|
PR ARTHRS KNEE SURG DRLG OSTEO DISS LES W/INT FIXJ
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 29887
|
| Min. Negotiated Rate |
$453.05 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$928.15
|
| Rate for Payer: Aetna Medicare |
$692.65
|
| Rate for Payer: BCBS Complete |
$475.70
|
| Rate for Payer: BCBS MAPPO |
$692.65
|
| Rate for Payer: BCN Commercial |
$1,151.83
|
| Rate for Payer: BCN Medicare Advantage |
$692.65
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$997.42
|
| Rate for Payer: Cofinity Commercial |
$928.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.65
|
| Rate for Payer: Healthscope Commercial |
$831.18
|
| Rate for Payer: Healthscope Whirlpool |
$831.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$727.28
|
| Rate for Payer: Meridian Medicaid |
$475.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$761.91
|
| Rate for Payer: Nomi Health Commercial |
$831.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
| Rate for Payer: PACE SWMI |
$692.65
|
| Rate for Payer: PHP Medicare Advantage |
$692.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,231.27
|
| Rate for Payer: Priority Health Medicare |
$692.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.27
|
| Rate for Payer: Railroad Medicare Medicare |
$692.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,309.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$692.65
|
| Rate for Payer: UHC Exchange |
$1,309.91
|
| Rate for Payer: UHC Medicaid |
$453.05
|
| Rate for Payer: UHCCP DNSP |
$692.65
|
| Rate for Payer: UHCCP Medicaid |
$453.05
|
|
|
PR ARTHRS KNEE SURG MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,667.00
|
|
|
Service Code
|
HCPCS 29880
|
| Min. Negotiated Rate |
$339.95 |
| Max. Negotiated Rate |
$2,000.25 |
| Rate for Payer: Aetna Commercial |
$694.47
|
| Rate for Payer: Aetna Medicare |
$518.26
|
| Rate for Payer: BCBS Complete |
$356.95
|
| Rate for Payer: BCBS MAPPO |
$518.26
|
| Rate for Payer: BCN Commercial |
$944.24
|
| Rate for Payer: BCN Medicare Advantage |
$518.26
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Cofinity Commercial |
$746.29
|
| Rate for Payer: Cofinity Commercial |
$694.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.26
|
| Rate for Payer: Healthscope Commercial |
$621.91
|
| Rate for Payer: Healthscope Whirlpool |
$621.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.17
|
| Rate for Payer: Meridian Medicaid |
$356.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$570.09
|
| Rate for Payer: Nomi Health Commercial |
$621.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,000.25
|
| Rate for Payer: PACE SWMI |
$518.26
|
| Rate for Payer: PHP Medicare Advantage |
$518.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$918.80
|
| Rate for Payer: Priority Health Medicare |
$518.26
|
| Rate for Payer: Priority Health Narrow Network |
$918.80
|
| Rate for Payer: Railroad Medicare Medicare |
$518.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$977.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$518.26
|
| Rate for Payer: UHC Exchange |
$977.18
|
| Rate for Payer: UHC Medicaid |
$339.95
|
| Rate for Payer: UHCCP DNSP |
$518.26
|
| Rate for Payer: UHCCP Medicaid |
$339.95
|
|
|
PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,467.00
|
|
|
Service Code
|
HCPCS 29881
|
| Min. Negotiated Rate |
$328.87 |
| Max. Negotiated Rate |
$1,850.25 |
| Rate for Payer: Aetna Commercial |
$671.14
|
| Rate for Payer: Aetna Medicare |
$500.85
|
| Rate for Payer: BCBS Complete |
$345.31
|
| Rate for Payer: BCBS MAPPO |
$500.85
|
| Rate for Payer: BCN Commercial |
$910.33
|
| Rate for Payer: BCN Medicare Advantage |
$500.85
|
| Rate for Payer: Cash Price |
$1,973.60
|
| Rate for Payer: Cash Price |
$1,973.60
|
| Rate for Payer: Cofinity Commercial |
$721.22
|
| Rate for Payer: Cofinity Commercial |
$671.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.85
|
| Rate for Payer: Healthscope Commercial |
$601.02
|
| Rate for Payer: Healthscope Whirlpool |
$601.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.89
|
| Rate for Payer: Meridian Medicaid |
$345.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$550.93
|
| Rate for Payer: Nomi Health Commercial |
$601.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,850.25
|
| Rate for Payer: PACE SWMI |
$500.85
|
| Rate for Payer: PHP Medicare Advantage |
$500.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$885.80
|
| Rate for Payer: Priority Health Medicare |
$500.85
|
| Rate for Payer: Priority Health Narrow Network |
$885.80
|
| Rate for Payer: Railroad Medicare Medicare |
$500.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$941.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$500.85
|
| Rate for Payer: UHC Exchange |
$941.04
|
| Rate for Payer: UHC Medicaid |
$328.87
|
| Rate for Payer: UHCCP DNSP |
$500.85
|
| Rate for Payer: UHCCP Medicaid |
$328.87
|
|
|
PR ARTHRS KNE SURG ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 29879
|
| Min. Negotiated Rate |
$397.46 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$814.25
|
| Rate for Payer: Aetna Medicare |
$607.65
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$607.65
|
| Rate for Payer: BCN Commercial |
$1,110.55
|
| Rate for Payer: BCN Medicare Advantage |
$607.65
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$875.02
|
| Rate for Payer: Cofinity Commercial |
$814.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.65
|
| Rate for Payer: Healthscope Commercial |
$729.18
|
| Rate for Payer: Healthscope Whirlpool |
$729.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$638.03
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$668.41
|
| Rate for Payer: Nomi Health Commercial |
$729.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
| Rate for Payer: PACE SWMI |
$607.65
|
| Rate for Payer: PHP Medicare Advantage |
$607.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,080.62
|
| Rate for Payer: Priority Health Medicare |
$607.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,080.62
|
| Rate for Payer: Railroad Medicare Medicare |
$607.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,154.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$607.65
|
| Rate for Payer: UHC Exchange |
$1,154.04
|
| Rate for Payer: UHC Medicaid |
$397.46
|
| Rate for Payer: UHCCP DNSP |
$607.65
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
|
|
PR ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,467.00
|
|
|
Service Code
|
HCPCS 29904
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$1,850.25 |
| Rate for Payer: Aetna Commercial |
$786.79
|
| Rate for Payer: Aetna Medicare |
$587.16
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS MAPPO |
$587.16
|
| Rate for Payer: BCN Commercial |
$981.02
|
| Rate for Payer: BCN Medicare Advantage |
$587.16
|
| Rate for Payer: Cash Price |
$1,973.60
|
| Rate for Payer: Cash Price |
$1,973.60
|
| Rate for Payer: Cofinity Commercial |
$845.51
|
| Rate for Payer: Cofinity Commercial |
$786.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.16
|
| Rate for Payer: Healthscope Commercial |
$704.59
|
| Rate for Payer: Healthscope Whirlpool |
$704.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$616.52
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$645.88
|
| Rate for Payer: Nomi Health Commercial |
$704.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,850.25
|
| Rate for Payer: PACE SWMI |
$587.16
|
| Rate for Payer: PHP Medicare Advantage |
$587.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,048.69
|
| Rate for Payer: Priority Health Medicare |
$587.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,048.69
|
| Rate for Payer: Railroad Medicare Medicare |
$587.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,111.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$587.16
|
| Rate for Payer: UHC Exchange |
$1,111.16
|
| Rate for Payer: UHC Medicaid |
$384.04
|
| Rate for Payer: UHCCP DNSP |
$587.16
|
| Rate for Payer: UHCCP Medicaid |
$384.04
|
|
|
PR ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,100.00
|
|
|
Service Code
|
HCPCS 29846
|
| Min. Negotiated Rate |
$311.19 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: Aetna Commercial |
$635.66
|
| Rate for Payer: Aetna Medicare |
$474.37
|
| Rate for Payer: BCBS Complete |
$326.75
|
| Rate for Payer: BCBS MAPPO |
$474.37
|
| Rate for Payer: BCN Commercial |
$802.25
|
| Rate for Payer: BCN Medicare Advantage |
$474.37
|
| Rate for Payer: Cash Price |
$1,680.00
|
| Rate for Payer: Cash Price |
$1,680.00
|
| Rate for Payer: Cofinity Commercial |
$683.09
|
| Rate for Payer: Cofinity Commercial |
$635.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.37
|
| Rate for Payer: Healthscope Commercial |
$569.24
|
| Rate for Payer: Healthscope Whirlpool |
$569.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.09
|
| Rate for Payer: Meridian Medicaid |
$326.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.81
|
| Rate for Payer: Nomi Health Commercial |
$569.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,575.00
|
| Rate for Payer: PACE SWMI |
$474.37
|
| Rate for Payer: PHP Medicare Advantage |
$474.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$857.58
|
| Rate for Payer: Priority Health Medicare |
$474.37
|
| Rate for Payer: Priority Health Narrow Network |
$857.58
|
| Rate for Payer: Railroad Medicare Medicare |
$474.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$908.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$474.37
|
| Rate for Payer: UHC Exchange |
$908.65
|
| Rate for Payer: UHC Medicaid |
$311.19
|
| Rate for Payer: UHCCP DNSP |
$474.37
|
| Rate for Payer: UHCCP Medicaid |
$311.19
|
|
|
PR ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 23044
|
| Min. Negotiated Rate |
$346.34 |
| Max. Negotiated Rate |
$986.82 |
| Rate for Payer: Aetna Commercial |
$709.10
|
| Rate for Payer: Aetna Medicare |
$529.18
|
| Rate for Payer: BCBS Complete |
$363.66
|
| Rate for Payer: BCBS MAPPO |
$529.18
|
| Rate for Payer: BCN Commercial |
$857.02
|
| Rate for Payer: BCN Medicare Advantage |
$529.18
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cofinity Commercial |
$762.02
|
| Rate for Payer: Cofinity Commercial |
$709.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.18
|
| Rate for Payer: Healthscope Commercial |
$635.02
|
| Rate for Payer: Healthscope Whirlpool |
$635.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.64
|
| Rate for Payer: Meridian Medicaid |
$363.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.10
|
| Rate for Payer: Nomi Health Commercial |
$635.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$946.50
|
| Rate for Payer: PACE SWMI |
$529.18
|
| Rate for Payer: PHP Medicare Advantage |
$529.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$916.13
|
| Rate for Payer: Priority Health Medicare |
$529.18
|
| Rate for Payer: Priority Health Narrow Network |
$916.13
|
| Rate for Payer: Railroad Medicare Medicare |
$529.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$986.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.18
|
| Rate for Payer: UHC Exchange |
$986.82
|
| Rate for Payer: UHC Medicaid |
$346.34
|
| Rate for Payer: UHCCP DNSP |
$529.18
|
| Rate for Payer: UHCCP Medicaid |
$346.34
|
|
|
PR ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG
|
Professional
|
Both
|
$829.00
|
|
|
Service Code
|
HCPCS 23101
|
| Min. Negotiated Rate |
$282.86 |
| Max. Negotiated Rate |
$792.69 |
| Rate for Payer: Aetna Commercial |
$576.00
|
| Rate for Payer: Aetna Medicare |
$429.85
|
| Rate for Payer: BCBS Complete |
$297.00
|
| Rate for Payer: BCBS MAPPO |
$429.85
|
| Rate for Payer: BCN Commercial |
$704.64
|
| Rate for Payer: BCN Medicare Advantage |
$429.85
|
| Rate for Payer: Cash Price |
$663.20
|
| Rate for Payer: Cash Price |
$663.20
|
| Rate for Payer: Cofinity Commercial |
$618.98
|
| Rate for Payer: Cofinity Commercial |
$576.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$429.85
|
| Rate for Payer: Healthscope Commercial |
$515.82
|
| Rate for Payer: Healthscope Whirlpool |
$515.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.34
|
| Rate for Payer: Meridian Medicaid |
$297.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$472.83
|
| Rate for Payer: Nomi Health Commercial |
$515.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.75
|
| Rate for Payer: PACE SWMI |
$429.85
|
| Rate for Payer: PHP Medicare Advantage |
$429.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$753.24
|
| Rate for Payer: Priority Health Medicare |
$429.85
|
| Rate for Payer: Priority Health Narrow Network |
$753.24
|
| Rate for Payer: Railroad Medicare Medicare |
$429.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$429.85
|
| Rate for Payer: UHC Exchange |
$792.69
|
| Rate for Payer: UHC Medicaid |
$282.86
|
| Rate for Payer: UHCCP DNSP |
$429.85
|
| Rate for Payer: UHCCP Medicaid |
$282.86
|
|
|
PR ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 27620
|
| Min. Negotiated Rate |
$277.75 |
| Max. Negotiated Rate |
$870.75 |
| Rate for Payer: Aetna Commercial |
$566.18
|
| Rate for Payer: Aetna Medicare |
$422.52
|
| Rate for Payer: BCBS Complete |
$291.64
|
| Rate for Payer: BCBS MAPPO |
$422.52
|
| Rate for Payer: BCN Commercial |
$686.72
|
| Rate for Payer: BCN Medicare Advantage |
$422.52
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$608.43
|
| Rate for Payer: Cofinity Commercial |
$566.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.52
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Healthscope Whirlpool |
$507.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.65
|
| Rate for Payer: Meridian Medicaid |
$291.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$464.77
|
| Rate for Payer: Nomi Health Commercial |
$507.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.75
|
| Rate for Payer: PACE SWMI |
$422.52
|
| Rate for Payer: PHP Medicare Advantage |
$422.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$734.08
|
| Rate for Payer: Priority Health Medicare |
$422.52
|
| Rate for Payer: Priority Health Narrow Network |
$734.08
|
| Rate for Payer: Railroad Medicare Medicare |
$422.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$422.52
|
| Rate for Payer: UHC Exchange |
$778.89
|
| Rate for Payer: UHC Medicaid |
$277.75
|
| Rate for Payer: UHCCP DNSP |
$422.52
|
| Rate for Payer: UHCCP Medicaid |
$277.75
|
|
|
PR ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 24006
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Aetna Commercial |
$868.43
|
| Rate for Payer: Aetna Medicare |
$648.08
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$648.08
|
| Rate for Payer: BCN Commercial |
$1,094.06
|
| Rate for Payer: BCN Medicare Advantage |
$648.08
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$933.24
|
| Rate for Payer: Cofinity Commercial |
$868.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.08
|
| Rate for Payer: Healthscope Commercial |
$777.70
|
| Rate for Payer: Healthscope Whirlpool |
$777.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.48
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.89
|
| Rate for Payer: Nomi Health Commercial |
$777.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.75
|
| Rate for Payer: PACE SWMI |
$648.08
|
| Rate for Payer: PHP Medicare Advantage |
$648.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,169.52
|
| Rate for Payer: Priority Health Medicare |
$648.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,169.52
|
| Rate for Payer: Railroad Medicare Medicare |
$648.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,241.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$648.08
|
| Rate for Payer: UHC Exchange |
$1,241.11
|
| Rate for Payer: UHC Medicaid |
$423.66
|
| Rate for Payer: UHCCP DNSP |
$648.08
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,099.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$1,574.25 |
| Rate for Payer: Aetna Commercial |
$599.21
|
| Rate for Payer: Aetna Medicare |
$447.17
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$447.17
|
| Rate for Payer: BCN Commercial |
$738.51
|
| Rate for Payer: BCN Medicare Advantage |
$447.17
|
| Rate for Payer: Cash Price |
$1,679.20
|
| Rate for Payer: Cash Price |
$1,679.20
|
| Rate for Payer: Cofinity Commercial |
$643.92
|
| Rate for Payer: Cofinity Commercial |
$599.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.17
|
| Rate for Payer: Healthscope Commercial |
$536.60
|
| Rate for Payer: Healthscope Whirlpool |
$536.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.53
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.89
|
| Rate for Payer: Nomi Health Commercial |
$536.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,574.25
|
| Rate for Payer: PACE SWMI |
$447.17
|
| Rate for Payer: PHP Medicare Advantage |
$447.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$789.44
|
| Rate for Payer: Priority Health Medicare |
$447.17
|
| Rate for Payer: Priority Health Narrow Network |
$789.44
|
| Rate for Payer: Railroad Medicare Medicare |
$447.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$830.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$447.17
|
| Rate for Payer: UHC Exchange |
$830.35
|
| Rate for Payer: UHC Medicaid |
$294.15
|
| Rate for Payer: UHCCP DNSP |
$447.17
|
| Rate for Payer: UHCCP Medicaid |
$294.15
|
|
|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$1,041.00 |
| Rate for Payer: Aetna Commercial |
$626.46
|
| Rate for Payer: Aetna Medicare |
$467.51
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$467.51
|
| Rate for Payer: BCN Commercial |
$775.85
|
| Rate for Payer: BCN Medicare Advantage |
$467.51
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$673.21
|
| Rate for Payer: Cofinity Commercial |
$626.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.51
|
| Rate for Payer: Healthscope Commercial |
$561.01
|
| Rate for Payer: Healthscope Whirlpool |
$561.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.89
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$514.26
|
| Rate for Payer: Nomi Health Commercial |
$561.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.00
|
| Rate for Payer: PACE SWMI |
$467.51
|
| Rate for Payer: PHP Medicare Advantage |
$467.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$829.37
|
| Rate for Payer: Priority Health Medicare |
$467.51
|
| Rate for Payer: Priority Health Narrow Network |
$829.37
|
| Rate for Payer: Railroad Medicare Medicare |
$467.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$870.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$467.51
|
| Rate for Payer: UHC Exchange |
$870.17
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP DNSP |
$467.51
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$1,329.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$199.58 |
| Max. Negotiated Rate |
$996.75 |
| Rate for Payer: Aetna Commercial |
$403.92
|
| Rate for Payer: Aetna Medicare |
$301.43
|
| Rate for Payer: BCBS Complete |
$209.56
|
| Rate for Payer: BCBS MAPPO |
$301.43
|
| Rate for Payer: BCN Commercial |
$500.47
|
| Rate for Payer: BCN Medicare Advantage |
$301.43
|
| Rate for Payer: Cash Price |
$1,063.20
|
| Rate for Payer: Cash Price |
$1,063.20
|
| Rate for Payer: Cofinity Commercial |
$434.06
|
| Rate for Payer: Cofinity Commercial |
$403.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.43
|
| Rate for Payer: Healthscope Commercial |
$361.72
|
| Rate for Payer: Healthscope Whirlpool |
$361.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.50
|
| Rate for Payer: Meridian Medicaid |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$331.57
|
| Rate for Payer: Nomi Health Commercial |
$361.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$996.75
|
| Rate for Payer: PACE SWMI |
$301.43
|
| Rate for Payer: PHP Medicare Advantage |
$301.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$534.99
|
| Rate for Payer: Priority Health Medicare |
$301.43
|
| Rate for Payer: Priority Health Narrow Network |
$534.99
|
| Rate for Payer: Railroad Medicare Medicare |
$301.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.43
|
| Rate for Payer: UHC Exchange |
$554.05
|
| Rate for Payer: UHC Medicaid |
$199.58
|
| Rate for Payer: UHCCP DNSP |
$301.43
|
| Rate for Payer: UHCCP Medicaid |
$199.58
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$247.29 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$499.53
|
| Rate for Payer: Aetna Medicare |
$372.78
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS MAPPO |
$372.78
|
| Rate for Payer: BCN Commercial |
$618.49
|
| Rate for Payer: BCN Medicare Advantage |
$372.78
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$536.80
|
| Rate for Payer: Cofinity Commercial |
$499.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.78
|
| Rate for Payer: Healthscope Commercial |
$447.34
|
| Rate for Payer: Healthscope Whirlpool |
$447.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.42
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.06
|
| Rate for Payer: Nomi Health Commercial |
$447.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE SWMI |
$372.78
|
| Rate for Payer: PHP Medicare Advantage |
$372.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$661.15
|
| Rate for Payer: Priority Health Medicare |
$372.78
|
| Rate for Payer: Priority Health Narrow Network |
$661.15
|
| Rate for Payer: Railroad Medicare Medicare |
$372.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$677.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.78
|
| Rate for Payer: UHC Exchange |
$677.89
|
| Rate for Payer: UHC Medicaid |
$247.29
|
| Rate for Payer: UHCCP DNSP |
$372.78
|
| Rate for Payer: UHCCP Medicaid |
$247.29
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$210.44 |
| Max. Negotiated Rate |
$578.36 |
| Rate for Payer: Aetna Commercial |
$425.62
|
| Rate for Payer: Aetna Medicare |
$317.63
|
| Rate for Payer: BCBS Complete |
$220.96
|
| Rate for Payer: BCBS MAPPO |
$317.63
|
| Rate for Payer: BCN Commercial |
$524.87
|
| Rate for Payer: BCN Medicare Advantage |
$317.63
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$457.39
|
| Rate for Payer: Cofinity Commercial |
$425.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.63
|
| Rate for Payer: Healthscope Commercial |
$381.16
|
| Rate for Payer: Healthscope Whirlpool |
$381.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.51
|
| Rate for Payer: Meridian Medicaid |
$220.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$349.39
|
| Rate for Payer: Nomi Health Commercial |
$381.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: PACE SWMI |
$317.63
|
| Rate for Payer: PHP Medicare Advantage |
$317.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$561.07
|
| Rate for Payer: Priority Health Medicare |
$317.63
|
| Rate for Payer: Priority Health Narrow Network |
$561.07
|
| Rate for Payer: Railroad Medicare Medicare |
$317.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$578.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$317.63
|
| Rate for Payer: UHC Exchange |
$578.36
|
| Rate for Payer: UHC Medicaid |
$210.44
|
| Rate for Payer: UHCCP DNSP |
$317.63
|
| Rate for Payer: UHCCP Medicaid |
$210.44
|
|
|
PR ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,293.00
|
|
|
Service Code
|
HCPCS 23107
|
| Min. Negotiated Rate |
$399.38 |
| Max. Negotiated Rate |
$1,149.74 |
| Rate for Payer: Aetna Commercial |
$817.27
|
| Rate for Payer: Aetna Medicare |
$609.90
|
| Rate for Payer: BCBS Complete |
$419.35
|
| Rate for Payer: BCBS MAPPO |
$609.90
|
| Rate for Payer: BCN Commercial |
$1,017.37
|
| Rate for Payer: BCN Medicare Advantage |
$609.90
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cofinity Commercial |
$878.26
|
| Rate for Payer: Cofinity Commercial |
$817.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.90
|
| Rate for Payer: Healthscope Commercial |
$731.88
|
| Rate for Payer: Healthscope Whirlpool |
$731.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.39
|
| Rate for Payer: Meridian Medicaid |
$419.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$670.89
|
| Rate for Payer: Nomi Health Commercial |
$731.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.75
|
| Rate for Payer: PACE SWMI |
$609.90
|
| Rate for Payer: PHP Medicare Advantage |
$609.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,087.55
|
| Rate for Payer: Priority Health Medicare |
$609.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,087.55
|
| Rate for Payer: Railroad Medicare Medicare |
$609.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,149.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$609.90
|
| Rate for Payer: UHC Exchange |
$1,149.74
|
| Rate for Payer: UHC Medicaid |
$399.38
|
| Rate for Payer: UHCCP DNSP |
$609.90
|
| Rate for Payer: UHCCP Medicaid |
$399.38
|
|
|
PR ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 23106
|
| Min. Negotiated Rate |
$311.19 |
| Max. Negotiated Rate |
$865.41 |
| Rate for Payer: Aetna Commercial |
$632.67
|
| Rate for Payer: Aetna Medicare |
$472.14
|
| Rate for Payer: BCBS Complete |
$326.75
|
| Rate for Payer: BCBS MAPPO |
$472.14
|
| Rate for Payer: BCN Commercial |
$774.86
|
| Rate for Payer: BCN Medicare Advantage |
$472.14
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$679.88
|
| Rate for Payer: Cofinity Commercial |
$632.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.14
|
| Rate for Payer: Healthscope Commercial |
$566.57
|
| Rate for Payer: Healthscope Whirlpool |
$566.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.75
|
| Rate for Payer: Meridian Medicaid |
$326.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$519.35
|
| Rate for Payer: Nomi Health Commercial |
$566.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.25
|
| Rate for Payer: PACE SWMI |
$472.14
|
| Rate for Payer: PHP Medicare Advantage |
$472.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$828.30
|
| Rate for Payer: Priority Health Medicare |
$472.14
|
| Rate for Payer: Priority Health Narrow Network |
$828.30
|
| Rate for Payer: Railroad Medicare Medicare |
$472.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$472.14
|
| Rate for Payer: UHC Exchange |
$865.41
|
| Rate for Payer: UHC Medicaid |
$311.19
|
| Rate for Payer: UHCCP DNSP |
$472.14
|
| Rate for Payer: UHCCP Medicaid |
$311.19
|
|
|
PR ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 23105
|
| Min. Negotiated Rate |
$385.96 |
| Max. Negotiated Rate |
$1,108.28 |
| Rate for Payer: Aetna Commercial |
$789.27
|
| Rate for Payer: Aetna Medicare |
$589.01
|
| Rate for Payer: BCBS Complete |
$405.26
|
| Rate for Payer: BCBS MAPPO |
$589.01
|
| Rate for Payer: BCN Commercial |
$982.52
|
| Rate for Payer: BCN Medicare Advantage |
$589.01
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cofinity Commercial |
$848.17
|
| Rate for Payer: Cofinity Commercial |
$789.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.01
|
| Rate for Payer: Healthscope Commercial |
$706.81
|
| Rate for Payer: Healthscope Whirlpool |
$706.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.46
|
| Rate for Payer: Meridian Medicaid |
$405.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$647.91
|
| Rate for Payer: Nomi Health Commercial |
$706.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$876.00
|
| Rate for Payer: PACE SWMI |
$589.01
|
| Rate for Payer: PHP Medicare Advantage |
$589.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,050.29
|
| Rate for Payer: Priority Health Medicare |
$589.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,050.29
|
| Rate for Payer: Railroad Medicare Medicare |
$589.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$589.01
|
| Rate for Payer: UHC Exchange |
$1,108.28
|
| Rate for Payer: UHC Medicaid |
$385.96
|
| Rate for Payer: UHCCP DNSP |
$589.01
|
| Rate for Payer: UHCCP Medicaid |
$385.96
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 27310
|
| Min. Negotiated Rate |
$439.42 |
| Max. Negotiated Rate |
$2,079.00 |
| Rate for Payer: Aetna Commercial |
$900.79
|
| Rate for Payer: Aetna Medicare |
$672.23
|
| Rate for Payer: BCBS Complete |
$461.39
|
| Rate for Payer: BCBS MAPPO |
$672.23
|
| Rate for Payer: BCN Commercial |
$1,119.46
|
| Rate for Payer: BCN Medicare Advantage |
$672.23
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cofinity Commercial |
$968.01
|
| Rate for Payer: Cofinity Commercial |
$900.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.23
|
| Rate for Payer: Healthscope Commercial |
$806.68
|
| Rate for Payer: Healthscope Whirlpool |
$806.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.84
|
| Rate for Payer: Meridian Medicaid |
$461.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.45
|
| Rate for Payer: Nomi Health Commercial |
$806.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.00
|
| Rate for Payer: PACE SWMI |
$672.23
|
| Rate for Payer: PHP Medicare Advantage |
$672.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,196.67
|
| Rate for Payer: Priority Health Medicare |
$672.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,196.67
|
| Rate for Payer: Railroad Medicare Medicare |
$672.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,276.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.23
|
| Rate for Payer: UHC Exchange |
$1,276.66
|
| Rate for Payer: UHC Medicaid |
$439.42
|
| Rate for Payer: UHCCP DNSP |
$672.23
|
| Rate for Payer: UHCCP Medicaid |
$439.42
|
|
|
PR ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB
|
Professional
|
Both
|
$1,801.00
|
|
|
Service Code
|
HCPCS 27331
|
| Min. Negotiated Rate |
$293.09 |
| Max. Negotiated Rate |
$1,350.75 |
| Rate for Payer: Aetna Commercial |
$597.02
|
| Rate for Payer: Aetna Medicare |
$445.54
|
| Rate for Payer: BCBS Complete |
$307.74
|
| Rate for Payer: BCBS MAPPO |
$445.54
|
| Rate for Payer: BCN Commercial |
$736.01
|
| Rate for Payer: BCN Medicare Advantage |
$445.54
|
| Rate for Payer: Cash Price |
$1,440.80
|
| Rate for Payer: Cash Price |
$1,440.80
|
| Rate for Payer: Cofinity Commercial |
$641.58
|
| Rate for Payer: Cofinity Commercial |
$597.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.54
|
| Rate for Payer: Healthscope Commercial |
$534.65
|
| Rate for Payer: Healthscope Whirlpool |
$534.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.82
|
| Rate for Payer: Meridian Medicaid |
$307.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$490.09
|
| Rate for Payer: Nomi Health Commercial |
$534.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.75
|
| Rate for Payer: PACE SWMI |
$445.54
|
| Rate for Payer: PHP Medicare Advantage |
$445.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$786.78
|
| Rate for Payer: Priority Health Medicare |
$445.54
|
| Rate for Payer: Priority Health Narrow Network |
$786.78
|
| Rate for Payer: Railroad Medicare Medicare |
$445.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.54
|
| Rate for Payer: UHC Exchange |
$824.33
|
| Rate for Payer: UHC Medicaid |
$293.09
|
| Rate for Payer: UHCCP DNSP |
$445.54
|
| Rate for Payer: UHCCP Medicaid |
$293.09
|
|
|
PR ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 28052
|
| Min. Negotiated Rate |
$154.64 |
| Max. Negotiated Rate |
$494.16 |
| Rate for Payer: Aetna Commercial |
$315.48
|
| Rate for Payer: Aetna Medicare |
$235.43
|
| Rate for Payer: BCBS Complete |
$162.37
|
| Rate for Payer: BCBS MAPPO |
$235.43
|
| Rate for Payer: BCN Commercial |
$387.93
|
| Rate for Payer: BCN Medicare Advantage |
$235.43
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cofinity Commercial |
$339.02
|
| Rate for Payer: Cofinity Commercial |
$315.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.43
|
| Rate for Payer: Healthscope Commercial |
$282.52
|
| Rate for Payer: Healthscope Whirlpool |
$282.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.20
|
| Rate for Payer: Meridian Medicaid |
$162.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.97
|
| Rate for Payer: Nomi Health Commercial |
$282.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$386.25
|
| Rate for Payer: PACE SWMI |
$235.43
|
| Rate for Payer: PHP Medicare Advantage |
$235.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$414.68
|
| Rate for Payer: Priority Health Medicare |
$235.43
|
| Rate for Payer: Priority Health Narrow Network |
$414.68
|
| Rate for Payer: Railroad Medicare Medicare |
$235.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$494.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$235.43
|
| Rate for Payer: UHC Exchange |
$494.16
|
| Rate for Payer: UHC Medicaid |
$154.64
|
| Rate for Payer: UHCCP DNSP |
$235.43
|
| Rate for Payer: UHCCP Medicaid |
$154.64
|
|
|
PR ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH
|
Professional
|
Both
|
$2,234.00
|
|
|
Service Code
|
HCPCS 27612
|
| Min. Negotiated Rate |
$345.27 |
| Max. Negotiated Rate |
$1,675.50 |
| Rate for Payer: Aetna Commercial |
$705.43
|
| Rate for Payer: Aetna Medicare |
$526.44
|
| Rate for Payer: BCBS Complete |
$362.53
|
| Rate for Payer: BCBS MAPPO |
$526.44
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$526.44
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cofinity Commercial |
$758.07
|
| Rate for Payer: Cofinity Commercial |
$705.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.44
|
| Rate for Payer: Healthscope Commercial |
$631.73
|
| Rate for Payer: Healthscope Whirlpool |
$631.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.76
|
| Rate for Payer: Meridian Medicaid |
$362.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.08
|
| Rate for Payer: Nomi Health Commercial |
$631.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,675.50
|
| Rate for Payer: PACE SWMI |
$526.44
|
| Rate for Payer: PHP Medicare Advantage |
$526.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$936.90
|
| Rate for Payer: Priority Health Medicare |
$526.44
|
| Rate for Payer: Priority Health Narrow Network |
$936.90
|
| Rate for Payer: Railroad Medicare Medicare |
$526.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$973.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$526.44
|
| Rate for Payer: UHC Exchange |
$973.44
|
| Rate for Payer: UHC Medicaid |
$345.27
|
| Rate for Payer: UHCCP DNSP |
$526.44
|
| Rate for Payer: UHCCP Medicaid |
$345.27
|
|
|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$334.62 |
| Max. Negotiated Rate |
$1,458.75 |
| Rate for Payer: Aetna Commercial |
$684.45
|
| Rate for Payer: Aetna Medicare |
$510.78
|
| Rate for Payer: BCBS Complete |
$351.35
|
| Rate for Payer: BCBS MAPPO |
$510.78
|
| Rate for Payer: BCN Commercial |
$859.02
|
| Rate for Payer: BCN Medicare Advantage |
$510.78
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$735.52
|
| Rate for Payer: Cofinity Commercial |
$684.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.78
|
| Rate for Payer: Healthscope Commercial |
$612.94
|
| Rate for Payer: Healthscope Whirlpool |
$612.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.32
|
| Rate for Payer: Meridian Medicaid |
$351.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$561.86
|
| Rate for Payer: Nomi Health Commercial |
$612.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,458.75
|
| Rate for Payer: PACE SWMI |
$510.78
|
| Rate for Payer: PHP Medicare Advantage |
$510.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$918.27
|
| Rate for Payer: Priority Health Medicare |
$510.78
|
| Rate for Payer: Priority Health Narrow Network |
$918.27
|
| Rate for Payer: Railroad Medicare Medicare |
$510.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$976.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$510.78
|
| Rate for Payer: UHC Exchange |
$976.94
|
| Rate for Payer: UHC Medicaid |
$334.62
|
| Rate for Payer: UHCCP DNSP |
$510.78
|
| Rate for Payer: UHCCP Medicaid |
$334.62
|
|
|
PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT
|
Professional
|
Both
|
$2,461.00
|
|
|
Service Code
|
HCPCS 27332
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$1,845.75 |
| Rate for Payer: Aetna Commercial |
$801.33
|
| Rate for Payer: Aetna Medicare |
$598.01
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$598.01
|
| Rate for Payer: BCN Commercial |
$991.48
|
| Rate for Payer: BCN Medicare Advantage |
$598.01
|
| Rate for Payer: Cash Price |
$1,968.80
|
| Rate for Payer: Cash Price |
$1,968.80
|
| Rate for Payer: Cofinity Commercial |
$861.13
|
| Rate for Payer: Cofinity Commercial |
$801.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.01
|
| Rate for Payer: Healthscope Commercial |
$717.61
|
| Rate for Payer: Healthscope Whirlpool |
$717.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.91
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$657.81
|
| Rate for Payer: Nomi Health Commercial |
$717.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,845.75
|
| Rate for Payer: PACE SWMI |
$598.01
|
| Rate for Payer: PHP Medicare Advantage |
$598.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,059.87
|
| Rate for Payer: Priority Health Medicare |
$598.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,059.87
|
| Rate for Payer: Railroad Medicare Medicare |
$598.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$598.01
|
| Rate for Payer: UHC Exchange |
$1,121.59
|
| Rate for Payer: UHC Medicaid |
$392.13
|
| Rate for Payer: UHCCP DNSP |
$598.01
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 28024
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$386.42
|
| Rate for Payer: Aetna Medicare |
$288.37
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$288.37
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$288.37
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$415.25
|
| Rate for Payer: Cofinity Commercial |
$386.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.37
|
| Rate for Payer: Healthscope Commercial |
$346.04
|
| Rate for Payer: Healthscope Whirlpool |
$346.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.79
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.21
|
| Rate for Payer: Nomi Health Commercial |
$346.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$288.37
|
| Rate for Payer: PHP Medicare Advantage |
$288.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$506.25
|
| Rate for Payer: Priority Health Medicare |
$288.37
|
| Rate for Payer: Priority Health Narrow Network |
$506.25
|
| Rate for Payer: Railroad Medicare Medicare |
$288.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$526.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.37
|
| Rate for Payer: UHC Exchange |
$526.91
|
| Rate for Payer: UHC Medicaid |
$190.00
|
| Rate for Payer: UHCCP DNSP |
$288.37
|
| Rate for Payer: UHCCP Medicaid |
$190.00
|
|
