|
PR ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 26843
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$2,135.00 |
| Rate for Payer: Aetna Commercial |
$1,028.09
|
| Rate for Payer: Aetna Medicare |
$767.23
|
| Rate for Payer: BCBS Complete |
$532.29
|
| Rate for Payer: BCBS MAPPO |
$767.23
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$1,163.54
|
| Rate for Payer: BCN Medicare Advantage |
$767.23
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.81
|
| Rate for Payer: Cofinity Commercial |
$1,028.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$767.23
|
| Rate for Payer: Healthscope Commercial |
$920.68
|
| Rate for Payer: Healthscope Whirlpool |
$920.68
|
| Rate for Payer: Meridian Medicaid |
$532.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$805.59
|
| Rate for Payer: PACE SWMI |
$767.23
|
| Rate for Payer: PHP Medicare Advantage |
$767.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$506.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,215.85
|
| Rate for Payer: Priority Health Medicare |
$767.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,215.85
|
| Rate for Payer: UHC Medicare Advantage |
$790.25
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT
|
Professional
|
Both
|
$3,282.00
|
|
|
Service Code
|
HCPCS 26844
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$2,297.40 |
| Rate for Payer: Aetna Commercial |
$1,131.95
|
| Rate for Payer: Aetna Medicare |
$844.74
|
| Rate for Payer: BCBS Complete |
$584.85
|
| Rate for Payer: BCBS MAPPO |
$844.74
|
| Rate for Payer: BCBS Trust/PPO |
$195.47
|
| Rate for Payer: BCN Commercial |
$1,278.38
|
| Rate for Payer: BCN Medicare Advantage |
$844.74
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,216.43
|
| Rate for Payer: Cofinity Commercial |
$1,131.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$844.74
|
| Rate for Payer: Healthscope Commercial |
$1,013.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,013.69
|
| Rate for Payer: Meridian Medicaid |
$584.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$886.98
|
| Rate for Payer: PACE SWMI |
$844.74
|
| Rate for Payer: PHP Medicare Advantage |
$844.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,335.86
|
| Rate for Payer: Priority Health Medicare |
$844.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,335.86
|
| Rate for Payer: UHC Medicare Advantage |
$870.08
|
|
|
PR ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 26841
|
| Min. Negotiated Rate |
$223.47 |
| Max. Negotiated Rate |
$2,135.00 |
| Rate for Payer: Aetna Commercial |
$1,012.18
|
| Rate for Payer: Aetna Medicare |
$755.36
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCBS MAPPO |
$755.36
|
| Rate for Payer: BCBS Trust/PPO |
$223.47
|
| Rate for Payer: BCN Commercial |
$1,148.40
|
| Rate for Payer: BCN Medicare Advantage |
$755.36
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Cofinity Commercial |
$1,012.18
|
| Rate for Payer: Cofinity Commercial |
$1,087.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.36
|
| Rate for Payer: Healthscope Commercial |
$906.43
|
| Rate for Payer: Healthscope Whirlpool |
$906.43
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$793.13
|
| Rate for Payer: PACE SWMI |
$755.36
|
| Rate for Payer: PHP Medicare Advantage |
$755.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.03
|
| Rate for Payer: Priority Health Medicare |
$755.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,200.03
|
| Rate for Payer: UHC Medicare Advantage |
$778.02
|
|
|
PR ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT
|
Professional
|
Both
|
$3,235.00
|
|
|
Service Code
|
HCPCS 26842
|
| Min. Negotiated Rate |
$161.13 |
| Max. Negotiated Rate |
$2,264.50 |
| Rate for Payer: Aetna Commercial |
$1,094.55
|
| Rate for Payer: Aetna Medicare |
$816.83
|
| Rate for Payer: BCBS Complete |
$565.83
|
| Rate for Payer: BCBS MAPPO |
$816.83
|
| Rate for Payer: BCBS Trust/PPO |
$161.13
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: BCN Medicare Advantage |
$816.83
|
| Rate for Payer: Cash Price |
$2,588.00
|
| Rate for Payer: Cash Price |
$2,588.00
|
| Rate for Payer: Cofinity Commercial |
$1,094.55
|
| Rate for Payer: Cofinity Commercial |
$1,176.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.83
|
| Rate for Payer: Healthscope Commercial |
$980.20
|
| Rate for Payer: Healthscope Whirlpool |
$980.20
|
| Rate for Payer: Meridian Medicaid |
$565.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$857.67
|
| Rate for Payer: PACE SWMI |
$816.83
|
| Rate for Payer: PHP Medicare Advantage |
$816.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,264.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.96
|
| Rate for Payer: Priority Health Medicare |
$816.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,292.96
|
| Rate for Payer: UHC Medicare Advantage |
$841.33
|
|
|
PR ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE
|
Professional
|
Both
|
$1,653.00
|
|
|
Service Code
|
HCPCS 25830
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,565.65 |
| Rate for Payer: Aetna Commercial |
$1,327.20
|
| Rate for Payer: Aetna Medicare |
$990.45
|
| Rate for Payer: BCBS Complete |
$698.24
|
| Rate for Payer: BCBS MAPPO |
$990.45
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$1,498.29
|
| Rate for Payer: BCN Medicare Advantage |
$990.45
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cofinity Commercial |
$1,327.20
|
| Rate for Payer: Cofinity Commercial |
$1,426.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$990.45
|
| Rate for Payer: Healthscope Commercial |
$1,188.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,188.54
|
| Rate for Payer: Meridian Medicaid |
$698.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,039.97
|
| Rate for Payer: PACE SWMI |
$990.45
|
| Rate for Payer: PHP Medicare Advantage |
$990.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,565.65
|
| Rate for Payer: Priority Health Medicare |
$990.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,565.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,020.16
|
|
|
PR ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 28735
|
| Min. Negotiated Rate |
$499.06 |
| Max. Negotiated Rate |
$1,971.20 |
| Rate for Payer: Aetna Commercial |
$1,027.65
|
| Rate for Payer: Aetna Medicare |
$766.90
|
| Rate for Payer: BCBS Complete |
$524.01
|
| Rate for Payer: BCBS MAPPO |
$766.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.09
|
| Rate for Payer: BCN Commercial |
$1,140.08
|
| Rate for Payer: BCN Medicare Advantage |
$766.90
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,104.34
|
| Rate for Payer: Cofinity Commercial |
$1,027.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.90
|
| Rate for Payer: Healthscope Commercial |
$920.28
|
| Rate for Payer: Healthscope Whirlpool |
$920.28
|
| Rate for Payer: Meridian Medicaid |
$524.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$805.24
|
| Rate for Payer: PACE SWMI |
$766.90
|
| Rate for Payer: PHP Medicare Advantage |
$766.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,971.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,191.35
|
| Rate for Payer: Priority Health Medicare |
$766.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,191.35
|
| Rate for Payer: UHC Medicare Advantage |
$789.91
|
|
|
PR ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS
|
Professional
|
Both
|
$2,728.00
|
|
|
Service Code
|
HCPCS 28730
|
| Min. Negotiated Rate |
$467.11 |
| Max. Negotiated Rate |
$1,909.60 |
| Rate for Payer: Aetna Commercial |
$957.38
|
| Rate for Payer: Aetna Medicare |
$714.46
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS MAPPO |
$714.46
|
| Rate for Payer: BCBS Trust/PPO |
$872.22
|
| Rate for Payer: BCN Commercial |
$1,065.80
|
| Rate for Payer: BCN Medicare Advantage |
$714.46
|
| Rate for Payer: Cash Price |
$2,182.40
|
| Rate for Payer: Cash Price |
$2,182.40
|
| Rate for Payer: Cofinity Commercial |
$957.38
|
| Rate for Payer: Cofinity Commercial |
$1,028.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.46
|
| Rate for Payer: Healthscope Commercial |
$857.35
|
| Rate for Payer: Healthscope Whirlpool |
$857.35
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$750.18
|
| Rate for Payer: PACE SWMI |
$714.46
|
| Rate for Payer: PHP Medicare Advantage |
$714.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,909.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.73
|
| Rate for Payer: Priority Health Medicare |
$714.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.73
|
| Rate for Payer: UHC Medicare Advantage |
$735.89
|
|
|
PR ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT
|
Professional
|
Both
|
$4,281.00
|
|
|
Service Code
|
HCPCS 22600
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$2,996.70 |
| Rate for Payer: Aetna Commercial |
$1,739.48
|
| Rate for Payer: Aetna Medicare |
$1,298.12
|
| Rate for Payer: BCBS Complete |
$887.89
|
| Rate for Payer: BCBS MAPPO |
$1,298.12
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$2,113.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,298.12
|
| Rate for Payer: Cash Price |
$3,424.80
|
| Rate for Payer: Cash Price |
$3,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,739.48
|
| Rate for Payer: Cofinity Commercial |
$1,869.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,298.12
|
| Rate for Payer: Healthscope Commercial |
$1,557.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,557.74
|
| Rate for Payer: Meridian Medicaid |
$887.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,363.03
|
| Rate for Payer: PACE SWMI |
$1,298.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,298.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$845.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,996.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,005.32
|
| Rate for Payer: Priority Health Medicare |
$1,298.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,005.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,337.06
|
|
|
PR ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 28737
|
| Min. Negotiated Rate |
$444.96 |
| Max. Negotiated Rate |
$2,092.60 |
| Rate for Payer: Aetna Commercial |
$902.38
|
| Rate for Payer: Aetna Medicare |
$673.42
|
| Rate for Payer: BCBS Complete |
$467.21
|
| Rate for Payer: BCBS MAPPO |
$673.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.60
|
| Rate for Payer: BCN Commercial |
$1,001.30
|
| Rate for Payer: BCN Medicare Advantage |
$673.42
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cofinity Commercial |
$969.72
|
| Rate for Payer: Cofinity Commercial |
$902.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.42
|
| Rate for Payer: Healthscope Commercial |
$808.10
|
| Rate for Payer: Healthscope Whirlpool |
$808.10
|
| Rate for Payer: Meridian Medicaid |
$467.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$707.09
|
| Rate for Payer: PACE SWMI |
$673.42
|
| Rate for Payer: PHP Medicare Advantage |
$673.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.32
|
| Rate for Payer: Priority Health Medicare |
$673.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.32
|
| Rate for Payer: UHC Medicare Advantage |
$693.62
|
|
|
PR ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK
|
Professional
|
Both
|
$1,443.00
|
|
|
Service Code
|
HCPCS 28760
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,105.87 |
| Rate for Payer: Aetna Commercial |
$741.10
|
| Rate for Payer: Aetna Medicare |
$553.06
|
| Rate for Payer: BCBS Complete |
$387.14
|
| Rate for Payer: BCBS MAPPO |
$553.06
|
| Rate for Payer: BCBS Trust/PPO |
$579.02
|
| Rate for Payer: BCN Commercial |
$1,105.87
|
| Rate for Payer: BCN Medicare Advantage |
$553.06
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Cofinity Commercial |
$741.10
|
| Rate for Payer: Cofinity Commercial |
$796.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.06
|
| Rate for Payer: Healthscope Commercial |
$663.67
|
| Rate for Payer: Healthscope Whirlpool |
$663.67
|
| Rate for Payer: Meridian Medicaid |
$387.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$580.71
|
| Rate for Payer: PACE SWMI |
$553.06
|
| Rate for Payer: PHP Medicare Advantage |
$553.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.45
|
| Rate for Payer: Priority Health Medicare |
$553.06
|
| Rate for Payer: Priority Health Narrow Network |
$860.45
|
| Rate for Payer: UHC Medicare Advantage |
$569.65
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 20605
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$85.40 |
| Rate for Payer: Aetna Commercial |
$49.00
|
| Rate for Payer: Aetna Medicare |
$36.57
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS MAPPO |
$36.57
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: BCN Medicare Advantage |
$36.57
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$52.66
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.57
|
| Rate for Payer: Healthscope Commercial |
$43.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.88
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.40
|
| Rate for Payer: PACE SWMI |
$36.57
|
| Rate for Payer: PHP Medicare Advantage |
$36.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.18
|
| Rate for Payer: Priority Health Medicare |
$36.57
|
| Rate for Payer: Priority Health Narrow Network |
$56.18
|
| Rate for Payer: UHC Medicare Advantage |
$37.67
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$262.93 |
| Rate for Payer: Aetna Commercial |
$68.65
|
| Rate for Payer: Aetna Medicare |
$51.23
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$51.23
|
| Rate for Payer: BCBS Trust/PPO |
$262.93
|
| Rate for Payer: BCN Commercial |
$104.84
|
| Rate for Payer: BCN Medicare Advantage |
$51.23
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$68.65
|
| Rate for Payer: Cofinity Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.23
|
| Rate for Payer: Healthscope Commercial |
$61.48
|
| Rate for Payer: Healthscope Whirlpool |
$61.48
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.79
|
| Rate for Payer: PACE SWMI |
$51.23
|
| Rate for Payer: PHP Medicare Advantage |
$51.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$51.23
|
| Rate for Payer: Priority Health Narrow Network |
$78.65
|
| Rate for Payer: UHC Medicare Advantage |
$52.77
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 20610
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$721.72 |
| Rate for Payer: Aetna Commercial |
$59.52
|
| Rate for Payer: Aetna Medicare |
$44.42
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$44.42
|
| Rate for Payer: BCBS Trust/PPO |
$721.72
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: BCN Medicare Advantage |
$44.42
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$63.96
|
| Rate for Payer: Cofinity Commercial |
$59.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.42
|
| Rate for Payer: Healthscope Commercial |
$53.30
|
| Rate for Payer: Healthscope Whirlpool |
$53.30
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.64
|
| Rate for Payer: PACE SWMI |
$44.42
|
| Rate for Payer: PHP Medicare Advantage |
$44.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.43
|
| Rate for Payer: Priority Health Medicare |
$44.42
|
| Rate for Payer: Priority Health Narrow Network |
$68.43
|
| Rate for Payer: UHC Medicare Advantage |
$45.75
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$162.00
|
| Rate for Payer: ASR ASR |
$174.60
|
| Rate for Payer: BCBS Trust/PPO |
$139.55
|
| Rate for Payer: BCN Commercial |
$139.55
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$169.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Healthscope Whirlpool |
$174.60
|
| Rate for Payer: Mclaren Commercial |
$162.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.40
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
20610
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$721.72 |
| Rate for Payer: Aetna Commercial |
$59.52
|
| Rate for Payer: Aetna Medicare |
$44.42
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$44.42
|
| Rate for Payer: BCBS Trust/PPO |
$721.72
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: BCN Medicare Advantage |
$44.42
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$59.52
|
| Rate for Payer: Cofinity Commercial |
$63.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.42
|
| Rate for Payer: Healthscope Commercial |
$53.30
|
| Rate for Payer: Healthscope Whirlpool |
$53.30
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.64
|
| Rate for Payer: PACE SWMI |
$44.42
|
| Rate for Payer: PHP Medicare Advantage |
$44.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.43
|
| Rate for Payer: Priority Health Medicare |
$44.42
|
| Rate for Payer: Priority Health Narrow Network |
$68.43
|
| Rate for Payer: UHC Medicare Advantage |
$45.75
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$377.64 |
| Rate for Payer: Aetna Commercial |
$162.00
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$174.60
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$139.55
|
| Rate for Payer: BCN Commercial |
$139.55
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$169.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Healthscope Whirlpool |
$174.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$162.00
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.00
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.40
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$133.00 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Trust/PPO |
$147.31
|
| Rate for Payer: BCN Commercial |
$147.31
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$190.00
|
| Rate for Payer: Healthscope Whirlpool |
$184.30
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.20
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$79.35
|
| Rate for Payer: Aetna Medicare |
$59.22
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$59.22
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$117.41
|
| Rate for Payer: BCN Medicare Advantage |
$59.22
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Cofinity Commercial |
$79.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.22
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Healthscope Whirlpool |
$71.06
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.18
|
| Rate for Payer: PACE SWMI |
$59.22
|
| Rate for Payer: PHP Medicare Advantage |
$59.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.90
|
| Rate for Payer: Priority Health Medicare |
$59.22
|
| Rate for Payer: Priority Health Narrow Network |
$90.90
|
| Rate for Payer: UHC Medicare Advantage |
$61.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$133.00 |
| Max. Negotiated Rate |
$329.09 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$147.31
|
| Rate for Payer: BCN Commercial |
$147.31
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$190.00
|
| Rate for Payer: Healthscope Whirlpool |
$184.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.90
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$134.90
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.20
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$79.35
|
| Rate for Payer: Aetna Medicare |
$59.22
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$59.22
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$117.41
|
| Rate for Payer: BCN Medicare Advantage |
$59.22
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Cofinity Commercial |
$79.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.22
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Healthscope Whirlpool |
$71.06
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.18
|
| Rate for Payer: PACE SWMI |
$59.22
|
| Rate for Payer: PHP Medicare Advantage |
$59.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.90
|
| Rate for Payer: Priority Health Medicare |
$59.22
|
| Rate for Payer: Priority Health Narrow Network |
$90.90
|
| Rate for Payer: UHC Medicare Advantage |
$61.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 20600
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$34.85
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$34.85
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$62.04
|
| Rate for Payer: BCN Medicare Advantage |
$34.85
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$50.18
|
| Rate for Payer: Cofinity Commercial |
$46.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.85
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$41.82
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.59
|
| Rate for Payer: PACE SWMI |
$34.85
|
| Rate for Payer: PHP Medicare Advantage |
$34.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.62
|
| Rate for Payer: Priority Health Medicare |
$34.85
|
| Rate for Payer: Priority Health Narrow Network |
$53.62
|
| Rate for Payer: UHC Medicare Advantage |
$35.90
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$96.60 |
| Rate for Payer: Aetna Commercial |
$60.61
|
| Rate for Payer: Aetna Medicare |
$45.23
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$45.23
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: BCN Medicare Advantage |
$45.23
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$65.13
|
| Rate for Payer: Cofinity Commercial |
$60.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.23
|
| Rate for Payer: Healthscope Commercial |
$54.28
|
| Rate for Payer: Healthscope Whirlpool |
$54.28
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.49
|
| Rate for Payer: PACE SWMI |
$45.23
|
| Rate for Payer: PHP Medicare Advantage |
$45.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.45
|
| Rate for Payer: Priority Health Medicare |
$45.23
|
| Rate for Payer: Priority Health Narrow Network |
$69.45
|
| Rate for Payer: UHC Medicare Advantage |
$46.59
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,228.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$621.84 |
| Max. Negotiated Rate |
$2,959.60 |
| Rate for Payer: Aetna Commercial |
$1,333.01
|
| Rate for Payer: Aetna Medicare |
$994.78
|
| Rate for Payer: BCBS Complete |
$680.57
|
| Rate for Payer: BCBS MAPPO |
$994.78
|
| Rate for Payer: BCBS Trust/PPO |
$621.84
|
| Rate for Payer: BCN Commercial |
$1,477.76
|
| Rate for Payer: BCN Medicare Advantage |
$994.78
|
| Rate for Payer: Cash Price |
$3,382.40
|
| Rate for Payer: Cash Price |
$3,382.40
|
| Rate for Payer: Cofinity Commercial |
$1,333.01
|
| Rate for Payer: Cofinity Commercial |
$1,432.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$994.78
|
| Rate for Payer: Healthscope Commercial |
$1,193.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,193.74
|
| Rate for Payer: Meridian Medicaid |
$680.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,044.52
|
| Rate for Payer: PACE SWMI |
$994.78
|
| Rate for Payer: PHP Medicare Advantage |
$994.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,959.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.21
|
| Rate for Payer: Priority Health Medicare |
$994.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,544.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,024.62
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,264.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$3,684.80 |
| Rate for Payer: Aetna Commercial |
$2,433.96
|
| Rate for Payer: Aetna Medicare |
$1,816.39
|
| Rate for Payer: BCBS Complete |
$1,236.33
|
| Rate for Payer: BCBS MAPPO |
$1,816.39
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,943.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,816.39
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cofinity Commercial |
$2,615.60
|
| Rate for Payer: Cofinity Commercial |
$2,433.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,816.39
|
| Rate for Payer: Healthscope Commercial |
$2,179.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,179.67
|
| Rate for Payer: Meridian Medicaid |
$1,236.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,907.21
|
| Rate for Payer: PACE SWMI |
$1,816.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,816.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,177.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,684.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,793.77
|
| Rate for Payer: Priority Health Medicare |
$1,816.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,793.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,870.88
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,342.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$4,439.40 |
| Rate for Payer: Aetna Commercial |
$2,652.22
|
| Rate for Payer: Aetna Medicare |
$1,979.27
|
| Rate for Payer: BCBS Complete |
$1,347.04
|
| Rate for Payer: BCBS MAPPO |
$1,979.27
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,926.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,979.27
|
| Rate for Payer: Cash Price |
$5,073.60
|
| Rate for Payer: Cash Price |
$5,073.60
|
| Rate for Payer: Cofinity Commercial |
$2,850.15
|
| Rate for Payer: Cofinity Commercial |
$2,652.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,979.27
|
| Rate for Payer: Healthscope Commercial |
$2,375.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,375.12
|
| Rate for Payer: Meridian Medicaid |
$1,347.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,078.23
|
| Rate for Payer: PACE SWMI |
$1,979.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,979.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,282.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,439.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,058.28
|
| Rate for Payer: Priority Health Medicare |
$1,979.27
|
| Rate for Payer: Priority Health Narrow Network |
$3,058.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,038.65
|
|
