|
PR CLTX IPHAL JT DISLC W/MANJ REQ ANES
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 26775
|
| Min. Negotiated Rate |
$227.91 |
| Max. Negotiated Rate |
$637.50 |
| Rate for Payer: Aetna Commercial |
$459.38
|
| Rate for Payer: Aetna Medicare |
$342.82
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS MAPPO |
$342.82
|
| Rate for Payer: BCN Commercial |
$556.75
|
| Rate for Payer: BCN Medicare Advantage |
$342.82
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cofinity Commercial |
$493.66
|
| Rate for Payer: Cofinity Commercial |
$459.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.82
|
| Rate for Payer: Healthscope Commercial |
$411.38
|
| Rate for Payer: Healthscope Whirlpool |
$411.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.96
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.10
|
| Rate for Payer: Nomi Health Commercial |
$411.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.50
|
| Rate for Payer: PACE SWMI |
$342.82
|
| Rate for Payer: PHP Medicare Advantage |
$342.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$595.14
|
| Rate for Payer: Priority Health Medicare |
$342.82
|
| Rate for Payer: Priority Health Narrow Network |
$595.14
|
| Rate for Payer: Railroad Medicare Medicare |
$342.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$596.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$342.82
|
| Rate for Payer: UHC Exchange |
$596.63
|
| Rate for Payer: UHC Medicaid |
$227.91
|
| Rate for Payer: UHCCP DNSP |
$342.82
|
| Rate for Payer: UHCCP Medicaid |
$227.91
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$196.17 |
| Max. Negotiated Rate |
$445.74 |
| Rate for Payer: Aetna Commercial |
$394.98
|
| Rate for Payer: Aetna Medicare |
$294.76
|
| Rate for Payer: BCBS Complete |
$205.98
|
| Rate for Payer: BCBS MAPPO |
$294.76
|
| Rate for Payer: BCN Commercial |
$416.31
|
| Rate for Payer: BCN Medicare Advantage |
$294.76
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$424.45
|
| Rate for Payer: Cofinity Commercial |
$394.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.76
|
| Rate for Payer: Healthscope Commercial |
$353.71
|
| Rate for Payer: Healthscope Whirlpool |
$353.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.50
|
| Rate for Payer: Meridian Medicaid |
$205.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$324.24
|
| Rate for Payer: Nomi Health Commercial |
$353.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$431.25
|
| Rate for Payer: PACE SWMI |
$294.76
|
| Rate for Payer: PHP Medicare Advantage |
$294.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.03
|
| Rate for Payer: Priority Health Medicare |
$294.76
|
| Rate for Payer: Priority Health Narrow Network |
$445.03
|
| Rate for Payer: Railroad Medicare Medicare |
$294.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$445.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$294.76
|
| Rate for Payer: UHC Exchange |
$445.74
|
| Rate for Payer: UHC Medicaid |
$196.17
|
| Rate for Payer: UHCCP DNSP |
$294.76
|
| Rate for Payer: UHCCP Medicaid |
$196.17
|
|
|
PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 21440
|
| Min. Negotiated Rate |
$383.61 |
| Max. Negotiated Rate |
$956.60 |
| Rate for Payer: Aetna Commercial |
$753.63
|
| Rate for Payer: Aetna Medicare |
$562.41
|
| Rate for Payer: BCBS Complete |
$402.79
|
| Rate for Payer: BCBS MAPPO |
$562.41
|
| Rate for Payer: BCN Commercial |
$894.87
|
| Rate for Payer: BCN Medicare Advantage |
$562.41
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$809.87
|
| Rate for Payer: Cofinity Commercial |
$753.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.41
|
| Rate for Payer: Healthscope Commercial |
$674.89
|
| Rate for Payer: Healthscope Whirlpool |
$674.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.53
|
| Rate for Payer: Meridian Medicaid |
$402.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.65
|
| Rate for Payer: Nomi Health Commercial |
$674.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$923.25
|
| Rate for Payer: PACE SWMI |
$562.41
|
| Rate for Payer: PHP Medicare Advantage |
$562.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$956.60
|
| Rate for Payer: Priority Health Medicare |
$562.41
|
| Rate for Payer: Priority Health Narrow Network |
$956.60
|
| Rate for Payer: Railroad Medicare Medicare |
$562.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$850.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$562.41
|
| Rate for Payer: UHC Exchange |
$850.48
|
| Rate for Payer: UHC Medicaid |
$383.61
|
| Rate for Payer: UHCCP DNSP |
$562.41
|
| Rate for Payer: UHCCP Medicaid |
$383.61
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$203.84 |
| Max. Negotiated Rate |
$673.50 |
| Rate for Payer: Aetna Commercial |
$408.95
|
| Rate for Payer: Aetna Medicare |
$305.19
|
| Rate for Payer: BCBS Complete |
$214.03
|
| Rate for Payer: BCBS MAPPO |
$305.19
|
| Rate for Payer: BCN Commercial |
$382.49
|
| Rate for Payer: BCN Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cofinity Commercial |
$439.47
|
| Rate for Payer: Cofinity Commercial |
$408.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.19
|
| Rate for Payer: Healthscope Commercial |
$366.23
|
| Rate for Payer: Healthscope Whirlpool |
$366.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.45
|
| Rate for Payer: Meridian Medicaid |
$214.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.71
|
| Rate for Payer: Nomi Health Commercial |
$366.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.50
|
| Rate for Payer: PACE SWMI |
$305.19
|
| Rate for Payer: PHP Medicare Advantage |
$305.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$518.48
|
| Rate for Payer: Priority Health Medicare |
$305.19
|
| Rate for Payer: Priority Health Narrow Network |
$518.48
|
| Rate for Payer: Railroad Medicare Medicare |
$305.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$526.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.19
|
| Rate for Payer: UHC Exchange |
$526.30
|
| Rate for Payer: UHC Medicaid |
$203.84
|
| Rate for Payer: UHCCP DNSP |
$305.19
|
| Rate for Payer: UHCCP Medicaid |
$203.84
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$198.94 |
| Max. Negotiated Rate |
$552.00 |
| Rate for Payer: Aetna Commercial |
$399.05
|
| Rate for Payer: Aetna Medicare |
$297.80
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$297.80
|
| Rate for Payer: BCN Commercial |
$468.60
|
| Rate for Payer: BCN Medicare Advantage |
$297.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Commercial |
$399.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.80
|
| Rate for Payer: Healthscope Commercial |
$357.36
|
| Rate for Payer: Healthscope Whirlpool |
$357.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.69
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$327.58
|
| Rate for Payer: Nomi Health Commercial |
$357.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.00
|
| Rate for Payer: PACE SWMI |
$297.80
|
| Rate for Payer: PHP Medicare Advantage |
$297.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$500.92
|
| Rate for Payer: Priority Health Medicare |
$297.80
|
| Rate for Payer: Priority Health Narrow Network |
$500.92
|
| Rate for Payer: Railroad Medicare Medicare |
$297.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.80
|
| Rate for Payer: UHC Exchange |
$504.65
|
| Rate for Payer: UHC Medicaid |
$198.94
|
| Rate for Payer: UHCCP DNSP |
$297.80
|
| Rate for Payer: UHCCP Medicaid |
$198.94
|
|
|
PR CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26607
|
| Min. Negotiated Rate |
$317.16 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$640.27
|
| Rate for Payer: Aetna Medicare |
$477.81
|
| Rate for Payer: BCBS Complete |
$333.02
|
| Rate for Payer: BCBS MAPPO |
$477.81
|
| Rate for Payer: BCN Commercial |
$776.35
|
| Rate for Payer: BCN Medicare Advantage |
$477.81
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$688.05
|
| Rate for Payer: Cofinity Commercial |
$640.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.81
|
| Rate for Payer: Healthscope Commercial |
$573.37
|
| Rate for Payer: Healthscope Whirlpool |
$573.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.70
|
| Rate for Payer: Meridian Medicaid |
$333.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$525.59
|
| Rate for Payer: Nomi Health Commercial |
$573.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$477.81
|
| Rate for Payer: PHP Medicare Advantage |
$477.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$829.90
|
| Rate for Payer: Priority Health Medicare |
$477.81
|
| Rate for Payer: Priority Health Narrow Network |
$829.90
|
| Rate for Payer: Railroad Medicare Medicare |
$477.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$477.81
|
| Rate for Payer: UHC Exchange |
$837.64
|
| Rate for Payer: UHC Medicaid |
$317.16
|
| Rate for Payer: UHCCP DNSP |
$477.81
|
| Rate for Payer: UHCCP Medicaid |
$317.16
|
|
|
PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 26600
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$487.08 |
| Rate for Payer: Aetna Commercial |
$382.40
|
| Rate for Payer: Aetna Medicare |
$285.37
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCBS MAPPO |
$285.37
|
| Rate for Payer: BCN Commercial |
$359.32
|
| Rate for Payer: BCN Medicare Advantage |
$285.37
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$410.93
|
| Rate for Payer: Cofinity Commercial |
$382.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.37
|
| Rate for Payer: Healthscope Commercial |
$342.44
|
| Rate for Payer: Healthscope Whirlpool |
$342.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.64
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.91
|
| Rate for Payer: Nomi Health Commercial |
$342.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.25
|
| Rate for Payer: PACE SWMI |
$285.37
|
| Rate for Payer: PHP Medicare Advantage |
$285.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$487.08
|
| Rate for Payer: Priority Health Medicare |
$285.37
|
| Rate for Payer: Priority Health Narrow Network |
$487.08
|
| Rate for Payer: Railroad Medicare Medicare |
$285.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.37
|
| Rate for Payer: UHC Exchange |
$479.53
|
| Rate for Payer: UHC Medicaid |
$191.70
|
| Rate for Payer: UHCCP DNSP |
$285.37
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 26705
|
| Min. Negotiated Rate |
$252.83 |
| Max. Negotiated Rate |
$663.81 |
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: Aetna Medicare |
$380.95
|
| Rate for Payer: BCBS Complete |
$265.47
|
| Rate for Payer: BCBS MAPPO |
$380.95
|
| Rate for Payer: BCN Commercial |
$620.98
|
| Rate for Payer: BCN Medicare Advantage |
$380.95
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cofinity Commercial |
$548.57
|
| Rate for Payer: Cofinity Commercial |
$510.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.95
|
| Rate for Payer: Healthscope Commercial |
$457.14
|
| Rate for Payer: Healthscope Whirlpool |
$457.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.00
|
| Rate for Payer: Meridian Medicaid |
$265.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$419.05
|
| Rate for Payer: Nomi Health Commercial |
$457.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.50
|
| Rate for Payer: PACE SWMI |
$380.95
|
| Rate for Payer: PHP Medicare Advantage |
$380.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$663.81
|
| Rate for Payer: Priority Health Medicare |
$380.95
|
| Rate for Payer: Priority Health Narrow Network |
$663.81
|
| Rate for Payer: Railroad Medicare Medicare |
$380.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$660.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.95
|
| Rate for Payer: UHC Exchange |
$660.73
|
| Rate for Payer: UHC Medicaid |
$252.83
|
| Rate for Payer: UHCCP DNSP |
$380.95
|
| Rate for Payer: UHCCP Medicaid |
$252.83
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 26700
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$533.38 |
| Rate for Payer: Aetna Commercial |
$448.75
|
| Rate for Payer: Aetna Medicare |
$334.89
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$334.89
|
| Rate for Payer: BCN Commercial |
$494.00
|
| Rate for Payer: BCN Medicare Advantage |
$334.89
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$482.24
|
| Rate for Payer: Cofinity Commercial |
$448.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.89
|
| Rate for Payer: Healthscope Commercial |
$401.87
|
| Rate for Payer: Healthscope Whirlpool |
$401.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.63
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$368.38
|
| Rate for Payer: Nomi Health Commercial |
$401.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.25
|
| Rate for Payer: PACE SWMI |
$334.89
|
| Rate for Payer: PHP Medicare Advantage |
$334.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$528.07
|
| Rate for Payer: Priority Health Medicare |
$334.89
|
| Rate for Payer: Priority Health Narrow Network |
$528.07
|
| Rate for Payer: Railroad Medicare Medicare |
$334.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$533.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$334.89
|
| Rate for Payer: UHC Exchange |
$533.38
|
| Rate for Payer: UHC Medicaid |
$222.16
|
| Rate for Payer: UHCCP DNSP |
$334.89
|
| Rate for Payer: UHCCP Medicaid |
$222.16
|
|
|
PR CLTX METATARSAL FRACTURE W/O MANIPULATION EACH
|
Professional
|
Both
|
$555.00
|
|
|
Service Code
|
HCPCS 28470
|
| Min. Negotiated Rate |
$133.13 |
| Max. Negotiated Rate |
$416.25 |
| Rate for Payer: Aetna Commercial |
$265.91
|
| Rate for Payer: Aetna Medicare |
$198.44
|
| Rate for Payer: BCBS Complete |
$139.79
|
| Rate for Payer: BCBS MAPPO |
$198.44
|
| Rate for Payer: BCN Commercial |
$252.51
|
| Rate for Payer: BCN Medicare Advantage |
$198.44
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cofinity Commercial |
$285.75
|
| Rate for Payer: Cofinity Commercial |
$265.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.44
|
| Rate for Payer: Healthscope Commercial |
$238.13
|
| Rate for Payer: Healthscope Whirlpool |
$238.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.36
|
| Rate for Payer: Meridian Medicaid |
$139.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.28
|
| Rate for Payer: Nomi Health Commercial |
$238.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$416.25
|
| Rate for Payer: PACE SWMI |
$198.44
|
| Rate for Payer: PHP Medicare Advantage |
$198.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$342.29
|
| Rate for Payer: Priority Health Medicare |
$198.44
|
| Rate for Payer: Priority Health Narrow Network |
$342.29
|
| Rate for Payer: Railroad Medicare Medicare |
$198.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.44
|
| Rate for Payer: UHC Exchange |
$348.56
|
| Rate for Payer: UHC Medicaid |
$133.13
|
| Rate for Payer: UHCCP DNSP |
$198.44
|
| Rate for Payer: UHCCP Medicaid |
$133.13
|
|
|
PR CLTX METATARSOPHLNGL JT DISLC REQ ANES
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 28635
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$159.94
|
| Rate for Payer: Aetna Medicare |
$119.36
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCBS MAPPO |
$119.36
|
| Rate for Payer: BCN Commercial |
$199.19
|
| Rate for Payer: BCN Medicare Advantage |
$119.36
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$171.88
|
| Rate for Payer: Cofinity Commercial |
$159.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.36
|
| Rate for Payer: Healthscope Commercial |
$143.23
|
| Rate for Payer: Healthscope Whirlpool |
$143.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.33
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.30
|
| Rate for Payer: Nomi Health Commercial |
$143.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$119.36
|
| Rate for Payer: PHP Medicare Advantage |
$119.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$212.94
|
| Rate for Payer: Priority Health Medicare |
$119.36
|
| Rate for Payer: Priority Health Narrow Network |
$212.94
|
| Rate for Payer: Railroad Medicare Medicare |
$119.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.36
|
| Rate for Payer: UHC Exchange |
$230.58
|
| Rate for Payer: UHC Medicaid |
$78.38
|
| Rate for Payer: UHCCP DNSP |
$119.36
|
| Rate for Payer: UHCCP Medicaid |
$78.38
|
|
|
PR CLTX METATARSOPHLNGL JT DISLC W/O ANES
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 28630
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$246.00 |
| Rate for Payer: Aetna Commercial |
$145.12
|
| Rate for Payer: Aetna Medicare |
$108.30
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$108.30
|
| Rate for Payer: BCN Commercial |
$169.31
|
| Rate for Payer: BCN Medicare Advantage |
$108.30
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$155.95
|
| Rate for Payer: Cofinity Commercial |
$145.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.30
|
| Rate for Payer: Healthscope Commercial |
$129.96
|
| Rate for Payer: Healthscope Whirlpool |
$129.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.72
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.13
|
| Rate for Payer: Nomi Health Commercial |
$129.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.00
|
| Rate for Payer: PACE SWMI |
$108.30
|
| Rate for Payer: PHP Medicare Advantage |
$108.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$180.99
|
| Rate for Payer: Priority Health Medicare |
$108.30
|
| Rate for Payer: Priority Health Narrow Network |
$180.99
|
| Rate for Payer: Railroad Medicare Medicare |
$108.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$194.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.30
|
| Rate for Payer: UHC Exchange |
$194.64
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP DNSP |
$108.30
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 26725
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$552.00 |
| Rate for Payer: Aetna Commercial |
$414.09
|
| Rate for Payer: Aetna Medicare |
$309.02
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$309.02
|
| Rate for Payer: BCN Commercial |
$479.55
|
| Rate for Payer: BCN Medicare Advantage |
$309.02
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$444.99
|
| Rate for Payer: Cofinity Commercial |
$414.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.02
|
| Rate for Payer: Healthscope Commercial |
$370.82
|
| Rate for Payer: Healthscope Whirlpool |
$370.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.47
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.92
|
| Rate for Payer: Nomi Health Commercial |
$370.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.00
|
| Rate for Payer: PACE SWMI |
$309.02
|
| Rate for Payer: PHP Medicare Advantage |
$309.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$512.64
|
| Rate for Payer: Priority Health Medicare |
$309.02
|
| Rate for Payer: Priority Health Narrow Network |
$512.64
|
| Rate for Payer: Railroad Medicare Medicare |
$309.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.02
|
| Rate for Payer: UHC Exchange |
$523.57
|
| Rate for Payer: UHC Medicaid |
$205.33
|
| Rate for Payer: UHCCP DNSP |
$309.02
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 26720
|
| Min. Negotiated Rate |
$130.78 |
| Max. Negotiated Rate |
$322.06 |
| Rate for Payer: Aetna Commercial |
$261.07
|
| Rate for Payer: Aetna Medicare |
$194.83
|
| Rate for Payer: BCBS Complete |
$137.32
|
| Rate for Payer: BCBS MAPPO |
$194.83
|
| Rate for Payer: BCN Commercial |
$301.28
|
| Rate for Payer: BCN Medicare Advantage |
$194.83
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$280.56
|
| Rate for Payer: Cofinity Commercial |
$261.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.83
|
| Rate for Payer: Healthscope Commercial |
$233.80
|
| Rate for Payer: Healthscope Whirlpool |
$233.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.57
|
| Rate for Payer: Meridian Medicaid |
$137.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$214.31
|
| Rate for Payer: Nomi Health Commercial |
$233.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$194.83
|
| Rate for Payer: PHP Medicare Advantage |
$194.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$322.06
|
| Rate for Payer: Priority Health Medicare |
$194.83
|
| Rate for Payer: Priority Health Narrow Network |
$322.06
|
| Rate for Payer: Railroad Medicare Medicare |
$194.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$194.83
|
| Rate for Payer: UHC Exchange |
$316.77
|
| Rate for Payer: UHC Medicaid |
$130.78
|
| Rate for Payer: UHCCP DNSP |
$194.83
|
| Rate for Payer: UHCCP Medicaid |
$130.78
|
|
|
PR CLTX POST HIP ARTHRP DISLC REQ ANES
|
Professional
|
Both
|
$1,576.00
|
|
|
Service Code
|
HCPCS 27266
|
| Min. Negotiated Rate |
$355.71 |
| Max. Negotiated Rate |
$1,182.00 |
| Rate for Payer: Aetna Commercial |
$727.63
|
| Rate for Payer: Aetna Medicare |
$543.01
|
| Rate for Payer: BCBS Complete |
$373.50
|
| Rate for Payer: BCBS MAPPO |
$543.01
|
| Rate for Payer: BCN Commercial |
$889.90
|
| Rate for Payer: BCN Medicare Advantage |
$543.01
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cofinity Commercial |
$781.93
|
| Rate for Payer: Cofinity Commercial |
$727.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.01
|
| Rate for Payer: Healthscope Commercial |
$651.61
|
| Rate for Payer: Healthscope Whirlpool |
$651.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.16
|
| Rate for Payer: Meridian Medicaid |
$373.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$597.31
|
| Rate for Payer: Nomi Health Commercial |
$651.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,182.00
|
| Rate for Payer: PACE SWMI |
$543.01
|
| Rate for Payer: PHP Medicare Advantage |
$543.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$951.27
|
| Rate for Payer: Priority Health Medicare |
$543.01
|
| Rate for Payer: Priority Health Narrow Network |
$951.27
|
| Rate for Payer: Railroad Medicare Medicare |
$543.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$543.01
|
| Rate for Payer: UHC Exchange |
$1,014.79
|
| Rate for Payer: UHC Medicaid |
$355.71
|
| Rate for Payer: UHCCP DNSP |
$543.01
|
| Rate for Payer: UHCCP Medicaid |
$355.71
|
|
|
PR CLTX POST HIP ARTHRP DISLC W/O ANES
|
Professional
|
Both
|
$764.00
|
|
|
Service Code
|
HCPCS 27265
|
| Min. Negotiated Rate |
$314.60 |
| Max. Negotiated Rate |
$703.41 |
| Rate for Payer: Aetna Commercial |
$635.33
|
| Rate for Payer: Aetna Medicare |
$474.13
|
| Rate for Payer: BCBS Complete |
$330.33
|
| Rate for Payer: BCBS MAPPO |
$474.13
|
| Rate for Payer: BCN Commercial |
$647.87
|
| Rate for Payer: BCN Medicare Advantage |
$474.13
|
| Rate for Payer: Cash Price |
$611.20
|
| Rate for Payer: Cash Price |
$611.20
|
| Rate for Payer: Cofinity Commercial |
$682.75
|
| Rate for Payer: Cofinity Commercial |
$635.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.13
|
| Rate for Payer: Healthscope Commercial |
$568.96
|
| Rate for Payer: Healthscope Whirlpool |
$568.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.84
|
| Rate for Payer: Meridian Medicaid |
$330.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.54
|
| Rate for Payer: Nomi Health Commercial |
$568.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.00
|
| Rate for Payer: PACE SWMI |
$474.13
|
| Rate for Payer: PHP Medicare Advantage |
$474.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$692.56
|
| Rate for Payer: Priority Health Medicare |
$474.13
|
| Rate for Payer: Priority Health Narrow Network |
$692.56
|
| Rate for Payer: Railroad Medicare Medicare |
$474.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$703.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$474.13
|
| Rate for Payer: UHC Exchange |
$703.41
|
| Rate for Payer: UHC Medicaid |
$314.60
|
| Rate for Payer: UHCCP DNSP |
$474.13
|
| Rate for Payer: UHCCP Medicaid |
$314.60
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/MANJ
|
Professional
|
Both
|
$1,248.00
|
|
|
Service Code
|
HCPCS 27781
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Commercial |
$525.37
|
| Rate for Payer: Aetna Medicare |
$392.07
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$392.07
|
| Rate for Payer: BCN Commercial |
$629.45
|
| Rate for Payer: BCN Medicare Advantage |
$392.07
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cofinity Commercial |
$564.58
|
| Rate for Payer: Cofinity Commercial |
$525.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.07
|
| Rate for Payer: Healthscope Commercial |
$470.48
|
| Rate for Payer: Healthscope Whirlpool |
$470.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.67
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$431.28
|
| Rate for Payer: Nomi Health Commercial |
$470.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$936.00
|
| Rate for Payer: PACE SWMI |
$392.07
|
| Rate for Payer: PHP Medicare Advantage |
$392.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$672.86
|
| Rate for Payer: Priority Health Medicare |
$392.07
|
| Rate for Payer: Priority Health Narrow Network |
$672.86
|
| Rate for Payer: Railroad Medicare Medicare |
$392.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$688.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$392.07
|
| Rate for Payer: UHC Exchange |
$688.24
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP DNSP |
$392.07
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/O MANJ
|
Professional
|
Both
|
$686.00
|
|
|
Service Code
|
HCPCS 27780
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$514.50 |
| Rate for Payer: Aetna Commercial |
$380.67
|
| Rate for Payer: Aetna Medicare |
$284.08
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$284.08
|
| Rate for Payer: BCN Commercial |
$449.68
|
| Rate for Payer: BCN Medicare Advantage |
$284.08
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cofinity Commercial |
$409.08
|
| Rate for Payer: Cofinity Commercial |
$380.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.08
|
| Rate for Payer: Healthscope Commercial |
$340.90
|
| Rate for Payer: Healthscope Whirlpool |
$340.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.28
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$312.49
|
| Rate for Payer: Nomi Health Commercial |
$340.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$514.50
|
| Rate for Payer: PACE SWMI |
$284.08
|
| Rate for Payer: PHP Medicare Advantage |
$284.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$480.69
|
| Rate for Payer: Priority Health Medicare |
$284.08
|
| Rate for Payer: Priority Health Narrow Network |
$480.69
|
| Rate for Payer: Railroad Medicare Medicare |
$284.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$482.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$284.08
|
| Rate for Payer: UHC Exchange |
$482.17
|
| Rate for Payer: UHC Medicaid |
$190.00
|
| Rate for Payer: UHCCP DNSP |
$284.08
|
| Rate for Payer: UHCCP Medicaid |
$190.00
|
|
|
PR CLTX PROX HUMRL FX W/MNPJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,467.00
|
|
|
Service Code
|
HCPCS 23605
|
| Min. Negotiated Rate |
$281.16 |
| Max. Negotiated Rate |
$1,100.25 |
| Rate for Payer: Aetna Commercial |
$569.03
|
| Rate for Payer: Aetna Medicare |
$424.65
|
| Rate for Payer: BCBS Complete |
$295.22
|
| Rate for Payer: BCBS MAPPO |
$424.65
|
| Rate for Payer: BCN Commercial |
$664.80
|
| Rate for Payer: BCN Medicare Advantage |
$424.65
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cofinity Commercial |
$611.50
|
| Rate for Payer: Cofinity Commercial |
$569.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.65
|
| Rate for Payer: Healthscope Commercial |
$509.58
|
| Rate for Payer: Healthscope Whirlpool |
$509.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$445.88
|
| Rate for Payer: Meridian Medicaid |
$295.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$467.12
|
| Rate for Payer: Nomi Health Commercial |
$509.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,100.25
|
| Rate for Payer: PACE SWMI |
$424.65
|
| Rate for Payer: PHP Medicare Advantage |
$424.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$710.66
|
| Rate for Payer: Priority Health Medicare |
$424.65
|
| Rate for Payer: Priority Health Narrow Network |
$710.66
|
| Rate for Payer: Railroad Medicare Medicare |
$424.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$424.65
|
| Rate for Payer: UHC Exchange |
$736.72
|
| Rate for Payer: UHC Medicaid |
$281.16
|
| Rate for Payer: UHCCP DNSP |
$424.65
|
| Rate for Payer: UHCCP Medicaid |
$281.16
|
|
|
PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 23600
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: Aetna Commercial |
$423.49
|
| Rate for Payer: Aetna Medicare |
$316.04
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$316.04
|
| Rate for Payer: BCN Commercial |
$394.27
|
| Rate for Payer: BCN Medicare Advantage |
$316.04
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$455.10
|
| Rate for Payer: Cofinity Commercial |
$423.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.04
|
| Rate for Payer: Healthscope Commercial |
$379.25
|
| Rate for Payer: Healthscope Whirlpool |
$379.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.84
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.64
|
| Rate for Payer: Nomi Health Commercial |
$379.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.75
|
| Rate for Payer: PACE SWMI |
$316.04
|
| Rate for Payer: PHP Medicare Advantage |
$316.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$534.46
|
| Rate for Payer: Priority Health Medicare |
$316.04
|
| Rate for Payer: Priority Health Narrow Network |
$534.46
|
| Rate for Payer: Railroad Medicare Medicare |
$316.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$531.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$316.04
|
| Rate for Payer: UHC Exchange |
$531.55
|
| Rate for Payer: UHC Medicaid |
$211.72
|
| Rate for Payer: UHCCP DNSP |
$316.04
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
|
|
PR CLTX PROX TIBFIB JT DISLC REQ ANES
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 27831
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$698.38 |
| Rate for Payer: Aetna Commercial |
$520.43
|
| Rate for Payer: Aetna Medicare |
$388.38
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS MAPPO |
$388.38
|
| Rate for Payer: BCN Commercial |
$637.42
|
| Rate for Payer: BCN Medicare Advantage |
$388.38
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$559.27
|
| Rate for Payer: Cofinity Commercial |
$520.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.38
|
| Rate for Payer: Healthscope Commercial |
$466.06
|
| Rate for Payer: Healthscope Whirlpool |
$466.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.80
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$427.22
|
| Rate for Payer: Nomi Health Commercial |
$466.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$587.25
|
| Rate for Payer: PACE SWMI |
$388.38
|
| Rate for Payer: PHP Medicare Advantage |
$388.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$681.39
|
| Rate for Payer: Priority Health Medicare |
$388.38
|
| Rate for Payer: Priority Health Narrow Network |
$681.39
|
| Rate for Payer: Railroad Medicare Medicare |
$388.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$698.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$388.38
|
| Rate for Payer: UHC Exchange |
$698.38
|
| Rate for Payer: UHC Medicaid |
$256.88
|
| Rate for Payer: UHCCP DNSP |
$388.38
|
| Rate for Payer: UHCCP Medicaid |
$256.88
|
|
|
PR CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MNPJ
|
Professional
|
Both
|
$740.00
|
|
|
Service Code
|
HCPCS 25660
|
| Min. Negotiated Rate |
$284.36 |
| Max. Negotiated Rate |
$749.52 |
| Rate for Payer: Aetna Commercial |
$574.61
|
| Rate for Payer: Aetna Medicare |
$428.81
|
| Rate for Payer: BCBS Complete |
$298.58
|
| Rate for Payer: BCBS MAPPO |
$428.81
|
| Rate for Payer: BCN Commercial |
$701.16
|
| Rate for Payer: BCN Medicare Advantage |
$428.81
|
| Rate for Payer: Cash Price |
$592.00
|
| Rate for Payer: Cash Price |
$592.00
|
| Rate for Payer: Cofinity Commercial |
$617.49
|
| Rate for Payer: Cofinity Commercial |
$574.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.81
|
| Rate for Payer: Healthscope Commercial |
$514.57
|
| Rate for Payer: Healthscope Whirlpool |
$514.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.25
|
| Rate for Payer: Meridian Medicaid |
$298.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$471.69
|
| Rate for Payer: Nomi Health Commercial |
$514.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.00
|
| Rate for Payer: PACE SWMI |
$428.81
|
| Rate for Payer: PHP Medicare Advantage |
$428.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$749.52
|
| Rate for Payer: Priority Health Medicare |
$428.81
|
| Rate for Payer: Priority Health Narrow Network |
$749.52
|
| Rate for Payer: Railroad Medicare Medicare |
$428.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$717.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$428.81
|
| Rate for Payer: UHC Exchange |
$717.65
|
| Rate for Payer: UHC Medicaid |
$284.36
|
| Rate for Payer: UHCCP DNSP |
$428.81
|
| Rate for Payer: UHCCP Medicaid |
$284.36
|
|
|
PR CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MNPJ
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 24640
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna Commercial |
$92.88
|
| Rate for Payer: Aetna Medicare |
$69.31
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS MAPPO |
$69.31
|
| Rate for Payer: BCN Commercial |
$119.02
|
| Rate for Payer: BCN Medicare Advantage |
$69.31
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$99.81
|
| Rate for Payer: Cofinity Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.31
|
| Rate for Payer: Healthscope Commercial |
$83.17
|
| Rate for Payer: Healthscope Whirlpool |
$83.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.78
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.24
|
| Rate for Payer: Nomi Health Commercial |
$83.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.25
|
| Rate for Payer: PACE SWMI |
$69.31
|
| Rate for Payer: PHP Medicare Advantage |
$69.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.23
|
| Rate for Payer: Priority Health Medicare |
$69.31
|
| Rate for Payer: Priority Health Narrow Network |
$127.23
|
| Rate for Payer: Railroad Medicare Medicare |
$69.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.31
|
| Rate for Payer: UHC Exchange |
$137.01
|
| Rate for Payer: UHC Medicaid |
$45.58
|
| Rate for Payer: UHCCP DNSP |
$69.31
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
|
|
PR CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 25520
|
| Min. Negotiated Rate |
$339.31 |
| Max. Negotiated Rate |
$1,161.00 |
| Rate for Payer: Aetna Commercial |
$688.60
|
| Rate for Payer: Aetna Medicare |
$513.88
|
| Rate for Payer: BCBS Complete |
$356.28
|
| Rate for Payer: BCBS MAPPO |
$513.88
|
| Rate for Payer: BCN Commercial |
$847.57
|
| Rate for Payer: BCN Medicare Advantage |
$513.88
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$739.99
|
| Rate for Payer: Cofinity Commercial |
$688.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.88
|
| Rate for Payer: Healthscope Commercial |
$616.66
|
| Rate for Payer: Healthscope Whirlpool |
$616.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.57
|
| Rate for Payer: Meridian Medicaid |
$356.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$565.27
|
| Rate for Payer: Nomi Health Commercial |
$616.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,161.00
|
| Rate for Payer: PACE SWMI |
$513.88
|
| Rate for Payer: PHP Medicare Advantage |
$513.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$906.03
|
| Rate for Payer: Priority Health Medicare |
$513.88
|
| Rate for Payer: Priority Health Narrow Network |
$906.03
|
| Rate for Payer: Railroad Medicare Medicare |
$513.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$936.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$513.88
|
| Rate for Payer: UHC Exchange |
$936.07
|
| Rate for Payer: UHC Medicaid |
$339.31
|
| Rate for Payer: UHCCP DNSP |
$513.88
|
| Rate for Payer: UHCCP Medicaid |
$339.31
|
|
|
PR CLTX SCAPULAR FX W/MNPJ W/WO SKELETAL TRACTION
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 23575
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$488.35
|
| Rate for Payer: Aetna Medicare |
$364.44
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCBS MAPPO |
$364.44
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: BCN Medicare Advantage |
$364.44
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$524.79
|
| Rate for Payer: Cofinity Commercial |
$488.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.44
|
| Rate for Payer: Healthscope Commercial |
$437.33
|
| Rate for Payer: Healthscope Whirlpool |
$437.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.66
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.88
|
| Rate for Payer: Nomi Health Commercial |
$437.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$364.44
|
| Rate for Payer: PHP Medicare Advantage |
$364.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$636.13
|
| Rate for Payer: Priority Health Medicare |
$364.44
|
| Rate for Payer: Priority Health Narrow Network |
$636.13
|
| Rate for Payer: Railroad Medicare Medicare |
$364.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$649.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.44
|
| Rate for Payer: UHC Exchange |
$649.86
|
| Rate for Payer: UHC Medicaid |
$241.76
|
| Rate for Payer: UHCCP DNSP |
$364.44
|
| Rate for Payer: UHCCP Medicaid |
$241.76
|
|
