|
PR TENOTOMY ADDUCTOR HIP OPEN
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 27001
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: Aetna Commercial |
$698.42
|
| Rate for Payer: Aetna Medicare |
$542.06
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$521.21
|
| Rate for Payer: BCBS Trust/PPO |
$781.36
|
| Rate for Payer: BCN Commercial |
$798.99
|
| Rate for Payer: BCN Medicare Advantage |
$521.21
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cofinity Commercial |
$750.54
|
| Rate for Payer: Cofinity Commercial |
$698.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$521.21
|
| Rate for Payer: Mclaren Medicaid |
$352.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$547.27
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Nomi Health Commercial |
$625.45
|
| Rate for Payer: PACE SWMI |
$521.21
|
| Rate for Payer: PHP Medicare Advantage |
$521.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$687.70
|
| Rate for Payer: Priority Health HMO/PPO |
$838.10
|
| Rate for Payer: Priority Health Medicare |
$526.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$838.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$521.21
|
| Rate for Payer: UHC Exchange |
$521.21
|
| Rate for Payer: UHC Medicare Advantage |
$521.21
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
|
|
PR TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 27000
|
| Min. Negotiated Rate |
$253.90 |
| Max. Negotiated Rate |
$635.54 |
| Rate for Payer: Aetna Commercial |
$499.53
|
| Rate for Payer: Aetna Medicare |
$387.69
|
| Rate for Payer: BCBS Complete |
$266.60
|
| Rate for Payer: BCBS MAPPO |
$372.78
|
| Rate for Payer: BCBS Trust/PPO |
$635.54
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$372.78
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$536.80
|
| Rate for Payer: Cofinity Commercial |
$499.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.78
|
| Rate for Payer: Mclaren Medicaid |
$253.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.42
|
| Rate for Payer: Meridian Medicaid |
$266.60
|
| Rate for Payer: Nomi Health Commercial |
$447.34
|
| Rate for Payer: PACE SWMI |
$372.78
|
| Rate for Payer: PHP Medicare Advantage |
$372.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.75
|
| Rate for Payer: Priority Health HMO/PPO |
$604.01
|
| Rate for Payer: Priority Health Medicare |
$376.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.78
|
| Rate for Payer: UHC Exchange |
$372.78
|
| Rate for Payer: UHC Medicare Advantage |
$372.78
|
| Rate for Payer: UHCCP Medicaid |
$253.90
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS
|
Professional
|
Both
|
$1,273.00
|
|
|
Service Code
|
HCPCS 24357
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$827.45 |
| Rate for Payer: Aetna Commercial |
$531.66
|
| Rate for Payer: Aetna Medicare |
$412.63
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$396.76
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$396.76
|
| Rate for Payer: Cash Price |
$1,018.40
|
| Rate for Payer: Cash Price |
$1,018.40
|
| Rate for Payer: Cofinity Commercial |
$571.33
|
| Rate for Payer: Cofinity Commercial |
$531.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.76
|
| Rate for Payer: Mclaren Medicaid |
$271.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.60
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Nomi Health Commercial |
$476.11
|
| Rate for Payer: PACE SWMI |
$396.76
|
| Rate for Payer: PHP Medicare Advantage |
$396.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.45
|
| Rate for Payer: Priority Health HMO/PPO |
$647.28
|
| Rate for Payer: Priority Health Medicare |
$400.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$647.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.76
|
| Rate for Payer: UHC Exchange |
$396.76
|
| Rate for Payer: UHC Medicare Advantage |
$396.76
|
| Rate for Payer: UHCCP Medicaid |
$271.36
|
|
|
PR TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 26460
|
| Min. Negotiated Rate |
$292.45 |
| Max. Negotiated Rate |
$1,932.52 |
| Rate for Payer: Aetna Commercial |
$563.35
|
| Rate for Payer: Aetna Medicare |
$437.23
|
| Rate for Payer: BCBS Complete |
$307.07
|
| Rate for Payer: BCBS MAPPO |
$420.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,932.52
|
| Rate for Payer: BCN Commercial |
$670.47
|
| Rate for Payer: BCN Medicare Advantage |
$420.41
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$605.39
|
| Rate for Payer: Cofinity Commercial |
$563.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.41
|
| Rate for Payer: Mclaren Medicaid |
$292.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.43
|
| Rate for Payer: Meridian Medicaid |
$307.07
|
| Rate for Payer: Nomi Health Commercial |
$504.49
|
| Rate for Payer: PACE SWMI |
$420.41
|
| Rate for Payer: PHP Medicare Advantage |
$420.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.15
|
| Rate for Payer: Priority Health HMO/PPO |
$701.71
|
| Rate for Payer: Priority Health Medicare |
$424.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$701.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.41
|
| Rate for Payer: UHC Exchange |
$420.41
|
| Rate for Payer: UHC Medicare Advantage |
$420.41
|
| Rate for Payer: UHCCP Medicaid |
$292.45
|
|
|
PR TENOTOMY FLEXOR FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 26455
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,822.64 |
| Rate for Payer: Aetna Commercial |
$576.56
|
| Rate for Payer: Aetna Medicare |
$447.48
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$430.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,822.64
|
| Rate for Payer: BCN Commercial |
$690.01
|
| Rate for Payer: BCN Medicare Advantage |
$430.27
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$619.59
|
| Rate for Payer: Cofinity Commercial |
$576.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.27
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.78
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Nomi Health Commercial |
$516.32
|
| Rate for Payer: PACE SWMI |
$430.27
|
| Rate for Payer: PHP Medicare Advantage |
$430.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.15
|
| Rate for Payer: Priority Health HMO/PPO |
$716.48
|
| Rate for Payer: Priority Health Medicare |
$434.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.27
|
| Rate for Payer: UHC Exchange |
$430.27
|
| Rate for Payer: UHC Medicare Advantage |
$430.27
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR TENOTOMY FLEXOR PALM OPEN EACH TENDON
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 26450
|
| Min. Negotiated Rate |
$300.97 |
| Max. Negotiated Rate |
$1,515.16 |
| Rate for Payer: Aetna Commercial |
$580.64
|
| Rate for Payer: Aetna Medicare |
$450.64
|
| Rate for Payer: BCBS Complete |
$316.02
|
| Rate for Payer: BCBS MAPPO |
$433.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.16
|
| Rate for Payer: BCN Commercial |
$693.93
|
| Rate for Payer: BCN Medicare Advantage |
$433.31
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$623.97
|
| Rate for Payer: Cofinity Commercial |
$580.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.31
|
| Rate for Payer: Mclaren Medicaid |
$300.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.98
|
| Rate for Payer: Meridian Medicaid |
$316.02
|
| Rate for Payer: Nomi Health Commercial |
$519.97
|
| Rate for Payer: PACE SWMI |
$433.31
|
| Rate for Payer: PHP Medicare Advantage |
$433.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health HMO/PPO |
$721.05
|
| Rate for Payer: Priority Health Medicare |
$437.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$721.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.31
|
| Rate for Payer: UHC Exchange |
$433.31
|
| Rate for Payer: UHC Medicare Advantage |
$433.31
|
| Rate for Payer: UHCCP Medicaid |
$300.97
|
|
|
PR TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 27005
|
| Min. Negotiated Rate |
$471.58 |
| Max. Negotiated Rate |
$1,113.39 |
| Rate for Payer: Aetna Commercial |
$935.68
|
| Rate for Payer: Aetna Medicare |
$726.20
|
| Rate for Payer: BCBS Complete |
$495.16
|
| Rate for Payer: BCBS MAPPO |
$698.27
|
| Rate for Payer: BCBS Trust/PPO |
$801.96
|
| Rate for Payer: BCN Commercial |
$1,053.58
|
| Rate for Payer: BCN Medicare Advantage |
$698.27
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$935.68
|
| Rate for Payer: Cofinity Commercial |
$1,005.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.27
|
| Rate for Payer: Mclaren Medicaid |
$471.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.18
|
| Rate for Payer: Meridian Medicaid |
$495.16
|
| Rate for Payer: Nomi Health Commercial |
$837.92
|
| Rate for Payer: PACE SWMI |
$698.27
|
| Rate for Payer: PHP Medicare Advantage |
$698.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,113.39
|
| Rate for Payer: Priority Health Medicare |
$705.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.27
|
| Rate for Payer: UHC Exchange |
$698.27
|
| Rate for Payer: UHC Medicare Advantage |
$698.27
|
| Rate for Payer: UHCCP Medicaid |
$471.58
|
|
|
PR TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 24310
|
| Min. Negotiated Rate |
$182.79 |
| Max. Negotiated Rate |
$739.38 |
| Rate for Payer: Aetna Commercial |
$610.80
|
| Rate for Payer: Aetna Medicare |
$474.05
|
| Rate for Payer: BCBS Complete |
$325.18
|
| Rate for Payer: BCBS MAPPO |
$455.82
|
| Rate for Payer: BCBS Trust/PPO |
$182.79
|
| Rate for Payer: BCN Commercial |
$704.67
|
| Rate for Payer: BCN Medicare Advantage |
$455.82
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$656.38
|
| Rate for Payer: Cofinity Commercial |
$610.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.82
|
| Rate for Payer: Mclaren Medicaid |
$309.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.61
|
| Rate for Payer: Meridian Medicaid |
$325.18
|
| Rate for Payer: Nomi Health Commercial |
$546.98
|
| Rate for Payer: PACE SWMI |
$455.82
|
| Rate for Payer: PHP Medicare Advantage |
$455.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.90
|
| Rate for Payer: Priority Health HMO/PPO |
$739.38
|
| Rate for Payer: Priority Health Medicare |
$460.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$739.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.82
|
| Rate for Payer: UHC Exchange |
$455.82
|
| Rate for Payer: UHC Medicare Advantage |
$455.82
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
|
|
PR TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 28234
|
| Min. Negotiated Rate |
$176.79 |
| Max. Negotiated Rate |
$2,375.77 |
| Rate for Payer: Aetna Commercial |
$345.48
|
| Rate for Payer: Aetna Medicare |
$268.13
|
| Rate for Payer: BCBS Complete |
$185.63
|
| Rate for Payer: BCBS MAPPO |
$257.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,375.77
|
| Rate for Payer: BCN Commercial |
$594.72
|
| Rate for Payer: BCN Medicare Advantage |
$257.82
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Cofinity Commercial |
$345.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.82
|
| Rate for Payer: Mclaren Medicaid |
$176.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.71
|
| Rate for Payer: Meridian Medicaid |
$185.63
|
| Rate for Payer: Nomi Health Commercial |
$309.38
|
| Rate for Payer: PACE SWMI |
$257.82
|
| Rate for Payer: PHP Medicare Advantage |
$257.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health HMO/PPO |
$417.27
|
| Rate for Payer: Priority Health Medicare |
$260.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$417.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.82
|
| Rate for Payer: UHC Exchange |
$257.82
|
| Rate for Payer: UHC Medicare Advantage |
$257.82
|
| Rate for Payer: UHCCP Medicaid |
$176.79
|
|
|
PR TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 27391
|
| Min. Negotiated Rate |
$380.63 |
| Max. Negotiated Rate |
$924.00 |
| Rate for Payer: Aetna Commercial |
$751.90
|
| Rate for Payer: Aetna Medicare |
$583.56
|
| Rate for Payer: BCBS Complete |
$399.66
|
| Rate for Payer: BCBS MAPPO |
$561.12
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$858.11
|
| Rate for Payer: BCN Medicare Advantage |
$561.12
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$808.01
|
| Rate for Payer: Cofinity Commercial |
$751.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.12
|
| Rate for Payer: Mclaren Medicaid |
$380.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.18
|
| Rate for Payer: Meridian Medicaid |
$399.66
|
| Rate for Payer: Nomi Health Commercial |
$673.34
|
| Rate for Payer: PACE SWMI |
$561.12
|
| Rate for Payer: PHP Medicare Advantage |
$561.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health HMO/PPO |
$900.69
|
| Rate for Payer: Priority Health Medicare |
$566.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$900.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.12
|
| Rate for Payer: UHC Exchange |
$561.12
|
| Rate for Payer: UHC Medicare Advantage |
$561.12
|
| Rate for Payer: UHCCP Medicaid |
$380.63
|
|
|
PR TENOTOMY PERCUTANEOUS TOE SINGLE TENDON
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 28010
|
| Min. Negotiated Rate |
$136.11 |
| Max. Negotiated Rate |
$3,603.53 |
| Rate for Payer: Aetna Commercial |
$266.62
|
| Rate for Payer: Aetna Medicare |
$206.93
|
| Rate for Payer: BCBS Complete |
$142.92
|
| Rate for Payer: BCBS MAPPO |
$198.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,603.53
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: BCN Medicare Advantage |
$198.97
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$286.52
|
| Rate for Payer: Cofinity Commercial |
$266.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.97
|
| Rate for Payer: Mclaren Medicaid |
$136.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.92
|
| Rate for Payer: Meridian Medicaid |
$142.92
|
| Rate for Payer: Nomi Health Commercial |
$238.76
|
| Rate for Payer: PACE SWMI |
$198.97
|
| Rate for Payer: PHP Medicare Advantage |
$198.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO |
$321.60
|
| Rate for Payer: Priority Health Medicare |
$200.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.97
|
| Rate for Payer: UHC Exchange |
$198.97
|
| Rate for Payer: UHC Medicare Advantage |
$198.97
|
| Rate for Payer: UHCCP Medicaid |
$136.11
|
|
|
PR TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 27606
|
| Min. Negotiated Rate |
$175.94 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$349.45
|
| Rate for Payer: Aetna Medicare |
$271.21
|
| Rate for Payer: BCBS Complete |
$184.74
|
| Rate for Payer: BCBS MAPPO |
$260.78
|
| Rate for Payer: BCBS Trust/PPO |
$852.15
|
| Rate for Payer: BCN Commercial |
$396.32
|
| Rate for Payer: BCN Medicare Advantage |
$260.78
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$375.52
|
| Rate for Payer: Cofinity Commercial |
$349.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.78
|
| Rate for Payer: Mclaren Medicaid |
$175.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.82
|
| Rate for Payer: Meridian Medicaid |
$184.74
|
| Rate for Payer: Nomi Health Commercial |
$312.94
|
| Rate for Payer: PACE SWMI |
$260.78
|
| Rate for Payer: PHP Medicare Advantage |
$260.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO |
$414.21
|
| Rate for Payer: Priority Health Medicare |
$263.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.78
|
| Rate for Payer: UHC Exchange |
$260.78
|
| Rate for Payer: UHC Medicare Advantage |
$260.78
|
| Rate for Payer: UHCCP Medicaid |
$175.94
|
|
|
PR TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 27605
|
| Min. Negotiated Rate |
$118.64 |
| Max. Negotiated Rate |
$832.60 |
| Rate for Payer: Aetna Commercial |
$234.50
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: BCBS Complete |
$124.57
|
| Rate for Payer: BCBS MAPPO |
$175.00
|
| Rate for Payer: BCBS Trust/PPO |
$832.60
|
| Rate for Payer: BCN Commercial |
$481.83
|
| Rate for Payer: BCN Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cofinity Commercial |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$234.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.00
|
| Rate for Payer: Mclaren Medicaid |
$118.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.75
|
| Rate for Payer: Meridian Medicaid |
$124.57
|
| Rate for Payer: Nomi Health Commercial |
$210.00
|
| Rate for Payer: PACE SWMI |
$175.00
|
| Rate for Payer: PHP Medicare Advantage |
$175.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
| Rate for Payer: Priority Health HMO/PPO |
$280.90
|
| Rate for Payer: Priority Health Medicare |
$176.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.00
|
| Rate for Payer: UHC Exchange |
$175.00
|
| Rate for Payer: UHC Medicare Advantage |
$175.00
|
| Rate for Payer: UHCCP Medicaid |
$118.64
|
|
|
PR TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX
|
Professional
|
Both
|
$1,181.00
|
|
|
Service Code
|
HCPCS 27306
|
| Min. Negotiated Rate |
$225.35 |
| Max. Negotiated Rate |
$767.65 |
| Rate for Payer: Aetna Commercial |
$441.73
|
| Rate for Payer: Aetna Medicare |
$342.84
|
| Rate for Payer: BCBS Complete |
$236.62
|
| Rate for Payer: BCBS MAPPO |
$329.65
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: BCN Medicare Advantage |
$329.65
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cofinity Commercial |
$474.70
|
| Rate for Payer: Cofinity Commercial |
$441.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.65
|
| Rate for Payer: Mclaren Medicaid |
$225.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.13
|
| Rate for Payer: Meridian Medicaid |
$236.62
|
| Rate for Payer: Nomi Health Commercial |
$395.58
|
| Rate for Payer: PACE SWMI |
$329.65
|
| Rate for Payer: PHP Medicare Advantage |
$329.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.65
|
| Rate for Payer: Priority Health HMO/PPO |
$533.28
|
| Rate for Payer: Priority Health Medicare |
$332.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.65
|
| Rate for Payer: UHC Exchange |
$329.65
|
| Rate for Payer: UHC Medicare Advantage |
$329.65
|
| Rate for Payer: UHCCP Medicaid |
$225.35
|
|
|
PR TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 27307
|
| Min. Negotiated Rate |
$268.81 |
| Max. Negotiated Rate |
$2,244.75 |
| Rate for Payer: Aetna Commercial |
$528.86
|
| Rate for Payer: Aetna Medicare |
$410.46
|
| Rate for Payer: BCBS Complete |
$282.25
|
| Rate for Payer: BCBS MAPPO |
$394.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.75
|
| Rate for Payer: BCN Commercial |
$602.05
|
| Rate for Payer: BCN Medicare Advantage |
$394.67
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$568.32
|
| Rate for Payer: Cofinity Commercial |
$528.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.67
|
| Rate for Payer: Mclaren Medicaid |
$268.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.40
|
| Rate for Payer: Meridian Medicaid |
$282.25
|
| Rate for Payer: Nomi Health Commercial |
$473.60
|
| Rate for Payer: PACE SWMI |
$394.67
|
| Rate for Payer: PHP Medicare Advantage |
$394.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: Priority Health HMO/PPO |
$632.51
|
| Rate for Payer: Priority Health Medicare |
$398.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$632.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.67
|
| Rate for Payer: UHC Exchange |
$394.67
|
| Rate for Payer: UHC Medicare Advantage |
$394.67
|
| Rate for Payer: UHCCP Medicaid |
$268.81
|
|
|
PR TENOTOMY SHOULDER AREA 1 TENDON
|
Professional
|
Both
|
$1,732.00
|
|
|
Service Code
|
HCPCS 23405
|
| Min. Negotiated Rate |
$87.87 |
| Max. Negotiated Rate |
$1,125.80 |
| Rate for Payer: Aetna Commercial |
$793.07
|
| Rate for Payer: Aetna Medicare |
$615.51
|
| Rate for Payer: BCBS Complete |
$420.68
|
| Rate for Payer: BCBS MAPPO |
$591.84
|
| Rate for Payer: BCBS Trust/PPO |
$87.87
|
| Rate for Payer: BCN Commercial |
$908.45
|
| Rate for Payer: BCN Medicare Advantage |
$591.84
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cofinity Commercial |
$852.25
|
| Rate for Payer: Cofinity Commercial |
$793.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.84
|
| Rate for Payer: Mclaren Medicaid |
$400.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.43
|
| Rate for Payer: Meridian Medicaid |
$420.68
|
| Rate for Payer: Nomi Health Commercial |
$710.21
|
| Rate for Payer: PACE SWMI |
$591.84
|
| Rate for Payer: PHP Medicare Advantage |
$591.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.80
|
| Rate for Payer: Priority Health HMO/PPO |
$952.08
|
| Rate for Payer: Priority Health Medicare |
$597.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$952.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.84
|
| Rate for Payer: UHC Exchange |
$591.84
|
| Rate for Payer: UHC Medicare Advantage |
$591.84
|
| Rate for Payer: UHCCP Medicaid |
$400.65
|
|
|
PR TERBUTALINE SULFATE INJ
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J3105
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Commercial |
$3.67
|
| Rate for Payer: Aetna Medicare |
$2.85
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$2.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.50
|
| Rate for Payer: BCN Commercial |
$0.18
|
| Rate for Payer: BCN Medicare Advantage |
$2.74
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Commercial |
$3.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.88
|
| Rate for Payer: Nomi Health Commercial |
$3.29
|
| Rate for Payer: PACE SWMI |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$2.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$2.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.74
|
| Rate for Payer: UHC Exchange |
$2.74
|
| Rate for Payer: UHC Medicare Advantage |
$2.74
|
|
|
PR TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION
|
Professional
|
Both
|
$439.00
|
|
|
Service Code
|
HCPCS 95923
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$759.17 |
| Rate for Payer: Aetna Commercial |
$143.43
|
| Rate for Payer: Aetna Medicare |
$111.32
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$107.04
|
| Rate for Payer: BCBS Trust/PPO |
$759.17
|
| Rate for Payer: BCN Commercial |
$179.83
|
| Rate for Payer: BCN Medicare Advantage |
$107.04
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cofinity Commercial |
$154.14
|
| Rate for Payer: Cofinity Commercial |
$143.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.04
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.39
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Nomi Health Commercial |
$128.45
|
| Rate for Payer: PACE SWMI |
$107.04
|
| Rate for Payer: PHP Medicare Advantage |
$107.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.35
|
| Rate for Payer: Priority Health HMO/PPO |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$108.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.04
|
| Rate for Payer: UHC Exchange |
$107.04
|
| Rate for Payer: UHC Medicare Advantage |
$107.04
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR TESTOSTERONE CYPIONAT 100 MG
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1070
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$5.03
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
|
|
PR TESTOSTERONE CYPIONAT 200 MG
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J1080
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCN Commercial |
$5.07
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR TESTOSTERONE CYPIONATE 1 ML
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J1060
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Medicare |
$3.00
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
|
|
PR TESTOSTERONE ENANTHATE INJ
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J3130
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCN Commercial |
$9.08
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR TESTOSTERONE PELLET 75 MG
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS S0189
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$106.79 |
| Rate for Payer: Aetna Commercial |
$100.93
|
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS Trust/PPO |
$106.47
|
| Rate for Payer: BCN Commercial |
$106.79
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
|
|
PR TESTOSTERONE UNDECANOATE 1MG
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J3145
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: Aetna Medicare |
$2.07
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$1.99
|
| Rate for Payer: BCBS Trust/PPO |
$1.87
|
| Rate for Payer: BCN Commercial |
$1.87
|
| Rate for Payer: BCN Medicare Advantage |
$1.99
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$2.87
|
| Rate for Payer: Cofinity Commercial |
$2.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.09
|
| Rate for Payer: Nomi Health Commercial |
$2.39
|
| Rate for Payer: PACE SWMI |
$1.99
|
| Rate for Payer: PHP Medicare Advantage |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$2.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.99
|
| Rate for Payer: UHC Exchange |
$1.99
|
| Rate for Payer: UHC Medicare Advantage |
$1.99
|
|
|
PR TETANUS IMMUNIZATION, IM
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 90703
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
|
