|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$348.26 |
| Max. Negotiated Rate |
$1,164.75 |
| Rate for Payer: Aetna Commercial |
$711.06
|
| Rate for Payer: Aetna Medicare |
$530.64
|
| Rate for Payer: BCBS Complete |
$365.67
|
| Rate for Payer: BCBS MAPPO |
$530.64
|
| Rate for Payer: BCN Commercial |
$878.94
|
| Rate for Payer: BCN Medicare Advantage |
$530.64
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$764.12
|
| Rate for Payer: Cofinity Commercial |
$711.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.64
|
| Rate for Payer: Healthscope Commercial |
$636.77
|
| Rate for Payer: Healthscope Whirlpool |
$636.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.17
|
| Rate for Payer: Meridian Medicaid |
$365.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$583.70
|
| Rate for Payer: Nomi Health Commercial |
$636.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,164.75
|
| Rate for Payer: PACE SWMI |
$530.64
|
| Rate for Payer: PHP Medicare Advantage |
$530.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$939.57
|
| Rate for Payer: Priority Health Medicare |
$530.64
|
| Rate for Payer: Priority Health Narrow Network |
$939.57
|
| Rate for Payer: Railroad Medicare Medicare |
$530.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$991.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$530.64
|
| Rate for Payer: UHC Exchange |
$991.92
|
| Rate for Payer: UHC Medicaid |
$348.26
|
| Rate for Payer: UHCCP DNSP |
$530.64
|
| Rate for Payer: UHCCP Medicaid |
$348.26
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,563.75 |
| Rate for Payer: Aetna Commercial |
$872.61
|
| Rate for Payer: Aetna Medicare |
$651.20
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$651.20
|
| Rate for Payer: BCN Commercial |
$1,103.03
|
| Rate for Payer: BCN Medicare Advantage |
$651.20
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cofinity Commercial |
$937.73
|
| Rate for Payer: Cofinity Commercial |
$872.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.20
|
| Rate for Payer: Healthscope Commercial |
$781.44
|
| Rate for Payer: Healthscope Whirlpool |
$781.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.76
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$716.32
|
| Rate for Payer: Nomi Health Commercial |
$781.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,563.75
|
| Rate for Payer: PACE SWMI |
$651.20
|
| Rate for Payer: PHP Medicare Advantage |
$651.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,179.10
|
| Rate for Payer: Priority Health Medicare |
$651.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,179.10
|
| Rate for Payer: Railroad Medicare Medicare |
$651.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,251.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.20
|
| Rate for Payer: UHC Exchange |
$1,251.84
|
| Rate for Payer: UHC Medicaid |
$426.64
|
| Rate for Payer: UHCCP DNSP |
$651.20
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,323.00
|
|
|
Service Code
|
HCPCS 26685
|
| Min. Negotiated Rate |
$341.44 |
| Max. Negotiated Rate |
$1,742.25 |
| Rate for Payer: Aetna Commercial |
$693.37
|
| Rate for Payer: Aetna Medicare |
$517.44
|
| Rate for Payer: BCBS Complete |
$358.51
|
| Rate for Payer: BCBS MAPPO |
$517.44
|
| Rate for Payer: BCN Commercial |
$890.39
|
| Rate for Payer: BCN Medicare Advantage |
$517.44
|
| Rate for Payer: Cash Price |
$1,858.40
|
| Rate for Payer: Cash Price |
$1,858.40
|
| Rate for Payer: Cofinity Commercial |
$745.11
|
| Rate for Payer: Cofinity Commercial |
$693.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.44
|
| Rate for Payer: Healthscope Commercial |
$620.93
|
| Rate for Payer: Healthscope Whirlpool |
$620.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.31
|
| Rate for Payer: Meridian Medicaid |
$358.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$569.18
|
| Rate for Payer: Nomi Health Commercial |
$620.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,742.25
|
| Rate for Payer: PACE SWMI |
$517.44
|
| Rate for Payer: PHP Medicare Advantage |
$517.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$951.81
|
| Rate for Payer: Priority Health Medicare |
$517.44
|
| Rate for Payer: Priority Health Narrow Network |
$951.81
|
| Rate for Payer: Railroad Medicare Medicare |
$517.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$995.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$517.44
|
| Rate for Payer: UHC Exchange |
$995.42
|
| Rate for Payer: UHC Medicaid |
$341.44
|
| Rate for Payer: UHCCP DNSP |
$517.44
|
| Rate for Payer: UHCCP Medicaid |
$341.44
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,975.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$368.49 |
| Max. Negotiated Rate |
$2,231.25 |
| Rate for Payer: Aetna Commercial |
$749.84
|
| Rate for Payer: Aetna Medicare |
$559.58
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$559.58
|
| Rate for Payer: BCN Commercial |
$966.08
|
| Rate for Payer: BCN Medicare Advantage |
$559.58
|
| Rate for Payer: Cash Price |
$2,380.00
|
| Rate for Payer: Cash Price |
$2,380.00
|
| Rate for Payer: Cofinity Commercial |
$805.80
|
| Rate for Payer: Cofinity Commercial |
$749.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.58
|
| Rate for Payer: Healthscope Commercial |
$671.50
|
| Rate for Payer: Healthscope Whirlpool |
$671.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.56
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$615.54
|
| Rate for Payer: Nomi Health Commercial |
$671.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,231.25
|
| Rate for Payer: PACE SWMI |
$559.58
|
| Rate for Payer: PHP Medicare Advantage |
$559.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,032.71
|
| Rate for Payer: Priority Health Medicare |
$559.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,032.71
|
| Rate for Payer: Railroad Medicare Medicare |
$559.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$559.58
|
| Rate for Payer: UHC Exchange |
$1,084.80
|
| Rate for Payer: UHC Medicaid |
$368.49
|
| Rate for Payer: UHCCP DNSP |
$559.58
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,529.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$433.03 |
| Max. Negotiated Rate |
$1,896.75 |
| Rate for Payer: Aetna Commercial |
$886.30
|
| Rate for Payer: Aetna Medicare |
$661.42
|
| Rate for Payer: BCBS Complete |
$454.68
|
| Rate for Payer: BCBS MAPPO |
$661.42
|
| Rate for Payer: BCN Commercial |
$1,101.04
|
| Rate for Payer: BCN Medicare Advantage |
$661.42
|
| Rate for Payer: Cash Price |
$2,023.20
|
| Rate for Payer: Cash Price |
$2,023.20
|
| Rate for Payer: Cofinity Commercial |
$952.44
|
| Rate for Payer: Cofinity Commercial |
$886.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.42
|
| Rate for Payer: Healthscope Commercial |
$793.70
|
| Rate for Payer: Healthscope Whirlpool |
$793.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.49
|
| Rate for Payer: Meridian Medicaid |
$454.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$727.56
|
| Rate for Payer: Nomi Health Commercial |
$793.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,896.75
|
| Rate for Payer: PACE SWMI |
$661.42
|
| Rate for Payer: PHP Medicare Advantage |
$661.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,176.97
|
| Rate for Payer: Priority Health Medicare |
$661.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,176.97
|
| Rate for Payer: Railroad Medicare Medicare |
$661.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,255.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$661.42
|
| Rate for Payer: UHC Exchange |
$1,255.04
|
| Rate for Payer: UHC Medicaid |
$433.03
|
| Rate for Payer: UHCCP DNSP |
$661.42
|
| Rate for Payer: UHCCP Medicaid |
$433.03
|
|
|
PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG
|
Professional
|
Both
|
$2,079.00
|
|
|
Service Code
|
HCPCS 21365
|
| Min. Negotiated Rate |
$613.87 |
| Max. Negotiated Rate |
$1,919.88 |
| Rate for Payer: Aetna Commercial |
$1,266.38
|
| Rate for Payer: Aetna Medicare |
$945.06
|
| Rate for Payer: BCBS Complete |
$644.56
|
| Rate for Payer: BCBS MAPPO |
$945.06
|
| Rate for Payer: BCN Commercial |
$1,632.88
|
| Rate for Payer: BCN Medicare Advantage |
$945.06
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Cofinity Commercial |
$1,360.89
|
| Rate for Payer: Cofinity Commercial |
$1,266.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.06
|
| Rate for Payer: Healthscope Commercial |
$1,134.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,134.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.31
|
| Rate for Payer: Meridian Medicaid |
$644.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.57
|
| Rate for Payer: Nomi Health Commercial |
$1,134.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.25
|
| Rate for Payer: PACE SWMI |
$945.06
|
| Rate for Payer: PHP Medicare Advantage |
$945.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,745.50
|
| Rate for Payer: Priority Health Medicare |
$945.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,745.50
|
| Rate for Payer: Railroad Medicare Medicare |
$945.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,919.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$945.06
|
| Rate for Payer: UHC Exchange |
$1,919.88
|
| Rate for Payer: UHC Medicaid |
$613.87
|
| Rate for Payer: UHCCP DNSP |
$945.06
|
| Rate for Payer: UHCCP Medicaid |
$613.87
|
|
|
PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$3,579.00
|
|
|
Service Code
|
HCPCS 21344
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$2,684.25 |
| Rate for Payer: Aetna Commercial |
$1,598.39
|
| Rate for Payer: Aetna Medicare |
$1,192.83
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS MAPPO |
$1,192.83
|
| Rate for Payer: BCN Commercial |
$2,088.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.83
|
| Rate for Payer: Cash Price |
$2,863.20
|
| Rate for Payer: Cash Price |
$2,863.20
|
| Rate for Payer: Cofinity Commercial |
$1,717.68
|
| Rate for Payer: Cofinity Commercial |
$1,598.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.83
|
| Rate for Payer: Healthscope Commercial |
$1,431.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,431.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,252.47
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,312.11
|
| Rate for Payer: Nomi Health Commercial |
$1,431.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,684.25
|
| Rate for Payer: PACE SWMI |
$1,192.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,232.05
|
| Rate for Payer: Priority Health Medicare |
$1,192.83
|
| Rate for Payer: Priority Health Narrow Network |
$2,232.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,410.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.83
|
| Rate for Payer: UHC Exchange |
$2,410.06
|
| Rate for Payer: UHC Medicaid |
$775.11
|
| Rate for Payer: UHCCP DNSP |
$1,192.83
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR
|
Professional
|
Both
|
$3,103.00
|
|
|
Service Code
|
HCPCS 21433
|
| Min. Negotiated Rate |
$973.41 |
| Max. Negotiated Rate |
$3,066.96 |
| Rate for Payer: Aetna Commercial |
$2,013.27
|
| Rate for Payer: Aetna Medicare |
$1,502.44
|
| Rate for Payer: BCBS Complete |
$1,022.08
|
| Rate for Payer: BCBS MAPPO |
$1,502.44
|
| Rate for Payer: BCN Commercial |
$2,605.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,502.44
|
| Rate for Payer: Cash Price |
$2,482.40
|
| Rate for Payer: Cash Price |
$2,482.40
|
| Rate for Payer: Cofinity Commercial |
$2,163.51
|
| Rate for Payer: Cofinity Commercial |
$2,013.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,502.44
|
| Rate for Payer: Healthscope Commercial |
$1,802.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,802.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,577.56
|
| Rate for Payer: Meridian Medicaid |
$1,022.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,652.68
|
| Rate for Payer: Nomi Health Commercial |
$1,802.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,327.25
|
| Rate for Payer: PACE SWMI |
$1,502.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,502.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$973.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,785.67
|
| Rate for Payer: Priority Health Medicare |
$1,502.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,785.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,502.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,066.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,502.44
|
| Rate for Payer: UHC Exchange |
$3,066.96
|
| Rate for Payer: UHC Medicaid |
$973.41
|
| Rate for Payer: UHCCP DNSP |
$1,502.44
|
| Rate for Payer: UHCCP Medicaid |
$973.41
|
|
|
PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$2,527.00
|
|
|
Service Code
|
HCPCS 21343
|
| Min. Negotiated Rate |
$621.53 |
| Max. Negotiated Rate |
$1,895.25 |
| Rate for Payer: Aetna Commercial |
$1,266.57
|
| Rate for Payer: Aetna Medicare |
$945.20
|
| Rate for Payer: BCBS Complete |
$652.61
|
| Rate for Payer: BCBS MAPPO |
$945.20
|
| Rate for Payer: BCN Commercial |
$1,633.88
|
| Rate for Payer: BCN Medicare Advantage |
$945.20
|
| Rate for Payer: Cash Price |
$2,021.60
|
| Rate for Payer: Cash Price |
$2,021.60
|
| Rate for Payer: Cofinity Commercial |
$1,361.09
|
| Rate for Payer: Cofinity Commercial |
$1,266.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.20
|
| Rate for Payer: Healthscope Commercial |
$1,134.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,134.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.46
|
| Rate for Payer: Meridian Medicaid |
$652.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.72
|
| Rate for Payer: Nomi Health Commercial |
$1,134.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.25
|
| Rate for Payer: PACE SWMI |
$945.20
|
| Rate for Payer: PHP Medicare Advantage |
$945.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,746.57
|
| Rate for Payer: Priority Health Medicare |
$945.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,746.57
|
| Rate for Payer: Railroad Medicare Medicare |
$945.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,850.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$945.20
|
| Rate for Payer: UHC Exchange |
$1,850.73
|
| Rate for Payer: UHC Medicaid |
$621.53
|
| Rate for Payer: UHCCP DNSP |
$945.20
|
| Rate for Payer: UHCCP Medicaid |
$621.53
|
|
|
PR OPEN TX DEPRESSED MALAR FRACTURE
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 21360
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$884.69 |
| Rate for Payer: Aetna Commercial |
$610.66
|
| Rate for Payer: Aetna Medicare |
$455.72
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$455.72
|
| Rate for Payer: BCN Commercial |
$795.27
|
| Rate for Payer: BCN Medicare Advantage |
$455.72
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$656.24
|
| Rate for Payer: Cofinity Commercial |
$610.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.72
|
| Rate for Payer: Healthscope Commercial |
$546.86
|
| Rate for Payer: Healthscope Whirlpool |
$546.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.51
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$501.29
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.00
|
| Rate for Payer: PACE SWMI |
$455.72
|
| Rate for Payer: PHP Medicare Advantage |
$455.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$850.12
|
| Rate for Payer: Priority Health Medicare |
$455.72
|
| Rate for Payer: Priority Health Narrow Network |
$850.12
|
| Rate for Payer: Railroad Medicare Medicare |
$455.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$884.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$455.72
|
| Rate for Payer: UHC Exchange |
$884.69
|
| Rate for Payer: UHC Medicaid |
$298.84
|
| Rate for Payer: UHCCP DNSP |
$455.72
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE
|
Professional
|
Both
|
$849.00
|
|
|
Service Code
|
HCPCS 21356
|
| Min. Negotiated Rate |
$242.18 |
| Max. Negotiated Rate |
$653.71 |
| Rate for Payer: Aetna Commercial |
$491.46
|
| Rate for Payer: Aetna Medicare |
$366.76
|
| Rate for Payer: BCBS Complete |
$254.29
|
| Rate for Payer: BCBS MAPPO |
$366.76
|
| Rate for Payer: BCN Commercial |
$611.52
|
| Rate for Payer: BCN Medicare Advantage |
$366.76
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cofinity Commercial |
$528.13
|
| Rate for Payer: Cofinity Commercial |
$491.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.76
|
| Rate for Payer: Healthscope Commercial |
$440.11
|
| Rate for Payer: Healthscope Whirlpool |
$440.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$385.10
|
| Rate for Payer: Meridian Medicaid |
$254.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$403.44
|
| Rate for Payer: Nomi Health Commercial |
$440.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$636.75
|
| Rate for Payer: PACE SWMI |
$366.76
|
| Rate for Payer: PHP Medicare Advantage |
$366.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$653.71
|
| Rate for Payer: Priority Health Medicare |
$366.76
|
| Rate for Payer: Priority Health Narrow Network |
$653.71
|
| Rate for Payer: Railroad Medicare Medicare |
$366.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$366.76
|
| Rate for Payer: UHC Exchange |
$647.51
|
| Rate for Payer: UHC Medicaid |
$242.18
|
| Rate for Payer: UHCCP DNSP |
$366.76
|
| Rate for Payer: UHCCP Medicaid |
$242.18
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 27792
|
| Min. Negotiated Rate |
$387.66 |
| Max. Negotiated Rate |
$1,908.75 |
| Rate for Payer: Aetna Commercial |
$792.49
|
| Rate for Payer: Aetna Medicare |
$591.41
|
| Rate for Payer: BCBS Complete |
$407.04
|
| Rate for Payer: BCBS MAPPO |
$591.41
|
| Rate for Payer: BCN Commercial |
$1,078.27
|
| Rate for Payer: BCN Medicare Advantage |
$591.41
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$851.63
|
| Rate for Payer: Cofinity Commercial |
$792.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.41
|
| Rate for Payer: Healthscope Commercial |
$709.69
|
| Rate for Payer: Healthscope Whirlpool |
$709.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.98
|
| Rate for Payer: Meridian Medicaid |
$407.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$650.55
|
| Rate for Payer: Nomi Health Commercial |
$709.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,908.75
|
| Rate for Payer: PACE SWMI |
$591.41
|
| Rate for Payer: PHP Medicare Advantage |
$591.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$591.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.22
|
| Rate for Payer: Railroad Medicare Medicare |
$591.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,127.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$591.41
|
| Rate for Payer: UHC Exchange |
$1,127.26
|
| Rate for Payer: UHC Medicaid |
$387.66
|
| Rate for Payer: UHCCP DNSP |
$591.41
|
| Rate for Payer: UHCCP Medicaid |
$387.66
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$310.34 |
| Max. Negotiated Rate |
$865.37 |
| Rate for Payer: Aetna Commercial |
$628.45
|
| Rate for Payer: Aetna Medicare |
$468.99
|
| Rate for Payer: BCBS Complete |
$325.86
|
| Rate for Payer: BCBS MAPPO |
$468.99
|
| Rate for Payer: BCN Commercial |
$777.85
|
| Rate for Payer: BCN Medicare Advantage |
$468.99
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$675.35
|
| Rate for Payer: Cofinity Commercial |
$628.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.99
|
| Rate for Payer: Healthscope Commercial |
$562.79
|
| Rate for Payer: Healthscope Whirlpool |
$562.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$492.44
|
| Rate for Payer: Meridian Medicaid |
$325.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.89
|
| Rate for Payer: Nomi Health Commercial |
$562.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$677.25
|
| Rate for Payer: PACE SWMI |
$468.99
|
| Rate for Payer: PHP Medicare Advantage |
$468.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$831.49
|
| Rate for Payer: Priority Health Medicare |
$468.99
|
| Rate for Payer: Priority Health Narrow Network |
$831.49
|
| Rate for Payer: Railroad Medicare Medicare |
$468.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$468.99
|
| Rate for Payer: UHC Exchange |
$865.37
|
| Rate for Payer: UHC Medicaid |
$310.34
|
| Rate for Payer: UHCCP DNSP |
$468.99
|
| Rate for Payer: UHCCP Medicaid |
$310.34
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,839.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$379.57 |
| Max. Negotiated Rate |
$1,379.25 |
| Rate for Payer: Aetna Commercial |
$775.22
|
| Rate for Payer: Aetna Medicare |
$578.52
|
| Rate for Payer: BCBS Complete |
$398.55
|
| Rate for Payer: BCBS MAPPO |
$578.52
|
| Rate for Payer: BCN Commercial |
$967.58
|
| Rate for Payer: BCN Medicare Advantage |
$578.52
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cofinity Commercial |
$833.07
|
| Rate for Payer: Cofinity Commercial |
$775.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.52
|
| Rate for Payer: Healthscope Commercial |
$694.22
|
| Rate for Payer: Healthscope Whirlpool |
$694.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$607.45
|
| Rate for Payer: Meridian Medicaid |
$398.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$636.37
|
| Rate for Payer: Nomi Health Commercial |
$694.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,379.25
|
| Rate for Payer: PACE SWMI |
$578.52
|
| Rate for Payer: PHP Medicare Advantage |
$578.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,034.31
|
| Rate for Payer: Priority Health Medicare |
$578.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.31
|
| Rate for Payer: Railroad Medicare Medicare |
$578.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,098.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$578.52
|
| Rate for Payer: UHC Exchange |
$1,098.90
|
| Rate for Payer: UHC Medicaid |
$379.57
|
| Rate for Payer: UHCCP DNSP |
$578.52
|
| Rate for Payer: UHCCP Medicaid |
$379.57
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,371.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$1,778.25 |
| Rate for Payer: Aetna Commercial |
$872.57
|
| Rate for Payer: Aetna Medicare |
$651.17
|
| Rate for Payer: BCBS Complete |
$450.66
|
| Rate for Payer: BCBS MAPPO |
$651.17
|
| Rate for Payer: BCN Commercial |
$1,070.66
|
| Rate for Payer: BCN Medicare Advantage |
$651.17
|
| Rate for Payer: Cash Price |
$1,896.80
|
| Rate for Payer: Cash Price |
$1,896.80
|
| Rate for Payer: Cofinity Commercial |
$937.68
|
| Rate for Payer: Cofinity Commercial |
$872.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.17
|
| Rate for Payer: Healthscope Commercial |
$781.40
|
| Rate for Payer: Healthscope Whirlpool |
$781.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.73
|
| Rate for Payer: Meridian Medicaid |
$450.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$716.29
|
| Rate for Payer: Nomi Health Commercial |
$781.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,778.25
|
| Rate for Payer: PACE SWMI |
$651.17
|
| Rate for Payer: PHP Medicare Advantage |
$651.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,144.51
|
| Rate for Payer: Priority Health Medicare |
$651.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,144.51
|
| Rate for Payer: Railroad Medicare Medicare |
$651.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,216.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.17
|
| Rate for Payer: UHC Exchange |
$1,216.12
|
| Rate for Payer: UHC Medicaid |
$429.20
|
| Rate for Payer: UHCCP DNSP |
$651.17
|
| Rate for Payer: UHCCP Medicaid |
$429.20
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$4,039.00
|
|
|
Service Code
|
HCPCS 27514
|
| Min. Negotiated Rate |
$558.06 |
| Max. Negotiated Rate |
$3,029.25 |
| Rate for Payer: Aetna Commercial |
$1,155.07
|
| Rate for Payer: Aetna Medicare |
$861.99
|
| Rate for Payer: BCBS Complete |
$585.96
|
| Rate for Payer: BCBS MAPPO |
$861.99
|
| Rate for Payer: BCN Commercial |
$1,460.08
|
| Rate for Payer: BCN Medicare Advantage |
$861.99
|
| Rate for Payer: Cash Price |
$3,231.20
|
| Rate for Payer: Cash Price |
$3,231.20
|
| Rate for Payer: Cofinity Commercial |
$1,241.27
|
| Rate for Payer: Cofinity Commercial |
$1,155.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$861.99
|
| Rate for Payer: Healthscope Commercial |
$1,034.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,034.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.09
|
| Rate for Payer: Meridian Medicaid |
$585.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$948.19
|
| Rate for Payer: Nomi Health Commercial |
$1,034.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,029.25
|
| Rate for Payer: PACE SWMI |
$861.99
|
| Rate for Payer: PHP Medicare Advantage |
$861.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,560.79
|
| Rate for Payer: Priority Health Medicare |
$861.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,560.79
|
| Rate for Payer: Railroad Medicare Medicare |
$861.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,701.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$861.99
|
| Rate for Payer: UHC Exchange |
$1,701.27
|
| Rate for Payer: UHC Medicaid |
$558.06
|
| Rate for Payer: UHCCP DNSP |
$861.99
|
| Rate for Payer: UHCCP Medicaid |
$558.06
|
|
|
PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD
|
Professional
|
Both
|
$4,037.00
|
|
|
Service Code
|
HCPCS 27269
|
| Min. Negotiated Rate |
$715.04 |
| Max. Negotiated Rate |
$3,027.75 |
| Rate for Payer: Aetna Commercial |
$1,481.12
|
| Rate for Payer: Aetna Medicare |
$1,105.31
|
| Rate for Payer: BCBS Complete |
$750.79
|
| Rate for Payer: BCBS MAPPO |
$1,105.31
|
| Rate for Payer: BCN Commercial |
$1,873.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.31
|
| Rate for Payer: Cash Price |
$3,229.60
|
| Rate for Payer: Cash Price |
$3,229.60
|
| Rate for Payer: Cofinity Commercial |
$1,591.65
|
| Rate for Payer: Cofinity Commercial |
$1,481.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.31
|
| Rate for Payer: Healthscope Commercial |
$1,326.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,326.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,160.58
|
| Rate for Payer: Meridian Medicaid |
$750.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,215.84
|
| Rate for Payer: Nomi Health Commercial |
$1,326.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,027.75
|
| Rate for Payer: PACE SWMI |
$1,105.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,003.15
|
| Rate for Payer: Priority Health Medicare |
$1,105.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,003.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,105.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,188.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,105.31
|
| Rate for Payer: UHC Exchange |
$2,188.43
|
| Rate for Payer: UHC Medicaid |
$715.04
|
| Rate for Payer: UHCCP DNSP |
$1,105.31
|
| Rate for Payer: UHCCP Medicaid |
$715.04
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,963.00
|
|
|
Service Code
|
HCPCS 27511
|
| Min. Negotiated Rate |
$574.46 |
| Max. Negotiated Rate |
$2,972.25 |
| Rate for Payer: Aetna Commercial |
$1,189.50
|
| Rate for Payer: Aetna Medicare |
$887.69
|
| Rate for Payer: BCBS Complete |
$603.18
|
| Rate for Payer: BCBS MAPPO |
$887.69
|
| Rate for Payer: BCN Commercial |
$1,502.40
|
| Rate for Payer: BCN Medicare Advantage |
$887.69
|
| Rate for Payer: Cash Price |
$3,170.40
|
| Rate for Payer: Cash Price |
$3,170.40
|
| Rate for Payer: Cofinity Commercial |
$1,278.27
|
| Rate for Payer: Cofinity Commercial |
$1,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$887.69
|
| Rate for Payer: Healthscope Commercial |
$1,065.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,065.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$932.07
|
| Rate for Payer: Meridian Medicaid |
$603.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$976.46
|
| Rate for Payer: Nomi Health Commercial |
$1,065.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,972.25
|
| Rate for Payer: PACE SWMI |
$887.69
|
| Rate for Payer: PHP Medicare Advantage |
$887.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,606.03
|
| Rate for Payer: Priority Health Medicare |
$887.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,606.03
|
| Rate for Payer: Railroad Medicare Medicare |
$887.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,756.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$887.69
|
| Rate for Payer: UHC Exchange |
$1,756.34
|
| Rate for Payer: UHC Medicaid |
$574.46
|
| Rate for Payer: UHCCP DNSP |
$887.69
|
| Rate for Payer: UHCCP Medicaid |
$574.46
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$4,529.00
|
|
|
Service Code
|
HCPCS 27513
|
| Min. Negotiated Rate |
$705.88 |
| Max. Negotiated Rate |
$3,396.75 |
| Rate for Payer: Aetna Commercial |
$1,465.58
|
| Rate for Payer: Aetna Medicare |
$1,093.72
|
| Rate for Payer: BCBS Complete |
$741.17
|
| Rate for Payer: BCBS MAPPO |
$1,093.72
|
| Rate for Payer: BCN Commercial |
$1,858.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,093.72
|
| Rate for Payer: Cash Price |
$3,623.20
|
| Rate for Payer: Cash Price |
$3,623.20
|
| Rate for Payer: Cofinity Commercial |
$1,574.96
|
| Rate for Payer: Cofinity Commercial |
$1,465.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,093.72
|
| Rate for Payer: Healthscope Commercial |
$1,312.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,148.41
|
| Rate for Payer: Meridian Medicaid |
$741.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,203.09
|
| Rate for Payer: Nomi Health Commercial |
$1,312.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,396.75
|
| Rate for Payer: PACE SWMI |
$1,093.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,093.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,987.17
|
| Rate for Payer: Priority Health Medicare |
$1,093.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,987.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,093.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,186.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,093.72
|
| Rate for Payer: UHC Exchange |
$2,186.12
|
| Rate for Payer: UHC Medicaid |
$705.88
|
| Rate for Payer: UHCCP DNSP |
$1,093.72
|
| Rate for Payer: UHCCP Medicaid |
$705.88
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,479.00
|
|
|
Service Code
|
HCPCS 28505
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,109.25 |
| Rate for Payer: Aetna Commercial |
$613.18
|
| Rate for Payer: Aetna Medicare |
$457.60
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$457.60
|
| Rate for Payer: BCN Commercial |
$753.95
|
| Rate for Payer: BCN Medicare Advantage |
$457.60
|
| Rate for Payer: Cash Price |
$1,183.20
|
| Rate for Payer: Cash Price |
$1,183.20
|
| Rate for Payer: Cofinity Commercial |
$658.94
|
| Rate for Payer: Cofinity Commercial |
$613.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.60
|
| Rate for Payer: Healthscope Commercial |
$549.12
|
| Rate for Payer: Healthscope Whirlpool |
$549.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$480.48
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$503.36
|
| Rate for Payer: Nomi Health Commercial |
$549.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,109.25
|
| Rate for Payer: PACE SWMI |
$457.60
|
| Rate for Payer: PHP Medicare Advantage |
$457.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$805.95
|
| Rate for Payer: Priority Health Medicare |
$457.60
|
| Rate for Payer: Priority Health Narrow Network |
$805.95
|
| Rate for Payer: Railroad Medicare Medicare |
$457.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$867.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.60
|
| Rate for Payer: UHC Exchange |
$867.27
|
| Rate for Payer: UHC Medicaid |
$300.12
|
| Rate for Payer: UHCCP DNSP |
$457.60
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 28525
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$700.58 |
| Rate for Payer: Aetna Commercial |
$499.98
|
| Rate for Payer: Aetna Medicare |
$373.12
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$373.12
|
| Rate for Payer: BCN Commercial |
$613.51
|
| Rate for Payer: BCN Medicare Advantage |
$373.12
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$537.29
|
| Rate for Payer: Cofinity Commercial |
$499.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.12
|
| Rate for Payer: Healthscope Commercial |
$447.74
|
| Rate for Payer: Healthscope Whirlpool |
$447.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.78
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.43
|
| Rate for Payer: Nomi Health Commercial |
$447.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$475.50
|
| Rate for Payer: PACE SWMI |
$373.12
|
| Rate for Payer: PHP Medicare Advantage |
$373.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$655.83
|
| Rate for Payer: Priority Health Medicare |
$373.12
|
| Rate for Payer: Priority Health Narrow Network |
$655.83
|
| Rate for Payer: Railroad Medicare Medicare |
$373.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$700.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.12
|
| Rate for Payer: UHC Exchange |
$700.58
|
| Rate for Payer: UHC Medicaid |
$246.02
|
| Rate for Payer: UHCCP DNSP |
$373.12
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
|
|
PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT
|
Professional
|
Both
|
$1,207.00
|
|
|
Service Code
|
HCPCS 21407
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$1,116.09 |
| Rate for Payer: Aetna Commercial |
$752.45
|
| Rate for Payer: Aetna Medicare |
$561.53
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS MAPPO |
$561.53
|
| Rate for Payer: BCN Commercial |
$979.52
|
| Rate for Payer: BCN Medicare Advantage |
$561.53
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cofinity Commercial |
$808.60
|
| Rate for Payer: Cofinity Commercial |
$752.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.53
|
| Rate for Payer: Healthscope Commercial |
$673.84
|
| Rate for Payer: Healthscope Whirlpool |
$673.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.61
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.68
|
| Rate for Payer: Nomi Health Commercial |
$673.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$905.25
|
| Rate for Payer: PACE SWMI |
$561.53
|
| Rate for Payer: PHP Medicare Advantage |
$561.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,047.10
|
| Rate for Payer: Priority Health Medicare |
$561.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.10
|
| Rate for Payer: Railroad Medicare Medicare |
$561.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.53
|
| Rate for Payer: UHC Exchange |
$1,116.09
|
| Rate for Payer: UHC Medicaid |
$368.28
|
| Rate for Payer: UHCCP DNSP |
$561.53
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
|
|
PR OPEN TX HUMERAL EPICONDYLAR FRACTURE
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 24575
|
| Min. Negotiated Rate |
$443.04 |
| Max. Negotiated Rate |
$1,881.75 |
| Rate for Payer: Aetna Commercial |
$905.59
|
| Rate for Payer: Aetna Medicare |
$675.81
|
| Rate for Payer: BCBS Complete |
$465.19
|
| Rate for Payer: BCBS MAPPO |
$675.81
|
| Rate for Payer: BCN Commercial |
$1,124.44
|
| Rate for Payer: BCN Medicare Advantage |
$675.81
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$973.17
|
| Rate for Payer: Cofinity Commercial |
$905.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.81
|
| Rate for Payer: Healthscope Commercial |
$810.97
|
| Rate for Payer: Healthscope Whirlpool |
$810.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.60
|
| Rate for Payer: Meridian Medicaid |
$465.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$743.39
|
| Rate for Payer: Nomi Health Commercial |
$810.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,881.75
|
| Rate for Payer: PACE SWMI |
$675.81
|
| Rate for Payer: PHP Medicare Advantage |
$675.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,201.99
|
| Rate for Payer: Priority Health Medicare |
$675.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,201.99
|
| Rate for Payer: Railroad Medicare Medicare |
$675.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,275.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$675.81
|
| Rate for Payer: UHC Exchange |
$1,275.73
|
| Rate for Payer: UHC Medicaid |
$443.04
|
| Rate for Payer: UHCCP DNSP |
$675.81
|
| Rate for Payer: UHCCP Medicaid |
$443.04
|
|
|
PR OPEN TX ILIAC SPINE UNI/BIL
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS G0412
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$2,034.75 |
| Rate for Payer: Aetna Commercial |
$879.15
|
| Rate for Payer: Aetna Medicare |
$656.08
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$656.08
|
| Rate for Payer: BCN Commercial |
$1,100.04
|
| Rate for Payer: BCN Medicare Advantage |
$656.08
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cofinity Commercial |
$944.76
|
| Rate for Payer: Cofinity Commercial |
$879.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$656.08
|
| Rate for Payer: Healthscope Commercial |
$787.30
|
| Rate for Payer: Healthscope Whirlpool |
$787.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.88
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$721.69
|
| Rate for Payer: Nomi Health Commercial |
$787.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,034.75
|
| Rate for Payer: PACE SWMI |
$656.08
|
| Rate for Payer: PHP Medicare Advantage |
$656.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,175.91
|
| Rate for Payer: Priority Health Medicare |
$656.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,175.91
|
| Rate for Payer: Railroad Medicare Medicare |
$656.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,273.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$656.08
|
| Rate for Payer: UHC Exchange |
$1,273.94
|
| Rate for Payer: UHC Medicaid |
$426.64
|
| Rate for Payer: UHCCP DNSP |
$656.08
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
|
|
PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE
|
Professional
|
Both
|
$2,831.00
|
|
|
Service Code
|
HCPCS 27540
|
| Min. Negotiated Rate |
$486.28 |
| Max. Negotiated Rate |
$2,123.25 |
| Rate for Payer: Aetna Commercial |
$998.34
|
| Rate for Payer: Aetna Medicare |
$745.03
|
| Rate for Payer: BCBS Complete |
$510.59
|
| Rate for Payer: BCBS MAPPO |
$745.03
|
| Rate for Payer: BCN Commercial |
$1,242.47
|
| Rate for Payer: BCN Medicare Advantage |
$745.03
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cash Price |
$2,264.80
|
| Rate for Payer: Cofinity Commercial |
$998.34
|
| Rate for Payer: Cofinity Commercial |
$1,072.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.03
|
| Rate for Payer: Healthscope Commercial |
$894.04
|
| Rate for Payer: Healthscope Whirlpool |
$894.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.28
|
| Rate for Payer: Meridian Medicaid |
$510.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$819.53
|
| Rate for Payer: Nomi Health Commercial |
$894.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,123.25
|
| Rate for Payer: PACE SWMI |
$745.03
|
| Rate for Payer: PHP Medicare Advantage |
$745.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,328.17
|
| Rate for Payer: Priority Health Medicare |
$745.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.17
|
| Rate for Payer: Railroad Medicare Medicare |
$745.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,415.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$745.03
|
| Rate for Payer: UHC Exchange |
$1,415.87
|
| Rate for Payer: UHC Medicaid |
$486.28
|
| Rate for Payer: UHCCP DNSP |
$745.03
|
| Rate for Payer: UHCCP Medicaid |
$486.28
|
|
