|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$3,440.00
|
|
|
Service Code
|
HCPCS 26118
|
| Min. Negotiated Rate |
$213.95 |
| Max. Negotiated Rate |
$2,408.00 |
| Rate for Payer: Aetna Commercial |
$1,391.62
|
| Rate for Payer: Aetna Medicare |
$1,038.52
|
| Rate for Payer: BCBS Complete |
$709.19
|
| Rate for Payer: BCBS MAPPO |
$1,038.52
|
| Rate for Payer: BCBS Trust/PPO |
$213.95
|
| Rate for Payer: BCN Commercial |
$1,547.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,038.52
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cofinity Commercial |
$1,495.47
|
| Rate for Payer: Cofinity Commercial |
$1,391.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,038.52
|
| Rate for Payer: Healthscope Commercial |
$1,246.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,246.22
|
| Rate for Payer: Meridian Medicaid |
$709.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,090.45
|
| Rate for Payer: PACE SWMI |
$1,038.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,038.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,617.23
|
| Rate for Payer: Priority Health Medicare |
$1,038.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,617.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.68
|
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$4,187.00
|
|
|
Service Code
|
HCPCS 27075
|
| Min. Negotiated Rate |
$572.15 |
| Max. Negotiated Rate |
$3,168.07 |
| Rate for Payer: Aetna Commercial |
$2,747.94
|
| Rate for Payer: Aetna Medicare |
$2,050.70
|
| Rate for Payer: BCBS Complete |
$1,395.12
|
| Rate for Payer: BCBS MAPPO |
$2,050.70
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$3,031.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.70
|
| Rate for Payer: Cash Price |
$3,349.60
|
| Rate for Payer: Cash Price |
$3,349.60
|
| Rate for Payer: Cofinity Commercial |
$2,953.01
|
| Rate for Payer: Cofinity Commercial |
$2,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.70
|
| Rate for Payer: Healthscope Commercial |
$2,460.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,460.84
|
| Rate for Payer: Meridian Medicaid |
$1,395.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,153.24
|
| Rate for Payer: PACE SWMI |
$2,050.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,328.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,930.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,168.07
|
| Rate for Payer: Priority Health Medicare |
$2,050.70
|
| Rate for Payer: Priority Health Narrow Network |
$3,168.07
|
| Rate for Payer: UHC Medicare Advantage |
$2,112.22
|
|
|
PR RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 26260
|
| Min. Negotiated Rate |
$278.41 |
| Max. Negotiated Rate |
$1,224.55 |
| Rate for Payer: Aetna Commercial |
$1,054.03
|
| Rate for Payer: Aetna Medicare |
$786.59
|
| Rate for Payer: BCBS Complete |
$540.78
|
| Rate for Payer: BCBS MAPPO |
$786.59
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$1,171.85
|
| Rate for Payer: BCN Medicare Advantage |
$786.59
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,132.69
|
| Rate for Payer: Cofinity Commercial |
$1,054.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$786.59
|
| Rate for Payer: Healthscope Commercial |
$943.91
|
| Rate for Payer: Healthscope Whirlpool |
$943.91
|
| Rate for Payer: Meridian Medicaid |
$540.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$825.92
|
| Rate for Payer: PACE SWMI |
$786.59
|
| Rate for Payer: PHP Medicare Advantage |
$786.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.55
|
| Rate for Payer: Priority Health Medicare |
$786.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,224.55
|
| Rate for Payer: UHC Medicare Advantage |
$810.19
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>
|
Professional
|
Both
|
$1,723.00
|
|
|
Service Code
|
HCPCS 21016
|
| Min. Negotiated Rate |
$87.70 |
| Max. Negotiated Rate |
$1,541.15 |
| Rate for Payer: Aetna Commercial |
$1,331.34
|
| Rate for Payer: Aetna Medicare |
$993.54
|
| Rate for Payer: BCBS Complete |
$677.66
|
| Rate for Payer: BCBS MAPPO |
$993.54
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$1,474.83
|
| Rate for Payer: BCN Medicare Advantage |
$993.54
|
| Rate for Payer: Cash Price |
$1,378.40
|
| Rate for Payer: Cash Price |
$1,378.40
|
| Rate for Payer: Cofinity Commercial |
$1,430.70
|
| Rate for Payer: Cofinity Commercial |
$1,331.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.54
|
| Rate for Payer: Healthscope Commercial |
$1,192.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,192.25
|
| Rate for Payer: Meridian Medicaid |
$677.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,043.22
|
| Rate for Payer: PACE SWMI |
$993.54
|
| Rate for Payer: PHP Medicare Advantage |
$993.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.15
|
| Rate for Payer: Priority Health Medicare |
$993.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,541.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,023.35
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 21015
|
| Min. Negotiated Rate |
$448.15 |
| Max. Negotiated Rate |
$6,178.65 |
| Rate for Payer: Aetna Commercial |
$918.72
|
| Rate for Payer: Aetna Medicare |
$685.61
|
| Rate for Payer: BCBS Complete |
$470.56
|
| Rate for Payer: BCBS MAPPO |
$685.61
|
| Rate for Payer: BCBS Trust/PPO |
$6,178.65
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: BCN Medicare Advantage |
$685.61
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cofinity Commercial |
$987.28
|
| Rate for Payer: Cofinity Commercial |
$918.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.61
|
| Rate for Payer: Healthscope Commercial |
$822.73
|
| Rate for Payer: Healthscope Whirlpool |
$822.73
|
| Rate for Payer: Meridian Medicaid |
$470.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$719.89
|
| Rate for Payer: PACE SWMI |
$685.61
|
| Rate for Payer: PHP Medicare Advantage |
$685.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$614.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,069.30
|
| Rate for Payer: Priority Health Medicare |
$685.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.30
|
| Rate for Payer: UHC Medicare Advantage |
$706.18
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$2,373.00
|
|
|
Service Code
|
HCPCS 22905
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$2,023.19 |
| Rate for Payer: Aetna Commercial |
$1,762.38
|
| Rate for Payer: Aetna Medicare |
$1,315.21
|
| Rate for Payer: BCBS Complete |
$893.71
|
| Rate for Payer: BCBS MAPPO |
$1,315.21
|
| Rate for Payer: BCBS Trust/PPO |
$149.00
|
| Rate for Payer: BCN Commercial |
$1,936.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,315.21
|
| Rate for Payer: Cash Price |
$1,898.40
|
| Rate for Payer: Cash Price |
$1,898.40
|
| Rate for Payer: Cofinity Commercial |
$1,893.90
|
| Rate for Payer: Cofinity Commercial |
$1,762.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,315.21
|
| Rate for Payer: Healthscope Commercial |
$1,578.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,578.25
|
| Rate for Payer: Meridian Medicaid |
$893.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,380.97
|
| Rate for Payer: PACE SWMI |
$1,315.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,315.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$851.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,023.19
|
| Rate for Payer: Priority Health Medicare |
$1,315.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,023.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,354.67
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 22904
|
| Min. Negotiated Rate |
$288.98 |
| Max. Negotiated Rate |
$1,602.93 |
| Rate for Payer: Aetna Commercial |
$1,394.30
|
| Rate for Payer: Aetna Medicare |
$1,040.52
|
| Rate for Payer: BCBS Complete |
$705.62
|
| Rate for Payer: BCBS MAPPO |
$1,040.52
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$1,533.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.52
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,394.30
|
| Rate for Payer: Cofinity Commercial |
$1,498.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.52
|
| Rate for Payer: Healthscope Commercial |
$1,248.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,248.62
|
| Rate for Payer: Meridian Medicaid |
$705.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,092.55
|
| Rate for Payer: PACE SWMI |
$1,040.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,464.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,602.93
|
| Rate for Payer: Priority Health Medicare |
$1,040.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,602.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.74
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM
|
Professional
|
Both
|
$2,882.00
|
|
|
Service Code
|
HCPCS 21935
|
| Min. Negotiated Rate |
$124.38 |
| Max. Negotiated Rate |
$2,017.40 |
| Rate for Payer: Aetna Commercial |
$1,352.81
|
| Rate for Payer: Aetna Medicare |
$1,009.56
|
| Rate for Payer: BCBS Complete |
$688.39
|
| Rate for Payer: BCBS MAPPO |
$1,009.56
|
| Rate for Payer: BCBS Trust/PPO |
$124.38
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,009.56
|
| Rate for Payer: Cash Price |
$2,305.60
|
| Rate for Payer: Cash Price |
$2,305.60
|
| Rate for Payer: Cofinity Commercial |
$1,352.81
|
| Rate for Payer: Cofinity Commercial |
$1,453.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,009.56
|
| Rate for Payer: Healthscope Commercial |
$1,211.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,211.47
|
| Rate for Payer: Meridian Medicaid |
$688.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,060.04
|
| Rate for Payer: PACE SWMI |
$1,009.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,009.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$655.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,017.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,558.51
|
| Rate for Payer: Priority Health Medicare |
$1,009.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,558.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,039.85
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>
|
Professional
|
Both
|
$2,547.00
|
|
|
Service Code
|
HCPCS 21936
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$2,156.99 |
| Rate for Payer: Aetna Commercial |
$1,877.76
|
| Rate for Payer: Aetna Medicare |
$1,401.31
|
| Rate for Payer: BCBS Complete |
$951.40
|
| Rate for Payer: BCBS MAPPO |
$1,401.31
|
| Rate for Payer: BCBS Trust/PPO |
$38.98
|
| Rate for Payer: BCN Commercial |
$2,064.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,401.31
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,877.76
|
| Rate for Payer: Cofinity Commercial |
$2,017.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,401.31
|
| Rate for Payer: Healthscope Commercial |
$1,681.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,681.57
|
| Rate for Payer: Meridian Medicaid |
$951.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,471.38
|
| Rate for Payer: PACE SWMI |
$1,401.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,401.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$906.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,782.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,156.99
|
| Rate for Payer: Priority Health Medicare |
$1,401.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,156.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,443.35
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>
|
Professional
|
Both
|
$2,268.00
|
|
|
Service Code
|
HCPCS 27616
|
| Min. Negotiated Rate |
$807.06 |
| Max. Negotiated Rate |
$1,936.38 |
| Rate for Payer: Aetna Commercial |
$1,679.45
|
| Rate for Payer: Aetna Medicare |
$1,253.32
|
| Rate for Payer: BCBS Complete |
$847.41
|
| Rate for Payer: BCBS MAPPO |
$1,253.32
|
| Rate for Payer: BCBS Trust/PPO |
$928.75
|
| Rate for Payer: BCN Commercial |
$1,853.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,253.32
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$1,804.78
|
| Rate for Payer: Cofinity Commercial |
$1,679.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.32
|
| Rate for Payer: Healthscope Commercial |
$1,503.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,503.98
|
| Rate for Payer: Meridian Medicaid |
$847.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,315.99
|
| Rate for Payer: PACE SWMI |
$1,253.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,253.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$807.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,936.38
|
| Rate for Payer: Priority Health Medicare |
$1,253.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,936.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,290.92
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM
|
Professional
|
Both
|
$2,011.00
|
|
|
Service Code
|
HCPCS 23077
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$1,724.46 |
| Rate for Payer: Aetna Commercial |
$1,499.45
|
| Rate for Payer: Aetna Medicare |
$1,118.99
|
| Rate for Payer: BCBS Complete |
$761.53
|
| Rate for Payer: BCBS MAPPO |
$1,118.99
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$1,650.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,118.99
|
| Rate for Payer: Cash Price |
$1,608.80
|
| Rate for Payer: Cash Price |
$1,608.80
|
| Rate for Payer: Cofinity Commercial |
$1,499.45
|
| Rate for Payer: Cofinity Commercial |
$1,611.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,118.99
|
| Rate for Payer: Healthscope Commercial |
$1,342.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.79
|
| Rate for Payer: Meridian Medicaid |
$761.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,174.94
|
| Rate for Payer: PACE SWMI |
$1,118.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,118.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,407.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,724.46
|
| Rate for Payer: Priority Health Medicare |
$1,118.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,724.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.56
|
|
|
PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>
|
Professional
|
Both
|
$6,526.00
|
|
|
Service Code
|
HCPCS 27364
|
| Min. Negotiated Rate |
$1,000.46 |
| Max. Negotiated Rate |
$4,568.20 |
| Rate for Payer: Aetna Commercial |
$2,071.85
|
| Rate for Payer: Aetna Medicare |
$1,546.16
|
| Rate for Payer: BCBS Complete |
$1,050.48
|
| Rate for Payer: BCBS MAPPO |
$1,546.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.03
|
| Rate for Payer: BCN Commercial |
$2,283.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.16
|
| Rate for Payer: Cash Price |
$5,220.80
|
| Rate for Payer: Cash Price |
$5,220.80
|
| Rate for Payer: Cofinity Commercial |
$2,071.85
|
| Rate for Payer: Cofinity Commercial |
$2,226.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.16
|
| Rate for Payer: Healthscope Commercial |
$1,855.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,855.39
|
| Rate for Payer: Meridian Medicaid |
$1,050.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,623.47
|
| Rate for Payer: PACE SWMI |
$1,546.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,568.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,386.27
|
| Rate for Payer: Priority Health Medicare |
$1,546.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,386.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,592.54
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
OP
|
$2,820.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$2,538.00
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$2,735.40
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,186.35
|
| Rate for Payer: BCN Commercial |
$2,186.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cofinity Commercial |
$2,650.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,256.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$2,820.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,735.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$2,538.00
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,397.00
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,566.20
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,002.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,481.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,820.00
|
|
|
Service Code
|
HCPCS 25077
|
| Min. Negotiated Rate |
$256.75 |
| Max. Negotiated Rate |
$1,974.00 |
| Rate for Payer: Aetna Commercial |
$1,173.12
|
| Rate for Payer: Aetna Medicare |
$875.46
|
| Rate for Payer: BCBS Complete |
$580.60
|
| Rate for Payer: BCBS MAPPO |
$875.46
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$1,300.37
|
| Rate for Payer: BCN Medicare Advantage |
$875.46
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cofinity Commercial |
$1,173.12
|
| Rate for Payer: Cofinity Commercial |
$1,260.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.46
|
| Rate for Payer: Healthscope Commercial |
$1,050.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,050.55
|
| Rate for Payer: Meridian Medicaid |
$580.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.23
|
| Rate for Payer: PACE SWMI |
$875.46
|
| Rate for Payer: PHP Medicare Advantage |
$875.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,358.84
|
| Rate for Payer: Priority Health Medicare |
$875.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,358.84
|
| Rate for Payer: UHC Medicare Advantage |
$901.72
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
IP
|
$2,820.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,974.00 |
| Max. Negotiated Rate |
$2,820.00 |
| Rate for Payer: Aetna Commercial |
$2,538.00
|
| Rate for Payer: ASR ASR |
$2,735.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,186.35
|
| Rate for Payer: BCN Commercial |
$2,186.35
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cofinity Commercial |
$2,650.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,256.00
|
| Rate for Payer: Healthscope Commercial |
$2,820.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,735.40
|
| Rate for Payer: Mclaren Commercial |
$2,538.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,397.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,481.60
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,820.00
|
|
|
Service Code
|
HCPCS 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$256.75 |
| Max. Negotiated Rate |
$1,974.00 |
| Rate for Payer: Aetna Commercial |
$1,173.12
|
| Rate for Payer: Aetna Medicare |
$875.46
|
| Rate for Payer: BCBS Complete |
$580.60
|
| Rate for Payer: BCBS MAPPO |
$875.46
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$1,300.37
|
| Rate for Payer: BCN Medicare Advantage |
$875.46
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cash Price |
$2,256.00
|
| Rate for Payer: Cofinity Commercial |
$1,173.12
|
| Rate for Payer: Cofinity Commercial |
$1,260.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.46
|
| Rate for Payer: Healthscope Commercial |
$1,050.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,050.55
|
| Rate for Payer: Meridian Medicaid |
$580.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.23
|
| Rate for Payer: PACE SWMI |
$875.46
|
| Rate for Payer: PHP Medicare Advantage |
$875.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,358.84
|
| Rate for Payer: Priority Health Medicare |
$875.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,358.84
|
| Rate for Payer: UHC Medicare Advantage |
$901.72
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 21557
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,459.44 |
| Rate for Payer: Aetna Commercial |
$1,264.83
|
| Rate for Payer: Aetna Medicare |
$943.90
|
| Rate for Payer: BCBS Complete |
$645.90
|
| Rate for Payer: BCBS MAPPO |
$943.90
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$1,396.64
|
| Rate for Payer: BCN Medicare Advantage |
$943.90
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$1,359.22
|
| Rate for Payer: Cofinity Commercial |
$1,264.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.90
|
| Rate for Payer: Healthscope Commercial |
$1,132.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,132.68
|
| Rate for Payer: Meridian Medicaid |
$645.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$991.10
|
| Rate for Payer: PACE SWMI |
$943.90
|
| Rate for Payer: PHP Medicare Advantage |
$943.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,150.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,459.44
|
| Rate for Payer: Priority Health Medicare |
$943.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,459.44
|
| Rate for Payer: UHC Medicare Advantage |
$972.22
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>
|
Professional
|
Both
|
$3,351.00
|
|
|
Service Code
|
HCPCS 21558
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$2,345.70 |
| Rate for Payer: Aetna Commercial |
$1,782.92
|
| Rate for Payer: Aetna Medicare |
$1,330.54
|
| Rate for Payer: BCBS Complete |
$900.20
|
| Rate for Payer: BCBS MAPPO |
$1,330.54
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$1,962.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,330.54
|
| Rate for Payer: Cash Price |
$2,680.80
|
| Rate for Payer: Cash Price |
$2,680.80
|
| Rate for Payer: Cofinity Commercial |
$1,915.98
|
| Rate for Payer: Cofinity Commercial |
$1,782.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,330.54
|
| Rate for Payer: Healthscope Commercial |
$1,596.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,596.65
|
| Rate for Payer: Meridian Medicaid |
$900.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,397.07
|
| Rate for Payer: PACE SWMI |
$1,330.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,330.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$857.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,345.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,050.77
|
| Rate for Payer: Priority Health Medicare |
$1,330.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,050.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,370.46
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM
|
Professional
|
Both
|
$2,315.00
|
|
|
Service Code
|
HCPCS 26117
|
| Min. Negotiated Rate |
$171.92 |
| Max. Negotiated Rate |
$1,620.50 |
| Rate for Payer: Aetna Commercial |
$979.55
|
| Rate for Payer: Aetna Medicare |
$731.01
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$731.01
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: BCN Commercial |
$1,091.70
|
| Rate for Payer: BCN Medicare Advantage |
$731.01
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cofinity Commercial |
$979.55
|
| Rate for Payer: Cofinity Commercial |
$1,052.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.01
|
| Rate for Payer: Healthscope Commercial |
$877.21
|
| Rate for Payer: Healthscope Whirlpool |
$877.21
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$767.56
|
| Rate for Payer: PACE SWMI |
$731.01
|
| Rate for Payer: PHP Medicare Advantage |
$731.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,620.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.79
|
| Rate for Payer: Priority Health Medicare |
$731.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.79
|
| Rate for Payer: UHC Medicare Advantage |
$752.94
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 27049
|
| Min. Negotiated Rate |
$913.34 |
| Max. Negotiated Rate |
$4,326.25 |
| Rate for Payer: Aetna Commercial |
$1,779.37
|
| Rate for Payer: Aetna Medicare |
$1,327.89
|
| Rate for Payer: BCBS Complete |
$959.01
|
| Rate for Payer: BCBS MAPPO |
$1,327.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,326.25
|
| Rate for Payer: BCN Commercial |
$1,956.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,327.89
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cofinity Commercial |
$1,912.16
|
| Rate for Payer: Cofinity Commercial |
$1,779.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,327.89
|
| Rate for Payer: Healthscope Commercial |
$1,593.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,593.47
|
| Rate for Payer: Meridian Medicaid |
$959.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,394.28
|
| Rate for Payer: PACE SWMI |
$1,327.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,327.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$913.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,044.12
|
| Rate for Payer: Priority Health Medicare |
$1,327.89
|
| Rate for Payer: Priority Health Narrow Network |
$2,044.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,367.73
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM
|
Professional
|
Both
|
$3,312.00
|
|
|
Service Code
|
HCPCS 27329
|
| Min. Negotiated Rate |
$668.39 |
| Max. Negotiated Rate |
$2,318.40 |
| Rate for Payer: Aetna Commercial |
$1,378.87
|
| Rate for Payer: Aetna Medicare |
$1,029.01
|
| Rate for Payer: BCBS Complete |
$701.81
|
| Rate for Payer: BCBS MAPPO |
$1,029.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.51
|
| Rate for Payer: BCN Commercial |
$1,523.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.01
|
| Rate for Payer: Cash Price |
$2,649.60
|
| Rate for Payer: Cash Price |
$2,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,378.87
|
| Rate for Payer: Cofinity Commercial |
$1,481.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.01
|
| Rate for Payer: Healthscope Commercial |
$1,234.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,234.81
|
| Rate for Payer: Meridian Medicaid |
$701.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,080.46
|
| Rate for Payer: PACE SWMI |
$1,029.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,318.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,591.69
|
| Rate for Payer: Priority Health Medicare |
$1,029.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,591.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.88
|
|
|
PR RAPID DESENSITIZATION PROCEDURE EACH HOUR
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 95180
|
| Min. Negotiated Rate |
$64.54 |
| Max. Negotiated Rate |
$430.04 |
| Rate for Payer: Aetna Commercial |
$133.24
|
| Rate for Payer: Aetna Medicare |
$99.43
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS MAPPO |
$99.43
|
| Rate for Payer: BCBS Trust/PPO |
$430.04
|
| Rate for Payer: BCN Commercial |
$198.89
|
| Rate for Payer: BCN Medicare Advantage |
$99.43
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$143.18
|
| Rate for Payer: Cofinity Commercial |
$133.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.43
|
| Rate for Payer: Healthscope Commercial |
$119.32
|
| Rate for Payer: Healthscope Whirlpool |
$119.32
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.40
|
| Rate for Payer: PACE SWMI |
$99.43
|
| Rate for Payer: PHP Medicare Advantage |
$99.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.82
|
| Rate for Payer: Priority Health Medicare |
$99.43
|
| Rate for Payer: Priority Health Narrow Network |
$125.82
|
| Rate for Payer: UHC Medicare Advantage |
$102.41
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Facility
|
OP
|
$834.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$750.60
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$808.98
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$646.60
|
| Rate for Payer: BCN Commercial |
$646.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$783.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$834.00
|
| Rate for Payer: Healthscope Whirlpool |
$808.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$750.60
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$708.90
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$758.94
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$592.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.92
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$333.60 |
| Max. Negotiated Rate |
$1,777.73 |
| Rate for Payer: Aetna Commercial |
$471.69
|
| Rate for Payer: Aetna Medicare |
$352.01
|
| Rate for Payer: BCBS Complete |
$333.60
|
| Rate for Payer: BCBS MAPPO |
$352.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.73
|
| Rate for Payer: BCN Commercial |
$770.16
|
| Rate for Payer: BCN Medicare Advantage |
$352.01
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$471.69
|
| Rate for Payer: Cofinity Commercial |
$506.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.01
|
| Rate for Payer: Healthscope Commercial |
$422.41
|
| Rate for Payer: Healthscope Whirlpool |
$422.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.61
|
| Rate for Payer: PACE SWMI |
$352.01
|
| Rate for Payer: PHP Medicare Advantage |
$352.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.47
|
| Rate for Payer: Priority Health Medicare |
$352.01
|
| Rate for Payer: Priority Health Narrow Network |
$550.47
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Facility
|
IP
|
$834.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$583.80 |
| Max. Negotiated Rate |
$834.00 |
| Rate for Payer: Aetna Commercial |
$750.60
|
| Rate for Payer: ASR ASR |
$808.98
|
| Rate for Payer: BCBS Trust/PPO |
$646.60
|
| Rate for Payer: BCN Commercial |
$646.60
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$783.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.20
|
| Rate for Payer: Healthscope Commercial |
$834.00
|
| Rate for Payer: Healthscope Whirlpool |
$808.98
|
| Rate for Payer: Mclaren Commercial |
$750.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$708.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.92
|
|
