|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$149.60 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$224.69
|
| Rate for Payer: Aetna Commercial |
$224.69
|
| Rate for Payer: Aetna Medicare |
$167.68
|
| Rate for Payer: Aetna Medicare |
$167.68
|
| Rate for Payer: BCBS Complete |
$149.60
|
| Rate for Payer: BCBS Complete |
$209.60
|
| Rate for Payer: BCBS MAPPO |
$167.68
|
| Rate for Payer: BCBS MAPPO |
$167.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Medicare Advantage |
$167.68
|
| Rate for Payer: BCN Medicare Advantage |
$167.68
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cofinity Commercial |
$241.46
|
| Rate for Payer: Cofinity Commercial |
$241.46
|
| Rate for Payer: Cofinity Commercial |
$224.69
|
| Rate for Payer: Cofinity Commercial |
$224.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.68
|
| Rate for Payer: Healthscope Commercial |
$201.22
|
| Rate for Payer: Healthscope Commercial |
$201.22
|
| Rate for Payer: Healthscope Whirlpool |
$201.22
|
| Rate for Payer: Healthscope Whirlpool |
$201.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$176.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$176.06
|
| Rate for Payer: PACE SWMI |
$167.68
|
| Rate for Payer: PACE SWMI |
$167.68
|
| Rate for Payer: PHP Medicare Advantage |
$167.68
|
| Rate for Payer: PHP Medicare Advantage |
$167.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.45
|
| Rate for Payer: Priority Health Medicare |
$167.68
|
| Rate for Payer: Priority Health Medicare |
$167.68
|
| Rate for Payer: Priority Health Narrow Network |
$234.45
|
| Rate for Payer: Priority Health Narrow Network |
$234.45
|
| Rate for Payer: UHC Medicare Advantage |
$172.71
|
| Rate for Payer: UHC Medicare Advantage |
$172.71
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$640.30 |
| Rate for Payer: Aetna Commercial |
$271.54
|
| Rate for Payer: Aetna Commercial |
$271.54
|
| Rate for Payer: Aetna Medicare |
$202.64
|
| Rate for Payer: Aetna Medicare |
$202.64
|
| Rate for Payer: BCBS Complete |
$253.60
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$202.64
|
| Rate for Payer: BCBS MAPPO |
$202.64
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$202.64
|
| Rate for Payer: BCN Medicare Advantage |
$202.64
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$291.80
|
| Rate for Payer: Cofinity Commercial |
$291.80
|
| Rate for Payer: Cofinity Commercial |
$271.54
|
| Rate for Payer: Cofinity Commercial |
$271.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.64
|
| Rate for Payer: Healthscope Commercial |
$243.17
|
| Rate for Payer: Healthscope Commercial |
$243.17
|
| Rate for Payer: Healthscope Whirlpool |
$243.17
|
| Rate for Payer: Healthscope Whirlpool |
$243.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.77
|
| Rate for Payer: PACE SWMI |
$202.64
|
| Rate for Payer: PACE SWMI |
$202.64
|
| Rate for Payer: PHP Medicare Advantage |
$202.64
|
| Rate for Payer: PHP Medicare Advantage |
$202.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.96
|
| Rate for Payer: Priority Health Medicare |
$202.64
|
| Rate for Payer: Priority Health Medicare |
$202.64
|
| Rate for Payer: Priority Health Narrow Network |
$282.96
|
| Rate for Payer: Priority Health Narrow Network |
$282.96
|
| Rate for Payer: UHC Medicare Advantage |
$208.72
|
| Rate for Payer: UHC Medicare Advantage |
$208.72
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,779.08 |
| Rate for Payer: Aetna Commercial |
$1,387.21
|
| Rate for Payer: Aetna Medicare |
$1,035.23
|
| Rate for Payer: BCBS Complete |
$706.95
|
| Rate for Payer: BCBS MAPPO |
$1,035.23
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$1,535.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.23
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,490.73
|
| Rate for Payer: Cofinity Commercial |
$1,387.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.23
|
| Rate for Payer: Healthscope Commercial |
$1,242.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,242.28
|
| Rate for Payer: Meridian Medicaid |
$706.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,086.99
|
| Rate for Payer: PACE SWMI |
$1,035.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,779.08
|
| Rate for Payer: Priority Health Medicare |
$1,035.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,779.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,066.29
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG >4 CM
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 64893
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$1,895.71 |
| Rate for Payer: Aetna Commercial |
$1,478.64
|
| Rate for Payer: Aetna Medicare |
$1,103.46
|
| Rate for Payer: BCBS Complete |
$753.48
|
| Rate for Payer: BCBS MAPPO |
$1,103.46
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,636.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.46
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,478.64
|
| Rate for Payer: Cofinity Commercial |
$1,588.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.46
|
| Rate for Payer: Healthscope Commercial |
$1,324.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,324.15
|
| Rate for Payer: Meridian Medicaid |
$753.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,158.63
|
| Rate for Payer: PACE SWMI |
$1,103.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$717.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,895.71
|
| Rate for Payer: Priority Health Medicare |
$1,103.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,895.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.56
|
|
|
PR NERVE GRAFT 1 STRAND HAND/FOOT </4 CM
|
Professional
|
Both
|
$3,638.00
|
|
|
Service Code
|
HCPCS 64890
|
| Min. Negotiated Rate |
$359.24 |
| Max. Negotiated Rate |
$2,546.60 |
| Rate for Payer: Aetna Commercial |
$1,425.06
|
| Rate for Payer: Aetna Medicare |
$1,063.48
|
| Rate for Payer: BCBS Complete |
$726.19
|
| Rate for Payer: BCBS MAPPO |
$1,063.48
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$1,576.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.48
|
| Rate for Payer: Cash Price |
$2,910.40
|
| Rate for Payer: Cash Price |
$2,910.40
|
| Rate for Payer: Cofinity Commercial |
$1,531.41
|
| Rate for Payer: Cofinity Commercial |
$1,425.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.48
|
| Rate for Payer: Healthscope Commercial |
$1,276.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.18
|
| Rate for Payer: Meridian Medicaid |
$726.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.65
|
| Rate for Payer: PACE SWMI |
$1,063.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,546.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.20
|
| Rate for Payer: Priority Health Medicare |
$1,063.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,827.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.38
|
|
|
PR NERVE GRAFT EACH NERVE MULTIPLE STRANDS
|
Professional
|
Both
|
$2,886.00
|
|
|
Service Code
|
HCPCS 64902
|
| Min. Negotiated Rate |
$379.32 |
| Max. Negotiated Rate |
$2,020.20 |
| Rate for Payer: Aetna Commercial |
$906.15
|
| Rate for Payer: Aetna Medicare |
$676.23
|
| Rate for Payer: BCBS Complete |
$454.90
|
| Rate for Payer: BCBS MAPPO |
$676.23
|
| Rate for Payer: BCBS Trust/PPO |
$379.32
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$676.23
|
| Rate for Payer: Cash Price |
$2,308.80
|
| Rate for Payer: Cash Price |
$2,308.80
|
| Rate for Payer: Cofinity Commercial |
$906.15
|
| Rate for Payer: Cofinity Commercial |
$973.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.23
|
| Rate for Payer: Healthscope Commercial |
$811.48
|
| Rate for Payer: Healthscope Whirlpool |
$811.48
|
| Rate for Payer: Meridian Medicaid |
$454.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$710.04
|
| Rate for Payer: PACE SWMI |
$676.23
|
| Rate for Payer: PHP Medicare Advantage |
$676.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,020.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.57
|
| Rate for Payer: Priority Health Medicare |
$676.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.57
|
| Rate for Payer: UHC Medicare Advantage |
$696.52
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG </4 CM
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 64897
|
| Min. Negotiated Rate |
$407.32 |
| Max. Negotiated Rate |
$2,139.76 |
| Rate for Payer: Aetna Commercial |
$1,670.82
|
| Rate for Payer: Aetna Medicare |
$1,246.88
|
| Rate for Payer: BCBS Complete |
$850.09
|
| Rate for Payer: BCBS MAPPO |
$1,246.88
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$1,846.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.88
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cofinity Commercial |
$1,670.82
|
| Rate for Payer: Cofinity Commercial |
$1,795.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.88
|
| Rate for Payer: Healthscope Commercial |
$1,496.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,496.26
|
| Rate for Payer: Meridian Medicaid |
$850.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,309.22
|
| Rate for Payer: PACE SWMI |
$1,246.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$809.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,139.76
|
| Rate for Payer: Priority Health Medicare |
$1,246.88
|
| Rate for Payer: Priority Health Narrow Network |
$2,139.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,284.29
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG >4 CM
|
Professional
|
Both
|
$3,128.00
|
|
|
Service Code
|
HCPCS 64898
|
| Min. Negotiated Rate |
$367.70 |
| Max. Negotiated Rate |
$2,316.43 |
| Rate for Payer: Aetna Commercial |
$1,808.71
|
| Rate for Payer: Aetna Medicare |
$1,349.78
|
| Rate for Payer: BCBS Complete |
$920.55
|
| Rate for Payer: BCBS MAPPO |
$1,349.78
|
| Rate for Payer: BCBS Trust/PPO |
$367.70
|
| Rate for Payer: BCN Commercial |
$1,999.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.78
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cofinity Commercial |
$1,943.68
|
| Rate for Payer: Cofinity Commercial |
$1,808.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.78
|
| Rate for Payer: Healthscope Commercial |
$1,619.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,619.74
|
| Rate for Payer: Meridian Medicaid |
$920.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,417.27
|
| Rate for Payer: PACE SWMI |
$1,349.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,316.43
|
| Rate for Payer: Priority Health Medicare |
$1,349.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,316.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,390.27
|
|
|
PR NERVE GRAFT MLT STRANDS HAND/FOOT </4 CM
|
Professional
|
Both
|
$3,152.00
|
|
|
Service Code
|
HCPCS 64895
|
| Min. Negotiated Rate |
$219.77 |
| Max. Negotiated Rate |
$2,239.42 |
| Rate for Payer: Aetna Commercial |
$1,749.36
|
| Rate for Payer: Aetna Medicare |
$1,305.49
|
| Rate for Payer: BCBS Complete |
$888.78
|
| Rate for Payer: BCBS MAPPO |
$1,305.49
|
| Rate for Payer: BCBS Trust/PPO |
$219.77
|
| Rate for Payer: BCN Commercial |
$1,932.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,305.49
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,879.91
|
| Rate for Payer: Cofinity Commercial |
$1,749.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,305.49
|
| Rate for Payer: Healthscope Commercial |
$1,566.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,566.59
|
| Rate for Payer: Meridian Medicaid |
$888.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,370.76
|
| Rate for Payer: PACE SWMI |
$1,305.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,305.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,206.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,239.42
|
| Rate for Payer: Priority Health Medicare |
$1,305.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,239.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,344.65
|
|
|
PR NERVE REPAIR W/CONDUIT EACH NERVE
|
Professional
|
Both
|
$2,570.00
|
|
|
Service Code
|
HCPCS 64910
|
| Min. Negotiated Rate |
$272.60 |
| Max. Negotiated Rate |
$1,799.00 |
| Rate for Payer: Aetna Commercial |
$998.06
|
| Rate for Payer: Aetna Medicare |
$744.82
|
| Rate for Payer: BCBS Complete |
$513.94
|
| Rate for Payer: BCBS MAPPO |
$744.82
|
| Rate for Payer: BCBS Trust/PPO |
$272.60
|
| Rate for Payer: BCN Commercial |
$1,113.21
|
| Rate for Payer: BCN Medicare Advantage |
$744.82
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cofinity Commercial |
$998.06
|
| Rate for Payer: Cofinity Commercial |
$1,072.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.82
|
| Rate for Payer: Healthscope Commercial |
$893.78
|
| Rate for Payer: Healthscope Whirlpool |
$893.78
|
| Rate for Payer: Meridian Medicaid |
$513.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$782.06
|
| Rate for Payer: PACE SWMI |
$744.82
|
| Rate for Payer: PHP Medicare Advantage |
$744.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.86
|
| Rate for Payer: Priority Health Medicare |
$744.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,289.86
|
| Rate for Payer: UHC Medicare Advantage |
$767.16
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 64913
|
| Min. Negotiated Rate |
$109.06 |
| Max. Negotiated Rate |
$290.47 |
| Rate for Payer: Aetna Commercial |
$228.31
|
| Rate for Payer: Aetna Medicare |
$170.38
|
| Rate for Payer: BCBS Complete |
$114.51
|
| Rate for Payer: BCBS MAPPO |
$170.38
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: BCN Medicare Advantage |
$170.38
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$228.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.38
|
| Rate for Payer: Healthscope Commercial |
$204.46
|
| Rate for Payer: Healthscope Whirlpool |
$204.46
|
| Rate for Payer: Meridian Medicaid |
$114.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.90
|
| Rate for Payer: PACE SWMI |
$170.38
|
| Rate for Payer: PHP Medicare Advantage |
$170.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.47
|
| Rate for Payer: Priority Health Medicare |
$170.38
|
| Rate for Payer: Priority Health Narrow Network |
$290.47
|
| Rate for Payer: UHC Medicare Advantage |
$175.49
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 64912
|
| Min. Negotiated Rate |
$311.17 |
| Max. Negotiated Rate |
$1,516.92 |
| Rate for Payer: Aetna Commercial |
$1,173.73
|
| Rate for Payer: Aetna Medicare |
$875.92
|
| Rate for Payer: BCBS Complete |
$602.96
|
| Rate for Payer: BCBS MAPPO |
$875.92
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$1,309.17
|
| Rate for Payer: BCN Medicare Advantage |
$875.92
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$1,173.73
|
| Rate for Payer: Cofinity Commercial |
$1,261.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.92
|
| Rate for Payer: Healthscope Commercial |
$1,051.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,051.10
|
| Rate for Payer: Meridian Medicaid |
$602.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.72
|
| Rate for Payer: PACE SWMI |
$875.92
|
| Rate for Payer: PHP Medicare Advantage |
$875.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,516.92
|
| Rate for Payer: Priority Health Medicare |
$875.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.92
|
| Rate for Payer: UHC Medicare Advantage |
$902.20
|
|
|
PR NEURAXIAL LABOR ANALG/ANES PLND VAGINAL DELIVERY
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01967
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.00
|
| Rate for Payer: Priority Health Narrow Network |
$650.00
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 96116
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$106.15
|
| Rate for Payer: Aetna Medicare |
$79.22
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$79.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$134.38
|
| Rate for Payer: BCN Medicare Advantage |
$79.22
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$106.15
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.22
|
| Rate for Payer: Healthscope Commercial |
$95.06
|
| Rate for Payer: Healthscope Whirlpool |
$95.06
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.18
|
| Rate for Payer: PACE SWMI |
$79.22
|
| Rate for Payer: PHP Medicare Advantage |
$79.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.44
|
| Rate for Payer: Priority Health Medicare |
$79.22
|
| Rate for Payer: Priority Health Narrow Network |
$106.44
|
| Rate for Payer: UHC Medicare Advantage |
$81.60
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$164.00
|
|
|
Service Code
|
HCPCS 96121
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$1,458.64 |
| Rate for Payer: Aetna Commercial |
$89.12
|
| Rate for Payer: Aetna Medicare |
$66.51
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS MAPPO |
$66.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.64
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$66.51
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$89.12
|
| Rate for Payer: Cofinity Commercial |
$95.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.51
|
| Rate for Payer: Healthscope Commercial |
$79.81
|
| Rate for Payer: Healthscope Whirlpool |
$79.81
|
| Rate for Payer: Meridian Medicaid |
$44.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.84
|
| Rate for Payer: PACE SWMI |
$66.51
|
| Rate for Payer: PHP Medicare Advantage |
$66.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.93
|
| Rate for Payer: Priority Health Medicare |
$66.51
|
| Rate for Payer: Priority Health Narrow Network |
$88.93
|
| Rate for Payer: UHC Medicare Advantage |
$68.51
|
|
|
PR NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY
|
Professional
|
Both
|
$4,301.50
|
|
|
Service Code
|
HCPCS 62164
|
| Min. Negotiated Rate |
$1,230.41 |
| Max. Negotiated Rate |
$4,290.63 |
| Rate for Payer: Aetna Commercial |
$2,826.40
|
| Rate for Payer: Aetna Medicare |
$2,109.25
|
| Rate for Payer: BCBS Complete |
$1,428.67
|
| Rate for Payer: BCBS MAPPO |
$2,109.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
| Rate for Payer: BCN Commercial |
$4,290.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,109.25
|
| Rate for Payer: Cash Price |
$3,441.20
|
| Rate for Payer: Cash Price |
$3,441.20
|
| Rate for Payer: Cofinity Commercial |
$3,037.32
|
| Rate for Payer: Cofinity Commercial |
$2,826.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,109.25
|
| Rate for Payer: Healthscope Commercial |
$2,531.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,531.10
|
| Rate for Payer: Meridian Medicaid |
$1,428.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,214.71
|
| Rate for Payer: PACE SWMI |
$2,109.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,109.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,360.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,011.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,583.63
|
| Rate for Payer: Priority Health Medicare |
$2,109.25
|
| Rate for Payer: Priority Health Narrow Network |
$3,583.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,172.53
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95937
|
| Min. Negotiated Rate |
$59.17 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna Commercial |
$133.30
|
| Rate for Payer: Aetna Medicare |
$99.48
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$99.48
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$153.93
|
| Rate for Payer: BCN Medicare Advantage |
$99.48
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$143.25
|
| Rate for Payer: Cofinity Commercial |
$133.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.48
|
| Rate for Payer: Healthscope Commercial |
$119.38
|
| Rate for Payer: Healthscope Whirlpool |
$119.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.45
|
| Rate for Payer: PACE SWMI |
$99.48
|
| Rate for Payer: PHP Medicare Advantage |
$99.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.47
|
| Rate for Payer: Priority Health Medicare |
$99.48
|
| Rate for Payer: Priority Health Narrow Network |
$141.47
|
| Rate for Payer: UHC Medicare Advantage |
$102.46
|
|
|
PR NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT
|
Professional
|
Both
|
$2,439.00
|
|
|
Service Code
|
HCPCS 64702
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$4,639.00 |
| Rate for Payer: Aetna Commercial |
$674.33
|
| Rate for Payer: Aetna Medicare |
$503.23
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS MAPPO |
$503.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,639.00
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: BCN Medicare Advantage |
$503.23
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cofinity Commercial |
$724.65
|
| Rate for Payer: Cofinity Commercial |
$674.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.23
|
| Rate for Payer: Healthscope Commercial |
$603.88
|
| Rate for Payer: Healthscope Whirlpool |
$603.88
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$528.39
|
| Rate for Payer: PACE SWMI |
$503.23
|
| Rate for Payer: PHP Medicare Advantage |
$503.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,707.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.08
|
| Rate for Payer: Priority Health Medicare |
$503.23
|
| Rate for Payer: Priority Health Narrow Network |
$877.08
|
| Rate for Payer: UHC Medicare Advantage |
$518.33
|
|
|
PR NEUROPLASTY NERVE HAND/FOOT
|
Professional
|
Both
|
$1,851.00
|
|
|
Service Code
|
HCPCS 64704
|
| Min. Negotiated Rate |
$209.59 |
| Max. Negotiated Rate |
$6,889.56 |
| Rate for Payer: Aetna Commercial |
$424.67
|
| Rate for Payer: Aetna Medicare |
$316.92
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$316.92
|
| Rate for Payer: BCBS Trust/PPO |
$6,889.56
|
| Rate for Payer: BCN Commercial |
$474.51
|
| Rate for Payer: BCN Medicare Advantage |
$316.92
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Cofinity Commercial |
$424.67
|
| Rate for Payer: Cofinity Commercial |
$456.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.92
|
| Rate for Payer: Healthscope Commercial |
$380.30
|
| Rate for Payer: Healthscope Whirlpool |
$380.30
|
| Rate for Payer: Meridian Medicaid |
$220.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$332.77
|
| Rate for Payer: PACE SWMI |
$316.92
|
| Rate for Payer: PHP Medicare Advantage |
$316.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$549.80
|
| Rate for Payer: Priority Health Medicare |
$316.92
|
| Rate for Payer: Priority Health Narrow Network |
$549.80
|
| Rate for Payer: UHC Medicare Advantage |
$326.43
|
|
|
PR NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 64716
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$5,621.64 |
| Rate for Payer: Aetna Commercial |
$672.95
|
| Rate for Payer: Aetna Medicare |
$502.20
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS MAPPO |
$502.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,621.64
|
| Rate for Payer: BCN Commercial |
$751.59
|
| Rate for Payer: BCN Medicare Advantage |
$502.20
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$672.95
|
| Rate for Payer: Cofinity Commercial |
$723.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.20
|
| Rate for Payer: Healthscope Commercial |
$602.64
|
| Rate for Payer: Healthscope Whirlpool |
$602.64
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$527.31
|
| Rate for Payer: PACE SWMI |
$502.20
|
| Rate for Payer: PHP Medicare Advantage |
$502.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.86
|
| Rate for Payer: Priority Health Medicare |
$502.20
|
| Rate for Payer: Priority Health Narrow Network |
$870.86
|
| Rate for Payer: UHC Medicare Advantage |
$517.27
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
IP
|
$3,084.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$2,158.80 |
| Max. Negotiated Rate |
$3,084.00 |
| Rate for Payer: Aetna Commercial |
$2,775.60
|
| Rate for Payer: ASR ASR |
$2,991.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.03
|
| Rate for Payer: BCN Commercial |
$2,391.03
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cofinity Commercial |
$2,898.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,467.20
|
| Rate for Payer: Healthscope Commercial |
$3,084.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,991.48
|
| Rate for Payer: Mclaren Commercial |
$2,775.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,621.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,158.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,713.92
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
OP
|
$3,084.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$938.78 |
| Max. Negotiated Rate |
$3,084.00 |
| Rate for Payer: Aetna Commercial |
$2,775.60
|
| Rate for Payer: Aetna Medicare |
$1,716.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: ASR ASR |
$2,991.48
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.03
|
| Rate for Payer: BCN Commercial |
$2,391.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cofinity Commercial |
$2,898.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,467.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$3,084.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,991.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,716.23
|
| Rate for Payer: Mclaren Commercial |
$2,775.60
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,621.40
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| Rate for Payer: PHP Medicaid |
$938.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,158.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,806.44
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,189.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,713.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,084.00
|
|
|
Service Code
|
HCPCS 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$4,438.25 |
| Rate for Payer: Aetna Commercial |
$793.09
|
| Rate for Payer: Aetna Medicare |
$591.86
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$591.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.25
|
| Rate for Payer: BCN Commercial |
$889.40
|
| Rate for Payer: BCN Medicare Advantage |
$591.86
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cofinity Commercial |
$793.09
|
| Rate for Payer: Cofinity Commercial |
$852.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.86
|
| Rate for Payer: Healthscope Commercial |
$710.23
|
| Rate for Payer: Healthscope Whirlpool |
$710.23
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$621.45
|
| Rate for Payer: PACE SWMI |
$591.86
|
| Rate for Payer: PHP Medicare Advantage |
$591.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,158.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.53
|
| Rate for Payer: Priority Health Medicare |
$591.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,030.53
|
| Rate for Payer: UHC Medicare Advantage |
$609.62
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,084.00
|
|
|
Service Code
|
HCPCS 64718
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$4,438.25 |
| Rate for Payer: Aetna Commercial |
$793.09
|
| Rate for Payer: Aetna Medicare |
$591.86
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$591.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.25
|
| Rate for Payer: BCN Commercial |
$889.40
|
| Rate for Payer: BCN Medicare Advantage |
$591.86
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cash Price |
$2,467.20
|
| Rate for Payer: Cofinity Commercial |
$852.28
|
| Rate for Payer: Cofinity Commercial |
$793.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.86
|
| Rate for Payer: Healthscope Commercial |
$710.23
|
| Rate for Payer: Healthscope Whirlpool |
$710.23
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$621.45
|
| Rate for Payer: PACE SWMI |
$591.86
|
| Rate for Payer: PHP Medicare Advantage |
$591.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,158.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.53
|
| Rate for Payer: Priority Health Medicare |
$591.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,030.53
|
| Rate for Payer: UHC Medicare Advantage |
$609.62
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 64719
|
| Min. Negotiated Rate |
$265.40 |
| Max. Negotiated Rate |
$3,989.19 |
| Rate for Payer: Aetna Commercial |
$536.78
|
| Rate for Payer: Aetna Medicare |
$400.58
|
| Rate for Payer: BCBS Complete |
$278.67
|
| Rate for Payer: BCBS MAPPO |
$400.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.19
|
| Rate for Payer: BCN Commercial |
$602.05
|
| Rate for Payer: BCN Medicare Advantage |
$400.58
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cofinity Commercial |
$536.78
|
| Rate for Payer: Cofinity Commercial |
$576.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.58
|
| Rate for Payer: Healthscope Commercial |
$480.70
|
| Rate for Payer: Healthscope Whirlpool |
$480.70
|
| Rate for Payer: Meridian Medicaid |
$278.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$420.61
|
| Rate for Payer: PACE SWMI |
$400.58
|
| Rate for Payer: PHP Medicare Advantage |
$400.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$697.59
|
| Rate for Payer: Priority Health Medicare |
$400.58
|
| Rate for Payer: Priority Health Narrow Network |
$697.59
|
| Rate for Payer: UHC Medicare Advantage |
$412.60
|
|
