|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 28600
|
| Min. Negotiated Rate |
$105.44 |
| Max. Negotiated Rate |
$1,628.75 |
| Rate for Payer: Aetna Commercial |
$243.84
|
| Rate for Payer: Aetna Medicare |
$189.25
|
| Rate for Payer: BCBS Complete |
$110.71
|
| Rate for Payer: BCBS MAPPO |
$181.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.75
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$181.97
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$243.84
|
| Rate for Payer: Cofinity Commercial |
$262.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.97
|
| Rate for Payer: Mclaren Medicaid |
$105.44
|
| Rate for Payer: Meridian Medicaid |
$110.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$191.07
|
| Rate for Payer: PACE SWMI |
$181.97
|
| Rate for Payer: PHP Medicare Advantage |
$181.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.51
|
| Rate for Payer: Priority Health Medicare |
$181.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.97
|
| Rate for Payer: UHC Medicare Advantage |
$187.43
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 21485
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,428.40 |
| Rate for Payer: Aetna Commercial |
$1,009.82
|
| Rate for Payer: Aetna Medicare |
$783.74
|
| Rate for Payer: BCBS Complete |
$524.91
|
| Rate for Payer: BCBS MAPPO |
$753.60
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,428.40
|
| Rate for Payer: BCN Medicare Advantage |
$753.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cofinity Commercial |
$1,085.18
|
| Rate for Payer: Cofinity Commercial |
$1,009.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.60
|
| Rate for Payer: Mclaren Medicaid |
$499.91
|
| Rate for Payer: Meridian Medicaid |
$524.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$791.28
|
| Rate for Payer: PACE SWMI |
$753.60
|
| Rate for Payer: PHP Medicare Advantage |
$753.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.41
|
| Rate for Payer: Priority Health Medicare |
$753.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,218.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$753.60
|
| Rate for Payer: UHC Medicare Advantage |
$776.21
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 21480
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$41.83
|
| Rate for Payer: Aetna Medicare |
$32.47
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$31.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$31.22
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$44.96
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$19.81
|
| Rate for Payer: Meridian Medicaid |
$20.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.78
|
| Rate for Payer: PACE SWMI |
$31.22
|
| Rate for Payer: PHP Medicare Advantage |
$31.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.50
|
| Rate for Payer: Priority Health Medicare |
$31.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.16
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ
|
Professional
|
Both
|
$1,230.00
|
|
|
Service Code
|
HCPCS 24675
|
| Min. Negotiated Rate |
$276.26 |
| Max. Negotiated Rate |
$1,365.66 |
| Rate for Payer: Aetna Commercial |
$555.56
|
| Rate for Payer: Aetna Medicare |
$431.18
|
| Rate for Payer: BCBS Complete |
$290.07
|
| Rate for Payer: BCBS MAPPO |
$414.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: BCN Commercial |
$690.01
|
| Rate for Payer: BCN Medicare Advantage |
$414.60
|
| Rate for Payer: Cash Price |
$984.00
|
| Rate for Payer: Cash Price |
$984.00
|
| Rate for Payer: Cofinity Commercial |
$597.02
|
| Rate for Payer: Cofinity Commercial |
$555.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.60
|
| Rate for Payer: Mclaren Medicaid |
$276.26
|
| Rate for Payer: Meridian Medicaid |
$290.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.33
|
| Rate for Payer: PACE SWMI |
$414.60
|
| Rate for Payer: PHP Medicare Advantage |
$414.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.61
|
| Rate for Payer: Priority Health Medicare |
$414.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$414.60
|
| Rate for Payer: UHC Medicare Advantage |
$427.04
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ
|
Professional
|
Both
|
$781.00
|
|
|
Service Code
|
HCPCS 24670
|
| Min. Negotiated Rate |
$178.92 |
| Max. Negotiated Rate |
$1,283.24 |
| Rate for Payer: Aetna Commercial |
$356.53
|
| Rate for Payer: Aetna Medicare |
$276.71
|
| Rate for Payer: BCBS Complete |
$187.87
|
| Rate for Payer: BCBS MAPPO |
$266.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.24
|
| Rate for Payer: BCN Commercial |
$441.27
|
| Rate for Payer: BCN Medicare Advantage |
$266.07
|
| Rate for Payer: Cash Price |
$624.80
|
| Rate for Payer: Cash Price |
$624.80
|
| Rate for Payer: Cofinity Commercial |
$383.14
|
| Rate for Payer: Cofinity Commercial |
$356.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.07
|
| Rate for Payer: Mclaren Medicaid |
$178.92
|
| Rate for Payer: Meridian Medicaid |
$187.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$279.37
|
| Rate for Payer: PACE SWMI |
$266.07
|
| Rate for Payer: PHP Medicare Advantage |
$266.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.80
|
| Rate for Payer: Priority Health Medicare |
$266.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.07
|
| Rate for Payer: UHC Medicare Advantage |
$274.05
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 25535
|
| Min. Negotiated Rate |
$302.46 |
| Max. Negotiated Rate |
$1,028.60 |
| Rate for Payer: Aetna Commercial |
$608.04
|
| Rate for Payer: Aetna Medicare |
$471.91
|
| Rate for Payer: BCBS Complete |
$317.58
|
| Rate for Payer: BCBS MAPPO |
$453.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$453.76
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cofinity Commercial |
$608.04
|
| Rate for Payer: Cofinity Commercial |
$653.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.76
|
| Rate for Payer: Mclaren Medicaid |
$302.46
|
| Rate for Payer: Meridian Medicaid |
$317.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$476.45
|
| Rate for Payer: PACE SWMI |
$453.76
|
| Rate for Payer: PHP Medicare Advantage |
$453.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$714.40
|
| Rate for Payer: Priority Health Medicare |
$453.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$714.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.76
|
| Rate for Payer: UHC Medicare Advantage |
$467.37
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$642.00
|
|
|
Service Code
|
HCPCS 25530
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$1,133.73 |
| Rate for Payer: Aetna Commercial |
$322.12
|
| Rate for Payer: Aetna Medicare |
$250.01
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$240.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.73
|
| Rate for Payer: BCN Commercial |
$398.76
|
| Rate for Payer: BCN Medicare Advantage |
$240.39
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cofinity Commercial |
$346.16
|
| Rate for Payer: Cofinity Commercial |
$322.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.39
|
| Rate for Payer: Mclaren Medicaid |
$162.95
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$252.41
|
| Rate for Payer: PACE SWMI |
$240.39
|
| Rate for Payer: PHP Medicare Advantage |
$240.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.48
|
| Rate for Payer: Priority Health Medicare |
$240.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$382.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.39
|
| Rate for Payer: UHC Medicare Advantage |
$247.60
|
|
|
PR CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 21750
|
| Min. Negotiated Rate |
$430.05 |
| Max. Negotiated Rate |
$1,437.10 |
| Rate for Payer: Aetna Commercial |
$897.00
|
| Rate for Payer: Aetna Medicare |
$696.18
|
| Rate for Payer: BCBS Complete |
$451.55
|
| Rate for Payer: BCBS MAPPO |
$669.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$669.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cofinity Commercial |
$897.00
|
| Rate for Payer: Cofinity Commercial |
$963.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.40
|
| Rate for Payer: Mclaren Medicaid |
$430.05
|
| Rate for Payer: Meridian Medicaid |
$451.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$702.87
|
| Rate for Payer: PACE SWMI |
$669.40
|
| Rate for Payer: PHP Medicare Advantage |
$669.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,437.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.89
|
| Rate for Payer: Priority Health Medicare |
$669.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$669.40
|
| Rate for Payer: UHC Medicare Advantage |
$689.48
|
|
|
PR CLOSURE CYSTOSTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,392.00
|
|
|
Service Code
|
HCPCS 51880
|
| Min. Negotiated Rate |
$298.20 |
| Max. Negotiated Rate |
$1,691.09 |
| Rate for Payer: Aetna Commercial |
$608.17
|
| Rate for Payer: Aetna Medicare |
$472.01
|
| Rate for Payer: BCBS Complete |
$313.11
|
| Rate for Payer: BCBS MAPPO |
$453.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.09
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$453.86
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cofinity Commercial |
$653.56
|
| Rate for Payer: Cofinity Commercial |
$608.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.86
|
| Rate for Payer: Mclaren Medicaid |
$298.20
|
| Rate for Payer: Meridian Medicaid |
$313.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$476.55
|
| Rate for Payer: PACE SWMI |
$453.86
|
| Rate for Payer: PHP Medicare Advantage |
$453.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$742.99
|
| Rate for Payer: Priority Health Medicare |
$453.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$742.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.86
|
| Rate for Payer: UHC Medicare Advantage |
$467.48
|
|
|
PR CLOSURE ENTEROSTOMY LG/SMALL INTESTINE
|
Professional
|
Both
|
$2,217.00
|
|
|
Service Code
|
HCPCS 44620
|
| Min. Negotiated Rate |
$210.79 |
| Max. Negotiated Rate |
$1,551.90 |
| Rate for Payer: Aetna Commercial |
$1,146.65
|
| Rate for Payer: Aetna Medicare |
$889.94
|
| Rate for Payer: BCBS Complete |
$578.36
|
| Rate for Payer: BCBS MAPPO |
$855.71
|
| Rate for Payer: BCBS Trust/PPO |
$210.79
|
| Rate for Payer: BCN Commercial |
$1,258.83
|
| Rate for Payer: BCN Medicare Advantage |
$855.71
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cofinity Commercial |
$1,232.22
|
| Rate for Payer: Cofinity Commercial |
$1,146.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.71
|
| Rate for Payer: Mclaren Medicaid |
$550.82
|
| Rate for Payer: Meridian Medicaid |
$578.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$898.50
|
| Rate for Payer: PACE SWMI |
$855.71
|
| Rate for Payer: PHP Medicare Advantage |
$855.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$550.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,551.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.61
|
| Rate for Payer: Priority Health Medicare |
$855.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$855.71
|
| Rate for Payer: UHC Medicare Advantage |
$881.38
|
|
|
PR CLOSURE GASTROCOLIC FISTULA
|
Professional
|
Both
|
$3,817.00
|
|
|
Service Code
|
HCPCS 43880
|
| Min. Negotiated Rate |
$198.11 |
| Max. Negotiated Rate |
$2,781.10 |
| Rate for Payer: Aetna Commercial |
$2,113.21
|
| Rate for Payer: Aetna Medicare |
$1,640.10
|
| Rate for Payer: BCBS Complete |
$1,077.32
|
| Rate for Payer: BCBS MAPPO |
$1,577.02
|
| Rate for Payer: BCBS Trust/PPO |
$198.11
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,577.02
|
| Rate for Payer: Cash Price |
$3,053.60
|
| Rate for Payer: Cash Price |
$3,053.60
|
| Rate for Payer: Cofinity Commercial |
$2,270.91
|
| Rate for Payer: Cofinity Commercial |
$2,113.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,577.02
|
| Rate for Payer: Mclaren Medicaid |
$1,026.02
|
| Rate for Payer: Meridian Medicaid |
$1,077.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,655.87
|
| Rate for Payer: PACE SWMI |
$1,577.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,577.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,026.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,671.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,781.10
|
| Rate for Payer: Priority Health Medicare |
$1,577.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,577.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,577.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,624.33
|
|
|
PR CLOSURE GASTROSTOMY SURG
|
Professional
|
Both
|
$1,917.00
|
|
|
Service Code
|
HCPCS 43870
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$1,341.90 |
| Rate for Payer: Aetna Commercial |
$945.70
|
| Rate for Payer: Aetna Medicare |
$733.98
|
| Rate for Payer: BCBS Complete |
$477.27
|
| Rate for Payer: BCBS MAPPO |
$705.75
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$705.75
|
| Rate for Payer: Cash Price |
$1,533.60
|
| Rate for Payer: Cash Price |
$1,533.60
|
| Rate for Payer: Cofinity Commercial |
$945.70
|
| Rate for Payer: Cofinity Commercial |
$1,016.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.75
|
| Rate for Payer: Mclaren Medicaid |
$454.54
|
| Rate for Payer: Meridian Medicaid |
$477.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$741.04
|
| Rate for Payer: PACE SWMI |
$705.75
|
| Rate for Payer: PHP Medicare Advantage |
$705.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,341.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,250.03
|
| Rate for Payer: Priority Health Medicare |
$705.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,250.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$705.75
|
| Rate for Payer: UHC Medicare Advantage |
$726.92
|
|
|
PR CLOSURE INTESTINAL CUTANEOUS FISTULA
|
Professional
|
Both
|
$2,496.00
|
|
|
Service Code
|
HCPCS 44640
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$2,437.73 |
| Rate for Payer: Aetna Commercial |
$1,852.68
|
| Rate for Payer: Aetna Medicare |
$1,437.90
|
| Rate for Payer: BCBS Complete |
$931.51
|
| Rate for Payer: BCBS MAPPO |
$1,382.60
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$2,026.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.60
|
| Rate for Payer: Cash Price |
$1,996.80
|
| Rate for Payer: Cash Price |
$1,996.80
|
| Rate for Payer: Cofinity Commercial |
$1,852.68
|
| Rate for Payer: Cofinity Commercial |
$1,990.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.60
|
| Rate for Payer: Mclaren Medicaid |
$887.15
|
| Rate for Payer: Meridian Medicaid |
$931.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,451.73
|
| Rate for Payer: PACE SWMI |
$1,382.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$887.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,437.73
|
| Rate for Payer: Priority Health Medicare |
$1,382.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,437.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,382.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,382.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,424.08
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
HCPCS 40830
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$805.66 |
| Rate for Payer: Aetna Commercial |
$189.37
|
| Rate for Payer: Aetna Medicare |
$146.97
|
| Rate for Payer: BCBS Complete |
$97.73
|
| Rate for Payer: BCBS MAPPO |
$141.32
|
| Rate for Payer: BCBS Trust/PPO |
$805.66
|
| Rate for Payer: BCN Commercial |
$332.79
|
| Rate for Payer: BCN Medicare Advantage |
$141.32
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cofinity Commercial |
$203.50
|
| Rate for Payer: Cofinity Commercial |
$189.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.32
|
| Rate for Payer: Mclaren Medicaid |
$93.08
|
| Rate for Payer: Meridian Medicaid |
$97.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.39
|
| Rate for Payer: PACE SWMI |
$141.32
|
| Rate for Payer: PHP Medicare Advantage |
$141.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.36
|
| Rate for Payer: Priority Health Medicare |
$141.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.32
|
| Rate for Payer: UHC Medicare Advantage |
$145.56
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 40831
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$949.88 |
| Rate for Payer: Aetna Commercial |
$261.59
|
| Rate for Payer: Aetna Medicare |
$203.03
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$195.22
|
| Rate for Payer: BCBS Trust/PPO |
$949.88
|
| Rate for Payer: BCN Commercial |
$436.39
|
| Rate for Payer: BCN Medicare Advantage |
$195.22
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$281.12
|
| Rate for Payer: Cofinity Commercial |
$261.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.22
|
| Rate for Payer: Mclaren Medicaid |
$128.44
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.98
|
| Rate for Payer: PACE SWMI |
$195.22
|
| Rate for Payer: PHP Medicare Advantage |
$195.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.96
|
| Rate for Payer: Priority Health Medicare |
$195.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.22
|
| Rate for Payer: UHC Medicare Advantage |
$201.08
|
|
|
PR CLOSURE RECTOURETHRAL FISTULA
|
Professional
|
Both
|
$3,219.00
|
|
|
Service Code
|
HCPCS 45820
|
| Min. Negotiated Rate |
$527.24 |
| Max. Negotiated Rate |
$2,253.30 |
| Rate for Payer: Aetna Commercial |
$1,697.12
|
| Rate for Payer: Aetna Medicare |
$1,317.17
|
| Rate for Payer: BCBS Complete |
$855.47
|
| Rate for Payer: BCBS MAPPO |
$1,266.51
|
| Rate for Payer: BCBS Trust/PPO |
$527.24
|
| Rate for Payer: BCN Commercial |
$1,862.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,266.51
|
| Rate for Payer: Cash Price |
$2,575.20
|
| Rate for Payer: Cash Price |
$2,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,823.77
|
| Rate for Payer: Cofinity Commercial |
$1,697.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,266.51
|
| Rate for Payer: Mclaren Medicaid |
$814.73
|
| Rate for Payer: Meridian Medicaid |
$855.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,329.84
|
| Rate for Payer: PACE SWMI |
$1,266.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,266.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$814.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,253.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,240.76
|
| Rate for Payer: Priority Health Medicare |
$1,266.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,240.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,266.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,266.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,304.51
|
|
|
PR CLOSURE RECTOVESICAL FISTULA
|
Professional
|
Both
|
$2,803.00
|
|
|
Service Code
|
HCPCS 45800
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$2,234.88 |
| Rate for Payer: Aetna Commercial |
$1,692.67
|
| Rate for Payer: Aetna Medicare |
$1,313.72
|
| Rate for Payer: BCBS Complete |
$853.23
|
| Rate for Payer: BCBS MAPPO |
$1,263.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.43
|
| Rate for Payer: BCN Commercial |
$1,857.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,263.19
|
| Rate for Payer: Cash Price |
$2,242.40
|
| Rate for Payer: Cash Price |
$2,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,818.99
|
| Rate for Payer: Cofinity Commercial |
$1,692.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,263.19
|
| Rate for Payer: Mclaren Medicaid |
$812.60
|
| Rate for Payer: Meridian Medicaid |
$853.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,326.35
|
| Rate for Payer: PACE SWMI |
$1,263.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,263.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,962.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,234.88
|
| Rate for Payer: Priority Health Medicare |
$1,263.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,234.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,263.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,263.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,301.09
|
|
|
PR CLOSURE SALIVARY FISTULA
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 42600
|
| Min. Negotiated Rate |
$230.47 |
| Max. Negotiated Rate |
$808.27 |
| Rate for Payer: Aetna Commercial |
$469.16
|
| Rate for Payer: Aetna Medicare |
$364.12
|
| Rate for Payer: BCBS Complete |
$241.99
|
| Rate for Payer: BCBS MAPPO |
$350.12
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$350.12
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$469.16
|
| Rate for Payer: Cofinity Commercial |
$504.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.12
|
| Rate for Payer: Mclaren Medicaid |
$230.47
|
| Rate for Payer: Meridian Medicaid |
$241.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$367.63
|
| Rate for Payer: PACE SWMI |
$350.12
|
| Rate for Payer: PHP Medicare Advantage |
$350.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$630.90
|
| Rate for Payer: Priority Health Medicare |
$350.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$630.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.12
|
| Rate for Payer: UHC Medicare Advantage |
$360.62
|
|
|
PR CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 57320
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$1,656.75 |
| Rate for Payer: Aetna Commercial |
$751.06
|
| Rate for Payer: Aetna Medicare |
$582.91
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS MAPPO |
$560.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.75
|
| Rate for Payer: BCN Commercial |
$831.73
|
| Rate for Payer: BCN Medicare Advantage |
$560.49
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$807.11
|
| Rate for Payer: Cofinity Commercial |
$751.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.49
|
| Rate for Payer: Mclaren Medicaid |
$364.02
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$588.51
|
| Rate for Payer: PACE SWMI |
$560.49
|
| Rate for Payer: PHP Medicare Advantage |
$560.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$805.77
|
| Rate for Payer: Priority Health Medicare |
$560.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.49
|
| Rate for Payer: UHC Medicare Advantage |
$577.30
|
|
|
PR CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
HCPCS 23540
|
| Min. Negotiated Rate |
$158.26 |
| Max. Negotiated Rate |
$410.20 |
| Rate for Payer: Aetna Commercial |
$314.97
|
| Rate for Payer: Aetna Medicare |
$244.45
|
| Rate for Payer: BCBS Complete |
$166.17
|
| Rate for Payer: BCBS MAPPO |
$235.05
|
| Rate for Payer: BCBS Trust/PPO |
$393.06
|
| Rate for Payer: BCN Commercial |
$361.13
|
| Rate for Payer: BCN Medicare Advantage |
$235.05
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cofinity Commercial |
$338.47
|
| Rate for Payer: Cofinity Commercial |
$314.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.05
|
| Rate for Payer: Mclaren Medicaid |
$158.26
|
| Rate for Payer: Meridian Medicaid |
$166.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$246.80
|
| Rate for Payer: PACE SWMI |
$235.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.78
|
| Rate for Payer: Priority Health Medicare |
$235.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.05
|
| Rate for Payer: UHC Medicare Advantage |
$242.10
|
|
|
PR CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$506.00
|
|
|
Service Code
|
HCPCS 23500
|
| Min. Negotiated Rate |
$152.93 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$303.87
|
| Rate for Payer: Aetna Medicare |
$235.84
|
| Rate for Payer: BCBS Complete |
$160.58
|
| Rate for Payer: BCBS MAPPO |
$226.77
|
| Rate for Payer: BCBS Trust/PPO |
$226.26
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$226.77
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cofinity Commercial |
$303.87
|
| Rate for Payer: Cofinity Commercial |
$326.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.77
|
| Rate for Payer: Mclaren Medicaid |
$152.93
|
| Rate for Payer: Meridian Medicaid |
$160.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$238.11
|
| Rate for Payer: PACE SWMI |
$226.77
|
| Rate for Payer: PHP Medicare Advantage |
$226.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.00
|
| Rate for Payer: Priority Health Medicare |
$226.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.77
|
| Rate for Payer: UHC Medicare Advantage |
$233.57
|
|
|
PR CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 24500
|
| Min. Negotiated Rate |
$223.22 |
| Max. Negotiated Rate |
$578.90 |
| Rate for Payer: Aetna Commercial |
$443.98
|
| Rate for Payer: Aetna Medicare |
$344.58
|
| Rate for Payer: BCBS Complete |
$234.38
|
| Rate for Payer: BCBS MAPPO |
$331.33
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$544.87
|
| Rate for Payer: BCN Medicare Advantage |
$331.33
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$443.98
|
| Rate for Payer: Cofinity Commercial |
$477.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.33
|
| Rate for Payer: Mclaren Medicaid |
$223.22
|
| Rate for Payer: Meridian Medicaid |
$234.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$347.90
|
| Rate for Payer: PACE SWMI |
$331.33
|
| Rate for Payer: PHP Medicare Advantage |
$331.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$524.95
|
| Rate for Payer: Priority Health Medicare |
$331.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$331.33
|
| Rate for Payer: UHC Medicare Advantage |
$341.27
|
|
|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$2,080.97 |
| Rate for Payer: Aetna Commercial |
$415.92
|
| Rate for Payer: Aetna Medicare |
$322.81
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$310.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,080.97
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: BCN Medicare Advantage |
$310.39
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$415.92
|
| Rate for Payer: Cofinity Commercial |
$446.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.39
|
| Rate for Payer: Mclaren Medicaid |
$202.35
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$325.91
|
| Rate for Payer: PACE SWMI |
$310.39
|
| Rate for Payer: PHP Medicare Advantage |
$310.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.06
|
| Rate for Payer: Priority Health Medicare |
$310.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$482.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.39
|
| Rate for Payer: UHC Medicare Advantage |
$319.70
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$1,831.62 |
| Rate for Payer: Aetna Commercial |
$174.72
|
| Rate for Payer: Aetna Medicare |
$135.61
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$130.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.62
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$130.39
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$174.72
|
| Rate for Payer: Cofinity Commercial |
$187.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.39
|
| Rate for Payer: Mclaren Medicaid |
$86.05
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.91
|
| Rate for Payer: PACE SWMI |
$130.39
|
| Rate for Payer: PHP Medicare Advantage |
$130.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.29
|
| Rate for Payer: Priority Health Medicare |
$130.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.39
|
| Rate for Payer: UHC Medicare Advantage |
$134.30
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$268.38 |
| Max. Negotiated Rate |
$707.70 |
| Rate for Payer: Aetna Commercial |
$540.33
|
| Rate for Payer: Aetna Medicare |
$419.36
|
| Rate for Payer: BCBS Complete |
$281.80
|
| Rate for Payer: BCBS MAPPO |
$403.23
|
| Rate for Payer: BCBS Trust/PPO |
$372.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$403.23
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cofinity Commercial |
$540.33
|
| Rate for Payer: Cofinity Commercial |
$580.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.23
|
| Rate for Payer: Mclaren Medicaid |
$268.38
|
| Rate for Payer: Meridian Medicaid |
$281.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$423.39
|
| Rate for Payer: PACE SWMI |
$403.23
|
| Rate for Payer: PHP Medicare Advantage |
$403.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.74
|
| Rate for Payer: Priority Health Medicare |
$403.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$634.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.23
|
| Rate for Payer: UHC Medicare Advantage |
$415.33
|
|
