|
PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 46612
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$120.20
|
| Rate for Payer: Aetna Medicare |
$89.70
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$89.70
|
| Rate for Payer: BCN Commercial |
$143.92
|
| Rate for Payer: BCN Medicare Advantage |
$89.70
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$129.17
|
| Rate for Payer: Cofinity Commercial |
$120.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.70
|
| Rate for Payer: Healthscope Commercial |
$107.64
|
| Rate for Payer: Healthscope Whirlpool |
$107.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.19
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.67
|
| Rate for Payer: Nomi Health Commercial |
$107.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$89.70
|
| Rate for Payer: PHP Medicare Advantage |
$89.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$175.35
|
| Rate for Payer: Priority Health Medicare |
$89.70
|
| Rate for Payer: Priority Health Narrow Network |
$175.35
|
| Rate for Payer: Railroad Medicare Medicare |
$89.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.70
|
| Rate for Payer: UHC Exchange |
$168.54
|
| Rate for Payer: UHC Medicaid |
$57.72
|
| Rate for Payer: UHCCP DNSP |
$89.70
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 45990
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$132.00
|
| Rate for Payer: Aetna Medicare |
$98.51
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.51
|
| Rate for Payer: BCN Commercial |
$159.35
|
| Rate for Payer: BCN Medicare Advantage |
$98.51
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$141.85
|
| Rate for Payer: Cofinity Commercial |
$132.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.51
|
| Rate for Payer: Healthscope Commercial |
$118.21
|
| Rate for Payer: Healthscope Whirlpool |
$118.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.44
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.36
|
| Rate for Payer: Nomi Health Commercial |
$118.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$98.51
|
| Rate for Payer: PHP Medicare Advantage |
$98.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$194.16
|
| Rate for Payer: Priority Health Medicare |
$98.51
|
| Rate for Payer: Priority Health Narrow Network |
$194.16
|
| Rate for Payer: Railroad Medicare Medicare |
$98.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.51
|
| Rate for Payer: UHC Exchange |
$187.64
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP DNSP |
$98.51
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ANTEPARTUM CARE ONLY 4-6 VISITS
|
Professional
|
Both
|
$1,191.00
|
|
|
Service Code
|
HCPCS 59425
|
| Min. Negotiated Rate |
$376.64 |
| Max. Negotiated Rate |
$893.25 |
| Rate for Payer: Aetna Commercial |
$531.26
|
| Rate for Payer: Aetna Medicare |
$396.46
|
| Rate for Payer: BCBS Complete |
$395.47
|
| Rate for Payer: BCBS MAPPO |
$396.46
|
| Rate for Payer: BCN Commercial |
$637.82
|
| Rate for Payer: BCN Medicare Advantage |
$396.46
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Cofinity Commercial |
$570.90
|
| Rate for Payer: Cofinity Commercial |
$531.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.46
|
| Rate for Payer: Healthscope Commercial |
$475.75
|
| Rate for Payer: Healthscope Whirlpool |
$475.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.28
|
| Rate for Payer: Meridian Medicaid |
$395.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$436.11
|
| Rate for Payer: Nomi Health Commercial |
$475.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$893.25
|
| Rate for Payer: PACE SWMI |
$396.46
|
| Rate for Payer: PHP Medicare Advantage |
$396.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$612.06
|
| Rate for Payer: Priority Health Medicare |
$396.46
|
| Rate for Payer: Priority Health Narrow Network |
$612.06
|
| Rate for Payer: Railroad Medicare Medicare |
$396.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$635.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$396.46
|
| Rate for Payer: UHC Exchange |
$635.60
|
| Rate for Payer: UHC Medicaid |
$376.64
|
| Rate for Payer: UHCCP DNSP |
$396.46
|
| Rate for Payer: UHCCP Medicaid |
$376.64
|
|
|
PR ANTEPARTUM CARE ONLY 7/> VISITS
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 59426
|
| Min. Negotiated Rate |
$690.73 |
| Max. Negotiated Rate |
$1,227.75 |
| Rate for Payer: Aetna Commercial |
$974.29
|
| Rate for Payer: Aetna Medicare |
$727.08
|
| Rate for Payer: BCBS Complete |
$725.27
|
| Rate for Payer: BCBS MAPPO |
$727.08
|
| Rate for Payer: BCN Commercial |
$1,138.94
|
| Rate for Payer: BCN Medicare Advantage |
$727.08
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$974.29
|
| Rate for Payer: Cofinity Commercial |
$1,047.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.08
|
| Rate for Payer: Healthscope Commercial |
$872.50
|
| Rate for Payer: Healthscope Whirlpool |
$872.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.43
|
| Rate for Payer: Meridian Medicaid |
$725.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$799.79
|
| Rate for Payer: Nomi Health Commercial |
$872.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,227.75
|
| Rate for Payer: PACE SWMI |
$727.08
|
| Rate for Payer: PHP Medicare Advantage |
$727.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,123.99
|
| Rate for Payer: Priority Health Medicare |
$727.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,123.99
|
| Rate for Payer: Railroad Medicare Medicare |
$727.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,120.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$727.08
|
| Rate for Payer: UHC Exchange |
$1,120.33
|
| Rate for Payer: UHC Medicaid |
$690.73
|
| Rate for Payer: UHCCP DNSP |
$727.08
|
| Rate for Payer: UHCCP Medicaid |
$690.73
|
|
|
PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 57240
|
| Min. Negotiated Rate |
$347.62 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$720.73
|
| Rate for Payer: Aetna Medicare |
$537.86
|
| Rate for Payer: BCBS Complete |
$365.00
|
| Rate for Payer: BCBS MAPPO |
$537.86
|
| Rate for Payer: BCN Commercial |
$921.26
|
| Rate for Payer: BCN Medicare Advantage |
$537.86
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$774.52
|
| Rate for Payer: Cofinity Commercial |
$720.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.86
|
| Rate for Payer: Healthscope Commercial |
$645.43
|
| Rate for Payer: Healthscope Whirlpool |
$645.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.75
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.65
|
| Rate for Payer: Nomi Health Commercial |
$645.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.00
|
| Rate for Payer: PACE SWMI |
$537.86
|
| Rate for Payer: PHP Medicare Advantage |
$537.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$933.04
|
| Rate for Payer: Priority Health Medicare |
$537.86
|
| Rate for Payer: Priority Health Narrow Network |
$933.04
|
| Rate for Payer: Railroad Medicare Medicare |
$537.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,066.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.86
|
| Rate for Payer: UHC Exchange |
$1,066.39
|
| Rate for Payer: UHC Medicaid |
$347.62
|
| Rate for Payer: UHCCP DNSP |
$537.86
|
| Rate for Payer: UHCCP Medicaid |
$347.62
|
|
|
PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,997.00
|
|
|
Service Code
|
HCPCS 22845
|
| Min. Negotiated Rate |
$413.01 |
| Max. Negotiated Rate |
$2,997.75 |
| Rate for Payer: Aetna Commercial |
$874.89
|
| Rate for Payer: Aetna Medicare |
$652.90
|
| Rate for Payer: BCBS Complete |
$433.66
|
| Rate for Payer: BCBS MAPPO |
$652.90
|
| Rate for Payer: BCN Commercial |
$1,192.61
|
| Rate for Payer: BCN Medicare Advantage |
$652.90
|
| Rate for Payer: Cash Price |
$3,197.60
|
| Rate for Payer: Cash Price |
$3,197.60
|
| Rate for Payer: Cofinity Commercial |
$940.18
|
| Rate for Payer: Cofinity Commercial |
$874.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.90
|
| Rate for Payer: Healthscope Commercial |
$783.48
|
| Rate for Payer: Healthscope Whirlpool |
$783.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.54
|
| Rate for Payer: Meridian Medicaid |
$433.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$718.19
|
| Rate for Payer: Nomi Health Commercial |
$783.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,997.75
|
| Rate for Payer: PACE SWMI |
$652.90
|
| Rate for Payer: PHP Medicare Advantage |
$652.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,160.47
|
| Rate for Payer: Priority Health Medicare |
$652.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,160.47
|
| Rate for Payer: Railroad Medicare Medicare |
$652.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,298.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$652.90
|
| Rate for Payer: UHC Exchange |
$1,298.89
|
| Rate for Payer: UHC Medicaid |
$413.01
|
| Rate for Payer: UHCCP DNSP |
$652.90
|
| Rate for Payer: UHCCP Medicaid |
$413.01
|
|
|
PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$4,398.00
|
|
|
Service Code
|
HCPCS 22846
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$3,298.50 |
| Rate for Payer: Aetna Commercial |
$909.65
|
| Rate for Payer: Aetna Medicare |
$678.84
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS MAPPO |
$678.84
|
| Rate for Payer: BCN Commercial |
$1,242.39
|
| Rate for Payer: BCN Medicare Advantage |
$678.84
|
| Rate for Payer: Cash Price |
$3,518.40
|
| Rate for Payer: Cash Price |
$3,518.40
|
| Rate for Payer: Cofinity Commercial |
$977.53
|
| Rate for Payer: Cofinity Commercial |
$909.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.84
|
| Rate for Payer: Healthscope Commercial |
$814.61
|
| Rate for Payer: Healthscope Whirlpool |
$814.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.78
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.72
|
| Rate for Payer: Nomi Health Commercial |
$814.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,298.50
|
| Rate for Payer: PACE SWMI |
$678.84
|
| Rate for Payer: PHP Medicare Advantage |
$678.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,208.92
|
| Rate for Payer: Priority Health Medicare |
$678.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,208.92
|
| Rate for Payer: Railroad Medicare Medicare |
$678.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,350.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$678.84
|
| Rate for Payer: UHC Exchange |
$1,350.41
|
| Rate for Payer: UHC Medicaid |
$429.41
|
| Rate for Payer: UHCCP DNSP |
$678.84
|
| Rate for Payer: UHCCP Medicaid |
$429.41
|
|
|
PR ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,892.00
|
|
|
Service Code
|
HCPCS 22847
|
| Min. Negotiated Rate |
$438.35 |
| Max. Negotiated Rate |
$2,919.00 |
| Rate for Payer: Aetna Commercial |
$920.96
|
| Rate for Payer: Aetna Medicare |
$687.28
|
| Rate for Payer: BCBS Complete |
$460.27
|
| Rate for Payer: BCBS MAPPO |
$687.28
|
| Rate for Payer: BCN Commercial |
$1,188.68
|
| Rate for Payer: BCN Medicare Advantage |
$687.28
|
| Rate for Payer: Cash Price |
$3,113.60
|
| Rate for Payer: Cash Price |
$3,113.60
|
| Rate for Payer: Cofinity Commercial |
$989.68
|
| Rate for Payer: Cofinity Commercial |
$920.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.28
|
| Rate for Payer: Healthscope Commercial |
$824.74
|
| Rate for Payer: Healthscope Whirlpool |
$824.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.64
|
| Rate for Payer: Meridian Medicaid |
$460.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$756.01
|
| Rate for Payer: Nomi Health Commercial |
$824.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,919.00
|
| Rate for Payer: PACE SWMI |
$687.28
|
| Rate for Payer: PHP Medicare Advantage |
$687.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,270.66
|
| Rate for Payer: Priority Health Medicare |
$687.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,270.66
|
| Rate for Payer: Railroad Medicare Medicare |
$687.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,434.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$687.28
|
| Rate for Payer: UHC Exchange |
$1,434.25
|
| Rate for Payer: UHC Medicaid |
$438.35
|
| Rate for Payer: UHCCP DNSP |
$687.28
|
| Rate for Payer: UHCCP Medicaid |
$438.35
|
|
|
PR ANTERIOR TIBIAL TUBERCLEPLASTY
|
Professional
|
Both
|
$2,654.00
|
|
|
Service Code
|
HCPCS 27418
|
| Min. Negotiated Rate |
$486.71 |
| Max. Negotiated Rate |
$1,990.50 |
| Rate for Payer: Aetna Commercial |
$999.61
|
| Rate for Payer: Aetna Medicare |
$745.98
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$745.98
|
| Rate for Payer: BCN Commercial |
$1,366.58
|
| Rate for Payer: BCN Medicare Advantage |
$745.98
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cofinity Commercial |
$1,074.21
|
| Rate for Payer: Cofinity Commercial |
$999.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.98
|
| Rate for Payer: Healthscope Commercial |
$895.18
|
| Rate for Payer: Healthscope Whirlpool |
$895.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.28
|
| Rate for Payer: Meridian Medicaid |
$511.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$820.58
|
| Rate for Payer: Nomi Health Commercial |
$895.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,990.50
|
| Rate for Payer: PACE SWMI |
$745.98
|
| Rate for Payer: PHP Medicare Advantage |
$745.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,329.76
|
| Rate for Payer: Priority Health Medicare |
$745.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,329.76
|
| Rate for Payer: Railroad Medicare Medicare |
$745.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,447.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$745.98
|
| Rate for Payer: UHC Exchange |
$1,447.87
|
| Rate for Payer: UHC Medicaid |
$486.71
|
| Rate for Payer: UHCCP DNSP |
$745.98
|
| Rate for Payer: UHCCP Medicaid |
$486.71
|
|
|
PR ANTICOAG MGMT, EACH SUBSEQ 90 DAYS
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 99364
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
|
|
PR ANTICOAG MGMT, INITIAL 90 DAYS
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 99363
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: BCBS Complete |
$85.20
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
|
|
PR ANTICOAGULANT MGMT FOR PT TAKING WARFARIN
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 93793
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$15.10
|
| Rate for Payer: Aetna Medicare |
$11.27
|
| Rate for Payer: BCBS MAPPO |
$11.27
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: BCN Medicare Advantage |
$11.27
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$16.23
|
| Rate for Payer: Cofinity Commercial |
$15.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.27
|
| Rate for Payer: Healthscope Commercial |
$13.52
|
| Rate for Payer: Healthscope Whirlpool |
$13.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.40
|
| Rate for Payer: Nomi Health Commercial |
$13.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE SWMI |
$11.27
|
| Rate for Payer: PHP Medicare Advantage |
$11.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.10
|
| Rate for Payer: Priority Health Medicare |
$11.27
|
| Rate for Payer: Priority Health Narrow Network |
$16.10
|
| Rate for Payer: Railroad Medicare Medicare |
$11.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.27
|
| Rate for Payer: UHC Exchange |
$18.48
|
| Rate for Payer: UHCCP DNSP |
$11.27
|
|
|
PR ANT VESICOURETHROPEXY/URETHROPEXY SMPL
|
Professional
|
Both
|
$2,533.00
|
|
|
Service Code
|
HCPCS 51840
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$1,899.75 |
| Rate for Payer: Aetna Commercial |
$820.19
|
| Rate for Payer: Aetna Medicare |
$612.08
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCBS MAPPO |
$612.08
|
| Rate for Payer: BCN Commercial |
$1,040.78
|
| Rate for Payer: BCN Medicare Advantage |
$612.08
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cofinity Commercial |
$881.40
|
| Rate for Payer: Cofinity Commercial |
$820.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$612.08
|
| Rate for Payer: Healthscope Commercial |
$734.50
|
| Rate for Payer: Healthscope Whirlpool |
$734.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.68
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$673.29
|
| Rate for Payer: Nomi Health Commercial |
$734.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,899.75
|
| Rate for Payer: PACE SWMI |
$612.08
|
| Rate for Payer: PHP Medicare Advantage |
$612.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,133.75
|
| Rate for Payer: Priority Health Medicare |
$612.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,133.75
|
| Rate for Payer: Railroad Medicare Medicare |
$612.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,200.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$612.08
|
| Rate for Payer: UHC Exchange |
$1,200.32
|
| Rate for Payer: UHC Medicaid |
$396.82
|
| Rate for Payer: UHCCP DNSP |
$612.08
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS
|
Professional
|
Both
|
$1,998.00
|
|
|
Service Code
|
HCPCS 33866
|
| Min. Negotiated Rate |
$533.57 |
| Max. Negotiated Rate |
$1,654.83 |
| Rate for Payer: Aetna Commercial |
$1,132.31
|
| Rate for Payer: Aetna Medicare |
$845.01
|
| Rate for Payer: BCBS Complete |
$560.25
|
| Rate for Payer: BCBS MAPPO |
$845.01
|
| Rate for Payer: BCN Commercial |
$1,343.55
|
| Rate for Payer: BCN Medicare Advantage |
$845.01
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cofinity Commercial |
$1,216.81
|
| Rate for Payer: Cofinity Commercial |
$1,132.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$845.01
|
| Rate for Payer: Healthscope Commercial |
$1,014.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,014.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$887.26
|
| Rate for Payer: Meridian Medicaid |
$560.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$929.51
|
| Rate for Payer: Nomi Health Commercial |
$1,014.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.50
|
| Rate for Payer: PACE SWMI |
$845.01
|
| Rate for Payer: PHP Medicare Advantage |
$845.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,444.82
|
| Rate for Payer: Priority Health Medicare |
$845.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,444.82
|
| Rate for Payer: Railroad Medicare Medicare |
$845.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,654.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$845.01
|
| Rate for Payer: UHC Exchange |
$1,654.83
|
| Rate for Payer: UHC Medicaid |
$533.57
|
| Rate for Payer: UHCCP DNSP |
$845.01
|
| Rate for Payer: UHCCP Medicaid |
$533.57
|
|
|
PR AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX
|
Professional
|
Both
|
$1,920.00
|
|
|
Service Code
|
HCPCS 33800
|
| Min. Negotiated Rate |
$597.04 |
| Max. Negotiated Rate |
$1,753.45 |
| Rate for Payer: Aetna Commercial |
$1,252.00
|
| Rate for Payer: Aetna Medicare |
$934.33
|
| Rate for Payer: BCBS Complete |
$626.89
|
| Rate for Payer: BCBS MAPPO |
$934.33
|
| Rate for Payer: BCN Commercial |
$1,458.09
|
| Rate for Payer: BCN Medicare Advantage |
$934.33
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cofinity Commercial |
$1,345.44
|
| Rate for Payer: Cofinity Commercial |
$1,252.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.33
|
| Rate for Payer: Healthscope Commercial |
$1,121.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,121.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.05
|
| Rate for Payer: Meridian Medicaid |
$626.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,027.76
|
| Rate for Payer: Nomi Health Commercial |
$1,121.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,440.00
|
| Rate for Payer: PACE SWMI |
$934.33
|
| Rate for Payer: PHP Medicare Advantage |
$934.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,568.00
|
| Rate for Payer: Priority Health Medicare |
$934.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,568.00
|
| Rate for Payer: Railroad Medicare Medicare |
$934.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,753.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$934.33
|
| Rate for Payer: UHC Exchange |
$1,753.45
|
| Rate for Payer: UHC Medicaid |
$597.04
|
| Rate for Payer: UHCCP DNSP |
$934.33
|
| Rate for Payer: UHCCP Medicaid |
$597.04
|
|
|
PR AORTOPLASTY SUPRAVALVULAR STENOSIS
|
Professional
|
Both
|
$9,659.00
|
|
|
Service Code
|
HCPCS 33417
|
| Min. Negotiated Rate |
$1,007.70 |
| Max. Negotiated Rate |
$7,244.25 |
| Rate for Payer: Aetna Commercial |
$2,114.41
|
| Rate for Payer: Aetna Medicare |
$1,577.92
|
| Rate for Payer: BCBS Complete |
$1,058.09
|
| Rate for Payer: BCBS MAPPO |
$1,577.92
|
| Rate for Payer: BCN Commercial |
$2,464.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,577.92
|
| Rate for Payer: Cash Price |
$7,727.20
|
| Rate for Payer: Cash Price |
$7,727.20
|
| Rate for Payer: Cofinity Commercial |
$2,114.41
|
| Rate for Payer: Cofinity Commercial |
$2,272.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,577.92
|
| Rate for Payer: Healthscope Commercial |
$1,893.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,893.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,656.82
|
| Rate for Payer: Meridian Medicaid |
$1,058.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,735.71
|
| Rate for Payer: Nomi Health Commercial |
$1,893.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,244.25
|
| Rate for Payer: PACE SWMI |
$1,577.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,577.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,007.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,649.72
|
| Rate for Payer: Priority Health Medicare |
$1,577.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,649.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,577.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,963.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,577.92
|
| Rate for Payer: UHC Exchange |
$2,963.05
|
| Rate for Payer: UHC Medicaid |
$1,007.70
|
| Rate for Payer: UHCCP DNSP |
$1,577.92
|
| Rate for Payer: UHCCP Medicaid |
$1,007.70
|
|
|
PR APNEALINK
|
Professional
|
Both
|
$10.00
|
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
|
|
PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 44955
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna Medicare |
$75.24
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$75.24
|
| Rate for Payer: BCN Commercial |
$124.00
|
| Rate for Payer: BCN Medicare Advantage |
$75.24
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$108.35
|
| Rate for Payer: Cofinity Commercial |
$100.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$90.29
|
| Rate for Payer: Healthscope Whirlpool |
$90.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.00
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.76
|
| Rate for Payer: Nomi Health Commercial |
$90.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$75.24
|
| Rate for Payer: PHP Medicare Advantage |
$75.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$151.08
|
| Rate for Payer: Priority Health Medicare |
$75.24
|
| Rate for Payer: Priority Health Narrow Network |
$151.08
|
| Rate for Payer: Railroad Medicare Medicare |
$75.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.24
|
| Rate for Payer: UHC Exchange |
$149.48
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP DNSP |
$75.24
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR APPENDEC RPTD APPENDIX ABSC/PRITONITIS
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 44960
|
| Min. Negotiated Rate |
$526.11 |
| Max. Negotiated Rate |
$1,650.75 |
| Rate for Payer: Aetna Commercial |
$1,099.97
|
| Rate for Payer: Aetna Medicare |
$820.87
|
| Rate for Payer: BCBS Complete |
$552.42
|
| Rate for Payer: BCBS MAPPO |
$820.87
|
| Rate for Payer: BCN Commercial |
$1,319.65
|
| Rate for Payer: BCN Medicare Advantage |
$820.87
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$1,182.05
|
| Rate for Payer: Cofinity Commercial |
$1,099.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.87
|
| Rate for Payer: Healthscope Commercial |
$985.04
|
| Rate for Payer: Healthscope Whirlpool |
$985.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.91
|
| Rate for Payer: Meridian Medicaid |
$552.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$902.96
|
| Rate for Payer: Nomi Health Commercial |
$985.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,650.75
|
| Rate for Payer: PACE SWMI |
$820.87
|
| Rate for Payer: PHP Medicare Advantage |
$820.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,607.90
|
| Rate for Payer: Priority Health Medicare |
$820.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,607.90
|
| Rate for Payer: Railroad Medicare Medicare |
$820.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,564.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.87
|
| Rate for Payer: UHC Exchange |
$1,564.17
|
| Rate for Payer: UHC Medicaid |
$526.11
|
| Rate for Payer: UHCCP DNSP |
$820.87
|
| Rate for Payer: UHCCP Medicaid |
$526.11
|
|
|
PR APPENDECTOMY
|
Professional
|
Both
|
$1,790.00
|
|
|
Service Code
|
HCPCS 44950
|
| Min. Negotiated Rate |
$386.17 |
| Max. Negotiated Rate |
$1,342.50 |
| Rate for Payer: Aetna Commercial |
$806.35
|
| Rate for Payer: Aetna Medicare |
$601.75
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS MAPPO |
$601.75
|
| Rate for Payer: BCN Commercial |
$967.08
|
| Rate for Payer: BCN Medicare Advantage |
$601.75
|
| Rate for Payer: Cash Price |
$1,432.00
|
| Rate for Payer: Cash Price |
$1,432.00
|
| Rate for Payer: Cofinity Commercial |
$866.52
|
| Rate for Payer: Cofinity Commercial |
$806.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.75
|
| Rate for Payer: Healthscope Commercial |
$722.10
|
| Rate for Payer: Healthscope Whirlpool |
$722.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$631.84
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$661.92
|
| Rate for Payer: Nomi Health Commercial |
$722.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,342.50
|
| Rate for Payer: PACE SWMI |
$601.75
|
| Rate for Payer: PHP Medicare Advantage |
$601.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,178.32
|
| Rate for Payer: Priority Health Medicare |
$601.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,178.32
|
| Rate for Payer: Railroad Medicare Medicare |
$601.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,145.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$601.75
|
| Rate for Payer: UHC Exchange |
$1,145.86
|
| Rate for Payer: UHC Medicaid |
$386.17
|
| Rate for Payer: UHCCP DNSP |
$601.75
|
| Rate for Payer: UHCCP Medicaid |
$386.17
|
|
|
PR APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 20660
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$667.50 |
| Rate for Payer: Aetna Commercial |
$290.12
|
| Rate for Payer: Aetna Medicare |
$216.51
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$216.51
|
| Rate for Payer: BCN Commercial |
$362.03
|
| Rate for Payer: BCN Medicare Advantage |
$216.51
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$311.77
|
| Rate for Payer: Cofinity Commercial |
$290.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.51
|
| Rate for Payer: Healthscope Commercial |
$259.81
|
| Rate for Payer: Healthscope Whirlpool |
$259.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.34
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$238.16
|
| Rate for Payer: Nomi Health Commercial |
$259.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$216.51
|
| Rate for Payer: PHP Medicare Advantage |
$216.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$387.00
|
| Rate for Payer: Priority Health Medicare |
$216.51
|
| Rate for Payer: Priority Health Narrow Network |
$387.00
|
| Rate for Payer: Railroad Medicare Medicare |
$216.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$429.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.51
|
| Rate for Payer: UHC Exchange |
$429.62
|
| Rate for Payer: UHC Medicaid |
$136.96
|
| Rate for Payer: UHCCP DNSP |
$216.51
|
| Rate for Payer: UHCCP Medicaid |
$136.96
|
|
|
PR APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 29325
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$219.29
|
| Rate for Payer: Aetna Medicare |
$163.65
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$163.65
|
| Rate for Payer: BCN Commercial |
$271.40
|
| Rate for Payer: BCN Medicare Advantage |
$163.65
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$235.66
|
| Rate for Payer: Cofinity Commercial |
$219.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.65
|
| Rate for Payer: Healthscope Commercial |
$196.38
|
| Rate for Payer: Healthscope Whirlpool |
$196.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.83
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.01
|
| Rate for Payer: Nomi Health Commercial |
$196.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.00
|
| Rate for Payer: PACE SWMI |
$163.65
|
| Rate for Payer: PHP Medicare Advantage |
$163.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$290.12
|
| Rate for Payer: Priority Health Medicare |
$163.65
|
| Rate for Payer: Priority Health Narrow Network |
$290.12
|
| Rate for Payer: Railroad Medicare Medicare |
$163.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$307.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.65
|
| Rate for Payer: UHC Exchange |
$307.32
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP DNSP |
$163.65
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR APPLICATION CAST ELBOW TO FINGER SHORT ARM
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 29075
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: Aetna Medicare |
$56.86
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$56.86
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: BCN Medicare Advantage |
$56.86
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$81.88
|
| Rate for Payer: Cofinity Commercial |
$76.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.86
|
| Rate for Payer: Healthscope Commercial |
$68.23
|
| Rate for Payer: Healthscope Whirlpool |
$68.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.70
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.55
|
| Rate for Payer: Nomi Health Commercial |
$68.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: PACE SWMI |
$56.86
|
| Rate for Payer: PHP Medicare Advantage |
$56.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.74
|
| Rate for Payer: Priority Health Medicare |
$56.86
|
| Rate for Payer: Priority Health Narrow Network |
$102.74
|
| Rate for Payer: Railroad Medicare Medicare |
$56.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.86
|
| Rate for Payer: UHC Exchange |
$105.91
|
| Rate for Payer: UHC Medicaid |
$37.49
|
| Rate for Payer: UHCCP DNSP |
$56.86
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
|
|
PR APPLICATION CAST FIGURE-OF-EIGHT
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 29049
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Aetna Commercial |
$87.35
|
| Rate for Payer: Aetna Medicare |
$65.19
|
| Rate for Payer: BCBS Complete |
$44.95
|
| Rate for Payer: BCBS MAPPO |
$65.19
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: BCN Medicare Advantage |
$65.19
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$93.87
|
| Rate for Payer: Cofinity Commercial |
$87.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.19
|
| Rate for Payer: Healthscope Commercial |
$78.23
|
| Rate for Payer: Healthscope Whirlpool |
$78.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.45
|
| Rate for Payer: Meridian Medicaid |
$44.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.71
|
| Rate for Payer: Nomi Health Commercial |
$78.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
| Rate for Payer: PACE SWMI |
$65.19
|
| Rate for Payer: PHP Medicare Advantage |
$65.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.92
|
| Rate for Payer: Priority Health Medicare |
$65.19
|
| Rate for Payer: Priority Health Narrow Network |
$113.92
|
| Rate for Payer: Railroad Medicare Medicare |
$65.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.19
|
| Rate for Payer: UHC Exchange |
$120.62
|
| Rate for Payer: UHC Medicaid |
$42.81
|
| Rate for Payer: UHCCP DNSP |
$65.19
|
| Rate for Payer: UHCCP Medicaid |
$42.81
|
|
|
PR APPLICATION CAST FINGER
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 29086
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Aetna Commercial |
$59.21
|
| Rate for Payer: Aetna Medicare |
$44.19
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$74.70
|
| Rate for Payer: BCN Medicare Advantage |
$44.19
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$63.63
|
| Rate for Payer: Cofinity Commercial |
$59.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.19
|
| Rate for Payer: Healthscope Commercial |
$53.03
|
| Rate for Payer: Healthscope Whirlpool |
$53.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.40
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.61
|
| Rate for Payer: Nomi Health Commercial |
$53.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$44.19
|
| Rate for Payer: PHP Medicare Advantage |
$44.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.85
|
| Rate for Payer: Priority Health Medicare |
$44.19
|
| Rate for Payer: Priority Health Narrow Network |
$79.85
|
| Rate for Payer: Railroad Medicare Medicare |
$44.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.19
|
| Rate for Payer: UHC Exchange |
$88.25
|
| Rate for Payer: UHC Medicaid |
$29.39
|
| Rate for Payer: UHCCP DNSP |
$44.19
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
|
