|
PR CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 57308
|
| Min. Negotiated Rate |
$402.14 |
| Max. Negotiated Rate |
$1,155.26 |
| Rate for Payer: Aetna Commercial |
$826.03
|
| Rate for Payer: Aetna Medicare |
$616.44
|
| Rate for Payer: BCBS Complete |
$422.25
|
| Rate for Payer: BCBS MAPPO |
$616.44
|
| Rate for Payer: BCN Commercial |
$999.45
|
| Rate for Payer: BCN Medicare Advantage |
$616.44
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cofinity Commercial |
$887.67
|
| Rate for Payer: Cofinity Commercial |
$826.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.44
|
| Rate for Payer: Healthscope Commercial |
$739.73
|
| Rate for Payer: Healthscope Whirlpool |
$739.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.26
|
| Rate for Payer: Meridian Medicaid |
$422.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$678.08
|
| Rate for Payer: Nomi Health Commercial |
$739.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,136.25
|
| Rate for Payer: PACE SWMI |
$616.44
|
| Rate for Payer: PHP Medicare Advantage |
$616.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,012.22
|
| Rate for Payer: Priority Health Medicare |
$616.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.22
|
| Rate for Payer: Railroad Medicare Medicare |
$616.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,155.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$616.44
|
| Rate for Payer: UHC Exchange |
$1,155.26
|
| Rate for Payer: UHC Medicaid |
$402.14
|
| Rate for Payer: UHCCP DNSP |
$616.44
|
| Rate for Payer: UHCCP Medicaid |
$402.14
|
|
|
PR CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,035.00
|
|
|
Service Code
|
HCPCS 57305
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$1,703.55 |
| Rate for Payer: Aetna Commercial |
$1,187.04
|
| Rate for Payer: Aetna Medicare |
$885.85
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$885.85
|
| Rate for Payer: BCN Commercial |
$1,458.59
|
| Rate for Payer: BCN Medicare Advantage |
$885.85
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cofinity Commercial |
$1,275.62
|
| Rate for Payer: Cofinity Commercial |
$1,187.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$885.85
|
| Rate for Payer: Healthscope Commercial |
$1,063.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$930.14
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$974.43
|
| Rate for Payer: Nomi Health Commercial |
$1,063.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.25
|
| Rate for Payer: PACE SWMI |
$885.85
|
| Rate for Payer: PHP Medicare Advantage |
$885.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,477.23
|
| Rate for Payer: Priority Health Medicare |
$885.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,477.23
|
| Rate for Payer: Railroad Medicare Medicare |
$885.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,703.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$885.85
|
| Rate for Payer: UHC Exchange |
$1,703.55
|
| Rate for Payer: UHC Medicaid |
$573.40
|
| Rate for Payer: UHCCP DNSP |
$885.85
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 57300
|
| Min. Negotiated Rate |
$359.76 |
| Max. Negotiated Rate |
$1,033.86 |
| Rate for Payer: Aetna Commercial |
$738.81
|
| Rate for Payer: Aetna Medicare |
$551.35
|
| Rate for Payer: BCBS Complete |
$377.75
|
| Rate for Payer: BCBS MAPPO |
$551.35
|
| Rate for Payer: BCN Commercial |
$919.27
|
| Rate for Payer: BCN Medicare Advantage |
$551.35
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cofinity Commercial |
$793.94
|
| Rate for Payer: Cofinity Commercial |
$738.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.35
|
| Rate for Payer: Healthscope Commercial |
$661.62
|
| Rate for Payer: Healthscope Whirlpool |
$661.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.92
|
| Rate for Payer: Meridian Medicaid |
$377.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$606.49
|
| Rate for Payer: Nomi Health Commercial |
$661.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,020.75
|
| Rate for Payer: PACE SWMI |
$551.35
|
| Rate for Payer: PHP Medicare Advantage |
$551.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$931.03
|
| Rate for Payer: Priority Health Medicare |
$551.35
|
| Rate for Payer: Priority Health Narrow Network |
$931.03
|
| Rate for Payer: Railroad Medicare Medicare |
$551.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.35
|
| Rate for Payer: UHC Exchange |
$1,033.86
|
| Rate for Payer: UHC Medicaid |
$359.76
|
| Rate for Payer: UHCCP DNSP |
$551.35
|
| Rate for Payer: UHCCP Medicaid |
$359.76
|
|
|
PR CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 53520
|
| Min. Negotiated Rate |
$326.74 |
| Max. Negotiated Rate |
$980.23 |
| Rate for Payer: Aetna Commercial |
$674.42
|
| Rate for Payer: Aetna Medicare |
$503.30
|
| Rate for Payer: BCBS Complete |
$343.08
|
| Rate for Payer: BCBS MAPPO |
$503.30
|
| Rate for Payer: BCN Commercial |
$841.09
|
| Rate for Payer: BCN Medicare Advantage |
$503.30
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$724.75
|
| Rate for Payer: Cofinity Commercial |
$674.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.30
|
| Rate for Payer: Healthscope Commercial |
$603.96
|
| Rate for Payer: Healthscope Whirlpool |
$603.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.47
|
| Rate for Payer: Meridian Medicaid |
$343.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$553.63
|
| Rate for Payer: Nomi Health Commercial |
$603.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$891.00
|
| Rate for Payer: PACE SWMI |
$503.30
|
| Rate for Payer: PHP Medicare Advantage |
$503.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$916.22
|
| Rate for Payer: Priority Health Medicare |
$503.30
|
| Rate for Payer: Priority Health Narrow Network |
$916.22
|
| Rate for Payer: Railroad Medicare Medicare |
$503.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$980.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.30
|
| Rate for Payer: UHC Exchange |
$980.23
|
| Rate for Payer: UHC Medicaid |
$326.74
|
| Rate for Payer: UHCCP DNSP |
$503.30
|
| Rate for Payer: UHCCP Medicaid |
$326.74
|
|
|
PR CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL
|
Professional
|
Both
|
$1,136.00
|
|
|
Service Code
|
HCPCS 57311
|
| Min. Negotiated Rate |
$321.42 |
| Max. Negotiated Rate |
$953.89 |
| Rate for Payer: Aetna Commercial |
$661.29
|
| Rate for Payer: Aetna Medicare |
$493.50
|
| Rate for Payer: BCBS Complete |
$337.49
|
| Rate for Payer: BCBS MAPPO |
$493.50
|
| Rate for Payer: BCN Commercial |
$835.61
|
| Rate for Payer: BCN Medicare Advantage |
$493.50
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cofinity Commercial |
$710.64
|
| Rate for Payer: Cofinity Commercial |
$661.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.50
|
| Rate for Payer: Healthscope Commercial |
$592.20
|
| Rate for Payer: Healthscope Whirlpool |
$592.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.17
|
| Rate for Payer: Meridian Medicaid |
$337.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$542.85
|
| Rate for Payer: Nomi Health Commercial |
$592.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.00
|
| Rate for Payer: PACE SWMI |
$493.50
|
| Rate for Payer: PHP Medicare Advantage |
$493.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$846.29
|
| Rate for Payer: Priority Health Medicare |
$493.50
|
| Rate for Payer: Priority Health Narrow Network |
$846.29
|
| Rate for Payer: Railroad Medicare Medicare |
$493.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$953.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$493.50
|
| Rate for Payer: UHC Exchange |
$953.89
|
| Rate for Payer: UHC Medicaid |
$321.42
|
| Rate for Payer: UHCCP DNSP |
$493.50
|
| Rate for Payer: UHCCP Medicaid |
$321.42
|
|
|
PR CLSR VESICOVAGINAL FISTUL AABDL APPROACH
|
Professional
|
Both
|
$4,033.00
|
|
|
Service Code
|
HCPCS 51900
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$3,024.75 |
| Rate for Payer: Aetna Commercial |
$984.87
|
| Rate for Payer: Aetna Medicare |
$734.98
|
| Rate for Payer: BCBS Complete |
$498.96
|
| Rate for Payer: BCBS MAPPO |
$734.98
|
| Rate for Payer: BCN Commercial |
$1,234.99
|
| Rate for Payer: BCN Medicare Advantage |
$734.98
|
| Rate for Payer: Cash Price |
$3,226.40
|
| Rate for Payer: Cash Price |
$3,226.40
|
| Rate for Payer: Cofinity Commercial |
$984.87
|
| Rate for Payer: Cofinity Commercial |
$1,058.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$734.98
|
| Rate for Payer: Healthscope Commercial |
$881.98
|
| Rate for Payer: Healthscope Whirlpool |
$881.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.73
|
| Rate for Payer: Meridian Medicaid |
$498.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$808.48
|
| Rate for Payer: Nomi Health Commercial |
$881.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,024.75
|
| Rate for Payer: PACE SWMI |
$734.98
|
| Rate for Payer: PHP Medicare Advantage |
$734.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,345.30
|
| Rate for Payer: Priority Health Medicare |
$734.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.30
|
| Rate for Payer: Railroad Medicare Medicare |
$734.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,454.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$734.98
|
| Rate for Payer: UHC Exchange |
$1,454.47
|
| Rate for Payer: UHC Medicaid |
$475.20
|
| Rate for Payer: UHCCP DNSP |
$734.98
|
| Rate for Payer: UHCCP Medicaid |
$475.20
|
|
|
PR CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 27222
|
| Min. Negotiated Rate |
$583.83 |
| Max. Negotiated Rate |
$1,756.50 |
| Rate for Payer: Aetna Commercial |
$1,202.36
|
| Rate for Payer: Aetna Medicare |
$897.28
|
| Rate for Payer: BCBS Complete |
$613.02
|
| Rate for Payer: BCBS MAPPO |
$897.28
|
| Rate for Payer: BCN Commercial |
$1,489.46
|
| Rate for Payer: BCN Medicare Advantage |
$897.28
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$1,292.08
|
| Rate for Payer: Cofinity Commercial |
$1,202.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.28
|
| Rate for Payer: Healthscope Commercial |
$1,076.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,076.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.14
|
| Rate for Payer: Meridian Medicaid |
$613.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.01
|
| Rate for Payer: Nomi Health Commercial |
$1,076.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,756.50
|
| Rate for Payer: PACE SWMI |
$897.28
|
| Rate for Payer: PHP Medicare Advantage |
$897.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,592.19
|
| Rate for Payer: Priority Health Medicare |
$897.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,592.19
|
| Rate for Payer: Railroad Medicare Medicare |
$897.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,706.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$897.28
|
| Rate for Payer: UHC Exchange |
$1,706.07
|
| Rate for Payer: UHC Medicaid |
$583.83
|
| Rate for Payer: UHCCP DNSP |
$897.28
|
| Rate for Payer: UHCCP Medicaid |
$583.83
|
|
|
PR CLTX ACETABULUM HIP/SOCKT FX W/O MANJ
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 27220
|
| Min. Negotiated Rate |
$249.00 |
| Max. Negotiated Rate |
$1,296.75 |
| Rate for Payer: Aetna Commercial |
$509.59
|
| Rate for Payer: Aetna Medicare |
$380.29
|
| Rate for Payer: BCBS Complete |
$261.45
|
| Rate for Payer: BCBS MAPPO |
$380.29
|
| Rate for Payer: BCN Commercial |
$633.93
|
| Rate for Payer: BCN Medicare Advantage |
$380.29
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$547.62
|
| Rate for Payer: Cofinity Commercial |
$509.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.29
|
| Rate for Payer: Healthscope Commercial |
$456.35
|
| Rate for Payer: Healthscope Whirlpool |
$456.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.30
|
| Rate for Payer: Meridian Medicaid |
$261.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.32
|
| Rate for Payer: Nomi Health Commercial |
$456.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.75
|
| Rate for Payer: PACE SWMI |
$380.29
|
| Rate for Payer: PHP Medicare Advantage |
$380.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$677.65
|
| Rate for Payer: Priority Health Medicare |
$380.29
|
| Rate for Payer: Priority Health Narrow Network |
$677.65
|
| Rate for Payer: Railroad Medicare Medicare |
$380.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$737.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.29
|
| Rate for Payer: UHC Exchange |
$737.71
|
| Rate for Payer: UHC Medicaid |
$249.00
|
| Rate for Payer: UHCCP DNSP |
$380.29
|
| Rate for Payer: UHCCP Medicaid |
$249.00
|
|
|
PR CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ
|
Professional
|
Both
|
$1,456.00
|
|
|
Service Code
|
HCPCS 27842
|
| Min. Negotiated Rate |
$313.11 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$637.88
|
| Rate for Payer: Aetna Medicare |
$476.03
|
| Rate for Payer: BCBS Complete |
$328.77
|
| Rate for Payer: BCBS MAPPO |
$476.03
|
| Rate for Payer: BCN Commercial |
$758.43
|
| Rate for Payer: BCN Medicare Advantage |
$476.03
|
| Rate for Payer: Cash Price |
$1,164.80
|
| Rate for Payer: Cash Price |
$1,164.80
|
| Rate for Payer: Cofinity Commercial |
$685.48
|
| Rate for Payer: Cofinity Commercial |
$637.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.03
|
| Rate for Payer: Healthscope Commercial |
$571.24
|
| Rate for Payer: Healthscope Whirlpool |
$571.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.83
|
| Rate for Payer: Meridian Medicaid |
$328.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$523.63
|
| Rate for Payer: Nomi Health Commercial |
$571.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,092.00
|
| Rate for Payer: PACE SWMI |
$476.03
|
| Rate for Payer: PHP Medicare Advantage |
$476.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$810.74
|
| Rate for Payer: Priority Health Medicare |
$476.03
|
| Rate for Payer: Priority Health Narrow Network |
$810.74
|
| Rate for Payer: Railroad Medicare Medicare |
$476.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$856.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$476.03
|
| Rate for Payer: UHC Exchange |
$856.78
|
| Rate for Payer: UHC Medicaid |
$313.11
|
| Rate for Payer: UHCCP DNSP |
$476.03
|
| Rate for Payer: UHCCP Medicaid |
$313.11
|
|
|
PR CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 26742
|
| Min. Negotiated Rate |
$217.26 |
| Max. Negotiated Rate |
$722.25 |
| Rate for Payer: Aetna Commercial |
$439.68
|
| Rate for Payer: Aetna Medicare |
$328.12
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS MAPPO |
$328.12
|
| Rate for Payer: BCN Commercial |
$525.37
|
| Rate for Payer: BCN Medicare Advantage |
$328.12
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cofinity Commercial |
$472.49
|
| Rate for Payer: Cofinity Commercial |
$439.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.12
|
| Rate for Payer: Healthscope Commercial |
$393.74
|
| Rate for Payer: Healthscope Whirlpool |
$393.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.53
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.93
|
| Rate for Payer: Nomi Health Commercial |
$393.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.25
|
| Rate for Payer: PACE SWMI |
$328.12
|
| Rate for Payer: PHP Medicare Advantage |
$328.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$561.61
|
| Rate for Payer: Priority Health Medicare |
$328.12
|
| Rate for Payer: Priority Health Narrow Network |
$561.61
|
| Rate for Payer: Railroad Medicare Medicare |
$328.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$579.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$328.12
|
| Rate for Payer: UHC Exchange |
$579.04
|
| Rate for Payer: UHC Medicaid |
$217.26
|
| Rate for Payer: UHCCP DNSP |
$328.12
|
| Rate for Payer: UHCCP Medicaid |
$217.26
|
|
|
PR CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 26740
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna Commercial |
$288.27
|
| Rate for Payer: Aetna Medicare |
$215.13
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$215.13
|
| Rate for Payer: BCN Commercial |
$351.07
|
| Rate for Payer: BCN Medicare Advantage |
$215.13
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cofinity Commercial |
$309.79
|
| Rate for Payer: Cofinity Commercial |
$288.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.13
|
| Rate for Payer: Healthscope Commercial |
$258.16
|
| Rate for Payer: Healthscope Whirlpool |
$258.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.89
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.64
|
| Rate for Payer: Nomi Health Commercial |
$258.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$488.25
|
| Rate for Payer: PACE SWMI |
$215.13
|
| Rate for Payer: PHP Medicare Advantage |
$215.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$375.29
|
| Rate for Payer: Priority Health Medicare |
$215.13
|
| Rate for Payer: Priority Health Narrow Network |
$375.29
|
| Rate for Payer: Railroad Medicare Medicare |
$215.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.13
|
| Rate for Payer: UHC Exchange |
$372.17
|
| Rate for Payer: UHC Medicaid |
$144.20
|
| Rate for Payer: UHCCP DNSP |
$215.13
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
|
|
PR CLTX CARPAL BONE FX W/MNPJ EACH BONE
|
Professional
|
Both
|
$1,157.00
|
|
|
Service Code
|
HCPCS 25635
|
| Min. Negotiated Rate |
$269.87 |
| Max. Negotiated Rate |
$867.75 |
| Rate for Payer: Aetna Commercial |
$544.51
|
| Rate for Payer: Aetna Medicare |
$406.35
|
| Rate for Payer: BCBS Complete |
$283.36
|
| Rate for Payer: BCBS MAPPO |
$406.35
|
| Rate for Payer: BCN Commercial |
$663.31
|
| Rate for Payer: BCN Medicare Advantage |
$406.35
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cash Price |
$925.60
|
| Rate for Payer: Cofinity Commercial |
$585.14
|
| Rate for Payer: Cofinity Commercial |
$544.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.35
|
| Rate for Payer: Healthscope Commercial |
$487.62
|
| Rate for Payer: Healthscope Whirlpool |
$487.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$426.67
|
| Rate for Payer: Meridian Medicaid |
$283.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$446.99
|
| Rate for Payer: Nomi Health Commercial |
$487.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.75
|
| Rate for Payer: PACE SWMI |
$406.35
|
| Rate for Payer: PHP Medicare Advantage |
$406.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$709.07
|
| Rate for Payer: Priority Health Medicare |
$406.35
|
| Rate for Payer: Priority Health Narrow Network |
$709.07
|
| Rate for Payer: Railroad Medicare Medicare |
$406.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$720.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$406.35
|
| Rate for Payer: UHC Exchange |
$720.57
|
| Rate for Payer: UHC Medicaid |
$269.87
|
| Rate for Payer: UHCCP DNSP |
$406.35
|
| Rate for Payer: UHCCP Medicaid |
$269.87
|
|
|
PR CLTX CARPAL BONE FX W/O MNPJ EACH BONE
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 25630
|
| Min. Negotiated Rate |
$185.31 |
| Max. Negotiated Rate |
$551.25 |
| Rate for Payer: Aetna Commercial |
$372.60
|
| Rate for Payer: Aetna Medicare |
$278.06
|
| Rate for Payer: BCBS Complete |
$194.58
|
| Rate for Payer: BCBS MAPPO |
$278.06
|
| Rate for Payer: BCN Commercial |
$450.17
|
| Rate for Payer: BCN Medicare Advantage |
$278.06
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$400.41
|
| Rate for Payer: Cofinity Commercial |
$372.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.06
|
| Rate for Payer: Healthscope Commercial |
$333.67
|
| Rate for Payer: Healthscope Whirlpool |
$333.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.96
|
| Rate for Payer: Meridian Medicaid |
$194.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$305.87
|
| Rate for Payer: Nomi Health Commercial |
$333.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$278.06
|
| Rate for Payer: PHP Medicare Advantage |
$278.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$481.22
|
| Rate for Payer: Priority Health Medicare |
$278.06
|
| Rate for Payer: Priority Health Narrow Network |
$481.22
|
| Rate for Payer: Railroad Medicare Medicare |
$278.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$486.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.06
|
| Rate for Payer: UHC Exchange |
$486.26
|
| Rate for Payer: UHC Medicaid |
$185.31
|
| Rate for Payer: UHCCP DNSP |
$278.06
|
| Rate for Payer: UHCCP Medicaid |
$185.31
|
|
|
PR CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 26641
|
| Min. Negotiated Rate |
$244.95 |
| Max. Negotiated Rate |
$641.46 |
| Rate for Payer: Aetna Commercial |
$493.94
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: BCBS Complete |
$257.20
|
| Rate for Payer: BCBS MAPPO |
$368.61
|
| Rate for Payer: BCN Commercial |
$600.06
|
| Rate for Payer: BCN Medicare Advantage |
$368.61
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$530.80
|
| Rate for Payer: Cofinity Commercial |
$493.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.61
|
| Rate for Payer: Healthscope Commercial |
$442.33
|
| Rate for Payer: Healthscope Whirlpool |
$442.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.04
|
| Rate for Payer: Meridian Medicaid |
$257.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$405.47
|
| Rate for Payer: Nomi Health Commercial |
$442.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.50
|
| Rate for Payer: PACE SWMI |
$368.61
|
| Rate for Payer: PHP Medicare Advantage |
$368.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$641.46
|
| Rate for Payer: Priority Health Medicare |
$368.61
|
| Rate for Payer: Priority Health Narrow Network |
$641.46
|
| Rate for Payer: Railroad Medicare Medicare |
$368.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$599.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$368.61
|
| Rate for Payer: UHC Exchange |
$599.06
|
| Rate for Payer: UHC Medicaid |
$244.95
|
| Rate for Payer: UHCCP DNSP |
$368.61
|
| Rate for Payer: UHCCP Medicaid |
$244.95
|
|
|
PR CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ
|
Professional
|
Both
|
$1,049.00
|
|
|
Service Code
|
HCPCS 26645
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$786.75 |
| Rate for Payer: Aetna Commercial |
$506.01
|
| Rate for Payer: Aetna Medicare |
$377.62
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$377.62
|
| Rate for Payer: BCN Commercial |
$618.00
|
| Rate for Payer: BCN Medicare Advantage |
$377.62
|
| Rate for Payer: Cash Price |
$839.20
|
| Rate for Payer: Cash Price |
$839.20
|
| Rate for Payer: Cofinity Commercial |
$543.77
|
| Rate for Payer: Cofinity Commercial |
$506.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.62
|
| Rate for Payer: Healthscope Commercial |
$453.14
|
| Rate for Payer: Healthscope Whirlpool |
$453.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.50
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$415.38
|
| Rate for Payer: Nomi Health Commercial |
$453.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$786.75
|
| Rate for Payer: PACE SWMI |
$377.62
|
| Rate for Payer: PHP Medicare Advantage |
$377.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$660.62
|
| Rate for Payer: Priority Health Medicare |
$377.62
|
| Rate for Payer: Priority Health Narrow Network |
$660.62
|
| Rate for Payer: Railroad Medicare Medicare |
$377.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$679.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.62
|
| Rate for Payer: UHC Exchange |
$679.63
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP DNSP |
$377.62
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 26670
|
| Min. Negotiated Rate |
$227.91 |
| Max. Negotiated Rate |
$533.80 |
| Rate for Payer: Aetna Commercial |
$460.08
|
| Rate for Payer: Aetna Medicare |
$343.34
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS MAPPO |
$343.34
|
| Rate for Payer: BCN Commercial |
$496.98
|
| Rate for Payer: BCN Medicare Advantage |
$343.34
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$494.41
|
| Rate for Payer: Cofinity Commercial |
$460.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.34
|
| Rate for Payer: Healthscope Commercial |
$412.01
|
| Rate for Payer: Healthscope Whirlpool |
$412.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.51
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.67
|
| Rate for Payer: Nomi Health Commercial |
$412.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$467.25
|
| Rate for Payer: PACE SWMI |
$343.34
|
| Rate for Payer: PHP Medicare Advantage |
$343.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$531.27
|
| Rate for Payer: Priority Health Medicare |
$343.34
|
| Rate for Payer: Priority Health Narrow Network |
$531.27
|
| Rate for Payer: Railroad Medicare Medicare |
$343.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$533.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$343.34
|
| Rate for Payer: UHC Exchange |
$533.80
|
| Rate for Payer: UHC Medicaid |
$227.91
|
| Rate for Payer: UHCCP DNSP |
$343.34
|
| Rate for Payer: UHCCP Medicaid |
$227.91
|
|
|
PR CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES
|
Professional
|
Both
|
$1,303.00
|
|
|
Service Code
|
HCPCS 26675
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$977.25 |
| Rate for Payer: Aetna Commercial |
$541.04
|
| Rate for Payer: Aetna Medicare |
$403.76
|
| Rate for Payer: BCBS Complete |
$280.69
|
| Rate for Payer: BCBS MAPPO |
$403.76
|
| Rate for Payer: BCN Commercial |
$660.82
|
| Rate for Payer: BCN Medicare Advantage |
$403.76
|
| Rate for Payer: Cash Price |
$1,042.40
|
| Rate for Payer: Cash Price |
$1,042.40
|
| Rate for Payer: Cofinity Commercial |
$581.41
|
| Rate for Payer: Cofinity Commercial |
$541.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.76
|
| Rate for Payer: Healthscope Commercial |
$484.51
|
| Rate for Payer: Healthscope Whirlpool |
$484.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.95
|
| Rate for Payer: Meridian Medicaid |
$280.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$444.14
|
| Rate for Payer: Nomi Health Commercial |
$484.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$977.25
|
| Rate for Payer: PACE SWMI |
$403.76
|
| Rate for Payer: PHP Medicare Advantage |
$403.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$706.40
|
| Rate for Payer: Priority Health Medicare |
$403.76
|
| Rate for Payer: Priority Health Narrow Network |
$706.40
|
| Rate for Payer: Railroad Medicare Medicare |
$403.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$724.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.76
|
| Rate for Payer: UHC Exchange |
$724.94
|
| Rate for Payer: UHC Medicaid |
$267.32
|
| Rate for Payer: UHCCP DNSP |
$403.76
|
| Rate for Payer: UHCCP Medicaid |
$267.32
|
|
|
PR CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ
|
Professional
|
Both
|
$1,345.00
|
|
|
Service Code
|
HCPCS 27516
|
| Min. Negotiated Rate |
$304.59 |
| Max. Negotiated Rate |
$1,008.75 |
| Rate for Payer: Aetna Commercial |
$616.88
|
| Rate for Payer: Aetna Medicare |
$460.36
|
| Rate for Payer: BCBS Complete |
$319.82
|
| Rate for Payer: BCBS MAPPO |
$460.36
|
| Rate for Payer: BCN Commercial |
$754.94
|
| Rate for Payer: BCN Medicare Advantage |
$460.36
|
| Rate for Payer: Cash Price |
$1,076.00
|
| Rate for Payer: Cash Price |
$1,076.00
|
| Rate for Payer: Cofinity Commercial |
$662.92
|
| Rate for Payer: Cofinity Commercial |
$616.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.36
|
| Rate for Payer: Healthscope Commercial |
$552.43
|
| Rate for Payer: Healthscope Whirlpool |
$552.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.38
|
| Rate for Payer: Meridian Medicaid |
$319.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$506.40
|
| Rate for Payer: Nomi Health Commercial |
$552.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,008.75
|
| Rate for Payer: PACE SWMI |
$460.36
|
| Rate for Payer: PHP Medicare Advantage |
$460.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$807.00
|
| Rate for Payer: Priority Health Medicare |
$460.36
|
| Rate for Payer: Priority Health Narrow Network |
$807.00
|
| Rate for Payer: Railroad Medicare Medicare |
$460.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$830.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$460.36
|
| Rate for Payer: UHC Exchange |
$830.35
|
| Rate for Payer: UHC Medicaid |
$304.59
|
| Rate for Payer: UHCCP DNSP |
$460.36
|
| Rate for Payer: UHCCP Medicaid |
$304.59
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/MANJ
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
HCPCS 27788
|
| Min. Negotiated Rate |
$264.12 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Aetna Commercial |
$533.88
|
| Rate for Payer: Aetna Medicare |
$398.42
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$398.42
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: BCN Medicare Advantage |
$398.42
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cofinity Commercial |
$573.72
|
| Rate for Payer: Cofinity Commercial |
$533.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.42
|
| Rate for Payer: Healthscope Commercial |
$478.10
|
| Rate for Payer: Healthscope Whirlpool |
$478.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.34
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.26
|
| Rate for Payer: Nomi Health Commercial |
$478.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,048.50
|
| Rate for Payer: PACE SWMI |
$398.42
|
| Rate for Payer: PHP Medicare Advantage |
$398.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$640.92
|
| Rate for Payer: Priority Health Medicare |
$398.42
|
| Rate for Payer: Priority Health Narrow Network |
$640.92
|
| Rate for Payer: Railroad Medicare Medicare |
$398.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$667.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.42
|
| Rate for Payer: UHC Exchange |
$667.15
|
| Rate for Payer: UHC Medicaid |
$264.12
|
| Rate for Payer: UHCCP DNSP |
$398.42
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
|
|
PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
HCPCS 27786
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna Commercial |
$375.86
|
| Rate for Payer: Aetna Medicare |
$280.49
|
| Rate for Payer: BCBS Complete |
$196.59
|
| Rate for Payer: BCBS MAPPO |
$280.49
|
| Rate for Payer: BCN Commercial |
$354.61
|
| Rate for Payer: BCN Medicare Advantage |
$280.49
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$403.91
|
| Rate for Payer: Cofinity Commercial |
$375.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.49
|
| Rate for Payer: Healthscope Commercial |
$336.59
|
| Rate for Payer: Healthscope Whirlpool |
$336.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.51
|
| Rate for Payer: Meridian Medicaid |
$196.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.54
|
| Rate for Payer: Nomi Health Commercial |
$336.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.50
|
| Rate for Payer: PACE SWMI |
$280.49
|
| Rate for Payer: PHP Medicare Advantage |
$280.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$480.69
|
| Rate for Payer: Priority Health Medicare |
$280.49
|
| Rate for Payer: Priority Health Narrow Network |
$480.69
|
| Rate for Payer: Railroad Medicare Medicare |
$280.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$492.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.49
|
| Rate for Payer: UHC Exchange |
$492.99
|
| Rate for Payer: UHC Medicaid |
$187.23
|
| Rate for Payer: UHCCP DNSP |
$280.49
|
| Rate for Payer: UHCCP Medicaid |
$187.23
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 26755
|
| Min. Negotiated Rate |
$190.85 |
| Max. Negotiated Rate |
$472.60 |
| Rate for Payer: Aetna Commercial |
$384.97
|
| Rate for Payer: Aetna Medicare |
$287.29
|
| Rate for Payer: BCBS Complete |
$200.39
|
| Rate for Payer: BCBS MAPPO |
$287.29
|
| Rate for Payer: BCN Commercial |
$434.74
|
| Rate for Payer: BCN Medicare Advantage |
$287.29
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$413.70
|
| Rate for Payer: Cofinity Commercial |
$384.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.29
|
| Rate for Payer: Healthscope Commercial |
$344.75
|
| Rate for Payer: Healthscope Whirlpool |
$344.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.65
|
| Rate for Payer: Meridian Medicaid |
$200.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$316.02
|
| Rate for Payer: Nomi Health Commercial |
$344.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.25
|
| Rate for Payer: PACE SWMI |
$287.29
|
| Rate for Payer: PHP Medicare Advantage |
$287.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$464.71
|
| Rate for Payer: Priority Health Medicare |
$287.29
|
| Rate for Payer: Priority Health Narrow Network |
$464.71
|
| Rate for Payer: Railroad Medicare Medicare |
$287.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$472.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$287.29
|
| Rate for Payer: UHC Exchange |
$472.60
|
| Rate for Payer: UHC Medicaid |
$190.85
|
| Rate for Payer: UHCCP DNSP |
$287.29
|
| Rate for Payer: UHCCP Medicaid |
$190.85
|
|
|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$132.91 |
| Max. Negotiated Rate |
$324.71 |
| Rate for Payer: Aetna Commercial |
$265.41
|
| Rate for Payer: Aetna Medicare |
$198.07
|
| Rate for Payer: BCBS Complete |
$139.56
|
| Rate for Payer: BCBS MAPPO |
$198.07
|
| Rate for Payer: BCN Commercial |
$303.77
|
| Rate for Payer: BCN Medicare Advantage |
$198.07
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$285.22
|
| Rate for Payer: Cofinity Commercial |
$265.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.07
|
| Rate for Payer: Healthscope Commercial |
$237.68
|
| Rate for Payer: Healthscope Whirlpool |
$237.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.97
|
| Rate for Payer: Meridian Medicaid |
$139.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.88
|
| Rate for Payer: Nomi Health Commercial |
$237.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$198.07
|
| Rate for Payer: PHP Medicare Advantage |
$198.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$324.71
|
| Rate for Payer: Priority Health Medicare |
$198.07
|
| Rate for Payer: Priority Health Narrow Network |
$324.71
|
| Rate for Payer: Railroad Medicare Medicare |
$198.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.07
|
| Rate for Payer: UHC Exchange |
$318.80
|
| Rate for Payer: UHC Medicaid |
$132.91
|
| Rate for Payer: UHCCP DNSP |
$198.07
|
| Rate for Payer: UHCCP Medicaid |
$132.91
|
|
|
PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ
|
Professional
|
Both
|
$777.00
|
|
|
Service Code
|
HCPCS 25600
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$582.75 |
| Rate for Payer: Aetna Commercial |
$434.31
|
| Rate for Payer: Aetna Medicare |
$324.11
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$324.11
|
| Rate for Payer: BCN Commercial |
$405.66
|
| Rate for Payer: BCN Medicare Advantage |
$324.11
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cofinity Commercial |
$466.72
|
| Rate for Payer: Cofinity Commercial |
$434.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.11
|
| Rate for Payer: Healthscope Commercial |
$388.93
|
| Rate for Payer: Healthscope Whirlpool |
$388.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.32
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$356.52
|
| Rate for Payer: Nomi Health Commercial |
$388.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.75
|
| Rate for Payer: PACE SWMI |
$324.11
|
| Rate for Payer: PHP Medicare Advantage |
$324.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$324.11
|
| Rate for Payer: Priority Health Narrow Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$324.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$324.11
|
| Rate for Payer: UHC Exchange |
$538.15
|
| Rate for Payer: UHC Medicaid |
$218.11
|
| Rate for Payer: UHCCP DNSP |
$324.11
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MNPJ
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$709.15
|
| Rate for Payer: Aetna Medicare |
$529.22
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCBS MAPPO |
$529.22
|
| Rate for Payer: BCN Commercial |
$793.28
|
| Rate for Payer: BCN Medicare Advantage |
$529.22
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Commercial |
$762.08
|
| Rate for Payer: Cofinity Commercial |
$709.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.22
|
| Rate for Payer: Healthscope Commercial |
$635.06
|
| Rate for Payer: Healthscope Whirlpool |
$635.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.68
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.14
|
| Rate for Payer: Nomi Health Commercial |
$635.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,072.50
|
| Rate for Payer: PACE SWMI |
$529.22
|
| Rate for Payer: PHP Medicare Advantage |
$529.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$848.00
|
| Rate for Payer: Priority Health Medicare |
$529.22
|
| Rate for Payer: Priority Health Narrow Network |
$848.00
|
| Rate for Payer: Railroad Medicare Medicare |
$529.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$886.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.22
|
| Rate for Payer: UHC Exchange |
$886.27
|
| Rate for Payer: UHC Medicaid |
$350.39
|
| Rate for Payer: UHCCP DNSP |
$529.22
|
| Rate for Payer: UHCCP Medicaid |
$350.39
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$346.13 |
| Max. Negotiated Rate |
$879.40 |
| Rate for Payer: Aetna Commercial |
$687.47
|
| Rate for Payer: Aetna Medicare |
$513.04
|
| Rate for Payer: BCBS Complete |
$363.44
|
| Rate for Payer: BCBS MAPPO |
$513.04
|
| Rate for Payer: BCN Commercial |
$822.67
|
| Rate for Payer: BCN Medicare Advantage |
$513.04
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cofinity Commercial |
$738.78
|
| Rate for Payer: Cofinity Commercial |
$687.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.04
|
| Rate for Payer: Healthscope Commercial |
$615.65
|
| Rate for Payer: Healthscope Whirlpool |
$615.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.69
|
| Rate for Payer: Meridian Medicaid |
$363.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$564.34
|
| Rate for Payer: Nomi Health Commercial |
$615.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.50
|
| Rate for Payer: PACE SWMI |
$513.04
|
| Rate for Payer: PHP Medicare Advantage |
$513.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$879.40
|
| Rate for Payer: Priority Health Medicare |
$513.04
|
| Rate for Payer: Priority Health Narrow Network |
$879.40
|
| Rate for Payer: Railroad Medicare Medicare |
$513.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$870.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$513.04
|
| Rate for Payer: UHC Exchange |
$870.75
|
| Rate for Payer: UHC Medicaid |
$346.13
|
| Rate for Payer: UHCCP DNSP |
$513.04
|
| Rate for Payer: UHCCP Medicaid |
$346.13
|
|
