|
PR PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,400.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$350.60 |
| Max. Negotiated Rate |
$1,651.47 |
| Rate for Payer: Aetna Commercial |
$702.74
|
| Rate for Payer: Aetna Medicare |
$524.43
|
| Rate for Payer: BCBS Complete |
$368.13
|
| Rate for Payer: BCBS MAPPO |
$524.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.47
|
| Rate for Payer: BCN Commercial |
$788.24
|
| Rate for Payer: BCN Medicare Advantage |
$524.43
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cofinity Commercial |
$755.18
|
| Rate for Payer: Cofinity Commercial |
$702.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.43
|
| Rate for Payer: Healthscope Commercial |
$629.32
|
| Rate for Payer: Healthscope Whirlpool |
$629.32
|
| Rate for Payer: Meridian Medicaid |
$368.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$550.65
|
| Rate for Payer: PACE SWMI |
$524.43
|
| Rate for Payer: PHP Medicare Advantage |
$524.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$823.68
|
| Rate for Payer: Priority Health Medicare |
$524.43
|
| Rate for Payer: Priority Health Narrow Network |
$823.68
|
| Rate for Payer: UHC Medicare Advantage |
$540.16
|
|
|
PR PRQ SKELETAL FIXJ FEMORAL FX DISTAL END
|
Professional
|
Both
|
$2,192.00
|
|
|
Service Code
|
HCPCS 27509
|
| Min. Negotiated Rate |
$438.14 |
| Max. Negotiated Rate |
$1,534.40 |
| Rate for Payer: Aetna Commercial |
$891.68
|
| Rate for Payer: Aetna Medicare |
$665.43
|
| Rate for Payer: BCBS Complete |
$460.05
|
| Rate for Payer: BCBS MAPPO |
$665.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.35
|
| Rate for Payer: BCN Commercial |
$1,000.32
|
| Rate for Payer: BCN Medicare Advantage |
$665.43
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cofinity Commercial |
$891.68
|
| Rate for Payer: Cofinity Commercial |
$958.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.43
|
| Rate for Payer: Healthscope Commercial |
$798.52
|
| Rate for Payer: Healthscope Whirlpool |
$798.52
|
| Rate for Payer: Meridian Medicaid |
$460.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$698.70
|
| Rate for Payer: PACE SWMI |
$665.43
|
| Rate for Payer: PHP Medicare Advantage |
$665.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,045.30
|
| Rate for Payer: Priority Health Medicare |
$665.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,045.30
|
| Rate for Payer: UHC Medicare Advantage |
$685.39
|
|
|
PR PRQ SKELETAL FIXJ METACARPAL FX EACH BONE
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 26608
|
| Min. Negotiated Rate |
$58.11 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$637.24
|
| Rate for Payer: Aetna Medicare |
$475.55
|
| Rate for Payer: BCBS Complete |
$331.89
|
| Rate for Payer: BCBS MAPPO |
$475.55
|
| Rate for Payer: BCBS Trust/PPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$716.89
|
| Rate for Payer: BCN Medicare Advantage |
$475.55
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$637.24
|
| Rate for Payer: Cofinity Commercial |
$684.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.55
|
| Rate for Payer: Healthscope Commercial |
$570.66
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Meridian Medicaid |
$331.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.33
|
| Rate for Payer: PACE SWMI |
$475.55
|
| Rate for Payer: PHP Medicare Advantage |
$475.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,057.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$749.13
|
| Rate for Payer: Priority Health Medicare |
$475.55
|
| Rate for Payer: Priority Health Narrow Network |
$749.13
|
| Rate for Payer: UHC Medicare Advantage |
$489.82
|
|
|
PR PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 26676
|
| Min. Negotiated Rate |
$65.37 |
| Max. Negotiated Rate |
$1,132.60 |
| Rate for Payer: Aetna Commercial |
$673.58
|
| Rate for Payer: Aetna Medicare |
$502.67
|
| Rate for Payer: BCBS Complete |
$351.35
|
| Rate for Payer: BCBS MAPPO |
$502.67
|
| Rate for Payer: BCBS Trust/PPO |
$65.37
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: BCN Medicare Advantage |
$502.67
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$723.84
|
| Rate for Payer: Cofinity Commercial |
$673.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.67
|
| Rate for Payer: Healthscope Commercial |
$603.20
|
| Rate for Payer: Healthscope Whirlpool |
$603.20
|
| Rate for Payer: Meridian Medicaid |
$351.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$527.80
|
| Rate for Payer: PACE SWMI |
$502.67
|
| Rate for Payer: PHP Medicare Advantage |
$502.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$793.04
|
| Rate for Payer: Priority Health Medicare |
$502.67
|
| Rate for Payer: Priority Health Narrow Network |
$793.04
|
| Rate for Payer: UHC Medicare Advantage |
$517.75
|
|
|
PR PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 26756
|
| Min. Negotiated Rate |
$279.03 |
| Max. Negotiated Rate |
$754.60 |
| Rate for Payer: Aetna Commercial |
$561.00
|
| Rate for Payer: Aetna Medicare |
$418.66
|
| Rate for Payer: BCBS Complete |
$292.98
|
| Rate for Payer: BCBS MAPPO |
$418.66
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$633.33
|
| Rate for Payer: BCN Medicare Advantage |
$418.66
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cofinity Commercial |
$561.00
|
| Rate for Payer: Cofinity Commercial |
$602.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$418.66
|
| Rate for Payer: Healthscope Commercial |
$502.39
|
| Rate for Payer: Healthscope Whirlpool |
$502.39
|
| Rate for Payer: Meridian Medicaid |
$292.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$439.59
|
| Rate for Payer: PACE SWMI |
$418.66
|
| Rate for Payer: PHP Medicare Advantage |
$418.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$279.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.81
|
| Rate for Payer: Priority Health Medicare |
$418.66
|
| Rate for Payer: Priority Health Narrow Network |
$661.81
|
| Rate for Payer: UHC Medicare Advantage |
$431.22
|
|
|
PR PRQ SKEL FIXJ FEMORAL FX PROX END NECK
|
Professional
|
Both
|
$3,293.00
|
|
|
Service Code
|
HCPCS 27235
|
| Min. Negotiated Rate |
$584.26 |
| Max. Negotiated Rate |
$2,305.10 |
| Rate for Payer: Aetna Commercial |
$1,196.91
|
| Rate for Payer: Aetna Medicare |
$893.22
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCBS MAPPO |
$893.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.62
|
| Rate for Payer: BCN Commercial |
$1,463.55
|
| Rate for Payer: BCN Medicare Advantage |
$893.22
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cofinity Commercial |
$1,196.91
|
| Rate for Payer: Cofinity Commercial |
$1,286.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.22
|
| Rate for Payer: Healthscope Commercial |
$1,071.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,071.86
|
| Rate for Payer: Meridian Medicaid |
$613.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$937.88
|
| Rate for Payer: PACE SWMI |
$893.22
|
| Rate for Payer: PHP Medicare Advantage |
$893.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,388.97
|
| Rate for Payer: Priority Health Medicare |
$893.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,388.97
|
| Rate for Payer: UHC Medicare Advantage |
$920.02
|
|
|
PR PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 28496
|
| Min. Negotiated Rate |
$179.56 |
| Max. Negotiated Rate |
$770.00 |
| Rate for Payer: Aetna Commercial |
$322.86
|
| Rate for Payer: Aetna Medicare |
$240.94
|
| Rate for Payer: BCBS Complete |
$188.54
|
| Rate for Payer: BCBS MAPPO |
$240.94
|
| Rate for Payer: BCBS Trust/PPO |
$690.49
|
| Rate for Payer: BCN Commercial |
$667.05
|
| Rate for Payer: BCN Medicare Advantage |
$240.94
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$322.86
|
| Rate for Payer: Cofinity Commercial |
$346.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.94
|
| Rate for Payer: Healthscope Commercial |
$289.13
|
| Rate for Payer: Healthscope Whirlpool |
$289.13
|
| Rate for Payer: Meridian Medicaid |
$188.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$252.99
|
| Rate for Payer: PACE SWMI |
$240.94
|
| Rate for Payer: PHP Medicare Advantage |
$240.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.48
|
| Rate for Payer: Priority Health Medicare |
$240.94
|
| Rate for Payer: Priority Health Narrow Network |
$382.48
|
| Rate for Payer: UHC Medicare Advantage |
$248.17
|
|
|
PR PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ
|
Professional
|
Both
|
$2,328.00
|
|
|
Service Code
|
HCPCS 24582
|
| Min. Negotiated Rate |
$473.89 |
| Max. Negotiated Rate |
$1,629.60 |
| Rate for Payer: Aetna Commercial |
$1,076.80
|
| Rate for Payer: Aetna Medicare |
$803.58
|
| Rate for Payer: BCBS Complete |
$557.56
|
| Rate for Payer: BCBS MAPPO |
$803.58
|
| Rate for Payer: BCBS Trust/PPO |
$473.89
|
| Rate for Payer: BCN Commercial |
$1,205.57
|
| Rate for Payer: BCN Medicare Advantage |
$803.58
|
| Rate for Payer: Cash Price |
$1,862.40
|
| Rate for Payer: Cash Price |
$1,862.40
|
| Rate for Payer: Cofinity Commercial |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$1,157.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.58
|
| Rate for Payer: Healthscope Commercial |
$964.30
|
| Rate for Payer: Healthscope Whirlpool |
$964.30
|
| Rate for Payer: Meridian Medicaid |
$557.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$843.76
|
| Rate for Payer: PACE SWMI |
$803.58
|
| Rate for Payer: PHP Medicare Advantage |
$803.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,629.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,259.78
|
| Rate for Payer: Priority Health Medicare |
$803.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,259.78
|
| Rate for Payer: UHC Medicare Advantage |
$827.69
|
|
|
PR PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 24566
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$1,294.30 |
| Rate for Payer: Aetna Commercial |
$951.57
|
| Rate for Payer: Aetna Medicare |
$710.13
|
| Rate for Payer: BCBS Complete |
$492.48
|
| Rate for Payer: BCBS MAPPO |
$710.13
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,064.83
|
| Rate for Payer: BCN Medicare Advantage |
$710.13
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cofinity Commercial |
$951.57
|
| Rate for Payer: Cofinity Commercial |
$1,022.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.13
|
| Rate for Payer: Healthscope Commercial |
$852.16
|
| Rate for Payer: Healthscope Whirlpool |
$852.16
|
| Rate for Payer: Meridian Medicaid |
$492.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$745.64
|
| Rate for Payer: PACE SWMI |
$710.13
|
| Rate for Payer: PHP Medicare Advantage |
$710.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,112.70
|
| Rate for Payer: Priority Health Medicare |
$710.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.70
|
| Rate for Payer: UHC Medicare Advantage |
$731.43
|
|
|
PR PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 28666
|
| Min. Negotiated Rate |
$112.89 |
| Max. Negotiated Rate |
$405.30 |
| Rate for Payer: Aetna Commercial |
$230.25
|
| Rate for Payer: Aetna Medicare |
$171.83
|
| Rate for Payer: BCBS Complete |
$118.53
|
| Rate for Payer: BCBS MAPPO |
$171.83
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$171.83
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cofinity Commercial |
$247.44
|
| Rate for Payer: Cofinity Commercial |
$230.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.83
|
| Rate for Payer: Healthscope Commercial |
$206.20
|
| Rate for Payer: Healthscope Whirlpool |
$206.20
|
| Rate for Payer: Meridian Medicaid |
$118.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$180.42
|
| Rate for Payer: PACE SWMI |
$171.83
|
| Rate for Payer: PHP Medicare Advantage |
$171.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.12
|
| Rate for Payer: Priority Health Medicare |
$171.83
|
| Rate for Payer: Priority Health Narrow Network |
$269.12
|
| Rate for Payer: UHC Medicare Advantage |
$176.98
|
|
|
PR PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 26776
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$953.40 |
| Rate for Payer: Aetna Commercial |
$594.36
|
| Rate for Payer: Aetna Medicare |
$443.55
|
| Rate for Payer: BCBS Complete |
$310.20
|
| Rate for Payer: BCBS MAPPO |
$443.55
|
| Rate for Payer: BCBS Trust/PPO |
$132.60
|
| Rate for Payer: BCN Commercial |
$669.98
|
| Rate for Payer: BCN Medicare Advantage |
$443.55
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cofinity Commercial |
$638.71
|
| Rate for Payer: Cofinity Commercial |
$594.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.55
|
| Rate for Payer: Healthscope Commercial |
$532.26
|
| Rate for Payer: Healthscope Whirlpool |
$532.26
|
| Rate for Payer: Meridian Medicaid |
$310.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$465.73
|
| Rate for Payer: PACE SWMI |
$443.55
|
| Rate for Payer: PHP Medicare Advantage |
$443.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$953.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.10
|
| Rate for Payer: Priority Health Medicare |
$443.55
|
| Rate for Payer: Priority Health Narrow Network |
$700.10
|
| Rate for Payer: UHC Medicare Advantage |
$456.86
|
|
|
PR PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ
|
Professional
|
Both
|
$1,348.00
|
|
|
Service Code
|
HCPCS 26706
|
| Min. Negotiated Rate |
$258.87 |
| Max. Negotiated Rate |
$943.60 |
| Rate for Payer: Aetna Commercial |
$590.81
|
| Rate for Payer: Aetna Medicare |
$440.90
|
| Rate for Payer: BCBS Complete |
$308.19
|
| Rate for Payer: BCBS MAPPO |
$440.90
|
| Rate for Payer: BCBS Trust/PPO |
$258.87
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$440.90
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cofinity Commercial |
$634.90
|
| Rate for Payer: Cofinity Commercial |
$590.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.90
|
| Rate for Payer: Healthscope Commercial |
$529.08
|
| Rate for Payer: Healthscope Whirlpool |
$529.08
|
| Rate for Payer: Meridian Medicaid |
$308.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.94
|
| Rate for Payer: PACE SWMI |
$440.90
|
| Rate for Payer: PHP Medicare Advantage |
$440.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.49
|
| Rate for Payer: Priority Health Medicare |
$440.90
|
| Rate for Payer: Priority Health Narrow Network |
$694.49
|
| Rate for Payer: UHC Medicare Advantage |
$454.13
|
|
|
PR PRQ SKEL FIXJ METAR FX W/MANJ
|
Professional
|
Both
|
$1,056.00
|
|
|
Service Code
|
HCPCS 28476
|
| Min. Negotiated Rate |
$252.41 |
| Max. Negotiated Rate |
$739.20 |
| Rate for Payer: Aetna Commercial |
$505.98
|
| Rate for Payer: Aetna Medicare |
$377.60
|
| Rate for Payer: BCBS Complete |
$265.03
|
| Rate for Payer: BCBS MAPPO |
$377.60
|
| Rate for Payer: BCBS Trust/PPO |
$394.11
|
| Rate for Payer: BCN Commercial |
$575.66
|
| Rate for Payer: BCN Medicare Advantage |
$377.60
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cofinity Commercial |
$505.98
|
| Rate for Payer: Cofinity Commercial |
$543.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.60
|
| Rate for Payer: Healthscope Commercial |
$453.12
|
| Rate for Payer: Healthscope Whirlpool |
$453.12
|
| Rate for Payer: Meridian Medicaid |
$265.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$396.48
|
| Rate for Payer: PACE SWMI |
$377.60
|
| Rate for Payer: PHP Medicare Advantage |
$377.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.54
|
| Rate for Payer: Priority Health Medicare |
$377.60
|
| Rate for Payer: Priority Health Narrow Network |
$601.54
|
| Rate for Payer: UHC Medicare Advantage |
$388.93
|
|
|
PR PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ
|
Professional
|
Both
|
$644.00
|
|
|
Service Code
|
HCPCS 28636
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$456.42 |
| Rate for Payer: Aetna Commercial |
$260.32
|
| Rate for Payer: Aetna Medicare |
$194.27
|
| Rate for Payer: BCBS Complete |
$152.08
|
| Rate for Payer: BCBS MAPPO |
$194.27
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$456.42
|
| Rate for Payer: BCN Medicare Advantage |
$194.27
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$260.32
|
| Rate for Payer: Cofinity Commercial |
$279.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.27
|
| Rate for Payer: Healthscope Commercial |
$233.12
|
| Rate for Payer: Healthscope Whirlpool |
$233.12
|
| Rate for Payer: Meridian Medicaid |
$152.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$203.98
|
| Rate for Payer: PACE SWMI |
$194.27
|
| Rate for Payer: PHP Medicare Advantage |
$194.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.84
|
| Rate for Payer: Priority Health Medicare |
$194.27
|
| Rate for Payer: Priority Health Narrow Network |
$303.84
|
| Rate for Payer: UHC Medicare Advantage |
$200.10
|
|
|
PR PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 26727
|
| Min. Negotiated Rate |
$311.62 |
| Max. Negotiated Rate |
$1,057.00 |
| Rate for Payer: Aetna Commercial |
$627.23
|
| Rate for Payer: Aetna Medicare |
$468.08
|
| Rate for Payer: BCBS Complete |
$327.20
|
| Rate for Payer: BCBS MAPPO |
$468.08
|
| Rate for Payer: BCBS Trust/PPO |
$765.51
|
| Rate for Payer: BCN Commercial |
$706.14
|
| Rate for Payer: BCN Medicare Advantage |
$468.08
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$627.23
|
| Rate for Payer: Cofinity Commercial |
$674.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.08
|
| Rate for Payer: Healthscope Commercial |
$561.70
|
| Rate for Payer: Healthscope Whirlpool |
$561.70
|
| Rate for Payer: Meridian Medicaid |
$327.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$491.48
|
| Rate for Payer: PACE SWMI |
$468.08
|
| Rate for Payer: PHP Medicare Advantage |
$468.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,057.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.89
|
| Rate for Payer: Priority Health Medicare |
$468.08
|
| Rate for Payer: Priority Health Narrow Network |
$737.89
|
| Rate for Payer: UHC Medicare Advantage |
$482.12
|
|
|
PR PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX
|
Professional
|
Both
|
$2,526.00
|
|
|
Service Code
|
HCPCS 24538
|
| Min. Negotiated Rate |
$512.27 |
| Max. Negotiated Rate |
$1,768.20 |
| Rate for Payer: Aetna Commercial |
$1,042.51
|
| Rate for Payer: Aetna Medicare |
$777.99
|
| Rate for Payer: BCBS Complete |
$537.88
|
| Rate for Payer: BCBS MAPPO |
$777.99
|
| Rate for Payer: BCBS Trust/PPO |
$660.38
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$777.99
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cofinity Commercial |
$1,120.31
|
| Rate for Payer: Cofinity Commercial |
$1,042.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.99
|
| Rate for Payer: Healthscope Commercial |
$933.59
|
| Rate for Payer: Healthscope Whirlpool |
$933.59
|
| Rate for Payer: Meridian Medicaid |
$537.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.89
|
| Rate for Payer: PACE SWMI |
$777.99
|
| Rate for Payer: PHP Medicare Advantage |
$777.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,219.95
|
| Rate for Payer: Priority Health Medicare |
$777.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,219.95
|
| Rate for Payer: UHC Medicare Advantage |
$801.33
|
|
|
PR PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ
|
Professional
|
Both
|
$959.00
|
|
|
Service Code
|
HCPCS 28576
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$1,476.60 |
| Rate for Payer: Aetna Commercial |
$510.23
|
| Rate for Payer: Aetna Medicare |
$380.77
|
| Rate for Payer: BCBS Complete |
$267.49
|
| Rate for Payer: BCBS MAPPO |
$380.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.60
|
| Rate for Payer: BCN Commercial |
$572.73
|
| Rate for Payer: BCN Medicare Advantage |
$380.77
|
| Rate for Payer: Cash Price |
$767.20
|
| Rate for Payer: Cash Price |
$767.20
|
| Rate for Payer: Cofinity Commercial |
$548.31
|
| Rate for Payer: Cofinity Commercial |
$510.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.77
|
| Rate for Payer: Healthscope Commercial |
$456.92
|
| Rate for Payer: Healthscope Whirlpool |
$456.92
|
| Rate for Payer: Meridian Medicaid |
$267.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$399.81
|
| Rate for Payer: PACE SWMI |
$380.77
|
| Rate for Payer: PHP Medicare Advantage |
$380.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.48
|
| Rate for Payer: Priority Health Medicare |
$380.77
|
| Rate for Payer: Priority Health Narrow Network |
$598.48
|
| Rate for Payer: UHC Medicare Advantage |
$392.19
|
|
|
PR PRQ SKEL FIXJ TARS JT DISLC W/MANJ
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 28606
|
| Min. Negotiated Rate |
$255.60 |
| Max. Negotiated Rate |
$2,188.75 |
| Rate for Payer: Aetna Commercial |
$507.48
|
| Rate for Payer: Aetna Medicare |
$378.72
|
| Rate for Payer: BCBS Complete |
$268.38
|
| Rate for Payer: BCBS MAPPO |
$378.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,188.75
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: BCN Medicare Advantage |
$378.72
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$545.36
|
| Rate for Payer: Cofinity Commercial |
$507.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.72
|
| Rate for Payer: Healthscope Commercial |
$454.46
|
| Rate for Payer: Healthscope Whirlpool |
$454.46
|
| Rate for Payer: Meridian Medicaid |
$268.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$397.66
|
| Rate for Payer: PACE SWMI |
$378.72
|
| Rate for Payer: PHP Medicare Advantage |
$378.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$593.38
|
| Rate for Payer: Priority Health Medicare |
$378.72
|
| Rate for Payer: Priority Health Narrow Network |
$593.38
|
| Rate for Payer: UHC Medicare Advantage |
$390.08
|
|
|
PR PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ
|
Professional
|
Both
|
$782.00
|
|
|
Service Code
|
HCPCS 28546
|
| Min. Negotiated Rate |
$231.74 |
| Max. Negotiated Rate |
$938.26 |
| Rate for Payer: Aetna Commercial |
$460.16
|
| Rate for Payer: Aetna Medicare |
$343.40
|
| Rate for Payer: BCBS Complete |
$243.33
|
| Rate for Payer: BCBS MAPPO |
$343.40
|
| Rate for Payer: BCBS Trust/PPO |
$938.26
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: BCN Medicare Advantage |
$343.40
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cofinity Commercial |
$494.50
|
| Rate for Payer: Cofinity Commercial |
$460.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.40
|
| Rate for Payer: Healthscope Commercial |
$412.08
|
| Rate for Payer: Healthscope Whirlpool |
$412.08
|
| Rate for Payer: Meridian Medicaid |
$243.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$360.57
|
| Rate for Payer: PACE SWMI |
$343.40
|
| Rate for Payer: PHP Medicare Advantage |
$343.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.87
|
| Rate for Payer: Priority Health Medicare |
$343.40
|
| Rate for Payer: Priority Health Narrow Network |
$544.87
|
| Rate for Payer: UHC Medicare Advantage |
$353.70
|
|
|
PR PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 28456
|
| Min. Negotiated Rate |
$242.82 |
| Max. Negotiated Rate |
$577.04 |
| Rate for Payer: Aetna Commercial |
$483.35
|
| Rate for Payer: Aetna Medicare |
$360.71
|
| Rate for Payer: BCBS Complete |
$254.96
|
| Rate for Payer: BCBS MAPPO |
$360.71
|
| Rate for Payer: BCBS Trust/PPO |
$385.66
|
| Rate for Payer: BCN Commercial |
$552.21
|
| Rate for Payer: BCN Medicare Advantage |
$360.71
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$519.42
|
| Rate for Payer: Cofinity Commercial |
$483.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.71
|
| Rate for Payer: Healthscope Commercial |
$432.85
|
| Rate for Payer: Healthscope Whirlpool |
$432.85
|
| Rate for Payer: Meridian Medicaid |
$254.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$378.75
|
| Rate for Payer: PACE SWMI |
$360.71
|
| Rate for Payer: PHP Medicare Advantage |
$360.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.04
|
| Rate for Payer: Priority Health Medicare |
$360.71
|
| Rate for Payer: Priority Health Narrow Network |
$577.04
|
| Rate for Payer: UHC Medicare Advantage |
$371.53
|
|
|
PR PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT
|
Professional
|
Both
|
$2,013.00
|
|
|
Service Code
|
HCPCS 93580
|
| Min. Negotiated Rate |
$222.94 |
| Max. Negotiated Rate |
$1,409.10 |
| Rate for Payer: Aetna Commercial |
$1,276.68
|
| Rate for Payer: Aetna Medicare |
$952.75
|
| Rate for Payer: BCBS Complete |
$637.85
|
| Rate for Payer: BCBS MAPPO |
$952.75
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Medicare Advantage |
$952.75
|
| Rate for Payer: Cash Price |
$1,610.40
|
| Rate for Payer: Cash Price |
$1,610.40
|
| Rate for Payer: Cofinity Commercial |
$1,371.96
|
| Rate for Payer: Cofinity Commercial |
$1,276.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$952.75
|
| Rate for Payer: Healthscope Commercial |
$1,143.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,143.30
|
| Rate for Payer: Meridian Medicaid |
$637.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,000.39
|
| Rate for Payer: PACE SWMI |
$952.75
|
| Rate for Payer: PHP Medicare Advantage |
$952.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$607.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.95
|
| Rate for Payer: Priority Health Medicare |
$952.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,342.95
|
| Rate for Payer: UHC Medicare Advantage |
$981.33
|
|
|
PR PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
HCPCS 37197
|
| Min. Negotiated Rate |
$186.59 |
| Max. Negotiated Rate |
$2,291.90 |
| Rate for Payer: Aetna Commercial |
$393.22
|
| Rate for Payer: Aetna Medicare |
$293.45
|
| Rate for Payer: BCBS Complete |
$195.92
|
| Rate for Payer: BCBS MAPPO |
$293.45
|
| Rate for Payer: BCBS Trust/PPO |
$922.41
|
| Rate for Payer: BCN Commercial |
$2,291.90
|
| Rate for Payer: BCN Medicare Advantage |
$293.45
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$393.22
|
| Rate for Payer: Cofinity Commercial |
$422.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.45
|
| Rate for Payer: Healthscope Commercial |
$352.14
|
| Rate for Payer: Healthscope Whirlpool |
$352.14
|
| Rate for Payer: Meridian Medicaid |
$195.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$308.12
|
| Rate for Payer: PACE SWMI |
$293.45
|
| Rate for Payer: PHP Medicare Advantage |
$293.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.92
|
| Rate for Payer: Priority Health Medicare |
$293.45
|
| Rate for Payer: Priority Health Narrow Network |
$464.92
|
| Rate for Payer: UHC Medicare Advantage |
$302.25
|
|
|
PR PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY
|
Professional
|
Both
|
$1,025.00
|
|
|
Service Code
|
HCPCS 92973
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna Commercial |
$230.45
|
| Rate for Payer: Aetna Medicare |
$171.98
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$171.98
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$250.20
|
| Rate for Payer: BCN Medicare Advantage |
$171.98
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cofinity Commercial |
$247.65
|
| Rate for Payer: Cofinity Commercial |
$230.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.98
|
| Rate for Payer: Healthscope Commercial |
$206.38
|
| Rate for Payer: Healthscope Whirlpool |
$206.38
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$180.58
|
| Rate for Payer: PACE SWMI |
$171.98
|
| Rate for Payer: PHP Medicare Advantage |
$171.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.11
|
| Rate for Payer: Priority Health Medicare |
$171.98
|
| Rate for Payer: Priority Health Narrow Network |
$242.11
|
| Rate for Payer: UHC Medicare Advantage |
$177.14
|
|
|
PR PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN
|
Professional
|
Both
|
$1,805.00
|
|
|
Service Code
|
HCPCS 37187
|
| Min. Negotiated Rate |
$243.89 |
| Max. Negotiated Rate |
$2,507.41 |
| Rate for Payer: Aetna Commercial |
$513.34
|
| Rate for Payer: Aetna Medicare |
$383.09
|
| Rate for Payer: BCBS Complete |
$256.08
|
| Rate for Payer: BCBS MAPPO |
$383.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.98
|
| Rate for Payer: BCN Commercial |
$2,507.41
|
| Rate for Payer: BCN Medicare Advantage |
$383.09
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cofinity Commercial |
$551.65
|
| Rate for Payer: Cofinity Commercial |
$513.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.09
|
| Rate for Payer: Healthscope Commercial |
$459.71
|
| Rate for Payer: Healthscope Whirlpool |
$459.71
|
| Rate for Payer: Meridian Medicaid |
$256.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.24
|
| Rate for Payer: PACE SWMI |
$383.09
|
| Rate for Payer: PHP Medicare Advantage |
$383.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$243.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$608.03
|
| Rate for Payer: Priority Health Medicare |
$383.09
|
| Rate for Payer: Priority Health Narrow Network |
$608.03
|
| Rate for Payer: UHC Medicare Advantage |
$394.58
|
|
|
PR PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 92924
|
| Min. Negotiated Rate |
$350.79 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$827.83
|
| Rate for Payer: Aetna Medicare |
$617.78
|
| Rate for Payer: BCBS Complete |
$412.19
|
| Rate for Payer: BCBS MAPPO |
$617.78
|
| Rate for Payer: BCBS Trust/PPO |
$350.79
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$617.78
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$827.83
|
| Rate for Payer: Cofinity Commercial |
$889.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.78
|
| Rate for Payer: Healthscope Commercial |
$741.34
|
| Rate for Payer: Healthscope Whirlpool |
$741.34
|
| Rate for Payer: Meridian Medicaid |
$412.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$648.67
|
| Rate for Payer: PACE SWMI |
$617.78
|
| Rate for Payer: PHP Medicare Advantage |
$617.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$869.61
|
| Rate for Payer: Priority Health Medicare |
$617.78
|
| Rate for Payer: Priority Health Narrow Network |
$869.61
|
| Rate for Payer: UHC Medicare Advantage |
$636.31
|
|
