|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$85.90 |
| Max. Negotiated Rate |
$561.05 |
| Rate for Payer: Aetna Commercial |
$85.90
|
| Rate for Payer: Aetna Medicare |
$113.00
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: BCBS Trust/PPO |
$561.05
|
| Rate for Payer: BCN Commercial |
$123.64
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.25
|
| Rate for Payer: Priority Health Narrow Network |
$129.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.92
|
| Rate for Payer: UHC Exchange |
$104.92
|
|
|
PR ARTHROPLASTY ANKLE
|
Professional
|
Both
|
$2,703.00
|
|
|
Service Code
|
HCPCS 27700
|
| Min. Negotiated Rate |
$464.98 |
| Max. Negotiated Rate |
$1,756.95 |
| Rate for Payer: Aetna Commercial |
$810.77
|
| Rate for Payer: Aetna Medicare |
$1,351.50
|
| Rate for Payer: BCBS Complete |
$488.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Meridian Medicaid |
$488.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,101.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.27
|
| Rate for Payer: UHC Exchange |
$706.27
|
| Rate for Payer: UHCCP Medicaid |
$464.98
|
|
|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$720.37 |
| Max. Negotiated Rate |
$2,923.61 |
| Rate for Payer: Aetna Commercial |
$1,490.55
|
| Rate for Payer: Aetna Medicare |
$1,022.00
|
| Rate for Payer: BCBS Complete |
$756.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.61
|
| Rate for Payer: BCN Commercial |
$1,625.83
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Meridian Medicaid |
$756.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,703.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,329.06
|
| Rate for Payer: UHC Exchange |
$1,329.06
|
| Rate for Payer: UHCCP Medicaid |
$720.37
|
|
|
PR ARTHROPLASTY ANKLE W/IMPLANT
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 27702
|
| Min. Negotiated Rate |
$622.81 |
| Max. Negotiated Rate |
$2,899.77 |
| Rate for Payer: Aetna Commercial |
$1,287.42
|
| Rate for Payer: Aetna Medicare |
$988.00
|
| Rate for Payer: BCBS Complete |
$653.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.77
|
| Rate for Payer: BCN Commercial |
$1,407.39
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Meridian Medicaid |
$653.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,477.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,477.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.11
|
| Rate for Payer: UHC Exchange |
$1,143.11
|
| Rate for Payer: UHCCP Medicaid |
$622.81
|
|
|
PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE
|
Professional
|
Both
|
$1,554.00
|
|
|
Service Code
|
HCPCS 27442
|
| Min. Negotiated Rate |
$567.65 |
| Max. Negotiated Rate |
$1,339.33 |
| Rate for Payer: Aetna Commercial |
$1,163.41
|
| Rate for Payer: Aetna Medicare |
$777.00
|
| Rate for Payer: BCBS Complete |
$596.03
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$1,280.82
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Meridian Medicaid |
$596.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,339.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,339.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$998.28
|
| Rate for Payer: UHC Exchange |
$998.28
|
| Rate for Payer: UHCCP Medicaid |
$567.65
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$197.82 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,937.50
|
| Rate for Payer: Aetna Medicare |
$2,287.50
|
| Rate for Payer: BCBS Complete |
$978.24
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| Rate for Payer: BCN Commercial |
$2,110.60
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Meridian Medicaid |
$978.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,209.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,209.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,745.35
|
| Rate for Payer: UHC Exchange |
$1,745.35
|
| Rate for Payer: UHCCP Medicaid |
$931.66
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
OP
|
$4,575.00
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$2,973.75 |
| Max. Negotiated Rate |
$27,928.21 |
| Rate for Payer: Aetna Commercial |
$4,117.50
|
| Rate for Payer: Aetna Medicare |
$18,018.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: ASR ASR |
$4,437.75
|
| Rate for Payer: ASR Commercial |
$4,437.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,746.47
|
| Rate for Payer: BCN Commercial |
$3,547.00
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$4,300.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,660.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Healthscope Commercial |
$4,575.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,437.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,018.20
|
| Rate for Payer: Mclaren Commercial |
$4,117.50
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,888.75
|
| Rate for Payer: Nomi Health Commercial |
$3,751.50
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Commercial |
$19,820.02
|
| Rate for Payer: PHP Medicaid |
$9,657.76
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,008.62
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$3,207.08
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,026.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$27,928.21
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP DNSP |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
IP
|
$4,575.00
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$2,973.75 |
| Max. Negotiated Rate |
$4,575.00 |
| Rate for Payer: Aetna Commercial |
$4,117.50
|
| Rate for Payer: ASR ASR |
$4,437.75
|
| Rate for Payer: ASR Commercial |
$4,437.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,728.17
|
| Rate for Payer: BCN Commercial |
$3,547.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$4,300.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,660.00
|
| Rate for Payer: Healthscope Commercial |
$4,575.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,437.75
|
| Rate for Payer: Mclaren Commercial |
$4,117.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,888.75
|
| Rate for Payer: Nomi Health Commercial |
$3,751.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,026.00
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$197.82 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,937.50
|
| Rate for Payer: Aetna Medicare |
$2,287.50
|
| Rate for Payer: BCBS Complete |
$978.24
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| Rate for Payer: BCN Commercial |
$2,110.60
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Meridian Medicaid |
$978.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,209.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,209.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,745.35
|
| Rate for Payer: UHC Exchange |
$1,745.35
|
| Rate for Payer: UHCCP Medicaid |
$931.66
|
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,466.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$171.92 |
| Max. Negotiated Rate |
$2,252.90 |
| Rate for Payer: Aetna Commercial |
$1,604.69
|
| Rate for Payer: Aetna Medicare |
$1,733.00
|
| Rate for Payer: BCBS Complete |
$812.97
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: BCN Commercial |
$1,751.91
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Meridian Medicaid |
$812.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,836.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,836.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,405.58
|
| Rate for Payer: UHC Exchange |
$1,405.58
|
| Rate for Payer: UHCCP Medicaid |
$774.26
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$291.60 |
| Max. Negotiated Rate |
$1,098.50 |
| Rate for Payer: Aetna Commercial |
$580.99
|
| Rate for Payer: Aetna Medicare |
$845.00
|
| Rate for Payer: BCBS Complete |
$306.18
|
| Rate for Payer: BCBS Trust/PPO |
$943.54
|
| Rate for Payer: BCN Commercial |
$649.94
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Meridian Medicaid |
$306.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.93
|
| Rate for Payer: Priority Health Narrow Network |
$684.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.05
|
| Rate for Payer: UHC Exchange |
$455.05
|
| Rate for Payer: UHCCP Medicaid |
$291.60
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,481.00
|
|
|
Service Code
|
HCPCS 26536
|
| Min. Negotiated Rate |
$331.24 |
| Max. Negotiated Rate |
$1,612.65 |
| Rate for Payer: Aetna Commercial |
$992.54
|
| Rate for Payer: Aetna Medicare |
$1,240.50
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS Trust/PPO |
$331.24
|
| Rate for Payer: BCN Commercial |
$1,115.65
|
| Rate for Payer: Cash Price |
$1,984.80
|
| Rate for Payer: Cash Price |
$1,984.80
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,159.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$748.88
|
| Rate for Payer: UHC Exchange |
$748.88
|
| Rate for Payer: UHCCP Medicaid |
$483.51
|
|
|
PR ARTHROPLASTY KNEE TIBIAL PLATEAU
|
Professional
|
Both
|
$1,777.00
|
|
|
Service Code
|
HCPCS 27440
|
| Min. Negotiated Rate |
$520.79 |
| Max. Negotiated Rate |
$1,732.82 |
| Rate for Payer: Aetna Commercial |
$1,065.93
|
| Rate for Payer: Aetna Medicare |
$888.50
|
| Rate for Payer: BCBS Complete |
$546.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: BCN Commercial |
$1,174.29
|
| Rate for Payer: Cash Price |
$1,421.60
|
| Rate for Payer: Cash Price |
$1,421.60
|
| Rate for Payer: Meridian Medicaid |
$546.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,232.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,232.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$889.60
|
| Rate for Payer: UHC Exchange |
$889.60
|
| Rate for Payer: UHCCP Medicaid |
$520.79
|
|
|
PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,806.00
|
|
|
Service Code
|
HCPCS 26530
|
| Min. Negotiated Rate |
$357.84 |
| Max. Negotiated Rate |
$1,277.96 |
| Rate for Payer: Aetna Commercial |
$718.60
|
| Rate for Payer: Aetna Medicare |
$903.00
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.96
|
| Rate for Payer: BCN Commercial |
$799.48
|
| Rate for Payer: Cash Price |
$1,444.80
|
| Rate for Payer: Cash Price |
$1,444.80
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.22
|
| Rate for Payer: Priority Health Narrow Network |
$845.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$601.67
|
| Rate for Payer: UHC Exchange |
$601.67
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
|
|
PR ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 27437
|
| Min. Negotiated Rate |
$432.82 |
| Max. Negotiated Rate |
$1,630.86 |
| Rate for Payer: Aetna Commercial |
$882.46
|
| Rate for Payer: Aetna Medicare |
$588.00
|
| Rate for Payer: BCBS Complete |
$454.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,630.86
|
| Rate for Payer: BCN Commercial |
$975.40
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Meridian Medicaid |
$454.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.56
|
| Rate for Payer: UHC Exchange |
$751.56
|
| Rate for Payer: UHCCP Medicaid |
$432.82
|
|
|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$548.05 |
| Max. Negotiated Rate |
$1,651.99 |
| Rate for Payer: Aetna Commercial |
$1,122.35
|
| Rate for Payer: Aetna Medicare |
$1,167.50
|
| Rate for Payer: BCBS Complete |
$575.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.99
|
| Rate for Payer: BCN Commercial |
$1,235.37
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Meridian Medicaid |
$575.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,297.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,297.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.75
|
| Rate for Payer: UHC Exchange |
$964.75
|
| Rate for Payer: UHCCP Medicaid |
$548.05
|
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 24365
|
| Min. Negotiated Rate |
$258.95 |
| Max. Negotiated Rate |
$1,084.20 |
| Rate for Payer: Aetna Commercial |
$857.03
|
| Rate for Payer: Aetna Medicare |
$834.00
|
| Rate for Payer: BCBS Complete |
$441.48
|
| Rate for Payer: BCBS Trust/PPO |
$258.95
|
| Rate for Payer: BCN Commercial |
$946.57
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Meridian Medicaid |
$441.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,084.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$994.82
|
| Rate for Payer: Priority Health Narrow Network |
$994.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$727.31
|
| Rate for Payer: UHC Exchange |
$727.31
|
| Rate for Payer: UHCCP Medicaid |
$420.46
|
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$1,634.10 |
| Rate for Payer: Aetna Commercial |
$909.61
|
| Rate for Payer: Aetna Medicare |
$1,257.00
|
| Rate for Payer: BCBS Complete |
$468.32
|
| Rate for Payer: BCBS Trust/PPO |
$304.79
|
| Rate for Payer: BCN Commercial |
$1,003.26
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Meridian Medicaid |
$468.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.82
|
| Rate for Payer: UHC Exchange |
$777.82
|
| Rate for Payer: UHCCP Medicaid |
$446.02
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$472.01 |
| Max. Negotiated Rate |
$1,115.92 |
| Rate for Payer: Aetna Commercial |
$960.91
|
| Rate for Payer: Aetna Medicare |
$642.00
|
| Rate for Payer: BCBS Complete |
$495.61
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: BCN Commercial |
$1,063.85
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Meridian Medicaid |
$495.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.60
|
| 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 |
$820.51
|
| Rate for Payer: UHC Exchange |
$820.51
|
| Rate for Payer: UHCCP Medicaid |
$472.01
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$610.88 |
| Max. Negotiated Rate |
$1,446.69 |
| Rate for Payer: Aetna Commercial |
$1,253.73
|
| Rate for Payer: Aetna Medicare |
$946.50
|
| Rate for Payer: BCBS Complete |
$641.42
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,379.54
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Meridian Medicaid |
$641.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,446.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,446.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,054.24
|
| Rate for Payer: UHC Exchange |
$1,054.24
|
| Rate for Payer: UHCCP Medicaid |
$610.88
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$529.52 |
| Max. Negotiated Rate |
$1,250.78 |
| Rate for Payer: Aetna Commercial |
$1,076.84
|
| Rate for Payer: Aetna Medicare |
$814.00
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS Trust/PPO |
$863.24
|
| Rate for Payer: BCN Commercial |
$1,192.37
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,250.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,250.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$901.44
|
| Rate for Payer: UHC Exchange |
$901.44
|
| Rate for Payer: UHCCP Medicaid |
$529.52
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,597.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$513.33 |
| Max. Negotiated Rate |
$1,216.68 |
| Rate for Payer: Aetna Commercial |
$1,047.50
|
| Rate for Payer: Aetna Medicare |
$798.50
|
| Rate for Payer: BCBS Complete |
$539.00
|
| Rate for Payer: BCBS Trust/PPO |
$628.15
|
| Rate for Payer: BCN Commercial |
$1,157.67
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Meridian Medicaid |
$539.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$892.39
|
| Rate for Payer: UHC Exchange |
$892.39
|
| Rate for Payer: UHCCP Medicaid |
$513.33
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$605.13 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,241.59
|
| Rate for Payer: Aetna Medicare |
$1,558.00
|
| Rate for Payer: BCBS Complete |
$635.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,262.11
|
| Rate for Payer: BCN Commercial |
$1,363.90
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Meridian Medicaid |
$635.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,431.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,073.32
|
| Rate for Payer: UHC Exchange |
$1,073.32
|
| Rate for Payer: UHCCP Medicaid |
$605.13
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$409.39 |
| Max. Negotiated Rate |
$968.36 |
| Rate for Payer: Aetna Commercial |
$830.82
|
| Rate for Payer: Aetna Medicare |
$615.50
|
| Rate for Payer: BCBS Complete |
$429.86
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: BCN Commercial |
$920.18
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Meridian Medicaid |
$429.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.36
|
| Rate for Payer: Priority Health Narrow Network |
$968.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.69
|
| Rate for Payer: UHC Exchange |
$670.69
|
| Rate for Payer: UHCCP Medicaid |
$409.39
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$1,477.13 |
| Rate for Payer: Aetna Commercial |
$747.21
|
| Rate for Payer: Aetna Medicare |
$1,100.50
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.13
|
| Rate for Payer: BCN Commercial |
$905.58
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$863.03
|
| Rate for Payer: Priority Health Narrow Network |
$863.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$665.52
|
| Rate for Payer: UHC Exchange |
$665.52
|
| Rate for Payer: UHCCP Medicaid |
$364.02
|
|
