|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$649.01 |
| Max. Negotiated Rate |
$1,340.95 |
| Rate for Payer: Aetna Commercial |
$869.67
|
| Rate for Payer: Aetna Medicare |
$649.01
|
| Rate for Payer: BCBS Complete |
$825.20
|
| Rate for Payer: BCBS MAPPO |
$649.01
|
| Rate for Payer: BCN Medicare Advantage |
$649.01
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cofinity Commercial |
$934.57
|
| Rate for Payer: Cofinity Commercial |
$869.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$649.01
|
| Rate for Payer: Healthscope Commercial |
$778.81
|
| Rate for Payer: Healthscope Whirlpool |
$778.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.46
|
| Rate for Payer: Nomi Health Commercial |
$778.81
|
| Rate for Payer: PACE SWMI |
$649.01
|
| Rate for Payer: PHP Medicare Advantage |
$649.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health Medicare |
$649.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$649.01
|
| Rate for Payer: UHC Medicare Advantage |
$649.01
|
| Rate for Payer: UHCCP DNSP |
$649.01
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$685.67 |
| Max. Negotiated Rate |
$1,297.40 |
| Rate for Payer: Aetna Commercial |
$918.80
|
| Rate for Payer: Aetna Medicare |
$685.67
|
| Rate for Payer: BCBS Complete |
$798.40
|
| Rate for Payer: BCBS MAPPO |
$685.67
|
| Rate for Payer: BCN Medicare Advantage |
$685.67
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$987.36
|
| Rate for Payer: Cofinity Commercial |
$918.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.67
|
| Rate for Payer: Healthscope Commercial |
$822.80
|
| Rate for Payer: Healthscope Whirlpool |
$822.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.95
|
| Rate for Payer: Nomi Health Commercial |
$822.80
|
| Rate for Payer: PACE SWMI |
$685.67
|
| Rate for Payer: PHP Medicare Advantage |
$685.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health Medicare |
$685.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.67
|
| Rate for Payer: UHC Medicare Advantage |
$685.67
|
| Rate for Payer: UHCCP DNSP |
$685.67
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,142.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$1,005.36 |
| Max. Negotiated Rate |
$2,042.30 |
| Rate for Payer: Aetna Commercial |
$1,347.18
|
| Rate for Payer: Aetna Medicare |
$1,005.36
|
| Rate for Payer: BCBS Complete |
$1,256.80
|
| Rate for Payer: BCBS MAPPO |
$1,005.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.36
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cofinity Commercial |
$1,447.72
|
| Rate for Payer: Cofinity Commercial |
$1,347.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.36
|
| Rate for Payer: Healthscope Commercial |
$1,206.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.63
|
| Rate for Payer: Nomi Health Commercial |
$1,206.43
|
| Rate for Payer: PACE SWMI |
$1,005.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,042.30
|
| Rate for Payer: Priority Health Medicare |
$1,005.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.36
|
| Rate for Payer: UHCCP DNSP |
$1,005.36
|
|
|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$624.71 |
| Max. Negotiated Rate |
$1,123.20 |
| Rate for Payer: Aetna Commercial |
$837.11
|
| Rate for Payer: Aetna Medicare |
$624.71
|
| Rate for Payer: BCBS Complete |
$691.20
|
| Rate for Payer: BCBS MAPPO |
$624.71
|
| Rate for Payer: BCN Medicare Advantage |
$624.71
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$899.58
|
| Rate for Payer: Cofinity Commercial |
$837.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.71
|
| Rate for Payer: Healthscope Commercial |
$749.65
|
| Rate for Payer: Healthscope Whirlpool |
$749.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.95
|
| Rate for Payer: Nomi Health Commercial |
$749.65
|
| Rate for Payer: PACE SWMI |
$624.71
|
| Rate for Payer: PHP Medicare Advantage |
$624.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.20
|
| Rate for Payer: Priority Health Medicare |
$624.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.71
|
| Rate for Payer: UHC Medicare Advantage |
$624.71
|
| Rate for Payer: UHCCP DNSP |
$624.71
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$718.00 |
| Max. Negotiated Rate |
$1,166.75 |
| Rate for Payer: Aetna Commercial |
$1,058.81
|
| Rate for Payer: Aetna Medicare |
$790.16
|
| Rate for Payer: BCBS Complete |
$718.00
|
| Rate for Payer: BCBS MAPPO |
$790.16
|
| Rate for Payer: BCN Medicare Advantage |
$790.16
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,137.83
|
| Rate for Payer: Cofinity Commercial |
$1,058.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.16
|
| Rate for Payer: Healthscope Commercial |
$948.19
|
| Rate for Payer: Healthscope Whirlpool |
$948.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.67
|
| Rate for Payer: Nomi Health Commercial |
$948.19
|
| Rate for Payer: PACE SWMI |
$790.16
|
| Rate for Payer: PHP Medicare Advantage |
$790.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.75
|
| Rate for Payer: Priority Health Medicare |
$790.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$790.16
|
| Rate for Payer: UHC Medicare Advantage |
$790.16
|
| Rate for Payer: UHCCP DNSP |
$790.16
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$631.56 |
| Max. Negotiated Rate |
$1,522.95 |
| Rate for Payer: Aetna Commercial |
$846.29
|
| Rate for Payer: Aetna Medicare |
$631.56
|
| Rate for Payer: BCBS Complete |
$937.20
|
| Rate for Payer: BCBS MAPPO |
$631.56
|
| Rate for Payer: BCN Medicare Advantage |
$631.56
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$909.45
|
| Rate for Payer: Cofinity Commercial |
$846.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.56
|
| Rate for Payer: Healthscope Commercial |
$757.87
|
| Rate for Payer: Healthscope Whirlpool |
$757.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.14
|
| Rate for Payer: Nomi Health Commercial |
$757.87
|
| Rate for Payer: PACE SWMI |
$631.56
|
| Rate for Payer: PHP Medicare Advantage |
$631.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health Medicare |
$631.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$631.56
|
| Rate for Payer: UHC Medicare Advantage |
$631.56
|
| Rate for Payer: UHCCP DNSP |
$631.56
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
OP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,522.95 |
| Max. Negotiated Rate |
$10,799.07 |
| Rate for Payer: Aetna Commercial |
$2,108.70
|
| Rate for Payer: Aetna Medicare |
$6,967.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: ASR ASR |
$2,272.71
|
| Rate for Payer: ASR Commercial |
$2,272.71
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.68
|
| Rate for Payer: BCN Commercial |
$1,816.53
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,202.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,343.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,272.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,967.14
|
| Rate for Payer: Mclaren Commercial |
$2,108.70
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: Nomi Health Commercial |
$1,921.26
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$7,663.85
|
| Rate for Payer: PHP Medicaid |
$3,734.39
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.94
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,642.44
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,061.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$10,799.07
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP DNSP |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$631.56 |
| Max. Negotiated Rate |
$1,522.95 |
| Rate for Payer: Aetna Commercial |
$846.29
|
| Rate for Payer: Aetna Medicare |
$631.56
|
| Rate for Payer: BCBS Complete |
$937.20
|
| Rate for Payer: BCBS MAPPO |
$631.56
|
| Rate for Payer: BCN Medicare Advantage |
$631.56
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$909.45
|
| Rate for Payer: Cofinity Commercial |
$846.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.56
|
| Rate for Payer: Healthscope Commercial |
$757.87
|
| Rate for Payer: Healthscope Whirlpool |
$757.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.14
|
| Rate for Payer: Nomi Health Commercial |
$757.87
|
| Rate for Payer: PACE SWMI |
$631.56
|
| Rate for Payer: PHP Medicare Advantage |
$631.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health Medicare |
$631.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$631.56
|
| Rate for Payer: UHC Medicare Advantage |
$631.56
|
| Rate for Payer: UHCCP DNSP |
$631.56
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
IP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,522.95 |
| Max. Negotiated Rate |
$2,343.00 |
| Rate for Payer: Aetna Commercial |
$2,108.70
|
| Rate for Payer: ASR ASR |
$2,272.71
|
| Rate for Payer: ASR Commercial |
$2,272.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,909.31
|
| Rate for Payer: BCN Commercial |
$1,816.53
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,202.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Healthscope Commercial |
$2,343.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,272.71
|
| Rate for Payer: Mclaren Commercial |
$2,108.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: Nomi Health Commercial |
$1,921.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,061.84
|
|
|
PR OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$605.31 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$811.12
|
| Rate for Payer: Aetna Medicare |
$605.31
|
| Rate for Payer: BCBS Complete |
$777.60
|
| Rate for Payer: BCBS MAPPO |
$605.31
|
| Rate for Payer: BCN Medicare Advantage |
$605.31
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$871.65
|
| Rate for Payer: Cofinity Commercial |
$811.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.31
|
| Rate for Payer: Healthscope Commercial |
$726.37
|
| Rate for Payer: Healthscope Whirlpool |
$726.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.58
|
| Rate for Payer: Nomi Health Commercial |
$726.37
|
| Rate for Payer: PACE SWMI |
$605.31
|
| Rate for Payer: PHP Medicare Advantage |
$605.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health Medicare |
$605.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.31
|
| Rate for Payer: UHC Medicare Advantage |
$605.31
|
| Rate for Payer: UHCCP DNSP |
$605.31
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,667.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$604.86 |
| Max. Negotiated Rate |
$1,083.55 |
| Rate for Payer: Aetna Commercial |
$810.51
|
| Rate for Payer: Aetna Medicare |
$604.86
|
| Rate for Payer: BCBS Complete |
$666.80
|
| Rate for Payer: BCBS MAPPO |
$604.86
|
| Rate for Payer: BCN Medicare Advantage |
$604.86
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cofinity Commercial |
$871.00
|
| Rate for Payer: Cofinity Commercial |
$810.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.86
|
| Rate for Payer: Healthscope Commercial |
$725.83
|
| Rate for Payer: Healthscope Whirlpool |
$725.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.10
|
| Rate for Payer: Nomi Health Commercial |
$725.83
|
| Rate for Payer: PACE SWMI |
$604.86
|
| Rate for Payer: PHP Medicare Advantage |
$604.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.55
|
| Rate for Payer: Priority Health Medicare |
$604.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.86
|
| Rate for Payer: UHC Medicare Advantage |
$604.86
|
| Rate for Payer: UHCCP DNSP |
$604.86
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 1-2 RIBS
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 0245T
|
| Min. Negotiated Rate |
$1,339.20 |
| Max. Negotiated Rate |
$2,176.20 |
| Rate for Payer: Aetna Medicare |
$1,674.00
|
| Rate for Payer: BCBS Complete |
$1,339.20
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS
|
Professional
|
Both
|
$3,689.00
|
|
|
Service Code
|
HCPCS 0246T
|
| Min. Negotiated Rate |
$1,475.60 |
| Max. Negotiated Rate |
$2,397.85 |
| Rate for Payer: Aetna Medicare |
$1,844.50
|
| Rate for Payer: BCBS Complete |
$1,475.60
|
| Rate for Payer: Cash Price |
$2,951.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.85
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS
|
Professional
|
Both
|
$4,080.00
|
|
|
Service Code
|
HCPCS 0247T
|
| Min. Negotiated Rate |
$1,632.00 |
| Max. Negotiated Rate |
$2,652.00 |
| Rate for Payer: Aetna Medicare |
$2,040.00
|
| Rate for Payer: BCBS Complete |
$1,632.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS
|
Professional
|
Both
|
$4,709.00
|
|
|
Service Code
|
HCPCS 0248T
|
| Min. Negotiated Rate |
$1,883.60 |
| Max. Negotiated Rate |
$3,060.85 |
| Rate for Payer: Aetna Medicare |
$2,354.50
|
| Rate for Payer: BCBS Complete |
$1,883.60
|
| Rate for Payer: Cash Price |
$3,767.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,060.85
|
|
|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,743.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$552.64 |
| Max. Negotiated Rate |
$1,782.95 |
| Rate for Payer: Aetna Commercial |
$740.54
|
| Rate for Payer: Aetna Medicare |
$552.64
|
| Rate for Payer: BCBS Complete |
$1,097.20
|
| Rate for Payer: BCBS MAPPO |
$552.64
|
| Rate for Payer: BCN Medicare Advantage |
$552.64
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cofinity Commercial |
$795.80
|
| Rate for Payer: Cofinity Commercial |
$740.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.64
|
| Rate for Payer: Healthscope Commercial |
$663.17
|
| Rate for Payer: Healthscope Whirlpool |
$663.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.27
|
| Rate for Payer: Nomi Health Commercial |
$663.17
|
| Rate for Payer: PACE SWMI |
$552.64
|
| Rate for Payer: PHP Medicare Advantage |
$552.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,782.95
|
| Rate for Payer: Priority Health Medicare |
$552.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.64
|
| Rate for Payer: UHC Medicare Advantage |
$552.64
|
| Rate for Payer: UHCCP DNSP |
$552.64
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$690.17 |
| Max. Negotiated Rate |
$1,675.05 |
| Rate for Payer: Aetna Commercial |
$924.83
|
| Rate for Payer: Aetna Medicare |
$690.17
|
| Rate for Payer: BCBS Complete |
$1,030.80
|
| Rate for Payer: BCBS MAPPO |
$690.17
|
| Rate for Payer: BCN Medicare Advantage |
$690.17
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cofinity Commercial |
$993.84
|
| Rate for Payer: Cofinity Commercial |
$924.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.17
|
| Rate for Payer: Healthscope Commercial |
$828.20
|
| Rate for Payer: Healthscope Whirlpool |
$828.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$724.68
|
| Rate for Payer: Nomi Health Commercial |
$828.20
|
| Rate for Payer: PACE SWMI |
$690.17
|
| Rate for Payer: PHP Medicare Advantage |
$690.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health Medicare |
$690.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$690.17
|
| Rate for Payer: UHC Medicare Advantage |
$690.17
|
| Rate for Payer: UHCCP DNSP |
$690.17
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,720.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$566.24 |
| Max. Negotiated Rate |
$1,768.00 |
| Rate for Payer: Aetna Commercial |
$758.76
|
| Rate for Payer: Aetna Medicare |
$566.24
|
| Rate for Payer: BCBS Complete |
$1,088.00
|
| Rate for Payer: BCBS MAPPO |
$566.24
|
| Rate for Payer: BCN Medicare Advantage |
$566.24
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cofinity Commercial |
$815.39
|
| Rate for Payer: Cofinity Commercial |
$758.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.24
|
| Rate for Payer: Healthscope Commercial |
$679.49
|
| Rate for Payer: Healthscope Whirlpool |
$679.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.55
|
| Rate for Payer: Nomi Health Commercial |
$679.49
|
| Rate for Payer: PACE SWMI |
$566.24
|
| Rate for Payer: PHP Medicare Advantage |
$566.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.00
|
| Rate for Payer: Priority Health Medicare |
$566.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.24
|
| Rate for Payer: UHC Medicare Advantage |
$566.24
|
| Rate for Payer: UHCCP DNSP |
$566.24
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$716.55 |
| Max. Negotiated Rate |
$1,644.50 |
| Rate for Payer: Aetna Commercial |
$960.18
|
| Rate for Payer: Aetna Medicare |
$716.55
|
| Rate for Payer: BCBS Complete |
$1,012.00
|
| Rate for Payer: BCBS MAPPO |
$716.55
|
| Rate for Payer: BCN Medicare Advantage |
$716.55
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$960.18
|
| Rate for Payer: Cofinity Commercial |
$1,031.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.55
|
| Rate for Payer: Healthscope Commercial |
$859.86
|
| Rate for Payer: Healthscope Whirlpool |
$859.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.38
|
| Rate for Payer: Nomi Health Commercial |
$859.86
|
| Rate for Payer: PACE SWMI |
$716.55
|
| Rate for Payer: PHP Medicare Advantage |
$716.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health Medicare |
$716.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.55
|
| Rate for Payer: UHC Medicare Advantage |
$716.55
|
| Rate for Payer: UHCCP DNSP |
$716.55
|
|
|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$554.35 |
| Max. Negotiated Rate |
$980.20 |
| Rate for Payer: Aetna Commercial |
$742.83
|
| Rate for Payer: Aetna Medicare |
$554.35
|
| Rate for Payer: BCBS Complete |
$603.20
|
| Rate for Payer: BCBS MAPPO |
$554.35
|
| Rate for Payer: BCN Medicare Advantage |
$554.35
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cofinity Commercial |
$798.26
|
| Rate for Payer: Cofinity Commercial |
$742.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.35
|
| Rate for Payer: Healthscope Commercial |
$665.22
|
| Rate for Payer: Healthscope Whirlpool |
$665.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.07
|
| Rate for Payer: Nomi Health Commercial |
$665.22
|
| Rate for Payer: PACE SWMI |
$554.35
|
| Rate for Payer: PHP Medicare Advantage |
$554.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health Medicare |
$554.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.35
|
| Rate for Payer: UHC Medicare Advantage |
$554.35
|
| Rate for Payer: UHCCP DNSP |
$554.35
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$695.80 |
| Max. Negotiated Rate |
$1,315.60 |
| Rate for Payer: Aetna Commercial |
$932.37
|
| Rate for Payer: Aetna Medicare |
$695.80
|
| Rate for Payer: BCBS Complete |
$809.60
|
| Rate for Payer: BCBS MAPPO |
$695.80
|
| Rate for Payer: BCN Medicare Advantage |
$695.80
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cofinity Commercial |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,001.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.80
|
| Rate for Payer: Healthscope Commercial |
$834.96
|
| Rate for Payer: Healthscope Whirlpool |
$834.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.59
|
| Rate for Payer: Nomi Health Commercial |
$834.96
|
| Rate for Payer: PACE SWMI |
$695.80
|
| Rate for Payer: PHP Medicare Advantage |
$695.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.60
|
| Rate for Payer: Priority Health Medicare |
$695.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.80
|
| Rate for Payer: UHC Medicare Advantage |
$695.80
|
| Rate for Payer: UHCCP DNSP |
$695.80
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,255.00
|
|
|
Service Code
|
HCPCS 26685
|
| Min. Negotiated Rate |
$557.66 |
| Max. Negotiated Rate |
$1,465.75 |
| Rate for Payer: Aetna Commercial |
$747.26
|
| Rate for Payer: Aetna Medicare |
$557.66
|
| Rate for Payer: BCBS Complete |
$902.00
|
| Rate for Payer: BCBS MAPPO |
$557.66
|
| Rate for Payer: BCN Medicare Advantage |
$557.66
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cofinity Commercial |
$803.03
|
| Rate for Payer: Cofinity Commercial |
$747.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.66
|
| Rate for Payer: Healthscope Commercial |
$669.19
|
| Rate for Payer: Healthscope Whirlpool |
$669.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.54
|
| Rate for Payer: Nomi Health Commercial |
$669.19
|
| Rate for Payer: PACE SWMI |
$557.66
|
| Rate for Payer: PHP Medicare Advantage |
$557.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.75
|
| Rate for Payer: Priority Health Medicare |
$557.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.66
|
| Rate for Payer: UHC Medicare Advantage |
$557.66
|
| Rate for Payer: UHCCP DNSP |
$557.66
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,888.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$606.14 |
| Max. Negotiated Rate |
$1,877.20 |
| Rate for Payer: Aetna Commercial |
$812.23
|
| Rate for Payer: Aetna Medicare |
$606.14
|
| Rate for Payer: BCBS Complete |
$1,155.20
|
| Rate for Payer: BCBS MAPPO |
$606.14
|
| Rate for Payer: BCN Medicare Advantage |
$606.14
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cofinity Commercial |
$872.84
|
| Rate for Payer: Cofinity Commercial |
$812.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.14
|
| Rate for Payer: Healthscope Commercial |
$727.37
|
| Rate for Payer: Healthscope Whirlpool |
$727.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.45
|
| Rate for Payer: Nomi Health Commercial |
$727.37
|
| Rate for Payer: PACE SWMI |
$606.14
|
| Rate for Payer: PHP Medicare Advantage |
$606.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,877.20
|
| Rate for Payer: Priority Health Medicare |
$606.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.14
|
| Rate for Payer: UHC Medicare Advantage |
$606.14
|
| Rate for Payer: UHCCP DNSP |
$606.14
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,455.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$695.61 |
| Max. Negotiated Rate |
$1,595.75 |
| Rate for Payer: Aetna Commercial |
$932.12
|
| Rate for Payer: Aetna Medicare |
$695.61
|
| Rate for Payer: BCBS Complete |
$982.00
|
| Rate for Payer: BCBS MAPPO |
$695.61
|
| Rate for Payer: BCN Medicare Advantage |
$695.61
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cofinity Commercial |
$932.12
|
| Rate for Payer: Cofinity Commercial |
$1,001.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.61
|
| Rate for Payer: Healthscope Commercial |
$834.73
|
| Rate for Payer: Healthscope Whirlpool |
$834.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.39
|
| Rate for Payer: Nomi Health Commercial |
$834.73
|
| Rate for Payer: PACE SWMI |
$695.61
|
| Rate for Payer: PHP Medicare Advantage |
$695.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,595.75
|
| Rate for Payer: Priority Health Medicare |
$695.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.61
|
| Rate for Payer: UHC Medicare Advantage |
$695.61
|
| Rate for Payer: UHCCP DNSP |
$695.61
|
|
|
PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 21365
|
| Min. Negotiated Rate |
$807.20 |
| Max. Negotiated Rate |
$1,490.82 |
| Rate for Payer: Aetna Commercial |
$1,387.29
|
| Rate for Payer: Aetna Medicare |
$1,035.29
|
| Rate for Payer: BCBS Complete |
$807.20
|
| Rate for Payer: BCBS MAPPO |
$1,035.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.29
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cofinity Commercial |
$1,490.82
|
| Rate for Payer: Cofinity Commercial |
$1,387.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.29
|
| Rate for Payer: Healthscope Commercial |
$1,242.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,242.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,087.05
|
| Rate for Payer: Nomi Health Commercial |
$1,242.35
|
| Rate for Payer: PACE SWMI |
$1,035.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.70
|
| Rate for Payer: Priority Health Medicare |
$1,035.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,035.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,035.29
|
| Rate for Payer: UHCCP DNSP |
$1,035.29
|
|
