|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC
|
Professional
|
Both
|
$4,202.00
|
|
|
Service Code
|
HCPCS 22610
|
| Min. Negotiated Rate |
$830.70 |
| Max. Negotiated Rate |
$4,702.18 |
| Rate for Payer: Aetna Commercial |
$1,708.23
|
| Rate for Payer: Aetna Medicare |
$1,274.80
|
| Rate for Payer: BCBS Complete |
$872.24
|
| Rate for Payer: BCBS MAPPO |
$1,274.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,702.18
|
| Rate for Payer: BCN Commercial |
$2,076.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,274.80
|
| Rate for Payer: Cash Price |
$3,361.60
|
| Rate for Payer: Cash Price |
$3,361.60
|
| Rate for Payer: Cofinity Commercial |
$1,835.71
|
| Rate for Payer: Cofinity Commercial |
$1,708.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,274.80
|
| Rate for Payer: Healthscope Commercial |
$1,529.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,529.76
|
| Rate for Payer: Meridian Medicaid |
$872.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,338.54
|
| Rate for Payer: PACE SWMI |
$1,274.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,274.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$830.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,941.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,970.60
|
| Rate for Payer: Priority Health Medicare |
$1,274.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,970.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,313.04
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM
|
Professional
|
Both
|
$4,967.20
|
|
|
Service Code
|
HCPCS 22804
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$3,719.06 |
| Rate for Payer: Aetna Commercial |
$3,240.01
|
| Rate for Payer: Aetna Medicare |
$2,417.92
|
| Rate for Payer: BCBS Complete |
$1,639.58
|
| Rate for Payer: BCBS MAPPO |
$2,417.92
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$3,559.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,417.92
|
| Rate for Payer: Cash Price |
$3,973.76
|
| Rate for Payer: Cash Price |
$3,973.76
|
| Rate for Payer: Cofinity Commercial |
$3,240.01
|
| Rate for Payer: Cofinity Commercial |
$3,481.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,417.92
|
| Rate for Payer: Healthscope Commercial |
$2,901.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,901.50
|
| Rate for Payer: Meridian Medicaid |
$1,639.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,538.82
|
| Rate for Payer: PACE SWMI |
$2,417.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,417.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,561.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,477.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,719.06
|
| Rate for Payer: Priority Health Medicare |
$2,417.92
|
| Rate for Payer: Priority Health Narrow Network |
$3,719.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,490.46
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM
|
Professional
|
Both
|
$2,756.40
|
|
|
Service Code
|
HCPCS 22800
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$2,098.27 |
| Rate for Payer: Aetna Commercial |
$1,819.80
|
| Rate for Payer: Aetna Medicare |
$1,358.06
|
| Rate for Payer: BCBS Complete |
$925.91
|
| Rate for Payer: BCBS MAPPO |
$1,358.06
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,007.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,358.06
|
| Rate for Payer: Cash Price |
$2,205.12
|
| Rate for Payer: Cash Price |
$2,205.12
|
| Rate for Payer: Cofinity Commercial |
$1,955.61
|
| Rate for Payer: Cofinity Commercial |
$1,819.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,358.06
|
| Rate for Payer: Healthscope Commercial |
$1,629.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,629.67
|
| Rate for Payer: Meridian Medicaid |
$925.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,425.96
|
| Rate for Payer: PACE SWMI |
$1,358.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,358.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,929.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,098.27
|
| Rate for Payer: Priority Health Medicare |
$1,358.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,098.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,398.80
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM
|
Professional
|
Both
|
$4,293.76
|
|
|
Service Code
|
HCPCS 22802
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$3,240.07 |
| Rate for Payer: Aetna Commercial |
$2,820.99
|
| Rate for Payer: Aetna Medicare |
$2,105.22
|
| Rate for Payer: BCBS Complete |
$1,429.58
|
| Rate for Payer: BCBS MAPPO |
$2,105.22
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$3,100.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,105.22
|
| Rate for Payer: Cash Price |
$3,435.01
|
| Rate for Payer: Cash Price |
$3,435.01
|
| Rate for Payer: Cofinity Commercial |
$2,820.99
|
| Rate for Payer: Cofinity Commercial |
$3,031.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,105.22
|
| Rate for Payer: Healthscope Commercial |
$2,526.26
|
| Rate for Payer: Healthscope Whirlpool |
$2,526.26
|
| Rate for Payer: Meridian Medicaid |
$1,429.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,210.48
|
| Rate for Payer: PACE SWMI |
$2,105.22
|
| Rate for Payer: PHP Medicare Advantage |
$2,105.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,361.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,005.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,240.07
|
| Rate for Payer: Priority Health Medicare |
$2,105.22
|
| Rate for Payer: Priority Health Narrow Network |
$3,240.07
|
| Rate for Payer: UHC Medicare Advantage |
$2,168.38
|
|
|
PR ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC
|
Professional
|
Both
|
$1,838.00
|
|
|
Service Code
|
HCPCS 22614
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$1,286.60 |
| Rate for Payer: Aetna Commercial |
$522.56
|
| Rate for Payer: Aetna Medicare |
$389.97
|
| Rate for Payer: BCBS Complete |
$261.67
|
| Rate for Payer: BCBS MAPPO |
$389.97
|
| Rate for Payer: BCBS Trust/PPO |
$934.38
|
| Rate for Payer: BCN Commercial |
$626.32
|
| Rate for Payer: BCN Medicare Advantage |
$389.97
|
| Rate for Payer: Cash Price |
$1,470.40
|
| Rate for Payer: Cash Price |
$1,470.40
|
| Rate for Payer: Cofinity Commercial |
$522.56
|
| Rate for Payer: Cofinity Commercial |
$561.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.97
|
| Rate for Payer: Healthscope Commercial |
$467.96
|
| Rate for Payer: Healthscope Whirlpool |
$467.96
|
| Rate for Payer: Meridian Medicaid |
$261.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$409.47
|
| Rate for Payer: PACE SWMI |
$389.97
|
| Rate for Payer: PHP Medicare Advantage |
$389.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$594.40
|
| Rate for Payer: Priority Health Medicare |
$389.97
|
| Rate for Payer: Priority Health Narrow Network |
$594.40
|
| Rate for Payer: UHC Medicare Advantage |
$401.67
|
|
|
PR ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE
|
Professional
|
Both
|
$1,290.00
|
|
|
Service Code
|
HCPCS 27279
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$3,376.37 |
| Rate for Payer: Aetna Commercial |
$1,077.57
|
| Rate for Payer: Aetna Medicare |
$804.16
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS MAPPO |
$804.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,376.37
|
| Rate for Payer: BCN Commercial |
$1,192.37
|
| Rate for Payer: BCN Medicare Advantage |
$804.16
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cofinity Commercial |
$1,077.57
|
| Rate for Payer: Cofinity Commercial |
$1,157.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.16
|
| Rate for Payer: Healthscope Commercial |
$964.99
|
| Rate for Payer: Healthscope Whirlpool |
$964.99
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$844.37
|
| Rate for Payer: PACE SWMI |
$804.16
|
| Rate for Payer: PHP Medicare Advantage |
$804.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,245.99
|
| Rate for Payer: Priority Health Medicare |
$804.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,245.99
|
| Rate for Payer: UHC Medicare Advantage |
$828.28
|
|
|
PR ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ
|
Professional
|
Both
|
$3,176.00
|
|
|
Service Code
|
HCPCS 27280
|
| Min. Negotiated Rate |
$876.28 |
| Max. Negotiated Rate |
$3,839.22 |
| Rate for Payer: Aetna Commercial |
$1,815.54
|
| Rate for Payer: Aetna Medicare |
$1,354.88
|
| Rate for Payer: BCBS Complete |
$920.09
|
| Rate for Payer: BCBS MAPPO |
$1,354.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,839.22
|
| Rate for Payer: BCN Commercial |
$1,997.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,354.88
|
| Rate for Payer: Cash Price |
$2,540.80
|
| Rate for Payer: Cash Price |
$2,540.80
|
| Rate for Payer: Cofinity Commercial |
$1,951.03
|
| Rate for Payer: Cofinity Commercial |
$1,815.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,354.88
|
| Rate for Payer: Healthscope Commercial |
$1,625.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,625.86
|
| Rate for Payer: Meridian Medicaid |
$920.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,422.62
|
| Rate for Payer: PACE SWMI |
$1,354.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,354.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,223.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,087.54
|
| Rate for Payer: Priority Health Medicare |
$1,354.88
|
| Rate for Payer: Priority Health Narrow Network |
$2,087.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,395.53
|
|
|
PR ARTHRODESIS SUBTALAR
|
Professional
|
Both
|
$3,212.00
|
|
|
Service Code
|
HCPCS 28725
|
| Min. Negotiated Rate |
$501.83 |
| Max. Negotiated Rate |
$2,248.40 |
| Rate for Payer: Aetna Commercial |
$1,022.62
|
| Rate for Payer: Aetna Medicare |
$763.15
|
| Rate for Payer: BCBS Complete |
$526.92
|
| Rate for Payer: BCBS MAPPO |
$763.15
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$1,138.62
|
| Rate for Payer: BCN Medicare Advantage |
$763.15
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cofinity Commercial |
$1,022.62
|
| Rate for Payer: Cofinity Commercial |
$1,098.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.15
|
| Rate for Payer: Healthscope Commercial |
$915.78
|
| Rate for Payer: Healthscope Whirlpool |
$915.78
|
| Rate for Payer: Meridian Medicaid |
$526.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$801.31
|
| Rate for Payer: PACE SWMI |
$763.15
|
| Rate for Payer: PHP Medicare Advantage |
$763.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$501.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,248.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,189.81
|
| Rate for Payer: Priority Health Medicare |
$763.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,189.81
|
| Rate for Payer: UHC Medicare Advantage |
$786.04
|
|
|
PR ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT
|
Professional
|
Both
|
$1,474.00
|
|
|
Service Code
|
HCPCS 27282
|
| Min. Negotiated Rate |
$555.72 |
| Max. Negotiated Rate |
$2,399.54 |
| Rate for Payer: Aetna Commercial |
$1,136.87
|
| Rate for Payer: Aetna Medicare |
$848.41
|
| Rate for Payer: BCBS Complete |
$583.51
|
| Rate for Payer: BCBS MAPPO |
$848.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.54
|
| Rate for Payer: BCN Commercial |
$1,265.19
|
| Rate for Payer: BCN Medicare Advantage |
$848.41
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$1,221.71
|
| Rate for Payer: Cofinity Commercial |
$1,136.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.41
|
| Rate for Payer: Healthscope Commercial |
$1,018.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.09
|
| Rate for Payer: Meridian Medicaid |
$583.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$890.83
|
| Rate for Payer: PACE SWMI |
$848.41
|
| Rate for Payer: PHP Medicare Advantage |
$848.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,322.07
|
| Rate for Payer: Priority Health Medicare |
$848.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,322.07
|
| Rate for Payer: UHC Medicare Advantage |
$873.86
|
|
|
PR ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 27871
|
| Min. Negotiated Rate |
$446.87 |
| Max. Negotiated Rate |
$2,282.01 |
| Rate for Payer: Aetna Commercial |
$912.75
|
| Rate for Payer: Aetna Medicare |
$681.16
|
| Rate for Payer: BCBS Complete |
$469.21
|
| Rate for Payer: BCBS MAPPO |
$681.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,282.01
|
| Rate for Payer: BCN Commercial |
$1,016.94
|
| Rate for Payer: BCN Medicare Advantage |
$681.16
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$912.75
|
| Rate for Payer: Cofinity Commercial |
$980.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.16
|
| Rate for Payer: Healthscope Commercial |
$817.39
|
| Rate for Payer: Healthscope Whirlpool |
$817.39
|
| Rate for Payer: Meridian Medicaid |
$469.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$715.22
|
| Rate for Payer: PACE SWMI |
$681.16
|
| Rate for Payer: PHP Medicare Advantage |
$681.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.66
|
| Rate for Payer: Priority Health Medicare |
$681.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,062.66
|
| Rate for Payer: UHC Medicare Advantage |
$701.59
|
|
|
PR ARTHRODESIS TRIPLE
|
Professional
|
Both
|
$4,004.00
|
|
|
Service Code
|
HCPCS 28715
|
| Min. Negotiated Rate |
$604.71 |
| Max. Negotiated Rate |
$2,802.80 |
| Rate for Payer: Aetna Commercial |
$1,236.57
|
| Rate for Payer: Aetna Medicare |
$922.81
|
| Rate for Payer: BCBS Complete |
$634.95
|
| Rate for Payer: BCBS MAPPO |
$922.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.92
|
| Rate for Payer: BCN Commercial |
$1,376.60
|
| Rate for Payer: BCN Medicare Advantage |
$922.81
|
| Rate for Payer: Cash Price |
$3,203.20
|
| Rate for Payer: Cash Price |
$3,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,328.85
|
| Rate for Payer: Cofinity Commercial |
$1,236.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.81
|
| Rate for Payer: Healthscope Commercial |
$1,107.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,107.37
|
| Rate for Payer: Meridian Medicaid |
$634.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$968.95
|
| Rate for Payer: PACE SWMI |
$922.81
|
| Rate for Payer: PHP Medicare Advantage |
$922.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,802.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,438.50
|
| Rate for Payer: Priority Health Medicare |
$922.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,438.50
|
| Rate for Payer: UHC Medicare Advantage |
$950.49
|
|
|
PR ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT
|
Professional
|
Both
|
$2,411.00
|
|
|
Service Code
|
HCPCS 25800
|
| Min. Negotiated Rate |
$473.50 |
| Max. Negotiated Rate |
$1,687.70 |
| Rate for Payer: Aetna Commercial |
$969.01
|
| Rate for Payer: Aetna Medicare |
$723.14
|
| Rate for Payer: BCBS Complete |
$497.18
|
| Rate for Payer: BCBS MAPPO |
$723.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,424.30
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: BCN Medicare Advantage |
$723.14
|
| Rate for Payer: Cash Price |
$1,928.80
|
| Rate for Payer: Cash Price |
$1,928.80
|
| Rate for Payer: Cofinity Commercial |
$969.01
|
| Rate for Payer: Cofinity Commercial |
$1,041.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$723.14
|
| Rate for Payer: Healthscope Commercial |
$867.77
|
| Rate for Payer: Healthscope Whirlpool |
$867.77
|
| Rate for Payer: Meridian Medicaid |
$497.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$759.30
|
| Rate for Payer: PACE SWMI |
$723.14
|
| Rate for Payer: PHP Medicare Advantage |
$723.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,687.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.54
|
| Rate for Payer: Priority Health Medicare |
$723.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.54
|
| Rate for Payer: UHC Medicare Advantage |
$744.83
|
|
|
PR ARTHRODESIS WRIST LIMITED W/AUTOGRAFT
|
Professional
|
Both
|
$13,812.00
|
|
|
Service Code
|
HCPCS 25825
|
| Min. Negotiated Rate |
$514.18 |
| Max. Negotiated Rate |
$9,668.40 |
| Rate for Payer: Aetna Commercial |
$1,044.82
|
| Rate for Payer: Aetna Medicare |
$779.72
|
| Rate for Payer: BCBS Complete |
$539.89
|
| Rate for Payer: BCBS MAPPO |
$779.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,865.96
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| Rate for Payer: BCN Medicare Advantage |
$779.72
|
| Rate for Payer: Cash Price |
$11,049.60
|
| Rate for Payer: Cash Price |
$11,049.60
|
| Rate for Payer: Cofinity Commercial |
$1,044.82
|
| Rate for Payer: Cofinity Commercial |
$1,122.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.72
|
| Rate for Payer: Healthscope Commercial |
$935.66
|
| Rate for Payer: Healthscope Whirlpool |
$935.66
|
| Rate for Payer: Meridian Medicaid |
$539.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.71
|
| Rate for Payer: PACE SWMI |
$779.72
|
| Rate for Payer: PHP Medicare Advantage |
$779.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,668.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,225.04
|
| Rate for Payer: Priority Health Medicare |
$779.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,225.04
|
| Rate for Payer: UHC Medicare Advantage |
$803.11
|
|
|
PR ARTHRODESIS WRIST LIMITED W/O BONE GRAFT
|
Professional
|
Both
|
$2,781.00
|
|
|
Service Code
|
HCPCS 25820
|
| Min. Negotiated Rate |
$421.53 |
| Max. Negotiated Rate |
$1,946.70 |
| Rate for Payer: Aetna Commercial |
$856.19
|
| Rate for Payer: Aetna Medicare |
$638.95
|
| Rate for Payer: BCBS Complete |
$442.61
|
| Rate for Payer: BCBS MAPPO |
$638.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$638.95
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$920.09
|
| Rate for Payer: Cofinity Commercial |
$856.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.95
|
| Rate for Payer: Healthscope Commercial |
$766.74
|
| Rate for Payer: Healthscope Whirlpool |
$766.74
|
| Rate for Payer: Meridian Medicaid |
$442.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$670.90
|
| Rate for Payer: PACE SWMI |
$638.95
|
| Rate for Payer: PHP Medicare Advantage |
$638.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,946.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.47
|
| Rate for Payer: Priority Health Medicare |
$638.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,005.47
|
| Rate for Payer: UHC Medicare Advantage |
$658.12
|
|
|
PR ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT
|
Professional
|
Both
|
$3,345.00
|
|
|
Service Code
|
HCPCS 25810
|
| Min. Negotiated Rate |
$561.04 |
| Max. Negotiated Rate |
$2,341.50 |
| Rate for Payer: Aetna Commercial |
$1,145.53
|
| Rate for Payer: Aetna Medicare |
$854.87
|
| Rate for Payer: BCBS Complete |
$589.09
|
| Rate for Payer: BCBS MAPPO |
$854.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.11
|
| Rate for Payer: BCN Commercial |
$1,276.43
|
| Rate for Payer: BCN Medicare Advantage |
$854.87
|
| Rate for Payer: Cash Price |
$2,676.00
|
| Rate for Payer: Cash Price |
$2,676.00
|
| Rate for Payer: Cofinity Commercial |
$1,231.01
|
| Rate for Payer: Cofinity Commercial |
$1,145.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.87
|
| Rate for Payer: Healthscope Commercial |
$1,025.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,025.84
|
| Rate for Payer: Meridian Medicaid |
$589.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$897.61
|
| Rate for Payer: PACE SWMI |
$854.87
|
| Rate for Payer: PHP Medicare Advantage |
$854.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,341.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,333.81
|
| Rate for Payer: Priority Health Medicare |
$854.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,333.81
|
| Rate for Payer: UHC Medicare Advantage |
$880.52
|
|
|
PR ARTHRODESIS WRIST W/SLIDING GRAFT
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 25805
|
| Min. Negotiated Rate |
$548.48 |
| Max. Negotiated Rate |
$2,041.90 |
| Rate for Payer: Aetna Commercial |
$1,121.61
|
| Rate for Payer: Aetna Medicare |
$837.02
|
| Rate for Payer: BCBS Complete |
$575.90
|
| Rate for Payer: BCBS MAPPO |
$837.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.24
|
| Rate for Payer: BCN Commercial |
$1,248.08
|
| Rate for Payer: BCN Medicare Advantage |
$837.02
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,205.31
|
| Rate for Payer: Cofinity Commercial |
$1,121.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$837.02
|
| Rate for Payer: Healthscope Commercial |
$1,004.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,004.42
|
| Rate for Payer: Meridian Medicaid |
$575.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$878.87
|
| Rate for Payer: PACE SWMI |
$837.02
|
| Rate for Payer: PHP Medicare Advantage |
$837.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,041.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,304.20
|
| Rate for Payer: Priority Health Medicare |
$837.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,304.20
|
| Rate for Payer: UHC Medicare Advantage |
$862.13
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
IP
|
$222.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$155.40 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Aetna Commercial |
$199.80
|
| Rate for Payer: ASR ASR |
$215.34
|
| Rate for Payer: BCBS Trust/PPO |
$172.12
|
| Rate for Payer: BCN Commercial |
$172.12
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$208.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.60
|
| Rate for Payer: Healthscope Commercial |
$222.00
|
| Rate for Payer: Healthscope Whirlpool |
$215.34
|
| Rate for Payer: Mclaren Commercial |
$199.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$188.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.36
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
OP
|
$222.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$88.80 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Aetna Commercial |
$199.80
|
| Rate for Payer: ASR ASR |
$215.34
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCBS Trust/PPO |
$172.12
|
| Rate for Payer: BCN Commercial |
$172.12
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$208.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.60
|
| Rate for Payer: Healthscope Commercial |
$222.00
|
| Rate for Payer: Healthscope Whirlpool |
$215.34
|
| Rate for Payer: Mclaren Commercial |
$199.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$188.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.02
|
| Rate for Payer: Priority Health Narrow Network |
$157.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.36
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$84.19 |
| Max. Negotiated Rate |
$561.05 |
| Rate for Payer: Aetna Commercial |
$112.81
|
| Rate for Payer: Aetna Medicare |
$84.19
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCBS MAPPO |
$84.19
|
| Rate for Payer: BCBS Trust/PPO |
$561.05
|
| Rate for Payer: BCN Commercial |
$123.64
|
| Rate for Payer: BCN Medicare Advantage |
$84.19
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.19
|
| Rate for Payer: Healthscope Commercial |
$101.03
|
| Rate for Payer: Healthscope Whirlpool |
$101.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.40
|
| Rate for Payer: PACE SWMI |
$84.19
|
| Rate for Payer: PHP Medicare Advantage |
$84.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.19
|
| Rate for Payer: Priority Health Medicare |
$84.19
|
| Rate for Payer: Priority Health Narrow Network |
$129.19
|
| Rate for Payer: UHC Medicare Advantage |
$86.72
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS G0289
|
| Min. Negotiated Rate |
$84.19 |
| Max. Negotiated Rate |
$561.05 |
| Rate for Payer: Aetna Commercial |
$112.81
|
| Rate for Payer: Aetna Medicare |
$84.19
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCBS MAPPO |
$84.19
|
| Rate for Payer: BCBS Trust/PPO |
$561.05
|
| Rate for Payer: BCN Commercial |
$123.64
|
| Rate for Payer: BCN Medicare Advantage |
$84.19
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.19
|
| Rate for Payer: Healthscope Commercial |
$101.03
|
| Rate for Payer: Healthscope Whirlpool |
$101.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.40
|
| Rate for Payer: PACE SWMI |
$84.19
|
| Rate for Payer: PHP Medicare Advantage |
$84.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.19
|
| Rate for Payer: Priority Health Medicare |
$84.19
|
| Rate for Payer: Priority Health Narrow Network |
$129.19
|
| Rate for Payer: UHC Medicare Advantage |
$86.72
|
|
|
PR ARTHROPLASTY ANKLE
|
Professional
|
Both
|
$2,650.00
|
|
|
Service Code
|
HCPCS 27700
|
| Min. Negotiated Rate |
$461.15 |
| Max. Negotiated Rate |
$1,855.00 |
| Rate for Payer: Aetna Commercial |
$806.25
|
| Rate for Payer: Aetna Medicare |
$601.68
|
| Rate for Payer: BCBS Complete |
$484.21
|
| Rate for Payer: BCBS MAPPO |
$601.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: BCN Medicare Advantage |
$601.68
|
| Rate for Payer: Cash Price |
$2,120.00
|
| Rate for Payer: Cash Price |
$2,120.00
|
| Rate for Payer: Cofinity Commercial |
$806.25
|
| Rate for Payer: Cofinity Commercial |
$866.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.68
|
| Rate for Payer: Healthscope Commercial |
$722.02
|
| Rate for Payer: Healthscope Whirlpool |
$722.02
|
| Rate for Payer: Meridian Medicaid |
$484.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$631.76
|
| Rate for Payer: PACE SWMI |
$601.68
|
| Rate for Payer: PHP Medicare Advantage |
$601.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.51
|
| Rate for Payer: Priority Health Medicare |
$601.68
|
| Rate for Payer: Priority Health Narrow Network |
$935.51
|
| Rate for Payer: UHC Medicare Advantage |
$619.73
|
|
|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,004.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$712.91 |
| Max. Negotiated Rate |
$2,923.61 |
| Rate for Payer: Aetna Commercial |
$1,467.69
|
| Rate for Payer: Aetna Medicare |
$1,095.29
|
| Rate for Payer: BCBS Complete |
$748.56
|
| Rate for Payer: BCBS MAPPO |
$1,095.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.61
|
| Rate for Payer: BCN Commercial |
$1,625.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,095.29
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cofinity Commercial |
$1,577.22
|
| Rate for Payer: Cofinity Commercial |
$1,467.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,095.29
|
| Rate for Payer: Healthscope Commercial |
$1,314.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,314.35
|
| Rate for Payer: Meridian Medicaid |
$748.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,150.05
|
| Rate for Payer: PACE SWMI |
$1,095.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,095.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$712.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.94
|
| Rate for Payer: Priority Health Medicare |
$1,095.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,698.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.15
|
|
|
PR ARTHROPLASTY ANKLE W/IMPLANT
|
Professional
|
Both
|
$1,937.74
|
|
|
Service Code
|
HCPCS 27702
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$2,899.77 |
| Rate for Payer: Aetna Commercial |
$1,268.85
|
| Rate for Payer: Aetna Medicare |
$946.90
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS MAPPO |
$946.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.77
|
| Rate for Payer: BCN Commercial |
$1,407.39
|
| Rate for Payer: BCN Medicare Advantage |
$946.90
|
| Rate for Payer: Cash Price |
$1,550.19
|
| Rate for Payer: Cash Price |
$1,550.19
|
| Rate for Payer: Cofinity Commercial |
$1,268.85
|
| Rate for Payer: Cofinity Commercial |
$1,363.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.90
|
| Rate for Payer: Healthscope Commercial |
$1,136.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,136.28
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$994.24
|
| Rate for Payer: PACE SWMI |
$946.90
|
| Rate for Payer: PHP Medicare Advantage |
$946.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.67
|
| Rate for Payer: Priority Health Medicare |
$946.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,470.67
|
| Rate for Payer: UHC Medicare Advantage |
$975.31
|
|
|
PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 27442
|
| Min. Negotiated Rate |
$560.62 |
| Max. Negotiated Rate |
$1,338.41 |
| Rate for Payer: Aetna Commercial |
$1,152.82
|
| Rate for Payer: Aetna Medicare |
$860.31
|
| Rate for Payer: BCBS Complete |
$588.65
|
| Rate for Payer: BCBS MAPPO |
$860.31
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$1,280.82
|
| Rate for Payer: BCN Medicare Advantage |
$860.31
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,238.85
|
| Rate for Payer: Cofinity Commercial |
$1,152.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$860.31
|
| Rate for Payer: Healthscope Commercial |
$1,032.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,032.37
|
| Rate for Payer: Meridian Medicaid |
$588.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$903.33
|
| Rate for Payer: PACE SWMI |
$860.31
|
| Rate for Payer: PHP Medicare Advantage |
$860.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,338.41
|
| Rate for Payer: Priority Health Medicare |
$860.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,338.41
|
| Rate for Payer: UHC Medicare Advantage |
$886.12
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,485.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$197.82 |
| Max. Negotiated Rate |
$3,139.50 |
| Rate for Payer: Aetna Commercial |
$1,908.16
|
| Rate for Payer: Aetna Medicare |
$1,424.00
|
| Rate for Payer: BCBS Complete |
$971.31
|
| Rate for Payer: BCBS MAPPO |
$1,424.00
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| Rate for Payer: BCN Commercial |
$2,110.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,424.00
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cofinity Commercial |
$2,050.56
|
| Rate for Payer: Cofinity Commercial |
$1,908.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,424.00
|
| Rate for Payer: Healthscope Commercial |
$1,708.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,708.80
|
| Rate for Payer: Meridian Medicaid |
$971.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,495.20
|
| Rate for Payer: PACE SWMI |
$1,424.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,424.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,205.50
|
| Rate for Payer: Priority Health Medicare |
$1,424.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,205.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.72
|
|
