO |
$1,188.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.86
|
| Rate for Payer: BCN Commercial |
$1,805.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,188.41
|
| Rate for Payer: Cash Price |
$3,517.60
|
| Rate for Payer: Cash Price |
$3,517.60
|
| Rate for Payer: Cofinity Commercial |
$1,592.47
|
| Rate for Payer: Cofinity Commercial |
$1,711.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,188.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.83
|
| Rate for Payer: Meridian Medicaid |
$834.89
|
| Rate for Payer: Nomi Health Commercial |
$1,426.09
|
| Rate for Payer: PACE SWMI |
$1,188.41
|
| Rate for Payer: PHP Commercial |
$1,663.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,188.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,887.36
|
| Rate for Payer: Priority Health Medicare |
$1,188.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,887.36
|
| Rate for Payer: Priority Health SBD |
$1,887.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,188.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,188.41
|
| Rate for Payer: UHCCP Medicaid |
$795.13
|
| Rate for Payer: UMR Bronson Commercial |
$2,022.62
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 28505
|
| Min. Negotiated Rate |
$322.48 |
| Max. Negotiated Rate |
$1,403.69 |
| Rate for Payer: Aetna Commercial |
$636.63
|
| Rate for Payer: Aetna Medicare |
$494.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.14
|
| Rate for Payer: BCBS Complete |
$338.60
|
| Rate for Payer: BCBS MAPPO |
$475.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,403.69
|
| Rate for Payer: BCN Commercial |
$951.46
|
| Rate for Payer: BCN Medicare Advantage |
$475.10
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$636.63
|
| Rate for Payer: Cofinity Commercial |
$684.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.86
|
| Rate for Payer: Meridian Medicaid |
$338.60
|
| Rate for Payer: Nomi Health Commercial |
$570.12
|
| Rate for Payer: PACE SWMI |
$475.10
|
| Rate for Payer: PHP Commercial |
$665.14
|
| Rate for Payer: PHP Medicare Advantage |
$475.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.84
|
| Rate for Payer: Priority Health Medicare |
$475.10
|
| Rate for Payer: Priority Health Narrow Network |
$765.84
|
| Rate for Payer: Priority Health SBD |
$765.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.10
|
| Rate for Payer: UHC Medicare Advantage |
$475.10
|
| Rate for Payer: UHCCP Medicaid |
$322.48
|
| Rate for Payer: UMR Bronson Commercial |
$660.56
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 28525
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$828.31 |
| Rate for Payer: Aetna Commercial |
$515.65
|
| Rate for Payer: Aetna Medicare |
$400.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.13
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$384.81
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: BCN Commercial |
$828.31
|
| Rate for Payer: BCN Medicare Advantage |
$384.81
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$515.65
|
| Rate for Payer: Cofinity Commercial |
$554.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.05
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Nomi Health Commercial |
$461.77
|
| Rate for Payer: PACE SWMI |
$384.81
|
| Rate for Payer: PHP Commercial |
$538.73
|
| Rate for Payer: PHP Medicare Advantage |
$384.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$630.48
|
| Rate for Payer: Priority Health Medicare |
$384.81
|
| Rate for Payer: Priority Health Narrow Network |
$630.48
|
| Rate for Payer: Priority Health SBD |
$630.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.81
|
| Rate for Payer: UHC Medicare Advantage |
$384.81
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
| Rate for Payer: UMR Bronson Commercial |
$283.36
|
|
|
PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 21407
|
| Min. Negotiated Rate |
$418.97 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$825.47
|
| Rate for Payer: Aetna Medicare |
$640.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.07
|
| Rate for Payer: BCBS Complete |
$439.92
|
| Rate for Payer: BCBS MAPPO |
$616.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$945.10
|
| Rate for Payer: BCN Medicare Advantage |
$616.02
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cofinity Commercial |
$825.47
|
| Rate for Payer: Cofinity Commercial |
$887.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.82
|
| Rate for Payer: Meridian Medicaid |
$439.92
|
| Rate for Payer: Nomi Health Commercial |
$739.22
|
| Rate for Payer: PACE SWMI |
$616.02
|
| Rate for Payer: PHP Commercial |
$862.43
|
| Rate for Payer: PHP Medicare Advantage |
$616.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.11
|
| Rate for Payer: Priority Health Medicare |
$616.02
|
| Rate for Payer: Priority Health Narrow Network |
$983.11
|
| Rate for Payer: Priority Health SBD |
$983.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.02
|
| Rate for Payer: UHC Medicare Advantage |
$616.02
|
| Rate for Payer: UHCCP Medicaid |
$418.97
|
| Rate for Payer: UMR Bronson Commercial |
$539.12
|
|
|
PR OPEN TX HUMERAL EPICONDYLAR FRACTURE
|
Professional
|
Both
|
$2,436.00
|
|
|
Service Code
|
HCPCS 24575
|
| Min. Negotiated Rate |
$402.56 |
| Max. Negotiated Rate |
$1,583.40 |
| Rate for Payer: Aetna Commercial |
$950.76
|
| Rate for Payer: Aetna Medicare |
$737.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.76
|
| Rate for Payer: BCBS Complete |
$505.00
|
| Rate for Payer: BCBS MAPPO |
$709.52
|
| Rate for Payer: BCBS Trust/PPO |
$402.56
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: BCN Medicare Advantage |
$709.52
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cofinity Commercial |
$1,021.71
|
| Rate for Payer: Cofinity Commercial |
$950.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$745.00
|
| Rate for Payer: Meridian Medicaid |
$505.00
|
| Rate for Payer: Nomi Health Commercial |
$851.42
|
| Rate for Payer: PACE SWMI |
$709.52
|
| Rate for Payer: PHP Commercial |
$993.33
|
| Rate for Payer: PHP Medicare Advantage |
$709.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,583.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.79
|
| Rate for Payer: Priority Health Medicare |
$709.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.79
|
| Rate for Payer: Priority Health SBD |
$1,136.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.52
|
| Rate for Payer: UHC Medicare Advantage |
$709.52
|
| Rate for Payer: UHCCP Medicaid |
$480.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,120.56
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,045.00
|
|
|
Service Code
|
HCPCS 24545
|
| Min. Negotiated Rate |
$314.34 |
| Max. Negotiated Rate |
$1,979.25 |
| Rate for Payer: Aetna Commercial |
$1,202.02
|
| Rate for Payer: Aetna Medicare |
$932.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,291.72
|
| Rate for Payer: BCBS Complete |
$635.17
|
| Rate for Payer: BCBS MAPPO |
$897.03
|
| Rate for Payer: BCBS Trust/PPO |
$314.34
|
| Rate for Payer: BCN Commercial |
$1,361.45
|
| Rate for Payer: BCN Medicare Advantage |
$897.03
|
| Rate for Payer: Cash Price |
$2,436.00
|
| Rate for Payer: Cash Price |
$2,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,202.02
|
| Rate for Payer: Cofinity Commercial |
$1,291.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$941.88
|
| Rate for Payer: Meridian Medicaid |
$635.17
|
| Rate for Payer: Nomi Health Commercial |
$1,076.44
|
| Rate for Payer: PACE SWMI |
$897.03
|
| Rate for Payer: PHP Commercial |
$1,255.84
|
| Rate for Payer: PHP Medicare Advantage |
$897.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,979.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.93
|
| Rate for Payer: Priority Health Medicare |
$897.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,431.93
|
| Rate for Payer: Priority Health SBD |
$1,431.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$897.03
|
| Rate for Payer: UHC Medicare Advantage |
$897.03
|
| Rate for Payer: UHCCP Medicaid |
$604.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,400.70
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$3,982.00
|
|
|
Service Code
|
HCPCS 24546
|
| Min. Negotiated Rate |
$387.77 |
| Max. Negotiated Rate |
$2,588.30 |
| Rate for Payer: Aetna Commercial |
$1,342.29
|
| Rate for Payer: Aetna Medicare |
$1,041.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.46
|
| Rate for Payer: BCBS Complete |
$708.52
|
| Rate for Payer: BCBS MAPPO |
$1,001.71
|
| Rate for Payer: BCBS Trust/PPO |
$387.77
|
| Rate for Payer: BCN Commercial |
$1,520.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,001.71
|
| Rate for Payer: Cash Price |
$3,185.60
|
| Rate for Payer: Cash Price |
$3,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,442.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,051.80
|
| Rate for Payer: Meridian Medicaid |
$708.52
|
| Rate for Payer: Nomi Health Commercial |
$1,202.05
|
| Rate for Payer: PACE SWMI |
$1,001.71
|
| Rate for Payer: PHP Commercial |
$1,402.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,001.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,596.30
|
| Rate for Payer: Priority Health Medicare |
$1,001.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,596.30
|
| Rate for Payer: Priority Health SBD |
$1,596.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,001.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,001.71
|
| Rate for Payer: UHCCP Medicaid |
$674.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,831.72
|
|
|
PR OPEN TX ILIAC SPINE UNI/BIL
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS G0412
|
| Min. Negotiated Rate |
$470.52 |
| Max. Negotiated Rate |
$2,061.43 |
| Rate for Payer: Aetna Commercial |
$936.77
|
| Rate for Payer: Aetna Medicare |
$727.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.77
|
| Rate for Payer: BCBS Complete |
$494.05
|
| Rate for Payer: BCBS MAPPO |
$699.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,061.43
|
| Rate for Payer: BCN Commercial |
$1,062.38
|
| Rate for Payer: BCN Medicare Advantage |
$699.08
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cofinity Commercial |
$1,006.68
|
| Rate for Payer: Cofinity Commercial |
$936.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.03
|
| Rate for Payer: Meridian Medicaid |
$494.05
|
| Rate for Payer: Nomi Health Commercial |
$838.90
|
| Rate for Payer: PACE SWMI |
$699.08
|
| Rate for Payer: PHP Commercial |
$978.71
|
| Rate for Payer: PHP Medicare Advantage |
$699.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.92
|
| Rate for Payer: Priority Health Medicare |
$699.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.92
|
| Rate for Payer: Priority Health SBD |
$1,115.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.08
|
| Rate for Payer: UHC Medicare Advantage |
$699.08
|
| Rate for Payer: UHCCP Medicaid |
$470.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,211.64
|
|
|
PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE
|
Professional
|
Both
|
$2,749.00
|
|
|
Service Code
|
HCPCS 27540
|
| Min. Negotiated Rate |
$246.72 |
| Max. Negotiated Rate |
$1,786.85 |
| Rate for Payer: Aetna Commercial |
$1,054.90
|
| Rate for Payer: Aetna Medicare |
$818.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,054.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.63
|
| Rate for Payer: BCBS Complete |
$558.01
|
| Rate for Payer: BCBS MAPPO |
$787.24
|
| Rate for Payer: BCBS Trust/PPO |
$246.72
|
| Rate for Payer: BCN Commercial |
$1,199.22
|
| Rate for Payer: BCN Medicare Advantage |
$787.24
|
| Rate for Payer: Cash Price |
$2,199.20
|
| Rate for Payer: Cash Price |
$2,199.20
|
| Rate for Payer: Cofinity Commercial |
$1,054.90
|
| Rate for Payer: Cofinity Commercial |
$1,133.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.60
|
| Rate for Payer: Meridian Medicaid |
$558.01
|
| Rate for Payer: Nomi Health Commercial |
$944.69
|
| Rate for Payer: PACE SWMI |
$787.24
|
| Rate for Payer: PHP Commercial |
$1,102.14
|
| Rate for Payer: PHP Medicare Advantage |
$787.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,786.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,256.38
|
| Rate for Payer: Priority Health Medicare |
$787.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,256.38
|
| Rate for Payer: Priority Health SBD |
$1,256.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.24
|
| Rate for Payer: UHC Medicare Advantage |
$787.24
|
| Rate for Payer: UHCCP Medicaid |
$531.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,264.54
|
|
|
PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26785
|
| Min. Negotiated Rate |
$101.43 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$711.83
|
| Rate for Payer: Aetna Medicare |
$552.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.96
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS MAPPO |
$531.22
|
| Rate for Payer: BCBS Trust/PPO |
$101.43
|
| Rate for Payer: BCN Commercial |
$812.67
|
| Rate for Payer: BCN Medicare Advantage |
$531.22
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$711.83
|
| Rate for Payer: Cofinity Commercial |
$764.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.78
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Nomi Health Commercial |
$637.46
|
| Rate for Payer: PACE SWMI |
$531.22
|
| Rate for Payer: PHP Commercial |
$743.71
|
| Rate for Payer: PHP Medicare Advantage |
$531.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$854.38
|
| Rate for Payer: Priority Health Medicare |
$531.22
|
| Rate for Payer: Priority Health Narrow Network |
$854.38
|
| Rate for Payer: Priority Health SBD |
$854.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.22
|
| Rate for Payer: UHC Medicare Advantage |
$531.22
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
| Rate for Payer: UMR Bronson Commercial |
$708.40
|
|
|
PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 27557
|
| Min. Negotiated Rate |
$673.93 |
| Max. Negotiated Rate |
$1,599.36 |
| Rate for Payer: Aetna Commercial |
$1,347.49
|
| Rate for Payer: Aetna Medicare |
$1,045.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.05
|
| Rate for Payer: BCBS Complete |
$707.63
|
| Rate for Payer: BCBS MAPPO |
$1,005.59
|
| Rate for Payer: BCBS Trust/PPO |
$843.70
|
| Rate for Payer: BCN Commercial |
$1,527.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.59
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,347.49
|
| Rate for Payer: Cofinity Commercial |
$1,448.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.87
|
| Rate for Payer: Meridian Medicaid |
$707.63
|
| Rate for Payer: Nomi Health Commercial |
$1,206.71
|
| Rate for Payer: PACE SWMI |
$1,005.59
|
| Rate for Payer: PHP Commercial |
$1,407.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,599.36
|
| Rate for Payer: Priority Health Medicare |
$1,005.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,599.36
|
| Rate for Payer: Priority Health SBD |
$1,599.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.59
|
| Rate for Payer: UHCCP Medicaid |
$673.93
|
| Rate for Payer: UMR Bronson Commercial |
$989.00
|
|
|
PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 27556
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$1,344.92 |
| Rate for Payer: Aetna Commercial |
$1,130.58
|
| Rate for Payer: Aetna Medicare |
$877.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,130.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.96
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$843.72
|
| Rate for Payer: BCBS Trust/PPO |
$488.15
|
| Rate for Payer: BCN Commercial |
$1,284.24
|
| Rate for Payer: BCN Medicare Advantage |
$843.72
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cofinity Commercial |
$1,130.58
|
| Rate for Payer: Cofinity Commercial |
$1,214.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$843.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$885.91
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Nomi Health Commercial |
$1,012.46
|
| Rate for Payer: PACE SWMI |
$843.72
|
| Rate for Payer: PHP Commercial |
$1,181.21
|
| Rate for Payer: PHP Medicare Advantage |
$843.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,344.92
|
| Rate for Payer: Priority Health Medicare |
$843.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,344.92
|
| Rate for Payer: Priority Health SBD |
$1,344.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$843.72
|
| Rate for Payer: UHC Medicare Advantage |
$843.72
|
| Rate for Payer: UHCCP Medicaid |
$566.58
|
| Rate for Payer: UMR Bronson Commercial |
$816.50
|
|
|
PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION
|
Professional
|
Both
|
$5,350.00
|
|
|
Service Code
|
HCPCS 27558
|
| Min. Negotiated Rate |
$765.95 |
| Max. Negotiated Rate |
$3,477.50 |
| Rate for Payer: Aetna Commercial |
$1,533.58
|
| Rate for Payer: Aetna Medicare |
$1,190.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,533.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,648.02
|
| Rate for Payer: BCBS Complete |
$804.25
|
| Rate for Payer: BCBS MAPPO |
$1,144.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.88
|
| Rate for Payer: BCN Commercial |
$1,736.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,144.46
|
| Rate for Payer: Cash Price |
$4,280.00
|
| Rate for Payer: Cash Price |
$4,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,533.58
|
| Rate for Payer: Cofinity Commercial |
$1,648.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,144.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,201.68
|
| Rate for Payer: Meridian Medicaid |
$804.25
|
| Rate for Payer: Nomi Health Commercial |
$1,373.35
|
| Rate for Payer: PACE SWMI |
$1,144.46
|
| Rate for Payer: PHP Commercial |
$1,602.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,144.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,477.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,817.15
|
| Rate for Payer: Priority Health Medicare |
$1,144.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,817.15
|
| Rate for Payer: Priority Health SBD |
$1,817.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,144.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,144.46
|
| Rate for Payer: UHCCP Medicaid |
$765.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,461.00
|
|
|
PR OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION
|
Professional
|
Both
|
$3,401.00
|
|
|
Service Code
|
HCPCS 21462
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,917.40 |
| Rate for Payer: Aetna Commercial |
$1,430.70
|
| Rate for Payer: Aetna Medicare |
$1,110.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.47
|
| Rate for Payer: BCBS Complete |
$776.96
|
| Rate for Payer: BCBS MAPPO |
$1,067.69
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,917.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,067.69
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cofinity Commercial |
$1,430.70
|
| Rate for Payer: Cofinity Commercial |
$1,537.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,067.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,121.07
|
| Rate for Payer: Meridian Medicaid |
$776.96
|
| Rate for Payer: Nomi Health Commercial |
$1,281.23
|
| Rate for Payer: PACE SWMI |
$1,067.69
|
| Rate for Payer: PHP Commercial |
$1,494.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,067.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$739.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,210.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,770.84
|
| Rate for Payer: Priority Health Medicare |
$1,067.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,770.84
|
| Rate for Payer: Priority Health SBD |
$1,770.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,067.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,067.69
|
| Rate for Payer: UHCCP Medicaid |
$739.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,564.46
|
|
|
PR OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION
|
Professional
|
Both
|
$4,190.00
|
|
|
Service Code
|
HCPCS 21461
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,723.50 |
| Rate for Payer: Aetna Commercial |
$1,285.31
|
| Rate for Payer: Aetna Medicare |
$997.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.23
|
| Rate for Payer: BCBS Complete |
$699.35
|
| Rate for Payer: BCBS MAPPO |
$959.19
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,696.52
|
| Rate for Payer: BCN Medicare Advantage |
$959.19
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,285.31
|
| Rate for Payer: Cofinity Commercial |
$1,381.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.15
|
| Rate for Payer: Meridian Medicaid |
$699.35
|
| Rate for Payer: Nomi Health Commercial |
$1,151.03
|
| Rate for Payer: PACE SWMI |
$959.19
|
| Rate for Payer: PHP Commercial |
$1,342.87
|
| Rate for Payer: PHP Medicare Advantage |
$959.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,723.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,624.29
|
| Rate for Payer: Priority Health Medicare |
$959.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,624.29
|
| Rate for Payer: Priority Health SBD |
$1,624.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.19
|
| Rate for Payer: UHC Medicare Advantage |
$959.19
|
| Rate for Payer: UHCCP Medicaid |
$666.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,927.40
|
|
|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 26615
|
| Min. Negotiated Rate |
$53.49 |
| Max. Negotiated Rate |
$1,251.25 |
| Rate for Payer: Aetna Commercial |
$746.65
|
| Rate for Payer: Aetna Medicare |
$579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.37
|
| Rate for Payer: BCBS Complete |
$398.77
|
| Rate for Payer: BCBS MAPPO |
$557.20
|
| Rate for Payer: BCBS Trust/PPO |
$53.49
|
| Rate for Payer: BCN Commercial |
$851.77
|
| Rate for Payer: BCN Medicare Advantage |
$557.20
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$746.65
|
| Rate for Payer: Cofinity Commercial |
$802.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.06
|
| Rate for Payer: Meridian Medicaid |
$398.77
|
| Rate for Payer: Nomi Health Commercial |
$668.64
|
| Rate for Payer: PACE SWMI |
$557.20
|
| Rate for Payer: PHP Commercial |
$780.08
|
| Rate for Payer: PHP Medicare Advantage |
$557.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.12
|
| Rate for Payer: Priority Health Medicare |
$557.20
|
| Rate for Payer: Priority Health Narrow Network |
$897.12
|
| Rate for Payer: Priority Health SBD |
$897.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.20
|
| Rate for Payer: UHC Medicare Advantage |
$557.20
|
| Rate for Payer: UHCCP Medicaid |
$379.78
|
| Rate for Payer: UMR Bronson Commercial |
$885.50
|
|
