|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,040.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$551.24 |
| Max. Negotiated Rate |
$3,384.29 |
| Rate for Payer: Aetna Commercial |
$1,135.98
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,384.29
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,314.42
|
| Rate for Payer: Priority Health SBD |
$1,314.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,398.40
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,276.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$721.86 |
| Max. Negotiated Rate |
$3,897.80 |
| Rate for Payer: Aetna Commercial |
$1,490.61
|
| Rate for Payer: BCBS Complete |
$757.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.80
|
| Rate for Payer: Cash Price |
$3,420.80
|
| Rate for Payer: Cash Price |
$3,420.80
|
| Rate for Payer: Meridian Medicaid |
$757.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,993.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,721.92
|
| Rate for Payer: Priority Health SBD |
$1,721.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,966.96
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$480.10 |
| Max. Negotiated Rate |
$2,101.58 |
| Rate for Payer: Aetna Commercial |
$996.94
|
| Rate for Payer: BCBS Complete |
$504.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.58
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Meridian Medicaid |
$504.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,143.34
|
| Rate for Payer: Priority Health SBD |
$1,143.34
|
| Rate for Payer: UMR Bronson Commercial |
$908.96
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,802.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$378.26 |
| Max. Negotiated Rate |
$1,961.40 |
| Rate for Payer: Aetna Commercial |
$1,111.10
|
| Rate for Payer: BCBS Complete |
$567.40
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Cash Price |
$2,241.60
|
| Rate for Payer: Meridian Medicaid |
$567.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,961.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,284.28
|
| Rate for Payer: Priority Health SBD |
$1,284.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,288.92
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 28675
|
| Min. Negotiated Rate |
$268.17 |
| Max. Negotiated Rate |
$672.00 |
| Rate for Payer: Aetna Commercial |
$534.76
|
| Rate for Payer: BCBS Complete |
$281.58
|
| Rate for Payer: BCBS Trust/PPO |
$671.47
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Meridian Medicaid |
$281.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.17
|
| Rate for Payer: Priority Health Narrow Network |
$631.17
|
| Rate for Payer: Priority Health SBD |
$631.17
|
| Rate for Payer: UMR Bronson Commercial |
$441.60
|
|
|
PR OPEN TREATMENT LUNATE DISLOCATION
|
Professional
|
Both
|
$1,867.00
|
|
|
Service Code
|
HCPCS 25695
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$1,306.90 |
| Rate for Payer: Aetna Commercial |
$848.78
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: Cash Price |
$1,493.60
|
| Rate for Payer: Cash Price |
$1,493.60
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$979.94
|
| Rate for Payer: Priority Health Narrow Network |
$979.94
|
| Rate for Payer: Priority Health SBD |
$979.94
|
| Rate for Payer: UMR Bronson Commercial |
$858.82
|
|
|
PR OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 21465
|
| Min. Negotiated Rate |
$509.71 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$1,066.23
|
| Rate for Payer: BCBS Complete |
$535.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Meridian Medicaid |
$535.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,211.77
|
| Rate for Payer: Priority Health SBD |
$1,211.77
|
| Rate for Payer: UMR Bronson Commercial |
$772.34
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 27766
|
| Min. Negotiated Rate |
$392.35 |
| Max. Negotiated Rate |
$2,661.86 |
| Rate for Payer: Aetna Commercial |
$805.90
|
| Rate for Payer: BCBS Complete |
$411.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,661.86
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Meridian Medicaid |
$411.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.51
|
| Rate for Payer: Priority Health Narrow Network |
$935.51
|
| Rate for Payer: Priority Health SBD |
$935.51
|
| Rate for Payer: UMR Bronson Commercial |
$983.48
|
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,887.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$374.24 |
| Max. Negotiated Rate |
$1,320.90 |
| Rate for Payer: Aetna Commercial |
$760.98
|
| Rate for Payer: BCBS Complete |
$392.95
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Meridian Medicaid |
$392.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$887.51
|
| Rate for Payer: Priority Health Narrow Network |
$887.51
|
| Rate for Payer: Priority Health SBD |
$887.51
|
| Rate for Payer: UMR Bronson Commercial |
$868.02
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$365.08 |
| Max. Negotiated Rate |
$924.00 |
| Rate for Payer: Aetna Commercial |
$740.09
|
| Rate for Payer: BCBS Complete |
$383.33
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Meridian Medicaid |
$383.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$861.98
|
| Rate for Payer: Priority Health Narrow Network |
$861.98
|
| Rate for Payer: Priority Health SBD |
$861.98
|
| Rate for Payer: UMR Bronson Commercial |
$607.20
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$286.49 |
| Max. Negotiated Rate |
$1,404.22 |
| Rate for Payer: Aetna Commercial |
$583.69
|
| Rate for Payer: BCBS Complete |
$300.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Meridian Medicaid |
$300.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.81
|
| Rate for Payer: Priority Health Narrow Network |
$685.81
|
| Rate for Payer: Priority Health SBD |
$685.81
|
| Rate for Payer: UMR Bronson Commercial |
$379.04
|
|
|
PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE
|
Professional
|
Both
|
$1,906.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$407.26 |
| Max. Negotiated Rate |
$1,334.20 |
| Rate for Payer: Aetna Commercial |
$829.87
|
| Rate for Payer: BCBS Complete |
$427.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Cash Price |
$1,524.80
|
| Rate for Payer: Meridian Medicaid |
$427.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.65
|
| Rate for Payer: Priority Health Narrow Network |
$966.65
|
| Rate for Payer: Priority Health SBD |
$966.65
|
| Rate for Payer: UMR Bronson Commercial |
$876.76
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,317.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$399.38 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$849.13
|
| Rate for Payer: BCBS Complete |
$419.35
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: Cash Price |
$1,053.60
|
| Rate for Payer: Cash Price |
$1,053.60
|
| Rate for Payer: Meridian Medicaid |
$419.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.57
|
| Rate for Payer: Priority Health Narrow Network |
$962.57
|
| Rate for Payer: Priority Health SBD |
$962.57
|
| Rate for Payer: UMR Bronson Commercial |
$605.82
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$469.67 |
| Max. Negotiated Rate |
$2,788.67 |
| Rate for Payer: Aetna Commercial |
$976.15
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,788.67
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Meridian Medicaid |
$493.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.30
|
| Rate for Payer: Priority Health SBD |
$1,117.30
|
| Rate for Payer: UMR Bronson Commercial |
$585.12
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,233.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$2,244.78 |
| Rate for Payer: Aetna Commercial |
$940.92
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.78
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,093.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,093.29
|
| Rate for Payer: Priority Health SBD |
$1,093.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,027.18
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE
|
Professional
|
Both
|
$2,023.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$436.44 |
| Max. Negotiated Rate |
$1,416.10 |
| Rate for Payer: Aetna Commercial |
$891.56
|
| Rate for Payer: BCBS Complete |
$458.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,387.32
|
| Rate for Payer: Cash Price |
$1,618.40
|
| Rate for Payer: Cash Price |
$1,618.40
|
| Rate for Payer: Meridian Medicaid |
$458.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.07
|
| Rate for Payer: Priority Health SBD |
$1,034.07
|
| Rate for Payer: UMR Bronson Commercial |
$930.58
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,957.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$312.23 |
| Max. Negotiated Rate |
$1,369.90 |
| Rate for Payer: Aetna Commercial |
$912.33
|
| Rate for Payer: BCBS Complete |
$478.83
|
| Rate for Payer: BCBS Trust/PPO |
$312.23
|
| Rate for Payer: Cash Price |
$1,565.60
|
| Rate for Payer: Cash Price |
$1,565.60
|
| Rate for Payer: Meridian Medicaid |
$478.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,065.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,065.22
|
| Rate for Payer: Priority Health SBD |
$1,065.22
|
| Rate for Payer: UMR Bronson Commercial |
$900.22
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,080.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$588.53 |
| Max. Negotiated Rate |
$2,156.00 |
| Rate for Payer: Aetna Commercial |
$1,370.13
|
| Rate for Payer: BCBS Complete |
$708.97
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Meridian Medicaid |
$708.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,589.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,589.66
|
| Rate for Payer: Priority Health SBD |
$1,589.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,416.80
|
|
|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,694.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$427.92 |
| Max. Negotiated Rate |
$1,185.80 |
| Rate for Payer: Aetna Commercial |
$870.72
|
| Rate for Payer: BCBS Complete |
$449.32
|
| Rate for Payer: BCBS Trust/PPO |
$645.58
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Meridian Medicaid |
$449.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,185.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,017.72
|
| Rate for Payer: Priority Health SBD |
$1,017.72
|
| Rate for Payer: UMR Bronson Commercial |
$779.24
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,760.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$535.48 |
| Max. Negotiated Rate |
$1,778.26 |
| Rate for Payer: Aetna Commercial |
$1,091.05
|
| Rate for Payer: BCBS Complete |
$562.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.26
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Meridian Medicaid |
$562.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,268.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,268.97
|
| Rate for Payer: Priority Health SBD |
$1,268.97
|
| Rate for Payer: UMR Bronson Commercial |
$809.60
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,607.90 |
| Rate for Payer: Aetna Commercial |
$871.05
|
| Rate for Payer: BCBS Complete |
$446.63
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Meridian Medicaid |
$446.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,009.04
|
| Rate for Payer: Priority Health SBD |
$1,009.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,056.62
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,607.90 |
| Rate for Payer: Aetna Commercial |
$871.05
|
| Rate for Payer: BCBS Complete |
$446.63
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Meridian Medicaid |
$446.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,009.04
|
| Rate for Payer: Priority Health SBD |
$1,009.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,056.62
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
OP
|
$2,297.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$653.90 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna American Axle |
$1,493.05
|
| Rate for Payer: Aetna Commercial |
$1,952.45
|
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$6,253.56
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$1,607.90
|
| Rate for Payer: Cofinity Commercial |
$1,975.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$2,067.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,607.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.75
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,952.45
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$1,952.45
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Priority Health SBD |
$1,447.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$653.90
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: UMR Bronson Commercial |
$849.89
|
| Rate for Payer: VA VA |
$6,359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.75
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
IP
|
$2,297.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,010.68 |
| Max. Negotiated Rate |
$2,067.30 |
| Rate for Payer: Aetna American Axle |
$1,493.05
|
| Rate for Payer: Aetna Commercial |
$1,952.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.05
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$1,607.90
|
| Rate for Payer: Cofinity Commercial |
$1,975.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.60
|
| Rate for Payer: Healthscope Commercial |
$2,067.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,607.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,952.45
|
| Rate for Payer: PHP Commercial |
$1,952.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.90
|
| Rate for Payer: Priority Health SBD |
$1,447.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,010.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.75
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$405.98 |
| Max. Negotiated Rate |
$1,501.43 |
| Rate for Payer: Aetna Commercial |
$828.66
|
| Rate for Payer: BCBS Complete |
$426.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.43
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Meridian Medicaid |
$426.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$963.59
|
| Rate for Payer: Priority Health Narrow Network |
$963.59
|
| Rate for Payer: Priority Health SBD |
$963.59
|
| Rate for Payer: UMR Bronson Commercial |
$751.64
|
|
