|
PR ARTHRODESIS WRIST W/SLIDING GRAFT
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 25805
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$2,298.00 |
| Rate for Payer: Aetna Commercial |
$1,037.41
|
| Rate for Payer: Aetna Medicare |
$774.19
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS MAPPO |
$774.19
|
| Rate for Payer: BCN Commercial |
$1,292.76
|
| Rate for Payer: BCN Medicare Advantage |
$774.19
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,114.83
|
| Rate for Payer: Cofinity Commercial |
$1,037.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.19
|
| Rate for Payer: Healthscope Commercial |
$929.03
|
| Rate for Payer: Healthscope Whirlpool |
$929.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.90
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$851.61
|
| Rate for Payer: Nomi Health Commercial |
$929.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,298.00
|
| Rate for Payer: PACE SWMI |
$774.19
|
| Rate for Payer: PHP Medicare Advantage |
$774.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,381.93
|
| Rate for Payer: Priority Health Medicare |
$774.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.93
|
| Rate for Payer: Railroad Medicare Medicare |
$774.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,479.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$774.19
|
| Rate for Payer: UHC Exchange |
$1,479.80
|
| Rate for Payer: UHC Medicaid |
$505.24
|
| Rate for Payer: UHCCP DNSP |
$774.19
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS G0289
|
| Min. Negotiated Rate |
$72.76 |
| Max. Negotiated Rate |
$174.75 |
| Rate for Payer: Aetna Commercial |
$97.50
|
| Rate for Payer: Aetna Medicare |
$72.76
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: BCBS MAPPO |
$72.76
|
| Rate for Payer: BCN Commercial |
$126.49
|
| Rate for Payer: BCN Medicare Advantage |
$72.76
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cofinity Commercial |
$97.50
|
| Rate for Payer: Cofinity Commercial |
$104.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.76
|
| Rate for Payer: Healthscope Commercial |
$87.31
|
| Rate for Payer: Healthscope Whirlpool |
$87.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.04
|
| Rate for Payer: Nomi Health Commercial |
$87.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.75
|
| Rate for Payer: PACE SWMI |
$72.76
|
| Rate for Payer: PHP Medicare Advantage |
$72.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$135.21
|
| Rate for Payer: Priority Health Medicare |
$72.76
|
| Rate for Payer: Priority Health Narrow Network |
$135.21
|
| Rate for Payer: Railroad Medicare Medicare |
$72.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72.76
|
| Rate for Payer: UHC Exchange |
$153.02
|
| Rate for Payer: UHCCP DNSP |
$72.76
|
|
|
PR ARTHROPLASTY ANKLE
|
Professional
|
Both
|
$2,784.00
|
|
|
Service Code
|
HCPCS 27700
|
| Min. Negotiated Rate |
$426.85 |
| Max. Negotiated Rate |
$2,088.00 |
| Rate for Payer: Aetna Commercial |
$874.91
|
| Rate for Payer: Aetna Medicare |
$652.92
|
| Rate for Payer: BCBS Complete |
$448.19
|
| Rate for Payer: BCBS MAPPO |
$652.92
|
| Rate for Payer: BCN Commercial |
$1,087.10
|
| Rate for Payer: BCN Medicare Advantage |
$652.92
|
| Rate for Payer: Cash Price |
$2,227.20
|
| Rate for Payer: Cash Price |
$2,227.20
|
| Rate for Payer: Cofinity Commercial |
$940.20
|
| Rate for Payer: Cofinity Commercial |
$874.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.92
|
| Rate for Payer: Healthscope Commercial |
$783.50
|
| Rate for Payer: Healthscope Whirlpool |
$783.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.57
|
| Rate for Payer: Meridian Medicaid |
$448.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$718.21
|
| Rate for Payer: Nomi Health Commercial |
$783.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,088.00
|
| Rate for Payer: PACE SWMI |
$652.92
|
| Rate for Payer: PHP Medicare Advantage |
$652.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,162.06
|
| Rate for Payer: Priority Health Medicare |
$652.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,162.06
|
| Rate for Payer: Railroad Medicare Medicare |
$652.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,074.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$652.92
|
| Rate for Payer: UHC Exchange |
$1,074.69
|
| Rate for Payer: UHC Medicaid |
$426.85
|
| Rate for Payer: UHCCP DNSP |
$652.92
|
| Rate for Payer: UHCCP Medicaid |
$426.85
|
|
|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$649.01 |
| Max. Negotiated Rate |
$1,958.75 |
| Rate for Payer: Aetna Commercial |
$1,339.69
|
| Rate for Payer: Aetna Medicare |
$999.77
|
| Rate for Payer: BCBS Complete |
$681.46
|
| Rate for Payer: BCBS MAPPO |
$999.77
|
| Rate for Payer: BCN Commercial |
$1,684.17
|
| Rate for Payer: BCN Medicare Advantage |
$999.77
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,439.67
|
| Rate for Payer: Cofinity Commercial |
$1,339.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$999.77
|
| Rate for Payer: Healthscope Commercial |
$1,199.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,049.76
|
| Rate for Payer: Meridian Medicaid |
$681.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,099.75
|
| Rate for Payer: Nomi Health Commercial |
$1,199.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.75
|
| Rate for Payer: PACE SWMI |
$999.77
|
| Rate for Payer: PHP Medicare Advantage |
$999.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,800.33
|
| Rate for Payer: Priority Health Medicare |
$999.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.33
|
| Rate for Payer: Railroad Medicare Medicare |
$999.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,958.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$999.77
|
| Rate for Payer: UHC Exchange |
$1,958.75
|
| Rate for Payer: UHC Medicaid |
$649.01
|
| Rate for Payer: UHCCP DNSP |
$999.77
|
| Rate for Payer: UHCCP Medicaid |
$649.01
|
|
|
PR ARTHROPLASTY ANKLE W/IMPLANT
|
Professional
|
Both
|
$2,035.00
|
|
|
Service Code
|
HCPCS 27702
|
| Min. Negotiated Rate |
$564.45 |
| Max. Negotiated Rate |
$1,690.69 |
| Rate for Payer: Aetna Commercial |
$1,163.15
|
| Rate for Payer: Aetna Medicare |
$868.02
|
| Rate for Payer: BCBS Complete |
$592.67
|
| Rate for Payer: BCBS MAPPO |
$868.02
|
| Rate for Payer: BCN Commercial |
$1,456.09
|
| Rate for Payer: BCN Medicare Advantage |
$868.02
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cofinity Commercial |
$1,249.95
|
| Rate for Payer: Cofinity Commercial |
$1,163.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.02
|
| Rate for Payer: Healthscope Commercial |
$1,041.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,041.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.42
|
| Rate for Payer: Meridian Medicaid |
$592.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$954.82
|
| Rate for Payer: Nomi Health Commercial |
$1,041.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.25
|
| Rate for Payer: PACE SWMI |
$868.02
|
| Rate for Payer: PHP Medicare Advantage |
$868.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,556.52
|
| Rate for Payer: Priority Health Medicare |
$868.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,556.52
|
| Rate for Payer: Railroad Medicare Medicare |
$868.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,690.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$868.02
|
| Rate for Payer: UHC Exchange |
$1,690.69
|
| Rate for Payer: UHC Medicaid |
$564.45
|
| Rate for Payer: UHCCP DNSP |
$868.02
|
| Rate for Payer: UHCCP Medicaid |
$564.45
|
|
|
PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE
|
Professional
|
Both
|
$1,601.00
|
|
|
Service Code
|
HCPCS 27442
|
| Min. Negotiated Rate |
$513.33 |
| Max. Negotiated Rate |
$1,526.85 |
| Rate for Payer: Aetna Commercial |
$1,056.23
|
| Rate for Payer: Aetna Medicare |
$788.23
|
| Rate for Payer: BCBS Complete |
$539.00
|
| Rate for Payer: BCBS MAPPO |
$788.23
|
| Rate for Payer: BCN Commercial |
$1,327.12
|
| Rate for Payer: BCN Medicare Advantage |
$788.23
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cofinity Commercial |
$1,135.05
|
| Rate for Payer: Cofinity Commercial |
$1,056.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.23
|
| Rate for Payer: Healthscope Commercial |
$945.88
|
| Rate for Payer: Healthscope Whirlpool |
$945.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.64
|
| Rate for Payer: Meridian Medicaid |
$539.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$867.05
|
| Rate for Payer: Nomi Health Commercial |
$945.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.75
|
| Rate for Payer: PACE SWMI |
$788.23
|
| Rate for Payer: PHP Medicare Advantage |
$788.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,418.65
|
| Rate for Payer: Priority Health Medicare |
$788.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,418.65
|
| Rate for Payer: Railroad Medicare Medicare |
$788.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,526.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$788.23
|
| Rate for Payer: UHC Exchange |
$1,526.85
|
| Rate for Payer: UHC Medicaid |
$513.33
|
| Rate for Payer: UHCCP DNSP |
$788.23
|
| Rate for Payer: UHCCP Medicaid |
$513.33
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,712.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$829.21 |
| Max. Negotiated Rate |
$3,534.00 |
| Rate for Payer: Aetna Commercial |
$1,717.00
|
| Rate for Payer: Aetna Medicare |
$1,281.34
|
| Rate for Payer: BCBS Complete |
$870.67
|
| Rate for Payer: BCBS MAPPO |
$1,281.34
|
| Rate for Payer: BCN Commercial |
$2,178.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,281.34
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,845.13
|
| Rate for Payer: Cofinity Commercial |
$1,717.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,281.34
|
| Rate for Payer: Healthscope Commercial |
$1,537.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,537.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,345.41
|
| Rate for Payer: Meridian Medicaid |
$870.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,409.47
|
| Rate for Payer: Nomi Health Commercial |
$1,537.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,534.00
|
| Rate for Payer: PACE SWMI |
$1,281.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,281.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,328.41
|
| Rate for Payer: Priority Health Medicare |
$1,281.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,328.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,281.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,552.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,281.34
|
| Rate for Payer: UHC Exchange |
$2,552.53
|
| Rate for Payer: UHC Medicaid |
$829.21
|
| Rate for Payer: UHCCP DNSP |
$1,281.34
|
| Rate for Payer: UHCCP Medicaid |
$829.21
|
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,570.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$693.74 |
| Max. Negotiated Rate |
$2,677.50 |
| Rate for Payer: Aetna Commercial |
$1,433.25
|
| Rate for Payer: Aetna Medicare |
$1,069.59
|
| Rate for Payer: BCBS Complete |
$728.43
|
| Rate for Payer: BCBS MAPPO |
$1,069.59
|
| Rate for Payer: BCN Commercial |
$1,810.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.59
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$1,540.21
|
| Rate for Payer: Cofinity Commercial |
$1,433.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.59
|
| Rate for Payer: Healthscope Commercial |
$1,283.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,283.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.07
|
| Rate for Payer: Meridian Medicaid |
$728.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,176.55
|
| Rate for Payer: Nomi Health Commercial |
$1,283.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.50
|
| Rate for Payer: PACE SWMI |
$1,069.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,935.02
|
| Rate for Payer: Priority Health Medicare |
$1,069.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,935.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,069.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,108.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,069.59
|
| Rate for Payer: UHC Exchange |
$2,108.53
|
| Rate for Payer: UHC Medicaid |
$693.74
|
| Rate for Payer: UHCCP DNSP |
$1,069.59
|
| Rate for Payer: UHCCP Medicaid |
$693.74
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,741.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$267.74 |
| Max. Negotiated Rate |
$1,305.75 |
| Rate for Payer: Aetna Commercial |
$543.84
|
| Rate for Payer: Aetna Medicare |
$405.85
|
| Rate for Payer: BCBS Complete |
$281.13
|
| Rate for Payer: BCBS MAPPO |
$405.85
|
| Rate for Payer: BCN Commercial |
$681.74
|
| Rate for Payer: BCN Medicare Advantage |
$405.85
|
| Rate for Payer: Cash Price |
$1,392.80
|
| Rate for Payer: Cash Price |
$1,392.80
|
| Rate for Payer: Cofinity Commercial |
$584.42
|
| Rate for Payer: Cofinity Commercial |
$543.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.85
|
| Rate for Payer: Healthscope Commercial |
$487.02
|
| Rate for Payer: Healthscope Whirlpool |
$487.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$426.14
|
| Rate for Payer: Meridian Medicaid |
$281.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$446.44
|
| Rate for Payer: Nomi Health Commercial |
$487.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,305.75
|
| Rate for Payer: PACE SWMI |
$405.85
|
| Rate for Payer: PHP Medicare Advantage |
$405.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$728.75
|
| Rate for Payer: Priority Health Medicare |
$405.85
|
| Rate for Payer: Priority Health Narrow Network |
$728.75
|
| Rate for Payer: Railroad Medicare Medicare |
$405.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$750.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.85
|
| Rate for Payer: UHC Exchange |
$750.76
|
| Rate for Payer: UHC Medicaid |
$267.74
|
| Rate for Payer: UHCCP DNSP |
$405.85
|
| Rate for Payer: UHCCP Medicaid |
$267.74
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,555.00
|
|
|
Service Code
|
HCPCS 26536
|
| Min. Negotiated Rate |
$466.26 |
| Max. Negotiated Rate |
$1,916.25 |
| Rate for Payer: Aetna Commercial |
$931.22
|
| Rate for Payer: Aetna Medicare |
$694.94
|
| Rate for Payer: BCBS Complete |
$489.57
|
| Rate for Payer: BCBS MAPPO |
$694.94
|
| Rate for Payer: BCN Commercial |
$1,130.42
|
| Rate for Payer: BCN Medicare Advantage |
$694.94
|
| Rate for Payer: Cash Price |
$2,044.00
|
| Rate for Payer: Cash Price |
$2,044.00
|
| Rate for Payer: Cofinity Commercial |
$1,000.71
|
| Rate for Payer: Cofinity Commercial |
$931.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.94
|
| Rate for Payer: Healthscope Commercial |
$833.93
|
| Rate for Payer: Healthscope Whirlpool |
$833.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.69
|
| Rate for Payer: Meridian Medicaid |
$489.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.43
|
| Rate for Payer: Nomi Health Commercial |
$833.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.25
|
| Rate for Payer: PACE SWMI |
$694.94
|
| Rate for Payer: PHP Medicare Advantage |
$694.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,208.39
|
| Rate for Payer: Priority Health Medicare |
$694.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,208.39
|
| Rate for Payer: Railroad Medicare Medicare |
$694.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,238.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.94
|
| Rate for Payer: UHC Exchange |
$1,238.04
|
| Rate for Payer: UHC Medicaid |
$466.26
|
| Rate for Payer: UHCCP DNSP |
$694.94
|
| Rate for Payer: UHCCP Medicaid |
$466.26
|
|
|
PR ARTHROPLASTY KNEE HINGE PROSTHESIS
|
Professional
|
Both
|
$2,716.00
|
|
|
Service Code
|
HCPCS 27445
|
| Min. Negotiated Rate |
$1,086.40 |
| Max. Negotiated Rate |
$2,037.00 |
| Rate for Payer: Aetna Commercial |
$1,677.91
|
| Rate for Payer: BCBS Complete |
$1,086.40
|
| Rate for Payer: BCN Commercial |
$1,896.81
|
| Rate for Payer: Cash Price |
$2,172.80
|
| Rate for Payer: Cash Price |
$2,172.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,037.00
|
|
|
PR ARTHROPLASTY KNEE TIBIAL PLATEAU
|
Professional
|
Both
|
$1,830.00
|
|
|
Service Code
|
HCPCS 27440
|
| Min. Negotiated Rate |
$475.63 |
| Max. Negotiated Rate |
$1,394.64 |
| Rate for Payer: Aetna Commercial |
$976.90
|
| Rate for Payer: Aetna Medicare |
$729.03
|
| Rate for Payer: BCBS Complete |
$499.41
|
| Rate for Payer: BCBS MAPPO |
$729.03
|
| Rate for Payer: BCN Commercial |
$1,217.57
|
| Rate for Payer: BCN Medicare Advantage |
$729.03
|
| Rate for Payer: Cash Price |
$1,464.00
|
| Rate for Payer: Cash Price |
$1,464.00
|
| Rate for Payer: Cofinity Commercial |
$976.90
|
| Rate for Payer: Cofinity Commercial |
$1,049.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.03
|
| Rate for Payer: Healthscope Commercial |
$874.84
|
| Rate for Payer: Healthscope Whirlpool |
$874.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.48
|
| Rate for Payer: Meridian Medicaid |
$499.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$801.93
|
| Rate for Payer: Nomi Health Commercial |
$874.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,372.50
|
| Rate for Payer: PACE SWMI |
$729.03
|
| Rate for Payer: PHP Medicare Advantage |
$729.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,301.54
|
| Rate for Payer: Priority Health Medicare |
$729.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,301.54
|
| Rate for Payer: Railroad Medicare Medicare |
$729.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,394.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$729.03
|
| Rate for Payer: UHC Exchange |
$1,394.64
|
| Rate for Payer: UHC Medicaid |
$475.63
|
| Rate for Payer: UHCCP DNSP |
$729.03
|
| Rate for Payer: UHCCP Medicaid |
$475.63
|
|
|
PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,860.00
|
|
|
Service Code
|
HCPCS 26530
|
| Min. Negotiated Rate |
$325.04 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Aetna Commercial |
$662.08
|
| Rate for Payer: Aetna Medicare |
$494.09
|
| Rate for Payer: BCBS Complete |
$341.29
|
| Rate for Payer: BCBS MAPPO |
$494.09
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: BCN Medicare Advantage |
$494.09
|
| Rate for Payer: Cash Price |
$1,488.00
|
| Rate for Payer: Cash Price |
$1,488.00
|
| Rate for Payer: Cofinity Commercial |
$711.49
|
| Rate for Payer: Cofinity Commercial |
$662.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.09
|
| Rate for Payer: Healthscope Commercial |
$592.91
|
| Rate for Payer: Healthscope Whirlpool |
$592.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.79
|
| Rate for Payer: Meridian Medicaid |
$341.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$543.50
|
| Rate for Payer: Nomi Health Commercial |
$592.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,395.00
|
| Rate for Payer: PACE SWMI |
$494.09
|
| Rate for Payer: PHP Medicare Advantage |
$494.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$894.31
|
| Rate for Payer: Priority Health Medicare |
$494.09
|
| Rate for Payer: Priority Health Narrow Network |
$894.31
|
| Rate for Payer: Railroad Medicare Medicare |
$494.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$494.09
|
| Rate for Payer: UHC Exchange |
$935.08
|
| Rate for Payer: UHC Medicaid |
$325.04
|
| Rate for Payer: UHCCP DNSP |
$494.09
|
| Rate for Payer: UHCCP Medicaid |
$325.04
|
|
|
PR ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$1,211.00
|
|
|
Service Code
|
HCPCS 27437
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$1,149.71 |
| Rate for Payer: Aetna Commercial |
$816.26
|
| Rate for Payer: Aetna Medicare |
$609.15
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$609.15
|
| Rate for Payer: BCN Commercial |
$1,011.89
|
| Rate for Payer: BCN Medicare Advantage |
$609.15
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Cofinity Commercial |
$877.18
|
| Rate for Payer: Cofinity Commercial |
$816.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.15
|
| Rate for Payer: Healthscope Commercial |
$730.98
|
| Rate for Payer: Healthscope Whirlpool |
$730.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$639.61
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$670.07
|
| Rate for Payer: Nomi Health Commercial |
$730.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$908.25
|
| Rate for Payer: PACE SWMI |
$609.15
|
| Rate for Payer: PHP Medicare Advantage |
$609.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,081.69
|
| Rate for Payer: Priority Health Medicare |
$609.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.69
|
| Rate for Payer: Railroad Medicare Medicare |
$609.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,149.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$609.15
|
| Rate for Payer: UHC Exchange |
$1,149.71
|
| Rate for Payer: UHC Medicaid |
$398.52
|
| Rate for Payer: UHCCP DNSP |
$609.15
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$498.63 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,025.23
|
| Rate for Payer: Aetna Medicare |
$765.10
|
| Rate for Payer: BCBS Complete |
$523.56
|
| Rate for Payer: BCBS MAPPO |
$765.10
|
| Rate for Payer: BCN Commercial |
$1,281.31
|
| Rate for Payer: BCN Medicare Advantage |
$765.10
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cofinity Commercial |
$1,101.74
|
| Rate for Payer: Cofinity Commercial |
$1,025.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.10
|
| Rate for Payer: Healthscope Commercial |
$918.12
|
| Rate for Payer: Healthscope Whirlpool |
$918.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.36
|
| Rate for Payer: Meridian Medicaid |
$523.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$841.61
|
| Rate for Payer: Nomi Health Commercial |
$918.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,803.75
|
| Rate for Payer: PACE SWMI |
$765.10
|
| Rate for Payer: PHP Medicare Advantage |
$765.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,369.69
|
| Rate for Payer: Priority Health Medicare |
$765.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,369.69
|
| Rate for Payer: Railroad Medicare Medicare |
$765.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,472.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$765.10
|
| Rate for Payer: UHC Exchange |
$1,472.61
|
| Rate for Payer: UHC Medicaid |
$498.63
|
| Rate for Payer: UHCCP DNSP |
$765.10
|
| Rate for Payer: UHCCP Medicaid |
$498.63
|
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,718.00
|
|
|
Service Code
|
HCPCS 24365
|
| Min. Negotiated Rate |
$386.17 |
| Max. Negotiated Rate |
$1,288.50 |
| Rate for Payer: Aetna Commercial |
$790.77
|
| Rate for Payer: Aetna Medicare |
$590.13
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS MAPPO |
$590.13
|
| Rate for Payer: BCN Commercial |
$983.01
|
| Rate for Payer: BCN Medicare Advantage |
$590.13
|
| Rate for Payer: Cash Price |
$1,374.40
|
| Rate for Payer: Cash Price |
$1,374.40
|
| Rate for Payer: Cofinity Commercial |
$849.79
|
| Rate for Payer: Cofinity Commercial |
$790.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.13
|
| Rate for Payer: Healthscope Commercial |
$708.16
|
| Rate for Payer: Healthscope Whirlpool |
$708.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.64
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$649.14
|
| Rate for Payer: Nomi Health Commercial |
$708.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,288.50
|
| Rate for Payer: PACE SWMI |
$590.13
|
| Rate for Payer: PHP Medicare Advantage |
$590.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,050.82
|
| Rate for Payer: Priority Health Medicare |
$590.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,050.82
|
| Rate for Payer: Railroad Medicare Medicare |
$590.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$590.13
|
| Rate for Payer: UHC Exchange |
$1,115.60
|
| Rate for Payer: UHC Medicaid |
$386.17
|
| Rate for Payer: UHCCP DNSP |
$590.13
|
| Rate for Payer: UHCCP Medicaid |
$386.17
|
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$1,941.75 |
| Rate for Payer: Aetna Commercial |
$830.65
|
| Rate for Payer: Aetna Medicare |
$619.89
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS MAPPO |
$619.89
|
| Rate for Payer: BCN Commercial |
$1,042.77
|
| Rate for Payer: BCN Medicare Advantage |
$619.89
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$892.64
|
| Rate for Payer: Cofinity Commercial |
$830.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.89
|
| Rate for Payer: Healthscope Commercial |
$743.87
|
| Rate for Payer: Healthscope Whirlpool |
$743.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.88
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$681.88
|
| Rate for Payer: Nomi Health Commercial |
$743.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,941.75
|
| Rate for Payer: PACE SWMI |
$619.89
|
| Rate for Payer: PHP Medicare Advantage |
$619.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,114.70
|
| Rate for Payer: Priority Health Medicare |
$619.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,114.70
|
| Rate for Payer: Railroad Medicare Medicare |
$619.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,191.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$619.89
|
| Rate for Payer: UHC Exchange |
$1,191.95
|
| Rate for Payer: UHC Medicaid |
$405.13
|
| Rate for Payer: UHCCP DNSP |
$619.89
|
| Rate for Payer: UHCCP Medicaid |
$405.13
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,258.61 |
| Rate for Payer: Aetna Commercial |
$867.84
|
| Rate for Payer: Aetna Medicare |
$647.64
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCBS MAPPO |
$647.64
|
| Rate for Payer: BCN Commercial |
$1,103.52
|
| Rate for Payer: BCN Medicare Advantage |
$647.64
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$932.60
|
| Rate for Payer: Cofinity Commercial |
$867.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.64
|
| Rate for Payer: Healthscope Commercial |
$777.17
|
| Rate for Payer: Healthscope Whirlpool |
$777.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.02
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.40
|
| Rate for Payer: Nomi Health Commercial |
$777.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$992.25
|
| Rate for Payer: PACE SWMI |
$647.64
|
| Rate for Payer: PHP Medicare Advantage |
$647.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,179.64
|
| Rate for Payer: Priority Health Medicare |
$647.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,179.64
|
| Rate for Payer: Railroad Medicare Medicare |
$647.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,258.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$647.64
|
| Rate for Payer: UHC Exchange |
$1,258.61
|
| Rate for Payer: UHC Medicaid |
$423.44
|
| Rate for Payer: UHCCP DNSP |
$647.64
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,950.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$554.23 |
| Max. Negotiated Rate |
$1,640.16 |
| Rate for Payer: Aetna Commercial |
$1,140.31
|
| Rate for Payer: Aetna Medicare |
$850.98
|
| Rate for Payer: BCBS Complete |
$581.94
|
| Rate for Payer: BCBS MAPPO |
$850.98
|
| Rate for Payer: BCN Commercial |
$1,428.21
|
| Rate for Payer: BCN Medicare Advantage |
$850.98
|
| Rate for Payer: Cash Price |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,560.00
|
| Rate for Payer: Cofinity Commercial |
$1,225.41
|
| Rate for Payer: Cofinity Commercial |
$1,140.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$850.98
|
| Rate for Payer: Healthscope Commercial |
$1,021.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,021.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$893.53
|
| Rate for Payer: Meridian Medicaid |
$581.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$936.08
|
| Rate for Payer: Nomi Health Commercial |
$1,021.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,462.50
|
| Rate for Payer: PACE SWMI |
$850.98
|
| Rate for Payer: PHP Medicare Advantage |
$850.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,526.72
|
| Rate for Payer: Priority Health Medicare |
$850.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,526.72
|
| Rate for Payer: Railroad Medicare Medicare |
$850.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,640.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$850.98
|
| Rate for Payer: UHC Exchange |
$1,640.16
|
| Rate for Payer: UHC Medicaid |
$554.23
|
| Rate for Payer: UHCCP DNSP |
$850.98
|
| Rate for Payer: UHCCP Medicaid |
$554.23
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$472.22 |
| Max. Negotiated Rate |
$1,407.38 |
| Rate for Payer: Aetna Commercial |
$967.96
|
| Rate for Payer: Aetna Medicare |
$722.36
|
| Rate for Payer: BCBS Complete |
$495.83
|
| Rate for Payer: BCBS MAPPO |
$722.36
|
| Rate for Payer: BCN Commercial |
$1,237.98
|
| Rate for Payer: BCN Medicare Advantage |
$722.36
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Cofinity Commercial |
$1,040.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.36
|
| Rate for Payer: Healthscope Commercial |
$866.83
|
| Rate for Payer: Healthscope Whirlpool |
$866.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.48
|
| Rate for Payer: Meridian Medicaid |
$495.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$794.60
|
| Rate for Payer: Nomi Health Commercial |
$866.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,257.75
|
| Rate for Payer: PACE SWMI |
$722.36
|
| Rate for Payer: PHP Medicare Advantage |
$722.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,323.36
|
| Rate for Payer: Priority Health Medicare |
$722.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.36
|
| Rate for Payer: Railroad Medicare Medicare |
$722.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$722.36
|
| Rate for Payer: UHC Exchange |
$1,407.38
|
| Rate for Payer: UHC Medicaid |
$472.22
|
| Rate for Payer: UHCCP DNSP |
$722.36
|
| Rate for Payer: UHCCP Medicaid |
$472.22
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$1,367.21 |
| Rate for Payer: Aetna Commercial |
$963.98
|
| Rate for Payer: Aetna Medicare |
$719.39
|
| Rate for Payer: BCBS Complete |
$493.81
|
| Rate for Payer: BCBS MAPPO |
$719.39
|
| Rate for Payer: BCN Commercial |
$1,200.14
|
| Rate for Payer: BCN Medicare Advantage |
$719.39
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$963.98
|
| Rate for Payer: Cofinity Commercial |
$1,035.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.39
|
| Rate for Payer: Healthscope Commercial |
$863.27
|
| Rate for Payer: Healthscope Whirlpool |
$863.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.36
|
| Rate for Payer: Meridian Medicaid |
$493.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.33
|
| Rate for Payer: Nomi Health Commercial |
$863.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.75
|
| Rate for Payer: PACE SWMI |
$719.39
|
| Rate for Payer: PHP Medicare Advantage |
$719.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,282.91
|
| Rate for Payer: Priority Health Medicare |
$719.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,282.91
|
| Rate for Payer: Railroad Medicare Medicare |
$719.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,367.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.39
|
| Rate for Payer: UHC Exchange |
$1,367.21
|
| Rate for Payer: UHC Medicaid |
$470.30
|
| Rate for Payer: UHCCP DNSP |
$719.39
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,209.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$549.54 |
| Max. Negotiated Rate |
$2,406.75 |
| Rate for Payer: Aetna Commercial |
$1,131.20
|
| Rate for Payer: Aetna Medicare |
$844.18
|
| Rate for Payer: BCBS Complete |
$577.02
|
| Rate for Payer: BCBS MAPPO |
$844.18
|
| Rate for Payer: BCN Commercial |
$1,414.77
|
| Rate for Payer: BCN Medicare Advantage |
$844.18
|
| Rate for Payer: Cash Price |
$2,567.20
|
| Rate for Payer: Cash Price |
$2,567.20
|
| Rate for Payer: Cofinity Commercial |
$1,215.62
|
| Rate for Payer: Cofinity Commercial |
$1,131.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$844.18
|
| Rate for Payer: Healthscope Commercial |
$1,013.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,013.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$886.39
|
| Rate for Payer: Meridian Medicaid |
$577.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$928.60
|
| Rate for Payer: Nomi Health Commercial |
$1,013.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,406.75
|
| Rate for Payer: PACE SWMI |
$844.18
|
| Rate for Payer: PHP Medicare Advantage |
$844.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,512.34
|
| Rate for Payer: Priority Health Medicare |
$844.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,512.34
|
| Rate for Payer: Railroad Medicare Medicare |
$844.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,628.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$844.18
|
| Rate for Payer: UHC Exchange |
$1,628.50
|
| Rate for Payer: UHC Medicaid |
$549.54
|
| Rate for Payer: UHCCP DNSP |
$844.18
|
| Rate for Payer: UHCCP Medicaid |
$549.54
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,268.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$378.50 |
| Max. Negotiated Rate |
$1,085.90 |
| Rate for Payer: Aetna Commercial |
$774.05
|
| Rate for Payer: Aetna Medicare |
$577.65
|
| Rate for Payer: BCBS Complete |
$397.43
|
| Rate for Payer: BCBS MAPPO |
$577.65
|
| Rate for Payer: BCN Commercial |
$957.12
|
| Rate for Payer: BCN Medicare Advantage |
$577.65
|
| Rate for Payer: Cash Price |
$1,014.40
|
| Rate for Payer: Cash Price |
$1,014.40
|
| Rate for Payer: Cofinity Commercial |
$831.82
|
| Rate for Payer: Cofinity Commercial |
$774.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.65
|
| Rate for Payer: Healthscope Commercial |
$693.18
|
| Rate for Payer: Healthscope Whirlpool |
$693.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.53
|
| Rate for Payer: Meridian Medicaid |
$397.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.41
|
| Rate for Payer: Nomi Health Commercial |
$693.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$951.00
|
| Rate for Payer: PACE SWMI |
$577.65
|
| Rate for Payer: PHP Medicare Advantage |
$577.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,023.13
|
| Rate for Payer: Priority Health Medicare |
$577.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.13
|
| Rate for Payer: Railroad Medicare Medicare |
$577.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,085.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.65
|
| Rate for Payer: UHC Exchange |
$1,085.90
|
| Rate for Payer: UHC Medicaid |
$378.50
|
| Rate for Payer: UHCCP DNSP |
$577.65
|
| Rate for Payer: UHCCP Medicaid |
$378.50
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,267.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$333.98 |
| Max. Negotiated Rate |
$1,700.25 |
| Rate for Payer: Aetna Commercial |
$685.16
|
| Rate for Payer: Aetna Medicare |
$511.31
|
| Rate for Payer: BCBS Complete |
$350.68
|
| Rate for Payer: BCBS MAPPO |
$511.31
|
| Rate for Payer: BCN Commercial |
$934.94
|
| Rate for Payer: BCN Medicare Advantage |
$511.31
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cofinity Commercial |
$736.29
|
| Rate for Payer: Cofinity Commercial |
$685.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.31
|
| Rate for Payer: Healthscope Commercial |
$613.57
|
| Rate for Payer: Healthscope Whirlpool |
$613.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.88
|
| Rate for Payer: Meridian Medicaid |
$350.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$562.44
|
| Rate for Payer: Nomi Health Commercial |
$613.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,700.25
|
| Rate for Payer: PACE SWMI |
$511.31
|
| Rate for Payer: PHP Medicare Advantage |
$511.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$909.75
|
| Rate for Payer: Priority Health Medicare |
$511.31
|
| Rate for Payer: Priority Health Narrow Network |
$909.75
|
| Rate for Payer: Railroad Medicare Medicare |
$511.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$511.31
|
| Rate for Payer: UHC Exchange |
$984.98
|
| Rate for Payer: UHC Medicaid |
$333.98
|
| Rate for Payer: UHCCP DNSP |
$511.31
|
| Rate for Payer: UHCCP Medicaid |
$333.98
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$296.50 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$607.84
|
| Rate for Payer: Aetna Medicare |
$453.61
|
| Rate for Payer: BCBS Complete |
$311.32
|
| Rate for Payer: BCBS MAPPO |
$453.61
|
| Rate for Payer: BCN Commercial |
$749.46
|
| Rate for Payer: BCN Medicare Advantage |
$453.61
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$653.20
|
| Rate for Payer: Cofinity Commercial |
$607.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.61
|
| Rate for Payer: Healthscope Commercial |
$544.33
|
| Rate for Payer: Healthscope Whirlpool |
$544.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.29
|
| Rate for Payer: Meridian Medicaid |
$311.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$498.97
|
| Rate for Payer: Nomi Health Commercial |
$544.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PACE SWMI |
$453.61
|
| Rate for Payer: PHP Medicare Advantage |
$453.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$801.15
|
| Rate for Payer: Priority Health Medicare |
$453.61
|
| Rate for Payer: Priority Health Narrow Network |
$801.15
|
| Rate for Payer: Railroad Medicare Medicare |
$453.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$873.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$453.61
|
| Rate for Payer: UHC Exchange |
$873.01
|
| Rate for Payer: UHC Medicaid |
$296.50
|
| Rate for Payer: UHCCP DNSP |
$453.61
|
| Rate for Payer: UHCCP Medicaid |
$296.50
|
|
