|
PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$3,475.00
|
|
|
Service Code
|
HCPCS 21344
|
| Min. Negotiated Rate |
$1,324.03 |
| Max. Negotiated Rate |
$2,258.75 |
| Rate for Payer: Aetna Commercial |
$1,774.20
|
| Rate for Payer: Aetna Medicare |
$1,324.03
|
| Rate for Payer: BCBS Complete |
$1,390.00
|
| Rate for Payer: BCBS MAPPO |
$1,324.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.03
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cofinity Commercial |
$1,906.60
|
| Rate for Payer: Cofinity Commercial |
$1,774.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.03
|
| Rate for Payer: Healthscope Commercial |
$1,588.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,588.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,390.23
|
| Rate for Payer: Nomi Health Commercial |
$1,588.84
|
| Rate for Payer: PACE SWMI |
$1,324.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,258.75
|
| Rate for Payer: Priority Health Medicare |
$1,324.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,324.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,324.03
|
| Rate for Payer: UHCCP DNSP |
$1,324.03
|
|
|
PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR
|
Professional
|
Both
|
$3,013.00
|
|
|
Service Code
|
HCPCS 21433
|
| Min. Negotiated Rate |
$1,205.20 |
| Max. Negotiated Rate |
$2,388.36 |
| Rate for Payer: Aetna Commercial |
$2,222.50
|
| Rate for Payer: Aetna Medicare |
$1,658.58
|
| Rate for Payer: BCBS Complete |
$1,205.20
|
| Rate for Payer: BCBS MAPPO |
$1,658.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,658.58
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cofinity Commercial |
$2,388.36
|
| Rate for Payer: Cofinity Commercial |
$2,222.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,658.58
|
| Rate for Payer: Healthscope Commercial |
$1,990.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,990.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,741.51
|
| Rate for Payer: Nomi Health Commercial |
$1,990.30
|
| Rate for Payer: PACE SWMI |
$1,658.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,658.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,958.45
|
| Rate for Payer: Priority Health Medicare |
$1,658.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,658.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,658.58
|
| Rate for Payer: UHCCP DNSP |
$1,658.58
|
|
|
PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$2,453.00
|
|
|
Service Code
|
HCPCS 21343
|
| Min. Negotiated Rate |
$981.20 |
| Max. Negotiated Rate |
$1,594.45 |
| Rate for Payer: Aetna Commercial |
$1,374.30
|
| Rate for Payer: Aetna Medicare |
$1,025.60
|
| Rate for Payer: BCBS Complete |
$981.20
|
| Rate for Payer: BCBS MAPPO |
$1,025.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cofinity Commercial |
$1,476.86
|
| Rate for Payer: Cofinity Commercial |
$1,374.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.60
|
| Rate for Payer: Healthscope Commercial |
$1,230.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,076.88
|
| Rate for Payer: Nomi Health Commercial |
$1,230.72
|
| Rate for Payer: PACE SWMI |
$1,025.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.45
|
| Rate for Payer: Priority Health Medicare |
$1,025.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,025.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.60
|
| Rate for Payer: UHCCP DNSP |
$1,025.60
|
|
|
PR OPEN TX DEPRESSED MALAR FRACTURE
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 21360
|
| Min. Negotiated Rate |
$414.80 |
| Max. Negotiated Rate |
$720.16 |
| Rate for Payer: Aetna Commercial |
$670.15
|
| Rate for Payer: Aetna Medicare |
$500.11
|
| Rate for Payer: BCBS Complete |
$414.80
|
| Rate for Payer: BCBS MAPPO |
$500.11
|
| Rate for Payer: BCN Medicare Advantage |
$500.11
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cofinity Commercial |
$720.16
|
| Rate for Payer: Cofinity Commercial |
$670.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.11
|
| Rate for Payer: Healthscope Commercial |
$600.13
|
| Rate for Payer: Healthscope Whirlpool |
$600.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.12
|
| Rate for Payer: Nomi Health Commercial |
$600.13
|
| Rate for Payer: PACE SWMI |
$500.11
|
| Rate for Payer: PHP Medicare Advantage |
$500.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health Medicare |
$500.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.11
|
| Rate for Payer: UHC Medicare Advantage |
$500.11
|
| Rate for Payer: UHCCP DNSP |
$500.11
|
|
|
PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
HCPCS 21356
|
| Min. Negotiated Rate |
$329.60 |
| Max. Negotiated Rate |
$551.85 |
| Rate for Payer: Aetna Commercial |
$513.53
|
| Rate for Payer: Aetna Medicare |
$383.23
|
| Rate for Payer: BCBS Complete |
$329.60
|
| Rate for Payer: BCBS MAPPO |
$383.23
|
| Rate for Payer: BCN Medicare Advantage |
$383.23
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cofinity Commercial |
$551.85
|
| Rate for Payer: Cofinity Commercial |
$513.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.23
|
| Rate for Payer: Healthscope Commercial |
$459.88
|
| Rate for Payer: Healthscope Whirlpool |
$459.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.39
|
| Rate for Payer: Nomi Health Commercial |
$459.88
|
| Rate for Payer: PACE SWMI |
$383.23
|
| Rate for Payer: PHP Medicare Advantage |
$383.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$535.60
|
| Rate for Payer: Priority Health Medicare |
$383.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.23
|
| Rate for Payer: UHC Medicare Advantage |
$383.23
|
| Rate for Payer: UHCCP DNSP |
$383.23
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Min. Negotiated Rate |
$619.39 |
| Max. Negotiated Rate |
$1,606.15 |
| Rate for Payer: Aetna Commercial |
$829.98
|
| Rate for Payer: Aetna Medicare |
$619.39
|
| Rate for Payer: BCBS Complete |
$988.40
|
| Rate for Payer: BCBS MAPPO |
$619.39
|
| Rate for Payer: BCN Medicare Advantage |
$619.39
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$891.92
|
| Rate for Payer: Cofinity Commercial |
$829.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.39
|
| Rate for Payer: Healthscope Commercial |
$743.27
|
| Rate for Payer: Healthscope Whirlpool |
$743.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.36
|
| Rate for Payer: Nomi Health Commercial |
$743.27
|
| Rate for Payer: PACE SWMI |
$619.39
|
| Rate for Payer: PHP Medicare Advantage |
$619.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health Medicare |
$619.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.39
|
| Rate for Payer: UHC Medicare Advantage |
$619.39
|
| Rate for Payer: UHCCP DNSP |
$619.39
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
IP
|
$2,471.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$1,606.15 |
| Max. Negotiated Rate |
$2,471.00 |
| Rate for Payer: Aetna Commercial |
$2,223.90
|
| Rate for Payer: ASR ASR |
$2,396.87
|
| Rate for Payer: ASR Commercial |
$2,396.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,013.62
|
| Rate for Payer: BCN Commercial |
$1,915.77
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$2,322.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.80
|
| Rate for Payer: Healthscope Commercial |
$2,471.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,396.87
|
| Rate for Payer: Mclaren Commercial |
$2,223.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,100.35
|
| Rate for Payer: Nomi Health Commercial |
$2,026.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,174.48
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$619.39 |
| Max. Negotiated Rate |
$1,606.15 |
| Rate for Payer: Aetna Commercial |
$829.98
|
| Rate for Payer: Aetna Medicare |
$619.39
|
| Rate for Payer: BCBS Complete |
$988.40
|
| Rate for Payer: BCBS MAPPO |
$619.39
|
| Rate for Payer: BCN Medicare Advantage |
$619.39
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$891.92
|
| Rate for Payer: Cofinity Commercial |
$829.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.39
|
| Rate for Payer: Healthscope Commercial |
$743.27
|
| Rate for Payer: Healthscope Whirlpool |
$743.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.36
|
| Rate for Payer: Nomi Health Commercial |
$743.27
|
| Rate for Payer: PACE SWMI |
$619.39
|
| Rate for Payer: PHP Medicare Advantage |
$619.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health Medicare |
$619.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.39
|
| Rate for Payer: UHC Medicare Advantage |
$619.39
|
| Rate for Payer: UHCCP DNSP |
$619.39
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
OP
|
$2,471.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$1,606.15 |
| Max. Negotiated Rate |
$10,799.07 |
| Rate for Payer: Aetna Commercial |
$2,223.90
|
| 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 |
$2,396.87
|
| Rate for Payer: ASR Commercial |
$2,396.87
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.50
|
| Rate for Payer: BCN Commercial |
$1,915.77
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$2,322.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,471.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,396.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,967.14
|
| Rate for Payer: Mclaren Commercial |
$2,223.90
|
| 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 |
$2,100.35
|
| Rate for Payer: Nomi Health Commercial |
$2,026.22
|
| 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 |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,165.09
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,732.17
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,174.48
|
| 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 TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 26765
|
| Min. Negotiated Rate |
$350.80 |
| Max. Negotiated Rate |
$700.65 |
| Rate for Payer: Aetna Commercial |
$651.99
|
| Rate for Payer: Aetna Medicare |
$486.56
|
| Rate for Payer: BCBS Complete |
$350.80
|
| Rate for Payer: BCBS MAPPO |
$486.56
|
| Rate for Payer: BCN Medicare Advantage |
$486.56
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$700.65
|
| Rate for Payer: Cofinity Commercial |
$651.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.56
|
| Rate for Payer: Healthscope Commercial |
$583.87
|
| Rate for Payer: Healthscope Whirlpool |
$583.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.89
|
| Rate for Payer: Nomi Health Commercial |
$583.87
|
| Rate for Payer: PACE SWMI |
$486.56
|
| Rate for Payer: PHP Medicare Advantage |
$486.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health Medicare |
$486.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.56
|
| Rate for Payer: UHC Medicare Advantage |
$486.56
|
| Rate for Payer: UHCCP DNSP |
$486.56
|
|
|
PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 25676
|
| Min. Negotiated Rate |
$609.64 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Aetna Commercial |
$816.92
|
| Rate for Payer: Aetna Medicare |
$609.64
|
| Rate for Payer: BCBS Complete |
$714.00
|
| Rate for Payer: BCBS MAPPO |
$609.64
|
| Rate for Payer: BCN Medicare Advantage |
$609.64
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$877.88
|
| Rate for Payer: Cofinity Commercial |
$816.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.64
|
| Rate for Payer: Healthscope Commercial |
$731.57
|
| Rate for Payer: Healthscope Whirlpool |
$731.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.12
|
| Rate for Payer: Nomi Health Commercial |
$731.57
|
| Rate for Payer: PACE SWMI |
$609.64
|
| Rate for Payer: PHP Medicare Advantage |
$609.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health Medicare |
$609.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$609.64
|
| Rate for Payer: UHC Medicare Advantage |
$609.64
|
| Rate for Payer: UHCCP DNSP |
$609.64
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
OP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$1,496.30 |
| Max. Negotiated Rate |
$10,799.07 |
| Rate for Payer: Aetna Commercial |
$2,071.80
|
| 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 |
$2,232.94
|
| Rate for Payer: ASR Commercial |
$2,232.94
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,885.11
|
| Rate for Payer: BCN Commercial |
$1,784.74
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$2,163.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,841.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,302.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,232.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,967.14
|
| Rate for Payer: Mclaren Commercial |
$2,071.80
|
| 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 |
$1,956.70
|
| Rate for Payer: Nomi Health Commercial |
$1,887.64
|
| 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 |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,017.01
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,613.70
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,025.76
|
| 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 TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Min. Negotiated Rate |
$672.53 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$901.19
|
| Rate for Payer: Aetna Medicare |
$672.53
|
| Rate for Payer: BCBS Complete |
$920.80
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| Rate for Payer: BCN Medicare Advantage |
$672.53
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$968.44
|
| Rate for Payer: Cofinity Commercial |
$901.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.53
|
| Rate for Payer: Healthscope Commercial |
$807.04
|
| Rate for Payer: Healthscope Whirlpool |
$807.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| Rate for Payer: Nomi Health Commercial |
$807.04
|
| Rate for Payer: PACE SWMI |
$672.53
|
| Rate for Payer: PHP Medicare Advantage |
$672.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health Medicare |
$672.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.53
|
| Rate for Payer: UHC Medicare Advantage |
$672.53
|
| Rate for Payer: UHCCP DNSP |
$672.53
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Facility
|
IP
|
$2,302.00
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$1,496.30 |
| Max. Negotiated Rate |
$2,302.00 |
| Rate for Payer: Aetna Commercial |
$2,071.80
|
| Rate for Payer: ASR ASR |
$2,232.94
|
| Rate for Payer: ASR Commercial |
$2,232.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.90
|
| Rate for Payer: BCN Commercial |
$1,784.74
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$2,163.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,841.60
|
| Rate for Payer: Healthscope Commercial |
$2,302.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,232.94
|
| Rate for Payer: Mclaren Commercial |
$2,071.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,956.70
|
| Rate for Payer: Nomi Health Commercial |
$1,887.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,025.76
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
27829
|
| Min. Negotiated Rate |
$672.53 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$901.19
|
| Rate for Payer: Aetna Medicare |
$672.53
|
| Rate for Payer: BCBS Complete |
$920.80
|
| Rate for Payer: BCBS MAPPO |
$672.53
|
| Rate for Payer: BCN Medicare Advantage |
$672.53
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$968.44
|
| Rate for Payer: Cofinity Commercial |
$901.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.53
|
| Rate for Payer: Healthscope Commercial |
$807.04
|
| Rate for Payer: Healthscope Whirlpool |
$807.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.16
|
| Rate for Payer: Nomi Health Commercial |
$807.04
|
| Rate for Payer: PACE SWMI |
$672.53
|
| Rate for Payer: PHP Medicare Advantage |
$672.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health Medicare |
$672.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.53
|
| Rate for Payer: UHC Medicare Advantage |
$672.53
|
| Rate for Payer: UHCCP DNSP |
$672.53
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$3,921.00
|
|
|
Service Code
|
HCPCS 27514
|
| Min. Negotiated Rate |
$931.19 |
| Max. Negotiated Rate |
$2,548.65 |
| Rate for Payer: Aetna Commercial |
$1,247.79
|
| Rate for Payer: Aetna Medicare |
$931.19
|
| Rate for Payer: BCBS Complete |
$1,568.40
|
| Rate for Payer: BCBS MAPPO |
$931.19
|
| Rate for Payer: BCN Medicare Advantage |
$931.19
|
| Rate for Payer: Cash Price |
$3,136.80
|
| Rate for Payer: Cash Price |
$3,136.80
|
| Rate for Payer: Cofinity Commercial |
$1,340.91
|
| Rate for Payer: Cofinity Commercial |
$1,247.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.19
|
| Rate for Payer: Healthscope Commercial |
$1,117.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.75
|
| Rate for Payer: Nomi Health Commercial |
$1,117.43
|
| Rate for Payer: PACE SWMI |
$931.19
|
| Rate for Payer: PHP Medicare Advantage |
$931.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.65
|
| Rate for Payer: Priority Health Medicare |
$931.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.19
|
| Rate for Payer: UHC Medicare Advantage |
$931.19
|
| Rate for Payer: UHCCP DNSP |
$931.19
|
|
|
PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD
|
Professional
|
Both
|
$3,919.00
|
|
|
Service Code
|
HCPCS 27269
|
| Min. Negotiated Rate |
$1,195.96 |
| Max. Negotiated Rate |
$2,547.35 |
| Rate for Payer: Aetna Commercial |
$1,602.59
|
| Rate for Payer: Aetna Medicare |
$1,195.96
|
| Rate for Payer: BCBS Complete |
$1,567.60
|
| Rate for Payer: BCBS MAPPO |
$1,195.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.96
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cash Price |
$3,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,722.18
|
| Rate for Payer: Cofinity Commercial |
$1,602.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.96
|
| Rate for Payer: Healthscope Commercial |
$1,435.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,435.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,255.76
|
| Rate for Payer: Nomi Health Commercial |
$1,435.15
|
| Rate for Payer: PACE SWMI |
$1,195.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.35
|
| Rate for Payer: Priority Health Medicare |
$1,195.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,195.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,195.96
|
| Rate for Payer: UHCCP DNSP |
$1,195.96
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,848.00
|
|
|
Service Code
|
HCPCS 27511
|
| Min. Negotiated Rate |
$958.39 |
| Max. Negotiated Rate |
$2,501.20 |
| Rate for Payer: Aetna Commercial |
$1,284.24
|
| Rate for Payer: Aetna Medicare |
$958.39
|
| Rate for Payer: BCBS Complete |
$1,539.20
|
| Rate for Payer: BCBS MAPPO |
$958.39
|
| Rate for Payer: BCN Medicare Advantage |
$958.39
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cash Price |
$3,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,380.08
|
| Rate for Payer: Cofinity Commercial |
$1,284.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.39
|
| Rate for Payer: Healthscope Commercial |
$1,150.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,150.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.31
|
| Rate for Payer: Nomi Health Commercial |
$1,150.07
|
| Rate for Payer: PACE SWMI |
$958.39
|
| Rate for Payer: PHP Medicare Advantage |
$958.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,501.20
|
| Rate for Payer: Priority Health Medicare |
$958.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.39
|
| Rate for Payer: UHC Medicare Advantage |
$958.39
|
| Rate for Payer: UHCCP DNSP |
$958.39
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$4,397.00
|
|
|
Service Code
|
HCPCS 27513
|
| Min. Negotiated Rate |
$1,188.41 |
| Max. Negotiated Rate |
$2,858.05 |
| Rate for Payer: Aetna Commercial |
$1,592.47
|
| Rate for Payer: Aetna Medicare |
$1,188.41
|
| Rate for Payer: BCBS Complete |
$1,758.80
|
| Rate for Payer: BCBS MAPPO |
$1,188.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,188.41
|
| Rate for Payer: Cash Price |
$3,517.60
|
| Rate for Payer: Cash Price |
$3,517.60
|
| Rate for Payer: Cofinity Commercial |
$1,711.31
|
| Rate for Payer: Cofinity Commercial |
$1,592.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,188.41
|
| Rate for Payer: Healthscope Commercial |
$1,426.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.83
|
| Rate for Payer: Nomi Health Commercial |
$1,426.09
|
| Rate for Payer: PACE SWMI |
$1,188.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,188.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.05
|
| Rate for Payer: Priority Health Medicare |
$1,188.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,188.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,188.41
|
| Rate for Payer: UHCCP DNSP |
$1,188.41
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 28505
|
| Min. Negotiated Rate |
$475.10 |
| Max. Negotiated Rate |
$933.40 |
| Rate for Payer: Aetna Commercial |
$636.63
|
| Rate for Payer: Aetna Medicare |
$475.10
|
| Rate for Payer: BCBS Complete |
$574.40
|
| Rate for Payer: BCBS MAPPO |
$475.10
|
| Rate for Payer: BCN Medicare Advantage |
$475.10
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$684.14
|
| Rate for Payer: Cofinity Commercial |
$636.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.10
|
| Rate for Payer: Healthscope Commercial |
$570.12
|
| Rate for Payer: Healthscope Whirlpool |
$570.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.86
|
| Rate for Payer: Nomi Health Commercial |
$570.12
|
| Rate for Payer: PACE SWMI |
$475.10
|
| Rate for Payer: PHP Medicare Advantage |
$475.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health Medicare |
$475.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.10
|
| Rate for Payer: UHC Medicare Advantage |
$475.10
|
| Rate for Payer: UHCCP DNSP |
$475.10
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 28525
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$554.13 |
| Rate for Payer: Aetna Commercial |
$515.65
|
| Rate for Payer: Aetna Medicare |
$384.81
|
| Rate for Payer: BCBS Complete |
$246.40
|
| Rate for Payer: BCBS MAPPO |
$384.81
|
| Rate for Payer: BCN Medicare Advantage |
$384.81
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$554.13
|
| Rate for Payer: Cofinity Commercial |
$515.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.81
|
| Rate for Payer: Healthscope Commercial |
$461.77
|
| Rate for Payer: Healthscope Whirlpool |
$461.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.05
|
| Rate for Payer: Nomi Health Commercial |
$461.77
|
| Rate for Payer: PACE SWMI |
$384.81
|
| Rate for Payer: PHP Medicare Advantage |
$384.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health Medicare |
$384.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.81
|
| Rate for Payer: UHC Medicare Advantage |
$384.81
|
| Rate for Payer: UHCCP DNSP |
$384.81
|
|
|
PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 21407
|
| Min. Negotiated Rate |
$468.80 |
| Max. Negotiated Rate |
$887.07 |
| Rate for Payer: Aetna Commercial |
$825.47
|
| Rate for Payer: Aetna Medicare |
$616.02
|
| Rate for Payer: BCBS Complete |
$468.80
|
| Rate for Payer: BCBS MAPPO |
$616.02
|
| Rate for Payer: BCN Medicare Advantage |
$616.02
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cofinity Commercial |
$887.07
|
| Rate for Payer: Cofinity Commercial |
$825.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.02
|
| Rate for Payer: Healthscope Commercial |
$739.22
|
| Rate for Payer: Healthscope Whirlpool |
$739.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.82
|
| Rate for Payer: Nomi Health Commercial |
$739.22
|
| Rate for Payer: PACE SWMI |
$616.02
|
| Rate for Payer: PHP Medicare Advantage |
$616.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.80
|
| Rate for Payer: Priority Health Medicare |
$616.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.02
|
| Rate for Payer: UHC Medicare Advantage |
$616.02
|
| Rate for Payer: UHCCP DNSP |
$616.02
|
|
|
PR OPEN TX HUMERAL EPICONDYLAR FRACTURE
|
Professional
|
Both
|
$2,436.00
|
|
|
Service Code
|
HCPCS 24575
|
| Min. Negotiated Rate |
$709.52 |
| Max. Negotiated Rate |
$1,583.40 |
| Rate for Payer: Aetna Commercial |
$950.76
|
| Rate for Payer: Aetna Medicare |
$709.52
|
| Rate for Payer: BCBS Complete |
$974.40
|
| Rate for Payer: BCBS MAPPO |
$709.52
|
| Rate for Payer: BCN Medicare Advantage |
$709.52
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cofinity Commercial |
$950.76
|
| Rate for Payer: Cofinity Commercial |
$1,021.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.52
|
| Rate for Payer: Healthscope Commercial |
$851.42
|
| Rate for Payer: Healthscope Whirlpool |
$851.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$745.00
|
| Rate for Payer: Nomi Health Commercial |
$851.42
|
| Rate for Payer: PACE SWMI |
$709.52
|
| Rate for Payer: PHP Medicare Advantage |
$709.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,583.40
|
| Rate for Payer: Priority Health Medicare |
$709.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.52
|
| Rate for Payer: UHC Medicare Advantage |
$709.52
|
| Rate for Payer: UHCCP DNSP |
$709.52
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$3,045.00
|
|
|
Service Code
|
HCPCS 24545
|
| Min. Negotiated Rate |
$897.03 |
| Max. Negotiated Rate |
$1,979.25 |
| Rate for Payer: Aetna Commercial |
$1,202.02
|
| Rate for Payer: Aetna Medicare |
$897.03
|
| Rate for Payer: BCBS Complete |
$1,218.00
|
| Rate for Payer: BCBS MAPPO |
$897.03
|
| Rate for Payer: BCN Medicare Advantage |
$897.03
|
| Rate for Payer: Cash Price |
$2,436.00
|
| Rate for Payer: Cash Price |
$2,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,291.72
|
| Rate for Payer: Cofinity Commercial |
$1,202.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.03
|
| Rate for Payer: Healthscope Commercial |
$1,076.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,076.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$941.88
|
| Rate for Payer: Nomi Health Commercial |
$1,076.44
|
| Rate for Payer: PACE SWMI |
$897.03
|
| Rate for Payer: PHP Medicare Advantage |
$897.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,979.25
|
| Rate for Payer: Priority Health Medicare |
$897.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$897.03
|
| Rate for Payer: UHC Medicare Advantage |
$897.03
|
| Rate for Payer: UHCCP DNSP |
$897.03
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN
|
Professional
|
Both
|
$3,982.00
|
|
|
Service Code
|
HCPCS 24546
|
| Min. Negotiated Rate |
$1,001.71 |
| Max. Negotiated Rate |
$2,588.30 |
| Rate for Payer: Aetna Commercial |
$1,342.29
|
| Rate for Payer: Aetna Medicare |
$1,001.71
|
| Rate for Payer: BCBS Complete |
$1,592.80
|
| Rate for Payer: BCBS MAPPO |
$1,001.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,001.71
|
| Rate for Payer: Cash Price |
$3,185.60
|
| Rate for Payer: Cash Price |
$3,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,442.46
|
| Rate for Payer: Cofinity Commercial |
$1,342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.71
|
| Rate for Payer: Healthscope Commercial |
$1,202.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,202.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,051.80
|
| Rate for Payer: Nomi Health Commercial |
$1,202.05
|
| Rate for Payer: PACE SWMI |
$1,001.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,001.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.30
|
| Rate for Payer: Priority Health Medicare |
$1,001.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,001.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,001.71
|
| Rate for Payer: UHCCP DNSP |
$1,001.71
|
|
