PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
OP
|
$4,485.00
|
|
Service Code
|
CPT 23472
|
Hospital Charge Code |
23472
|
Min. Negotiated Rate |
$3,139.50 |
Max. Negotiated Rate |
$20,706.49 |
Rate for Payer: Aetna Commercial |
$4,036.50
|
Rate for Payer: Aetna Medicare |
$16,565.19
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,706.49
|
Rate for Payer: Amish Plain Church Group Commercial |
$20,706.49
|
Rate for Payer: ASR ASR |
$4,350.45
|
Rate for Payer: BCBS Complete |
$9,515.05
|
Rate for Payer: BCBS MAPPO |
$16,565.19
|
Rate for Payer: BCBS Trust/PPO |
$3,477.22
|
Rate for Payer: BCN Commercial |
$3,477.22
|
Rate for Payer: BCN Medicare Advantage |
$16,565.19
|
Rate for Payer: Cash Price |
$3,588.00
|
Rate for Payer: Cash Price |
$3,588.00
|
Rate for Payer: Cofinity Commercial |
$4,215.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,565.19
|
Rate for Payer: Healthscope Commercial |
$4,485.00
|
Rate for Payer: Healthscope Whirlpool |
$4,350.45
|
Rate for Payer: Humana Choice PPO Medicare |
$16,565.19
|
Rate for Payer: Mclaren Commercial |
$4,036.50
|
Rate for Payer: Mclaren Medicaid |
$9,061.16
|
Rate for Payer: Mclaren Medicare |
$16,565.19
|
Rate for Payer: Meridian Medicaid |
$9,515.05
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,393.45
|
Rate for Payer: MI Amish Medical Board Commercial |
$19,049.97
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,812.25
|
Rate for Payer: PACE Medicare |
$15,736.93
|
Rate for Payer: PACE SWMI |
$16,565.19
|
Rate for Payer: PHP Commercial |
$18,221.71
|
Rate for Payer: PHP Medicaid |
$9,061.16
|
Rate for Payer: PHP Medicare Advantage |
$16,565.19
|
Rate for Payer: Priority Health Choice Medicaid |
$9,061.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,081.35
|
Rate for Payer: Priority Health Medicare |
$16,565.19
|
Rate for Payer: Priority Health Narrow Network |
$3,184.35
|
Rate for Payer: Railroad Medicare Medicare |
$16,565.19
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.80
|
Rate for Payer: UHC Medicare Advantage |
$17,062.15
|
Rate for Payer: VA VA |
$16,565.19
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,485.00
|
|
Service Code
|
HCPCS 23472
|
Hospital Charge Code |
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 |
$1,908.16
|
Rate for Payer: Cofinity Commercial |
$2,050.56
|
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
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
IP
|
$4,485.00
|
|
Service Code
|
CPT 23472
|
Hospital Charge Code |
23472
|
Min. Negotiated Rate |
$3,139.50 |
Max. Negotiated Rate |
$4,485.00 |
Rate for Payer: Aetna Commercial |
$4,036.50
|
Rate for Payer: ASR ASR |
$4,350.45
|
Rate for Payer: BCBS Trust/PPO |
$3,477.22
|
Rate for Payer: BCN Commercial |
$3,477.22
|
Rate for Payer: Cash Price |
$3,588.00
|
Rate for Payer: Cofinity Commercial |
$4,215.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.00
|
Rate for Payer: Healthscope Commercial |
$4,485.00
|
Rate for Payer: Healthscope Whirlpool |
$4,350.45
|
Rate for Payer: Mclaren Commercial |
$4,036.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,812.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,946.80
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,398.00
|
|
Service Code
|
HCPCS 23470
|
Min. Negotiated Rate |
$171.92 |
Max. Negotiated Rate |
$2,378.60 |
Rate for Payer: Aetna Commercial |
$1,581.09
|
Rate for Payer: Aetna Medicare |
$1,179.92
|
Rate for Payer: BCBS Complete |
$807.38
|
Rate for Payer: BCBS MAPPO |
$1,179.92
|
Rate for Payer: BCBS Trust/PPO |
$171.92
|
Rate for Payer: BCN Commercial |
$1,751.91
|
Rate for Payer: BCN Medicare Advantage |
$1,179.92
|
Rate for Payer: Cash Price |
$2,718.40
|
Rate for Payer: Cash Price |
$2,718.40
|
Rate for Payer: Cofinity Commercial |
$1,581.09
|
Rate for Payer: Cofinity Commercial |
$1,699.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,179.92
|
Rate for Payer: Healthscope Commercial |
$1,415.90
|
Rate for Payer: Healthscope Whirlpool |
$1,415.90
|
Rate for Payer: Meridian Medicaid |
$807.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,238.92
|
Rate for Payer: PACE SWMI |
$1,179.92
|
Rate for Payer: PHP Medicare Advantage |
$1,179.92
|
Rate for Payer: Priority Health Choice Medicaid |
$768.93
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,378.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.69
|
Rate for Payer: Priority Health Medicare |
$1,179.92
|
Rate for Payer: Priority Health Narrow Network |
$1,830.69
|
Rate for Payer: UHC Medicare Advantage |
$1,215.32
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,657.00
|
|
Service Code
|
HCPCS 26535
|
Min. Negotiated Rate |
$286.70 |
Max. Negotiated Rate |
$1,159.90 |
Rate for Payer: Aetna Commercial |
$579.17
|
Rate for Payer: Aetna Medicare |
$432.22
|
Rate for Payer: BCBS Complete |
$301.04
|
Rate for Payer: BCBS MAPPO |
$432.22
|
Rate for Payer: BCBS Trust/PPO |
$943.54
|
Rate for Payer: BCN Commercial |
$649.94
|
Rate for Payer: BCN Medicare Advantage |
$432.22
|
Rate for Payer: Cash Price |
$1,325.60
|
Rate for Payer: Cash Price |
$1,325.60
|
Rate for Payer: Cofinity Commercial |
$579.17
|
Rate for Payer: Cofinity Commercial |
$622.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.22
|
Rate for Payer: Healthscope Commercial |
$518.66
|
Rate for Payer: Healthscope Whirlpool |
$518.66
|
Rate for Payer: Meridian Medicaid |
$301.04
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$453.83
|
Rate for Payer: PACE SWMI |
$432.22
|
Rate for Payer: PHP Medicare Advantage |
$432.22
|
Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,159.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.16
|
Rate for Payer: Priority Health Medicare |
$432.22
|
Rate for Payer: Priority Health Narrow Network |
$679.16
|
Rate for Payer: UHC Medicare Advantage |
$445.19
|
|
PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,432.00
|
|
Service Code
|
HCPCS 26536
|
Min. Negotiated Rate |
$331.24 |
Max. Negotiated Rate |
$1,702.40 |
Rate for Payer: Aetna Commercial |
$979.92
|
Rate for Payer: Aetna Medicare |
$731.28
|
Rate for Payer: BCBS Complete |
$509.70
|
Rate for Payer: BCBS MAPPO |
$731.28
|
Rate for Payer: BCBS Trust/PPO |
$331.24
|
Rate for Payer: BCN Commercial |
$1,115.65
|
Rate for Payer: BCN Medicare Advantage |
$731.28
|
Rate for Payer: Cash Price |
$1,945.60
|
Rate for Payer: Cash Price |
$1,945.60
|
Rate for Payer: Cofinity Commercial |
$979.92
|
Rate for Payer: Cofinity Commercial |
$1,053.04
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.28
|
Rate for Payer: Healthscope Commercial |
$877.54
|
Rate for Payer: Healthscope Whirlpool |
$877.54
|
Rate for Payer: Meridian Medicaid |
$509.70
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$767.84
|
Rate for Payer: PACE SWMI |
$731.28
|
Rate for Payer: PHP Medicare Advantage |
$731.28
|
Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,702.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,165.81
|
Rate for Payer: Priority Health Medicare |
$731.28
|
Rate for Payer: Priority Health Narrow Network |
$1,165.81
|
Rate for Payer: UHC Medicare Advantage |
$753.22
|
|
PR ARTHROPLASTY KNEE TIBIAL PLATEAU
|
Professional
|
Both
|
$1,742.00
|
|
Service Code
|
HCPCS 27440
|
Min. Negotiated Rate |
$516.10 |
Max. Negotiated Rate |
$1,732.82 |
Rate for Payer: Aetna Commercial |
$1,055.67
|
Rate for Payer: Aetna Medicare |
$787.81
|
Rate for Payer: BCBS Complete |
$541.90
|
Rate for Payer: BCBS MAPPO |
$787.81
|
Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
Rate for Payer: BCN Commercial |
$1,174.29
|
Rate for Payer: BCN Medicare Advantage |
$787.81
|
Rate for Payer: Cash Price |
$1,393.60
|
Rate for Payer: Cash Price |
$1,393.60
|
Rate for Payer: Cofinity Commercial |
$1,055.67
|
Rate for Payer: Cofinity Commercial |
$1,134.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.81
|
Rate for Payer: Healthscope Commercial |
$945.37
|
Rate for Payer: Healthscope Whirlpool |
$945.37
|
Rate for Payer: Meridian Medicaid |
$541.90
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$827.20
|
Rate for Payer: PACE SWMI |
$787.81
|
Rate for Payer: PHP Medicare Advantage |
$787.81
|
Rate for Payer: Priority Health Choice Medicaid |
$516.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,219.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,227.09
|
Rate for Payer: Priority Health Medicare |
$787.81
|
Rate for Payer: Priority Health Narrow Network |
$1,227.09
|
Rate for Payer: UHC Medicare Advantage |
$811.44
|
|
PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,771.00
|
|
Service Code
|
HCPCS 26530
|
Min. Negotiated Rate |
$353.79 |
Max. Negotiated Rate |
$1,277.96 |
Rate for Payer: Aetna Commercial |
$714.02
|
Rate for Payer: Aetna Medicare |
$532.85
|
Rate for Payer: BCBS Complete |
$371.48
|
Rate for Payer: BCBS MAPPO |
$532.85
|
Rate for Payer: BCBS Trust/PPO |
$1,277.96
|
Rate for Payer: BCN Commercial |
$799.48
|
Rate for Payer: BCN Medicare Advantage |
$532.85
|
Rate for Payer: Cash Price |
$1,416.80
|
Rate for Payer: Cash Price |
$1,416.80
|
Rate for Payer: Cofinity Commercial |
$767.30
|
Rate for Payer: Cofinity Commercial |
$714.02
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.85
|
Rate for Payer: Healthscope Commercial |
$639.42
|
Rate for Payer: Healthscope Whirlpool |
$639.42
|
Rate for Payer: Meridian Medicaid |
$371.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$559.49
|
Rate for Payer: PACE SWMI |
$532.85
|
Rate for Payer: PHP Medicare Advantage |
$532.85
|
Rate for Payer: Priority Health Choice Medicaid |
$353.79
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,239.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.42
|
Rate for Payer: Priority Health Medicare |
$532.85
|
Rate for Payer: Priority Health Narrow Network |
$835.42
|
Rate for Payer: UHC Medicare Advantage |
$548.84
|
|
PR ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$1,153.00
|
|
Service Code
|
HCPCS 27437
|
Min. Negotiated Rate |
$429.41 |
Max. Negotiated Rate |
$1,630.86 |
Rate for Payer: Aetna Commercial |
$875.05
|
Rate for Payer: Aetna Medicare |
$653.02
|
Rate for Payer: BCBS Complete |
$450.88
|
Rate for Payer: BCBS MAPPO |
$653.02
|
Rate for Payer: BCBS Trust/PPO |
$1,630.86
|
Rate for Payer: BCN Commercial |
$975.40
|
Rate for Payer: BCN Medicare Advantage |
$653.02
|
Rate for Payer: Cash Price |
$922.40
|
Rate for Payer: Cash Price |
$922.40
|
Rate for Payer: Cofinity Commercial |
$940.35
|
Rate for Payer: Cofinity Commercial |
$875.05
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.02
|
Rate for Payer: Healthscope Commercial |
$783.62
|
Rate for Payer: Healthscope Whirlpool |
$783.62
|
Rate for Payer: Meridian Medicaid |
$450.88
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$685.67
|
Rate for Payer: PACE SWMI |
$653.02
|
Rate for Payer: PHP Medicare Advantage |
$653.02
|
Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
Rate for Payer: Priority Health Cigna Priority Health |
$807.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.26
|
Rate for Payer: Priority Health Medicare |
$653.02
|
Rate for Payer: Priority Health Narrow Network |
$1,019.26
|
Rate for Payer: UHC Medicare Advantage |
$672.61
|
|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,289.00
|
|
Service Code
|
HCPCS 27438
|
Min. Negotiated Rate |
$543.15 |
Max. Negotiated Rate |
$1,651.99 |
Rate for Payer: Aetna Commercial |
$1,111.42
|
Rate for Payer: Aetna Medicare |
$829.42
|
Rate for Payer: BCBS Complete |
$570.31
|
Rate for Payer: BCBS MAPPO |
$829.42
|
Rate for Payer: BCBS Trust/PPO |
$1,651.99
|
Rate for Payer: BCN Commercial |
$1,235.37
|
Rate for Payer: BCN Medicare Advantage |
$829.42
|
Rate for Payer: Cash Price |
$1,831.20
|
Rate for Payer: Cash Price |
$1,831.20
|
Rate for Payer: Cofinity Commercial |
$1,111.42
|
Rate for Payer: Cofinity Commercial |
$1,194.36
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.42
|
Rate for Payer: Healthscope Commercial |
$995.30
|
Rate for Payer: Healthscope Whirlpool |
$995.30
|
Rate for Payer: Meridian Medicaid |
$570.31
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$870.89
|
Rate for Payer: PACE SWMI |
$829.42
|
Rate for Payer: PHP Medicare Advantage |
$829.42
|
Rate for Payer: Priority Health Choice Medicaid |
$543.15
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,602.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,290.93
|
Rate for Payer: Priority Health Medicare |
$829.42
|
Rate for Payer: Priority Health Narrow Network |
$1,290.93
|
Rate for Payer: UHC Medicare Advantage |
$854.30
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,635.00
|
|
Service Code
|
HCPCS 24365
|
Min. Negotiated Rate |
$258.95 |
Max. Negotiated Rate |
$1,144.50 |
Rate for Payer: Aetna Commercial |
$849.09
|
Rate for Payer: Aetna Medicare |
$633.65
|
Rate for Payer: BCBS Complete |
$437.24
|
Rate for Payer: BCBS MAPPO |
$633.65
|
Rate for Payer: BCBS Trust/PPO |
$258.95
|
Rate for Payer: BCN Commercial |
$946.57
|
Rate for Payer: BCN Medicare Advantage |
$633.65
|
Rate for Payer: Cash Price |
$1,308.00
|
Rate for Payer: Cash Price |
$1,308.00
|
Rate for Payer: Cofinity Commercial |
$912.46
|
Rate for Payer: Cofinity Commercial |
$849.09
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.65
|
Rate for Payer: Healthscope Commercial |
$760.38
|
Rate for Payer: Healthscope Whirlpool |
$760.38
|
Rate for Payer: Meridian Medicaid |
$437.24
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$665.33
|
Rate for Payer: PACE SWMI |
$633.65
|
Rate for Payer: PHP Medicare Advantage |
$633.65
|
Rate for Payer: Priority Health Choice Medicaid |
$416.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,144.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$989.14
|
Rate for Payer: Priority Health Medicare |
$633.65
|
Rate for Payer: Priority Health Narrow Network |
$989.14
|
Rate for Payer: UHC Medicare Advantage |
$652.66
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,465.00
|
|
Service Code
|
HCPCS 24366
|
Min. Negotiated Rate |
$304.79 |
Max. Negotiated Rate |
$1,725.50 |
Rate for Payer: Aetna Commercial |
$900.36
|
Rate for Payer: Aetna Medicare |
$671.91
|
Rate for Payer: BCBS Complete |
$462.96
|
Rate for Payer: BCBS MAPPO |
$671.91
|
Rate for Payer: BCBS Trust/PPO |
$304.79
|
Rate for Payer: BCN Commercial |
$1,003.26
|
Rate for Payer: BCN Medicare Advantage |
$671.91
|
Rate for Payer: Cash Price |
$1,972.00
|
Rate for Payer: Cash Price |
$1,972.00
|
Rate for Payer: Cofinity Commercial |
$967.55
|
Rate for Payer: Cofinity Commercial |
$900.36
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.91
|
Rate for Payer: Healthscope Commercial |
$806.29
|
Rate for Payer: Healthscope Whirlpool |
$806.29
|
Rate for Payer: Meridian Medicaid |
$462.96
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$705.51
|
Rate for Payer: PACE SWMI |
$671.91
|
Rate for Payer: PHP Medicare Advantage |
$671.91
|
Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,725.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.36
|
Rate for Payer: Priority Health Medicare |
$671.91
|
Rate for Payer: Priority Health Narrow Network |
$1,048.36
|
Rate for Payer: UHC Medicare Advantage |
$692.07
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,259.00
|
|
Service Code
|
HCPCS 25445
|
Min. Negotiated Rate |
$467.11 |
Max. Negotiated Rate |
$1,111.68 |
Rate for Payer: Aetna Commercial |
$954.43
|
Rate for Payer: Aetna Medicare |
$712.26
|
Rate for Payer: BCBS Complete |
$490.47
|
Rate for Payer: BCBS MAPPO |
$712.26
|
Rate for Payer: BCBS Trust/PPO |
$864.30
|
Rate for Payer: BCN Commercial |
$1,063.85
|
Rate for Payer: BCN Medicare Advantage |
$712.26
|
Rate for Payer: Cash Price |
$1,007.20
|
Rate for Payer: Cash Price |
$1,007.20
|
Rate for Payer: Cofinity Commercial |
$954.43
|
Rate for Payer: Cofinity Commercial |
$1,025.65
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.26
|
Rate for Payer: Healthscope Commercial |
$854.71
|
Rate for Payer: Healthscope Whirlpool |
$854.71
|
Rate for Payer: Meridian Medicaid |
$490.47
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.87
|
Rate for Payer: PACE SWMI |
$712.26
|
Rate for Payer: PHP Medicare Advantage |
$712.26
|
Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$881.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.68
|
Rate for Payer: Priority Health Medicare |
$712.26
|
Rate for Payer: Priority Health Narrow Network |
$1,111.68
|
Rate for Payer: UHC Medicare Advantage |
$733.63
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,856.00
|
|
Service Code
|
HCPCS 25441
|
Min. Negotiated Rate |
$605.56 |
Max. Negotiated Rate |
$1,441.57 |
Rate for Payer: Aetna Commercial |
$1,241.59
|
Rate for Payer: Aetna Medicare |
$926.56
|
Rate for Payer: BCBS Complete |
$635.84
|
Rate for Payer: BCBS MAPPO |
$926.56
|
Rate for Payer: BCBS Trust/PPO |
$807.77
|
Rate for Payer: BCN Commercial |
$1,379.54
|
Rate for Payer: BCN Medicare Advantage |
$926.56
|
Rate for Payer: Cash Price |
$1,484.80
|
Rate for Payer: Cash Price |
$1,484.80
|
Rate for Payer: Cofinity Commercial |
$1,334.25
|
Rate for Payer: Cofinity Commercial |
$1,241.59
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.56
|
Rate for Payer: Healthscope Commercial |
$1,111.87
|
Rate for Payer: Healthscope Whirlpool |
$1,111.87
|
Rate for Payer: Meridian Medicaid |
$635.84
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$972.89
|
Rate for Payer: PACE SWMI |
$926.56
|
Rate for Payer: PHP Medicare Advantage |
$926.56
|
Rate for Payer: Priority Health Choice Medicaid |
$605.56
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,299.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,441.57
|
Rate for Payer: Priority Health Medicare |
$926.56
|
Rate for Payer: Priority Health Narrow Network |
$1,441.57
|
Rate for Payer: UHC Medicare Advantage |
$954.36
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,596.00
|
|
Service Code
|
HCPCS 25442
|
Min. Negotiated Rate |
$523.55 |
Max. Negotiated Rate |
$1,245.99 |
Rate for Payer: Aetna Commercial |
$1,069.90
|
Rate for Payer: Aetna Medicare |
$798.43
|
Rate for Payer: BCBS Complete |
$549.73
|
Rate for Payer: BCBS MAPPO |
$798.43
|
Rate for Payer: BCBS Trust/PPO |
$863.24
|
Rate for Payer: BCN Commercial |
$1,192.37
|
Rate for Payer: BCN Medicare Advantage |
$798.43
|
Rate for Payer: Cash Price |
$1,276.80
|
Rate for Payer: Cash Price |
$1,276.80
|
Rate for Payer: Cofinity Commercial |
$1,149.74
|
Rate for Payer: Cofinity Commercial |
$1,069.90
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.43
|
Rate for Payer: Healthscope Commercial |
$958.12
|
Rate for Payer: Healthscope Whirlpool |
$958.12
|
Rate for Payer: Meridian Medicaid |
$549.73
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$838.35
|
Rate for Payer: PACE SWMI |
$798.43
|
Rate for Payer: PHP Medicare Advantage |
$798.43
|
Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,117.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,245.99
|
Rate for Payer: Priority Health Medicare |
$798.43
|
Rate for Payer: Priority Health Narrow Network |
$1,245.99
|
Rate for Payer: UHC Medicare Advantage |
$822.38
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,566.00
|
|
Service Code
|
HCPCS 25443
|
Min. Negotiated Rate |
$509.28 |
Max. Negotiated Rate |
$1,209.73 |
Rate for Payer: Aetna Commercial |
$1,039.12
|
Rate for Payer: Aetna Medicare |
$775.46
|
Rate for Payer: BCBS Complete |
$534.74
|
Rate for Payer: BCBS MAPPO |
$775.46
|
Rate for Payer: BCBS Trust/PPO |
$628.15
|
Rate for Payer: BCN Commercial |
$1,157.67
|
Rate for Payer: BCN Medicare Advantage |
$775.46
|
Rate for Payer: Cash Price |
$1,252.80
|
Rate for Payer: Cash Price |
$1,252.80
|
Rate for Payer: Cofinity Commercial |
$1,116.66
|
Rate for Payer: Cofinity Commercial |
$1,039.12
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.46
|
Rate for Payer: Healthscope Commercial |
$930.55
|
Rate for Payer: Healthscope Whirlpool |
$930.55
|
Rate for Payer: Meridian Medicaid |
$534.74
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$814.23
|
Rate for Payer: PACE SWMI |
$775.46
|
Rate for Payer: PHP Medicare Advantage |
$775.46
|
Rate for Payer: Priority Health Choice Medicaid |
$509.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,096.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.73
|
Rate for Payer: Priority Health Medicare |
$775.46
|
Rate for Payer: Priority Health Narrow Network |
$1,209.73
|
Rate for Payer: UHC Medicare Advantage |
$798.72
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,055.00
|
|
Service Code
|
HCPCS 29851
|
Min. Negotiated Rate |
$599.38 |
Max. Negotiated Rate |
$2,138.50 |
Rate for Payer: Aetna Commercial |
$1,228.16
|
Rate for Payer: Aetna Medicare |
$916.54
|
Rate for Payer: BCBS Complete |
$629.35
|
Rate for Payer: BCBS MAPPO |
$916.54
|
Rate for Payer: BCBS Trust/PPO |
$1,262.11
|
Rate for Payer: BCN Commercial |
$1,363.90
|
Rate for Payer: BCN Medicare Advantage |
$916.54
|
Rate for Payer: Cash Price |
$2,444.00
|
Rate for Payer: Cash Price |
$2,444.00
|
Rate for Payer: Cofinity Commercial |
$1,228.16
|
Rate for Payer: Cofinity Commercial |
$1,319.82
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$916.54
|
Rate for Payer: Healthscope Commercial |
$1,099.85
|
Rate for Payer: Healthscope Whirlpool |
$1,099.85
|
Rate for Payer: Meridian Medicaid |
$629.35
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$962.37
|
Rate for Payer: PACE SWMI |
$916.54
|
Rate for Payer: PHP Medicare Advantage |
$916.54
|
Rate for Payer: Priority Health Choice Medicaid |
$599.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,138.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,425.22
|
Rate for Payer: Priority Health Medicare |
$916.54
|
Rate for Payer: Priority Health Narrow Network |
$1,425.22
|
Rate for Payer: UHC Medicare Advantage |
$944.04
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,207.00
|
|
Service Code
|
HCPCS 29850
|
Min. Negotiated Rate |
$405.34 |
Max. Negotiated Rate |
$961.56 |
Rate for Payer: Aetna Commercial |
$824.89
|
Rate for Payer: Aetna Medicare |
$615.59
|
Rate for Payer: BCBS Complete |
$425.61
|
Rate for Payer: BCBS MAPPO |
$615.59
|
Rate for Payer: BCBS Trust/PPO |
$917.66
|
Rate for Payer: BCN Commercial |
$920.18
|
Rate for Payer: BCN Medicare Advantage |
$615.59
|
Rate for Payer: Cash Price |
$965.60
|
Rate for Payer: Cash Price |
$965.60
|
Rate for Payer: Cofinity Commercial |
$886.45
|
Rate for Payer: Cofinity Commercial |
$824.89
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.59
|
Rate for Payer: Healthscope Commercial |
$738.71
|
Rate for Payer: Healthscope Whirlpool |
$738.71
|
Rate for Payer: Meridian Medicaid |
$425.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.37
|
Rate for Payer: PACE SWMI |
$615.59
|
Rate for Payer: PHP Medicare Advantage |
$615.59
|
Rate for Payer: Priority Health Choice Medicaid |
$405.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$844.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.56
|
Rate for Payer: Priority Health Medicare |
$615.59
|
Rate for Payer: Priority Health Narrow Network |
$961.56
|
Rate for Payer: UHC Medicare Advantage |
$634.06
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,158.00
|
|
Service Code
|
HCPCS 29898
|
Min. Negotiated Rate |
$361.25 |
Max. Negotiated Rate |
$1,510.60 |
Rate for Payer: Aetna Commercial |
$739.81
|
Rate for Payer: Aetna Medicare |
$552.10
|
Rate for Payer: BCBS Complete |
$379.31
|
Rate for Payer: BCBS MAPPO |
$552.10
|
Rate for Payer: BCBS Trust/PPO |
$1,477.13
|
Rate for Payer: BCN Commercial |
$905.58
|
Rate for Payer: BCN Medicare Advantage |
$552.10
|
Rate for Payer: Cash Price |
$1,726.40
|
Rate for Payer: Cash Price |
$1,726.40
|
Rate for Payer: Cofinity Commercial |
$795.02
|
Rate for Payer: Cofinity Commercial |
$739.81
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.10
|
Rate for Payer: Healthscope Commercial |
$662.52
|
Rate for Payer: Healthscope Whirlpool |
$662.52
|
Rate for Payer: Meridian Medicaid |
$379.31
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$579.70
|
Rate for Payer: PACE SWMI |
$552.10
|
Rate for Payer: PHP Medicare Advantage |
$552.10
|
Rate for Payer: Priority Health Choice Medicaid |
$361.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$859.42
|
Rate for Payer: Priority Health Medicare |
$552.10
|
Rate for Payer: Priority Health Narrow Network |
$859.42
|
Rate for Payer: UHC Medicare Advantage |
$568.66
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,904.00
|
|
Service Code
|
HCPCS 29897
|
Min. Negotiated Rate |
$319.93 |
Max. Negotiated Rate |
$1,332.80 |
Rate for Payer: Aetna Commercial |
$656.91
|
Rate for Payer: Aetna Medicare |
$490.23
|
Rate for Payer: BCBS Complete |
$335.93
|
Rate for Payer: BCBS MAPPO |
$490.23
|
Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
Rate for Payer: BCN Commercial |
$731.06
|
Rate for Payer: BCN Medicare Advantage |
$490.23
|
Rate for Payer: Cash Price |
$1,523.20
|
Rate for Payer: Cash Price |
$1,523.20
|
Rate for Payer: Cofinity Commercial |
$705.93
|
Rate for Payer: Cofinity Commercial |
$656.91
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.23
|
Rate for Payer: Healthscope Commercial |
$588.28
|
Rate for Payer: Healthscope Whirlpool |
$588.28
|
Rate for Payer: Meridian Medicaid |
$335.93
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.74
|
Rate for Payer: PACE SWMI |
$490.23
|
Rate for Payer: PHP Medicare Advantage |
$490.23
|
Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,332.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.93
|
Rate for Payer: Priority Health Medicare |
$490.23
|
Rate for Payer: Priority Health Narrow Network |
$763.93
|
Rate for Payer: UHC Medicare Advantage |
$504.94
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,840.00
|
|
Service Code
|
HCPCS 29895
|
Min. Negotiated Rate |
$298.84 |
Max. Negotiated Rate |
$1,288.00 |
Rate for Payer: Aetna Commercial |
$611.58
|
Rate for Payer: Aetna Medicare |
$456.40
|
Rate for Payer: BCBS Complete |
$313.78
|
Rate for Payer: BCBS MAPPO |
$456.40
|
Rate for Payer: BCBS Trust/PPO |
$911.32
|
Rate for Payer: BCN Commercial |
$679.75
|
Rate for Payer: BCN Medicare Advantage |
$456.40
|
Rate for Payer: Cash Price |
$1,472.00
|
Rate for Payer: Cash Price |
$1,472.00
|
Rate for Payer: Cofinity Commercial |
$657.22
|
Rate for Payer: Cofinity Commercial |
$611.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.40
|
Rate for Payer: Healthscope Commercial |
$547.68
|
Rate for Payer: Healthscope Whirlpool |
$547.68
|
Rate for Payer: Meridian Medicaid |
$313.78
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$479.22
|
Rate for Payer: PACE SWMI |
$456.40
|
Rate for Payer: PHP Medicare Advantage |
$456.40
|
Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.31
|
Rate for Payer: Priority Health Medicare |
$456.40
|
Rate for Payer: Priority Health Narrow Network |
$710.31
|
Rate for Payer: UHC Medicare Advantage |
$470.09
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,028.00
|
|
Service Code
|
HCPCS 29899
|
Min. Negotiated Rate |
$645.82 |
Max. Negotiated Rate |
$2,119.60 |
Rate for Payer: Aetna Commercial |
$1,328.34
|
Rate for Payer: Aetna Medicare |
$991.30
|
Rate for Payer: BCBS Complete |
$678.11
|
Rate for Payer: BCBS MAPPO |
$991.30
|
Rate for Payer: BCBS Trust/PPO |
$1,942.03
|
Rate for Payer: BCN Commercial |
$1,471.90
|
Rate for Payer: BCN Medicare Advantage |
$991.30
|
Rate for Payer: Cash Price |
$2,422.40
|
Rate for Payer: Cash Price |
$2,422.40
|
Rate for Payer: Cofinity Commercial |
$1,427.47
|
Rate for Payer: Cofinity Commercial |
$1,328.34
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.30
|
Rate for Payer: Healthscope Commercial |
$1,189.56
|
Rate for Payer: Healthscope Whirlpool |
$1,189.56
|
Rate for Payer: Meridian Medicaid |
$678.11
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,040.86
|
Rate for Payer: PACE SWMI |
$991.30
|
Rate for Payer: PHP Medicare Advantage |
$991.30
|
Rate for Payer: Priority Health Choice Medicaid |
$645.82
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,119.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,538.07
|
Rate for Payer: Priority Health Medicare |
$991.30
|
Rate for Payer: Priority Health Narrow Network |
$1,538.07
|
Rate for Payer: UHC Medicare Advantage |
$1,021.04
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,904.00
|
|
Service Code
|
HCPCS 29894
|
Min. Negotiated Rate |
$325.89 |
Max. Negotiated Rate |
$1,332.80 |
Rate for Payer: Aetna Commercial |
$654.55
|
Rate for Payer: Aetna Medicare |
$488.47
|
Rate for Payer: BCBS Complete |
$342.18
|
Rate for Payer: BCBS MAPPO |
$488.47
|
Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
Rate for Payer: BCN Commercial |
$728.13
|
Rate for Payer: BCN Medicare Advantage |
$488.47
|
Rate for Payer: Cash Price |
$1,523.20
|
Rate for Payer: Cash Price |
$1,523.20
|
Rate for Payer: Cofinity Commercial |
$703.40
|
Rate for Payer: Cofinity Commercial |
$654.55
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.47
|
Rate for Payer: Healthscope Commercial |
$586.16
|
Rate for Payer: Healthscope Whirlpool |
$586.16
|
Rate for Payer: Meridian Medicaid |
$342.18
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$512.89
|
Rate for Payer: PACE SWMI |
$488.47
|
Rate for Payer: PHP Medicare Advantage |
$488.47
|
Rate for Payer: Priority Health Choice Medicaid |
$325.89
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,332.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.87
|
Rate for Payer: Priority Health Medicare |
$488.47
|
Rate for Payer: Priority Health Narrow Network |
$760.87
|
Rate for Payer: UHC Medicare Advantage |
$503.12
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,158.00
|
|
Service Code
|
HCPCS 29838
|
Min. Negotiated Rate |
$386.17 |
Max. Negotiated Rate |
$1,510.60 |
Rate for Payer: Aetna Commercial |
$785.36
|
Rate for Payer: Aetna Medicare |
$586.09
|
Rate for Payer: BCBS Complete |
$405.48
|
Rate for Payer: BCBS MAPPO |
$586.09
|
Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
Rate for Payer: BCN Commercial |
$876.69
|
Rate for Payer: BCN Medicare Advantage |
$586.09
|
Rate for Payer: Cash Price |
$1,726.40
|
Rate for Payer: Cash Price |
$1,726.40
|
Rate for Payer: Cofinity Commercial |
$785.36
|
Rate for Payer: Cofinity Commercial |
$843.97
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.09
|
Rate for Payer: Healthscope Commercial |
$703.31
|
Rate for Payer: Healthscope Whirlpool |
$703.31
|
Rate for Payer: Meridian Medicaid |
$405.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$615.39
|
Rate for Payer: PACE SWMI |
$586.09
|
Rate for Payer: PHP Medicare Advantage |
$586.09
|
Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$916.11
|
Rate for Payer: Priority Health Medicare |
$586.09
|
Rate for Payer: Priority Health Narrow Network |
$916.11
|
Rate for Payer: UHC Medicare Advantage |
$603.67
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,902.00
|
|
Service Code
|
HCPCS 29837
|
Min. Negotiated Rate |
$340.80 |
Max. Negotiated Rate |
$1,331.40 |
Rate for Payer: Aetna Commercial |
$697.20
|
Rate for Payer: Aetna Medicare |
$520.30
|
Rate for Payer: BCBS Complete |
$357.84
|
Rate for Payer: BCBS MAPPO |
$520.30
|
Rate for Payer: BCBS Trust/PPO |
$1,072.98
|
Rate for Payer: BCN Commercial |
$778.46
|
Rate for Payer: BCN Medicare Advantage |
$520.30
|
Rate for Payer: Cash Price |
$1,521.60
|
Rate for Payer: Cash Price |
$1,521.60
|
Rate for Payer: Cofinity Commercial |
$697.20
|
Rate for Payer: Cofinity Commercial |
$749.23
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.30
|
Rate for Payer: Healthscope Commercial |
$624.36
|
Rate for Payer: Healthscope Whirlpool |
$624.36
|
Rate for Payer: Meridian Medicaid |
$357.84
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.32
|
Rate for Payer: PACE SWMI |
$520.30
|
Rate for Payer: PHP Medicare Advantage |
$520.30
|
Rate for Payer: Priority Health Choice Medicaid |
$340.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,331.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.46
|
Rate for Payer: Priority Health Medicare |
$520.30
|
Rate for Payer: Priority Health Narrow Network |
$813.46
|
Rate for Payer: UHC Medicare Advantage |
$535.91
|
|