|
PR EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 0298T
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR EXTENDED ABDOMINOPLASTY
|
Professional
|
Both
|
$5,304.00
|
|
|
Service Code
|
HCPCS 00366
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,121.60 |
| Max. Negotiated Rate |
$3,447.60 |
| Rate for Payer: Aetna Medicare |
$2,652.00
|
| Rate for Payer: BCBS Complete |
$2,121.60
|
| Rate for Payer: Cash Price |
$4,243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,447.60
|
|
|
PR EXTENDED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 92083
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$82.51 |
| Rate for Payer: Aetna Commercial |
$76.78
|
| Rate for Payer: Aetna Medicare |
$59.59
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$57.30
|
| Rate for Payer: BCN Medicare Advantage |
$57.30
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$82.51
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.16
|
| Rate for Payer: Nomi Health Commercial |
$68.76
|
| Rate for Payer: PACE SWMI |
$57.30
|
| Rate for Payer: PHP Medicare Advantage |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Medicare |
$57.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.30
|
| Rate for Payer: UHC Exchange |
$57.30
|
| Rate for Payer: UHC Medicare Advantage |
$57.30
|
|
|
PR EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 59412
|
| Min. Negotiated Rate |
$100.38 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Aetna Commercial |
$134.51
|
| Rate for Payer: Aetna Medicare |
$104.40
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$100.38
|
| Rate for Payer: BCN Medicare Advantage |
$100.38
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$134.51
|
| Rate for Payer: Cofinity Commercial |
$144.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.40
|
| Rate for Payer: Nomi Health Commercial |
$120.46
|
| Rate for Payer: PACE SWMI |
$100.38
|
| Rate for Payer: PHP Medicare Advantage |
$100.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health Medicare |
$101.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.38
|
| Rate for Payer: UHC Exchange |
$100.38
|
| Rate for Payer: UHC Medicare Advantage |
$100.38
|
|
|
PR EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 48510
|
| Min. Negotiated Rate |
$1,063.54 |
| Max. Negotiated Rate |
$2,002.65 |
| Rate for Payer: Aetna Commercial |
$1,425.14
|
| Rate for Payer: Aetna Medicare |
$1,106.08
|
| Rate for Payer: BCBS Complete |
$1,232.40
|
| Rate for Payer: BCBS MAPPO |
$1,063.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.54
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,531.50
|
| Rate for Payer: Cofinity Commercial |
$1,425.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,116.72
|
| Rate for Payer: Nomi Health Commercial |
$1,276.25
|
| Rate for Payer: PACE SWMI |
$1,063.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health Medicare |
$1,074.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.54
|
| Rate for Payer: UHC Exchange |
$1,063.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,063.54
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93242
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$13.94
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.92
|
| Rate for Payer: Nomi Health Commercial |
$12.48
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
|
|
PR EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 93244
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$31.85 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare |
$22.52
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$21.65
|
| Rate for Payer: BCN Medicare Advantage |
$21.65
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.73
|
| Rate for Payer: Nomi Health Commercial |
$25.98
|
| Rate for Payer: PACE SWMI |
$21.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Medicare |
$21.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.65
|
| Rate for Payer: UHC Exchange |
$21.65
|
| Rate for Payer: UHC Medicare Advantage |
$21.65
|
|
|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93246
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$13.94
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.92
|
| Rate for Payer: Nomi Health Commercial |
$12.48
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
|
|
PR EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93248
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$31.96
|
| Rate for Payer: Aetna Medicare |
$24.80
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$23.85
|
| Rate for Payer: BCN Medicare Advantage |
$23.85
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$34.34
|
| Rate for Payer: Cofinity Commercial |
$31.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.04
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: PACE SWMI |
$23.85
|
| Rate for Payer: PHP Medicare Advantage |
$23.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.85
|
| Rate for Payer: UHC Exchange |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$23.85
|
|
|
PR EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 32540
|
| Min. Negotiated Rate |
$1,286.40 |
| Max. Negotiated Rate |
$2,389.15 |
| Rate for Payer: Aetna Commercial |
$2,223.23
|
| Rate for Payer: Aetna Medicare |
$1,725.50
|
| Rate for Payer: BCBS Complete |
$1,286.40
|
| Rate for Payer: BCBS MAPPO |
$1,659.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,659.13
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cofinity Commercial |
$2,389.15
|
| Rate for Payer: Cofinity Commercial |
$2,223.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,659.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,742.09
|
| Rate for Payer: Nomi Health Commercial |
$1,990.96
|
| Rate for Payer: PACE SWMI |
$1,659.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,659.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health Medicare |
$1,675.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,659.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,659.13
|
| Rate for Payer: UHC Exchange |
$1,659.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,659.13
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 26111
|
| Min. Negotiated Rate |
$402.99 |
| Max. Negotiated Rate |
$782.60 |
| Rate for Payer: Aetna Commercial |
$540.01
|
| Rate for Payer: Aetna Medicare |
$419.11
|
| Rate for Payer: BCBS Complete |
$481.60
|
| Rate for Payer: BCBS MAPPO |
$402.99
|
| Rate for Payer: BCN Medicare Advantage |
$402.99
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$580.31
|
| Rate for Payer: Cofinity Commercial |
$540.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.14
|
| Rate for Payer: Nomi Health Commercial |
$483.59
|
| Rate for Payer: PACE SWMI |
$402.99
|
| Rate for Payer: PHP Medicare Advantage |
$402.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health Medicare |
$407.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.99
|
| Rate for Payer: UHC Exchange |
$402.99
|
| Rate for Payer: UHC Medicare Advantage |
$402.99
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$1,839.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$530.18 |
| Max. Negotiated Rate |
$1,195.35 |
| Rate for Payer: Aetna Commercial |
$710.44
|
| Rate for Payer: Aetna Medicare |
$551.39
|
| Rate for Payer: BCBS Complete |
$735.60
|
| Rate for Payer: BCBS MAPPO |
$530.18
|
| Rate for Payer: BCN Medicare Advantage |
$530.18
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cofinity Commercial |
$763.46
|
| Rate for Payer: Cofinity Commercial |
$710.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.69
|
| Rate for Payer: Nomi Health Commercial |
$636.22
|
| Rate for Payer: PACE SWMI |
$530.18
|
| Rate for Payer: PHP Medicare Advantage |
$530.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.35
|
| Rate for Payer: Priority Health Medicare |
$535.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$530.18
|
| Rate for Payer: UHC Exchange |
$530.18
|
| Rate for Payer: UHC Medicare Advantage |
$530.18
|
|
|
PR FAA PHYSICAL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 00180
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$86.45 |
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
|
|
PR FACIAL NERVE FUNCTION STUDIES
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 92516
|
| Min. Negotiated Rate |
$21.24 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$22.09
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$21.24
|
| Rate for Payer: BCN Medicare Advantage |
$21.24
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$28.46
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.30
|
| Rate for Payer: Nomi Health Commercial |
$25.49
|
| Rate for Payer: PACE SWMI |
$21.24
|
| Rate for Payer: PHP Medicare Advantage |
$21.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.24
|
| Rate for Payer: UHC Exchange |
$21.24
|
| Rate for Payer: UHC Medicare Advantage |
$21.24
|
|
|
PR FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 97156
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
|
|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 90846
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$140.63 |
| Rate for Payer: Aetna Commercial |
$130.86
|
| Rate for Payer: Aetna Medicare |
$101.57
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$97.66
|
| Rate for Payer: BCN Medicare Advantage |
$97.66
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$130.86
|
| Rate for Payer: Cofinity Commercial |
$140.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.54
|
| Rate for Payer: Nomi Health Commercial |
$117.19
|
| Rate for Payer: PACE SWMI |
$97.66
|
| Rate for Payer: PHP Medicare Advantage |
$97.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$98.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.66
|
| Rate for Payer: UHC Exchange |
$97.66
|
| Rate for Payer: UHC Medicare Advantage |
$97.66
|
|
|
PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 90847
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$146.61 |
| Rate for Payer: Aetna Commercial |
$136.43
|
| Rate for Payer: Aetna Medicare |
$105.88
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$101.81
|
| Rate for Payer: BCN Medicare Advantage |
$101.81
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$146.61
|
| Rate for Payer: Cofinity Commercial |
$136.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.90
|
| Rate for Payer: Nomi Health Commercial |
$122.17
|
| Rate for Payer: PACE SWMI |
$101.81
|
| Rate for Payer: PHP Medicare Advantage |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$102.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.81
|
| Rate for Payer: UHC Exchange |
$101.81
|
| Rate for Payer: UHC Medicare Advantage |
$101.81
|
|
|
PR FASCIA LATA GRAFT INCISION & AREA EXPOSURE
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 20922
|
| Min. Negotiated Rate |
$430.80 |
| Max. Negotiated Rate |
$700.05 |
| Rate for Payer: Aetna Commercial |
$645.54
|
| Rate for Payer: Aetna Medicare |
$501.02
|
| Rate for Payer: BCBS Complete |
$430.80
|
| Rate for Payer: BCBS MAPPO |
$481.75
|
| Rate for Payer: BCN Medicare Advantage |
$481.75
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$693.72
|
| Rate for Payer: Cofinity Commercial |
$645.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.84
|
| Rate for Payer: Nomi Health Commercial |
$578.10
|
| Rate for Payer: PACE SWMI |
$481.75
|
| Rate for Payer: PHP Medicare Advantage |
$481.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.05
|
| Rate for Payer: Priority Health Medicare |
$486.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.75
|
| Rate for Payer: UHC Exchange |
$481.75
|
| Rate for Payer: UHC Medicare Advantage |
$481.75
|
|
|
PR FASCIECTOMY PLANTAR FASCIA PARTIAL SPX
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 28060
|
| Min. Negotiated Rate |
$344.40 |
| Max. Negotiated Rate |
$633.75 |
| Rate for Payer: Aetna Commercial |
$461.50
|
| Rate for Payer: Aetna Medicare |
$358.18
|
| Rate for Payer: BCBS Complete |
$390.00
|
| Rate for Payer: BCBS MAPPO |
$344.40
|
| Rate for Payer: BCN Medicare Advantage |
$344.40
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cofinity Commercial |
$495.94
|
| Rate for Payer: Cofinity Commercial |
$461.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.62
|
| Rate for Payer: Nomi Health Commercial |
$413.28
|
| Rate for Payer: PACE SWMI |
$344.40
|
| Rate for Payer: PHP Medicare Advantage |
$344.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.75
|
| Rate for Payer: Priority Health Medicare |
$347.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.40
|
| Rate for Payer: UHC Exchange |
$344.40
|
| Rate for Payer: UHC Medicare Advantage |
$344.40
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$170.76 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna Medicare |
$186.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.69
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$179.75
|
| Rate for Payer: BCBS Trust/PPO |
$591.09
|
| Rate for Payer: BCN Commercial |
$559.02
|
| Rate for Payer: BCN Medicare Advantage |
$179.75
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.75
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.74
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: PACE Senior Care Partners |
$170.76
|
| Rate for Payer: PACE SWMI |
$179.75
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: PHP Medicare Advantage |
$179.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health HMO/PPO |
$625.53
|
| Rate for Payer: Priority Health Medicare |
$181.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.73
|
| Rate for Payer: Railroad Medicare Medicare |
$179.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.72
|
| Rate for Payer: UHC Core |
$600.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.75
|
| Rate for Payer: UHC Exchange |
$179.75
|
| Rate for Payer: UHC Medicare Advantage |
$179.75
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$179.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$281.98 |
| Max. Negotiated Rate |
$467.35 |
| Rate for Payer: Aetna Commercial |
$377.85
|
| Rate for Payer: Aetna Medicare |
$293.26
|
| Rate for Payer: BCBS Complete |
$287.60
|
| Rate for Payer: BCBS MAPPO |
$281.98
|
| Rate for Payer: BCN Medicare Advantage |
$281.98
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$406.05
|
| Rate for Payer: Cofinity Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.08
|
| Rate for Payer: Nomi Health Commercial |
$338.38
|
| Rate for Payer: PACE SWMI |
$281.98
|
| Rate for Payer: PHP Medicare Advantage |
$281.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health Medicare |
$284.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.98
|
| Rate for Payer: UHC Exchange |
$281.98
|
| Rate for Payer: UHC Medicare Advantage |
$281.98
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$467.35 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: BCBS Trust/PPO |
$586.92
|
| Rate for Payer: BCN Commercial |
$555.64
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health HMO/PPO |
$625.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.72
|
| Rate for Payer: UHC Core |
$600.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 28008
|
| Min. Negotiated Rate |
$281.98 |
| Max. Negotiated Rate |
$467.35 |
| Rate for Payer: Aetna Commercial |
$377.85
|
| Rate for Payer: Aetna Medicare |
$293.26
|
| Rate for Payer: BCBS Complete |
$287.60
|
| Rate for Payer: BCBS MAPPO |
$281.98
|
| Rate for Payer: BCN Medicare Advantage |
$281.98
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$406.05
|
| Rate for Payer: Cofinity Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.08
|
| Rate for Payer: Nomi Health Commercial |
$338.38
|
| Rate for Payer: PACE SWMI |
$281.98
|
| Rate for Payer: PHP Medicare Advantage |
$281.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.35
|
| Rate for Payer: Priority Health Medicare |
$284.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.98
|
| Rate for Payer: UHC Exchange |
$281.98
|
| Rate for Payer: UHC Medicare Advantage |
$281.98
|
|
|
PR FASCIOTOMY HIP/THIGH ANY TYPE
|
Professional
|
Both
|
$3,485.00
|
|
|
Service Code
|
HCPCS 27025
|
| Min. Negotiated Rate |
$902.59 |
| Max. Negotiated Rate |
$2,265.25 |
| Rate for Payer: Aetna Commercial |
$1,209.47
|
| Rate for Payer: Aetna Medicare |
$938.69
|
| Rate for Payer: BCBS Complete |
$1,394.00
|
| Rate for Payer: BCBS MAPPO |
$902.59
|
| Rate for Payer: BCN Medicare Advantage |
$902.59
|
| Rate for Payer: Cash Price |
$2,788.00
|
| Rate for Payer: Cash Price |
$2,788.00
|
| Rate for Payer: Cofinity Commercial |
$1,299.73
|
| Rate for Payer: Cofinity Commercial |
$1,209.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.72
|
| Rate for Payer: Nomi Health Commercial |
$1,083.11
|
| Rate for Payer: PACE SWMI |
$902.59
|
| Rate for Payer: PHP Medicare Advantage |
$902.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.25
|
| Rate for Payer: Priority Health Medicare |
$911.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.59
|
| Rate for Payer: UHC Exchange |
$902.59
|
| Rate for Payer: UHC Medicare Advantage |
$902.59
|
|
|
PR FASCIOTOMY ILIOTIBIAL OPEN
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 27305
|
| Min. Negotiated Rate |
$468.34 |
| Max. Negotiated Rate |
$859.95 |
| Rate for Payer: Aetna Commercial |
$627.58
|
| Rate for Payer: Aetna Medicare |
$487.07
|
| Rate for Payer: BCBS Complete |
$529.20
|
| Rate for Payer: BCBS MAPPO |
$468.34
|
| Rate for Payer: BCN Medicare Advantage |
$468.34
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$674.41
|
| Rate for Payer: Cofinity Commercial |
$627.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.76
|
| Rate for Payer: Nomi Health Commercial |
$562.01
|
| Rate for Payer: PACE SWMI |
$468.34
|
| Rate for Payer: PHP Medicare Advantage |
$468.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.95
|
| Rate for Payer: Priority Health Medicare |
$473.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$468.34
|
| Rate for Payer: UHC Exchange |
$468.34
|
| Rate for Payer: UHC Medicare Advantage |
$468.34
|
|
