|
PR CLTX DSTL FIBULAR FX LAT MALLS W/MANJ
|
Professional
|
Both
|
$1,330.00
|
|
|
Service Code
|
HCPCS 27788
|
| Min. Negotiated Rate |
$254.54 |
| Max. Negotiated Rate |
$931.00 |
| Rate for Payer: Aetna Commercial |
$513.14
|
| Rate for Payer: Aetna Medicare |
$382.94
|
| Rate for Payer: BCBS Complete |
$267.27
|
| Rate for Payer: BCBS MAPPO |
$382.94
|
| Rate for Payer: BCBS Trust/PPO |
$677.10
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Medicare Advantage |
$382.94
|
| Rate for Payer: Cash Price |
$1,064.00
|
| Rate for Payer: Cash Price |
$1,064.00
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$513.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.94
|
| Rate for Payer: Healthscope Commercial |
$459.53
|
| Rate for Payer: Healthscope Whirlpool |
$459.53
|
| Rate for Payer: Meridian Medicaid |
$267.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.09
|
| Rate for Payer: PACE SWMI |
$382.94
|
| Rate for Payer: PHP Medicare Advantage |
$382.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$602.06
|
| Rate for Payer: Priority Health Medicare |
$382.94
|
| Rate for Payer: Priority Health Narrow Network |
$602.06
|
| Rate for Payer: UHC Medicare Advantage |
$394.43
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 27786
|
| Min. Negotiated Rate |
$191.06 |
| Max. Negotiated Rate |
$2,764.24 |
| Rate for Payer: Aetna Commercial |
$381.52
|
| Rate for Payer: Aetna Medicare |
$284.72
|
| Rate for Payer: BCBS Complete |
$200.61
|
| Rate for Payer: BCBS MAPPO |
$284.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,764.24
|
| Rate for Payer: BCN Commercial |
$378.53
|
| Rate for Payer: BCN Medicare Advantage |
$284.72
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$410.00
|
| Rate for Payer: Cofinity Commercial |
$381.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.72
|
| Rate for Payer: Healthscope Commercial |
$341.66
|
| Rate for Payer: Healthscope Whirlpool |
$341.66
|
| Rate for Payer: Meridian Medicaid |
$200.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$298.96
|
| Rate for Payer: PACE SWMI |
$284.72
|
| Rate for Payer: PHP Medicare Advantage |
$284.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$450.90
|
| Rate for Payer: Priority Health Medicare |
$284.72
|
| Rate for Payer: Priority Health Narrow Network |
$450.90
|
| Rate for Payer: UHC Medicare Advantage |
$293.26
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 26755
|
| Min. Negotiated Rate |
$182.54 |
| Max. Negotiated Rate |
$1,776.67 |
| Rate for Payer: Aetna Commercial |
$368.23
|
| Rate for Payer: Aetna Medicare |
$274.80
|
| Rate for Payer: BCBS Complete |
$191.67
|
| Rate for Payer: BCBS MAPPO |
$274.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,776.67
|
| Rate for Payer: BCN Commercial |
$482.81
|
| Rate for Payer: BCN Medicare Advantage |
$274.80
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$395.71
|
| Rate for Payer: Cofinity Commercial |
$368.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.80
|
| Rate for Payer: Healthscope Commercial |
$329.76
|
| Rate for Payer: Healthscope Whirlpool |
$329.76
|
| Rate for Payer: Meridian Medicaid |
$191.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.54
|
| Rate for Payer: PACE SWMI |
$274.80
|
| Rate for Payer: PHP Medicare Advantage |
$274.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.51
|
| Rate for Payer: Priority Health Medicare |
$274.80
|
| Rate for Payer: Priority Health Narrow Network |
$432.51
|
| Rate for Payer: UHC Medicare Advantage |
$283.04
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$945.13 |
| Rate for Payer: Aetna Commercial |
$252.31
|
| Rate for Payer: Aetna Medicare |
$188.29
|
| Rate for Payer: BCBS Complete |
$134.19
|
| Rate for Payer: BCBS MAPPO |
$188.29
|
| Rate for Payer: BCBS Trust/PPO |
$945.13
|
| Rate for Payer: BCN Commercial |
$283.92
|
| Rate for Payer: BCN Medicare Advantage |
$188.29
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$252.31
|
| Rate for Payer: Cofinity Commercial |
$271.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.29
|
| Rate for Payer: Healthscope Commercial |
$225.95
|
| Rate for Payer: Healthscope Whirlpool |
$225.95
|
| Rate for Payer: Meridian Medicaid |
$134.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$197.70
|
| Rate for Payer: PACE SWMI |
$188.29
|
| Rate for Payer: PHP Medicare Advantage |
$188.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.24
|
| Rate for Payer: Priority Health Medicare |
$188.29
|
| Rate for Payer: Priority Health Narrow Network |
$299.24
|
| Rate for Payer: UHC Medicare Advantage |
$193.94
|
|
|
PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ
|
Professional
|
Both
|
$739.00
|
|
|
Service Code
|
HCPCS 25600
|
| Min. Negotiated Rate |
$216.83 |
| Max. Negotiated Rate |
$579.96 |
| Rate for Payer: Aetna Commercial |
$428.55
|
| Rate for Payer: Aetna Medicare |
$319.81
|
| Rate for Payer: BCBS Complete |
$227.67
|
| Rate for Payer: BCBS MAPPO |
$319.81
|
| Rate for Payer: BCBS Trust/PPO |
$579.96
|
| Rate for Payer: BCN Commercial |
$410.33
|
| Rate for Payer: BCN Medicare Advantage |
$319.81
|
| Rate for Payer: Cash Price |
$591.20
|
| Rate for Payer: Cash Price |
$591.20
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Cofinity Commercial |
$428.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.81
|
| Rate for Payer: Healthscope Commercial |
$383.77
|
| Rate for Payer: Healthscope Whirlpool |
$383.77
|
| Rate for Payer: Meridian Medicaid |
$227.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.80
|
| Rate for Payer: PACE SWMI |
$319.81
|
| Rate for Payer: PHP Medicare Advantage |
$319.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.13
|
| Rate for Payer: Priority Health Medicare |
$319.81
|
| Rate for Payer: Priority Health Narrow Network |
$510.13
|
| Rate for Payer: UHC Medicare Advantage |
$329.40
|
|
|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$952.70 |
| Rate for Payer: Aetna Commercial |
$681.20
|
| Rate for Payer: Aetna Medicare |
$508.36
|
| Rate for Payer: BCBS Complete |
$353.82
|
| Rate for Payer: BCBS MAPPO |
$508.36
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$808.76
|
| Rate for Payer: BCN Medicare Advantage |
$508.36
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cofinity Commercial |
$732.04
|
| Rate for Payer: Cofinity Commercial |
$681.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.36
|
| Rate for Payer: Healthscope Commercial |
$610.03
|
| Rate for Payer: Healthscope Whirlpool |
$610.03
|
| Rate for Payer: Meridian Medicaid |
$353.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$533.78
|
| Rate for Payer: PACE SWMI |
$508.36
|
| Rate for Payer: PHP Medicare Advantage |
$508.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$798.15
|
| Rate for Payer: Priority Health Medicare |
$508.36
|
| Rate for Payer: Priority Health Narrow Network |
$798.15
|
| Rate for Payer: UHC Medicare Advantage |
$523.61
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,026.00
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$257.28 |
| Max. Negotiated Rate |
$849.20 |
| Rate for Payer: Aetna Commercial |
$710.52
|
| Rate for Payer: Aetna Medicare |
$530.24
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$530.24
|
| Rate for Payer: BCBS Trust/PPO |
$257.28
|
| Rate for Payer: BCN Commercial |
$812.67
|
| Rate for Payer: BCN Medicare Advantage |
$530.24
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Cofinity Commercial |
$710.52
|
| Rate for Payer: Cofinity Commercial |
$763.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.24
|
| Rate for Payer: Healthscope Commercial |
$636.29
|
| Rate for Payer: Healthscope Whirlpool |
$636.29
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.75
|
| Rate for Payer: PACE SWMI |
$530.24
|
| Rate for Payer: PHP Medicare Advantage |
$530.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$849.20
|
| Rate for Payer: Priority Health Medicare |
$530.24
|
| Rate for Payer: Priority Health Narrow Network |
$849.20
|
| Rate for Payer: UHC Medicare Advantage |
$546.15
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 27510
|
| Min. Negotiated Rate |
$442.19 |
| Max. Negotiated Rate |
$1,050.92 |
| Rate for Payer: Aetna Commercial |
$905.71
|
| Rate for Payer: Aetna Medicare |
$675.90
|
| Rate for Payer: BCBS Complete |
$464.30
|
| Rate for Payer: BCBS MAPPO |
$675.90
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$1,005.70
|
| Rate for Payer: BCN Medicare Advantage |
$675.90
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cofinity Commercial |
$973.30
|
| Rate for Payer: Cofinity Commercial |
$905.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.90
|
| Rate for Payer: Healthscope Commercial |
$811.08
|
| Rate for Payer: Healthscope Whirlpool |
$811.08
|
| Rate for Payer: Meridian Medicaid |
$464.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$709.70
|
| Rate for Payer: PACE SWMI |
$675.90
|
| Rate for Payer: PHP Medicare Advantage |
$675.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,050.92
|
| Rate for Payer: Priority Health Medicare |
$675.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,050.92
|
| Rate for Payer: UHC Medicare Advantage |
$696.18
|
|
|
PR CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 27508
|
| Min. Negotiated Rate |
$326.53 |
| Max. Negotiated Rate |
$781.39 |
| Rate for Payer: Aetna Commercial |
$660.83
|
| Rate for Payer: Aetna Medicare |
$493.16
|
| Rate for Payer: BCBS Complete |
$342.86
|
| Rate for Payer: BCBS MAPPO |
$493.16
|
| Rate for Payer: BCBS Trust/PPO |
$738.04
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$493.16
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cofinity Commercial |
$710.15
|
| Rate for Payer: Cofinity Commercial |
$660.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.16
|
| Rate for Payer: Healthscope Commercial |
$591.79
|
| Rate for Payer: Healthscope Whirlpool |
$591.79
|
| Rate for Payer: Meridian Medicaid |
$342.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$517.82
|
| Rate for Payer: PACE SWMI |
$493.16
|
| Rate for Payer: PHP Medicare Advantage |
$493.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$773.63
|
| Rate for Payer: Priority Health Medicare |
$493.16
|
| Rate for Payer: Priority Health Narrow Network |
$773.63
|
| Rate for Payer: UHC Medicare Advantage |
$507.95
|
|
|
PR CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 27232
|
| Min. Negotiated Rate |
$467.75 |
| Max. Negotiated Rate |
$1,113.73 |
| Rate for Payer: Aetna Commercial |
$967.20
|
| Rate for Payer: Aetna Medicare |
$721.79
|
| Rate for Payer: BCBS Complete |
$491.14
|
| Rate for Payer: BCBS MAPPO |
$721.79
|
| Rate for Payer: BCBS Trust/PPO |
$835.77
|
| Rate for Payer: BCN Commercial |
$1,065.80
|
| Rate for Payer: BCN Medicare Advantage |
$721.79
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$1,039.38
|
| Rate for Payer: Cofinity Commercial |
$967.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$721.79
|
| Rate for Payer: Healthscope Commercial |
$866.15
|
| Rate for Payer: Healthscope Whirlpool |
$866.15
|
| Rate for Payer: Meridian Medicaid |
$491.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$757.88
|
| Rate for Payer: PACE SWMI |
$721.79
|
| Rate for Payer: PHP Medicare Advantage |
$721.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.73
|
| Rate for Payer: Priority Health Medicare |
$721.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.73
|
| Rate for Payer: UHC Medicare Advantage |
$743.44
|
|
|
PR CLTX FEM FX PROX END NCK W/O MANJ
|
Professional
|
Both
|
$979.00
|
|
|
Service Code
|
HCPCS 27230
|
| Min. Negotiated Rate |
$313.75 |
| Max. Negotiated Rate |
$806.71 |
| Rate for Payer: Aetna Commercial |
$632.75
|
| Rate for Payer: Aetna Medicare |
$472.20
|
| Rate for Payer: BCBS Complete |
$329.44
|
| Rate for Payer: BCBS MAPPO |
$472.20
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$723.73
|
| Rate for Payer: BCN Medicare Advantage |
$472.20
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cofinity Commercial |
$632.75
|
| Rate for Payer: Cofinity Commercial |
$679.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.20
|
| Rate for Payer: Healthscope Commercial |
$566.64
|
| Rate for Payer: Healthscope Whirlpool |
$566.64
|
| Rate for Payer: Meridian Medicaid |
$329.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$495.81
|
| Rate for Payer: PACE SWMI |
$472.20
|
| Rate for Payer: PHP Medicare Advantage |
$472.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$741.46
|
| Rate for Payer: Priority Health Medicare |
$472.20
|
| Rate for Payer: Priority Health Narrow Network |
$741.46
|
| Rate for Payer: UHC Medicare Advantage |
$486.37
|
|
|
PR CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ
|
Professional
|
Both
|
$1,796.00
|
|
|
Service Code
|
HCPCS 27502
|
| Min. Negotiated Rate |
$486.71 |
| Max. Negotiated Rate |
$1,257.20 |
| Rate for Payer: Aetna Commercial |
$1,004.18
|
| Rate for Payer: Aetna Medicare |
$749.39
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$749.39
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$1,111.74
|
| Rate for Payer: BCN Medicare Advantage |
$749.39
|
| Rate for Payer: Cash Price |
$1,436.80
|
| Rate for Payer: Cash Price |
$1,436.80
|
| Rate for Payer: Cofinity Commercial |
$1,079.12
|
| Rate for Payer: Cofinity Commercial |
$1,004.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.39
|
| Rate for Payer: Healthscope Commercial |
$899.27
|
| Rate for Payer: Healthscope Whirlpool |
$899.27
|
| Rate for Payer: Meridian Medicaid |
$511.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$786.86
|
| Rate for Payer: PACE SWMI |
$749.39
|
| Rate for Payer: PHP Medicare Advantage |
$749.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,257.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,161.72
|
| Rate for Payer: Priority Health Medicare |
$749.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,161.72
|
| Rate for Payer: UHC Medicare Advantage |
$771.87
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 28495
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$413.04 |
| Rate for Payer: Aetna Commercial |
$194.37
|
| Rate for Payer: Aetna Medicare |
$145.05
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$145.05
|
| Rate for Payer: BCBS Trust/PPO |
$413.04
|
| Rate for Payer: BCN Commercial |
$263.88
|
| Rate for Payer: BCN Medicare Advantage |
$145.05
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$194.37
|
| Rate for Payer: Cofinity Commercial |
$208.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.05
|
| Rate for Payer: Healthscope Commercial |
$174.06
|
| Rate for Payer: Healthscope Whirlpool |
$174.06
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.30
|
| Rate for Payer: PACE SWMI |
$145.05
|
| Rate for Payer: PHP Medicare Advantage |
$145.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.79
|
| Rate for Payer: Priority Health Medicare |
$145.05
|
| Rate for Payer: Priority Health Narrow Network |
$229.79
|
| Rate for Payer: UHC Medicare Advantage |
$149.40
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 28490
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$1,548.98 |
| Rate for Payer: Aetna Commercial |
$163.20
|
| Rate for Payer: Aetna Medicare |
$121.79
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$121.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$121.79
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$175.38
|
| Rate for Payer: Cofinity Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.79
|
| Rate for Payer: Healthscope Commercial |
$146.15
|
| Rate for Payer: Healthscope Whirlpool |
$146.15
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.88
|
| Rate for Payer: PACE SWMI |
$121.79
|
| Rate for Payer: PHP Medicare Advantage |
$121.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.04
|
| Rate for Payer: Priority Health Medicare |
$121.79
|
| Rate for Payer: Priority Health Narrow Network |
$194.04
|
| Rate for Payer: UHC Medicare Advantage |
$125.44
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$1,548.98 |
| Rate for Payer: Aetna Commercial |
$163.20
|
| Rate for Payer: Aetna Medicare |
$121.79
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$121.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.98
|
| Rate for Payer: BCN Commercial |
$210.62
|
| Rate for Payer: BCN Medicare Advantage |
$121.79
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.79
|
| Rate for Payer: Healthscope Commercial |
$146.15
|
| Rate for Payer: Healthscope Whirlpool |
$146.15
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.88
|
| Rate for Payer: PACE SWMI |
$121.79
|
| Rate for Payer: PHP Medicare Advantage |
$121.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.04
|
| Rate for Payer: Priority Health Medicare |
$121.79
|
| Rate for Payer: Priority Health Narrow Network |
$194.04
|
| Rate for Payer: UHC Medicare Advantage |
$125.44
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
OP
|
$297.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$297.00 |
| Rate for Payer: Aetna Commercial |
$267.30
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$288.09
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$230.26
|
| Rate for Payer: BCN Commercial |
$230.26
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$279.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$297.00
|
| Rate for Payer: Healthscope Whirlpool |
$288.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$267.30
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$252.45
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.20
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$204.16
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.36
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Facility
|
IP
|
$297.00
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
28490
|
| Min. Negotiated Rate |
$207.90 |
| Max. Negotiated Rate |
$297.00 |
| Rate for Payer: Aetna Commercial |
$267.30
|
| Rate for Payer: ASR ASR |
$288.09
|
| Rate for Payer: BCBS Trust/PPO |
$230.26
|
| Rate for Payer: BCN Commercial |
$230.26
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$279.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.60
|
| Rate for Payer: Healthscope Commercial |
$297.00
|
| Rate for Payer: Healthscope Whirlpool |
$288.09
|
| Rate for Payer: Mclaren Commercial |
$267.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$252.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.36
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$423.70 |
| Rate for Payer: Aetna Commercial |
$187.18
|
| Rate for Payer: Aetna Medicare |
$139.69
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$139.69
|
| Rate for Payer: BCBS Trust/PPO |
$423.70
|
| Rate for Payer: BCN Commercial |
$242.88
|
| Rate for Payer: BCN Medicare Advantage |
$139.69
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$201.15
|
| Rate for Payer: Cofinity Commercial |
$187.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.69
|
| Rate for Payer: Healthscope Commercial |
$167.63
|
| Rate for Payer: Healthscope Whirlpool |
$167.63
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.67
|
| Rate for Payer: PACE SWMI |
$139.69
|
| Rate for Payer: PHP Medicare Advantage |
$139.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.62
|
| Rate for Payer: Priority Health Medicare |
$139.69
|
| Rate for Payer: Priority Health Narrow Network |
$221.62
|
| Rate for Payer: UHC Medicare Advantage |
$143.88
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$79.88 |
| Max. Negotiated Rate |
$1,955.77 |
| Rate for Payer: Aetna Commercial |
$156.77
|
| Rate for Payer: Aetna Medicare |
$116.99
|
| Rate for Payer: BCBS Complete |
$83.87
|
| Rate for Payer: BCBS MAPPO |
$116.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.77
|
| Rate for Payer: BCN Commercial |
$179.35
|
| Rate for Payer: BCN Medicare Advantage |
$116.99
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$168.47
|
| Rate for Payer: Cofinity Commercial |
$156.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.99
|
| Rate for Payer: Healthscope Commercial |
$140.39
|
| Rate for Payer: Healthscope Whirlpool |
$140.39
|
| Rate for Payer: Meridian Medicaid |
$83.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.84
|
| Rate for Payer: PACE SWMI |
$116.99
|
| Rate for Payer: PHP Medicare Advantage |
$116.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.39
|
| Rate for Payer: Priority Health Medicare |
$116.99
|
| Rate for Payer: Priority Health Narrow Network |
$186.39
|
| Rate for Payer: UHC Medicare Advantage |
$120.50
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$3,163.99 |
| Rate for Payer: Aetna Commercial |
$405.90
|
| Rate for Payer: Aetna Medicare |
$302.91
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$302.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,163.99
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$302.91
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$405.90
|
| Rate for Payer: Cofinity Commercial |
$436.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.91
|
| Rate for Payer: Healthscope Commercial |
$363.49
|
| Rate for Payer: Healthscope Whirlpool |
$363.49
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.06
|
| Rate for Payer: PACE SWMI |
$302.91
|
| Rate for Payer: PHP Medicare Advantage |
$302.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.99
|
| Rate for Payer: Priority Health Medicare |
$302.91
|
| Rate for Payer: Priority Health Narrow Network |
$478.99
|
| Rate for Payer: UHC Medicare Advantage |
$312.00
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$322.27 |
| Max. Negotiated Rate |
$3,467.23 |
| Rate for Payer: Aetna Commercial |
$656.05
|
| Rate for Payer: Aetna Medicare |
$489.59
|
| Rate for Payer: BCBS Complete |
$338.38
|
| Rate for Payer: BCBS MAPPO |
$489.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,467.23
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$489.59
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$705.01
|
| Rate for Payer: Cofinity Commercial |
$656.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.59
|
| Rate for Payer: Healthscope Commercial |
$587.51
|
| Rate for Payer: Healthscope Whirlpool |
$587.51
|
| Rate for Payer: Meridian Medicaid |
$338.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.07
|
| Rate for Payer: PACE SWMI |
$489.59
|
| Rate for Payer: PHP Medicare Advantage |
$489.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.44
|
| Rate for Payer: Priority Health Medicare |
$489.59
|
| Rate for Payer: Priority Health Narrow Network |
$764.44
|
| Rate for Payer: UHC Medicare Advantage |
$504.28
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$674.00
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$471.80 |
| Rate for Payer: Aetna Commercial |
$345.81
|
| Rate for Payer: Aetna Medicare |
$258.07
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$258.07
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$258.07
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cofinity Commercial |
$371.62
|
| Rate for Payer: Cofinity Commercial |
$345.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.07
|
| Rate for Payer: Healthscope Commercial |
$309.68
|
| Rate for Payer: Healthscope Whirlpool |
$309.68
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.97
|
| Rate for Payer: PACE SWMI |
$258.07
|
| Rate for Payer: PHP Medicare Advantage |
$258.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.55
|
| Rate for Payer: Priority Health Medicare |
$258.07
|
| Rate for Payer: Priority Health Narrow Network |
$409.55
|
| Rate for Payer: UHC Medicare Advantage |
$265.81
|
|
|
PR CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 23625
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$582.99 |
| Rate for Payer: Aetna Commercial |
$474.04
|
| Rate for Payer: Aetna Medicare |
$353.76
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$353.76
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$582.99
|
| Rate for Payer: BCN Medicare Advantage |
$353.76
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$474.04
|
| Rate for Payer: Cofinity Commercial |
$509.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.76
|
| Rate for Payer: Healthscope Commercial |
$424.51
|
| Rate for Payer: Healthscope Whirlpool |
$424.51
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.45
|
| Rate for Payer: PACE SWMI |
$353.76
|
| Rate for Payer: PHP Medicare Advantage |
$353.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.12
|
| Rate for Payer: Priority Health Medicare |
$353.76
|
| Rate for Payer: Priority Health Narrow Network |
$557.12
|
| Rate for Payer: UHC Medicare Advantage |
$364.37
|
|
|
PR CLTX GREATER TROCHANTERIC FX W/O MANJ
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 27246
|
| Min. Negotiated Rate |
$253.90 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$513.61
|
| Rate for Payer: Aetna Medicare |
$383.29
|
| Rate for Payer: BCBS Complete |
$266.60
|
| Rate for Payer: BCBS MAPPO |
$383.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$383.29
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cofinity Commercial |
$513.61
|
| Rate for Payer: Cofinity Commercial |
$551.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.29
|
| Rate for Payer: Healthscope Commercial |
$459.95
|
| Rate for Payer: Healthscope Whirlpool |
$459.95
|
| Rate for Payer: Meridian Medicaid |
$266.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.45
|
| Rate for Payer: PACE SWMI |
$383.29
|
| Rate for Payer: PHP Medicare Advantage |
$383.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$614.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.03
|
| Rate for Payer: Priority Health Medicare |
$383.29
|
| Rate for Payer: Priority Health Narrow Network |
$601.03
|
| Rate for Payer: UHC Medicare Advantage |
$394.79
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$1,920.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$483.51 |
| Max. Negotiated Rate |
$2,221.50 |
| Rate for Payer: Aetna Commercial |
$999.09
|
| Rate for Payer: Aetna Medicare |
$745.59
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS MAPPO |
$745.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,221.50
|
| Rate for Payer: BCN Commercial |
$1,107.84
|
| Rate for Payer: BCN Medicare Advantage |
$745.59
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cofinity Commercial |
$999.09
|
| Rate for Payer: Cofinity Commercial |
$1,073.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.59
|
| Rate for Payer: Healthscope Commercial |
$894.71
|
| Rate for Payer: Healthscope Whirlpool |
$894.71
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$782.87
|
| Rate for Payer: PACE SWMI |
$745.59
|
| Rate for Payer: PHP Medicare Advantage |
$745.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,157.64
|
| Rate for Payer: Priority Health Medicare |
$745.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.64
|
| Rate for Payer: UHC Medicare Advantage |
$767.96
|
|
