|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$195.70
|
|
|
Service Code
|
NDC 00527411737
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.11 |
| Max. Negotiated Rate |
$176.13 |
| Rate for Payer: Aetna American Axle |
$127.20
|
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.20
|
| Rate for Payer: Cash Price |
$156.56
|
| Rate for Payer: Cofinity Commercial |
$136.99
|
| Rate for Payer: Cofinity Commercial |
$168.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$136.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.56
|
| Rate for Payer: Healthscope Commercial |
$176.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.34
|
| Rate for Payer: PHP Commercial |
$166.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.20
|
| Rate for Payer: Priority Health SBD |
$123.29
|
| Rate for Payer: UMR Bronson Commercial |
$86.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.78
|
|
|
PR OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 92544
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$2,260.07 |
| Rate for Payer: Aetna Commercial |
$22.59
|
| Rate for Payer: Aetna Medicare |
$17.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.28
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$16.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,260.07
|
| Rate for Payer: BCN Commercial |
$25.90
|
| Rate for Payer: BCN Medicare Advantage |
$16.86
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$22.59
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.70
|
| Rate for Payer: Meridian Medicaid |
$9.62
|
| Rate for Payer: Nomi Health Commercial |
$20.23
|
| Rate for Payer: PACE SWMI |
$16.86
|
| Rate for Payer: PHP Commercial |
$23.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.97
|
| Rate for Payer: Priority Health Medicare |
$16.86
|
| Rate for Payer: Priority Health Narrow Network |
$23.97
|
| Rate for Payer: Priority Health SBD |
$19.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.86
|
| Rate for Payer: UHC Medicare Advantage |
$16.86
|
| Rate for Payer: UHCCP Medicaid |
$9.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF
|
Professional
|
Both
|
$3,471.00
|
|
|
Service Code
|
HCPCS 23552
|
| Min. Negotiated Rate |
$422.59 |
| Max. Negotiated Rate |
$2,256.15 |
| Rate for Payer: Aetna Commercial |
$836.07
|
| Rate for Payer: Aetna Medicare |
$648.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.46
|
| Rate for Payer: BCBS Complete |
$443.72
|
| Rate for Payer: BCBS MAPPO |
$623.93
|
| Rate for Payer: BCBS Trust/PPO |
$455.39
|
| Rate for Payer: BCN Commercial |
$956.34
|
| Rate for Payer: BCN Medicare Advantage |
$623.93
|
| Rate for Payer: Cash Price |
$2,776.80
|
| Rate for Payer: Cash Price |
$2,776.80
|
| Rate for Payer: Cofinity Commercial |
$836.07
|
| Rate for Payer: Cofinity Commercial |
$898.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.13
|
| Rate for Payer: Meridian Medicaid |
$443.72
|
| Rate for Payer: Nomi Health Commercial |
$748.72
|
| Rate for Payer: PACE SWMI |
$623.93
|
| Rate for Payer: PHP Commercial |
$873.50
|
| Rate for Payer: PHP Medicare Advantage |
$623.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.04
|
| Rate for Payer: Priority Health Medicare |
$623.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.04
|
| Rate for Payer: Priority Health SBD |
$1,007.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.93
|
| Rate for Payer: UHC Medicare Advantage |
$623.93
|
| Rate for Payer: UHCCP Medicaid |
$422.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,596.66
|
|
|
PR OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT
|
Professional
|
Both
|
$3,890.00
|
|
|
Service Code
|
HCPCS 27228
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$2,865.40 |
| Rate for Payer: Aetna Commercial |
$2,421.25
|
| Rate for Payer: Aetna Medicare |
$1,879.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,601.94
|
| Rate for Payer: BCBS Complete |
$1,268.77
|
| Rate for Payer: BCBS MAPPO |
$1,806.90
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$2,737.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,806.90
|
| Rate for Payer: Cash Price |
$3,112.00
|
| Rate for Payer: Cash Price |
$3,112.00
|
| Rate for Payer: Cofinity Commercial |
$2,421.25
|
| Rate for Payer: Cofinity Commercial |
$2,601.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,806.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,897.24
|
| Rate for Payer: Meridian Medicaid |
$1,268.77
|
| Rate for Payer: Nomi Health Commercial |
$2,168.28
|
| Rate for Payer: PACE SWMI |
$1,806.90
|
| Rate for Payer: PHP Commercial |
$2,529.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,806.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,208.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,528.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,865.40
|
| Rate for Payer: Priority Health Medicare |
$1,806.90
|
| Rate for Payer: Priority Health Narrow Network |
$2,865.40
|
| Rate for Payer: Priority Health SBD |
$2,865.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,806.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,806.90
|
| Rate for Payer: UHCCP Medicaid |
$1,208.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,789.40
|
|
|
PR OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT
|
Professional
|
Both
|
$4,665.00
|
|
|
Service Code
|
HCPCS 27227
|
| Min. Negotiated Rate |
$1,064.79 |
| Max. Negotiated Rate |
$3,032.25 |
| Rate for Payer: Aetna Commercial |
$2,130.67
|
| Rate for Payer: Aetna Medicare |
$1,653.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,130.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,289.67
|
| Rate for Payer: BCBS Complete |
$1,118.03
|
| Rate for Payer: BCBS MAPPO |
$1,590.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.43
|
| Rate for Payer: BCN Commercial |
$2,406.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,590.05
|
| Rate for Payer: Cash Price |
$3,732.00
|
| Rate for Payer: Cash Price |
$3,732.00
|
| Rate for Payer: Cofinity Commercial |
$2,130.67
|
| Rate for Payer: Cofinity Commercial |
$2,289.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,590.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,669.55
|
| Rate for Payer: Meridian Medicaid |
$1,118.03
|
| Rate for Payer: Nomi Health Commercial |
$1,908.06
|
| Rate for Payer: PACE SWMI |
$1,590.05
|
| Rate for Payer: PHP Commercial |
$2,226.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,590.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,064.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,032.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,522.92
|
| Rate for Payer: Priority Health Medicare |
$1,590.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,522.92
|
| Rate for Payer: Priority Health SBD |
$2,522.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,590.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,590.05
|
| Rate for Payer: UHCCP Medicaid |
$1,064.79
|
| Rate for Payer: UMR Bronson Commercial |
$2,145.90
|
|
|
PR OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27846
|
| Min. Negotiated Rate |
$471.37 |
| Max. Negotiated Rate |
$1,953.25 |
| Rate for Payer: Aetna Commercial |
$934.96
|
| Rate for Payer: Aetna Medicare |
$725.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.96
|
| Rate for Payer: BCBS Complete |
$494.94
|
| Rate for Payer: BCBS MAPPO |
$697.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.80
|
| Rate for Payer: BCN Commercial |
$1,056.52
|
| Rate for Payer: BCN Medicare Advantage |
$697.73
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$1,004.73
|
| Rate for Payer: Cofinity Commercial |
$934.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.62
|
| Rate for Payer: Meridian Medicaid |
$494.94
|
| Rate for Payer: Nomi Health Commercial |
$837.28
|
| Rate for Payer: PACE SWMI |
$697.73
|
| Rate for Payer: PHP Commercial |
$976.82
|
| Rate for Payer: PHP Medicare Advantage |
$697.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,123.57
|
| Rate for Payer: Priority Health Medicare |
$697.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,123.57
|
| Rate for Payer: Priority Health SBD |
$1,123.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.73
|
| Rate for Payer: UHC Medicare Advantage |
$697.73
|
| Rate for Payer: UHCCP Medicaid |
$471.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,382.30
|
|
|
PR OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ
|
Professional
|
Both
|
$3,247.00
|
|
|
Service Code
|
HCPCS 27848
|
| Min. Negotiated Rate |
$516.95 |
| Max. Negotiated Rate |
$2,110.55 |
| Rate for Payer: Aetna Commercial |
$1,027.24
|
| Rate for Payer: Aetna Medicare |
$797.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.90
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$766.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.99
|
| Rate for Payer: BCN Commercial |
$1,152.30
|
| Rate for Payer: BCN Medicare Advantage |
$766.60
|
| Rate for Payer: Cash Price |
$2,597.60
|
| Rate for Payer: Cash Price |
$2,597.60
|
| Rate for Payer: Cofinity Commercial |
$1,027.24
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$804.93
|
| Rate for Payer: Meridian Medicaid |
$542.80
|
| Rate for Payer: Nomi Health Commercial |
$919.92
|
| Rate for Payer: PACE SWMI |
$766.60
|
| Rate for Payer: PHP Commercial |
$1,073.24
|
| Rate for Payer: PHP Medicare Advantage |
$766.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,110.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.18
|
| Rate for Payer: Priority Health Medicare |
$766.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.18
|
| Rate for Payer: Priority Health SBD |
$1,216.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$766.60
|
| Rate for Payer: UHC Medicare Advantage |
$766.60
|
| Rate for Payer: UHCCP Medicaid |
$516.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,493.62
|
|
|
PR OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR
|
Professional
|
Both
|
$3,134.00
|
|
|
Service Code
|
HCPCS 27217
|
| Min. Negotiated Rate |
$538.68 |
| Max. Negotiated Rate |
$2,037.10 |
| Rate for Payer: Aetna Commercial |
$1,119.55
|
| Rate for Payer: Aetna Medicare |
$1,567.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.55
|
| Rate for Payer: BCBS Complete |
$565.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,869.65
|
| Rate for Payer: BCN Commercial |
$1,224.63
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Meridian Medicaid |
$565.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,037.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,284.37
|
| Rate for Payer: Priority Health SBD |
$1,284.37
|
| Rate for Payer: UHCCP Medicaid |
$538.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,441.64
|
|
|
PR OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ
|
Professional
|
Both
|
$3,239.00
|
|
|
Service Code
|
HCPCS 26686
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$2,105.35 |
| Rate for Payer: Aetna Commercial |
$807.95
|
| Rate for Payer: Aetna Medicare |
$627.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.25
|
| Rate for Payer: BCBS Complete |
$428.96
|
| Rate for Payer: BCBS MAPPO |
$602.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.56
|
| Rate for Payer: BCN Commercial |
$921.16
|
| Rate for Payer: BCN Medicare Advantage |
$602.95
|
| Rate for Payer: Cash Price |
$2,591.20
|
| Rate for Payer: Cash Price |
$2,591.20
|
| Rate for Payer: Cofinity Commercial |
$868.25
|
| Rate for Payer: Cofinity Commercial |
$807.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.10
|
| Rate for Payer: Meridian Medicaid |
$428.96
|
| Rate for Payer: Nomi Health Commercial |
$723.54
|
| Rate for Payer: PACE SWMI |
$602.95
|
| Rate for Payer: PHP Commercial |
$844.13
|
| Rate for Payer: PHP Medicare Advantage |
$602.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,105.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$967.86
|
| Rate for Payer: Priority Health Medicare |
$602.95
|
| Rate for Payer: Priority Health Narrow Network |
$967.86
|
| Rate for Payer: Priority Health SBD |
$967.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.95
|
| Rate for Payer: UHC Medicare Advantage |
$602.95
|
| Rate for Payer: UHCCP Medicaid |
$408.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,489.94
|
|
|
PR OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION
|
Professional
|
Both
|
$2,461.00
|
|
|
Service Code
|
HCPCS 21470
|
| Min. Negotiated Rate |
$749.97 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$1,484.79
|
| Rate for Payer: Aetna Medicare |
$1,152.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,484.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,595.59
|
| Rate for Payer: BCBS Complete |
$787.47
|
| Rate for Payer: BCBS MAPPO |
$1,108.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$1,692.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,108.05
|
| Rate for Payer: Cash Price |
$1,968.80
|
| Rate for Payer: Cash Price |
$1,968.80
|
| Rate for Payer: Cofinity Commercial |
$1,484.79
|
| Rate for Payer: Cofinity Commercial |
$1,595.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,108.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,163.45
|
| Rate for Payer: Meridian Medicaid |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$1,329.66
|
| Rate for Payer: PACE SWMI |
$1,108.05
|
| Rate for Payer: PHP Commercial |
$1,551.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,108.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,599.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,780.00
|
| Rate for Payer: Priority Health Medicare |
$1,108.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,780.00
|
| Rate for Payer: Priority Health SBD |
$1,780.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,108.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,108.05
|
| Rate for Payer: UHCCP Medicaid |
$749.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,132.06
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG
|
Professional
|
Both
|
$2,420.00
|
|
|
Service Code
|
HCPCS 25608
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$1,573.00 |
| Rate for Payer: Aetna Commercial |
$1,072.74
|
| Rate for Payer: Aetna Medicare |
$832.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,072.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,152.79
|
| Rate for Payer: BCBS Complete |
$569.64
|
| Rate for Payer: BCBS MAPPO |
$800.55
|
| Rate for Payer: BCBS Trust/PPO |
$25.36
|
| Rate for Payer: BCN Commercial |
$1,220.23
|
| Rate for Payer: BCN Medicare Advantage |
$800.55
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cofinity Commercial |
$1,072.74
|
| Rate for Payer: Cofinity Commercial |
$1,152.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.58
|
| Rate for Payer: Meridian Medicaid |
$569.64
|
| Rate for Payer: Nomi Health Commercial |
$960.66
|
| Rate for Payer: PACE SWMI |
$800.55
|
| Rate for Payer: PHP Commercial |
$1,120.77
|
| Rate for Payer: PHP Medicare Advantage |
$800.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,573.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,283.85
|
| Rate for Payer: Priority Health Medicare |
$800.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,283.85
|
| Rate for Payer: Priority Health SBD |
$1,283.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.55
|
| Rate for Payer: UHC Medicare Advantage |
$800.55
|
| Rate for Payer: UHCCP Medicaid |
$542.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,113.20
|
|
|
PR OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3+ FRAG
|
Professional
|
Both
|
$2,959.00
|
|
|
Service Code
|
HCPCS 25609
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$1,923.35 |
| Rate for Payer: Aetna Commercial |
$1,361.44
|
| Rate for Payer: Aetna Medicare |
$1,056.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.04
|
| Rate for Payer: BCBS Complete |
$721.94
|
| Rate for Payer: BCBS MAPPO |
$1,016.00
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$1,547.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.00
|
| Rate for Payer: Cash Price |
$2,367.20
|
| Rate for Payer: Cash Price |
$2,367.20
|
| Rate for Payer: Cofinity Commercial |
$1,361.44
|
| Rate for Payer: Cofinity Commercial |
$1,463.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.80
|
| Rate for Payer: Meridian Medicaid |
$721.94
|
| Rate for Payer: Nomi Health Commercial |
$1,219.20
|
| Rate for Payer: PACE SWMI |
$1,016.00
|
| Rate for Payer: PHP Commercial |
$1,422.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,923.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,625.30
|
| Rate for Payer: Priority Health Medicare |
$1,016.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,625.30
|
| Rate for Payer: Priority Health SBD |
$1,625.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,016.00
|
| Rate for Payer: UHCCP Medicaid |
$687.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,361.14
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Facility
|
OP
|
$1,944.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$718.06 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna American Axle |
$1,263.60
|
| Rate for Payer: Aetna Commercial |
$1,652.40
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,263.60
|
| 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 |
$5,183.77
|
| Rate for Payer: BCN Commercial |
$5,183.77
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,671.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,360.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,555.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$1,749.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,360.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,458.00
|
| 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: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,652.40
|
| 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 |
$1,652.40
|
| 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 |
$1,263.60
|
| 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 |
$1,224.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.87
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$718.06
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$719.28
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,458.00
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Facility
|
IP
|
$1,944.00
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$855.36 |
| Max. Negotiated Rate |
$1,749.60 |
| Rate for Payer: Cofinity Commercial |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,671.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,360.80
|
| Rate for Payer: Aetna American Axle |
$1,263.60
|
| Rate for Payer: Aetna Commercial |
$1,652.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,263.60
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,555.20
|
| Rate for Payer: Healthscope Commercial |
$1,749.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,360.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,458.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,652.40
|
| Rate for Payer: PHP Commercial |
$1,652.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health SBD |
$1,224.72
|
| Rate for Payer: UMR Bronson Commercial |
$855.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,458.00
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25607
|
| Hospital Charge Code |
25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Priority Health Narrow Network |
$1,150.03
|
| Rate for Payer: Priority Health SBD |
$1,150.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.46
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
| Rate for Payer: UMR Bronson Commercial |
$894.24
|
| Rate for Payer: Aetna Commercial |
$961.40
|
| Rate for Payer: Aetna Medicare |
$746.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.40
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$717.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$717.46
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$961.40
|
| Rate for Payer: Cofinity Commercial |
$1,033.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.33
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Nomi Health Commercial |
$860.95
|
| Rate for Payer: PACE SWMI |
$717.46
|
| Rate for Payer: PHP Commercial |
$1,004.44
|
| Rate for Payer: PHP Medicare Advantage |
$717.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$717.46
|
|
|
PR OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25607
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$961.40
|
| Rate for Payer: Aetna Medicare |
$746.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.40
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$717.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$717.46
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,033.14
|
| Rate for Payer: Cofinity Commercial |
$961.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.33
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Nomi Health Commercial |
$860.95
|
| Rate for Payer: PACE SWMI |
$717.46
|
| Rate for Payer: PHP Commercial |
$1,004.44
|
| Rate for Payer: PHP Medicare Advantage |
$717.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$717.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.03
|
| Rate for Payer: Priority Health SBD |
$1,150.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.46
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
| Rate for Payer: UMR Bronson Commercial |
$894.24
|
|
|
PR OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 27236
|
| Min. Negotiated Rate |
$772.13 |
| Max. Negotiated Rate |
$2,425.80 |
| Rate for Payer: Aetna Commercial |
$1,539.53
|
| Rate for Payer: Aetna Medicare |
$1,194.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,539.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.42
|
| Rate for Payer: BCBS Complete |
$810.74
|
| Rate for Payer: BCBS MAPPO |
$1,148.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,920.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,148.90
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,539.53
|
| Rate for Payer: Cofinity Commercial |
$1,654.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,148.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,206.34
|
| Rate for Payer: Meridian Medicaid |
$810.74
|
| Rate for Payer: Nomi Health Commercial |
$1,378.68
|
| Rate for Payer: PACE SWMI |
$1,148.90
|
| Rate for Payer: PHP Commercial |
$1,608.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,148.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,831.39
|
| Rate for Payer: Priority Health Medicare |
$1,148.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,831.39
|
| Rate for Payer: Priority Health SBD |
$1,831.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,148.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.90
|
| Rate for Payer: UHCCP Medicaid |
$772.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,716.72
|
|
|
PR OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW
|
Professional
|
Both
|
$4,215.00
|
|
|
Service Code
|
HCPCS 27506
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$2,739.75 |
| Rate for Payer: Aetna Commercial |
$1,726.52
|
| Rate for Payer: Aetna Medicare |
$1,339.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,726.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.37
|
| Rate for Payer: BCBS Complete |
$909.36
|
| Rate for Payer: BCBS MAPPO |
$1,288.45
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,154.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,288.45
|
| Rate for Payer: Cash Price |
$3,372.00
|
| Rate for Payer: Cash Price |
$3,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,726.52
|
| Rate for Payer: Cofinity Commercial |
$1,855.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,288.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,352.87
|
| Rate for Payer: Meridian Medicaid |
$909.36
|
| Rate for Payer: Nomi Health Commercial |
$1,546.14
|
| Rate for Payer: PACE SWMI |
$1,288.45
|
| Rate for Payer: PHP Commercial |
$1,803.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,288.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.75
|
| Rate for Payer: Priority Health Medicare |
$1,288.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.75
|
| Rate for Payer: Priority Health SBD |
$2,052.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,288.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,288.45
|
| Rate for Payer: UHCCP Medicaid |
$866.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,938.90
|
|
|
PR OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27507
|
| Min. Negotiated Rate |
$626.65 |
| Max. Negotiated Rate |
$2,501.20 |
| Rate for Payer: Aetna Commercial |
$1,250.94
|
| Rate for Payer: Aetna Medicare |
$970.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.30
|
| Rate for Payer: BCBS Complete |
$657.98
|
| Rate for Payer: BCBS MAPPO |
$933.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.62
|
| Rate for Payer: BCN Commercial |
$1,416.67
|
| Rate for Payer: BCN Medicare Advantage |
$933.54
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,250.94
|
| Rate for Payer: Cofinity Commercial |
$1,344.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.22
|
| Rate for Payer: Meridian Medicaid |
$657.98
|
| Rate for Payer: Nomi Health Commercial |
$1,120.25
|
| Rate for Payer: PACE SWMI |
$933.54
|
| Rate for Payer: PHP Commercial |
$1,306.96
|
| Rate for Payer: PHP Medicare Advantage |
$933.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,483.83
|
| Rate for Payer: Priority Health Medicare |
$933.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,483.83
|
| Rate for Payer: Priority Health SBD |
$1,483.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.54
|
| Rate for Payer: UHC Medicare Advantage |
$933.54
|
| Rate for Payer: UHCCP Medicaid |
$626.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,770.08
|
|
|
PR OPTX GREATER HUMERAL TUBEROSITY FX W/INT FIXJ
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 23630
|
| Min. Negotiated Rate |
$265.21 |
| Max. Negotiated Rate |
$1,209.05 |
| Rate for Payer: Aetna Commercial |
$1,011.63
|
| Rate for Payer: Aetna Medicare |
$785.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,087.13
|
| Rate for Payer: BCBS Complete |
$536.31
|
| Rate for Payer: BCBS MAPPO |
$754.95
|
| Rate for Payer: BCBS Trust/PPO |
$265.21
|
| Rate for Payer: BCN Commercial |
$1,149.86
|
| Rate for Payer: BCN Medicare Advantage |
$754.95
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$1,011.63
|
| Rate for Payer: Cofinity Commercial |
$1,087.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$792.70
|
| Rate for Payer: Meridian Medicaid |
$536.31
|
| Rate for Payer: Nomi Health Commercial |
$905.94
|
| Rate for Payer: PACE SWMI |
$754.95
|
| Rate for Payer: PHP Commercial |
$1,056.93
|
| Rate for Payer: PHP Medicare Advantage |
$754.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.05
|
| Rate for Payer: Priority Health Medicare |
$754.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.05
|
| Rate for Payer: Priority Health SBD |
$1,209.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$754.95
|
| Rate for Payer: UHC Medicare Advantage |
$754.95
|
| Rate for Payer: UHCCP Medicaid |
$510.77
|
| Rate for Payer: UMR Bronson Commercial |
$638.48
|
|
|
PR OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD
|
Professional
|
Both
|
$3,546.00
|
|
|
Service Code
|
HCPCS 27254
|
| Min. Negotiated Rate |
$821.97 |
| Max. Negotiated Rate |
$2,549.58 |
| Rate for Payer: Aetna Commercial |
$1,640.68
|
| Rate for Payer: Aetna Medicare |
$1,273.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,640.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,763.12
|
| Rate for Payer: BCBS Complete |
$863.07
|
| Rate for Payer: BCBS MAPPO |
$1,224.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.58
|
| Rate for Payer: BCN Commercial |
$1,859.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,224.39
|
| Rate for Payer: Cash Price |
$2,836.80
|
| Rate for Payer: Cash Price |
$2,836.80
|
| Rate for Payer: Cofinity Commercial |
$1,640.68
|
| Rate for Payer: Cofinity Commercial |
$1,763.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,224.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,285.61
|
| Rate for Payer: Meridian Medicaid |
$863.07
|
| Rate for Payer: Nomi Health Commercial |
$1,469.27
|
| Rate for Payer: PACE SWMI |
$1,224.39
|
| Rate for Payer: PHP Commercial |
$1,714.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,224.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,304.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,949.44
|
| Rate for Payer: Priority Health Medicare |
$1,224.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,949.44
|
| Rate for Payer: Priority Health SBD |
$1,949.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,224.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,224.39
|
| Rate for Payer: UHCCP Medicaid |
$821.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,631.16
|
|
|
PR OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ
|
Professional
|
Both
|
$2,351.00
|
|
|
Service Code
|
HCPCS 27253
|
| Min. Negotiated Rate |
$609.82 |
| Max. Negotiated Rate |
$2,442.33 |
| Rate for Payer: Aetna Commercial |
$1,214.46
|
| Rate for Payer: Aetna Medicare |
$942.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.09
|
| Rate for Payer: BCBS Complete |
$640.31
|
| Rate for Payer: BCBS MAPPO |
$906.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,442.33
|
| Rate for Payer: BCN Commercial |
$1,379.05
|
| Rate for Payer: BCN Medicare Advantage |
$906.31
|
| Rate for Payer: Cash Price |
$1,880.80
|
| Rate for Payer: Cash Price |
$1,880.80
|
| Rate for Payer: Cofinity Commercial |
$1,214.46
|
| Rate for Payer: Cofinity Commercial |
$1,305.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.63
|
| Rate for Payer: Meridian Medicaid |
$640.31
|
| Rate for Payer: Nomi Health Commercial |
$1,087.57
|
| Rate for Payer: PACE SWMI |
$906.31
|
| Rate for Payer: PHP Commercial |
$1,268.83
|
| Rate for Payer: PHP Medicare Advantage |
$906.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,445.17
|
| Rate for Payer: Priority Health Medicare |
$906.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,445.17
|
| Rate for Payer: Priority Health SBD |
$1,445.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.31
|
| Rate for Payer: UHC Medicare Advantage |
$906.31
|
| Rate for Payer: UHCCP Medicaid |
$609.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,081.46
|
|
|
PR OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE
|
Professional
|
Both
|
$3,092.00
|
|
|
Service Code
|
HCPCS 24515
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$2,009.80 |
| Rate for Payer: Aetna Commercial |
$1,137.89
|
| Rate for Payer: Aetna Medicare |
$883.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,137.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.80
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$849.17
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$849.17
|
| Rate for Payer: Cash Price |
$2,473.60
|
| Rate for Payer: Cash Price |
$2,473.60
|
| Rate for Payer: Cofinity Commercial |
$1,222.80
|
| Rate for Payer: Cofinity Commercial |
$1,137.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.63
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Nomi Health Commercial |
$1,019.00
|
| Rate for Payer: PACE SWMI |
$849.17
|
| Rate for Payer: PHP Commercial |
$1,188.84
|
| Rate for Payer: PHP Medicare Advantage |
$849.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,009.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,359.67
|
| Rate for Payer: Priority Health Medicare |
$849.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.67
|
| Rate for Payer: Priority Health SBD |
$1,359.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.17
|
| Rate for Payer: UHC Medicare Advantage |
$849.17
|
| Rate for Payer: UHCCP Medicaid |
$573.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,422.32
|
|
|
PR OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS 27215
|
| Min. Negotiated Rate |
$387.66 |
| Max. Negotiated Rate |
$1,741.81 |
| Rate for Payer: Aetna Commercial |
$803.86
|
| Rate for Payer: Aetna Medicare |
$1,317.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.86
|
| Rate for Payer: BCBS Complete |
$407.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.81
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Meridian Medicaid |
$407.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.59
|
| Rate for Payer: Priority Health Narrow Network |
$924.59
|
| Rate for Payer: Priority Health SBD |
$924.59
|
| Rate for Payer: UHCCP Medicaid |
$387.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,211.64
|
|
|
PR OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN
|
Professional
|
Both
|
$2,054.00
|
|
|
Service Code
|
HCPCS 21347
|
| Min. Negotiated Rate |
$86.11 |
| Max. Negotiated Rate |
$1,587.65 |
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: Aetna Medicare |
$1,018.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,312.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,410.72
|
| Rate for Payer: BCBS Complete |
$701.37
|
| Rate for Payer: BCBS MAPPO |
$979.67
|
| Rate for Payer: BCBS Trust/PPO |
$86.11
|
| Rate for Payer: BCN Commercial |
$1,528.09
|
| Rate for Payer: BCN Medicare Advantage |
$979.67
|
| Rate for Payer: Cash Price |
$1,643.20
|
| Rate for Payer: Cash Price |
$1,643.20
|
| Rate for Payer: Cofinity Commercial |
$1,312.76
|
| Rate for Payer: Cofinity Commercial |
$1,410.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.65
|
| Rate for Payer: Meridian Medicaid |
$701.37
|
| Rate for Payer: Nomi Health Commercial |
$1,175.60
|
| Rate for Payer: PACE SWMI |
$979.67
|
| Rate for Payer: PHP Commercial |
$1,371.54
|
| Rate for Payer: PHP Medicare Advantage |
$979.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,587.65
|
| Rate for Payer: Priority Health Medicare |
$979.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,587.65
|
| Rate for Payer: Priority Health SBD |
$1,587.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.67
|
| Rate for Payer: UHC Medicare Advantage |
$979.67
|
| Rate for Payer: UHCCP Medicaid |
$667.97
|
| Rate for Payer: UMR Bronson Commercial |
$944.84
|
|
