|
PR BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL
|
Professional
|
Both
|
$2,743.00
|
|
|
Service Code
|
HCPCS 35570
|
| Min. Negotiated Rate |
$919.73 |
| Max. Negotiated Rate |
$2,284.77 |
| Rate for Payer: Aetna Commercial |
$1,947.44
|
| Rate for Payer: Aetna Medicare |
$1,453.31
|
| Rate for Payer: BCBS Complete |
$965.72
|
| Rate for Payer: BCBS MAPPO |
$1,453.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$2,098.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,453.31
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cofinity Commercial |
$2,092.77
|
| Rate for Payer: Cofinity Commercial |
$1,947.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,453.31
|
| Rate for Payer: Healthscope Commercial |
$1,743.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,743.97
|
| Rate for Payer: Meridian Medicaid |
$965.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,525.98
|
| Rate for Payer: PACE SWMI |
$1,453.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,453.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$919.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,920.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,284.77
|
| Rate for Payer: Priority Health Medicare |
$1,453.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,284.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,496.91
|
|
|
PR BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL
|
Professional
|
Both
|
$5,135.00
|
|
|
Service Code
|
HCPCS 35571
|
| Min. Negotiated Rate |
$824.95 |
| Max. Negotiated Rate |
$3,594.50 |
| Rate for Payer: Aetna Commercial |
$1,746.78
|
| Rate for Payer: Aetna Medicare |
$1,303.57
|
| Rate for Payer: BCBS Complete |
$866.20
|
| Rate for Payer: BCBS MAPPO |
$1,303.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,402.64
|
| Rate for Payer: BCN Commercial |
$1,886.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,303.57
|
| Rate for Payer: Cash Price |
$4,108.00
|
| Rate for Payer: Cash Price |
$4,108.00
|
| Rate for Payer: Cofinity Commercial |
$1,877.14
|
| Rate for Payer: Cofinity Commercial |
$1,746.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,303.57
|
| Rate for Payer: Healthscope Commercial |
$1,564.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,564.28
|
| Rate for Payer: Meridian Medicaid |
$866.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,368.75
|
| Rate for Payer: PACE SWMI |
$1,303.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,303.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,594.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,053.88
|
| Rate for Payer: Priority Health Medicare |
$1,303.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,053.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.68
|
|
|
PR CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,394.00
|
|
|
Service Code
|
HCPCS 33536
|
| Min. Negotiated Rate |
$1,086.18 |
| Max. Negotiated Rate |
$4,101.39 |
| Rate for Payer: Aetna Commercial |
$3,468.62
|
| Rate for Payer: Aetna Medicare |
$2,588.52
|
| Rate for Payer: BCBS Complete |
$1,731.94
|
| Rate for Payer: BCBS MAPPO |
$2,588.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.18
|
| Rate for Payer: BCN Commercial |
$3,767.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,588.52
|
| Rate for Payer: Cash Price |
$4,315.20
|
| Rate for Payer: Cash Price |
$4,315.20
|
| Rate for Payer: Cofinity Commercial |
$3,468.62
|
| Rate for Payer: Cofinity Commercial |
$3,727.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,588.52
|
| Rate for Payer: Healthscope Commercial |
$3,106.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,106.22
|
| Rate for Payer: Meridian Medicaid |
$1,731.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,717.95
|
| Rate for Payer: PACE SWMI |
$2,588.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,588.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,649.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,775.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,101.39
|
| Rate for Payer: Priority Health Medicare |
$2,588.52
|
| Rate for Payer: Priority Health Narrow Network |
$4,101.39
|
| Rate for Payer: UHC Medicare Advantage |
$2,666.18
|
|
|
PR CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT
|
Professional
|
Both
|
$3,834.34
|
|
|
Service Code
|
HCPCS 33533
|
| Min. Negotiated Rate |
$1,173.42 |
| Max. Negotiated Rate |
$2,920.45 |
| Rate for Payer: Aetna Commercial |
$2,466.59
|
| Rate for Payer: Aetna Medicare |
$1,840.74
|
| Rate for Payer: BCBS Complete |
$1,232.09
|
| Rate for Payer: BCBS MAPPO |
$1,840.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.66
|
| Rate for Payer: BCN Commercial |
$2,682.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,840.74
|
| Rate for Payer: Cash Price |
$3,067.47
|
| Rate for Payer: Cash Price |
$3,067.47
|
| Rate for Payer: Cofinity Commercial |
$2,650.67
|
| Rate for Payer: Cofinity Commercial |
$2,466.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,840.74
|
| Rate for Payer: Healthscope Commercial |
$2,208.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,208.89
|
| Rate for Payer: Meridian Medicaid |
$1,232.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,932.78
|
| Rate for Payer: PACE SWMI |
$1,840.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,840.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,173.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,684.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,920.45
|
| Rate for Payer: Priority Health Medicare |
$1,840.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,920.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,895.96
|
|
|
PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,035.48
|
|
|
Service Code
|
HCPCS 33535
|
| Min. Negotiated Rate |
$1,100.98 |
| Max. Negotiated Rate |
$3,811.48 |
| Rate for Payer: Aetna Commercial |
$3,222.23
|
| Rate for Payer: Aetna Medicare |
$2,404.65
|
| Rate for Payer: BCBS Complete |
$1,607.37
|
| Rate for Payer: BCBS MAPPO |
$2,404.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$3,501.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,404.65
|
| Rate for Payer: Cash Price |
$4,028.38
|
| Rate for Payer: Cash Price |
$4,028.38
|
| Rate for Payer: Cofinity Commercial |
$3,462.70
|
| Rate for Payer: Cofinity Commercial |
$3,222.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,404.65
|
| Rate for Payer: Healthscope Commercial |
$2,885.58
|
| Rate for Payer: Healthscope Whirlpool |
$2,885.58
|
| Rate for Payer: Meridian Medicaid |
$1,607.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,524.88
|
| Rate for Payer: PACE SWMI |
$2,404.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,404.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,530.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,524.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,811.48
|
| Rate for Payer: Priority Health Medicare |
$2,404.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,811.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,476.79
|
|
|
PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS
|
Professional
|
Both
|
$4,511.60
|
|
|
Service Code
|
HCPCS 33534
|
| Min. Negotiated Rate |
$1,126.86 |
| Max. Negotiated Rate |
$3,427.93 |
| Rate for Payer: Aetna Commercial |
$2,896.34
|
| Rate for Payer: Aetna Medicare |
$2,161.45
|
| Rate for Payer: BCBS Complete |
$1,446.80
|
| Rate for Payer: BCBS MAPPO |
$2,161.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.86
|
| Rate for Payer: BCN Commercial |
$3,149.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,161.45
|
| Rate for Payer: Cash Price |
$3,609.28
|
| Rate for Payer: Cash Price |
$3,609.28
|
| Rate for Payer: Cofinity Commercial |
$3,112.49
|
| Rate for Payer: Cofinity Commercial |
$2,896.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,161.45
|
| Rate for Payer: Healthscope Commercial |
$2,593.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,593.74
|
| Rate for Payer: Meridian Medicaid |
$1,446.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,269.52
|
| Rate for Payer: PACE SWMI |
$2,161.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,161.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,377.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,158.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,427.93
|
| Rate for Payer: Priority Health Medicare |
$2,161.45
|
| Rate for Payer: Priority Health Narrow Network |
$3,427.93
|
| Rate for Payer: UHC Medicare Advantage |
$2,226.29
|
|
|
PR CALIBRATED MICROCAP TUBE
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS A4651
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$0.03
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
|
|
PR CALORIC VESTIBULAR TEST, EACH IRRIGATION, WITH RECORDING
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 92543
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.30
|
|
|
PR CANALITH REPOSITIONING PROCEDURE
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 95992
|
| Min. Negotiated Rate |
$35.52 |
| Max. Negotiated Rate |
$189.13 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$35.52
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS Trust/PPO |
$189.13
|
| Rate for Payer: BCN Commercial |
$63.04
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Healthscope Commercial |
$42.62
|
| Rate for Payer: Healthscope Whirlpool |
$42.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.06
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: Priority Health Narrow Network |
$48.06
|
| Rate for Payer: UHC Medicare Advantage |
$36.59
|
|
|
PR CANTHOPLASTY
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 67950
|
| Min. Negotiated Rate |
$292.66 |
| Max. Negotiated Rate |
$2,419.61 |
| Rate for Payer: Aetna Commercial |
$591.19
|
| Rate for Payer: Aetna Medicare |
$441.19
|
| Rate for Payer: BCBS Complete |
$307.29
|
| Rate for Payer: BCBS MAPPO |
$441.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.61
|
| Rate for Payer: BCN Commercial |
$850.79
|
| Rate for Payer: BCN Medicare Advantage |
$441.19
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cofinity Commercial |
$591.19
|
| Rate for Payer: Cofinity Commercial |
$635.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.19
|
| Rate for Payer: Healthscope Commercial |
$529.43
|
| Rate for Payer: Healthscope Whirlpool |
$529.43
|
| Rate for Payer: Meridian Medicaid |
$307.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$463.25
|
| Rate for Payer: PACE SWMI |
$441.19
|
| Rate for Payer: PHP Medicare Advantage |
$441.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.75
|
| Rate for Payer: Priority Health Medicare |
$441.19
|
| Rate for Payer: Priority Health Narrow Network |
$796.75
|
| Rate for Payer: UHC Medicare Advantage |
$454.43
|
|
|
PR CANTHOTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 67715
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$523.55 |
| Rate for Payer: Aetna Commercial |
$139.27
|
| Rate for Payer: Aetna Medicare |
$103.93
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$103.93
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$388.50
|
| Rate for Payer: BCN Medicare Advantage |
$103.93
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$139.27
|
| Rate for Payer: Cofinity Commercial |
$149.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.93
|
| Rate for Payer: Healthscope Commercial |
$124.72
|
| Rate for Payer: Healthscope Whirlpool |
$124.72
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.13
|
| Rate for Payer: PACE SWMI |
$103.93
|
| Rate for Payer: PHP Medicare Advantage |
$103.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.92
|
| Rate for Payer: Priority Health Medicare |
$103.93
|
| Rate for Payer: Priority Health Narrow Network |
$187.92
|
| Rate for Payer: UHC Medicare Advantage |
$107.05
|
|
|
PR CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC
|
Professional
|
Both
|
$4,705.00
|
|
|
Service Code
|
HCPCS 27036
|
| Min. Negotiated Rate |
$197.75 |
| Max. Negotiated Rate |
$3,293.50 |
| Rate for Payer: Aetna Commercial |
$1,343.06
|
| Rate for Payer: Aetna Medicare |
$1,002.28
|
| Rate for Payer: BCBS Complete |
$689.29
|
| Rate for Payer: BCBS MAPPO |
$1,002.28
|
| Rate for Payer: BCBS Trust/PPO |
$197.75
|
| Rate for Payer: BCN Commercial |
$1,492.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,002.28
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cofinity Commercial |
$1,343.06
|
| Rate for Payer: Cofinity Commercial |
$1,443.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,002.28
|
| Rate for Payer: Healthscope Commercial |
$1,202.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,202.74
|
| Rate for Payer: Meridian Medicaid |
$689.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,052.39
|
| Rate for Payer: PACE SWMI |
$1,002.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,002.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$656.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,293.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,559.53
|
| Rate for Payer: Priority Health Medicare |
$1,002.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,559.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,032.35
|
|
|
PR CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 25320
|
| Min. Negotiated Rate |
$400.98 |
| Max. Negotiated Rate |
$1,520.20 |
| Rate for Payer: Aetna Commercial |
$1,300.72
|
| Rate for Payer: Aetna Medicare |
$970.69
|
| Rate for Payer: BCBS Complete |
$673.86
|
| Rate for Payer: BCBS MAPPO |
$970.69
|
| Rate for Payer: BCBS Trust/PPO |
$400.98
|
| Rate for Payer: BCN Commercial |
$1,454.79
|
| Rate for Payer: BCN Medicare Advantage |
$970.69
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,300.72
|
| Rate for Payer: Cofinity Commercial |
$1,397.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.69
|
| Rate for Payer: Healthscope Commercial |
$1,164.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.83
|
| Rate for Payer: Meridian Medicaid |
$673.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,019.22
|
| Rate for Payer: PACE SWMI |
$970.69
|
| Rate for Payer: PHP Medicare Advantage |
$970.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,520.20
|
| Rate for Payer: Priority Health Medicare |
$970.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,520.20
|
| Rate for Payer: UHC Medicare Advantage |
$999.81
|
|
|
PR CAPSULAR CONTRACTURE RELEASE
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 23020
|
| Min. Negotiated Rate |
$282.11 |
| Max. Negotiated Rate |
$1,379.70 |
| Rate for Payer: Aetna Commercial |
$913.37
|
| Rate for Payer: Aetna Medicare |
$681.62
|
| Rate for Payer: BCBS Complete |
$469.66
|
| Rate for Payer: BCBS MAPPO |
$681.62
|
| Rate for Payer: BCBS Trust/PPO |
$282.11
|
| Rate for Payer: BCN Commercial |
$1,017.92
|
| Rate for Payer: BCN Medicare Advantage |
$681.62
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$981.53
|
| Rate for Payer: Cofinity Commercial |
$913.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.62
|
| Rate for Payer: Healthscope Commercial |
$817.94
|
| Rate for Payer: Healthscope Whirlpool |
$817.94
|
| Rate for Payer: Meridian Medicaid |
$469.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$715.70
|
| Rate for Payer: PACE SWMI |
$681.62
|
| Rate for Payer: PHP Medicare Advantage |
$681.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.68
|
| Rate for Payer: Priority Health Medicare |
$681.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.68
|
| Rate for Payer: UHC Medicare Advantage |
$702.07
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26525
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,128.45 |
| Rate for Payer: Aetna Commercial |
$894.87
|
| Rate for Payer: Aetna Medicare |
$667.81
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$667.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$1,021.83
|
| Rate for Payer: BCN Medicare Advantage |
$667.81
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$894.87
|
| Rate for Payer: Cofinity Commercial |
$961.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.81
|
| Rate for Payer: Healthscope Commercial |
$801.37
|
| Rate for Payer: Healthscope Whirlpool |
$801.37
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$701.20
|
| Rate for Payer: PACE SWMI |
$667.81
|
| Rate for Payer: PHP Medicare Advantage |
$667.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.77
|
| Rate for Payer: Priority Health Medicare |
$667.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.77
|
| Rate for Payer: UHC Medicare Advantage |
$687.84
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26520
|
| Min. Negotiated Rate |
$441.55 |
| Max. Negotiated Rate |
$1,088.50 |
| Rate for Payer: Aetna Commercial |
$890.87
|
| Rate for Payer: Aetna Medicare |
$664.83
|
| Rate for Payer: BCBS Complete |
$463.63
|
| Rate for Payer: BCBS MAPPO |
$664.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.94
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$664.83
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$957.36
|
| Rate for Payer: Cofinity Commercial |
$890.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.83
|
| Rate for Payer: Healthscope Commercial |
$797.80
|
| Rate for Payer: Healthscope Whirlpool |
$797.80
|
| Rate for Payer: Meridian Medicaid |
$463.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$698.07
|
| Rate for Payer: PACE SWMI |
$664.83
|
| Rate for Payer: PHP Medicare Advantage |
$664.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.17
|
| Rate for Payer: Priority Health Medicare |
$664.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.17
|
| Rate for Payer: UHC Medicare Advantage |
$684.77
|
|
|
PR CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX
|
Professional
|
Both
|
$786.00
|
|
|
Service Code
|
HCPCS 28270
|
| Min. Negotiated Rate |
$215.77 |
| Max. Negotiated Rate |
$706.63 |
| Rate for Payer: Aetna Commercial |
$435.62
|
| Rate for Payer: Aetna Medicare |
$325.09
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCBS MAPPO |
$325.09
|
| Rate for Payer: BCBS Trust/PPO |
$265.73
|
| Rate for Payer: BCN Commercial |
$706.63
|
| Rate for Payer: BCN Medicare Advantage |
$325.09
|
| Rate for Payer: Cash Price |
$628.80
|
| Rate for Payer: Cash Price |
$628.80
|
| Rate for Payer: Cofinity Commercial |
$468.13
|
| Rate for Payer: Cofinity Commercial |
$435.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.09
|
| Rate for Payer: Healthscope Commercial |
$390.11
|
| Rate for Payer: Healthscope Whirlpool |
$390.11
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.34
|
| Rate for Payer: PACE SWMI |
$325.09
|
| Rate for Payer: PHP Medicare Advantage |
$325.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.61
|
| Rate for Payer: Priority Health Medicare |
$325.09
|
| Rate for Payer: Priority Health Narrow Network |
$508.61
|
| Rate for Payer: UHC Medicare Advantage |
$334.84
|
|
|
PR CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT
|
Professional
|
Both
|
$1,964.00
|
|
|
Service Code
|
HCPCS 26516
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$3,178.25 |
| Rate for Payer: Aetna Commercial |
$975.77
|
| Rate for Payer: Aetna Medicare |
$728.19
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$728.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,178.25
|
| Rate for Payer: BCN Commercial |
$1,105.87
|
| Rate for Payer: BCN Medicare Advantage |
$728.19
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cofinity Commercial |
$1,048.59
|
| Rate for Payer: Cofinity Commercial |
$975.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.19
|
| Rate for Payer: Healthscope Commercial |
$873.83
|
| Rate for Payer: Healthscope Whirlpool |
$873.83
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$764.60
|
| Rate for Payer: PACE SWMI |
$728.19
|
| Rate for Payer: PHP Medicare Advantage |
$728.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.60
|
| Rate for Payer: Priority Health Medicare |
$728.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.60
|
| Rate for Payer: UHC Medicare Advantage |
$750.04
|
|
|
PR CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON
|
Professional
|
Both
|
$2,811.00
|
|
|
Service Code
|
HCPCS 23450
|
| Min. Negotiated Rate |
$146.45 |
| Max. Negotiated Rate |
$1,967.70 |
| Rate for Payer: Aetna Commercial |
$1,251.29
|
| Rate for Payer: Aetna Medicare |
$933.80
|
| Rate for Payer: BCBS Complete |
$639.86
|
| Rate for Payer: BCBS MAPPO |
$933.80
|
| Rate for Payer: BCBS Trust/PPO |
$146.45
|
| Rate for Payer: BCN Commercial |
$1,388.33
|
| Rate for Payer: BCN Medicare Advantage |
$933.80
|
| Rate for Payer: Cash Price |
$2,248.80
|
| Rate for Payer: Cash Price |
$2,248.80
|
| Rate for Payer: Cofinity Commercial |
$1,344.67
|
| Rate for Payer: Cofinity Commercial |
$1,251.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.80
|
| Rate for Payer: Healthscope Commercial |
$1,120.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,120.56
|
| Rate for Payer: Meridian Medicaid |
$639.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$980.49
|
| Rate for Payer: PACE SWMI |
$933.80
|
| Rate for Payer: PHP Medicare Advantage |
$933.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,967.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,450.76
|
| Rate for Payer: Priority Health Medicare |
$933.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,450.76
|
| Rate for Payer: UHC Medicare Advantage |
$961.81
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR
|
Professional
|
Both
|
$3,347.00
|
|
|
Service Code
|
HCPCS 23462
|
| Min. Negotiated Rate |
$313.71 |
| Max. Negotiated Rate |
$2,342.90 |
| Rate for Payer: Aetna Commercial |
$1,411.94
|
| Rate for Payer: Aetna Medicare |
$1,053.69
|
| Rate for Payer: BCBS Complete |
$721.05
|
| Rate for Payer: BCBS MAPPO |
$1,053.69
|
| Rate for Payer: BCBS Trust/PPO |
$313.71
|
| Rate for Payer: BCN Commercial |
$1,564.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.69
|
| Rate for Payer: Cash Price |
$2,677.60
|
| Rate for Payer: Cash Price |
$2,677.60
|
| Rate for Payer: Cofinity Commercial |
$1,517.31
|
| Rate for Payer: Cofinity Commercial |
$1,411.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.69
|
| Rate for Payer: Healthscope Commercial |
$1,264.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,264.43
|
| Rate for Payer: Meridian Medicaid |
$721.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,106.37
|
| Rate for Payer: PACE SWMI |
$1,053.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,342.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,635.10
|
| Rate for Payer: Priority Health Medicare |
$1,053.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,635.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,085.30
|
|
|
PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK
|
Professional
|
Both
|
$2,738.00
|
|
|
Service Code
|
HCPCS 23460
|
| Min. Negotiated Rate |
$208.43 |
| Max. Negotiated Rate |
$1,916.60 |
| Rate for Payer: Aetna Commercial |
$1,440.89
|
| Rate for Payer: Aetna Medicare |
$1,075.29
|
| Rate for Payer: BCBS Complete |
$736.93
|
| Rate for Payer: BCBS MAPPO |
$1,075.29
|
| Rate for Payer: BCBS Trust/PPO |
$208.43
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,075.29
|
| Rate for Payer: Cash Price |
$2,190.40
|
| Rate for Payer: Cash Price |
$2,190.40
|
| Rate for Payer: Cofinity Commercial |
$1,548.42
|
| Rate for Payer: Cofinity Commercial |
$1,440.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,075.29
|
| Rate for Payer: Healthscope Commercial |
$1,290.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.35
|
| Rate for Payer: Meridian Medicaid |
$736.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,129.05
|
| Rate for Payer: PACE SWMI |
$1,075.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,075.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,670.34
|
| Rate for Payer: Priority Health Medicare |
$1,075.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,670.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,107.55
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR
|
Professional
|
Both
|
$3,140.00
|
|
|
Service Code
|
HCPCS 23455
|
| Min. Negotiated Rate |
$188.90 |
| Max. Negotiated Rate |
$2,198.00 |
| Rate for Payer: Aetna Commercial |
$1,307.16
|
| Rate for Payer: Aetna Medicare |
$975.49
|
| Rate for Payer: BCBS Complete |
$666.48
|
| Rate for Payer: BCBS MAPPO |
$975.49
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$975.49
|
| Rate for Payer: Cash Price |
$2,512.00
|
| Rate for Payer: Cash Price |
$2,512.00
|
| Rate for Payer: Cofinity Commercial |
$1,404.71
|
| Rate for Payer: Cofinity Commercial |
$1,307.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$975.49
|
| Rate for Payer: Healthscope Commercial |
$1,170.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,170.59
|
| Rate for Payer: Meridian Medicaid |
$666.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,024.26
|
| Rate for Payer: PACE SWMI |
$975.49
|
| Rate for Payer: PHP Medicare Advantage |
$975.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,198.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.58
|
| Rate for Payer: Priority Health Medicare |
$975.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,514.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,004.75
|
|
|
PR CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK
|
Professional
|
Both
|
$3,431.00
|
|
|
Service Code
|
HCPCS 23465
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$2,401.70 |
| Rate for Payer: Aetna Commercial |
$1,477.91
|
| Rate for Payer: Aetna Medicare |
$1,102.92
|
| Rate for Payer: BCBS Complete |
$755.49
|
| Rate for Payer: BCBS MAPPO |
$1,102.92
|
| Rate for Payer: BCBS Trust/PPO |
$104.00
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,102.92
|
| Rate for Payer: Cash Price |
$2,744.80
|
| Rate for Payer: Cash Price |
$2,744.80
|
| Rate for Payer: Cofinity Commercial |
$1,588.20
|
| Rate for Payer: Cofinity Commercial |
$1,477.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,102.92
|
| Rate for Payer: Healthscope Commercial |
$1,323.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,323.50
|
| Rate for Payer: Meridian Medicaid |
$755.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,158.07
|
| Rate for Payer: PACE SWMI |
$1,102.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,102.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$719.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,712.73
|
| Rate for Payer: Priority Health Medicare |
$1,102.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,712.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.01
|
|
|
PR CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 23466
|
| Min. Negotiated Rate |
$138.81 |
| Max. Negotiated Rate |
$1,718.33 |
| Rate for Payer: Aetna Commercial |
$1,479.17
|
| Rate for Payer: Aetna Medicare |
$1,103.86
|
| Rate for Payer: BCBS Complete |
$759.74
|
| Rate for Payer: BCBS MAPPO |
$1,103.86
|
| Rate for Payer: BCBS Trust/PPO |
$138.81
|
| Rate for Payer: BCN Commercial |
$1,644.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.86
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,479.17
|
| Rate for Payer: Cofinity Commercial |
$1,589.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.86
|
| Rate for Payer: Healthscope Commercial |
$1,324.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,324.63
|
| Rate for Payer: Meridian Medicaid |
$759.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,159.05
|
| Rate for Payer: PACE SWMI |
$1,103.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$723.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.33
|
| Rate for Payer: Priority Health Medicare |
$1,103.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.98
|
|
|
PR CAPSULOTOMY WRIST
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 25085
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$1,125.60 |
| Rate for Payer: Aetna Commercial |
$593.11
|
| Rate for Payer: Aetna Medicare |
$442.62
|
| Rate for Payer: BCBS Complete |
$308.19
|
| Rate for Payer: BCBS MAPPO |
$442.62
|
| Rate for Payer: BCBS Trust/PPO |
$119.92
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$442.62
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$593.11
|
| Rate for Payer: Cofinity Commercial |
$637.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.62
|
| Rate for Payer: Healthscope Commercial |
$531.14
|
| Rate for Payer: Healthscope Whirlpool |
$531.14
|
| Rate for Payer: Meridian Medicaid |
$308.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.75
|
| Rate for Payer: PACE SWMI |
$442.62
|
| Rate for Payer: PHP Medicare Advantage |
$442.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.49
|
| Rate for Payer: Priority Health Medicare |
$442.62
|
| Rate for Payer: Priority Health Narrow Network |
$694.49
|
| Rate for Payer: UHC Medicare Advantage |
$455.90
|
|
