|
PR OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
Both
|
$2,436.00
|
|
|
Service Code
|
HCPCS 24665
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$1,827.00 |
| Rate for Payer: Aetna Commercial |
$875.66
|
| Rate for Payer: Aetna Medicare |
$1,218.00
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCN Commercial |
$1,010.90
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Cash Price |
$1,948.80
|
| Rate for Payer: Mclaren Medicaid |
$396.82
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,827.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,080.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,080.62
|
| Rate for Payer: UHC Medicaid |
$396.82
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
HCPCS 25670
|
| Min. Negotiated Rate |
$369.98 |
| Max. Negotiated Rate |
$1,533.00 |
| Rate for Payer: Aetna Commercial |
$813.10
|
| Rate for Payer: Aetna Medicare |
$1,022.00
|
| Rate for Payer: BCBS Complete |
$388.48
|
| Rate for Payer: BCN Commercial |
$930.23
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Mclaren Medicaid |
$369.98
|
| Rate for Payer: Meridian Medicaid |
$388.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$994.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$994.38
|
| Rate for Payer: UHC Medicaid |
$369.98
|
| Rate for Payer: UHCCP Medicaid |
$369.98
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 21811
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$975.75 |
| Rate for Payer: Aetna Commercial |
$802.06
|
| Rate for Payer: Aetna Medicare |
$650.50
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Mclaren Medicaid |
$347.40
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$975.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$942.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.22
|
| Rate for Payer: UHC Medicaid |
$347.40
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS
|
Professional
|
Both
|
$1,816.00
|
|
|
Service Code
|
HCPCS 21812
|
| Min. Negotiated Rate |
$417.91 |
| Max. Negotiated Rate |
$1,362.00 |
| Rate for Payer: Aetna Commercial |
$970.72
|
| Rate for Payer: Aetna Medicare |
$908.00
|
| Rate for Payer: BCBS Complete |
$438.81
|
| Rate for Payer: BCN Commercial |
$1,067.17
|
| Rate for Payer: Cash Price |
$1,452.80
|
| Rate for Payer: Cash Price |
$1,452.80
|
| Rate for Payer: Mclaren Medicaid |
$417.91
|
| Rate for Payer: Meridian Medicaid |
$438.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,362.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,140.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.79
|
| Rate for Payer: UHC Medicaid |
$417.91
|
| Rate for Payer: UHCCP Medicaid |
$417.91
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS
|
Professional
|
Both
|
$2,045.00
|
|
|
Service Code
|
HCPCS 21813
|
| Min. Negotiated Rate |
$568.50 |
| Max. Negotiated Rate |
$1,562.91 |
| Rate for Payer: Aetna Commercial |
$1,332.58
|
| Rate for Payer: Aetna Medicare |
$1,022.50
|
| Rate for Payer: BCBS Complete |
$596.92
|
| Rate for Payer: BCN Commercial |
$1,462.07
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Mclaren Medicaid |
$568.50
|
| Rate for Payer: Meridian Medicaid |
$596.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,562.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,562.91
|
| Rate for Payer: UHC Medicaid |
$568.50
|
| Rate for Payer: UHCCP Medicaid |
$568.50
|
|
|
PR OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,288.00
|
|
|
Service Code
|
HCPCS 23585
|
| Min. Negotiated Rate |
$571.05 |
| Max. Negotiated Rate |
$2,466.00 |
| Rate for Payer: Aetna Commercial |
$1,304.27
|
| Rate for Payer: Aetna Medicare |
$1,644.00
|
| Rate for Payer: BCBS Complete |
$599.60
|
| Rate for Payer: BCN Commercial |
$1,480.50
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Mclaren Medicaid |
$571.05
|
| Rate for Payer: Meridian Medicaid |
$599.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,582.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,582.61
|
| Rate for Payer: UHC Medicaid |
$571.05
|
| Rate for Payer: UHCCP Medicaid |
$571.05
|
|
|
PR OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 28531
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$237.60
|
| Rate for Payer: Aetna Medicare |
$345.00
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCN Commercial |
$277.87
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Mclaren Medicaid |
$111.40
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$297.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.03
|
| Rate for Payer: UHC Medicaid |
$111.40
|
| Rate for Payer: UHCCP Medicaid |
$111.40
|
|
|
PR OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 23530
|
| Min. Negotiated Rate |
$350.17 |
| Max. Negotiated Rate |
$1,893.75 |
| Rate for Payer: Aetna Commercial |
$767.80
|
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: BCBS Complete |
$367.68
|
| Rate for Payer: BCN Commercial |
$884.91
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Mclaren Medicaid |
$350.17
|
| Rate for Payer: Meridian Medicaid |
$367.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,893.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$945.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.95
|
| Rate for Payer: UHC Medicaid |
$350.17
|
| Rate for Payer: UHCCP Medicaid |
$350.17
|
|
|
PR OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION
|
Professional
|
Both
|
$1,034.00
|
|
|
Service Code
|
HCPCS 21825
|
| Min. Negotiated Rate |
$359.54 |
| Max. Negotiated Rate |
$894.84 |
| Rate for Payer: Aetna Commercial |
$728.58
|
| Rate for Payer: Aetna Medicare |
$517.00
|
| Rate for Payer: BCBS Complete |
$377.52
|
| Rate for Payer: BCN Commercial |
$837.11
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Mclaren Medicaid |
$359.54
|
| Rate for Payer: Meridian Medicaid |
$377.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$894.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$894.84
|
| Rate for Payer: UHC Medicaid |
$359.54
|
| Rate for Payer: UHCCP Medicaid |
$359.54
|
|
|
PR OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 28465
|
| Min. Negotiated Rate |
$395.12 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$835.92
|
| Rate for Payer: Aetna Medicare |
$809.00
|
| Rate for Payer: BCBS Complete |
$414.88
|
| Rate for Payer: BCN Commercial |
$980.03
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Mclaren Medicaid |
$395.12
|
| Rate for Payer: Meridian Medicaid |
$414.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,047.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,047.62
|
| Rate for Payer: UHC Medicaid |
$395.12
|
| Rate for Payer: UHCCP Medicaid |
$395.12
|
|
|
PR OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,870.00
|
|
|
Service Code
|
HCPCS 27535
|
| Min. Negotiated Rate |
$519.93 |
| Max. Negotiated Rate |
$2,152.50 |
| Rate for Payer: Aetna Commercial |
$1,202.31
|
| Rate for Payer: Aetna Medicare |
$1,435.00
|
| Rate for Payer: BCBS Complete |
$545.93
|
| Rate for Payer: BCN Commercial |
$1,356.50
|
| Rate for Payer: Cash Price |
$2,296.00
|
| Rate for Payer: Cash Price |
$2,296.00
|
| Rate for Payer: Mclaren Medicaid |
$519.93
|
| Rate for Payer: Meridian Medicaid |
$545.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,152.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,450.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,450.06
|
| Rate for Payer: UHC Medicaid |
$519.93
|
| Rate for Payer: UHCCP Medicaid |
$519.93
|
|
|
PR OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC
|
Professional
|
Both
|
$2,171.00
|
|
|
Service Code
|
HCPCS 25685
|
| Min. Negotiated Rate |
$440.91 |
| Max. Negotiated Rate |
$1,628.25 |
| Rate for Payer: Aetna Commercial |
$981.61
|
| Rate for Payer: Aetna Medicare |
$1,085.50
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Mclaren Medicaid |
$440.91
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,628.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,202.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,202.53
|
| Rate for Payer: UHC Medicaid |
$440.91
|
| Rate for Payer: UHCCP Medicaid |
$440.91
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$4,293.00
|
|
|
Service Code
|
HCPCS 27823
|
| Min. Negotiated Rate |
$588.73 |
| Max. Negotiated Rate |
$3,219.75 |
| Rate for Payer: Aetna Commercial |
$1,313.54
|
| Rate for Payer: Aetna Medicare |
$2,146.50
|
| Rate for Payer: BCBS Complete |
$618.17
|
| Rate for Payer: BCN Commercial |
$1,488.46
|
| Rate for Payer: Cash Price |
$3,434.40
|
| Rate for Payer: Cash Price |
$3,434.40
|
| Rate for Payer: Mclaren Medicaid |
$588.73
|
| Rate for Payer: Meridian Medicaid |
$618.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,219.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,591.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,591.13
|
| Rate for Payer: UHC Medicaid |
$588.73
|
| Rate for Payer: UHCCP Medicaid |
$588.73
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP
|
Professional
|
Both
|
$3,643.00
|
|
|
Service Code
|
HCPCS 27822
|
| Min. Negotiated Rate |
$526.96 |
| Max. Negotiated Rate |
$2,732.25 |
| Rate for Payer: Aetna Commercial |
$1,164.75
|
| Rate for Payer: Aetna Medicare |
$1,821.50
|
| Rate for Payer: BCBS Complete |
$553.31
|
| Rate for Payer: BCN Commercial |
$1,321.64
|
| Rate for Payer: Cash Price |
$2,914.40
|
| Rate for Payer: Cash Price |
$2,914.40
|
| Rate for Payer: Mclaren Medicaid |
$526.96
|
| Rate for Payer: Meridian Medicaid |
$553.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,732.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,412.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,412.80
|
| Rate for Payer: UHC Medicaid |
$526.96
|
| Rate for Payer: UHCCP Medicaid |
$526.96
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 92014
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$82.96
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCN Commercial |
$81.01
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Mclaren Medicaid |
$39.62
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.02
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 92004
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Aetna Commercial |
$103.20
|
| Rate for Payer: Aetna Medicare |
$107.50
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCN Commercial |
$100.26
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.61
|
| Rate for Payer: UHC Medicaid |
$49.63
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE EST PT
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 92012
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Aetna Commercial |
$55.00
|
| Rate for Payer: Aetna Medicare |
$77.50
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCN Commercial |
$53.76
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Mclaren Medicaid |
$26.41
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.06
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE NEW PT
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 92002
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$50.66
|
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCN Commercial |
$48.68
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.09
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
PR OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 34716
|
| Min. Negotiated Rate |
$215.77 |
| Max. Negotiated Rate |
$608.25 |
| Rate for Payer: Aetna Commercial |
$499.69
|
| Rate for Payer: Aetna Medicare |
$405.50
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCN Commercial |
$543.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Mclaren Medicaid |
$215.77
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$584.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$584.78
|
| Rate for Payer: UHC Medicaid |
$215.77
|
| Rate for Payer: UHCCP Medicaid |
$215.77
|
|
|
PR OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 34834
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$224.25 |
| Rate for Payer: Aetna Commercial |
$174.94
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCN Commercial |
$187.74
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$201.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.90
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR OPN FEM ART EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$1,305.00
|
|
|
Service Code
|
HCPCS 34812
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$978.75 |
| Rate for Payer: Aetna Commercial |
$278.36
|
| Rate for Payer: Aetna Medicare |
$652.50
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCN Commercial |
$299.28
|
| Rate for Payer: Cash Price |
$1,044.00
|
| Rate for Payer: Cash Price |
$1,044.00
|
| Rate for Payer: Mclaren Medicaid |
$118.00
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$978.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$321.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.84
|
| Rate for Payer: UHC Medicaid |
$118.00
|
| Rate for Payer: UHCCP Medicaid |
$118.00
|
|
|
PR OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH
|
Professional
|
Both
|
$585.00
|
|
|
Service Code
|
HCPCS 34714
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$438.75 |
| Rate for Payer: Aetna Commercial |
$363.18
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: BCBS Complete |
$164.16
|
| Rate for Payer: BCN Commercial |
$392.91
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Mclaren Medicaid |
$156.34
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$422.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.52
|
| Rate for Payer: UHC Medicaid |
$156.34
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
PR OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 34833
|
| Min. Negotiated Rate |
$226.42 |
| Max. Negotiated Rate |
$1,724.25 |
| Rate for Payer: Aetna Commercial |
$530.13
|
| Rate for Payer: Aetna Medicare |
$1,149.50
|
| Rate for Payer: BCBS Complete |
$237.74
|
| Rate for Payer: BCN Commercial |
$571.68
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Mclaren Medicaid |
$226.42
|
| Rate for Payer: Meridian Medicaid |
$237.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$614.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$614.78
|
| Rate for Payer: UHC Medicaid |
$226.42
|
| Rate for Payer: UHCCP Medicaid |
$226.42
|
|
|
PR OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH
|
Professional
|
Both
|
$4,956.00
|
|
|
Service Code
|
HCPCS 34830
|
| Min. Negotiated Rate |
$1,021.12 |
| Max. Negotiated Rate |
$3,717.00 |
| Rate for Payer: Aetna Commercial |
$2,372.61
|
| Rate for Payer: Aetna Medicare |
$2,478.00
|
| Rate for Payer: BCBS Complete |
$1,072.18
|
| Rate for Payer: BCN Commercial |
$2,574.56
|
| Rate for Payer: Cash Price |
$3,964.80
|
| Rate for Payer: Cash Price |
$3,964.80
|
| Rate for Payer: Mclaren Medicaid |
$1,021.12
|
| Rate for Payer: Meridian Medicaid |
$1,072.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,717.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,021.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,768.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,768.61
|
| Rate for Payer: UHC Medicaid |
$1,021.12
|
| Rate for Payer: UHCCP Medicaid |
$1,021.12
|
|
|
PR OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH
|
Professional
|
Both
|
$4,199.00
|
|
|
Service Code
|
HCPCS 34831
|
| Min. Negotiated Rate |
$1,118.68 |
| Max. Negotiated Rate |
$3,149.25 |
| Rate for Payer: Aetna Commercial |
$2,587.95
|
| Rate for Payer: Aetna Medicare |
$2,099.50
|
| Rate for Payer: BCBS Complete |
$1,174.61
|
| Rate for Payer: BCN Commercial |
$2,825.05
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Mclaren Medicaid |
$1,118.68
|
| Rate for Payer: Meridian Medicaid |
$1,174.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,149.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,118.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,037.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,037.98
|
| Rate for Payer: UHC Medicaid |
$1,118.68
|
| Rate for Payer: UHCCP Medicaid |
$1,118.68
|
|
