|
PR DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 11047
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Aetna Commercial |
$128.63
|
| Rate for Payer: Aetna Medicare |
$95.99
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$95.99
|
| Rate for Payer: BCBS Trust/PPO |
$242.22
|
| Rate for Payer: BCN Commercial |
$175.93
|
| Rate for Payer: BCN Medicare Advantage |
$95.99
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$138.23
|
| Rate for Payer: Cofinity Commercial |
$128.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.99
|
| Rate for Payer: Healthscope Commercial |
$115.19
|
| Rate for Payer: Healthscope Whirlpool |
$115.19
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.79
|
| Rate for Payer: PACE SWMI |
$95.99
|
| Rate for Payer: PHP Medicare Advantage |
$95.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.97
|
| Rate for Payer: Priority Health Medicare |
$95.99
|
| Rate for Payer: Priority Health Narrow Network |
$117.97
|
| Rate for Payer: UHC Medicare Advantage |
$98.87
|
|
|
PR DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 11044
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$577.50 |
| Rate for Payer: Aetna Commercial |
$297.36
|
| Rate for Payer: Aetna Medicare |
$221.91
|
| Rate for Payer: BCBS Complete |
$150.30
|
| Rate for Payer: BCBS MAPPO |
$221.91
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$452.52
|
| Rate for Payer: BCN Medicare Advantage |
$221.91
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$297.36
|
| Rate for Payer: Cofinity Commercial |
$319.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.91
|
| Rate for Payer: Healthscope Commercial |
$266.29
|
| Rate for Payer: Healthscope Whirlpool |
$266.29
|
| Rate for Payer: Meridian Medicaid |
$150.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.01
|
| Rate for Payer: PACE SWMI |
$221.91
|
| Rate for Payer: PHP Medicare Advantage |
$221.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.17
|
| Rate for Payer: Priority Health Medicare |
$221.91
|
| Rate for Payer: Priority Health Narrow Network |
$274.17
|
| Rate for Payer: UHC Medicare Advantage |
$228.57
|
|
|
PR DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 69222
|
| Min. Negotiated Rate |
$88.18 |
| Max. Negotiated Rate |
$1,975.31 |
| Rate for Payer: Aetna Commercial |
$177.38
|
| Rate for Payer: Aetna Medicare |
$132.37
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$132.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,975.31
|
| Rate for Payer: BCN Commercial |
$319.60
|
| Rate for Payer: BCN Medicare Advantage |
$132.37
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$190.61
|
| Rate for Payer: Cofinity Commercial |
$177.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.37
|
| Rate for Payer: Healthscope Commercial |
$158.84
|
| Rate for Payer: Healthscope Whirlpool |
$158.84
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.99
|
| Rate for Payer: PACE SWMI |
$132.37
|
| Rate for Payer: PHP Medicare Advantage |
$132.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.77
|
| Rate for Payer: Priority Health Medicare |
$132.37
|
| Rate for Payer: Priority Health Narrow Network |
$193.77
|
| Rate for Payer: UHC Medicare Advantage |
$136.34
|
|
|
PR DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 69220
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$1,803.09 |
| Rate for Payer: Aetna Commercial |
$67.55
|
| Rate for Payer: Aetna Medicare |
$50.41
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$50.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.09
|
| Rate for Payer: BCN Commercial |
$114.84
|
| Rate for Payer: BCN Medicare Advantage |
$50.41
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$72.59
|
| Rate for Payer: Cofinity Commercial |
$67.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.41
|
| Rate for Payer: Healthscope Commercial |
$60.49
|
| Rate for Payer: Healthscope Whirlpool |
$60.49
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.93
|
| Rate for Payer: PACE SWMI |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$50.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.14
|
| Rate for Payer: Priority Health Medicare |
$50.41
|
| Rate for Payer: Priority Health Narrow Network |
$72.14
|
| Rate for Payer: UHC Medicare Advantage |
$51.92
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$697.82 |
| Rate for Payer: Aetna Commercial |
$423.00
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$455.90
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$364.39
|
| Rate for Payer: BCN Commercial |
$364.39
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$441.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$470.00
|
| Rate for Payer: Healthscope Whirlpool |
$455.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$423.00
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.50
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.52
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$323.62
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$413.60
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$329.00 |
| Max. Negotiated Rate |
$470.00 |
| Rate for Payer: Aetna Commercial |
$423.00
|
| Rate for Payer: ASR ASR |
$455.90
|
| Rate for Payer: BCBS Trust/PPO |
$364.39
|
| Rate for Payer: BCN Commercial |
$364.39
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$441.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.00
|
| Rate for Payer: Healthscope Commercial |
$470.00
|
| Rate for Payer: Healthscope Whirlpool |
$455.90
|
| Rate for Payer: Mclaren Commercial |
$423.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$413.60
|
|
|
PR DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 11043
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$202.13
|
| Rate for Payer: Aetna Medicare |
$150.84
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$150.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,522.50
|
| Rate for Payer: BCN Commercial |
$338.65
|
| Rate for Payer: BCN Medicare Advantage |
$150.84
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$217.21
|
| Rate for Payer: Cofinity Commercial |
$202.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.84
|
| Rate for Payer: Healthscope Commercial |
$181.01
|
| Rate for Payer: Healthscope Whirlpool |
$181.01
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.38
|
| Rate for Payer: PACE SWMI |
$150.84
|
| Rate for Payer: PHP Medicare Advantage |
$150.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.03
|
| Rate for Payer: Priority Health Medicare |
$150.84
|
| Rate for Payer: Priority Health Narrow Network |
$187.03
|
| Rate for Payer: UHC Medicare Advantage |
$155.37
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$89.10
|
| Rate for Payer: ASR ASR |
$96.03
|
| Rate for Payer: BCBS Trust/PPO |
$76.75
|
| Rate for Payer: BCN Commercial |
$76.75
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$93.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.20
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Healthscope Whirlpool |
$96.03
|
| Rate for Payer: Mclaren Commercial |
$89.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.12
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 11046
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Aetna Commercial |
$72.60
|
| Rate for Payer: Aetna Medicare |
$54.18
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$54.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.00
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$54.18
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Cofinity Commercial |
$72.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.18
|
| Rate for Payer: Healthscope Commercial |
$65.02
|
| Rate for Payer: Healthscope Whirlpool |
$65.02
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.89
|
| Rate for Payer: PACE SWMI |
$54.18
|
| Rate for Payer: PHP Medicare Advantage |
$54.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$54.18
|
| Rate for Payer: Priority Health Narrow Network |
$66.59
|
| Rate for Payer: UHC Medicare Advantage |
$55.81
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Aetna Commercial |
$72.60
|
| Rate for Payer: Aetna Medicare |
$54.18
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$54.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.00
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$54.18
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Cofinity Commercial |
$72.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.18
|
| Rate for Payer: Healthscope Commercial |
$65.02
|
| Rate for Payer: Healthscope Whirlpool |
$65.02
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.89
|
| Rate for Payer: PACE SWMI |
$54.18
|
| Rate for Payer: PHP Medicare Advantage |
$54.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$54.18
|
| Rate for Payer: Priority Health Narrow Network |
$66.59
|
| Rate for Payer: UHC Medicare Advantage |
$55.81
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$89.10
|
| Rate for Payer: ASR ASR |
$96.03
|
| Rate for Payer: BCBS Complete |
$39.60
|
| Rate for Payer: BCBS Trust/PPO |
$76.75
|
| Rate for Payer: BCN Commercial |
$76.75
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$93.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.20
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Healthscope Whirlpool |
$96.03
|
| Rate for Payer: Mclaren Commercial |
$89.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.09
|
| Rate for Payer: Priority Health Narrow Network |
$70.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.12
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 1-5
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 11720
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$57.48 |
| Rate for Payer: Aetna Commercial |
$19.38
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$38.48
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$19.38
|
| Rate for Payer: Cofinity Commercial |
$20.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$17.35
|
| Rate for Payer: Healthscope Whirlpool |
$17.35
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.67
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: UHC Medicare Advantage |
$14.89
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 6/>
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 11721
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Aetna Commercial |
$31.44
|
| Rate for Payer: Aetna Medicare |
$23.46
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$23.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,712.50
|
| Rate for Payer: BCN Commercial |
$51.83
|
| Rate for Payer: BCN Medicare Advantage |
$23.46
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$33.78
|
| Rate for Payer: Cofinity Commercial |
$31.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$28.15
|
| Rate for Payer: Healthscope Whirlpool |
$28.15
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.63
|
| Rate for Payer: PACE SWMI |
$23.46
|
| Rate for Payer: PHP Medicare Advantage |
$23.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.77
|
| Rate for Payer: Priority Health Medicare |
$23.46
|
| Rate for Payer: Priority Health Narrow Network |
$28.77
|
| Rate for Payer: UHC Medicare Advantage |
$24.16
|
|
|
PR DEBRIDEMENT OPEN WOUND 20 SQ CM/<
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 97597
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$839.47 |
| Rate for Payer: Aetna Commercial |
$46.99
|
| Rate for Payer: Aetna Medicare |
$35.07
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$35.07
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$147.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.07
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$50.50
|
| Rate for Payer: Cofinity Commercial |
$46.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.07
|
| Rate for Payer: Healthscope Commercial |
$42.08
|
| Rate for Payer: Healthscope Whirlpool |
$42.08
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.82
|
| Rate for Payer: PACE SWMI |
$35.07
|
| Rate for Payer: PHP Medicare Advantage |
$35.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.95
|
| Rate for Payer: Priority Health Medicare |
$35.07
|
| Rate for Payer: Priority Health Narrow Network |
$48.95
|
| Rate for Payer: UHC Medicare Advantage |
$36.12
|
|
|
PR DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 97598
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$514.04 |
| Rate for Payer: Aetna Commercial |
$32.67
|
| Rate for Payer: Aetna Medicare |
$24.38
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$24.38
|
| Rate for Payer: BCBS Trust/PPO |
$514.04
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: BCN Medicare Advantage |
$24.38
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$32.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.38
|
| Rate for Payer: Healthscope Commercial |
$29.26
|
| Rate for Payer: Healthscope Whirlpool |
$29.26
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.60
|
| Rate for Payer: PACE SWMI |
$24.38
|
| Rate for Payer: PHP Medicare Advantage |
$24.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$24.38
|
| Rate for Payer: Priority Health Narrow Network |
$34.51
|
| Rate for Payer: UHC Medicare Advantage |
$25.11
|
|
|
PR DEBRIDEMENT, SKIN, PARTIAL THICKNESS
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 11040
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$53.20 |
| Rate for Payer: BCBS Complete |
$30.40
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
11042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$297.00
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$320.10
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$255.85
|
| Rate for Payer: BCN Commercial |
$255.85
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$310.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$330.00
|
| Rate for Payer: Healthscope Whirlpool |
$320.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$297.00
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.50
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.52
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$323.62
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.40
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<
|
Facility
|
IP
|
$330.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
11042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$231.00 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$297.00
|
| Rate for Payer: ASR ASR |
$320.10
|
| Rate for Payer: BCBS Trust/PPO |
$255.85
|
| Rate for Payer: BCN Commercial |
$255.85
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$310.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Healthscope Commercial |
$330.00
|
| Rate for Payer: Healthscope Whirlpool |
$320.10
|
| Rate for Payer: Mclaren Commercial |
$297.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.40
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 11042
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$78.20
|
| Rate for Payer: Aetna Medicare |
$58.36
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$58.36
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$188.63
|
| Rate for Payer: BCN Medicare Advantage |
$58.36
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$84.04
|
| Rate for Payer: Cofinity Commercial |
$78.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.36
|
| Rate for Payer: Healthscope Commercial |
$70.03
|
| Rate for Payer: Healthscope Whirlpool |
$70.03
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.28
|
| Rate for Payer: PACE SWMI |
$58.36
|
| Rate for Payer: PHP Medicare Advantage |
$58.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.75
|
| Rate for Payer: Priority Health Medicare |
$58.36
|
| Rate for Payer: Priority Health Narrow Network |
$72.75
|
| Rate for Payer: UHC Medicare Advantage |
$60.11
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
11045
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: ASR ASR |
$66.93
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$53.50
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Healthscope Whirlpool |
$66.93
|
| Rate for Payer: Mclaren Commercial |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
|
|
PR DEBRIDEMENT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
11045
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: ASR ASR |
$66.93
|
| Rate for Payer: BCBS Complete |
$27.60
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$53.50
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Healthscope Whirlpool |
$66.93
|
| Rate for Payer: Mclaren Commercial |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.79
|
| Rate for Payer: Priority Health Narrow Network |
$48.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
|
|
PR DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 36593
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$549.96 |
| Rate for Payer: Aetna Commercial |
$41.10
|
| Rate for Payer: Aetna Medicare |
$30.67
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS MAPPO |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$549.96
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$30.67
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$41.10
|
| Rate for Payer: Cofinity Commercial |
$44.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.67
|
| Rate for Payer: Healthscope Commercial |
$36.80
|
| Rate for Payer: Healthscope Whirlpool |
$36.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.20
|
| Rate for Payer: PACE SWMI |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.67
|
| Rate for Payer: Priority Health Medicare |
$30.67
|
| Rate for Payer: Priority Health Narrow Network |
$52.67
|
| Rate for Payer: UHC Medicare Advantage |
$31.59
|
|
|
PR DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI
|
Professional
|
Both
|
$1,798.00
|
|
|
Service Code
|
HCPCS 27027
|
| Min. Negotiated Rate |
$570.41 |
| Max. Negotiated Rate |
$1,369.56 |
| Rate for Payer: Aetna Commercial |
$1,182.17
|
| Rate for Payer: Aetna Medicare |
$882.22
|
| Rate for Payer: BCBS Complete |
$598.93
|
| Rate for Payer: BCBS MAPPO |
$882.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCN Commercial |
$1,310.63
|
| Rate for Payer: BCN Medicare Advantage |
$882.22
|
| Rate for Payer: Cash Price |
$1,438.40
|
| Rate for Payer: Cash Price |
$1,438.40
|
| Rate for Payer: Cofinity Commercial |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$1,182.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.22
|
| Rate for Payer: Healthscope Commercial |
$1,058.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,058.66
|
| Rate for Payer: Meridian Medicaid |
$598.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$926.33
|
| Rate for Payer: PACE SWMI |
$882.22
|
| Rate for Payer: PHP Medicare Advantage |
$882.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,369.56
|
| Rate for Payer: Priority Health Medicare |
$882.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,369.56
|
| Rate for Payer: UHC Medicare Advantage |
$908.69
|
|
|
PR DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT
|
Professional
|
Both
|
$929.00
|
|
|
Service Code
|
HCPCS 27496
|
| Min. Negotiated Rate |
$358.27 |
| Max. Negotiated Rate |
$1,098.34 |
| Rate for Payer: Aetna Commercial |
$724.14
|
| Rate for Payer: Aetna Medicare |
$540.40
|
| Rate for Payer: BCBS Complete |
$376.18
|
| Rate for Payer: BCBS MAPPO |
$540.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.34
|
| Rate for Payer: BCN Commercial |
$811.21
|
| Rate for Payer: BCN Medicare Advantage |
$540.40
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cofinity Commercial |
$778.18
|
| Rate for Payer: Cofinity Commercial |
$724.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.40
|
| Rate for Payer: Healthscope Commercial |
$648.48
|
| Rate for Payer: Healthscope Whirlpool |
$648.48
|
| Rate for Payer: Meridian Medicaid |
$376.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$567.42
|
| Rate for Payer: PACE SWMI |
$540.40
|
| Rate for Payer: PHP Medicare Advantage |
$540.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$847.68
|
| Rate for Payer: Priority Health Medicare |
$540.40
|
| Rate for Payer: Priority Health Narrow Network |
$847.68
|
| Rate for Payer: UHC Medicare Advantage |
$556.61
|
|
|
PR DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 24495
|
| Min. Negotiated Rate |
$501.36 |
| Max. Negotiated Rate |
$1,430.84 |
| Rate for Payer: Aetna Commercial |
$1,205.77
|
| Rate for Payer: Aetna Medicare |
$899.83
|
| Rate for Payer: BCBS Complete |
$623.76
|
| Rate for Payer: BCBS MAPPO |
$899.83
|
| Rate for Payer: BCBS Trust/PPO |
$501.36
|
| Rate for Payer: BCN Commercial |
$1,369.28
|
| Rate for Payer: BCN Medicare Advantage |
$899.83
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cofinity Commercial |
$1,205.77
|
| Rate for Payer: Cofinity Commercial |
$1,295.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$899.83
|
| Rate for Payer: Healthscope Commercial |
$1,079.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,079.80
|
| Rate for Payer: Meridian Medicaid |
$623.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$944.82
|
| Rate for Payer: PACE SWMI |
$899.83
|
| Rate for Payer: PHP Medicare Advantage |
$899.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,161.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,430.84
|
| Rate for Payer: Priority Health Medicare |
$899.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,430.84
|
| Rate for Payer: UHC Medicare Advantage |
$926.82
|
|
