|
PR CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 47490
|
| Min. Negotiated Rate |
$190.21 |
| Max. Negotiated Rate |
$598.87 |
| Rate for Payer: Aetna Commercial |
$387.72
|
| Rate for Payer: Aetna Medicare |
$289.34
|
| Rate for Payer: BCBS Complete |
$199.72
|
| Rate for Payer: BCBS MAPPO |
$289.34
|
| Rate for Payer: BCN Commercial |
$491.51
|
| Rate for Payer: BCN Medicare Advantage |
$289.34
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$416.65
|
| Rate for Payer: Cofinity Commercial |
$387.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.34
|
| Rate for Payer: Healthscope Commercial |
$347.21
|
| Rate for Payer: Healthscope Whirlpool |
$347.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.81
|
| Rate for Payer: Meridian Medicaid |
$199.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.27
|
| Rate for Payer: Nomi Health Commercial |
$347.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$522.75
|
| Rate for Payer: PACE SWMI |
$289.34
|
| Rate for Payer: PHP Medicare Advantage |
$289.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$598.87
|
| Rate for Payer: Priority Health Medicare |
$289.34
|
| Rate for Payer: Priority Health Narrow Network |
$598.87
|
| Rate for Payer: Railroad Medicare Medicare |
$289.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$578.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$289.34
|
| Rate for Payer: UHC Exchange |
$578.60
|
| Rate for Payer: UHC Medicaid |
$190.21
|
| Rate for Payer: UHCCP DNSP |
$289.34
|
| Rate for Payer: UHCCP Medicaid |
$190.21
|
|
|
PR CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,477.00
|
|
|
Service Code
|
HCPCS 47420
|
| Min. Negotiated Rate |
$790.02 |
| Max. Negotiated Rate |
$2,440.39 |
| Rate for Payer: Aetna Commercial |
$1,651.27
|
| Rate for Payer: Aetna Medicare |
$1,232.29
|
| Rate for Payer: BCBS Complete |
$829.52
|
| Rate for Payer: BCBS MAPPO |
$1,232.29
|
| Rate for Payer: BCN Commercial |
$2,002.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,232.29
|
| Rate for Payer: Cash Price |
$1,981.60
|
| Rate for Payer: Cash Price |
$1,981.60
|
| Rate for Payer: Cofinity Commercial |
$1,651.27
|
| Rate for Payer: Cofinity Commercial |
$1,774.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,232.29
|
| Rate for Payer: Healthscope Commercial |
$1,478.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,293.90
|
| Rate for Payer: Meridian Medicaid |
$829.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,355.52
|
| Rate for Payer: Nomi Health Commercial |
$1,478.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,857.75
|
| Rate for Payer: PACE SWMI |
$1,232.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,232.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$790.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,440.39
|
| Rate for Payer: Priority Health Medicare |
$1,232.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,440.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,232.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,391.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,232.29
|
| Rate for Payer: UHC Exchange |
$2,391.53
|
| Rate for Payer: UHC Medicaid |
$790.02
|
| Rate for Payer: UHCCP DNSP |
$1,232.29
|
| Rate for Payer: UHCCP Medicaid |
$790.02
|
|
|
PR CHOLERA IMMUNIZATION,INJECTABLE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 90725
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
|
|
PR CHOLINESTERASE INHIBITOR CHALLENGE TEST
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 95857
|
| Min. Negotiated Rate |
$15.12 |
| Max. Negotiated Rate |
$124.50 |
| Rate for Payer: Aetna Commercial |
$31.42
|
| Rate for Payer: Aetna Medicare |
$23.45
|
| Rate for Payer: BCBS Complete |
$15.88
|
| Rate for Payer: BCBS MAPPO |
$23.45
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: BCN Medicare Advantage |
$23.45
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$33.77
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.45
|
| Rate for Payer: Healthscope Commercial |
$28.14
|
| Rate for Payer: Healthscope Whirlpool |
$28.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.62
|
| Rate for Payer: Meridian Medicaid |
$15.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.80
|
| Rate for Payer: Nomi Health Commercial |
$28.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$23.45
|
| Rate for Payer: PHP Medicare Advantage |
$23.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.58
|
| Rate for Payer: Priority Health Medicare |
$23.45
|
| Rate for Payer: Priority Health Narrow Network |
$38.58
|
| Rate for Payer: Railroad Medicare Medicare |
$23.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.45
|
| Rate for Payer: UHC Exchange |
$48.59
|
| Rate for Payer: UHC Medicaid |
$15.12
|
| Rate for Payer: UHCCP DNSP |
$23.45
|
| Rate for Payer: UHCCP Medicaid |
$15.12
|
|
|
PR CHORIONIC VILLUS SAMPLING
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 59015
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$158.79
|
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCBS Complete |
$78.73
|
| Rate for Payer: BCBS MAPPO |
$118.50
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$118.50
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$170.64
|
| Rate for Payer: Cofinity Commercial |
$158.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.50
|
| Rate for Payer: Healthscope Commercial |
$142.20
|
| Rate for Payer: Healthscope Whirlpool |
$142.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.42
|
| Rate for Payer: Meridian Medicaid |
$78.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.35
|
| Rate for Payer: Nomi Health Commercial |
$142.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$118.50
|
| Rate for Payer: PHP Medicare Advantage |
$118.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.22
|
| Rate for Payer: Priority Health Medicare |
$118.50
|
| Rate for Payer: Priority Health Narrow Network |
$185.22
|
| Rate for Payer: Railroad Medicare Medicare |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.50
|
| Rate for Payer: UHC Exchange |
$234.40
|
| Rate for Payer: UHC Medicaid |
$74.98
|
| Rate for Payer: UHCCP DNSP |
$118.50
|
| Rate for Payer: UHCCP Medicaid |
$74.98
|
|
|
PR CHROMOTUBATION OVIDUCT W/MATERIALS
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 58350
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$108.31
|
| Rate for Payer: Aetna Medicare |
$80.83
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$80.83
|
| Rate for Payer: BCN Commercial |
$141.92
|
| Rate for Payer: BCN Medicare Advantage |
$80.83
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$116.40
|
| Rate for Payer: Cofinity Commercial |
$108.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.83
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.87
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.91
|
| Rate for Payer: Nomi Health Commercial |
$97.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$80.83
|
| Rate for Payer: PHP Medicare Advantage |
$80.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.74
|
| Rate for Payer: Priority Health Medicare |
$80.83
|
| Rate for Payer: Priority Health Narrow Network |
$143.74
|
| Rate for Payer: Railroad Medicare Medicare |
$80.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.83
|
| Rate for Payer: UHC Exchange |
$150.72
|
| Rate for Payer: UHC Medicaid |
$53.46
|
| Rate for Payer: UHCCP DNSP |
$80.83
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 99490
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Aetna Commercial |
$58.10
|
| Rate for Payer: Aetna Medicare |
$43.36
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.36
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: BCN Medicare Advantage |
$43.36
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$62.44
|
| Rate for Payer: Cofinity Commercial |
$58.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.36
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Healthscope Whirlpool |
$47.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.53
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.70
|
| Rate for Payer: Nomi Health Commercial |
$52.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.25
|
| Rate for Payer: PACE SWMI |
$43.36
|
| Rate for Payer: PHP Medicare Advantage |
$43.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.29
|
| Rate for Payer: Priority Health Medicare |
$43.36
|
| Rate for Payer: Priority Health Narrow Network |
$66.29
|
| Rate for Payer: Railroad Medicare Medicare |
$43.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.36
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP DNSP |
$43.36
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE
|
Professional
|
Both
|
$3,641.00
|
|
|
Service Code
|
HCPCS 24940
|
| Min. Negotiated Rate |
$602.42 |
| Max. Negotiated Rate |
$11,802.16 |
| Rate for Payer: Aetna Commercial |
$1,439.82
|
| Rate for Payer: BCBS Complete |
$632.54
|
| Rate for Payer: BCN Commercial |
$11,802.16
|
| Rate for Payer: Cash Price |
$2,912.80
|
| Rate for Payer: Cash Price |
$2,912.80
|
| Rate for Payer: Meridian Medicaid |
$632.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,730.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,773.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,773.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,704.31
|
| Rate for Payer: UHC Exchange |
$1,704.31
|
| Rate for Payer: UHC Medicaid |
$602.42
|
| Rate for Payer: UHCCP Medicaid |
$602.42
|
|
|
PR CIRCADIAN RESPIRATORY PATTERN REC 12-24 HR INFT
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 94772
|
| Min. Negotiated Rate |
$98.71 |
| Max. Negotiated Rate |
$498.75 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: BCN Commercial |
$98.71
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$436.28
|
| Rate for Payer: Priority Health Narrow Network |
$436.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.11
|
| Rate for Payer: UHC Exchange |
$440.11
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
IP
|
$1,589.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,191.75 |
| Max. Negotiated Rate |
$1,589.00 |
| Rate for Payer: Aetna Commercial |
$1,430.10
|
| Rate for Payer: ASR ASR |
$1,541.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.89
|
| Rate for Payer: BCN Commercial |
$1,304.89
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,493.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Healthscope Commercial |
$1,541.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,589.00
|
| Rate for Payer: Mclaren Commercial |
$1,430.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$1,302.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 54161
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$1,191.75 |
| Rate for Payer: Aetna Commercial |
$238.16
|
| Rate for Payer: Aetna Medicare |
$177.73
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.73
|
| Rate for Payer: BCN Commercial |
$297.29
|
| Rate for Payer: BCN Medicare Advantage |
$177.73
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$255.93
|
| Rate for Payer: Cofinity Commercial |
$238.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.73
|
| Rate for Payer: Healthscope Commercial |
$213.28
|
| Rate for Payer: Healthscope Whirlpool |
$213.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.62
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.50
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PACE SWMI |
$177.73
|
| Rate for Payer: PHP Medicare Advantage |
$177.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$323.85
|
| Rate for Payer: Priority Health Medicare |
$177.73
|
| Rate for Payer: Priority Health Narrow Network |
$323.85
|
| Rate for Payer: Railroad Medicare Medicare |
$177.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.73
|
| Rate for Payer: UHC Exchange |
$346.14
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP DNSP |
$177.73
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
54161
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$1,191.75 |
| Rate for Payer: Aetna Commercial |
$238.16
|
| Rate for Payer: Aetna Medicare |
$177.73
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.73
|
| Rate for Payer: BCN Commercial |
$297.29
|
| Rate for Payer: BCN Medicare Advantage |
$177.73
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$255.93
|
| Rate for Payer: Cofinity Commercial |
$238.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.73
|
| Rate for Payer: Healthscope Commercial |
$213.28
|
| Rate for Payer: Healthscope Whirlpool |
$213.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.62
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.50
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PACE SWMI |
$177.73
|
| Rate for Payer: PHP Medicare Advantage |
$177.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$323.85
|
| Rate for Payer: Priority Health Medicare |
$177.73
|
| Rate for Payer: Priority Health Narrow Network |
$323.85
|
| Rate for Payer: Railroad Medicare Medicare |
$177.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.73
|
| Rate for Payer: UHC Exchange |
$346.14
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP DNSP |
$177.73
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
OP
|
$1,589.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$2,603.59 |
| Rate for Payer: Aetna Commercial |
$1,430.10
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$1,541.33
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.13
|
| Rate for Payer: BCN Commercial |
$1,310.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,493.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$1,541.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,589.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$1,430.10
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$1,302.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,392.28
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
PR CIRCUMCISION NEONATE
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 54160
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$174.63
|
| Rate for Payer: Aetna Medicare |
$130.32
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$130.32
|
| Rate for Payer: BCN Commercial |
$217.62
|
| Rate for Payer: BCN Medicare Advantage |
$130.32
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$187.66
|
| Rate for Payer: Cofinity Commercial |
$174.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.32
|
| Rate for Payer: Healthscope Commercial |
$156.38
|
| Rate for Payer: Healthscope Whirlpool |
$156.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.84
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.35
|
| Rate for Payer: Nomi Health Commercial |
$156.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.00
|
| Rate for Payer: PACE SWMI |
$130.32
|
| Rate for Payer: PHP Medicare Advantage |
$130.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.05
|
| Rate for Payer: Priority Health Medicare |
$130.32
|
| Rate for Payer: Priority Health Narrow Network |
$237.05
|
| Rate for Payer: Railroad Medicare Medicare |
$130.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.32
|
| Rate for Payer: UHC Exchange |
$254.58
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHCCP DNSP |
$130.32
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 54150
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$402.75 |
| Rate for Payer: Aetna Commercial |
$112.49
|
| Rate for Payer: Aetna Medicare |
$83.95
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$83.95
|
| Rate for Payer: BCN Commercial |
$142.92
|
| Rate for Payer: BCN Medicare Advantage |
$83.95
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$120.89
|
| Rate for Payer: Cofinity Commercial |
$112.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.95
|
| Rate for Payer: Healthscope Commercial |
$100.74
|
| Rate for Payer: Healthscope Whirlpool |
$100.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.15
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.34
|
| Rate for Payer: Nomi Health Commercial |
$100.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$83.95
|
| Rate for Payer: PHP Medicare Advantage |
$83.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$155.68
|
| Rate for Payer: Priority Health Medicare |
$83.95
|
| Rate for Payer: Priority Health Narrow Network |
$155.68
|
| Rate for Payer: Railroad Medicare Medicare |
$83.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.95
|
| Rate for Payer: UHC Exchange |
$174.64
|
| Rate for Payer: UHC Medicaid |
$53.68
|
| Rate for Payer: UHCCP DNSP |
$83.95
|
| Rate for Payer: UHCCP Medicaid |
$53.68
|
|
|
PR CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
HCPCS 61050
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$369.75 |
| Rate for Payer: Aetna Commercial |
$91.67
|
| Rate for Payer: Aetna Medicare |
$68.41
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$68.41
|
| Rate for Payer: BCN Commercial |
$120.02
|
| Rate for Payer: BCN Medicare Advantage |
$68.41
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$98.51
|
| Rate for Payer: Cofinity Commercial |
$91.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.41
|
| Rate for Payer: Healthscope Commercial |
$82.09
|
| Rate for Payer: Healthscope Whirlpool |
$82.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.83
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.25
|
| Rate for Payer: Nomi Health Commercial |
$82.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PACE SWMI |
$68.41
|
| Rate for Payer: PHP Medicare Advantage |
$68.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$139.40
|
| Rate for Payer: Priority Health Medicare |
$68.41
|
| Rate for Payer: Priority Health Narrow Network |
$139.40
|
| Rate for Payer: Railroad Medicare Medicare |
$68.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$68.41
|
| Rate for Payer: UHC Exchange |
$149.05
|
| Rate for Payer: UHC Medicaid |
$44.09
|
| Rate for Payer: UHCCP DNSP |
$68.41
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR CLAVICULECTOMY PARTIAL
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 23120
|
| Min. Negotiated Rate |
$360.18 |
| Max. Negotiated Rate |
$1,015.74 |
| Rate for Payer: Aetna Commercial |
$733.38
|
| Rate for Payer: Aetna Medicare |
$547.30
|
| Rate for Payer: BCBS Complete |
$378.19
|
| Rate for Payer: BCBS MAPPO |
$547.30
|
| Rate for Payer: BCN Commercial |
$991.29
|
| Rate for Payer: BCN Medicare Advantage |
$547.30
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$788.11
|
| Rate for Payer: Cofinity Commercial |
$733.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.30
|
| Rate for Payer: Healthscope Commercial |
$656.76
|
| Rate for Payer: Healthscope Whirlpool |
$656.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.66
|
| Rate for Payer: Meridian Medicaid |
$378.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.03
|
| Rate for Payer: Nomi Health Commercial |
$656.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PACE SWMI |
$547.30
|
| Rate for Payer: PHP Medicare Advantage |
$547.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$964.58
|
| Rate for Payer: Priority Health Medicare |
$547.30
|
| Rate for Payer: Priority Health Narrow Network |
$964.58
|
| Rate for Payer: Railroad Medicare Medicare |
$547.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,015.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.30
|
| Rate for Payer: UHC Exchange |
$1,015.74
|
| Rate for Payer: UHC Medicaid |
$360.18
|
| Rate for Payer: UHCCP DNSP |
$547.30
|
| Rate for Payer: UHCCP Medicaid |
$360.18
|
|
|
PR CLAVICULECTOMY TOTAL
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 23125
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,238.27 |
| Rate for Payer: Aetna Commercial |
$874.43
|
| Rate for Payer: Aetna Medicare |
$652.56
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$652.56
|
| Rate for Payer: BCN Commercial |
$1,086.10
|
| Rate for Payer: BCN Medicare Advantage |
$652.56
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$874.43
|
| Rate for Payer: Cofinity Commercial |
$939.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.56
|
| Rate for Payer: Healthscope Commercial |
$783.07
|
| Rate for Payer: Healthscope Whirlpool |
$783.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.19
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$717.82
|
| Rate for Payer: Nomi Health Commercial |
$783.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,235.25
|
| Rate for Payer: PACE SWMI |
$652.56
|
| Rate for Payer: PHP Medicare Advantage |
$652.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,161.01
|
| Rate for Payer: Priority Health Medicare |
$652.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,161.01
|
| Rate for Payer: Railroad Medicare Medicare |
$652.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,238.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$652.56
|
| Rate for Payer: UHC Exchange |
$1,238.27
|
| Rate for Payer: UHC Medicaid |
$426.64
|
| Rate for Payer: UHCCP DNSP |
$652.56
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
|
|
PR CLOSED RX PELVIC RING FX/SUBLUX
|
Professional
|
Both
|
$999.00
|
|
|
Service Code
|
HCPCS 27193
|
| Min. Negotiated Rate |
$399.60 |
| Max. Negotiated Rate |
$749.25 |
| Rate for Payer: BCBS Complete |
$399.60
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.25
|
|
|
PR CLOSED RX PELV RING FX/SUBLUX,MANIP
|
Professional
|
Both
|
$1,999.00
|
|
|
Service Code
|
HCPCS 27194
|
| Min. Negotiated Rate |
$799.60 |
| Max. Negotiated Rate |
$1,499.25 |
| Rate for Payer: BCBS Complete |
$799.60
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.25
|
|
|
PR CLOSED RX RIB FRACTURE
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 21800
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
|
|
PR CLOSED TREATMENT COCCYGEAL FRACTURE
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 27200
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$323.12 |
| Rate for Payer: Aetna Commercial |
$256.64
|
| Rate for Payer: Aetna Medicare |
$191.52
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$191.52
|
| Rate for Payer: BCN Commercial |
$302.28
|
| Rate for Payer: BCN Medicare Advantage |
$191.52
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$275.79
|
| Rate for Payer: Cofinity Commercial |
$256.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.52
|
| Rate for Payer: Healthscope Commercial |
$229.82
|
| Rate for Payer: Healthscope Whirlpool |
$229.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.10
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$210.67
|
| Rate for Payer: Nomi Health Commercial |
$229.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$301.50
|
| Rate for Payer: PACE SWMI |
$191.52
|
| Rate for Payer: PHP Medicare Advantage |
$191.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$323.12
|
| Rate for Payer: Priority Health Medicare |
$191.52
|
| Rate for Payer: Priority Health Narrow Network |
$323.12
|
| Rate for Payer: Railroad Medicare Medicare |
$191.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$191.52
|
| Rate for Payer: UHC Exchange |
$322.47
|
| Rate for Payer: UHC Medicaid |
$128.01
|
| Rate for Payer: UHCCP DNSP |
$191.52
|
| Rate for Payer: UHCCP Medicaid |
$128.01
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 27768
|
| Min. Negotiated Rate |
$282.01 |
| Max. Negotiated Rate |
$765.98 |
| Rate for Payer: Aetna Commercial |
$570.88
|
| Rate for Payer: Aetna Medicare |
$426.03
|
| Rate for Payer: BCBS Complete |
$296.11
|
| Rate for Payer: BCBS MAPPO |
$426.03
|
| Rate for Payer: BCN Commercial |
$697.67
|
| Rate for Payer: BCN Medicare Advantage |
$426.03
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$613.48
|
| Rate for Payer: Cofinity Commercial |
$570.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.03
|
| Rate for Payer: Healthscope Commercial |
$511.24
|
| Rate for Payer: Healthscope Whirlpool |
$511.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.33
|
| Rate for Payer: Meridian Medicaid |
$296.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.63
|
| Rate for Payer: Nomi Health Commercial |
$511.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$426.03
|
| Rate for Payer: PHP Medicare Advantage |
$426.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$745.78
|
| Rate for Payer: Priority Health Medicare |
$426.03
|
| Rate for Payer: Priority Health Narrow Network |
$745.78
|
| Rate for Payer: Railroad Medicare Medicare |
$426.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.03
|
| Rate for Payer: UHC Exchange |
$765.98
|
| Rate for Payer: UHC Medicaid |
$282.01
|
| Rate for Payer: UHCCP DNSP |
$426.03
|
| Rate for Payer: UHCCP Medicaid |
$282.01
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ
|
Professional
|
Both
|
$749.00
|
|
|
Service Code
|
HCPCS 27767
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$561.75 |
| Rate for Payer: Aetna Commercial |
$382.42
|
| Rate for Payer: Aetna Medicare |
$285.39
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCBS MAPPO |
$285.39
|
| Rate for Payer: BCN Commercial |
$460.13
|
| Rate for Payer: BCN Medicare Advantage |
$285.39
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$410.96
|
| Rate for Payer: Cofinity Commercial |
$382.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.39
|
| Rate for Payer: Healthscope Commercial |
$342.47
|
| Rate for Payer: Healthscope Whirlpool |
$342.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.66
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.93
|
| Rate for Payer: Nomi Health Commercial |
$342.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.75
|
| Rate for Payer: PACE SWMI |
$285.39
|
| Rate for Payer: PHP Medicare Advantage |
$285.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$491.87
|
| Rate for Payer: Priority Health Medicare |
$285.39
|
| Rate for Payer: Priority Health Narrow Network |
$491.87
|
| Rate for Payer: Railroad Medicare Medicare |
$285.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.39
|
| Rate for Payer: UHC Exchange |
$487.77
|
| Rate for Payer: UHC Medicaid |
$191.70
|
| Rate for Payer: UHCCP DNSP |
$285.39
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
|
|
PR CLOSED TREATMENT SESAMOID FRACTURE
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 28530
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$272.25 |
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Medicare |
$98.23
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$98.23
|
| Rate for Payer: BCN Commercial |
$161.85
|
| Rate for Payer: BCN Medicare Advantage |
$98.23
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$141.45
|
| Rate for Payer: Cofinity Commercial |
$131.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.23
|
| Rate for Payer: Healthscope Commercial |
$117.88
|
| Rate for Payer: Healthscope Whirlpool |
$117.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.14
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.05
|
| Rate for Payer: Nomi Health Commercial |
$117.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.25
|
| Rate for Payer: PACE SWMI |
$98.23
|
| Rate for Payer: PHP Medicare Advantage |
$98.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$173.01
|
| Rate for Payer: Priority Health Medicare |
$98.23
|
| Rate for Payer: Priority Health Narrow Network |
$173.01
|
| Rate for Payer: Railroad Medicare Medicare |
$98.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.23
|
| Rate for Payer: UHC Exchange |
$171.98
|
| Rate for Payer: UHC Medicaid |
$65.82
|
| Rate for Payer: UHCCP DNSP |
$98.23
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
|
