|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$408.75 |
| Max. Negotiated Rate |
$1,017.10 |
| Rate for Payer: Aetna Commercial |
$830.71
|
| Rate for Payer: Aetna Medicare |
$619.93
|
| Rate for Payer: BCBS Complete |
$429.19
|
| Rate for Payer: BCBS MAPPO |
$619.93
|
| Rate for Payer: BCBS Trust/PPO |
$889.13
|
| Rate for Payer: BCN Commercial |
$930.44
|
| Rate for Payer: BCN Medicare Advantage |
$619.93
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$892.70
|
| Rate for Payer: Cofinity Commercial |
$830.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.93
|
| Rate for Payer: Healthscope Commercial |
$743.92
|
| Rate for Payer: Healthscope Whirlpool |
$743.92
|
| Rate for Payer: Meridian Medicaid |
$429.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$650.93
|
| Rate for Payer: PACE SWMI |
$619.93
|
| Rate for Payer: PHP Medicare Advantage |
$619.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$972.27
|
| Rate for Payer: Priority Health Medicare |
$619.93
|
| Rate for Payer: Priority Health Narrow Network |
$972.27
|
| Rate for Payer: UHC Medicare Advantage |
$638.53
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,631.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$96.79 |
| Max. Negotiated Rate |
$1,141.70 |
| Rate for Payer: Aetna Commercial |
$979.34
|
| Rate for Payer: Aetna Medicare |
$730.85
|
| Rate for Payer: BCBS Complete |
$504.78
|
| Rate for Payer: BCBS MAPPO |
$730.85
|
| Rate for Payer: BCBS Trust/PPO |
$96.79
|
| Rate for Payer: BCN Commercial |
$1,092.19
|
| Rate for Payer: BCN Medicare Advantage |
$730.85
|
| Rate for Payer: Cash Price |
$1,304.80
|
| Rate for Payer: Cash Price |
$1,304.80
|
| Rate for Payer: Cofinity Commercial |
$1,052.42
|
| Rate for Payer: Cofinity Commercial |
$979.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.85
|
| Rate for Payer: Healthscope Commercial |
$877.02
|
| Rate for Payer: Healthscope Whirlpool |
$877.02
|
| Rate for Payer: Meridian Medicaid |
$504.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$767.39
|
| Rate for Payer: PACE SWMI |
$730.85
|
| Rate for Payer: PHP Medicare Advantage |
$730.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,141.30
|
| Rate for Payer: Priority Health Medicare |
$730.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,141.30
|
| Rate for Payer: UHC Medicare Advantage |
$752.78
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,244.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$380.42 |
| Max. Negotiated Rate |
$1,570.80 |
| Rate for Payer: Aetna Commercial |
$774.04
|
| Rate for Payer: Aetna Medicare |
$577.64
|
| Rate for Payer: BCBS Complete |
$399.44
|
| Rate for Payer: BCBS MAPPO |
$577.64
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: BCN Medicare Advantage |
$577.64
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Cofinity Commercial |
$831.80
|
| Rate for Payer: Cofinity Commercial |
$774.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.64
|
| Rate for Payer: Healthscope Commercial |
$693.17
|
| Rate for Payer: Healthscope Whirlpool |
$693.17
|
| Rate for Payer: Meridian Medicaid |
$399.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$606.52
|
| Rate for Payer: PACE SWMI |
$577.64
|
| Rate for Payer: PHP Medicare Advantage |
$577.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.85
|
| Rate for Payer: Priority Health Medicare |
$577.64
|
| Rate for Payer: Priority Health Narrow Network |
$903.85
|
| Rate for Payer: UHC Medicare Advantage |
$594.97
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,240.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$1,037.13 |
| Rate for Payer: Aetna Commercial |
$887.94
|
| Rate for Payer: Aetna Medicare |
$662.64
|
| Rate for Payer: BCBS Complete |
$458.70
|
| Rate for Payer: BCBS MAPPO |
$662.64
|
| Rate for Payer: BCBS Trust/PPO |
$38.63
|
| Rate for Payer: BCN Commercial |
$992.51
|
| Rate for Payer: BCN Medicare Advantage |
$662.64
|
| Rate for Payer: Cash Price |
$992.00
|
| Rate for Payer: Cash Price |
$992.00
|
| Rate for Payer: Cofinity Commercial |
$954.20
|
| Rate for Payer: Cofinity Commercial |
$887.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$662.64
|
| Rate for Payer: Healthscope Commercial |
$795.17
|
| Rate for Payer: Healthscope Whirlpool |
$795.17
|
| Rate for Payer: Meridian Medicaid |
$458.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$695.77
|
| Rate for Payer: PACE SWMI |
$662.64
|
| Rate for Payer: PHP Medicare Advantage |
$662.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$868.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.13
|
| Rate for Payer: Priority Health Medicare |
$662.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.13
|
| Rate for Payer: UHC Medicare Advantage |
$682.52
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,249.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$319.71 |
| Max. Negotiated Rate |
$978.82 |
| Rate for Payer: Aetna Commercial |
$650.56
|
| Rate for Payer: Aetna Medicare |
$485.49
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS MAPPO |
$485.49
|
| Rate for Payer: BCBS Trust/PPO |
$732.22
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$485.49
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cofinity Commercial |
$650.56
|
| Rate for Payer: Cofinity Commercial |
$699.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.49
|
| Rate for Payer: Healthscope Commercial |
$582.59
|
| Rate for Payer: Healthscope Whirlpool |
$582.59
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$509.76
|
| Rate for Payer: PACE SWMI |
$485.49
|
| Rate for Payer: PHP Medicare Advantage |
$485.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.81
|
| Rate for Payer: Priority Health Medicare |
$485.49
|
| Rate for Payer: Priority Health Narrow Network |
$757.81
|
| Rate for Payer: UHC Medicare Advantage |
$500.05
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$535.91 |
| Max. Negotiated Rate |
$2,231.54 |
| Rate for Payer: Aetna Commercial |
$1,097.77
|
| Rate for Payer: Aetna Medicare |
$819.23
|
| Rate for Payer: BCBS Complete |
$562.71
|
| Rate for Payer: BCBS MAPPO |
$819.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,231.54
|
| Rate for Payer: BCN Commercial |
$1,219.25
|
| Rate for Payer: BCN Medicare Advantage |
$819.23
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cofinity Commercial |
$1,097.77
|
| Rate for Payer: Cofinity Commercial |
$1,179.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.23
|
| Rate for Payer: Healthscope Commercial |
$983.08
|
| Rate for Payer: Healthscope Whirlpool |
$983.08
|
| Rate for Payer: Meridian Medicaid |
$562.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$860.19
|
| Rate for Payer: PACE SWMI |
$819.23
|
| Rate for Payer: PHP Medicare Advantage |
$819.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,274.08
|
| Rate for Payer: Priority Health Medicare |
$819.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,274.08
|
| Rate for Payer: UHC Medicare Advantage |
$843.81
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$369.13 |
| Max. Negotiated Rate |
$877.29 |
| Rate for Payer: Aetna Commercial |
$750.94
|
| Rate for Payer: Aetna Medicare |
$560.40
|
| Rate for Payer: BCBS Complete |
$387.59
|
| Rate for Payer: BCBS MAPPO |
$560.40
|
| Rate for Payer: BCBS Trust/PPO |
$386.72
|
| Rate for Payer: BCN Commercial |
$839.55
|
| Rate for Payer: BCN Medicare Advantage |
$560.40
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cofinity Commercial |
$806.98
|
| Rate for Payer: Cofinity Commercial |
$750.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.40
|
| Rate for Payer: Healthscope Commercial |
$672.48
|
| Rate for Payer: Healthscope Whirlpool |
$672.48
|
| Rate for Payer: Meridian Medicaid |
$387.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$588.42
|
| Rate for Payer: PACE SWMI |
$560.40
|
| Rate for Payer: PHP Medicare Advantage |
$560.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.29
|
| Rate for Payer: Priority Health Medicare |
$560.40
|
| Rate for Payer: Priority Health Narrow Network |
$877.29
|
| Rate for Payer: UHC Medicare Advantage |
$577.21
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,164.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$2,214.80 |
| Rate for Payer: Aetna Commercial |
$1,283.61
|
| Rate for Payer: Aetna Medicare |
$957.92
|
| Rate for Payer: BCBS Complete |
$657.98
|
| Rate for Payer: BCBS MAPPO |
$957.92
|
| Rate for Payer: BCBS Trust/PPO |
$50.72
|
| Rate for Payer: BCN Commercial |
$1,435.25
|
| Rate for Payer: BCN Medicare Advantage |
$957.92
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Cofinity Commercial |
$1,283.61
|
| Rate for Payer: Cofinity Commercial |
$1,379.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$957.92
|
| Rate for Payer: Healthscope Commercial |
$1,149.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.50
|
| Rate for Payer: Meridian Medicaid |
$657.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,005.82
|
| Rate for Payer: PACE SWMI |
$957.92
|
| Rate for Payer: PHP Medicare Advantage |
$957.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,214.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.78
|
| Rate for Payer: Priority Health Medicare |
$957.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,499.78
|
| Rate for Payer: UHC Medicare Advantage |
$986.66
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$239.32 |
| Max. Negotiated Rate |
$872.90 |
| Rate for Payer: Aetna Commercial |
$583.21
|
| Rate for Payer: Aetna Medicare |
$435.23
|
| Rate for Payer: BCBS Complete |
$303.49
|
| Rate for Payer: BCBS MAPPO |
$435.23
|
| Rate for Payer: BCBS Trust/PPO |
$239.32
|
| Rate for Payer: BCN Commercial |
$653.85
|
| Rate for Payer: BCN Medicare Advantage |
$435.23
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cofinity Commercial |
$626.73
|
| Rate for Payer: Cofinity Commercial |
$583.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.23
|
| Rate for Payer: Healthscope Commercial |
$522.28
|
| Rate for Payer: Healthscope Whirlpool |
$522.28
|
| Rate for Payer: Meridian Medicaid |
$303.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$456.99
|
| Rate for Payer: PACE SWMI |
$435.23
|
| Rate for Payer: PHP Medicare Advantage |
$435.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.25
|
| Rate for Payer: Priority Health Medicare |
$435.23
|
| Rate for Payer: Priority Health Narrow Network |
$683.25
|
| Rate for Payer: UHC Medicare Advantage |
$448.29
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$935.20 |
| Rate for Payer: Aetna Commercial |
$651.82
|
| Rate for Payer: Aetna Medicare |
$486.43
|
| Rate for Payer: BCBS Complete |
$337.93
|
| Rate for Payer: BCBS MAPPO |
$486.43
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$729.59
|
| Rate for Payer: BCN Medicare Advantage |
$486.43
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$700.46
|
| Rate for Payer: Cofinity Commercial |
$651.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.43
|
| Rate for Payer: Healthscope Commercial |
$583.72
|
| Rate for Payer: Healthscope Whirlpool |
$583.72
|
| Rate for Payer: Meridian Medicaid |
$337.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$510.75
|
| Rate for Payer: PACE SWMI |
$486.43
|
| Rate for Payer: PHP Medicare Advantage |
$486.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$935.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.41
|
| Rate for Payer: Priority Health Medicare |
$486.43
|
| Rate for Payer: Priority Health Narrow Network |
$762.41
|
| Rate for Payer: UHC Medicare Advantage |
$501.02
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,498.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$303.65 |
| Max. Negotiated Rate |
$1,361.39 |
| Rate for Payer: Aetna Commercial |
$1,166.05
|
| Rate for Payer: Aetna Medicare |
$870.19
|
| Rate for Payer: BCBS Complete |
$598.71
|
| Rate for Payer: BCBS MAPPO |
$870.19
|
| Rate for Payer: BCBS Trust/PPO |
$303.65
|
| Rate for Payer: BCN Commercial |
$1,302.82
|
| Rate for Payer: BCN Medicare Advantage |
$870.19
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Cash Price |
$1,198.40
|
| Rate for Payer: Cofinity Commercial |
$1,166.05
|
| Rate for Payer: Cofinity Commercial |
$1,253.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.19
|
| Rate for Payer: Healthscope Commercial |
$1,044.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,044.23
|
| Rate for Payer: Meridian Medicaid |
$598.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$913.70
|
| Rate for Payer: PACE SWMI |
$870.19
|
| Rate for Payer: PHP Medicare Advantage |
$870.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,048.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,361.39
|
| Rate for Payer: Priority Health Medicare |
$870.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.39
|
| Rate for Payer: UHC Medicare Advantage |
$896.30
|
|
|
PR PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE
|
Professional
|
Both
|
$1,121.00
|
|
|
Service Code
|
HCPCS 23130
|
| Min. Negotiated Rate |
$47.54 |
| Max. Negotiated Rate |
$955.43 |
| Rate for Payer: Aetna Commercial |
$817.08
|
| Rate for Payer: Aetna Medicare |
$609.76
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS MAPPO |
$609.76
|
| Rate for Payer: BCBS Trust/PPO |
$47.54
|
| Rate for Payer: BCN Commercial |
$914.32
|
| Rate for Payer: BCN Medicare Advantage |
$609.76
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cofinity Commercial |
$878.05
|
| Rate for Payer: Cofinity Commercial |
$817.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.76
|
| Rate for Payer: Healthscope Commercial |
$731.71
|
| Rate for Payer: Healthscope Whirlpool |
$731.71
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$640.25
|
| Rate for Payer: PACE SWMI |
$609.76
|
| Rate for Payer: PHP Medicare Advantage |
$609.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.43
|
| Rate for Payer: Priority Health Medicare |
$609.76
|
| Rate for Payer: Priority Health Narrow Network |
$955.43
|
| Rate for Payer: UHC Medicare Advantage |
$628.05
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$215.98 |
| Max. Negotiated Rate |
$805.13 |
| Rate for Payer: Aetna Commercial |
$434.28
|
| Rate for Payer: Aetna Medicare |
$324.09
|
| Rate for Payer: BCBS Complete |
$226.78
|
| Rate for Payer: BCBS MAPPO |
$324.09
|
| Rate for Payer: BCBS Trust/PPO |
$805.13
|
| Rate for Payer: BCN Commercial |
$690.50
|
| Rate for Payer: BCN Medicare Advantage |
$324.09
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$466.69
|
| Rate for Payer: Cofinity Commercial |
$434.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.09
|
| Rate for Payer: Healthscope Commercial |
$388.91
|
| Rate for Payer: Healthscope Whirlpool |
$388.91
|
| Rate for Payer: Meridian Medicaid |
$226.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$340.29
|
| Rate for Payer: PACE SWMI |
$324.09
|
| Rate for Payer: PHP Medicare Advantage |
$324.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$507.08
|
| Rate for Payer: Priority Health Medicare |
$324.09
|
| Rate for Payer: Priority Health Narrow Network |
$507.08
|
| Rate for Payer: UHC Medicare Advantage |
$333.81
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,060.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$425.15 |
| Max. Negotiated Rate |
$1,442.00 |
| Rate for Payer: Aetna Commercial |
$866.14
|
| Rate for Payer: Aetna Medicare |
$646.37
|
| Rate for Payer: BCBS Complete |
$446.41
|
| Rate for Payer: BCBS MAPPO |
$646.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.24
|
| Rate for Payer: BCN Commercial |
$966.61
|
| Rate for Payer: BCN Medicare Advantage |
$646.37
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cofinity Commercial |
$930.77
|
| Rate for Payer: Cofinity Commercial |
$866.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.37
|
| Rate for Payer: Healthscope Commercial |
$775.64
|
| Rate for Payer: Healthscope Whirlpool |
$775.64
|
| Rate for Payer: Meridian Medicaid |
$446.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$678.69
|
| Rate for Payer: PACE SWMI |
$646.37
|
| Rate for Payer: PHP Medicare Advantage |
$646.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.07
|
| Rate for Payer: Priority Health Medicare |
$646.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.07
|
| Rate for Payer: UHC Medicare Advantage |
$665.76
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$1,168.60 |
| Rate for Payer: Aetna Commercial |
$38.14
|
| Rate for Payer: Aetna Medicare |
$28.46
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.60
|
| Rate for Payer: BCN Commercial |
$44.96
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$38.14
|
| Rate for Payer: Cofinity Commercial |
$40.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$34.15
|
| Rate for Payer: Healthscope Whirlpool |
$34.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.33
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Narrow Network |
$41.33
|
| Rate for Payer: UHC Medicare Advantage |
$29.31
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$371.50 |
| Rate for Payer: Aetna Commercial |
$345.71
|
| Rate for Payer: Aetna Medicare |
$257.99
|
| Rate for Payer: BCBS Complete |
$113.60
|
| Rate for Payer: BCBS MAPPO |
$257.99
|
| Rate for Payer: BCBS Trust/PPO |
$270.00
|
| Rate for Payer: BCN Commercial |
$231.18
|
| Rate for Payer: BCN Medicare Advantage |
$257.99
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$371.50
|
| Rate for Payer: Cofinity Commercial |
$345.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.99
|
| Rate for Payer: Healthscope Commercial |
$309.59
|
| Rate for Payer: Healthscope Whirlpool |
$309.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.89
|
| Rate for Payer: PACE SWMI |
$257.99
|
| Rate for Payer: PHP Medicare Advantage |
$257.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.80
|
| Rate for Payer: Priority Health Medicare |
$257.99
|
| Rate for Payer: UHC Medicare Advantage |
$265.73
|
|
|
PR PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 90677
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$415.68 |
| Rate for Payer: Aetna Commercial |
$386.81
|
| Rate for Payer: Aetna Medicare |
$288.66
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$288.66
|
| Rate for Payer: BCBS Trust/PPO |
$298.65
|
| Rate for Payer: BCN Commercial |
$298.65
|
| Rate for Payer: BCN Medicare Advantage |
$288.66
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$415.68
|
| Rate for Payer: Cofinity Commercial |
$386.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.66
|
| Rate for Payer: Healthscope Commercial |
$346.40
|
| Rate for Payer: Healthscope Whirlpool |
$346.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$303.10
|
| Rate for Payer: PACE SWMI |
$288.66
|
| Rate for Payer: PHP Medicare Advantage |
$288.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
| Rate for Payer: Priority Health Medicare |
$288.66
|
| Rate for Payer: UHC Medicare Advantage |
$297.32
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 96573
|
| Min. Negotiated Rate |
$143.20 |
| Max. Negotiated Rate |
$1,125.28 |
| Rate for Payer: Aetna Commercial |
$287.52
|
| Rate for Payer: Aetna Medicare |
$214.57
|
| Rate for Payer: BCBS Complete |
$143.20
|
| Rate for Payer: BCBS MAPPO |
$214.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.28
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$214.57
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$308.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.57
|
| Rate for Payer: Healthscope Commercial |
$257.48
|
| Rate for Payer: Healthscope Whirlpool |
$257.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$225.30
|
| Rate for Payer: PACE SWMI |
$214.57
|
| Rate for Payer: PHP Medicare Advantage |
$214.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.91
|
| Rate for Payer: Priority Health Medicare |
$214.57
|
| Rate for Payer: Priority Health Narrow Network |
$309.91
|
| Rate for Payer: UHC Medicare Advantage |
$221.01
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 96567
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$2,195.61 |
| Rate for Payer: Aetna Commercial |
$174.23
|
| Rate for Payer: Aetna Medicare |
$130.02
|
| Rate for Payer: BCBS Complete |
$85.60
|
| Rate for Payer: BCBS MAPPO |
$130.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,195.61
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$130.02
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$187.23
|
| Rate for Payer: Cofinity Commercial |
$174.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.02
|
| Rate for Payer: Healthscope Commercial |
$156.02
|
| Rate for Payer: Healthscope Whirlpool |
$156.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.52
|
| Rate for Payer: PACE SWMI |
$130.02
|
| Rate for Payer: PHP Medicare Advantage |
$130.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.10
|
| Rate for Payer: Priority Health Medicare |
$130.02
|
| Rate for Payer: Priority Health Narrow Network |
$189.10
|
| Rate for Payer: UHC Medicare Advantage |
$133.92
|
|
|
PR PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR
|
Professional
|
Both
|
$1,273.00
|
|
|
Service Code
|
HCPCS 38770
|
| Min. Negotiated Rate |
$391.47 |
| Max. Negotiated Rate |
$1,729.73 |
| Rate for Payer: Aetna Commercial |
$1,060.26
|
| Rate for Payer: Aetna Medicare |
$791.24
|
| Rate for Payer: BCBS Complete |
$540.78
|
| Rate for Payer: BCBS MAPPO |
$791.24
|
| Rate for Payer: BCBS Trust/PPO |
$391.47
|
| Rate for Payer: BCN Commercial |
$1,166.96
|
| Rate for Payer: BCN Medicare Advantage |
$791.24
|
| Rate for Payer: Cash Price |
$1,018.40
|
| Rate for Payer: Cash Price |
$1,018.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.26
|
| Rate for Payer: Cofinity Commercial |
$1,139.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$791.24
|
| Rate for Payer: Healthscope Commercial |
$949.49
|
| Rate for Payer: Healthscope Whirlpool |
$949.49
|
| Rate for Payer: Meridian Medicaid |
$540.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$830.80
|
| Rate for Payer: PACE SWMI |
$791.24
|
| Rate for Payer: PHP Medicare Advantage |
$791.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,729.73
|
| Rate for Payer: Priority Health Medicare |
$791.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,729.73
|
| Rate for Payer: UHC Medicare Advantage |
$814.98
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 57410
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$1,808.90 |
| Rate for Payer: Aetna Commercial |
$138.98
|
| Rate for Payer: Aetna Medicare |
$103.72
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$103.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.90
|
| Rate for Payer: BCN Commercial |
$153.45
|
| Rate for Payer: BCN Medicare Advantage |
$103.72
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$149.36
|
| Rate for Payer: Cofinity Commercial |
$138.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.72
|
| Rate for Payer: Healthscope Commercial |
$124.46
|
| Rate for Payer: Healthscope Whirlpool |
$124.46
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.91
|
| Rate for Payer: PACE SWMI |
$103.72
|
| Rate for Payer: PHP Medicare Advantage |
$103.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.66
|
| Rate for Payer: Priority Health Medicare |
$103.72
|
| Rate for Payer: Priority Health Narrow Network |
$148.66
|
| Rate for Payer: UHC Medicare Advantage |
$106.83
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
57410
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$172.80
|
| Rate for Payer: ASR ASR |
$186.24
|
| Rate for Payer: BCBS Trust/PPO |
$148.86
|
| Rate for Payer: BCN Commercial |
$148.86
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$180.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.60
|
| Rate for Payer: Healthscope Commercial |
$192.00
|
| Rate for Payer: Healthscope Whirlpool |
$186.24
|
| Rate for Payer: Mclaren Commercial |
$172.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.96
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 57410
|
| Hospital Charge Code |
57410
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$1,808.90 |
| Rate for Payer: Aetna Commercial |
$138.98
|
| Rate for Payer: Aetna Medicare |
$103.72
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$103.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.90
|
| Rate for Payer: BCN Commercial |
$153.45
|
| Rate for Payer: BCN Medicare Advantage |
$103.72
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$138.98
|
| Rate for Payer: Cofinity Commercial |
$149.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.72
|
| Rate for Payer: Healthscope Commercial |
$124.46
|
| Rate for Payer: Healthscope Whirlpool |
$124.46
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.91
|
| Rate for Payer: PACE SWMI |
$103.72
|
| Rate for Payer: PHP Medicare Advantage |
$103.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.66
|
| Rate for Payer: Priority Health Medicare |
$103.72
|
| Rate for Payer: Priority Health Narrow Network |
$148.66
|
| Rate for Payer: UHC Medicare Advantage |
$106.83
|
|
|
PR PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
57410
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$3,473.69 |
| Rate for Payer: Aetna Commercial |
$172.80
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$186.24
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$148.86
|
| Rate for Payer: BCN Commercial |
$148.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$180.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$192.00
|
| Rate for Payer: Healthscope Whirlpool |
$186.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$172.80
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.20
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.72
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$136.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.96
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
PR PELVIC FIXATION OTHER THAN SACRUM
|
Professional
|
Both
|
$1,756.00
|
|
|
Service Code
|
HCPCS 22848
|
| Min. Negotiated Rate |
$65.80 |
| Max. Negotiated Rate |
$1,229.20 |
| Rate for Payer: Aetna Commercial |
$479.09
|
| Rate for Payer: Aetna Medicare |
$357.53
|
| Rate for Payer: BCBS Complete |
$240.20
|
| Rate for Payer: BCBS MAPPO |
$357.53
|
| Rate for Payer: BCBS Trust/PPO |
$65.80
|
| Rate for Payer: BCN Commercial |
$575.20
|
| Rate for Payer: BCN Medicare Advantage |
$357.53
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cofinity Commercial |
$514.84
|
| Rate for Payer: Cofinity Commercial |
$479.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.53
|
| Rate for Payer: Healthscope Commercial |
$429.04
|
| Rate for Payer: Healthscope Whirlpool |
$429.04
|
| Rate for Payer: Meridian Medicaid |
$240.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$375.41
|
| Rate for Payer: PACE SWMI |
$357.53
|
| Rate for Payer: PHP Medicare Advantage |
$357.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,229.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$545.88
|
| Rate for Payer: Priority Health Medicare |
$357.53
|
| Rate for Payer: Priority Health Narrow Network |
$545.88
|
| Rate for Payer: UHC Medicare Advantage |
$368.26
|
|
