|
PR AMPICILLIN 500 MG INJ
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J0290
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$1.05
|
| Rate for Payer: Aetna Medicare |
$0.81
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$0.78
|
| Rate for Payer: BCBS Trust/PPO |
$0.17
|
| Rate for Payer: BCN Commercial |
$0.15
|
| Rate for Payer: BCN Medicare Advantage |
$0.78
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$1.05
|
| Rate for Payer: Cofinity Commercial |
$1.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.82
|
| Rate for Payer: PACE SWMI |
$0.78
|
| Rate for Payer: PHP Medicare Advantage |
$0.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
| Rate for Payer: Priority Health Medicare |
$0.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.78
|
| Rate for Payer: UHC Medicare Advantage |
$0.81
|
|
|
PR AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION
|
Professional
|
Both
|
$1,954.00
|
|
|
Service Code
|
HCPCS 27886
|
| Min. Negotiated Rate |
$414.71 |
| Max. Negotiated Rate |
$1,367.80 |
| Rate for Payer: Aetna Commercial |
$857.29
|
| Rate for Payer: Aetna Medicare |
$665.36
|
| Rate for Payer: BCBS Complete |
$435.45
|
| Rate for Payer: BCBS MAPPO |
$639.77
|
| Rate for Payer: BCBS Trust/PPO |
$527.77
|
| Rate for Payer: BCN Commercial |
$944.61
|
| Rate for Payer: BCN Medicare Advantage |
$639.77
|
| Rate for Payer: Cash Price |
$1,563.20
|
| Rate for Payer: Cash Price |
$1,563.20
|
| Rate for Payer: Cofinity Commercial |
$857.29
|
| Rate for Payer: Cofinity Commercial |
$921.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.77
|
| Rate for Payer: Mclaren Medicaid |
$414.71
|
| Rate for Payer: Meridian Medicaid |
$435.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$671.76
|
| Rate for Payer: PACE SWMI |
$639.77
|
| Rate for Payer: PHP Medicare Advantage |
$639.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,367.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.09
|
| Rate for Payer: Priority Health Medicare |
$639.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$987.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$639.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.77
|
| Rate for Payer: UHC Medicare Advantage |
$658.96
|
|
|
PR AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 27884
|
| Min. Negotiated Rate |
$370.41 |
| Max. Negotiated Rate |
$1,180.90 |
| Rate for Payer: Aetna Commercial |
$764.47
|
| Rate for Payer: Aetna Medicare |
$593.32
|
| Rate for Payer: BCBS Complete |
$388.93
|
| Rate for Payer: BCBS MAPPO |
$570.50
|
| Rate for Payer: BCBS Trust/PPO |
$405.73
|
| Rate for Payer: BCN Commercial |
$843.46
|
| Rate for Payer: BCN Medicare Advantage |
$570.50
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$821.52
|
| Rate for Payer: Cofinity Commercial |
$764.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.50
|
| Rate for Payer: Mclaren Medicaid |
$370.41
|
| Rate for Payer: Meridian Medicaid |
$388.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$599.02
|
| Rate for Payer: PACE SWMI |
$570.50
|
| Rate for Payer: PHP Medicare Advantage |
$570.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$881.38
|
| Rate for Payer: Priority Health Medicare |
$570.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$881.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$570.50
|
| Rate for Payer: UHC Medicare Advantage |
$587.62
|
|
|
PR AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER
|
Professional
|
Both
|
$2,426.00
|
|
|
Service Code
|
HCPCS 26910
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$2,869.73 |
| Rate for Payer: Aetna Commercial |
$1,002.37
|
| Rate for Payer: Aetna Medicare |
$777.96
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS MAPPO |
$748.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,869.73
|
| Rate for Payer: BCN Commercial |
$1,133.74
|
| Rate for Payer: BCN Medicare Advantage |
$748.04
|
| Rate for Payer: Cash Price |
$1,940.80
|
| Rate for Payer: Cash Price |
$1,940.80
|
| Rate for Payer: Cofinity Commercial |
$1,077.18
|
| Rate for Payer: Cofinity Commercial |
$1,002.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.04
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$785.44
|
| Rate for Payer: PACE SWMI |
$748.04
|
| Rate for Payer: PHP Medicare Advantage |
$748.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,698.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,184.70
|
| Rate for Payer: Priority Health Medicare |
$748.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,184.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.04
|
| Rate for Payer: UHC Medicare Advantage |
$770.48
|
|
|
PR AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION
|
Professional
|
Both
|
$1,090.00
|
|
|
Service Code
|
HCPCS 27594
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$977.88 |
| Rate for Payer: Aetna Commercial |
$664.56
|
| Rate for Payer: Aetna Medicare |
$515.78
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$495.94
|
| Rate for Payer: BCBS Trust/PPO |
$977.88
|
| Rate for Payer: BCN Commercial |
$735.46
|
| Rate for Payer: BCN Medicare Advantage |
$495.94
|
| Rate for Payer: Cash Price |
$872.00
|
| Rate for Payer: Cash Price |
$872.00
|
| Rate for Payer: Cofinity Commercial |
$714.15
|
| Rate for Payer: Cofinity Commercial |
$664.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.94
|
| Rate for Payer: Mclaren Medicaid |
$324.19
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$520.74
|
| Rate for Payer: PACE SWMI |
$495.94
|
| Rate for Payer: PHP Medicare Advantage |
$495.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.52
|
| Rate for Payer: Priority Health Medicare |
$495.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$768.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$495.94
|
| Rate for Payer: UHC Medicare Advantage |
$510.82
|
|
|
PR AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 24920
|
| Min. Negotiated Rate |
$407.32 |
| Max. Negotiated Rate |
$1,129.05 |
| Rate for Payer: Aetna Commercial |
$970.86
|
| Rate for Payer: Aetna Medicare |
$753.50
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$724.52
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$1,080.46
|
| Rate for Payer: BCN Medicare Advantage |
$724.52
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$1,043.31
|
| Rate for Payer: Cofinity Commercial |
$970.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.52
|
| Rate for Payer: Mclaren Medicaid |
$474.78
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$760.75
|
| Rate for Payer: PACE SWMI |
$724.52
|
| Rate for Payer: PHP Medicare Advantage |
$724.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$866.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,129.05
|
| Rate for Payer: Priority Health Medicare |
$724.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,129.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.52
|
| Rate for Payer: UHC Medicare Advantage |
$746.26
|
|
|
PR AMPUTATION ARM THRU HUMERUS RE-AMPUTATION
|
Professional
|
Both
|
$2,327.00
|
|
|
Service Code
|
HCPCS 24930
|
| Min. Negotiated Rate |
$194.41 |
| Max. Negotiated Rate |
$1,628.90 |
| Rate for Payer: Aetna Commercial |
$1,023.40
|
| Rate for Payer: Aetna Medicare |
$794.28
|
| Rate for Payer: BCBS Complete |
$525.36
|
| Rate for Payer: BCBS MAPPO |
$763.73
|
| Rate for Payer: BCBS Trust/PPO |
$194.41
|
| Rate for Payer: BCN Commercial |
$1,138.13
|
| Rate for Payer: BCN Medicare Advantage |
$763.73
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Cofinity Commercial |
$1,099.77
|
| Rate for Payer: Cofinity Commercial |
$1,023.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.73
|
| Rate for Payer: Mclaren Medicaid |
$500.34
|
| Rate for Payer: Meridian Medicaid |
$525.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$801.92
|
| Rate for Payer: PACE SWMI |
$763.73
|
| Rate for Payer: PHP Medicare Advantage |
$763.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,189.30
|
| Rate for Payer: Priority Health Medicare |
$763.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,189.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.73
|
| Rate for Payer: UHC Medicare Advantage |
$786.64
|
|
|
PR AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE
|
Professional
|
Both
|
$2,268.00
|
|
|
Service Code
|
HCPCS 24900
|
| Min. Negotiated Rate |
$70.79 |
| Max. Negotiated Rate |
$1,587.60 |
| Rate for Payer: Aetna Commercial |
$974.86
|
| Rate for Payer: Aetna Medicare |
$756.61
|
| Rate for Payer: BCBS Complete |
$502.54
|
| Rate for Payer: BCBS MAPPO |
$727.51
|
| Rate for Payer: BCBS Trust/PPO |
$70.79
|
| Rate for Payer: BCN Commercial |
$1,084.87
|
| Rate for Payer: BCN Medicare Advantage |
$727.51
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$974.86
|
| Rate for Payer: Cofinity Commercial |
$1,047.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.51
|
| Rate for Payer: Mclaren Medicaid |
$478.61
|
| Rate for Payer: Meridian Medicaid |
$502.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$763.89
|
| Rate for Payer: PACE SWMI |
$727.51
|
| Rate for Payer: PHP Medicare Advantage |
$727.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,133.65
|
| Rate for Payer: Priority Health Medicare |
$727.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,133.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$727.51
|
| Rate for Payer: UHC Medicare Advantage |
$749.34
|
|
|
PR AMPUTATION FOOT MIDTARSAL
|
Professional
|
Both
|
$1,601.00
|
|
|
Service Code
|
HCPCS 28800
|
| Min. Negotiated Rate |
$338.24 |
| Max. Negotiated Rate |
$1,120.70 |
| Rate for Payer: Aetna Commercial |
$692.34
|
| Rate for Payer: Aetna Medicare |
$537.34
|
| Rate for Payer: BCBS Complete |
$355.15
|
| Rate for Payer: BCBS MAPPO |
$516.67
|
| Rate for Payer: BCBS Trust/PPO |
$945.13
|
| Rate for Payer: BCN Commercial |
$767.22
|
| Rate for Payer: BCN Medicare Advantage |
$516.67
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cofinity Commercial |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$692.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.67
|
| Rate for Payer: Mclaren Medicaid |
$338.24
|
| Rate for Payer: Meridian Medicaid |
$355.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.50
|
| Rate for Payer: PACE SWMI |
$516.67
|
| Rate for Payer: PHP Medicare Advantage |
$516.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$801.72
|
| Rate for Payer: Priority Health Medicare |
$516.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.67
|
| Rate for Payer: UHC Medicare Advantage |
$532.17
|
|
|
PR AMPUTATION FOOT TRANSMETARSAL
|
Professional
|
Both
|
$1,892.00
|
|
|
Service Code
|
HCPCS 28805
|
| Min. Negotiated Rate |
$450.92 |
| Max. Negotiated Rate |
$1,324.40 |
| Rate for Payer: Aetna Commercial |
$932.89
|
| Rate for Payer: Aetna Medicare |
$724.04
|
| Rate for Payer: BCBS Complete |
$473.47
|
| Rate for Payer: BCBS MAPPO |
$696.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,175.47
|
| Rate for Payer: BCN Commercial |
$1,027.20
|
| Rate for Payer: BCN Medicare Advantage |
$696.19
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cofinity Commercial |
$932.89
|
| Rate for Payer: Cofinity Commercial |
$1,002.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.19
|
| Rate for Payer: Mclaren Medicaid |
$450.92
|
| Rate for Payer: Meridian Medicaid |
$473.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$731.00
|
| Rate for Payer: PACE SWMI |
$696.19
|
| Rate for Payer: PHP Medicare Advantage |
$696.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.39
|
| Rate for Payer: Priority Health Medicare |
$696.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,073.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$696.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.19
|
| Rate for Payer: UHC Medicare Advantage |
$717.08
|
|
|
PR AMPUTATION FOREARM THROUGH RADIUS & ULNA
|
Professional
|
Both
|
$2,334.00
|
|
|
Service Code
|
HCPCS 25900
|
| Min. Negotiated Rate |
$87.17 |
| Max. Negotiated Rate |
$1,633.80 |
| Rate for Payer: Aetna Commercial |
$946.80
|
| Rate for Payer: Aetna Medicare |
$734.83
|
| Rate for Payer: BCBS Complete |
$488.23
|
| Rate for Payer: BCBS MAPPO |
$706.57
|
| Rate for Payer: BCBS Trust/PPO |
$87.17
|
| Rate for Payer: BCN Commercial |
$1,056.04
|
| Rate for Payer: BCN Medicare Advantage |
$706.57
|
| Rate for Payer: Cash Price |
$1,867.20
|
| Rate for Payer: Cash Price |
$1,867.20
|
| Rate for Payer: Cofinity Commercial |
$1,017.46
|
| Rate for Payer: Cofinity Commercial |
$946.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.57
|
| Rate for Payer: Mclaren Medicaid |
$464.98
|
| Rate for Payer: Meridian Medicaid |
$488.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$741.90
|
| Rate for Payer: PACE SWMI |
$706.57
|
| Rate for Payer: PHP Medicare Advantage |
$706.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.51
|
| Rate for Payer: Priority Health Medicare |
$706.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,103.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$706.57
|
| Rate for Payer: UHC Medicare Advantage |
$727.77
|
|
|
PR AMPUTATION LEG THROUGH TIBIA&FIBULA
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 27880
|
| Min. Negotiated Rate |
$571.69 |
| Max. Negotiated Rate |
$1,859.90 |
| Rate for Payer: Aetna Commercial |
$1,195.44
|
| Rate for Payer: Aetna Medicare |
$927.80
|
| Rate for Payer: BCBS Complete |
$600.27
|
| Rate for Payer: BCBS MAPPO |
$892.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.71
|
| Rate for Payer: BCN Commercial |
$1,307.21
|
| Rate for Payer: BCN Medicare Advantage |
$892.12
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,284.65
|
| Rate for Payer: Cofinity Commercial |
$1,195.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.12
|
| Rate for Payer: Mclaren Medicaid |
$571.69
|
| Rate for Payer: Meridian Medicaid |
$600.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$936.73
|
| Rate for Payer: PACE SWMI |
$892.12
|
| Rate for Payer: PHP Medicare Advantage |
$892.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.98
|
| Rate for Payer: Priority Health Medicare |
$892.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,365.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$892.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$892.12
|
| Rate for Payer: UHC Medicare Advantage |
$918.88
|
|
|
PR AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR
|
Professional
|
Both
|
$2,098.00
|
|
|
Service Code
|
HCPCS 27882
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$1,468.60 |
| Rate for Payer: Aetna Commercial |
$784.60
|
| Rate for Payer: Aetna Medicare |
$608.94
|
| Rate for Payer: BCBS Complete |
$395.64
|
| Rate for Payer: BCBS MAPPO |
$585.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.86
|
| Rate for Payer: BCN Commercial |
$859.58
|
| Rate for Payer: BCN Medicare Advantage |
$585.52
|
| Rate for Payer: Cash Price |
$1,678.40
|
| Rate for Payer: Cash Price |
$1,678.40
|
| Rate for Payer: Cofinity Commercial |
$784.60
|
| Rate for Payer: Cofinity Commercial |
$843.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.52
|
| Rate for Payer: Mclaren Medicaid |
$376.80
|
| Rate for Payer: Meridian Medicaid |
$395.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$614.80
|
| Rate for Payer: PACE SWMI |
$585.52
|
| Rate for Payer: PHP Medicare Advantage |
$585.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,468.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.24
|
| Rate for Payer: Priority Health Medicare |
$585.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$898.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.52
|
| Rate for Payer: UHC Medicare Advantage |
$603.09
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Professional
|
Both
|
$1,408.00
|
|
|
Service Code
|
HCPCS 28810
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$1,367.24 |
| Rate for Payer: Aetna Commercial |
$554.99
|
| Rate for Payer: Aetna Medicare |
$430.74
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$414.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.24
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: BCN Medicare Advantage |
$414.17
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cofinity Commercial |
$554.99
|
| Rate for Payer: Cofinity Commercial |
$596.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.17
|
| Rate for Payer: Mclaren Medicaid |
$271.36
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$434.88
|
| Rate for Payer: PACE SWMI |
$414.17
|
| Rate for Payer: PHP Medicare Advantage |
$414.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.91
|
| Rate for Payer: Priority Health Medicare |
$414.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$642.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$414.17
|
| Rate for Payer: UHC Medicare Advantage |
$426.60
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Facility
|
IP
|
$1,408.00
|
|
|
Service Code
|
CPT 28810
|
| Hospital Charge Code |
28810
|
| Min. Negotiated Rate |
$858.74 |
| Max. Negotiated Rate |
$1,267.20 |
| Rate for Payer: Aetna Commercial |
$1,196.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.10
|
| Rate for Payer: BCN Commercial |
$1,088.10
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cofinity Commercial |
$1,210.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.40
|
| Rate for Payer: Healthscope Commercial |
$1,267.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,196.80
|
| Rate for Payer: PHP Commercial |
$1,196.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.04
|
| Rate for Payer: UHC Core |
$1,175.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.00
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Professional
|
Both
|
$1,408.00
|
|
|
Service Code
|
HCPCS 28810
|
| Hospital Charge Code |
28810
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$1,367.24 |
| Rate for Payer: Aetna Commercial |
$554.99
|
| Rate for Payer: Aetna Medicare |
$430.74
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$414.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.24
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: BCN Medicare Advantage |
$414.17
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cofinity Commercial |
$596.40
|
| Rate for Payer: Cofinity Commercial |
$554.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.17
|
| Rate for Payer: Mclaren Medicaid |
$271.36
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$434.88
|
| Rate for Payer: PACE SWMI |
$414.17
|
| Rate for Payer: PHP Medicare Advantage |
$414.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.91
|
| Rate for Payer: Priority Health Medicare |
$414.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$642.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$414.17
|
| Rate for Payer: UHC Medicare Advantage |
$426.60
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Facility
|
OP
|
$1,408.00
|
|
|
Service Code
|
CPT 28810
|
| Hospital Charge Code |
28810
|
| Min. Negotiated Rate |
$334.40 |
| Max. Negotiated Rate |
$2,229.50 |
| Rate for Payer: Aetna Commercial |
$1,196.80
|
| Rate for Payer: Aetna Medicare |
$366.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.00
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$352.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.72
|
| Rate for Payer: BCN Commercial |
$1,094.72
|
| Rate for Payer: BCN Medicare Advantage |
$352.00
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cofinity Commercial |
$1,210.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.00
|
| Rate for Payer: Healthscope Commercial |
$1,267.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.00
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,196.80
|
| Rate for Payer: PACE Senior Care Partners |
$334.40
|
| Rate for Payer: PACE SWMI |
$352.00
|
| Rate for Payer: PHP Commercial |
$1,196.80
|
| Rate for Payer: PHP Medicare Advantage |
$352.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.96
|
| Rate for Payer: Priority Health Medicare |
$352.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.74
|
| Rate for Payer: Railroad Medicare Medicare |
$352.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.04
|
| Rate for Payer: UHC Core |
$1,175.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.00
|
| Rate for Payer: UHC Medicare Advantage |
$362.56
|
| Rate for Payer: VA VA |
$352.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.00
|
|
|
PR AMPUTATION PENIS COMPLETE
|
Professional
|
Both
|
$1,522.00
|
|
|
Service Code
|
HCPCS 54125
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$2,350.94 |
| Rate for Payer: Aetna Commercial |
$1,080.33
|
| Rate for Payer: Aetna Medicare |
$838.47
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS MAPPO |
$806.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,350.94
|
| Rate for Payer: BCN Commercial |
$1,190.42
|
| Rate for Payer: BCN Medicare Advantage |
$806.22
|
| Rate for Payer: Cash Price |
$1,217.60
|
| Rate for Payer: Cash Price |
$1,217.60
|
| Rate for Payer: Cofinity Commercial |
$1,080.33
|
| Rate for Payer: Cofinity Commercial |
$1,160.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$806.22
|
| Rate for Payer: Mclaren Medicaid |
$523.55
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.53
|
| Rate for Payer: PACE SWMI |
$806.22
|
| Rate for Payer: PHP Medicare Advantage |
$806.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.31
|
| Rate for Payer: Priority Health Medicare |
$806.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,316.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$806.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$806.22
|
| Rate for Payer: UHC Medicare Advantage |
$830.41
|
|
|
PR AMPUTATION PENIS PARTIAL
|
Professional
|
Both
|
$1,178.00
|
|
|
Service Code
|
HCPCS 54120
|
| Min. Negotiated Rate |
$403.85 |
| Max. Negotiated Rate |
$3,526.40 |
| Rate for Payer: Aetna Commercial |
$827.06
|
| Rate for Payer: Aetna Medicare |
$641.90
|
| Rate for Payer: BCBS Complete |
$424.04
|
| Rate for Payer: BCBS MAPPO |
$617.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,526.40
|
| Rate for Payer: BCN Commercial |
$912.85
|
| Rate for Payer: BCN Medicare Advantage |
$617.21
|
| Rate for Payer: Cash Price |
$942.40
|
| Rate for Payer: Cash Price |
$942.40
|
| Rate for Payer: Cofinity Commercial |
$888.78
|
| Rate for Payer: Cofinity Commercial |
$827.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.21
|
| Rate for Payer: Mclaren Medicaid |
$403.85
|
| Rate for Payer: Meridian Medicaid |
$424.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$648.07
|
| Rate for Payer: PACE SWMI |
$617.21
|
| Rate for Payer: PHP Medicare Advantage |
$617.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.38
|
| Rate for Payer: Priority Health Medicare |
$617.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.21
|
| Rate for Payer: UHC Medicare Advantage |
$635.73
|
|
|
PR AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE
|
Professional
|
Both
|
$2,433.00
|
|
|
Service Code
|
HCPCS 54130
|
| Min. Negotiated Rate |
$756.58 |
| Max. Negotiated Rate |
$3,502.63 |
| Rate for Payer: Aetna Commercial |
$1,560.23
|
| Rate for Payer: Aetna Medicare |
$1,210.92
|
| Rate for Payer: BCBS Complete |
$794.41
|
| Rate for Payer: BCBS MAPPO |
$1,164.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,502.63
|
| Rate for Payer: BCN Commercial |
$1,715.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,164.35
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cofinity Commercial |
$1,676.66
|
| Rate for Payer: Cofinity Commercial |
$1,560.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,164.35
|
| Rate for Payer: Mclaren Medicaid |
$756.58
|
| Rate for Payer: Meridian Medicaid |
$794.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,222.57
|
| Rate for Payer: PACE SWMI |
$1,164.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,164.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$756.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,897.20
|
| Rate for Payer: Priority Health Medicare |
$1,164.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,897.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,164.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,199.28
|
|
|
PR AMPUTATION THIGH THROUGH FEMUR ANY LEVEL
|
Professional
|
Both
|
$2,531.00
|
|
|
Service Code
|
HCPCS 27590
|
| Min. Negotiated Rate |
$499.27 |
| Max. Negotiated Rate |
$2,644.67 |
| Rate for Payer: Aetna Commercial |
$1,042.95
|
| Rate for Payer: Aetna Medicare |
$809.45
|
| Rate for Payer: BCBS Complete |
$524.23
|
| Rate for Payer: BCBS MAPPO |
$778.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,644.67
|
| Rate for Payer: BCN Commercial |
$1,139.60
|
| Rate for Payer: BCN Medicare Advantage |
$778.32
|
| Rate for Payer: Cash Price |
$2,024.80
|
| Rate for Payer: Cash Price |
$2,024.80
|
| Rate for Payer: Cofinity Commercial |
$1,120.78
|
| Rate for Payer: Cofinity Commercial |
$1,042.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.32
|
| Rate for Payer: Mclaren Medicaid |
$499.27
|
| Rate for Payer: Meridian Medicaid |
$524.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$817.24
|
| Rate for Payer: PACE SWMI |
$778.32
|
| Rate for Payer: PHP Medicare Advantage |
$778.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,190.84
|
| Rate for Payer: Priority Health Medicare |
$778.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,190.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$778.32
|
| Rate for Payer: UHC Medicare Advantage |
$801.67
|
|
|
PR AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 27596
|
| Min. Negotiated Rate |
$454.33 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$945.60
|
| Rate for Payer: Aetna Medicare |
$733.90
|
| Rate for Payer: BCBS Complete |
$477.05
|
| Rate for Payer: BCBS MAPPO |
$705.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,116.83
|
| Rate for Payer: BCN Commercial |
$1,040.39
|
| Rate for Payer: BCN Medicare Advantage |
$705.67
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cofinity Commercial |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,016.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.67
|
| Rate for Payer: Mclaren Medicaid |
$454.33
|
| Rate for Payer: Meridian Medicaid |
$477.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$740.95
|
| Rate for Payer: PACE SWMI |
$705.67
|
| Rate for Payer: PHP Medicare Advantage |
$705.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,087.18
|
| Rate for Payer: Priority Health Medicare |
$705.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,087.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$705.67
|
| Rate for Payer: UHC Medicare Advantage |
$726.84
|
|
|
PR AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR
|
Professional
|
Both
|
$3,036.00
|
|
|
Service Code
|
HCPCS 27592
|
| Min. Negotiated Rate |
$427.49 |
| Max. Negotiated Rate |
$2,125.20 |
| Rate for Payer: Aetna Commercial |
$889.67
|
| Rate for Payer: Aetna Medicare |
$690.49
|
| Rate for Payer: BCBS Complete |
$448.86
|
| Rate for Payer: BCBS MAPPO |
$663.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.62
|
| Rate for Payer: BCN Commercial |
$975.89
|
| Rate for Payer: BCN Medicare Advantage |
$663.93
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cofinity Commercial |
$956.06
|
| Rate for Payer: Cofinity Commercial |
$889.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.93
|
| Rate for Payer: Mclaren Medicaid |
$427.49
|
| Rate for Payer: Meridian Medicaid |
$448.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$697.13
|
| Rate for Payer: PACE SWMI |
$663.93
|
| Rate for Payer: PHP Medicare Advantage |
$663.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,125.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.77
|
| Rate for Payer: Priority Health Medicare |
$663.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.93
|
| Rate for Payer: UHC Medicare Advantage |
$683.85
|
|
|
PR AMPUTATION TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 28825
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$995.32 |
| Rate for Payer: Aetna Commercial |
$228.01
|
| Rate for Payer: Aetna Medicare |
$176.97
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$170.16
|
| Rate for Payer: BCBS Trust/PPO |
$995.32
|
| Rate for Payer: BCN Commercial |
$425.15
|
| Rate for Payer: BCN Medicare Advantage |
$170.16
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$245.03
|
| Rate for Payer: Cofinity Commercial |
$228.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.16
|
| Rate for Payer: Mclaren Medicaid |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.67
|
| Rate for Payer: PACE SWMI |
$170.16
|
| Rate for Payer: PHP Medicare Advantage |
$170.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.94
|
| Rate for Payer: Priority Health Medicare |
$170.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.16
|
| Rate for Payer: UHC Medicare Advantage |
$175.26
|
|
|
PR AMPUTATION TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 28820
|
| Min. Negotiated Rate |
$112.89 |
| Max. Negotiated Rate |
$1,068.20 |
| Rate for Payer: Aetna Commercial |
$235.75
|
| Rate for Payer: Aetna Medicare |
$182.97
|
| Rate for Payer: BCBS Complete |
$118.53
|
| Rate for Payer: BCBS MAPPO |
$175.93
|
| Rate for Payer: BCBS Trust/PPO |
$852.68
|
| Rate for Payer: BCN Commercial |
$434.44
|
| Rate for Payer: BCN Medicare Advantage |
$175.93
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$253.34
|
| Rate for Payer: Cofinity Commercial |
$235.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.93
|
| Rate for Payer: Mclaren Medicaid |
$112.89
|
| Rate for Payer: Meridian Medicaid |
$118.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.73
|
| Rate for Payer: PACE SWMI |
$175.93
|
| Rate for Payer: PHP Medicare Advantage |
$175.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,068.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.62
|
| Rate for Payer: Priority Health Medicare |
$175.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.93
|
| Rate for Payer: UHC Medicare Advantage |
$181.21
|
|
