|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$200.22 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$400.66
|
| Rate for Payer: Aetna Medicare |
$310.96
|
| Rate for Payer: BCBS Complete |
$210.23
|
| Rate for Payer: BCBS MAPPO |
$299.00
|
| Rate for Payer: BCBS Trust/PPO |
$328.60
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: BCN Medicare Advantage |
$299.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$430.56
|
| Rate for Payer: Cofinity Commercial |
$400.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.00
|
| Rate for Payer: Mclaren Medicaid |
$200.22
|
| Rate for Payer: Meridian Medicaid |
$210.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$313.95
|
| Rate for Payer: PACE SWMI |
$299.00
|
| Rate for Payer: PHP Medicare Advantage |
$299.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.31
|
| Rate for Payer: Priority Health Medicare |
$299.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.00
|
| Rate for Payer: UHC Medicare Advantage |
$307.97
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$359.54 |
| Max. Negotiated Rate |
$2,458.18 |
| Rate for Payer: Aetna Commercial |
$734.28
|
| Rate for Payer: Aetna Medicare |
$569.89
|
| Rate for Payer: BCBS Complete |
$377.52
|
| Rate for Payer: BCBS MAPPO |
$547.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$818.53
|
| Rate for Payer: BCN Medicare Advantage |
$547.97
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$734.28
|
| Rate for Payer: Cofinity Commercial |
$789.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.97
|
| Rate for Payer: Mclaren Medicaid |
$359.54
|
| Rate for Payer: Meridian Medicaid |
$377.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$575.37
|
| Rate for Payer: PACE SWMI |
$547.97
|
| Rate for Payer: PHP Medicare Advantage |
$547.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,151.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$984.85
|
| Rate for Payer: Priority Health Medicare |
$547.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$984.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$547.97
|
| Rate for Payer: UHC Medicare Advantage |
$564.41
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$570.84 |
| Max. Negotiated Rate |
$1,299.88 |
| Rate for Payer: Aetna Commercial |
$1,187.70
|
| Rate for Payer: Aetna Medicare |
$921.79
|
| Rate for Payer: BCBS Complete |
$599.38
|
| Rate for Payer: BCBS MAPPO |
$886.34
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,299.88
|
| Rate for Payer: BCN Medicare Advantage |
$886.34
|
| Rate for Payer: Cash Price |
$1,468.00
|
| Rate for Payer: Cash Price |
$1,468.00
|
| Rate for Payer: Cofinity Commercial |
$1,187.70
|
| Rate for Payer: Cofinity Commercial |
$1,276.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$886.34
|
| Rate for Payer: Mclaren Medicaid |
$570.84
|
| Rate for Payer: Meridian Medicaid |
$599.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$930.66
|
| Rate for Payer: PACE SWMI |
$886.34
|
| Rate for Payer: PHP Medicare Advantage |
$886.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,231.70
|
| Rate for Payer: Priority Health Medicare |
$886.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,231.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$886.34
|
| Rate for Payer: UHC Medicare Advantage |
$912.93
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$245.13 |
| Max. Negotiated Rate |
$2,514.18 |
| Rate for Payer: Aetna Commercial |
$1,910.63
|
| Rate for Payer: Aetna Medicare |
$1,482.87
|
| Rate for Payer: BCBS Complete |
$960.35
|
| Rate for Payer: BCBS MAPPO |
$1,425.84
|
| Rate for Payer: BCBS Trust/PPO |
$245.13
|
| Rate for Payer: BCN Commercial |
$2,089.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,425.84
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cofinity Commercial |
$2,053.21
|
| Rate for Payer: Cofinity Commercial |
$1,910.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,425.84
|
| Rate for Payer: Mclaren Medicaid |
$914.62
|
| Rate for Payer: Meridian Medicaid |
$960.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,497.13
|
| Rate for Payer: PACE SWMI |
$1,425.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,425.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,769.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,514.18
|
| Rate for Payer: Priority Health Medicare |
$1,425.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,514.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,425.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,468.62
|
|
|
PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ
|
Professional
|
Both
|
$3,506.00
|
|
|
Service Code
|
HCPCS 44661
|
| Min. Negotiated Rate |
$246.19 |
| Max. Negotiated Rate |
$2,694.09 |
| Rate for Payer: Aetna Commercial |
$2,048.02
|
| Rate for Payer: Aetna Medicare |
$1,589.50
|
| Rate for Payer: BCBS Complete |
$1,027.00
|
| Rate for Payer: BCBS MAPPO |
$1,528.37
|
| Rate for Payer: BCBS Trust/PPO |
$246.19
|
| Rate for Payer: BCN Commercial |
$2,239.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,528.37
|
| Rate for Payer: Cash Price |
$2,804.80
|
| Rate for Payer: Cash Price |
$2,804.80
|
| Rate for Payer: Cofinity Commercial |
$2,200.85
|
| Rate for Payer: Cofinity Commercial |
$2,048.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,528.37
|
| Rate for Payer: Mclaren Medicaid |
$978.10
|
| Rate for Payer: Meridian Medicaid |
$1,027.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,604.79
|
| Rate for Payer: PACE SWMI |
$1,528.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,528.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$978.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,454.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,694.09
|
| Rate for Payer: Priority Health Medicare |
$1,528.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,694.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,528.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,528.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,574.22
|
|
|
PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ
|
Professional
|
Both
|
$2,610.00
|
|
|
Service Code
|
HCPCS 44660
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,327.78 |
| Rate for Payer: Aetna Commercial |
$1,766.44
|
| Rate for Payer: Aetna Medicare |
$1,370.97
|
| Rate for Payer: BCBS Complete |
$895.05
|
| Rate for Payer: BCBS MAPPO |
$1,318.24
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,934.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.24
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cofinity Commercial |
$1,898.27
|
| Rate for Payer: Cofinity Commercial |
$1,766.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.24
|
| Rate for Payer: Mclaren Medicaid |
$852.43
|
| Rate for Payer: Meridian Medicaid |
$895.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,384.15
|
| Rate for Payer: PACE SWMI |
$1,318.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,827.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,327.78
|
| Rate for Payer: Priority Health Medicare |
$1,318.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,327.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,318.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,357.79
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR
|
Professional
|
Both
|
$2,640.00
|
|
|
Service Code
|
HCPCS 43420
|
| Min. Negotiated Rate |
$652.21 |
| Max. Negotiated Rate |
$1,848.00 |
| Rate for Payer: Aetna Commercial |
$1,347.92
|
| Rate for Payer: Aetna Medicare |
$1,046.15
|
| Rate for Payer: BCBS Complete |
$684.82
|
| Rate for Payer: BCBS MAPPO |
$1,005.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,490.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.91
|
| Rate for Payer: Cash Price |
$2,112.00
|
| Rate for Payer: Cash Price |
$2,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,347.92
|
| Rate for Payer: Cofinity Commercial |
$1,448.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.91
|
| Rate for Payer: Mclaren Medicaid |
$652.21
|
| Rate for Payer: Meridian Medicaid |
$684.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,056.21
|
| Rate for Payer: PACE SWMI |
$1,005.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,848.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.91
|
| Rate for Payer: Priority Health Medicare |
$1,005.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,793.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,036.09
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,095.00
|
|
|
Service Code
|
HCPCS 43425
|
| Min. Negotiated Rate |
$911.43 |
| Max. Negotiated Rate |
$2,866.50 |
| Rate for Payer: Aetna Commercial |
$1,907.38
|
| Rate for Payer: Aetna Medicare |
$1,480.36
|
| Rate for Payer: BCBS Complete |
$957.00
|
| Rate for Payer: BCBS MAPPO |
$1,423.42
|
| Rate for Payer: BCBS Trust/PPO |
$986.34
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.42
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$2,049.72
|
| Rate for Payer: Cofinity Commercial |
$1,907.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.42
|
| Rate for Payer: Mclaren Medicaid |
$911.43
|
| Rate for Payer: Meridian Medicaid |
$957.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.59
|
| Rate for Payer: PACE SWMI |
$1,423.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$911.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,866.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,503.00
|
| Rate for Payer: Priority Health Medicare |
$1,423.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,503.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,423.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.12
|
|
|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,031.77 |
| Rate for Payer: Aetna Commercial |
$149.42
|
| Rate for Payer: Aetna Medicare |
$115.97
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$111.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.77
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$111.51
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$149.42
|
| Rate for Payer: Cofinity Commercial |
$160.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.51
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$117.09
|
| Rate for Payer: PACE SWMI |
$111.51
|
| Rate for Payer: PHP Medicare Advantage |
$111.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.56
|
| Rate for Payer: Priority Health Medicare |
$111.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.51
|
| Rate for Payer: UHC Medicare Advantage |
$114.86
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT
|
Professional
|
Both
|
$2,856.00
|
|
|
Service Code
|
HCPCS 44625
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$1,999.20 |
| Rate for Payer: Aetna Commercial |
$1,337.57
|
| Rate for Payer: Aetna Medicare |
$1,038.12
|
| Rate for Payer: BCBS Complete |
$674.97
|
| Rate for Payer: BCBS MAPPO |
$998.19
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,467.49
|
| Rate for Payer: BCN Medicare Advantage |
$998.19
|
| Rate for Payer: Cash Price |
$2,284.80
|
| Rate for Payer: Cash Price |
$2,284.80
|
| Rate for Payer: Cofinity Commercial |
$1,437.39
|
| Rate for Payer: Cofinity Commercial |
$1,337.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.19
|
| Rate for Payer: Mclaren Medicaid |
$642.83
|
| Rate for Payer: Meridian Medicaid |
$674.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,048.10
|
| Rate for Payer: PACE SWMI |
$998.19
|
| Rate for Payer: PHP Medicare Advantage |
$998.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,999.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,765.68
|
| Rate for Payer: Priority Health Medicare |
$998.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,765.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$998.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,028.14
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS
|
Professional
|
Both
|
$2,914.00
|
|
|
Service Code
|
HCPCS 44626
|
| Min. Negotiated Rate |
$205.51 |
| Max. Negotiated Rate |
$2,781.10 |
| Rate for Payer: Aetna Commercial |
$2,115.28
|
| Rate for Payer: Aetna Medicare |
$1,641.71
|
| Rate for Payer: BCBS Complete |
$1,060.10
|
| Rate for Payer: BCBS MAPPO |
$1,578.57
|
| Rate for Payer: BCBS Trust/PPO |
$205.51
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,578.57
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cofinity Commercial |
$2,273.14
|
| Rate for Payer: Cofinity Commercial |
$2,115.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,578.57
|
| Rate for Payer: Mclaren Medicaid |
$1,009.62
|
| Rate for Payer: Meridian Medicaid |
$1,060.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,657.50
|
| Rate for Payer: PACE SWMI |
$1,578.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,578.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,009.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,039.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,781.10
|
| Rate for Payer: Priority Health Medicare |
$1,578.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,578.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,578.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,625.93
|
|
|
PR CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ
|
Professional
|
Both
|
$1,442.00
|
|
|
Service Code
|
HCPCS 57308
|
| Min. Negotiated Rate |
$426.21 |
| Max. Negotiated Rate |
$1,574.86 |
| Rate for Payer: Aetna Commercial |
$874.77
|
| Rate for Payer: Aetna Medicare |
$678.92
|
| Rate for Payer: BCBS Complete |
$447.52
|
| Rate for Payer: BCBS MAPPO |
$652.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,574.86
|
| Rate for Payer: BCN Commercial |
$970.51
|
| Rate for Payer: BCN Medicare Advantage |
$652.81
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cofinity Commercial |
$874.77
|
| Rate for Payer: Cofinity Commercial |
$940.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.81
|
| Rate for Payer: Mclaren Medicaid |
$426.21
|
| Rate for Payer: Meridian Medicaid |
$447.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$685.45
|
| Rate for Payer: PACE SWMI |
$652.81
|
| Rate for Payer: PHP Medicare Advantage |
$652.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,009.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.22
|
| Rate for Payer: Priority Health Medicare |
$652.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$940.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.81
|
| Rate for Payer: UHC Medicare Advantage |
$672.39
|
|
|
PR CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,937.00
|
|
|
Service Code
|
HCPCS 57305
|
| Min. Negotiated Rate |
$627.50 |
| Max. Negotiated Rate |
$2,391.09 |
| Rate for Payer: Aetna Commercial |
$1,306.10
|
| Rate for Payer: Aetna Medicare |
$1,013.69
|
| Rate for Payer: BCBS Complete |
$658.88
|
| Rate for Payer: BCBS MAPPO |
$974.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.09
|
| Rate for Payer: BCN Commercial |
$1,444.05
|
| Rate for Payer: BCN Medicare Advantage |
$974.70
|
| Rate for Payer: Cash Price |
$1,549.60
|
| Rate for Payer: Cash Price |
$1,549.60
|
| Rate for Payer: Cofinity Commercial |
$1,403.57
|
| Rate for Payer: Cofinity Commercial |
$1,306.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.70
|
| Rate for Payer: Mclaren Medicaid |
$627.50
|
| Rate for Payer: Meridian Medicaid |
$658.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,023.44
|
| Rate for Payer: PACE SWMI |
$974.70
|
| Rate for Payer: PHP Medicare Advantage |
$974.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,398.97
|
| Rate for Payer: Priority Health Medicare |
$974.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,398.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$974.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,003.94
|
|
|
PR CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR
|
Professional
|
Both
|
$1,295.00
|
|
|
Service Code
|
HCPCS 57300
|
| Min. Negotiated Rate |
$395.12 |
| Max. Negotiated Rate |
$2,627.76 |
| Rate for Payer: Aetna Commercial |
$807.04
|
| Rate for Payer: Aetna Medicare |
$626.36
|
| Rate for Payer: BCBS Complete |
$414.88
|
| Rate for Payer: BCBS MAPPO |
$602.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,627.76
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$602.27
|
| Rate for Payer: Cash Price |
$1,036.00
|
| Rate for Payer: Cash Price |
$1,036.00
|
| Rate for Payer: Cofinity Commercial |
$867.27
|
| Rate for Payer: Cofinity Commercial |
$807.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.27
|
| Rate for Payer: Mclaren Medicaid |
$395.12
|
| Rate for Payer: Meridian Medicaid |
$414.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$632.38
|
| Rate for Payer: PACE SWMI |
$602.27
|
| Rate for Payer: PHP Medicare Advantage |
$602.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.63
|
| Rate for Payer: Priority Health Medicare |
$602.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$870.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.27
|
| Rate for Payer: UHC Medicare Advantage |
$620.34
|
|
|
PR CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX
|
Professional
|
Both
|
$1,130.00
|
|
|
Service Code
|
HCPCS 53520
|
| Min. Negotiated Rate |
$256.23 |
| Max. Negotiated Rate |
$893.75 |
| Rate for Payer: Aetna Commercial |
$731.00
|
| Rate for Payer: Aetna Medicare |
$567.34
|
| Rate for Payer: BCBS Complete |
$375.51
|
| Rate for Payer: BCBS MAPPO |
$545.52
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$545.52
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cofinity Commercial |
$785.55
|
| Rate for Payer: Cofinity Commercial |
$731.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.52
|
| Rate for Payer: Mclaren Medicaid |
$357.63
|
| Rate for Payer: Meridian Medicaid |
$375.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$572.80
|
| Rate for Payer: PACE SWMI |
$545.52
|
| Rate for Payer: PHP Medicare Advantage |
$545.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$893.75
|
| Rate for Payer: Priority Health Medicare |
$545.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$893.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$545.52
|
| Rate for Payer: UHC Medicare Advantage |
$561.89
|
|
|
PR CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL
|
Professional
|
Both
|
$1,081.00
|
|
|
Service Code
|
HCPCS 57311
|
| Min. Negotiated Rate |
$356.78 |
| Max. Negotiated Rate |
$2,101.05 |
| Rate for Payer: Aetna Commercial |
$728.17
|
| Rate for Payer: Aetna Medicare |
$565.15
|
| Rate for Payer: BCBS Complete |
$374.62
|
| Rate for Payer: BCBS MAPPO |
$543.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.05
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$543.41
|
| Rate for Payer: Cash Price |
$864.80
|
| Rate for Payer: Cash Price |
$864.80
|
| Rate for Payer: Cofinity Commercial |
$728.17
|
| Rate for Payer: Cofinity Commercial |
$782.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.41
|
| Rate for Payer: Mclaren Medicaid |
$356.78
|
| Rate for Payer: Meridian Medicaid |
$374.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$570.58
|
| Rate for Payer: PACE SWMI |
$543.41
|
| Rate for Payer: PHP Medicare Advantage |
$543.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.04
|
| Rate for Payer: Priority Health Medicare |
$543.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.41
|
| Rate for Payer: UHC Medicare Advantage |
$559.71
|
|
|
PR CLSR VESICOVAGINAL FISTUL AABDL APPROACH
|
Professional
|
Both
|
$3,839.00
|
|
|
Service Code
|
HCPCS 51900
|
| Min. Negotiated Rate |
$524.19 |
| Max. Negotiated Rate |
$2,687.30 |
| Rate for Payer: Aetna Commercial |
$1,077.80
|
| Rate for Payer: Aetna Medicare |
$836.50
|
| Rate for Payer: BCBS Complete |
$550.40
|
| Rate for Payer: BCBS MAPPO |
$804.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,187.98
|
| Rate for Payer: BCN Medicare Advantage |
$804.33
|
| Rate for Payer: Cash Price |
$3,071.20
|
| Rate for Payer: Cash Price |
$3,071.20
|
| Rate for Payer: Cofinity Commercial |
$1,158.24
|
| Rate for Payer: Cofinity Commercial |
$1,077.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.33
|
| Rate for Payer: Mclaren Medicaid |
$524.19
|
| Rate for Payer: Meridian Medicaid |
$550.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$844.55
|
| Rate for Payer: PACE SWMI |
$804.33
|
| Rate for Payer: PHP Medicare Advantage |
$804.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$524.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,687.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,313.61
|
| Rate for Payer: Priority Health Medicare |
$804.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,313.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.33
|
| Rate for Payer: UHC Medicare Advantage |
$828.46
|
|
|
PR CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 15155
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,166.47 |
| Rate for Payer: Aetna Commercial |
$956.57
|
| Rate for Payer: Aetna Medicare |
$742.41
|
| Rate for Payer: BCBS Complete |
$488.90
|
| Rate for Payer: BCBS MAPPO |
$713.86
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$713.86
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cofinity Commercial |
$1,027.96
|
| Rate for Payer: Cofinity Commercial |
$956.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.86
|
| Rate for Payer: Mclaren Medicaid |
$465.62
|
| Rate for Payer: Meridian Medicaid |
$488.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$749.55
|
| Rate for Payer: PACE SWMI |
$713.86
|
| Rate for Payer: PHP Medicare Advantage |
$713.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.06
|
| Rate for Payer: Priority Health Medicare |
$713.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$896.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$713.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$713.86
|
| Rate for Payer: UHC Medicare Advantage |
$735.28
|
|
|
PR CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 15156
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$200.37
|
| Rate for Payer: Aetna Medicare |
$155.51
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$149.53
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: BCN Medicare Advantage |
$149.53
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$215.32
|
| Rate for Payer: Cofinity Commercial |
$200.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.53
|
| Rate for Payer: Mclaren Medicaid |
$95.21
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.01
|
| Rate for Payer: PACE SWMI |
$149.53
|
| Rate for Payer: PHP Medicare Advantage |
$149.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.91
|
| Rate for Payer: Priority Health Medicare |
$149.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.53
|
| Rate for Payer: UHC Medicare Advantage |
$154.02
|
|
|
PR CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 15151
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$206.12 |
| Rate for Payer: Aetna Commercial |
$146.35
|
| Rate for Payer: Aetna Medicare |
$113.59
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$109.22
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$172.50
|
| Rate for Payer: BCN Medicare Advantage |
$109.22
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$146.35
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.22
|
| Rate for Payer: Mclaren Medicaid |
$69.01
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.68
|
| Rate for Payer: PACE SWMI |
$109.22
|
| Rate for Payer: PHP Medicare Advantage |
$109.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.58
|
| Rate for Payer: Priority Health Medicare |
$109.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.22
|
| Rate for Payer: UHC Medicare Advantage |
$112.50
|
|
|
PR CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 15152
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$187.25
|
| Rate for Payer: Aetna Medicare |
$145.33
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$139.74
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$218.44
|
| Rate for Payer: BCN Medicare Advantage |
$139.74
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$201.23
|
| Rate for Payer: Cofinity Commercial |
$187.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.74
|
| Rate for Payer: Mclaren Medicaid |
$87.97
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.73
|
| Rate for Payer: PACE SWMI |
$139.74
|
| Rate for Payer: PHP Medicare Advantage |
$139.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.23
|
| Rate for Payer: Priority Health Medicare |
$139.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.74
|
| Rate for Payer: UHC Medicare Advantage |
$143.93
|
|
|
PR CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<
|
Professional
|
Both
|
$1,181.00
|
|
|
Service Code
|
HCPCS 15150
|
| Min. Negotiated Rate |
$212.16 |
| Max. Negotiated Rate |
$1,035.02 |
| Rate for Payer: Aetna Commercial |
$846.99
|
| Rate for Payer: Aetna Medicare |
$657.36
|
| Rate for Payer: BCBS Complete |
$430.53
|
| Rate for Payer: BCBS MAPPO |
$632.08
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: BCN Medicare Advantage |
$632.08
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cofinity Commercial |
$910.20
|
| Rate for Payer: Cofinity Commercial |
$846.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.08
|
| Rate for Payer: Mclaren Medicaid |
$410.03
|
| Rate for Payer: Meridian Medicaid |
$430.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$663.68
|
| Rate for Payer: PACE SWMI |
$632.08
|
| Rate for Payer: PHP Medicare Advantage |
$632.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$786.31
|
| Rate for Payer: Priority Health Medicare |
$632.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$786.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.08
|
| Rate for Payer: UHC Medicare Advantage |
$651.04
|
|
|
PR CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$2,229.00
|
|
|
Service Code
|
HCPCS 27222
|
| Min. Negotiated Rate |
$631.33 |
| Max. Negotiated Rate |
$2,011.24 |
| Rate for Payer: Aetna Commercial |
$1,303.34
|
| Rate for Payer: Aetna Medicare |
$1,011.55
|
| Rate for Payer: BCBS Complete |
$662.90
|
| Rate for Payer: BCBS MAPPO |
$972.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$1,446.98
|
| Rate for Payer: BCN Medicare Advantage |
$972.64
|
| Rate for Payer: Cash Price |
$1,783.20
|
| Rate for Payer: Cash Price |
$1,783.20
|
| Rate for Payer: Cofinity Commercial |
$1,400.60
|
| Rate for Payer: Cofinity Commercial |
$1,303.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.64
|
| Rate for Payer: Mclaren Medicaid |
$631.33
|
| Rate for Payer: Meridian Medicaid |
$662.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,021.27
|
| Rate for Payer: PACE SWMI |
$972.64
|
| Rate for Payer: PHP Medicare Advantage |
$972.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$631.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,560.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,512.03
|
| Rate for Payer: Priority Health Medicare |
$972.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,512.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$972.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$972.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,001.82
|
|
|
PR CLTX ACETABULUM HIP/SOCKT FX W/O MANJ
|
Professional
|
Both
|
$1,646.00
|
|
|
Service Code
|
HCPCS 27220
|
| Min. Negotiated Rate |
$269.02 |
| Max. Negotiated Rate |
$2,011.24 |
| Rate for Payer: Aetna Commercial |
$547.63
|
| Rate for Payer: Aetna Medicare |
$425.03
|
| Rate for Payer: BCBS Complete |
$282.47
|
| Rate for Payer: BCBS MAPPO |
$408.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$620.13
|
| Rate for Payer: BCN Medicare Advantage |
$408.68
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cofinity Commercial |
$547.63
|
| Rate for Payer: Cofinity Commercial |
$588.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.68
|
| Rate for Payer: Mclaren Medicaid |
$269.02
|
| Rate for Payer: Meridian Medicaid |
$282.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.11
|
| Rate for Payer: PACE SWMI |
$408.68
|
| Rate for Payer: PHP Medicare Advantage |
$408.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,152.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.31
|
| Rate for Payer: Priority Health Medicare |
$408.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$638.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.68
|
| Rate for Payer: UHC Medicare Advantage |
$420.94
|
|
|
PR CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 27842
|
| Min. Negotiated Rate |
$321.84 |
| Max. Negotiated Rate |
$1,704.38 |
| Rate for Payer: Aetna Commercial |
$651.07
|
| Rate for Payer: Aetna Medicare |
$505.30
|
| Rate for Payer: BCBS Complete |
$337.93
|
| Rate for Payer: BCBS MAPPO |
$485.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.38
|
| Rate for Payer: BCN Commercial |
$727.64
|
| Rate for Payer: BCN Medicare Advantage |
$485.87
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$651.07
|
| Rate for Payer: Cofinity Commercial |
$699.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.87
|
| Rate for Payer: Mclaren Medicaid |
$321.84
|
| Rate for Payer: Meridian Medicaid |
$337.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$510.16
|
| Rate for Payer: PACE SWMI |
$485.87
|
| Rate for Payer: PHP Medicare Advantage |
$485.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.36
|
| Rate for Payer: Priority Health Medicare |
$485.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.87
|
| Rate for Payer: UHC Medicare Advantage |
$500.45
|
|
