|
PR CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 23665
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$1,060.50 |
| Rate for Payer: Aetna Commercial |
$536.91
|
| Rate for Payer: Aetna Medicare |
$400.68
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$400.68
|
| Rate for Payer: BCN Commercial |
$625.47
|
| Rate for Payer: BCN Medicare Advantage |
$400.68
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cofinity Commercial |
$576.98
|
| Rate for Payer: Cofinity Commercial |
$536.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.68
|
| Rate for Payer: Healthscope Commercial |
$480.82
|
| Rate for Payer: Healthscope Whirlpool |
$480.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.71
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.75
|
| Rate for Payer: Nomi Health Commercial |
$480.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,060.50
|
| Rate for Payer: PACE SWMI |
$400.68
|
| Rate for Payer: PHP Medicare Advantage |
$400.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$668.60
|
| Rate for Payer: Priority Health Medicare |
$400.68
|
| Rate for Payer: Priority Health Narrow Network |
$668.60
|
| Rate for Payer: Railroad Medicare Medicare |
$400.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$685.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$400.68
|
| Rate for Payer: UHC Exchange |
$685.21
|
| Rate for Payer: UHC Medicaid |
$265.61
|
| Rate for Payer: UHCCP DNSP |
$400.68
|
| Rate for Payer: UHCCP Medicaid |
$265.61
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MNPJ
|
Professional
|
Both
|
$1,689.00
|
|
|
Service Code
|
HCPCS 24535
|
| Min. Negotiated Rate |
$360.18 |
| Max. Negotiated Rate |
$1,266.75 |
| Rate for Payer: Aetna Commercial |
$732.19
|
| Rate for Payer: Aetna Medicare |
$546.41
|
| Rate for Payer: BCBS Complete |
$378.19
|
| Rate for Payer: BCBS MAPPO |
$546.41
|
| Rate for Payer: BCN Commercial |
$887.90
|
| Rate for Payer: BCN Medicare Advantage |
$546.41
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cofinity Commercial |
$786.83
|
| Rate for Payer: Cofinity Commercial |
$732.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.41
|
| Rate for Payer: Healthscope Commercial |
$655.69
|
| Rate for Payer: Healthscope Whirlpool |
$655.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.73
|
| Rate for Payer: Meridian Medicaid |
$378.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.05
|
| Rate for Payer: Nomi Health Commercial |
$655.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,266.75
|
| Rate for Payer: PACE SWMI |
$546.41
|
| Rate for Payer: PHP Medicare Advantage |
$546.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$949.14
|
| Rate for Payer: Priority Health Medicare |
$546.41
|
| Rate for Payer: Priority Health Narrow Network |
$949.14
|
| Rate for Payer: Railroad Medicare Medicare |
$546.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.41
|
| Rate for Payer: UHC Exchange |
$984.09
|
| Rate for Payer: UHC Medicaid |
$360.18
|
| Rate for Payer: UHCCP DNSP |
$546.41
|
| Rate for Payer: UHCCP Medicaid |
$360.18
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MNPJ
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 24530
|
| Min. Negotiated Rate |
$229.19 |
| Max. Negotiated Rate |
$651.75 |
| Rate for Payer: Aetna Commercial |
$460.96
|
| Rate for Payer: Aetna Medicare |
$344.00
|
| Rate for Payer: BCBS Complete |
$240.65
|
| Rate for Payer: BCBS MAPPO |
$344.00
|
| Rate for Payer: BCN Commercial |
$551.76
|
| Rate for Payer: BCN Medicare Advantage |
$344.00
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$495.36
|
| Rate for Payer: Cofinity Commercial |
$460.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.00
|
| Rate for Payer: Healthscope Commercial |
$412.80
|
| Rate for Payer: Healthscope Whirlpool |
$412.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.20
|
| Rate for Payer: Meridian Medicaid |
$240.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$378.40
|
| Rate for Payer: Nomi Health Commercial |
$412.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.75
|
| Rate for Payer: PACE SWMI |
$344.00
|
| Rate for Payer: PHP Medicare Advantage |
$344.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$589.82
|
| Rate for Payer: Priority Health Medicare |
$344.00
|
| Rate for Payer: Priority Health Narrow Network |
$589.82
|
| Rate for Payer: Railroad Medicare Medicare |
$344.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.00
|
| Rate for Payer: UHC Exchange |
$595.67
|
| Rate for Payer: UHC Medicaid |
$229.19
|
| Rate for Payer: UHCCP DNSP |
$344.00
|
| Rate for Payer: UHCCP Medicaid |
$229.19
|
|
|
PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 27503
|
| Min. Negotiated Rate |
$478.61 |
| Max. Negotiated Rate |
$1,698.75 |
| Rate for Payer: Aetna Commercial |
$983.81
|
| Rate for Payer: Aetna Medicare |
$734.19
|
| Rate for Payer: BCBS Complete |
$502.54
|
| Rate for Payer: BCBS MAPPO |
$734.19
|
| Rate for Payer: BCN Commercial |
$1,220.05
|
| Rate for Payer: BCN Medicare Advantage |
$734.19
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$983.81
|
| Rate for Payer: Cofinity Commercial |
$1,057.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$734.19
|
| Rate for Payer: Healthscope Commercial |
$881.03
|
| Rate for Payer: Healthscope Whirlpool |
$881.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.90
|
| Rate for Payer: Meridian Medicaid |
$502.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$807.61
|
| Rate for Payer: Nomi Health Commercial |
$881.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,698.75
|
| Rate for Payer: PACE SWMI |
$734.19
|
| Rate for Payer: PHP Medicare Advantage |
$734.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,304.20
|
| Rate for Payer: Priority Health Medicare |
$734.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,304.20
|
| Rate for Payer: Railroad Medicare Medicare |
$734.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,400.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$734.19
|
| Rate for Payer: UHC Exchange |
$1,400.25
|
| Rate for Payer: UHC Medicaid |
$478.61
|
| Rate for Payer: UHCCP DNSP |
$734.19
|
| Rate for Payer: UHCCP Medicaid |
$478.61
|
|
|
PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ
|
Professional
|
Both
|
$1,623.00
|
|
|
Service Code
|
HCPCS 27501
|
| Min. Negotiated Rate |
$305.87 |
| Max. Negotiated Rate |
$1,217.25 |
| Rate for Payer: Aetna Commercial |
$624.05
|
| Rate for Payer: Aetna Medicare |
$465.71
|
| Rate for Payer: BCBS Complete |
$321.16
|
| Rate for Payer: BCBS MAPPO |
$465.71
|
| Rate for Payer: BCN Commercial |
$766.39
|
| Rate for Payer: BCN Medicare Advantage |
$465.71
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Cofinity Commercial |
$670.62
|
| Rate for Payer: Cofinity Commercial |
$624.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.71
|
| Rate for Payer: Healthscope Commercial |
$558.85
|
| Rate for Payer: Healthscope Whirlpool |
$558.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.00
|
| Rate for Payer: Meridian Medicaid |
$321.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.28
|
| Rate for Payer: Nomi Health Commercial |
$558.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,217.25
|
| Rate for Payer: PACE SWMI |
$465.71
|
| Rate for Payer: PHP Medicare Advantage |
$465.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$819.25
|
| Rate for Payer: Priority Health Medicare |
$465.71
|
| Rate for Payer: Priority Health Narrow Network |
$819.25
|
| Rate for Payer: Railroad Medicare Medicare |
$465.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$864.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.71
|
| Rate for Payer: UHC Exchange |
$864.97
|
| Rate for Payer: UHC Medicaid |
$305.87
|
| Rate for Payer: UHCCP DNSP |
$465.71
|
| Rate for Payer: UHCCP Medicaid |
$305.87
|
|
|
PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES
|
Professional
|
Both
|
$731.00
|
|
|
Service Code
|
HCPCS 28545
|
| Min. Negotiated Rate |
$176.79 |
| Max. Negotiated Rate |
$548.25 |
| Rate for Payer: Aetna Commercial |
$354.18
|
| Rate for Payer: Aetna Medicare |
$264.31
|
| Rate for Payer: BCBS Complete |
$185.63
|
| Rate for Payer: BCBS MAPPO |
$264.31
|
| Rate for Payer: BCN Commercial |
$425.77
|
| Rate for Payer: BCN Medicare Advantage |
$264.31
|
| Rate for Payer: Cash Price |
$584.80
|
| Rate for Payer: Cash Price |
$584.80
|
| Rate for Payer: Cofinity Commercial |
$380.61
|
| Rate for Payer: Cofinity Commercial |
$354.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.31
|
| Rate for Payer: Healthscope Commercial |
$317.17
|
| Rate for Payer: Healthscope Whirlpool |
$317.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$277.53
|
| Rate for Payer: Meridian Medicaid |
$185.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$290.74
|
| Rate for Payer: Nomi Health Commercial |
$317.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$548.25
|
| Rate for Payer: PACE SWMI |
$264.31
|
| Rate for Payer: PHP Medicare Advantage |
$264.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$455.14
|
| Rate for Payer: Priority Health Medicare |
$264.31
|
| Rate for Payer: Priority Health Narrow Network |
$455.14
|
| Rate for Payer: Railroad Medicare Medicare |
$264.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$264.31
|
| Rate for Payer: UHC Exchange |
$454.45
|
| Rate for Payer: UHC Medicaid |
$176.79
|
| Rate for Payer: UHCCP DNSP |
$264.31
|
| Rate for Payer: UHCCP Medicaid |
$176.79
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 27530
|
| Min. Negotiated Rate |
$191.91 |
| Max. Negotiated Rate |
$651.00 |
| Rate for Payer: Aetna Commercial |
$383.35
|
| Rate for Payer: Aetna Medicare |
$286.08
|
| Rate for Payer: BCBS Complete |
$201.51
|
| Rate for Payer: BCBS MAPPO |
$286.08
|
| Rate for Payer: BCN Commercial |
$456.15
|
| Rate for Payer: BCN Medicare Advantage |
$286.08
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$411.96
|
| Rate for Payer: Cofinity Commercial |
$383.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.08
|
| Rate for Payer: Healthscope Commercial |
$343.30
|
| Rate for Payer: Healthscope Whirlpool |
$343.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.38
|
| Rate for Payer: Meridian Medicaid |
$201.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.69
|
| Rate for Payer: Nomi Health Commercial |
$343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.00
|
| Rate for Payer: PACE SWMI |
$286.08
|
| Rate for Payer: PHP Medicare Advantage |
$286.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$487.61
|
| Rate for Payer: Priority Health Medicare |
$286.08
|
| Rate for Payer: Priority Health Narrow Network |
$487.61
|
| Rate for Payer: Railroad Medicare Medicare |
$286.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$485.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$286.08
|
| Rate for Payer: UHC Exchange |
$485.11
|
| Rate for Payer: UHC Medicaid |
$191.91
|
| Rate for Payer: UHCCP DNSP |
$286.08
|
| Rate for Payer: UHCCP Medicaid |
$191.91
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 27532
|
| Min. Negotiated Rate |
$354.43 |
| Max. Negotiated Rate |
$1,003.58 |
| Rate for Payer: Aetna Commercial |
$723.51
|
| Rate for Payer: Aetna Medicare |
$539.93
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS MAPPO |
$539.93
|
| Rate for Payer: BCN Commercial |
$893.88
|
| Rate for Payer: BCN Medicare Advantage |
$539.93
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$777.50
|
| Rate for Payer: Cofinity Commercial |
$723.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.93
|
| Rate for Payer: Healthscope Commercial |
$647.92
|
| Rate for Payer: Healthscope Whirlpool |
$647.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.93
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$593.92
|
| Rate for Payer: Nomi Health Commercial |
$647.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$877.50
|
| Rate for Payer: PACE SWMI |
$539.93
|
| Rate for Payer: PHP Medicare Advantage |
$539.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$955.53
|
| Rate for Payer: Priority Health Medicare |
$539.93
|
| Rate for Payer: Priority Health Narrow Network |
$955.53
|
| Rate for Payer: Railroad Medicare Medicare |
$539.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,003.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$539.93
|
| Rate for Payer: UHC Exchange |
$1,003.58
|
| Rate for Payer: UHC Medicaid |
$354.43
|
| Rate for Payer: UHCCP DNSP |
$539.93
|
| Rate for Payer: UHCCP Medicaid |
$354.43
|
|
|
PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 27752
|
| Min. Negotiated Rate |
$319.29 |
| Max. Negotiated Rate |
$1,385.25 |
| Rate for Payer: Aetna Commercial |
$649.28
|
| Rate for Payer: Aetna Medicare |
$484.54
|
| Rate for Payer: BCBS Complete |
$335.25
|
| Rate for Payer: BCBS MAPPO |
$484.54
|
| Rate for Payer: BCN Commercial |
$756.93
|
| Rate for Payer: BCN Medicare Advantage |
$484.54
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$697.74
|
| Rate for Payer: Cofinity Commercial |
$649.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.54
|
| Rate for Payer: Healthscope Commercial |
$581.45
|
| Rate for Payer: Healthscope Whirlpool |
$581.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.77
|
| Rate for Payer: Meridian Medicaid |
$335.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$532.99
|
| Rate for Payer: Nomi Health Commercial |
$581.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.25
|
| Rate for Payer: PACE SWMI |
$484.54
|
| Rate for Payer: PHP Medicare Advantage |
$484.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$809.14
|
| Rate for Payer: Priority Health Medicare |
$484.54
|
| Rate for Payer: Priority Health Narrow Network |
$809.14
|
| Rate for Payer: Railroad Medicare Medicare |
$484.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$484.54
|
| Rate for Payer: UHC Exchange |
$855.33
|
| Rate for Payer: UHC Medicaid |
$319.29
|
| Rate for Payer: UHCCP DNSP |
$484.54
|
| Rate for Payer: UHCCP Medicaid |
$319.29
|
|
|
PR CLTX TIBIAL SHAFT FX W/O MANIPULATION
|
Professional
|
Both
|
$949.00
|
|
|
Service Code
|
HCPCS 27750
|
| Min. Negotiated Rate |
$212.79 |
| Max. Negotiated Rate |
$711.75 |
| Rate for Payer: Aetna Commercial |
$427.61
|
| Rate for Payer: Aetna Medicare |
$319.11
|
| Rate for Payer: BCBS Complete |
$223.43
|
| Rate for Payer: BCBS MAPPO |
$319.11
|
| Rate for Payer: BCN Commercial |
$506.95
|
| Rate for Payer: BCN Medicare Advantage |
$319.11
|
| Rate for Payer: Cash Price |
$759.20
|
| Rate for Payer: Cash Price |
$759.20
|
| Rate for Payer: Cofinity Commercial |
$459.52
|
| Rate for Payer: Cofinity Commercial |
$427.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.11
|
| Rate for Payer: Healthscope Commercial |
$382.93
|
| Rate for Payer: Healthscope Whirlpool |
$382.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.07
|
| Rate for Payer: Meridian Medicaid |
$223.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$351.02
|
| Rate for Payer: Nomi Health Commercial |
$382.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.75
|
| Rate for Payer: PACE SWMI |
$319.11
|
| Rate for Payer: PHP Medicare Advantage |
$319.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$541.91
|
| Rate for Payer: Priority Health Medicare |
$319.11
|
| Rate for Payer: Priority Health Narrow Network |
$541.91
|
| Rate for Payer: Railroad Medicare Medicare |
$319.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$548.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$319.11
|
| Rate for Payer: UHC Exchange |
$548.78
|
| Rate for Payer: UHC Medicaid |
$212.79
|
| Rate for Payer: UHCCP DNSP |
$319.11
|
| Rate for Payer: UHCCP Medicaid |
$212.79
|
|
|
PR CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MNPJ
|
Professional
|
Both
|
$921.00
|
|
|
Service Code
|
HCPCS 25680
|
| Min. Negotiated Rate |
$331.00 |
| Max. Negotiated Rate |
$908.04 |
| Rate for Payer: Aetna Commercial |
$671.22
|
| Rate for Payer: Aetna Medicare |
$500.91
|
| Rate for Payer: BCBS Complete |
$347.55
|
| Rate for Payer: BCBS MAPPO |
$500.91
|
| Rate for Payer: BCN Commercial |
$824.16
|
| Rate for Payer: BCN Medicare Advantage |
$500.91
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cofinity Commercial |
$721.31
|
| Rate for Payer: Cofinity Commercial |
$671.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.91
|
| Rate for Payer: Healthscope Commercial |
$601.09
|
| Rate for Payer: Healthscope Whirlpool |
$601.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.96
|
| Rate for Payer: Meridian Medicaid |
$347.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$551.00
|
| Rate for Payer: Nomi Health Commercial |
$601.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.75
|
| Rate for Payer: PACE SWMI |
$500.91
|
| Rate for Payer: PHP Medicare Advantage |
$500.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$880.99
|
| Rate for Payer: Priority Health Medicare |
$500.91
|
| Rate for Payer: Priority Health Narrow Network |
$880.99
|
| Rate for Payer: Railroad Medicare Medicare |
$500.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$908.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$500.91
|
| Rate for Payer: UHC Exchange |
$908.04
|
| Rate for Payer: UHC Medicaid |
$331.00
|
| Rate for Payer: UHCCP DNSP |
$500.91
|
| Rate for Payer: UHCCP Medicaid |
$331.00
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION
|
Professional
|
Both
|
$1,747.00
|
|
|
Service Code
|
HCPCS 27818
|
| Min. Negotiated Rate |
$303.74 |
| Max. Negotiated Rate |
$1,310.25 |
| Rate for Payer: Aetna Commercial |
$616.40
|
| Rate for Payer: Aetna Medicare |
$460.00
|
| Rate for Payer: BCBS Complete |
$318.93
|
| Rate for Payer: BCBS MAPPO |
$460.00
|
| Rate for Payer: BCN Commercial |
$684.22
|
| Rate for Payer: BCN Medicare Advantage |
$460.00
|
| Rate for Payer: Cash Price |
$1,397.60
|
| Rate for Payer: Cash Price |
$1,397.60
|
| Rate for Payer: Cofinity Commercial |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$616.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.00
|
| Rate for Payer: Healthscope Commercial |
$552.00
|
| Rate for Payer: Healthscope Whirlpool |
$552.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.00
|
| Rate for Payer: Meridian Medicaid |
$318.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$506.00
|
| Rate for Payer: Nomi Health Commercial |
$552.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,310.25
|
| Rate for Payer: PACE SWMI |
$460.00
|
| Rate for Payer: PHP Medicare Advantage |
$460.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$731.42
|
| Rate for Payer: Priority Health Medicare |
$460.00
|
| Rate for Payer: Priority Health Narrow Network |
$731.42
|
| Rate for Payer: Railroad Medicare Medicare |
$460.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$756.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$460.00
|
| Rate for Payer: UHC Exchange |
$756.64
|
| Rate for Payer: UHC Medicaid |
$303.74
|
| Rate for Payer: UHCCP DNSP |
$460.00
|
| Rate for Payer: UHCCP Medicaid |
$303.74
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 27816
|
| Min. Negotiated Rate |
$200.01 |
| Max. Negotiated Rate |
$499.69 |
| Rate for Payer: Aetna Commercial |
$401.34
|
| Rate for Payer: Aetna Medicare |
$299.51
|
| Rate for Payer: BCBS Complete |
$210.01
|
| Rate for Payer: BCBS MAPPO |
$299.51
|
| Rate for Payer: BCN Commercial |
$463.12
|
| Rate for Payer: BCN Medicare Advantage |
$299.51
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$431.29
|
| Rate for Payer: Cofinity Commercial |
$401.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.51
|
| Rate for Payer: Healthscope Commercial |
$359.41
|
| Rate for Payer: Healthscope Whirlpool |
$359.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.49
|
| Rate for Payer: Meridian Medicaid |
$210.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.46
|
| Rate for Payer: Nomi Health Commercial |
$359.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.50
|
| Rate for Payer: PACE SWMI |
$299.51
|
| Rate for Payer: PHP Medicare Advantage |
$299.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$495.06
|
| Rate for Payer: Priority Health Medicare |
$299.51
|
| Rate for Payer: Priority Health Narrow Network |
$495.06
|
| Rate for Payer: Railroad Medicare Medicare |
$299.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$499.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.51
|
| Rate for Payer: UHC Exchange |
$499.69
|
| Rate for Payer: UHC Medicaid |
$200.01
|
| Rate for Payer: UHCCP DNSP |
$299.51
|
| Rate for Payer: UHCCP Medicaid |
$200.01
|
|
|
PR CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 22310
|
| Min. Negotiated Rate |
$185.95 |
| Max. Negotiated Rate |
$691.50 |
| Rate for Payer: Aetna Commercial |
$377.45
|
| Rate for Payer: Aetna Medicare |
$281.68
|
| Rate for Payer: BCBS Complete |
$195.25
|
| Rate for Payer: BCBS MAPPO |
$281.68
|
| Rate for Payer: BCN Commercial |
$457.15
|
| Rate for Payer: BCN Medicare Advantage |
$281.68
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$405.62
|
| Rate for Payer: Cofinity Commercial |
$377.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.68
|
| Rate for Payer: Healthscope Commercial |
$338.02
|
| Rate for Payer: Healthscope Whirlpool |
$338.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$295.76
|
| Rate for Payer: Meridian Medicaid |
$195.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$338.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$691.50
|
| Rate for Payer: PACE SWMI |
$281.68
|
| Rate for Payer: PHP Medicare Advantage |
$281.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$488.68
|
| Rate for Payer: Priority Health Medicare |
$281.68
|
| Rate for Payer: Priority Health Narrow Network |
$488.68
|
| Rate for Payer: Railroad Medicare Medicare |
$281.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$281.68
|
| Rate for Payer: UHC Exchange |
$503.76
|
| Rate for Payer: UHC Medicaid |
$185.95
|
| Rate for Payer: UHCCP DNSP |
$281.68
|
| Rate for Payer: UHCCP Medicaid |
$185.95
|
|
|
PR CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ
|
Professional
|
Both
|
$1,341.00
|
|
|
Service Code
|
HCPCS 22315
|
| Min. Negotiated Rate |
$482.02 |
| Max. Negotiated Rate |
$1,342.51 |
| Rate for Payer: Aetna Commercial |
$987.69
|
| Rate for Payer: Aetna Medicare |
$737.08
|
| Rate for Payer: BCBS Complete |
$506.12
|
| Rate for Payer: BCBS MAPPO |
$737.08
|
| Rate for Payer: BCN Commercial |
$1,196.15
|
| Rate for Payer: BCN Medicare Advantage |
$737.08
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cofinity Commercial |
$987.69
|
| Rate for Payer: Cofinity Commercial |
$1,061.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.08
|
| Rate for Payer: Healthscope Commercial |
$884.50
|
| Rate for Payer: Healthscope Whirlpool |
$884.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.93
|
| Rate for Payer: Meridian Medicaid |
$506.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.79
|
| Rate for Payer: Nomi Health Commercial |
$884.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.75
|
| Rate for Payer: PACE SWMI |
$737.08
|
| Rate for Payer: PHP Medicare Advantage |
$737.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,278.65
|
| Rate for Payer: Priority Health Medicare |
$737.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,278.65
|
| Rate for Payer: Railroad Medicare Medicare |
$737.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,342.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$737.08
|
| Rate for Payer: UHC Exchange |
$1,342.51
|
| Rate for Payer: UHC Medicaid |
$482.02
|
| Rate for Payer: UHCCP DNSP |
$737.08
|
| Rate for Payer: UHCCP Medicaid |
$482.02
|
|
|
PR CMBND ANTERPOST COLPORRAPHY W/CYSTO
|
Professional
|
Both
|
$2,090.00
|
|
|
Service Code
|
HCPCS 57260
|
| Min. Negotiated Rate |
$438.35 |
| Max. Negotiated Rate |
$1,567.50 |
| Rate for Payer: Aetna Commercial |
$912.26
|
| Rate for Payer: Aetna Medicare |
$680.79
|
| Rate for Payer: BCBS Complete |
$460.27
|
| Rate for Payer: BCBS MAPPO |
$680.79
|
| Rate for Payer: BCN Commercial |
$1,167.26
|
| Rate for Payer: BCN Medicare Advantage |
$680.79
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cofinity Commercial |
$980.34
|
| Rate for Payer: Cofinity Commercial |
$912.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.79
|
| Rate for Payer: Healthscope Commercial |
$816.95
|
| Rate for Payer: Healthscope Whirlpool |
$816.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.83
|
| Rate for Payer: Meridian Medicaid |
$460.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$748.87
|
| Rate for Payer: Nomi Health Commercial |
$816.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,567.50
|
| Rate for Payer: PACE SWMI |
$680.79
|
| Rate for Payer: PHP Medicare Advantage |
$680.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,182.19
|
| Rate for Payer: Priority Health Medicare |
$680.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,182.19
|
| Rate for Payer: Railroad Medicare Medicare |
$680.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,370.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$680.79
|
| Rate for Payer: UHC Exchange |
$1,370.06
|
| Rate for Payer: UHC Medicaid |
$438.35
|
| Rate for Payer: UHCCP DNSP |
$680.79
|
| Rate for Payer: UHCCP Medicaid |
$438.35
|
|
|
PR CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR
|
Professional
|
Both
|
$2,690.00
|
|
|
Service Code
|
HCPCS 57265
|
| Min. Negotiated Rate |
$489.90 |
| Max. Negotiated Rate |
$2,017.50 |
| Rate for Payer: Aetna Commercial |
$1,020.80
|
| Rate for Payer: Aetna Medicare |
$761.79
|
| Rate for Payer: BCBS Complete |
$514.39
|
| Rate for Payer: BCBS MAPPO |
$761.79
|
| Rate for Payer: BCN Commercial |
$1,305.20
|
| Rate for Payer: BCN Medicare Advantage |
$761.79
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.98
|
| Rate for Payer: Cofinity Commercial |
$1,020.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.79
|
| Rate for Payer: Healthscope Commercial |
$914.15
|
| Rate for Payer: Healthscope Whirlpool |
$914.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.88
|
| Rate for Payer: Meridian Medicaid |
$514.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$837.97
|
| Rate for Payer: Nomi Health Commercial |
$914.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,017.50
|
| Rate for Payer: PACE SWMI |
$761.79
|
| Rate for Payer: PHP Medicare Advantage |
$761.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,321.89
|
| Rate for Payer: Priority Health Medicare |
$761.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,321.89
|
| Rate for Payer: Railroad Medicare Medicare |
$761.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,539.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.79
|
| Rate for Payer: UHC Exchange |
$1,539.10
|
| Rate for Payer: UHC Medicaid |
$489.90
|
| Rate for Payer: UHCCP DNSP |
$761.79
|
| Rate for Payer: UHCCP Medicaid |
$489.90
|
|
|
PR CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 36598
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$305.25 |
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$30.35
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$30.35
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Medicare Advantage |
$30.35
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$43.70
|
| Rate for Payer: Cofinity Commercial |
$40.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.35
|
| Rate for Payer: Healthscope Commercial |
$36.42
|
| Rate for Payer: Healthscope Whirlpool |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.87
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.38
|
| Rate for Payer: Nomi Health Commercial |
$36.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.25
|
| Rate for Payer: PACE SWMI |
$30.35
|
| Rate for Payer: PHP Medicare Advantage |
$30.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$30.35
|
| Rate for Payer: Priority Health Narrow Network |
$55.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.35
|
| Rate for Payer: UHC Exchange |
$65.86
|
| Rate for Payer: UHC Medicaid |
$19.38
|
| Rate for Payer: UHCCP DNSP |
$30.35
|
| Rate for Payer: UHCCP Medicaid |
$19.38
|
|
|
PR COCCYGECTOMY PRIMARY
|
Professional
|
Both
|
$2,010.00
|
|
|
Service Code
|
HCPCS 27080
|
| Min. Negotiated Rate |
$319.29 |
| Max. Negotiated Rate |
$1,507.50 |
| Rate for Payer: Aetna Commercial |
$655.05
|
| Rate for Payer: Aetna Medicare |
$488.84
|
| Rate for Payer: BCBS Complete |
$335.25
|
| Rate for Payer: BCBS MAPPO |
$488.84
|
| Rate for Payer: BCN Commercial |
$775.85
|
| Rate for Payer: BCN Medicare Advantage |
$488.84
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cofinity Commercial |
$703.93
|
| Rate for Payer: Cofinity Commercial |
$655.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.84
|
| Rate for Payer: Healthscope Commercial |
$586.61
|
| Rate for Payer: Healthscope Whirlpool |
$586.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.28
|
| Rate for Payer: Meridian Medicaid |
$335.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$537.72
|
| Rate for Payer: Nomi Health Commercial |
$586.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,507.50
|
| Rate for Payer: PACE SWMI |
$488.84
|
| Rate for Payer: PHP Medicare Advantage |
$488.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$829.37
|
| Rate for Payer: Priority Health Medicare |
$488.84
|
| Rate for Payer: Priority Health Narrow Network |
$829.37
|
| Rate for Payer: Railroad Medicare Medicare |
$488.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$894.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$488.84
|
| Rate for Payer: UHC Exchange |
$894.86
|
| Rate for Payer: UHC Medicaid |
$319.29
|
| Rate for Payer: UHCCP DNSP |
$488.84
|
| Rate for Payer: UHCCP Medicaid |
$319.29
|
|
|
PR COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY
|
Professional
|
Both
|
$4,353.00
|
|
|
Service Code
|
HCPCS 69930
|
| Min. Negotiated Rate |
$675.85 |
| Max. Negotiated Rate |
$3,264.75 |
| Rate for Payer: Aetna Commercial |
$1,388.47
|
| Rate for Payer: Aetna Medicare |
$1,036.17
|
| Rate for Payer: BCBS Complete |
$709.64
|
| Rate for Payer: BCBS MAPPO |
$1,036.17
|
| Rate for Payer: BCN Commercial |
$1,811.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.17
|
| Rate for Payer: Cash Price |
$3,482.40
|
| Rate for Payer: Cash Price |
$3,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,388.47
|
| Rate for Payer: Cofinity Commercial |
$1,492.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.17
|
| Rate for Payer: Healthscope Commercial |
$1,243.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,243.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,087.98
|
| Rate for Payer: Meridian Medicaid |
$709.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,139.79
|
| Rate for Payer: Nomi Health Commercial |
$1,243.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,264.75
|
| Rate for Payer: PACE SWMI |
$1,036.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,790.10
|
| Rate for Payer: Priority Health Medicare |
$1,036.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,790.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,036.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,104.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,036.17
|
| Rate for Payer: UHC Exchange |
$2,104.08
|
| Rate for Payer: UHC Medicaid |
$675.85
|
| Rate for Payer: UHCCP DNSP |
$1,036.17
|
| Rate for Payer: UHCCP Medicaid |
$675.85
|
|
|
PR COCHLEAR DEVICE/SOFT BAND FITTING FEE
|
Professional
|
Both
|
$525.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
|
|
PR COCM BY RHC/FQHC 60 MIN MO
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS G0512
|
| Min. Negotiated Rate |
$105.08 |
| Max. Negotiated Rate |
$273.75 |
| Rate for Payer: Aetna Commercial |
$148.37
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.75
|
|
|
PR COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST
|
Professional
|
Both
|
$3,955.00
|
|
|
Service Code
|
HCPCS 44151
|
| Min. Negotiated Rate |
$1,282.47 |
| Max. Negotiated Rate |
$3,912.99 |
| Rate for Payer: Aetna Commercial |
$2,681.23
|
| Rate for Payer: Aetna Medicare |
$2,000.92
|
| Rate for Payer: BCBS Complete |
$1,346.59
|
| Rate for Payer: BCBS MAPPO |
$2,000.92
|
| Rate for Payer: BCN Commercial |
$3,211.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,000.92
|
| Rate for Payer: Cash Price |
$3,164.00
|
| Rate for Payer: Cash Price |
$3,164.00
|
| Rate for Payer: Cofinity Commercial |
$2,881.32
|
| Rate for Payer: Cofinity Commercial |
$2,681.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,000.92
|
| Rate for Payer: Healthscope Commercial |
$2,401.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,401.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,100.97
|
| Rate for Payer: Meridian Medicaid |
$1,346.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,201.01
|
| Rate for Payer: Nomi Health Commercial |
$2,401.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,966.25
|
| Rate for Payer: PACE SWMI |
$2,000.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,000.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,282.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,912.99
|
| Rate for Payer: Priority Health Medicare |
$2,000.92
|
| Rate for Payer: Priority Health Narrow Network |
$3,912.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2,000.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,848.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,000.92
|
| Rate for Payer: UHC Exchange |
$3,848.22
|
| Rate for Payer: UHC Medicaid |
$1,282.47
|
| Rate for Payer: UHCCP DNSP |
$2,000.92
|
| Rate for Payer: UHCCP Medicaid |
$1,282.47
|
|
|
PR COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$4,749.00
|
|
|
Service Code
|
HCPCS 44150
|
| Min. Negotiated Rate |
$1,103.55 |
| Max. Negotiated Rate |
$3,561.75 |
| Rate for Payer: Aetna Commercial |
$2,297.36
|
| Rate for Payer: Aetna Medicare |
$1,714.45
|
| Rate for Payer: BCBS Complete |
$1,158.73
|
| Rate for Payer: BCBS MAPPO |
$1,714.45
|
| Rate for Payer: BCN Commercial |
$2,765.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,714.45
|
| Rate for Payer: Cash Price |
$3,799.20
|
| Rate for Payer: Cash Price |
$3,799.20
|
| Rate for Payer: Cofinity Commercial |
$2,468.81
|
| Rate for Payer: Cofinity Commercial |
$2,297.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,714.45
|
| Rate for Payer: Healthscope Commercial |
$2,057.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,057.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,800.17
|
| Rate for Payer: Meridian Medicaid |
$1,158.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,885.89
|
| Rate for Payer: Nomi Health Commercial |
$2,057.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,561.75
|
| Rate for Payer: PACE SWMI |
$1,714.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,714.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,103.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,369.32
|
| Rate for Payer: Priority Health Medicare |
$1,714.45
|
| Rate for Payer: Priority Health Narrow Network |
$3,369.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,714.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,307.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,714.45
|
| Rate for Payer: UHC Exchange |
$3,307.27
|
| Rate for Payer: UHC Medicaid |
$1,103.55
|
| Rate for Payer: UHCCP DNSP |
$1,714.45
|
| Rate for Payer: UHCCP Medicaid |
$1,103.55
|
|
|
PR COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR
|
Professional
|
Both
|
$4,840.00
|
|
|
Service Code
|
HCPCS 44158
|
| Min. Negotiated Rate |
$1,333.59 |
| Max. Negotiated Rate |
$4,078.02 |
| Rate for Payer: Aetna Commercial |
$2,790.39
|
| Rate for Payer: Aetna Medicare |
$2,082.38
|
| Rate for Payer: BCBS Complete |
$1,400.27
|
| Rate for Payer: BCBS MAPPO |
$2,082.38
|
| Rate for Payer: BCN Commercial |
$3,346.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.38
|
| Rate for Payer: Cash Price |
$3,872.00
|
| Rate for Payer: Cash Price |
$3,872.00
|
| Rate for Payer: Cofinity Commercial |
$2,998.63
|
| Rate for Payer: Cofinity Commercial |
$2,790.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.38
|
| Rate for Payer: Healthscope Commercial |
$2,498.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,498.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,186.50
|
| Rate for Payer: Meridian Medicaid |
$1,400.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,290.62
|
| Rate for Payer: Nomi Health Commercial |
$2,498.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,630.00
|
| Rate for Payer: PACE SWMI |
$2,082.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,333.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,078.02
|
| Rate for Payer: Priority Health Medicare |
$2,082.38
|
| Rate for Payer: Priority Health Narrow Network |
$4,078.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,007.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.38
|
| Rate for Payer: UHC Exchange |
$4,007.66
|
| Rate for Payer: UHC Medicaid |
$1,333.59
|
| Rate for Payer: UHCCP DNSP |
$2,082.38
|
| Rate for Payer: UHCCP Medicaid |
$1,333.59
|
|
