|
PR CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA
|
Professional
|
Both
|
$724.00
|
|
|
Service Code
|
HCPCS 27250
|
| Min. Negotiated Rate |
$114.38 |
| Max. Negotiated Rate |
$2,156.52 |
| Rate for Payer: Aetna Commercial |
$243.42
|
| Rate for Payer: Aetna Medicare |
$181.66
|
| Rate for Payer: BCBS Complete |
$120.10
|
| Rate for Payer: BCBS MAPPO |
$181.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$262.42
|
| Rate for Payer: BCN Medicare Advantage |
$181.66
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$243.42
|
| Rate for Payer: Cofinity Commercial |
$261.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.66
|
| Rate for Payer: Healthscope Commercial |
$217.99
|
| Rate for Payer: Healthscope Whirlpool |
$217.99
|
| Rate for Payer: Meridian Medicaid |
$120.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.74
|
| Rate for Payer: PACE SWMI |
$181.66
|
| Rate for Payer: PHP Medicare Advantage |
$181.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.21
|
| Rate for Payer: Priority Health Medicare |
$181.66
|
| Rate for Payer: Priority Health Narrow Network |
$274.21
|
| Rate for Payer: UHC Medicare Advantage |
$187.11
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$666.00
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$129.43 |
| Max. Negotiated Rate |
$529.24 |
| Rate for Payer: Aetna Commercial |
$415.99
|
| Rate for Payer: Aetna Medicare |
$310.44
|
| Rate for Payer: BCBS Complete |
$220.30
|
| Rate for Payer: BCBS MAPPO |
$310.44
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$529.24
|
| Rate for Payer: BCN Medicare Advantage |
$310.44
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cofinity Commercial |
$447.03
|
| Rate for Payer: Cofinity Commercial |
$415.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.44
|
| Rate for Payer: Healthscope Commercial |
$372.53
|
| Rate for Payer: Healthscope Whirlpool |
$372.53
|
| Rate for Payer: Meridian Medicaid |
$220.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$325.96
|
| Rate for Payer: PACE SWMI |
$310.44
|
| Rate for Payer: PHP Medicare Advantage |
$310.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$492.78
|
| Rate for Payer: Priority Health Medicare |
$310.44
|
| Rate for Payer: Priority Health Narrow Network |
$492.78
|
| Rate for Payer: UHC Medicare Advantage |
$319.75
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$562.80 |
| Rate for Payer: Aetna Commercial |
$392.83
|
| Rate for Payer: Aetna Medicare |
$293.16
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$293.16
|
| Rate for Payer: BCBS Trust/PPO |
$112.00
|
| Rate for Payer: BCN Commercial |
$502.36
|
| Rate for Payer: BCN Medicare Advantage |
$293.16
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$422.15
|
| Rate for Payer: Cofinity Commercial |
$392.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.16
|
| Rate for Payer: Healthscope Commercial |
$351.79
|
| Rate for Payer: Healthscope Whirlpool |
$351.79
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$307.82
|
| Rate for Payer: PACE SWMI |
$293.16
|
| Rate for Payer: PHP Medicare Advantage |
$293.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.69
|
| Rate for Payer: Priority Health Medicare |
$293.16
|
| Rate for Payer: Priority Health Narrow Network |
$464.69
|
| Rate for Payer: UHC Medicare Advantage |
$301.95
|
|
|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$884.10 |
| Rate for Payer: Aetna Commercial |
$601.83
|
| Rate for Payer: Aetna Medicare |
$449.13
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$449.13
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$754.03
|
| Rate for Payer: BCN Medicare Advantage |
$449.13
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$601.83
|
| Rate for Payer: Cofinity Commercial |
$646.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.13
|
| Rate for Payer: Healthscope Commercial |
$538.96
|
| Rate for Payer: Healthscope Whirlpool |
$538.96
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$471.59
|
| Rate for Payer: PACE SWMI |
$449.13
|
| Rate for Payer: PHP Medicare Advantage |
$449.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$706.23
|
| Rate for Payer: Priority Health Medicare |
$449.13
|
| Rate for Payer: Priority Health Narrow Network |
$706.23
|
| Rate for Payer: UHC Medicare Advantage |
$462.60
|
|
|
PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 27538
|
| Min. Negotiated Rate |
$296.71 |
| Max. Negotiated Rate |
$723.24 |
| Rate for Payer: Aetna Commercial |
$596.86
|
| Rate for Payer: Aetna Medicare |
$445.42
|
| Rate for Payer: BCBS Complete |
$311.55
|
| Rate for Payer: BCBS MAPPO |
$445.42
|
| Rate for Payer: BCBS Trust/PPO |
$716.37
|
| Rate for Payer: BCN Commercial |
$723.24
|
| Rate for Payer: BCN Medicare Advantage |
$445.42
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$641.40
|
| Rate for Payer: Cofinity Commercial |
$596.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.42
|
| Rate for Payer: Healthscope Commercial |
$534.50
|
| Rate for Payer: Healthscope Whirlpool |
$534.50
|
| Rate for Payer: Meridian Medicaid |
$311.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$467.69
|
| Rate for Payer: PACE SWMI |
$445.42
|
| Rate for Payer: PHP Medicare Advantage |
$445.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$702.15
|
| Rate for Payer: Priority Health Medicare |
$445.42
|
| Rate for Payer: Priority Health Narrow Network |
$702.15
|
| Rate for Payer: UHC Medicare Advantage |
$458.78
|
|
|
PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ
|
Professional
|
Both
|
$933.00
|
|
|
Service Code
|
HCPCS 27238
|
| Min. Negotiated Rate |
$306.51 |
| Max. Negotiated Rate |
$1,049.20 |
| Rate for Payer: Aetna Commercial |
$619.20
|
| Rate for Payer: Aetna Medicare |
$462.09
|
| Rate for Payer: BCBS Complete |
$321.84
|
| Rate for Payer: BCBS MAPPO |
$462.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$693.93
|
| Rate for Payer: BCN Medicare Advantage |
$462.09
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cofinity Commercial |
$665.41
|
| Rate for Payer: Cofinity Commercial |
$619.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.09
|
| Rate for Payer: Healthscope Commercial |
$554.51
|
| Rate for Payer: Healthscope Whirlpool |
$554.51
|
| Rate for Payer: Meridian Medicaid |
$321.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$485.19
|
| Rate for Payer: PACE SWMI |
$462.09
|
| Rate for Payer: PHP Medicare Advantage |
$462.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.13
|
| Rate for Payer: Priority Health Medicare |
$462.09
|
| Rate for Payer: Priority Health Narrow Network |
$725.13
|
| Rate for Payer: UHC Medicare Advantage |
$475.95
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 28665
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$1,135.32 |
| Rate for Payer: Aetna Commercial |
$163.20
|
| Rate for Payer: Aetna Medicare |
$121.79
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$121.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.32
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$121.79
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| 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 |
$85.88
|
| 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 |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.96
|
| Rate for Payer: Priority Health Medicare |
$121.79
|
| Rate for Payer: Priority Health Narrow Network |
$189.96
|
| Rate for Payer: UHC Medicare Advantage |
$125.44
|
|
|
PR CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 28660
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$766.04 |
| Rate for Payer: Aetna Commercial |
$122.65
|
| Rate for Payer: Aetna Medicare |
$91.53
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$91.53
|
| Rate for Payer: BCBS Trust/PPO |
$766.04
|
| Rate for Payer: BCN Commercial |
$183.74
|
| Rate for Payer: BCN Medicare Advantage |
$91.53
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$122.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.53
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Healthscope Whirlpool |
$109.84
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.11
|
| Rate for Payer: PACE SWMI |
$91.53
|
| Rate for Payer: PHP Medicare Advantage |
$91.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.98
|
| Rate for Payer: Priority Health Medicare |
$91.53
|
| Rate for Payer: Priority Health Narrow Network |
$142.98
|
| Rate for Payer: UHC Medicare Advantage |
$94.28
|
|
|
PR CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ
|
Professional
|
Both
|
$1,946.00
|
|
|
Service Code
|
HCPCS 27240
|
| Min. Negotiated Rate |
$613.87 |
| Max. Negotiated Rate |
$1,467.10 |
| Rate for Payer: Aetna Commercial |
$1,265.05
|
| Rate for Payer: Aetna Medicare |
$944.07
|
| Rate for Payer: BCBS Complete |
$644.56
|
| Rate for Payer: BCBS MAPPO |
$944.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.47
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| Rate for Payer: BCN Medicare Advantage |
$944.07
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.46
|
| Rate for Payer: Cofinity Commercial |
$1,265.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.07
|
| Rate for Payer: Healthscope Commercial |
$1,132.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,132.88
|
| Rate for Payer: Meridian Medicaid |
$644.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$991.27
|
| Rate for Payer: PACE SWMI |
$944.07
|
| Rate for Payer: PHP Medicare Advantage |
$944.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.10
|
| Rate for Payer: Priority Health Medicare |
$944.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,467.10
|
| Rate for Payer: UHC Medicare Advantage |
$972.39
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ REQ ANES
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 26775
|
| Min. Negotiated Rate |
$236.22 |
| Max. Negotiated Rate |
$2,900.37 |
| Rate for Payer: Aetna Commercial |
$472.55
|
| Rate for Payer: Aetna Medicare |
$352.65
|
| Rate for Payer: BCBS Complete |
$248.03
|
| Rate for Payer: BCBS MAPPO |
$352.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$594.23
|
| Rate for Payer: BCN Medicare Advantage |
$352.65
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$507.82
|
| Rate for Payer: Cofinity Commercial |
$472.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.65
|
| Rate for Payer: Healthscope Commercial |
$423.18
|
| Rate for Payer: Healthscope Whirlpool |
$423.18
|
| Rate for Payer: Meridian Medicaid |
$248.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.28
|
| Rate for Payer: PACE SWMI |
$352.65
|
| Rate for Payer: PHP Medicare Advantage |
$352.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.12
|
| Rate for Payer: Priority Health Medicare |
$352.65
|
| Rate for Payer: Priority Health Narrow Network |
$557.12
|
| Rate for Payer: UHC Medicare Advantage |
$363.23
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$1,851.16 |
| Rate for Payer: Aetna Commercial |
$351.07
|
| Rate for Payer: Aetna Medicare |
$261.99
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$261.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.16
|
| Rate for Payer: BCN Commercial |
$433.46
|
| Rate for Payer: BCN Medicare Advantage |
$261.99
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cofinity Commercial |
$351.07
|
| Rate for Payer: Cofinity Commercial |
$377.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.99
|
| Rate for Payer: Healthscope Commercial |
$314.39
|
| Rate for Payer: Healthscope Whirlpool |
$314.39
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$275.09
|
| Rate for Payer: PACE SWMI |
$261.99
|
| Rate for Payer: PHP Medicare Advantage |
$261.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$412.09
|
| Rate for Payer: Priority Health Medicare |
$261.99
|
| Rate for Payer: Priority Health Narrow Network |
$412.09
|
| Rate for Payer: UHC Medicare Advantage |
$269.85
|
|
|
PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 21440
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$2,978.97 |
| Rate for Payer: Aetna Commercial |
$704.61
|
| Rate for Payer: Aetna Medicare |
$525.83
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS MAPPO |
$525.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,978.97
|
| Rate for Payer: BCN Commercial |
$1,012.05
|
| Rate for Payer: BCN Medicare Advantage |
$525.83
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cofinity Commercial |
$757.20
|
| Rate for Payer: Cofinity Commercial |
$704.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.83
|
| Rate for Payer: Healthscope Commercial |
$631.00
|
| Rate for Payer: Healthscope Whirlpool |
$631.00
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.12
|
| Rate for Payer: PACE SWMI |
$525.83
|
| Rate for Payer: PHP Medicare Advantage |
$525.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$849.20
|
| Rate for Payer: Priority Health Medicare |
$525.83
|
| Rate for Payer: Priority Health Narrow Network |
$849.20
|
| Rate for Payer: UHC Medicare Advantage |
$541.60
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$2,919.55 |
| Rate for Payer: Aetna Commercial |
$406.36
|
| Rate for Payer: Aetna Medicare |
$303.25
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$303.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,919.55
|
| Rate for Payer: BCN Commercial |
$400.52
|
| Rate for Payer: BCN Medicare Advantage |
$303.25
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$436.68
|
| Rate for Payer: Cofinity Commercial |
$406.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.25
|
| Rate for Payer: Healthscope Commercial |
$363.90
|
| Rate for Payer: Healthscope Whirlpool |
$363.90
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.41
|
| Rate for Payer: PACE SWMI |
$303.25
|
| Rate for Payer: PHP Medicare Advantage |
$303.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$480.52
|
| Rate for Payer: Priority Health Medicare |
$303.25
|
| Rate for Payer: Priority Health Narrow Network |
$480.52
|
| Rate for Payer: UHC Medicare Advantage |
$312.35
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$701.00
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$497.47 |
| Rate for Payer: Aetna Commercial |
$395.93
|
| Rate for Payer: Aetna Medicare |
$295.47
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$295.47
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$497.47
|
| Rate for Payer: BCN Medicare Advantage |
$295.47
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cofinity Commercial |
$425.48
|
| Rate for Payer: Cofinity Commercial |
$395.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.47
|
| Rate for Payer: Healthscope Commercial |
$354.56
|
| Rate for Payer: Healthscope Whirlpool |
$354.56
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$310.24
|
| Rate for Payer: PACE SWMI |
$295.47
|
| Rate for Payer: PHP Medicare Advantage |
$295.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.27
|
| Rate for Payer: Priority Health Medicare |
$295.47
|
| Rate for Payer: Priority Health Narrow Network |
$468.27
|
| Rate for Payer: UHC Medicare Advantage |
$304.33
|
|
|
PR CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 26607
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$671.66
|
| Rate for Payer: Aetna Medicare |
$501.24
|
| Rate for Payer: BCBS Complete |
$348.44
|
| Rate for Payer: BCBS MAPPO |
$501.24
|
| Rate for Payer: BCBS Trust/PPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$757.45
|
| Rate for Payer: BCN Medicare Advantage |
$501.24
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$721.79
|
| Rate for Payer: Cofinity Commercial |
$671.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.24
|
| Rate for Payer: Healthscope Commercial |
$601.49
|
| Rate for Payer: Healthscope Whirlpool |
$601.49
|
| Rate for Payer: Meridian Medicaid |
$348.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$526.30
|
| Rate for Payer: PACE SWMI |
$501.24
|
| Rate for Payer: PHP Medicare Advantage |
$501.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,057.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.51
|
| Rate for Payer: Priority Health Medicare |
$501.24
|
| Rate for Payer: Priority Health Narrow Network |
$791.51
|
| Rate for Payer: UHC Medicare Advantage |
$516.28
|
|
|
PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 26600
|
| Min. Negotiated Rate |
$103.55 |
| Max. Negotiated Rate |
$451.41 |
| Rate for Payer: Aetna Commercial |
$379.86
|
| Rate for Payer: Aetna Medicare |
$283.48
|
| Rate for Payer: BCBS Complete |
$201.74
|
| Rate for Payer: BCBS MAPPO |
$283.48
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCN Commercial |
$364.78
|
| Rate for Payer: BCN Medicare Advantage |
$283.48
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$408.21
|
| Rate for Payer: Cofinity Commercial |
$379.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.48
|
| Rate for Payer: Healthscope Commercial |
$340.18
|
| Rate for Payer: Healthscope Whirlpool |
$340.18
|
| Rate for Payer: Meridian Medicaid |
$201.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$297.65
|
| Rate for Payer: PACE SWMI |
$283.48
|
| Rate for Payer: PHP Medicare Advantage |
$283.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$451.41
|
| Rate for Payer: Priority Health Medicare |
$283.48
|
| Rate for Payer: Priority Health Narrow Network |
$451.41
|
| Rate for Payer: UHC Medicare Advantage |
$291.98
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 26705
|
| Min. Negotiated Rate |
$254.64 |
| Max. Negotiated Rate |
$657.27 |
| Rate for Payer: Aetna Commercial |
$527.40
|
| Rate for Payer: Aetna Medicare |
$393.58
|
| Rate for Payer: BCBS Complete |
$276.21
|
| Rate for Payer: BCBS MAPPO |
$393.58
|
| Rate for Payer: BCBS Trust/PPO |
$254.64
|
| Rate for Payer: BCN Commercial |
$657.27
|
| Rate for Payer: BCN Medicare Advantage |
$393.58
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$566.76
|
| Rate for Payer: Cofinity Commercial |
$527.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.58
|
| Rate for Payer: Healthscope Commercial |
$472.30
|
| Rate for Payer: Healthscope Whirlpool |
$472.30
|
| Rate for Payer: Meridian Medicaid |
$276.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$413.26
|
| Rate for Payer: PACE SWMI |
$393.58
|
| Rate for Payer: PHP Medicare Advantage |
$393.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.95
|
| Rate for Payer: Priority Health Medicare |
$393.58
|
| Rate for Payer: Priority Health Narrow Network |
$620.95
|
| Rate for Payer: UHC Medicare Advantage |
$405.39
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 26700
|
| Min. Negotiated Rate |
$64.45 |
| Max. Negotiated Rate |
$512.14 |
| Rate for Payer: Aetna Commercial |
$419.88
|
| Rate for Payer: Aetna Medicare |
$313.34
|
| Rate for Payer: BCBS Complete |
$219.18
|
| Rate for Payer: BCBS MAPPO |
$313.34
|
| Rate for Payer: BCBS Trust/PPO |
$64.45
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$313.34
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$419.88
|
| Rate for Payer: Cofinity Commercial |
$451.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.34
|
| Rate for Payer: Healthscope Commercial |
$376.01
|
| Rate for Payer: Healthscope Whirlpool |
$376.01
|
| Rate for Payer: Meridian Medicaid |
$219.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$329.01
|
| Rate for Payer: PACE SWMI |
$313.34
|
| Rate for Payer: PHP Medicare Advantage |
$313.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$492.26
|
| Rate for Payer: Priority Health Medicare |
$313.34
|
| Rate for Payer: Priority Health Narrow Network |
$492.26
|
| Rate for Payer: UHC Medicare Advantage |
$322.74
|
|
|
PR CLTX METAR FX W/MANJ
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 28475
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$1,033.88 |
| Rate for Payer: Aetna Commercial |
$299.40
|
| Rate for Payer: Aetna Medicare |
$223.43
|
| Rate for Payer: BCBS Complete |
$158.34
|
| Rate for Payer: BCBS MAPPO |
$223.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.88
|
| Rate for Payer: BCN Commercial |
$382.64
|
| Rate for Payer: BCN Medicare Advantage |
$223.43
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$299.40
|
| Rate for Payer: Cofinity Commercial |
$321.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.43
|
| Rate for Payer: Healthscope Commercial |
$268.12
|
| Rate for Payer: Healthscope Whirlpool |
$268.12
|
| Rate for Payer: Meridian Medicaid |
$158.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$234.60
|
| Rate for Payer: PACE SWMI |
$223.43
|
| Rate for Payer: PHP Medicare Advantage |
$223.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$351.32
|
| Rate for Payer: Priority Health Medicare |
$223.43
|
| Rate for Payer: Priority Health Narrow Network |
$351.32
|
| Rate for Payer: UHC Medicare Advantage |
$230.13
|
|
|
PR CLTX METATARSOPHLNGL JT DISLC REQ ANES
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 28635
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$342.34 |
| Rate for Payer: Aetna Commercial |
$175.94
|
| Rate for Payer: Aetna Medicare |
$131.30
|
| Rate for Payer: BCBS Complete |
$88.79
|
| Rate for Payer: BCBS MAPPO |
$131.30
|
| Rate for Payer: BCBS Trust/PPO |
$342.34
|
| Rate for Payer: BCN Commercial |
$258.51
|
| Rate for Payer: BCN Medicare Advantage |
$131.30
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$189.07
|
| Rate for Payer: Cofinity Commercial |
$175.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.30
|
| Rate for Payer: Healthscope Commercial |
$157.56
|
| Rate for Payer: Healthscope Whirlpool |
$157.56
|
| Rate for Payer: Meridian Medicaid |
$88.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.86
|
| Rate for Payer: PACE SWMI |
$131.30
|
| Rate for Payer: PHP Medicare Advantage |
$131.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.29
|
| Rate for Payer: Priority Health Medicare |
$131.30
|
| Rate for Payer: Priority Health Narrow Network |
$205.29
|
| Rate for Payer: UHC Medicare Advantage |
$135.24
|
|
|
PR CLTX METATARSOPHLNGL JT DISLC W/O ANES
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS 28630
|
| Min. Negotiated Rate |
$71.78 |
| Max. Negotiated Rate |
$753.88 |
| Rate for Payer: Aetna Commercial |
$146.35
|
| Rate for Payer: Aetna Medicare |
$109.22
|
| Rate for Payer: BCBS Complete |
$75.37
|
| Rate for Payer: BCBS MAPPO |
$109.22
|
| Rate for Payer: BCBS Trust/PPO |
$753.88
|
| Rate for Payer: BCN Commercial |
$227.24
|
| Rate for Payer: BCN Medicare Advantage |
$109.22
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Cofinity Commercial |
$146.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.22
|
| Rate for Payer: Healthscope Commercial |
$131.06
|
| Rate for Payer: Healthscope Whirlpool |
$131.06
|
| Rate for Payer: Meridian Medicaid |
$75.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.68
|
| Rate for Payer: PACE SWMI |
$109.22
|
| Rate for Payer: PHP Medicare Advantage |
$109.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.54
|
| Rate for Payer: Priority Health Medicare |
$109.22
|
| Rate for Payer: Priority Health Narrow Network |
$169.54
|
| Rate for Payer: UHC Medicare Advantage |
$112.50
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA
|
Professional
|
Both
|
$701.00
|
|
|
Service Code
|
HCPCS 26725
|
| Min. Negotiated Rate |
$202.99 |
| Max. Negotiated Rate |
$830.49 |
| Rate for Payer: Aetna Commercial |
$406.70
|
| Rate for Payer: Aetna Medicare |
$303.51
|
| Rate for Payer: BCBS Complete |
$213.14
|
| Rate for Payer: BCBS MAPPO |
$303.51
|
| Rate for Payer: BCBS Trust/PPO |
$830.49
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$303.51
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cofinity Commercial |
$406.70
|
| Rate for Payer: Cofinity Commercial |
$437.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.51
|
| Rate for Payer: Healthscope Commercial |
$364.21
|
| Rate for Payer: Healthscope Whirlpool |
$364.21
|
| Rate for Payer: Meridian Medicaid |
$213.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.69
|
| Rate for Payer: PACE SWMI |
$303.51
|
| Rate for Payer: PHP Medicare Advantage |
$303.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.47
|
| Rate for Payer: Priority Health Medicare |
$303.51
|
| Rate for Payer: Priority Health Narrow Network |
$478.47
|
| Rate for Payer: UHC Medicare Advantage |
$312.62
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 26720
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$909.78 |
| Rate for Payer: Aetna Commercial |
$250.83
|
| Rate for Payer: Aetna Medicare |
$187.19
|
| Rate for Payer: BCBS Complete |
$133.52
|
| Rate for Payer: BCBS MAPPO |
$187.19
|
| Rate for Payer: BCBS Trust/PPO |
$909.78
|
| Rate for Payer: BCN Commercial |
$303.46
|
| Rate for Payer: BCN Medicare Advantage |
$187.19
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$269.55
|
| Rate for Payer: Cofinity Commercial |
$250.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.19
|
| Rate for Payer: Healthscope Commercial |
$224.63
|
| Rate for Payer: Healthscope Whirlpool |
$224.63
|
| Rate for Payer: Meridian Medicaid |
$133.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$196.55
|
| Rate for Payer: PACE SWMI |
$187.19
|
| Rate for Payer: PHP Medicare Advantage |
$187.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$297.71
|
| Rate for Payer: Priority Health Medicare |
$187.19
|
| Rate for Payer: Priority Health Narrow Network |
$297.71
|
| Rate for Payer: UHC Medicare Advantage |
$192.81
|
|
|
PR CLTX POST HIP ARTHRP DISLC REQ ANES
|
Professional
|
Both
|
$1,500.00
|
|
|
Service Code
|
HCPCS 27266
|
| Min. Negotiated Rate |
$378.93 |
| Max. Negotiated Rate |
$3,076.82 |
| Rate for Payer: Aetna Commercial |
$774.02
|
| Rate for Payer: Aetna Medicare |
$577.63
|
| Rate for Payer: BCBS Complete |
$397.88
|
| Rate for Payer: BCBS MAPPO |
$577.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,076.82
|
| Rate for Payer: BCN Commercial |
$863.50
|
| Rate for Payer: BCN Medicare Advantage |
$577.63
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$831.79
|
| Rate for Payer: Cofinity Commercial |
$774.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.63
|
| Rate for Payer: Healthscope Commercial |
$693.16
|
| Rate for Payer: Healthscope Whirlpool |
$693.16
|
| Rate for Payer: Meridian Medicaid |
$397.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$606.51
|
| Rate for Payer: PACE SWMI |
$577.63
|
| Rate for Payer: PHP Medicare Advantage |
$577.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$902.32
|
| Rate for Payer: Priority Health Medicare |
$577.63
|
| Rate for Payer: Priority Health Narrow Network |
$902.32
|
| Rate for Payer: UHC Medicare Advantage |
$594.96
|
|
|
PR CLTX POST HIP ARTHRP DISLC W/O ANES
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 27265
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$2,859.69 |
| Rate for Payer: Aetna Commercial |
$553.25
|
| Rate for Payer: Aetna Medicare |
$412.87
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$412.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,859.69
|
| Rate for Payer: BCN Commercial |
$619.16
|
| Rate for Payer: BCN Medicare Advantage |
$412.87
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$553.25
|
| Rate for Payer: Cofinity Commercial |
$594.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.87
|
| Rate for Payer: Healthscope Commercial |
$495.44
|
| Rate for Payer: Healthscope Whirlpool |
$495.44
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.51
|
| Rate for Payer: PACE SWMI |
$412.87
|
| Rate for Payer: PHP Medicare Advantage |
$412.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.99
|
| Rate for Payer: Priority Health Medicare |
$412.87
|
| Rate for Payer: Priority Health Narrow Network |
$646.99
|
| Rate for Payer: UHC Medicare Advantage |
$425.26
|
|
