|
PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26785
|
| Min. Negotiated Rate |
$334.41 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$678.71
|
| Rate for Payer: Aetna Medicare |
$506.50
|
| Rate for Payer: BCBS Complete |
$351.13
|
| Rate for Payer: BCBS MAPPO |
$506.50
|
| Rate for Payer: BCN Commercial |
$847.57
|
| Rate for Payer: BCN Medicare Advantage |
$506.50
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$729.36
|
| Rate for Payer: Cofinity Commercial |
$678.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.50
|
| Rate for Payer: Healthscope Commercial |
$607.80
|
| Rate for Payer: Healthscope Whirlpool |
$607.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.83
|
| Rate for Payer: Meridian Medicaid |
$351.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.15
|
| Rate for Payer: Nomi Health Commercial |
$607.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$506.50
|
| Rate for Payer: PHP Medicare Advantage |
$506.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$906.03
|
| Rate for Payer: Priority Health Medicare |
$506.50
|
| Rate for Payer: Priority Health Narrow Network |
$906.03
|
| Rate for Payer: Railroad Medicare Medicare |
$506.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$944.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.50
|
| Rate for Payer: UHC Exchange |
$944.28
|
| Rate for Payer: UHC Medicaid |
$334.41
|
| Rate for Payer: UHCCP DNSP |
$506.50
|
| Rate for Payer: UHCCP Medicaid |
$334.41
|
|
|
PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 27557
|
| Min. Negotiated Rate |
$601.51 |
| Max. Negotiated Rate |
$1,841.79 |
| Rate for Payer: Aetna Commercial |
$1,246.33
|
| Rate for Payer: Aetna Medicare |
$930.10
|
| Rate for Payer: BCBS Complete |
$631.59
|
| Rate for Payer: BCBS MAPPO |
$930.10
|
| Rate for Payer: BCN Commercial |
$1,575.62
|
| Rate for Payer: BCN Medicare Advantage |
$930.10
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,339.34
|
| Rate for Payer: Cofinity Commercial |
$1,246.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.10
|
| Rate for Payer: Healthscope Commercial |
$1,116.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,116.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$976.61
|
| Rate for Payer: Meridian Medicaid |
$631.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,023.11
|
| Rate for Payer: Nomi Health Commercial |
$1,116.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.25
|
| Rate for Payer: PACE SWMI |
$930.10
|
| Rate for Payer: PHP Medicare Advantage |
$930.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$601.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,684.28
|
| Rate for Payer: Priority Health Medicare |
$930.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,684.28
|
| Rate for Payer: Railroad Medicare Medicare |
$930.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,841.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$930.10
|
| Rate for Payer: UHC Exchange |
$1,841.79
|
| Rate for Payer: UHC Medicaid |
$601.51
|
| Rate for Payer: UHCCP DNSP |
$930.10
|
| Rate for Payer: UHCCP Medicaid |
$601.51
|
|
|
PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR
|
Professional
|
Both
|
$1,828.00
|
|
|
Service Code
|
HCPCS 27556
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$1,541.29 |
| Rate for Payer: Aetna Commercial |
$1,052.52
|
| Rate for Payer: Aetna Medicare |
$785.46
|
| Rate for Payer: BCBS Complete |
$534.74
|
| Rate for Payer: BCBS MAPPO |
$785.46
|
| Rate for Payer: BCN Commercial |
$1,324.63
|
| Rate for Payer: BCN Medicare Advantage |
$785.46
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cofinity Commercial |
$1,131.06
|
| Rate for Payer: Cofinity Commercial |
$1,052.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.46
|
| Rate for Payer: Healthscope Commercial |
$942.55
|
| Rate for Payer: Healthscope Whirlpool |
$942.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.73
|
| Rate for Payer: Meridian Medicaid |
$534.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$864.01
|
| Rate for Payer: Nomi Health Commercial |
$942.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.00
|
| Rate for Payer: PACE SWMI |
$785.46
|
| Rate for Payer: PHP Medicare Advantage |
$785.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,416.00
|
| Rate for Payer: Priority Health Medicare |
$785.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,416.00
|
| Rate for Payer: Railroad Medicare Medicare |
$785.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,541.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$785.46
|
| Rate for Payer: UHC Exchange |
$1,541.29
|
| Rate for Payer: UHC Medicaid |
$509.28
|
| Rate for Payer: UHCCP DNSP |
$785.46
|
| Rate for Payer: UHCCP Medicaid |
$509.28
|
|
|
PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION
|
Professional
|
Both
|
$5,511.00
|
|
|
Service Code
|
HCPCS 27558
|
| Min. Negotiated Rate |
$680.75 |
| Max. Negotiated Rate |
$4,133.25 |
| Rate for Payer: Aetna Commercial |
$1,412.84
|
| Rate for Payer: Aetna Medicare |
$1,054.36
|
| Rate for Payer: BCBS Complete |
$714.79
|
| Rate for Payer: BCBS MAPPO |
$1,054.36
|
| Rate for Payer: BCN Commercial |
$1,790.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,054.36
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cofinity Commercial |
$1,518.28
|
| Rate for Payer: Cofinity Commercial |
$1,412.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,054.36
|
| Rate for Payer: Healthscope Commercial |
$1,265.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,265.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.08
|
| Rate for Payer: Meridian Medicaid |
$714.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,159.80
|
| Rate for Payer: Nomi Health Commercial |
$1,265.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,133.25
|
| Rate for Payer: PACE SWMI |
$1,054.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,054.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,914.25
|
| Rate for Payer: Priority Health Medicare |
$1,054.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,914.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,054.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,101.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,054.36
|
| Rate for Payer: UHC Exchange |
$2,101.40
|
| Rate for Payer: UHC Medicaid |
$680.75
|
| Rate for Payer: UHCCP DNSP |
$1,054.36
|
| Rate for Payer: UHCCP Medicaid |
$680.75
|
|
|
PR OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION
|
Professional
|
Both
|
$3,503.00
|
|
|
Service Code
|
HCPCS 21462
|
| Min. Negotiated Rate |
$705.67 |
| Max. Negotiated Rate |
$2,627.25 |
| Rate for Payer: Aetna Commercial |
$1,411.15
|
| Rate for Payer: Aetna Medicare |
$1,053.10
|
| Rate for Payer: BCBS Complete |
$740.95
|
| Rate for Payer: BCBS MAPPO |
$1,053.10
|
| Rate for Payer: BCN Commercial |
$1,729.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.10
|
| Rate for Payer: Cash Price |
$2,802.40
|
| Rate for Payer: Cash Price |
$2,802.40
|
| Rate for Payer: Cofinity Commercial |
$1,516.46
|
| Rate for Payer: Cofinity Commercial |
$1,411.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.10
|
| Rate for Payer: Healthscope Commercial |
$1,263.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,263.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,105.76
|
| Rate for Payer: Meridian Medicaid |
$740.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,158.41
|
| Rate for Payer: Nomi Health Commercial |
$1,263.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,627.25
|
| Rate for Payer: PACE SWMI |
$1,053.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,849.31
|
| Rate for Payer: Priority Health Medicare |
$1,053.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,849.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,053.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,898.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,053.10
|
| Rate for Payer: UHC Exchange |
$1,898.65
|
| Rate for Payer: UHC Medicaid |
$705.67
|
| Rate for Payer: UHCCP DNSP |
$1,053.10
|
| Rate for Payer: UHCCP Medicaid |
$705.67
|
|
|
PR OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION
|
Professional
|
Both
|
$4,316.00
|
|
|
Service Code
|
HCPCS 21461
|
| Min. Negotiated Rate |
$618.77 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Aetna Commercial |
$1,235.10
|
| Rate for Payer: Aetna Medicare |
$921.72
|
| Rate for Payer: BCBS Complete |
$649.71
|
| Rate for Payer: BCBS MAPPO |
$921.72
|
| Rate for Payer: BCN Commercial |
$1,557.19
|
| Rate for Payer: BCN Medicare Advantage |
$921.72
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cofinity Commercial |
$1,327.28
|
| Rate for Payer: Cofinity Commercial |
$1,235.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.72
|
| Rate for Payer: Healthscope Commercial |
$1,106.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,106.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.81
|
| Rate for Payer: Meridian Medicaid |
$649.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,013.89
|
| Rate for Payer: Nomi Health Commercial |
$1,106.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,237.00
|
| Rate for Payer: PACE SWMI |
$921.72
|
| Rate for Payer: PHP Medicare Advantage |
$921.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,664.60
|
| Rate for Payer: Priority Health Medicare |
$921.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,664.60
|
| Rate for Payer: Railroad Medicare Medicare |
$921.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,713.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$921.72
|
| Rate for Payer: UHC Exchange |
$1,713.80
|
| Rate for Payer: UHC Medicaid |
$618.77
|
| Rate for Payer: UHCCP DNSP |
$921.72
|
| Rate for Payer: UHCCP Medicaid |
$618.77
|
|
|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26615
|
| Min. Negotiated Rate |
$349.32 |
| Max. Negotiated Rate |
$1,487.25 |
| Rate for Payer: Aetna Commercial |
$709.85
|
| Rate for Payer: Aetna Medicare |
$529.74
|
| Rate for Payer: BCBS Complete |
$366.79
|
| Rate for Payer: BCBS MAPPO |
$529.74
|
| Rate for Payer: BCN Commercial |
$887.90
|
| Rate for Payer: BCN Medicare Advantage |
$529.74
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$762.83
|
| Rate for Payer: Cofinity Commercial |
$709.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.74
|
| Rate for Payer: Healthscope Commercial |
$635.69
|
| Rate for Payer: Healthscope Whirlpool |
$635.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.23
|
| Rate for Payer: Meridian Medicaid |
$366.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.71
|
| Rate for Payer: Nomi Health Commercial |
$635.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,487.25
|
| Rate for Payer: PACE SWMI |
$529.74
|
| Rate for Payer: PHP Medicare Advantage |
$529.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$949.14
|
| Rate for Payer: Priority Health Medicare |
$529.74
|
| Rate for Payer: Priority Health Narrow Network |
$949.14
|
| Rate for Payer: Railroad Medicare Medicare |
$529.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$995.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.74
|
| Rate for Payer: UHC Exchange |
$995.47
|
| Rate for Payer: UHC Medicaid |
$349.32
|
| Rate for Payer: UHCCP DNSP |
$529.74
|
| Rate for Payer: UHCCP Medicaid |
$349.32
|
|
|
PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 28645
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$848.56 |
| Rate for Payer: Aetna Commercial |
$601.26
|
| Rate for Payer: Aetna Medicare |
$448.70
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$448.70
|
| Rate for Payer: BCN Commercial |
$740.00
|
| Rate for Payer: BCN Medicare Advantage |
$448.70
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$646.13
|
| Rate for Payer: Cofinity Commercial |
$601.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.70
|
| Rate for Payer: Healthscope Commercial |
$538.44
|
| Rate for Payer: Healthscope Whirlpool |
$538.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.13
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$493.57
|
| Rate for Payer: Nomi Health Commercial |
$538.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.00
|
| Rate for Payer: PACE SWMI |
$448.70
|
| Rate for Payer: PHP Medicare Advantage |
$448.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$791.04
|
| Rate for Payer: Priority Health Medicare |
$448.70
|
| Rate for Payer: Priority Health Narrow Network |
$791.04
|
| Rate for Payer: Railroad Medicare Medicare |
$448.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$848.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$448.70
|
| Rate for Payer: UHC Exchange |
$848.56
|
| Rate for Payer: UHC Medicaid |
$294.15
|
| Rate for Payer: UHCCP DNSP |
$448.70
|
| Rate for Payer: UHCCP Medicaid |
$294.15
|
|
|
PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$3,547.00
|
|
|
Service Code
|
HCPCS 24635
|
| Min. Negotiated Rate |
$408.11 |
| Max. Negotiated Rate |
$2,660.25 |
| Rate for Payer: Aetna Commercial |
$833.17
|
| Rate for Payer: Aetna Medicare |
$621.77
|
| Rate for Payer: BCBS Complete |
$428.52
|
| Rate for Payer: BCBS MAPPO |
$621.77
|
| Rate for Payer: BCN Commercial |
$1,040.28
|
| Rate for Payer: BCN Medicare Advantage |
$621.77
|
| Rate for Payer: Cash Price |
$2,837.60
|
| Rate for Payer: Cash Price |
$2,837.60
|
| Rate for Payer: Cofinity Commercial |
$895.35
|
| Rate for Payer: Cofinity Commercial |
$833.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.77
|
| Rate for Payer: Healthscope Commercial |
$746.12
|
| Rate for Payer: Healthscope Whirlpool |
$746.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.86
|
| Rate for Payer: Meridian Medicaid |
$428.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$683.95
|
| Rate for Payer: Nomi Health Commercial |
$746.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,660.25
|
| Rate for Payer: PACE SWMI |
$621.77
|
| Rate for Payer: PHP Medicare Advantage |
$621.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,112.04
|
| Rate for Payer: Priority Health Medicare |
$621.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.04
|
| Rate for Payer: Railroad Medicare Medicare |
$621.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,172.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$621.77
|
| Rate for Payer: UHC Exchange |
$1,172.31
|
| Rate for Payer: UHC Medicaid |
$408.11
|
| Rate for Payer: UHCCP DNSP |
$621.77
|
| Rate for Payer: UHCCP Medicaid |
$408.11
|
|
|
PR OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 21330
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$629.89
|
| Rate for Payer: Aetna Medicare |
$470.07
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$470.07
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: BCN Medicare Advantage |
$470.07
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Cofinity Commercial |
$629.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.07
|
| Rate for Payer: Healthscope Commercial |
$564.08
|
| Rate for Payer: Healthscope Whirlpool |
$564.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.57
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.08
|
| Rate for Payer: Nomi Health Commercial |
$564.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$470.07
|
| Rate for Payer: PHP Medicare Advantage |
$470.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$858.65
|
| Rate for Payer: Priority Health Medicare |
$470.07
|
| Rate for Payer: Priority Health Narrow Network |
$858.65
|
| Rate for Payer: Railroad Medicare Medicare |
$470.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$955.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.07
|
| Rate for Payer: UHC Exchange |
$955.40
|
| Rate for Payer: UHC Medicaid |
$312.68
|
| Rate for Payer: UHCCP DNSP |
$470.07
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
|
|
PR OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION
|
Professional
|
Both
|
$1,520.00
|
|
|
Service Code
|
HCPCS 21336
|
| Min. Negotiated Rate |
$371.90 |
| Max. Negotiated Rate |
$1,140.00 |
| Rate for Payer: Aetna Commercial |
$748.64
|
| Rate for Payer: Aetna Medicare |
$558.69
|
| Rate for Payer: BCBS Complete |
$390.50
|
| Rate for Payer: BCBS MAPPO |
$558.69
|
| Rate for Payer: BCN Commercial |
$957.12
|
| Rate for Payer: BCN Medicare Advantage |
$558.69
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cofinity Commercial |
$804.51
|
| Rate for Payer: Cofinity Commercial |
$748.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.69
|
| Rate for Payer: Healthscope Commercial |
$670.43
|
| Rate for Payer: Healthscope Whirlpool |
$670.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$586.62
|
| Rate for Payer: Meridian Medicaid |
$390.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$614.56
|
| Rate for Payer: Nomi Health Commercial |
$670.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.00
|
| Rate for Payer: PACE SWMI |
$558.69
|
| Rate for Payer: PHP Medicare Advantage |
$558.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,023.13
|
| Rate for Payer: Priority Health Medicare |
$558.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.13
|
| Rate for Payer: Railroad Medicare Medicare |
$558.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.69
|
| Rate for Payer: UHC Exchange |
$1,086.94
|
| Rate for Payer: UHC Medicaid |
$371.90
|
| Rate for Payer: UHCCP DNSP |
$558.69
|
| Rate for Payer: UHCCP Medicaid |
$371.90
|
|
|
PR OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 21338
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,447.50 |
| Rate for Payer: Aetna Commercial |
$802.66
|
| Rate for Payer: Aetna Medicare |
$599.00
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS MAPPO |
$599.00
|
| Rate for Payer: BCN Commercial |
$1,010.90
|
| Rate for Payer: BCN Medicare Advantage |
$599.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$862.56
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.00
|
| Rate for Payer: Healthscope Commercial |
$718.80
|
| Rate for Payer: Healthscope Whirlpool |
$718.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.95
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$658.90
|
| Rate for Payer: Nomi Health Commercial |
$718.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,447.50
|
| Rate for Payer: PACE SWMI |
$599.00
|
| Rate for Payer: PHP Medicare Advantage |
$599.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,080.62
|
| Rate for Payer: Priority Health Medicare |
$599.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,080.62
|
| Rate for Payer: Railroad Medicare Medicare |
$599.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,118.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$599.00
|
| Rate for Payer: UHC Exchange |
$1,118.35
|
| Rate for Payer: UHC Medicaid |
$399.80
|
| Rate for Payer: UHCCP DNSP |
$599.00
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
|
|
PR OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 21386
|
| Min. Negotiated Rate |
$402.36 |
| Max. Negotiated Rate |
$1,134.13 |
| Rate for Payer: Aetna Commercial |
$824.96
|
| Rate for Payer: Aetna Medicare |
$615.64
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS MAPPO |
$615.64
|
| Rate for Payer: BCN Commercial |
$1,048.75
|
| Rate for Payer: BCN Medicare Advantage |
$615.64
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$886.52
|
| Rate for Payer: Cofinity Commercial |
$824.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.64
|
| Rate for Payer: Healthscope Commercial |
$738.77
|
| Rate for Payer: Healthscope Whirlpool |
$738.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.42
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.20
|
| Rate for Payer: Nomi Health Commercial |
$738.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.00
|
| Rate for Payer: PACE SWMI |
$615.64
|
| Rate for Payer: PHP Medicare Advantage |
$615.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,121.09
|
| Rate for Payer: Priority Health Medicare |
$615.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,121.09
|
| Rate for Payer: Railroad Medicare Medicare |
$615.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,134.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.64
|
| Rate for Payer: UHC Exchange |
$1,134.13
|
| Rate for Payer: UHC Medicaid |
$402.36
|
| Rate for Payer: UHCCP DNSP |
$615.64
|
| Rate for Payer: UHCCP Medicaid |
$402.36
|
|
|
PR OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL
|
Professional
|
Both
|
$1,591.00
|
|
|
Service Code
|
HCPCS 21385
|
| Min. Negotiated Rate |
$430.05 |
| Max. Negotiated Rate |
$1,299.88 |
| Rate for Payer: Aetna Commercial |
$878.09
|
| Rate for Payer: Aetna Medicare |
$655.29
|
| Rate for Payer: BCBS Complete |
$451.55
|
| Rate for Payer: BCBS MAPPO |
$655.29
|
| Rate for Payer: BCN Commercial |
$1,106.52
|
| Rate for Payer: BCN Medicare Advantage |
$655.29
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cofinity Commercial |
$943.62
|
| Rate for Payer: Cofinity Commercial |
$878.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.29
|
| Rate for Payer: Healthscope Commercial |
$786.35
|
| Rate for Payer: Healthscope Whirlpool |
$786.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.05
|
| Rate for Payer: Meridian Medicaid |
$451.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$720.82
|
| Rate for Payer: Nomi Health Commercial |
$786.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,193.25
|
| Rate for Payer: PACE SWMI |
$655.29
|
| Rate for Payer: PHP Medicare Advantage |
$655.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,182.83
|
| Rate for Payer: Priority Health Medicare |
$655.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,182.83
|
| Rate for Payer: Railroad Medicare Medicare |
$655.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,299.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$655.29
|
| Rate for Payer: UHC Exchange |
$1,299.88
|
| Rate for Payer: UHC Medicaid |
$430.05
|
| Rate for Payer: UHCCP DNSP |
$655.29
|
| Rate for Payer: UHCCP Medicaid |
$430.05
|
|
|
PR OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 21423
|
| Min. Negotiated Rate |
$460.29 |
| Max. Negotiated Rate |
$1,332.37 |
| Rate for Payer: Aetna Commercial |
$943.20
|
| Rate for Payer: Aetna Medicare |
$703.88
|
| Rate for Payer: BCBS Complete |
$483.30
|
| Rate for Payer: BCBS MAPPO |
$703.88
|
| Rate for Payer: BCN Commercial |
$1,199.14
|
| Rate for Payer: BCN Medicare Advantage |
$703.88
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cofinity Commercial |
$943.20
|
| Rate for Payer: Cofinity Commercial |
$1,013.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.88
|
| Rate for Payer: Healthscope Commercial |
$844.66
|
| Rate for Payer: Healthscope Whirlpool |
$844.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.07
|
| Rate for Payer: Meridian Medicaid |
$483.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$774.27
|
| Rate for Payer: Nomi Health Commercial |
$844.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,219.50
|
| Rate for Payer: PACE SWMI |
$703.88
|
| Rate for Payer: PHP Medicare Advantage |
$703.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,281.84
|
| Rate for Payer: Priority Health Medicare |
$703.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,281.84
|
| Rate for Payer: Railroad Medicare Medicare |
$703.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,332.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.88
|
| Rate for Payer: UHC Exchange |
$1,332.37
|
| Rate for Payer: UHC Medicaid |
$460.29
|
| Rate for Payer: UHCCP DNSP |
$703.88
|
| Rate for Payer: UHCCP Medicaid |
$460.29
|
|
|
PR OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA
|
Professional
|
Both
|
$1,869.00
|
|
|
Service Code
|
HCPCS 26735
|
| Min. Negotiated Rate |
$359.97 |
| Max. Negotiated Rate |
$1,401.75 |
| Rate for Payer: Aetna Commercial |
$732.28
|
| Rate for Payer: Aetna Medicare |
$546.48
|
| Rate for Payer: BCBS Complete |
$377.97
|
| Rate for Payer: BCBS MAPPO |
$546.48
|
| Rate for Payer: BCN Commercial |
$916.28
|
| Rate for Payer: BCN Medicare Advantage |
$546.48
|
| Rate for Payer: Cash Price |
$1,495.20
|
| Rate for Payer: Cash Price |
$1,495.20
|
| Rate for Payer: Cofinity Commercial |
$786.93
|
| Rate for Payer: Cofinity Commercial |
$732.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.48
|
| Rate for Payer: Healthscope Commercial |
$655.78
|
| Rate for Payer: Healthscope Whirlpool |
$655.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.80
|
| Rate for Payer: Meridian Medicaid |
$377.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.13
|
| Rate for Payer: Nomi Health Commercial |
$655.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.75
|
| Rate for Payer: PACE SWMI |
$546.48
|
| Rate for Payer: PHP Medicare Advantage |
$546.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$979.49
|
| Rate for Payer: Priority Health Medicare |
$546.48
|
| Rate for Payer: Priority Health Narrow Network |
$979.49
|
| Rate for Payer: Railroad Medicare Medicare |
$546.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,029.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.48
|
| Rate for Payer: UHC Exchange |
$1,029.78
|
| Rate for Payer: UHC Medicaid |
$359.97
|
| Rate for Payer: UHCCP DNSP |
$546.48
|
| Rate for Payer: UHCCP Medicaid |
$359.97
|
|
|
PR OPEN TX POST PELVIC FXCTURE
|
Professional
|
Both
|
$2,438.00
|
|
|
Service Code
|
HCPCS G0415
|
| Min. Negotiated Rate |
$790.23 |
| Max. Negotiated Rate |
$2,408.18 |
| Rate for Payer: Aetna Commercial |
$1,638.32
|
| Rate for Payer: Aetna Medicare |
$1,222.63
|
| Rate for Payer: BCBS Complete |
$829.74
|
| Rate for Payer: BCBS MAPPO |
$1,222.63
|
| Rate for Payer: BCN Commercial |
$2,074.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.63
|
| Rate for Payer: Cash Price |
$1,950.40
|
| Rate for Payer: Cash Price |
$1,950.40
|
| Rate for Payer: Cofinity Commercial |
$1,760.59
|
| Rate for Payer: Cofinity Commercial |
$1,638.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.63
|
| Rate for Payer: Healthscope Commercial |
$1,467.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,467.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.76
|
| Rate for Payer: Meridian Medicaid |
$829.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,344.89
|
| Rate for Payer: Nomi Health Commercial |
$1,467.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,828.50
|
| Rate for Payer: PACE SWMI |
$1,222.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$790.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,217.14
|
| Rate for Payer: Priority Health Medicare |
$1,222.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,217.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,222.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,408.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,222.63
|
| Rate for Payer: UHC Exchange |
$2,408.18
|
| Rate for Payer: UHC Medicaid |
$790.23
|
| Rate for Payer: UHCCP DNSP |
$1,222.63
|
| Rate for Payer: UHCCP Medicaid |
$790.23
|
|
|
PR OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB
|
Professional
|
Both
|
$1,898.00
|
|
|
Service Code
|
HCPCS 27832
|
| Min. Negotiated Rate |
$457.10 |
| Max. Negotiated Rate |
$1,423.50 |
| Rate for Payer: Aetna Commercial |
$935.95
|
| Rate for Payer: Aetna Medicare |
$698.47
|
| Rate for Payer: BCBS Complete |
$479.95
|
| Rate for Payer: BCBS MAPPO |
$698.47
|
| Rate for Payer: BCN Commercial |
$1,160.79
|
| Rate for Payer: BCN Medicare Advantage |
$698.47
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cofinity Commercial |
$935.95
|
| Rate for Payer: Cofinity Commercial |
$1,005.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.47
|
| Rate for Payer: Healthscope Commercial |
$838.16
|
| Rate for Payer: Healthscope Whirlpool |
$838.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.39
|
| Rate for Payer: Meridian Medicaid |
$479.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$768.32
|
| Rate for Payer: Nomi Health Commercial |
$838.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.50
|
| Rate for Payer: PACE SWMI |
$698.47
|
| Rate for Payer: PHP Medicare Advantage |
$698.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,240.86
|
| Rate for Payer: Priority Health Medicare |
$698.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,240.86
|
| Rate for Payer: Railroad Medicare Medicare |
$698.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,318.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$698.47
|
| Rate for Payer: UHC Exchange |
$1,318.57
|
| Rate for Payer: UHC Medicaid |
$457.10
|
| Rate for Payer: UHCCP DNSP |
$698.47
|
| Rate for Payer: UHCCP Medicaid |
$457.10
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
Both
|
$2,436.00
|
|
|
Service Code
|
HCPCS 24665
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$1,827.00 |
| Rate for Payer: Aetna Commercial |
$808.88
|
| Rate for Payer: Aetna Medicare |
$603.64
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCBS MAPPO |
$603.64
|
| Rate for Payer: BCN Commercial |
$1,010.90
|
| Rate for Payer: BCN Medicare Advantage |
$603.64
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cofinity Commercial |
$869.24
|
| Rate for Payer: Cofinity Commercial |
$808.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.64
|
| Rate for Payer: Healthscope Commercial |
$724.37
|
| Rate for Payer: Healthscope Whirlpool |
$724.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.82
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$664.00
|
| Rate for Payer: Nomi Health Commercial |
$724.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,827.00
|
| Rate for Payer: PACE SWMI |
$603.64
|
| Rate for Payer: PHP Medicare Advantage |
$603.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,080.62
|
| Rate for Payer: Priority Health Medicare |
$603.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,080.62
|
| Rate for Payer: Railroad Medicare Medicare |
$603.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,137.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$603.64
|
| Rate for Payer: UHC Exchange |
$1,137.19
|
| Rate for Payer: UHC Medicaid |
$396.82
|
| Rate for Payer: UHCCP DNSP |
$603.64
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
HCPCS 25670
|
| Min. Negotiated Rate |
$369.98 |
| Max. Negotiated Rate |
$1,533.00 |
| Rate for Payer: Aetna Commercial |
$756.76
|
| Rate for Payer: Aetna Medicare |
$564.75
|
| Rate for Payer: BCBS Complete |
$388.48
|
| Rate for Payer: BCBS MAPPO |
$564.75
|
| Rate for Payer: BCN Commercial |
$930.23
|
| Rate for Payer: BCN Medicare Advantage |
$564.75
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cofinity Commercial |
$813.24
|
| Rate for Payer: Cofinity Commercial |
$756.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.75
|
| Rate for Payer: Healthscope Commercial |
$677.70
|
| Rate for Payer: Healthscope Whirlpool |
$677.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.99
|
| Rate for Payer: Meridian Medicaid |
$388.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$621.23
|
| Rate for Payer: Nomi Health Commercial |
$677.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.00
|
| Rate for Payer: PACE SWMI |
$564.75
|
| Rate for Payer: PHP Medicare Advantage |
$564.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$994.38
|
| Rate for Payer: Priority Health Medicare |
$564.75
|
| Rate for Payer: Priority Health Narrow Network |
$994.38
|
| Rate for Payer: Railroad Medicare Medicare |
$564.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,058.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$564.75
|
| Rate for Payer: UHC Exchange |
$1,058.65
|
| Rate for Payer: UHC Medicaid |
$369.98
|
| Rate for Payer: UHCCP DNSP |
$564.75
|
| Rate for Payer: UHCCP Medicaid |
$369.98
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 21811
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$1,060.67 |
| Rate for Payer: Aetna Commercial |
$732.58
|
| Rate for Payer: Aetna Medicare |
$546.70
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$546.70
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: BCN Medicare Advantage |
$546.70
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$787.25
|
| Rate for Payer: Cofinity Commercial |
$732.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.70
|
| Rate for Payer: Healthscope Commercial |
$656.04
|
| Rate for Payer: Healthscope Whirlpool |
$656.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.03
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.37
|
| Rate for Payer: Nomi Health Commercial |
$656.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$975.75
|
| Rate for Payer: PACE SWMI |
$546.70
|
| Rate for Payer: PHP Medicare Advantage |
$546.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$942.22
|
| Rate for Payer: Priority Health Medicare |
$546.70
|
| Rate for Payer: Priority Health Narrow Network |
$942.22
|
| Rate for Payer: Railroad Medicare Medicare |
$546.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.70
|
| Rate for Payer: UHC Exchange |
$1,060.67
|
| Rate for Payer: UHC Medicaid |
$347.40
|
| Rate for Payer: UHCCP DNSP |
$546.70
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS
|
Professional
|
Both
|
$1,816.00
|
|
|
Service Code
|
HCPCS 21812
|
| Min. Negotiated Rate |
$417.91 |
| Max. Negotiated Rate |
$1,362.00 |
| Rate for Payer: Aetna Commercial |
$880.80
|
| Rate for Payer: Aetna Medicare |
$657.31
|
| Rate for Payer: BCBS Complete |
$438.81
|
| Rate for Payer: BCBS MAPPO |
$657.31
|
| Rate for Payer: BCN Commercial |
$1,067.17
|
| Rate for Payer: BCN Medicare Advantage |
$657.31
|
| Rate for Payer: Cash Price |
$1,452.80
|
| Rate for Payer: Cash Price |
$1,452.80
|
| Rate for Payer: Cofinity Commercial |
$946.53
|
| Rate for Payer: Cofinity Commercial |
$880.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.31
|
| Rate for Payer: Healthscope Commercial |
$788.77
|
| Rate for Payer: Healthscope Whirlpool |
$788.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.18
|
| Rate for Payer: Meridian Medicaid |
$438.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$723.04
|
| Rate for Payer: Nomi Health Commercial |
$788.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,362.00
|
| Rate for Payer: PACE SWMI |
$657.31
|
| Rate for Payer: PHP Medicare Advantage |
$657.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,140.79
|
| Rate for Payer: Priority Health Medicare |
$657.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.79
|
| Rate for Payer: Railroad Medicare Medicare |
$657.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,292.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$657.31
|
| Rate for Payer: UHC Exchange |
$1,292.92
|
| Rate for Payer: UHC Medicaid |
$417.91
|
| Rate for Payer: UHCCP DNSP |
$657.31
|
| Rate for Payer: UHCCP Medicaid |
$417.91
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS
|
Professional
|
Both
|
$2,045.00
|
|
|
Service Code
|
HCPCS 21813
|
| Min. Negotiated Rate |
$568.50 |
| Max. Negotiated Rate |
$1,768.50 |
| Rate for Payer: Aetna Commercial |
$1,201.97
|
| Rate for Payer: Aetna Medicare |
$896.99
|
| Rate for Payer: BCBS Complete |
$596.92
|
| Rate for Payer: BCBS MAPPO |
$896.99
|
| Rate for Payer: BCN Commercial |
$1,462.07
|
| Rate for Payer: BCN Medicare Advantage |
$896.99
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cofinity Commercial |
$1,291.67
|
| Rate for Payer: Cofinity Commercial |
$1,201.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$896.99
|
| Rate for Payer: Healthscope Commercial |
$1,076.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,076.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$941.84
|
| Rate for Payer: Meridian Medicaid |
$596.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$986.69
|
| Rate for Payer: Nomi Health Commercial |
$1,076.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.75
|
| Rate for Payer: PACE SWMI |
$896.99
|
| Rate for Payer: PHP Medicare Advantage |
$896.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,562.91
|
| Rate for Payer: Priority Health Medicare |
$896.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,562.91
|
| Rate for Payer: Railroad Medicare Medicare |
$896.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,768.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$896.99
|
| Rate for Payer: UHC Exchange |
$1,768.50
|
| Rate for Payer: UHC Medicaid |
$568.50
|
| Rate for Payer: UHCCP DNSP |
$896.99
|
| Rate for Payer: UHCCP Medicaid |
$568.50
|
|
|
PR OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,288.00
|
|
|
Service Code
|
HCPCS 23585
|
| Min. Negotiated Rate |
$571.05 |
| Max. Negotiated Rate |
$2,466.00 |
| Rate for Payer: Aetna Commercial |
$1,176.81
|
| Rate for Payer: Aetna Medicare |
$878.22
|
| Rate for Payer: BCBS Complete |
$599.60
|
| Rate for Payer: BCBS MAPPO |
$878.22
|
| Rate for Payer: BCN Commercial |
$1,480.50
|
| Rate for Payer: BCN Medicare Advantage |
$878.22
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$1,264.64
|
| Rate for Payer: Cofinity Commercial |
$1,176.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.22
|
| Rate for Payer: Healthscope Commercial |
$1,053.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,053.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.13
|
| Rate for Payer: Meridian Medicaid |
$599.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.04
|
| Rate for Payer: Nomi Health Commercial |
$1,053.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.00
|
| Rate for Payer: PACE SWMI |
$878.22
|
| Rate for Payer: PHP Medicare Advantage |
$878.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,582.61
|
| Rate for Payer: Priority Health Medicare |
$878.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,582.61
|
| Rate for Payer: Railroad Medicare Medicare |
$878.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,715.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$878.22
|
| Rate for Payer: UHC Exchange |
$1,715.85
|
| Rate for Payer: UHC Medicaid |
$571.05
|
| Rate for Payer: UHCCP DNSP |
$878.22
|
| Rate for Payer: UHCCP Medicaid |
$571.05
|
|
|
PR OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 28531
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$225.52
|
| Rate for Payer: Aetna Medicare |
$168.30
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCBS MAPPO |
$168.30
|
| Rate for Payer: BCN Commercial |
$277.87
|
| Rate for Payer: BCN Medicare Advantage |
$168.30
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$225.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.30
|
| Rate for Payer: Healthscope Commercial |
$201.96
|
| Rate for Payer: Healthscope Whirlpool |
$201.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.72
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.13
|
| Rate for Payer: Nomi Health Commercial |
$201.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$168.30
|
| Rate for Payer: PHP Medicare Advantage |
$168.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$297.03
|
| Rate for Payer: Priority Health Medicare |
$168.30
|
| Rate for Payer: Priority Health Narrow Network |
$297.03
|
| Rate for Payer: Railroad Medicare Medicare |
$168.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.30
|
| Rate for Payer: UHC Exchange |
$314.77
|
| Rate for Payer: UHC Medicaid |
$111.40
|
| Rate for Payer: UHCCP DNSP |
$168.30
|
| Rate for Payer: UHCCP Medicaid |
$111.40
|
|
