|
PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2
|
Professional
|
Both
|
$4,416.00
|
|
|
Service Code
|
HCPCS 22551
|
| Min. Negotiated Rate |
$1,102.06 |
| Max. Negotiated Rate |
$12,500.50 |
| Rate for Payer: Aetna Commercial |
$2,284.82
|
| Rate for Payer: Aetna Medicare |
$2,208.00
|
| Rate for Payer: BCBS Complete |
$1,157.16
|
| Rate for Payer: BCBS Trust/PPO |
$12,500.50
|
| Rate for Payer: BCN Commercial |
$2,498.61
|
| Rate for Payer: Cash Price |
$3,532.80
|
| Rate for Payer: Cash Price |
$3,532.80
|
| Rate for Payer: Meridian Medicaid |
$1,157.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,102.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,620.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,620.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,259.40
|
| Rate for Payer: UHC Exchange |
$2,259.40
|
| Rate for Payer: UHCCP Medicaid |
$1,102.06
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2
|
Professional
|
Both
|
$4,916.00
|
|
|
Service Code
|
HCPCS 22554
|
| Min. Negotiated Rate |
$407.75 |
| Max. Negotiated Rate |
$3,195.40 |
| Rate for Payer: Aetna Commercial |
$1,684.41
|
| Rate for Payer: Aetna Medicare |
$2,458.00
|
| Rate for Payer: BCBS Complete |
$862.40
|
| Rate for Payer: BCBS Trust/PPO |
$407.75
|
| Rate for Payer: BCN Commercial |
$2,043.60
|
| Rate for Payer: Cash Price |
$3,932.80
|
| Rate for Payer: Cash Price |
$3,932.80
|
| Rate for Payer: Meridian Medicaid |
$862.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,195.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,950.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,950.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,475.95
|
| Rate for Payer: UHC Exchange |
$1,475.95
|
| Rate for Payer: UHCCP Medicaid |
$821.33
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC LUMBAR
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 22558
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,462.22 |
| Rate for Payer: Aetna Commercial |
$2,054.27
|
| Rate for Payer: Aetna Medicare |
$1,595.00
|
| Rate for Payer: BCBS Complete |
$1,035.50
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,462.22
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Meridian Medicaid |
$1,035.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$986.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,073.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,343.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,343.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,795.98
|
| Rate for Payer: UHC Exchange |
$1,795.98
|
| Rate for Payer: UHCCP Medicaid |
$986.19
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC THORACIC
|
Professional
|
Both
|
$5,983.00
|
|
|
Service Code
|
HCPCS 22556
|
| Min. Negotiated Rate |
$350.50 |
| Max. Negotiated Rate |
$3,888.95 |
| Rate for Payer: Aetna Commercial |
$2,232.24
|
| Rate for Payer: Aetna Medicare |
$2,991.50
|
| Rate for Payer: BCBS Complete |
$1,147.54
|
| Rate for Payer: BCBS Trust/PPO |
$350.50
|
| Rate for Payer: BCN Commercial |
$2,700.58
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Meridian Medicaid |
$1,147.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,092.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,888.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,597.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,597.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.66
|
| Rate for Payer: UHC Exchange |
$1,939.66
|
| Rate for Payer: UHCCP Medicaid |
$1,092.90
|
|
|
PR ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 22552
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$670.15 |
| Rate for Payer: Aetna Commercial |
$532.98
|
| Rate for Payer: Aetna Medicare |
$515.50
|
| Rate for Payer: BCBS Complete |
$266.36
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$576.64
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Meridian Medicaid |
$266.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.00
|
| Rate for Payer: Priority Health Narrow Network |
$603.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$527.84
|
| Rate for Payer: UHC Exchange |
$527.84
|
| Rate for Payer: UHCCP Medicaid |
$253.68
|
|
|
PR ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE
|
Professional
|
Both
|
$1,667.00
|
|
|
Service Code
|
HCPCS 22585
|
| Min. Negotiated Rate |
$207.04 |
| Max. Negotiated Rate |
$1,083.55 |
| Rate for Payer: Aetna Commercial |
$439.49
|
| Rate for Payer: Aetna Medicare |
$833.50
|
| Rate for Payer: BCBS Complete |
$217.39
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$520.86
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Meridian Medicaid |
$217.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.09
|
| Rate for Payer: Priority Health Narrow Network |
$493.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.60
|
| Rate for Payer: UHC Exchange |
$404.60
|
| Rate for Payer: UHCCP Medicaid |
$207.04
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH
|
Professional
|
Both
|
$3,111.00
|
|
|
Service Code
|
HCPCS 26843
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$2,022.15 |
| Rate for Payer: Aetna Commercial |
$1,037.06
|
| Rate for Payer: Aetna Medicare |
$1,555.50
|
| Rate for Payer: BCBS Complete |
$530.05
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$1,163.54
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Meridian Medicaid |
$530.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,211.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$816.40
|
| Rate for Payer: UHC Exchange |
$816.40
|
| Rate for Payer: UHCCP Medicaid |
$504.81
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 26844
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$2,176.20 |
| Rate for Payer: Aetna Commercial |
$1,141.96
|
| Rate for Payer: Aetna Medicare |
$1,674.00
|
| Rate for Payer: BCBS Complete |
$583.73
|
| Rate for Payer: BCBS Trust/PPO |
$195.47
|
| Rate for Payer: BCN Commercial |
$1,278.38
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Meridian Medicaid |
$583.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,330.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,330.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$911.75
|
| Rate for Payer: UHC Exchange |
$911.75
|
| Rate for Payer: UHCCP Medicaid |
$555.93
|
|
|
PR ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ
|
Professional
|
Both
|
$3,111.00
|
|
|
Service Code
|
HCPCS 26841
|
| Min. Negotiated Rate |
$223.47 |
| Max. Negotiated Rate |
$2,022.15 |
| Rate for Payer: Aetna Commercial |
$1,018.84
|
| Rate for Payer: Aetna Medicare |
$1,555.50
|
| Rate for Payer: BCBS Complete |
$524.23
|
| Rate for Payer: BCBS Trust/PPO |
$223.47
|
| Rate for Payer: BCN Commercial |
$1,148.40
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Meridian Medicaid |
$524.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,200.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$806.15
|
| Rate for Payer: UHC Exchange |
$806.15
|
| Rate for Payer: UHCCP Medicaid |
$499.27
|
|
|
PR ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT
|
Professional
|
Both
|
$3,300.00
|
|
|
Service Code
|
HCPCS 26842
|
| Min. Negotiated Rate |
$161.13 |
| Max. Negotiated Rate |
$2,145.00 |
| Rate for Payer: Aetna Commercial |
$1,103.54
|
| Rate for Payer: Aetna Medicare |
$1,650.00
|
| Rate for Payer: BCBS Complete |
$564.72
|
| Rate for Payer: BCBS Trust/PPO |
$161.13
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Meridian Medicaid |
$564.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,145.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$878.51
|
| Rate for Payer: UHC Exchange |
$878.51
|
| Rate for Payer: UHCCP Medicaid |
$537.83
|
|
|
PR ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE
|
Professional
|
Both
|
$1,686.00
|
|
|
Service Code
|
HCPCS 25830
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,588.67 |
| Rate for Payer: Aetna Commercial |
$1,340.21
|
| Rate for Payer: Aetna Medicare |
$843.00
|
| Rate for Payer: BCBS Complete |
$697.12
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$1,498.29
|
| Rate for Payer: Cash Price |
$1,348.80
|
| Rate for Payer: Cash Price |
$1,348.80
|
| Rate for Payer: Meridian Medicaid |
$697.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$663.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,588.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,588.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,070.05
|
| Rate for Payer: UHC Exchange |
$1,070.05
|
| Rate for Payer: UHCCP Medicaid |
$663.92
|
|
|
PR ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT
|
Professional
|
Both
|
$2,872.00
|
|
|
Service Code
|
HCPCS 28735
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$1,866.80 |
| Rate for Payer: Aetna Commercial |
$1,039.96
|
| Rate for Payer: Aetna Medicare |
$1,436.00
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.09
|
| Rate for Payer: BCN Commercial |
$1,140.08
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,192.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,192.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$926.57
|
| Rate for Payer: UHC Exchange |
$926.57
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
|
|
PR ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS
|
Professional
|
Both
|
$2,783.00
|
|
|
Service Code
|
HCPCS 28730
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$1,808.95 |
| Rate for Payer: Aetna Commercial |
$976.15
|
| Rate for Payer: Aetna Medicare |
$1,391.50
|
| Rate for Payer: BCBS Complete |
$493.82
|
| Rate for Payer: BCBS Trust/PPO |
$872.22
|
| Rate for Payer: BCN Commercial |
$1,065.80
|
| Rate for Payer: Cash Price |
$2,226.40
|
| Rate for Payer: Cash Price |
$2,226.40
|
| Rate for Payer: Meridian Medicaid |
$493.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,808.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$974.26
|
| Rate for Payer: UHC Exchange |
$974.26
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
|
|
PR ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT
|
Professional
|
Both
|
$4,367.00
|
|
|
Service Code
|
HCPCS 22600
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$2,838.55 |
| Rate for Payer: Aetna Commercial |
$1,732.46
|
| Rate for Payer: Aetna Medicare |
$2,183.50
|
| Rate for Payer: BCBS Complete |
$893.93
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$2,113.01
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Meridian Medicaid |
$893.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$851.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,020.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,020.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,468.07
|
| Rate for Payer: UHC Exchange |
$1,468.07
|
| Rate for Payer: UHCCP Medicaid |
$851.36
|
|
|
PR ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 28737
|
| Min. Negotiated Rate |
$444.53 |
| Max. Negotiated Rate |
$2,092.60 |
| Rate for Payer: Aetna Commercial |
$910.09
|
| Rate for Payer: Aetna Medicare |
$612.00
|
| Rate for Payer: BCBS Complete |
$466.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.60
|
| Rate for Payer: BCN Commercial |
$1,001.30
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Meridian Medicaid |
$466.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.50
|
| Rate for Payer: UHC Exchange |
$808.50
|
| Rate for Payer: UHCCP Medicaid |
$444.53
|
|
|
PR ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS 28760
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$1,105.87 |
| Rate for Payer: Aetna Commercial |
$754.22
|
| Rate for Payer: Aetna Medicare |
$736.00
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS Trust/PPO |
$579.02
|
| Rate for Payer: BCN Commercial |
$1,105.87
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$880.84
|
| Rate for Payer: Priority Health Narrow Network |
$880.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$680.11
|
| Rate for Payer: UHC Exchange |
$680.11
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 20605
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$80.60 |
| Rate for Payer: Aetna Commercial |
$49.91
|
| Rate for Payer: Aetna Medicare |
$62.00
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.98
|
| Rate for Payer: Priority Health Narrow Network |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.86
|
| Rate for Payer: UHC Exchange |
$47.86
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$262.93 |
| Rate for Payer: Aetna Commercial |
$71.12
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS Trust/PPO |
$262.93
|
| Rate for Payer: BCN Commercial |
$104.84
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.88
|
| Rate for Payer: Priority Health Narrow Network |
$78.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.60
|
| Rate for Payer: UHC Exchange |
$66.60
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$448.29 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$150.68
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.07
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$323.26
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Trust/PPO |
$149.94
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 20610
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$721.72 |
| Rate for Payer: Aetna Commercial |
$61.23
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$721.72
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.20
|
| Rate for Payer: Priority Health Narrow Network |
$69.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.00
|
| Rate for Payer: UHC Exchange |
$58.00
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
20610
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$721.72 |
| Rate for Payer: Aetna Commercial |
$61.23
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$721.72
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.20
|
| Rate for Payer: Priority Health Narrow Network |
$69.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.00
|
| Rate for Payer: UHC Exchange |
$58.00
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$117.41
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.57
|
| Rate for Payer: Priority Health Narrow Network |
$89.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.53
|
| Rate for Payer: UHC Exchange |
$78.53
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$194.00 |
| Rate for Payer: Aetna Commercial |
$174.60
|
| Rate for Payer: ASR ASR |
$188.18
|
| Rate for Payer: ASR Commercial |
$188.18
|
| Rate for Payer: BCBS Trust/PPO |
$158.09
|
| Rate for Payer: BCN Commercial |
$150.41
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$182.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Healthscope Commercial |
$194.00
|
| Rate for Payer: Healthscope Whirlpool |
$188.18
|
| Rate for Payer: Mclaren Commercial |
$174.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.90
|
| Rate for Payer: Nomi Health Commercial |
$159.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.72
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$117.41
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.57
|
| Rate for Payer: Priority Health Narrow Network |
$89.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.53
|
| Rate for Payer: UHC Exchange |
$78.53
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
|
