|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 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 |
$506.89
|
| Rate for Payer: Cofinity Commercial |
$471.69
|
| 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 BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD
|
Professional
|
Both
|
$7,055.00
|
|
|
Service Code
|
HCPCS 21175
|
| Min. Negotiated Rate |
$377.57 |
| Max. Negotiated Rate |
$4,938.50 |
| Rate for Payer: Aetna Commercial |
$2,911.22
|
| Rate for Payer: Aetna Medicare |
$2,172.55
|
| Rate for Payer: BCBS Complete |
$1,476.31
|
| Rate for Payer: BCBS MAPPO |
$2,172.55
|
| Rate for Payer: BCBS Trust/PPO |
$377.57
|
| Rate for Payer: BCN Commercial |
$3,551.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,172.55
|
| Rate for Payer: Cash Price |
$5,644.00
|
| Rate for Payer: Cash Price |
$5,644.00
|
| Rate for Payer: Cofinity Commercial |
$3,128.47
|
| Rate for Payer: Cofinity Commercial |
$2,911.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,172.55
|
| Rate for Payer: Healthscope Commercial |
$2,607.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,607.06
|
| Rate for Payer: Meridian Medicaid |
$1,476.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,281.18
|
| Rate for Payer: PACE SWMI |
$2,172.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,172.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,406.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,938.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,370.30
|
| Rate for Payer: Priority Health Medicare |
$2,172.55
|
| Rate for Payer: Priority Health Narrow Network |
$3,370.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,237.73
|
|
|
PR RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT
|
Professional
|
Both
|
$1,192.00
|
|
|
Service Code
|
HCPCS 26545
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$1,139.77 |
| Rate for Payer: Aetna Commercial |
$961.87
|
| Rate for Payer: Aetna Medicare |
$717.81
|
| Rate for Payer: BCBS Complete |
$500.08
|
| Rate for Payer: BCBS MAPPO |
$717.81
|
| Rate for Payer: BCBS Trust/PPO |
$149.51
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| Rate for Payer: BCN Medicare Advantage |
$717.81
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cofinity Commercial |
$961.87
|
| Rate for Payer: Cofinity Commercial |
$1,033.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.81
|
| Rate for Payer: Healthscope Commercial |
$861.37
|
| Rate for Payer: Healthscope Whirlpool |
$861.37
|
| Rate for Payer: Meridian Medicaid |
$500.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$753.70
|
| Rate for Payer: PACE SWMI |
$717.81
|
| Rate for Payer: PHP Medicare Advantage |
$717.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,139.77
|
| Rate for Payer: Priority Health Medicare |
$717.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,139.77
|
| Rate for Payer: UHC Medicare Advantage |
$739.34
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS
|
Professional
|
Both
|
$3,496.00
|
|
|
Service Code
|
HCPCS 26542
|
| Min. Negotiated Rate |
$467.96 |
| Max. Negotiated Rate |
$2,447.20 |
| Rate for Payer: Aetna Commercial |
$946.38
|
| Rate for Payer: Aetna Medicare |
$706.25
|
| Rate for Payer: BCBS Complete |
$491.36
|
| Rate for Payer: BCBS MAPPO |
$706.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,587.54
|
| Rate for Payer: BCN Commercial |
$1,073.63
|
| Rate for Payer: BCN Medicare Advantage |
$706.25
|
| Rate for Payer: Cash Price |
$2,796.80
|
| Rate for Payer: Cash Price |
$2,796.80
|
| Rate for Payer: Cofinity Commercial |
$1,017.00
|
| Rate for Payer: Cofinity Commercial |
$946.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.25
|
| Rate for Payer: Healthscope Commercial |
$847.50
|
| Rate for Payer: Healthscope Whirlpool |
$847.50
|
| Rate for Payer: Meridian Medicaid |
$491.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$741.56
|
| Rate for Payer: PACE SWMI |
$706.25
|
| Rate for Payer: PHP Medicare Advantage |
$706.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,447.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,121.90
|
| Rate for Payer: Priority Health Medicare |
$706.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,121.90
|
| Rate for Payer: UHC Medicare Advantage |
$727.44
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 26541
|
| Min. Negotiated Rate |
$540.81 |
| Max. Negotiated Rate |
$1,633.10 |
| Rate for Payer: Aetna Commercial |
$1,095.65
|
| Rate for Payer: Aetna Medicare |
$817.65
|
| Rate for Payer: BCBS Complete |
$567.85
|
| Rate for Payer: BCBS MAPPO |
$817.65
|
| Rate for Payer: BCBS Trust/PPO |
$544.15
|
| Rate for Payer: BCN Commercial |
$1,237.82
|
| Rate for Payer: BCN Medicare Advantage |
$817.65
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,177.42
|
| Rate for Payer: Cofinity Commercial |
$1,095.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$817.65
|
| Rate for Payer: Healthscope Commercial |
$981.18
|
| Rate for Payer: Healthscope Whirlpool |
$981.18
|
| Rate for Payer: Meridian Medicaid |
$567.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$858.53
|
| Rate for Payer: PACE SWMI |
$817.65
|
| Rate for Payer: PHP Medicare Advantage |
$817.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,293.47
|
| Rate for Payer: Priority Health Medicare |
$817.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,293.47
|
| Rate for Payer: UHC Medicare Advantage |
$842.18
|
|
|
PR RCNSTJ DISLC PATELLA W/PATELLECTOMY
|
Professional
|
Both
|
$1,489.00
|
|
|
Service Code
|
HCPCS 27424
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$1,153.56 |
| Rate for Payer: Aetna Commercial |
$991.39
|
| Rate for Payer: Aetna Medicare |
$739.84
|
| Rate for Payer: BCBS Complete |
$509.47
|
| Rate for Payer: BCBS MAPPO |
$739.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.81
|
| Rate for Payer: BCN Commercial |
$1,103.92
|
| Rate for Payer: BCN Medicare Advantage |
$739.84
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cofinity Commercial |
$991.39
|
| Rate for Payer: Cofinity Commercial |
$1,065.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.84
|
| Rate for Payer: Healthscope Commercial |
$887.81
|
| Rate for Payer: Healthscope Whirlpool |
$887.81
|
| Rate for Payer: Meridian Medicaid |
$509.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$776.83
|
| Rate for Payer: PACE SWMI |
$739.84
|
| Rate for Payer: PHP Medicare Advantage |
$739.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,042.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,153.56
|
| Rate for Payer: Priority Health Medicare |
$739.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.56
|
| Rate for Payer: UHC Medicare Advantage |
$762.04
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
IP
|
$2,268.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,587.60 |
| Max. Negotiated Rate |
$2,268.00 |
| Rate for Payer: Aetna Commercial |
$2,041.20
|
| Rate for Payer: ASR ASR |
$2,199.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,758.38
|
| Rate for Payer: BCN Commercial |
$1,758.38
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$2,131.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,814.40
|
| Rate for Payer: Healthscope Commercial |
$2,268.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,199.96
|
| Rate for Payer: Mclaren Commercial |
$2,041.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,927.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,995.84
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
OP
|
$2,268.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,587.60 |
| Max. Negotiated Rate |
$7,948.86 |
| Rate for Payer: Aetna Commercial |
$2,041.20
|
| Rate for Payer: Aetna Medicare |
$6,359.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: ASR ASR |
$2,199.96
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,758.38
|
| Rate for Payer: BCN Commercial |
$1,758.38
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$2,131.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,814.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$2,268.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,199.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,359.09
|
| Rate for Payer: Mclaren Commercial |
$2,041.20
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,927.80
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$6,995.00
|
| Rate for Payer: PHP Medicaid |
$3,478.42
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,063.88
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,610.28
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,995.84
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,268.00
|
|
|
Service Code
|
HCPCS 27422
|
| Hospital Charge Code |
27422
|
| Min. Negotiated Rate |
$478.11 |
| Max. Negotiated Rate |
$1,587.60 |
| Rate for Payer: Aetna Commercial |
$981.71
|
| Rate for Payer: Aetna Medicare |
$732.62
|
| Rate for Payer: BCBS Complete |
$504.56
|
| Rate for Payer: BCBS MAPPO |
$732.62
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$732.62
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$1,054.97
|
| Rate for Payer: Cofinity Commercial |
$981.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.62
|
| Rate for Payer: Healthscope Commercial |
$879.14
|
| Rate for Payer: Healthscope Whirlpool |
$879.14
|
| Rate for Payer: Meridian Medicaid |
$504.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$769.25
|
| Rate for Payer: PACE SWMI |
$732.62
|
| Rate for Payer: PHP Medicare Advantage |
$732.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$732.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,142.33
|
| Rate for Payer: UHC Medicare Advantage |
$754.60
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,268.00
|
|
|
Service Code
|
HCPCS 27422
|
| Min. Negotiated Rate |
$478.11 |
| Max. Negotiated Rate |
$1,587.60 |
| Rate for Payer: Aetna Commercial |
$981.71
|
| Rate for Payer: Aetna Medicare |
$732.62
|
| Rate for Payer: BCBS Complete |
$504.56
|
| Rate for Payer: BCBS MAPPO |
$732.62
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$732.62
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$1,054.97
|
| Rate for Payer: Cofinity Commercial |
$981.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.62
|
| Rate for Payer: Healthscope Commercial |
$879.14
|
| Rate for Payer: Healthscope Whirlpool |
$879.14
|
| Rate for Payer: Meridian Medicaid |
$504.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$769.25
|
| Rate for Payer: PACE SWMI |
$732.62
|
| Rate for Payer: PHP Medicare Advantage |
$732.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$732.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,142.33
|
| Rate for Payer: UHC Medicare Advantage |
$754.60
|
|
|
PR RCNSTJ DISLOCATING PATELLA
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 27420
|
| Min. Negotiated Rate |
$486.07 |
| Max. Negotiated Rate |
$1,602.30 |
| Rate for Payer: Aetna Commercial |
$987.51
|
| Rate for Payer: Aetna Medicare |
$736.95
|
| Rate for Payer: BCBS Complete |
$510.37
|
| Rate for Payer: BCBS MAPPO |
$736.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,099.53
|
| Rate for Payer: BCN Medicare Advantage |
$736.95
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$1,061.21
|
| Rate for Payer: Cofinity Commercial |
$987.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.95
|
| Rate for Payer: Healthscope Commercial |
$884.34
|
| Rate for Payer: Healthscope Whirlpool |
$884.34
|
| Rate for Payer: Meridian Medicaid |
$510.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$773.80
|
| Rate for Payer: PACE SWMI |
$736.95
|
| Rate for Payer: PHP Medicare Advantage |
$736.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,602.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.96
|
| Rate for Payer: Priority Health Medicare |
$736.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.96
|
| Rate for Payer: UHC Medicare Advantage |
$759.06
|
|
|
PR RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT
|
Professional
|
Both
|
$2,961.00
|
|
|
Service Code
|
HCPCS 24344
|
| Min. Negotiated Rate |
$200.75 |
| Max. Negotiated Rate |
$2,072.70 |
| Rate for Payer: Aetna Commercial |
$1,439.52
|
| Rate for Payer: Aetna Medicare |
$1,074.27
|
| Rate for Payer: BCBS Complete |
$749.01
|
| Rate for Payer: BCBS MAPPO |
$1,074.27
|
| Rate for Payer: BCBS Trust/PPO |
$200.75
|
| Rate for Payer: BCN Commercial |
$1,602.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,074.27
|
| Rate for Payer: Cash Price |
$2,368.80
|
| Rate for Payer: Cash Price |
$2,368.80
|
| Rate for Payer: Cofinity Commercial |
$1,546.95
|
| Rate for Payer: Cofinity Commercial |
$1,439.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,074.27
|
| Rate for Payer: Healthscope Commercial |
$1,289.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,289.12
|
| Rate for Payer: Meridian Medicaid |
$749.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,127.98
|
| Rate for Payer: PACE SWMI |
$1,074.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,074.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,072.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.93
|
| Rate for Payer: Priority Health Medicare |
$1,074.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,674.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.50
|
|
|
PR RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF
|
Professional
|
Both
|
$3,270.00
|
|
|
Service Code
|
HCPCS 24346
|
| Min. Negotiated Rate |
$272.60 |
| Max. Negotiated Rate |
$2,289.00 |
| Rate for Payer: Aetna Commercial |
$1,457.38
|
| Rate for Payer: Aetna Medicare |
$1,087.60
|
| Rate for Payer: BCBS Complete |
$749.01
|
| Rate for Payer: BCBS MAPPO |
$1,087.60
|
| Rate for Payer: BCBS Trust/PPO |
$272.60
|
| Rate for Payer: BCN Commercial |
$1,621.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,087.60
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cofinity Commercial |
$1,457.38
|
| Rate for Payer: Cofinity Commercial |
$1,566.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,087.60
|
| Rate for Payer: Healthscope Commercial |
$1,305.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,305.12
|
| Rate for Payer: Meridian Medicaid |
$749.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,141.98
|
| Rate for Payer: PACE SWMI |
$1,087.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,087.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,289.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,694.85
|
| Rate for Payer: Priority Health Medicare |
$1,087.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,694.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,120.23
|
|
|
PR RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT
|
Professional
|
Both
|
$6,334.00
|
|
|
Service Code
|
HCPCS 21194
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$4,433.80 |
| Rate for Payer: Aetna Commercial |
$1,862.29
|
| Rate for Payer: Aetna Medicare |
$1,389.77
|
| Rate for Payer: BCBS Complete |
$948.73
|
| Rate for Payer: BCBS MAPPO |
$1,389.77
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$2,076.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.77
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cofinity Commercial |
$2,001.27
|
| Rate for Payer: Cofinity Commercial |
$1,862.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.77
|
| Rate for Payer: Healthscope Commercial |
$1,667.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,667.72
|
| Rate for Payer: Meridian Medicaid |
$948.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,459.26
|
| Rate for Payer: PACE SWMI |
$1,389.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$903.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,433.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,169.76
|
| Rate for Payer: Priority Health Medicare |
$1,389.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,169.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,431.46
|
|
|
PR RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE
|
Professional
|
Both
|
$3,440.00
|
|
|
Service Code
|
HCPCS 21244
|
| Min. Negotiated Rate |
$110.96 |
| Max. Negotiated Rate |
$2,408.00 |
| Rate for Payer: Aetna Commercial |
$1,316.55
|
| Rate for Payer: Aetna Medicare |
$982.50
|
| Rate for Payer: BCBS Complete |
$675.87
|
| Rate for Payer: BCBS MAPPO |
$982.50
|
| Rate for Payer: BCBS Trust/PPO |
$110.96
|
| Rate for Payer: BCN Commercial |
$1,474.83
|
| Rate for Payer: BCN Medicare Advantage |
$982.50
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cofinity Commercial |
$1,316.55
|
| Rate for Payer: Cofinity Commercial |
$1,414.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$982.50
|
| Rate for Payer: Healthscope Commercial |
$1,179.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,179.00
|
| Rate for Payer: Meridian Medicaid |
$675.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,031.62
|
| Rate for Payer: PACE SWMI |
$982.50
|
| Rate for Payer: PHP Medicare Advantage |
$982.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.15
|
| Rate for Payer: Priority Health Medicare |
$982.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,541.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,011.98
|
|
|
PR RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 26587
|
| Min. Negotiated Rate |
$57.06 |
| Max. Negotiated Rate |
$1,602.42 |
| Rate for Payer: Aetna Commercial |
$1,378.51
|
| Rate for Payer: Aetna Medicare |
$1,028.74
|
| Rate for Payer: BCBS Complete |
$707.63
|
| Rate for Payer: BCBS MAPPO |
$1,028.74
|
| Rate for Payer: BCBS Trust/PPO |
$57.06
|
| Rate for Payer: BCN Commercial |
$1,533.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,028.74
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,481.39
|
| Rate for Payer: Cofinity Commercial |
$1,378.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,028.74
|
| Rate for Payer: Healthscope Commercial |
$1,234.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,234.49
|
| Rate for Payer: Meridian Medicaid |
$707.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,080.18
|
| Rate for Payer: PACE SWMI |
$1,028.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,028.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,193.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,602.42
|
| Rate for Payer: Priority Health Medicare |
$1,028.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,602.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.60
|
|
|
PR RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 28238
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$2,785.20 |
| Rate for Payer: Aetna Commercial |
$645.29
|
| Rate for Payer: Aetna Medicare |
$481.56
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS MAPPO |
$481.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,785.20
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$481.56
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$693.45
|
| Rate for Payer: Cofinity Commercial |
$645.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.56
|
| Rate for Payer: Healthscope Commercial |
$577.87
|
| Rate for Payer: Healthscope Whirlpool |
$577.87
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$505.64
|
| Rate for Payer: PACE SWMI |
$481.56
|
| Rate for Payer: PHP Medicare Advantage |
$481.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.62
|
| Rate for Payer: Priority Health Medicare |
$481.56
|
| Rate for Payer: Priority Health Narrow Network |
$748.62
|
| Rate for Payer: UHC Medicare Advantage |
$496.01
|
|
|
PR RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ
|
Professional
|
Both
|
$3,376.00
|
|
|
Service Code
|
HCPCS 25337
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$2,363.20 |
| Rate for Payer: Aetna Commercial |
$1,170.50
|
| Rate for Payer: Aetna Medicare |
$873.51
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCBS MAPPO |
$873.51
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$1,307.70
|
| Rate for Payer: BCN Medicare Advantage |
$873.51
|
| Rate for Payer: Cash Price |
$2,700.80
|
| Rate for Payer: Cash Price |
$2,700.80
|
| Rate for Payer: Cofinity Commercial |
$1,257.85
|
| Rate for Payer: Cofinity Commercial |
$1,170.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.51
|
| Rate for Payer: Healthscope Commercial |
$1,048.21
|
| Rate for Payer: Healthscope Whirlpool |
$1,048.21
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$917.19
|
| Rate for Payer: PACE SWMI |
$873.51
|
| Rate for Payer: PHP Medicare Advantage |
$873.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,363.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,366.50
|
| Rate for Payer: Priority Health Medicare |
$873.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,366.50
|
| Rate for Payer: UHC Medicare Advantage |
$899.72
|
|
|
PR RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD
|
Professional
|
Both
|
$4,390.00
|
|
|
Service Code
|
HCPCS 21172
|
| Min. Negotiated Rate |
$580.95 |
| Max. Negotiated Rate |
$3,263.56 |
| Rate for Payer: Aetna Commercial |
$2,843.25
|
| Rate for Payer: Aetna Medicare |
$2,121.83
|
| Rate for Payer: BCBS Complete |
$1,439.19
|
| Rate for Payer: BCBS MAPPO |
$2,121.83
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$3,123.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,121.83
|
| Rate for Payer: Cash Price |
$3,512.00
|
| Rate for Payer: Cash Price |
$3,512.00
|
| Rate for Payer: Cofinity Commercial |
$3,055.44
|
| Rate for Payer: Cofinity Commercial |
$2,843.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,121.83
|
| Rate for Payer: Healthscope Commercial |
$2,546.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,546.20
|
| Rate for Payer: Meridian Medicaid |
$1,439.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,227.92
|
| Rate for Payer: PACE SWMI |
$2,121.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,121.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,370.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,073.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,263.56
|
| Rate for Payer: Priority Health Medicare |
$2,121.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,263.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,185.48
|
|
|
PR RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 26502
|
| Min. Negotiated Rate |
$489.90 |
| Max. Negotiated Rate |
$2,792.59 |
| Rate for Payer: Aetna Commercial |
$992.50
|
| Rate for Payer: Aetna Medicare |
$740.67
|
| Rate for Payer: BCBS Complete |
$514.40
|
| Rate for Payer: BCBS MAPPO |
$740.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$1,124.45
|
| Rate for Payer: BCN Medicare Advantage |
$740.67
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$992.50
|
| Rate for Payer: Cofinity Commercial |
$1,066.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.67
|
| Rate for Payer: Healthscope Commercial |
$888.80
|
| Rate for Payer: Healthscope Whirlpool |
$888.80
|
| Rate for Payer: Meridian Medicaid |
$514.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$777.70
|
| Rate for Payer: PACE SWMI |
$740.67
|
| Rate for Payer: PHP Medicare Advantage |
$740.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.00
|
| Rate for Payer: Priority Health Medicare |
$740.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,175.00
|
| Rate for Payer: UHC Medicare Advantage |
$762.89
|
|
|
PR RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 26500
|
| Min. Negotiated Rate |
$446.24 |
| Max. Negotiated Rate |
$5,862.74 |
| Rate for Payer: Aetna Commercial |
$868.87
|
| Rate for Payer: Aetna Medicare |
$648.41
|
| Rate for Payer: BCBS Complete |
$468.55
|
| Rate for Payer: BCBS MAPPO |
$648.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,862.74
|
| Rate for Payer: BCN Commercial |
$987.13
|
| Rate for Payer: BCN Medicare Advantage |
$648.41
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cofinity Commercial |
$868.87
|
| Rate for Payer: Cofinity Commercial |
$933.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.41
|
| Rate for Payer: Healthscope Commercial |
$778.09
|
| Rate for Payer: Healthscope Whirlpool |
$778.09
|
| Rate for Payer: Meridian Medicaid |
$468.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$680.83
|
| Rate for Payer: PACE SWMI |
$648.41
|
| Rate for Payer: PHP Medicare Advantage |
$648.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,031.51
|
| Rate for Payer: Priority Health Medicare |
$648.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,031.51
|
| Rate for Payer: UHC Medicare Advantage |
$667.86
|
|
|
PR RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 45900
|
| Min. Negotiated Rate |
$136.75 |
| Max. Negotiated Rate |
$771.85 |
| Rate for Payer: Aetna Commercial |
$281.63
|
| Rate for Payer: Aetna Medicare |
$210.17
|
| Rate for Payer: BCBS Complete |
$143.59
|
| Rate for Payer: BCBS MAPPO |
$210.17
|
| Rate for Payer: BCBS Trust/PPO |
$771.85
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$210.17
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$302.64
|
| Rate for Payer: Cofinity Commercial |
$281.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.17
|
| Rate for Payer: Healthscope Commercial |
$252.20
|
| Rate for Payer: Healthscope Whirlpool |
$252.20
|
| Rate for Payer: Meridian Medicaid |
$143.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.68
|
| Rate for Payer: PACE SWMI |
$210.17
|
| Rate for Payer: PHP Medicare Advantage |
$210.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$375.13
|
| Rate for Payer: Priority Health Medicare |
$210.17
|
| Rate for Payer: Priority Health Narrow Network |
$375.13
|
| Rate for Payer: UHC Medicare Advantage |
$216.48
|
|
|
PR RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS
|
Professional
|
Both
|
$801.00
|
|
|
Service Code
|
HCPCS 54600
|
| Min. Negotiated Rate |
$290.11 |
| Max. Negotiated Rate |
$2,890.86 |
| Rate for Payer: Aetna Commercial |
$592.43
|
| Rate for Payer: Aetna Medicare |
$442.11
|
| Rate for Payer: BCBS Complete |
$304.62
|
| Rate for Payer: BCBS MAPPO |
$442.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,890.86
|
| Rate for Payer: BCN Commercial |
$655.32
|
| Rate for Payer: BCN Medicare Advantage |
$442.11
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cofinity Commercial |
$636.64
|
| Rate for Payer: Cofinity Commercial |
$592.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.11
|
| Rate for Payer: Healthscope Commercial |
$530.53
|
| Rate for Payer: Healthscope Whirlpool |
$530.53
|
| Rate for Payer: Meridian Medicaid |
$304.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.22
|
| Rate for Payer: PACE SWMI |
$442.11
|
| Rate for Payer: PHP Medicare Advantage |
$442.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.62
|
| Rate for Payer: Priority Health Medicare |
$442.11
|
| Rate for Payer: Priority Health Narrow Network |
$724.62
|
| Rate for Payer: UHC Medicare Advantage |
$455.37
|
|
|
PR RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 44050
|
| Min. Negotiated Rate |
$598.96 |
| Max. Negotiated Rate |
$2,793.65 |
| Rate for Payer: Aetna Commercial |
$1,247.30
|
| Rate for Payer: Aetna Medicare |
$930.82
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$930.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,793.65
|
| Rate for Payer: BCN Commercial |
$1,366.35
|
| Rate for Payer: BCN Medicare Advantage |
$930.82
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$1,247.30
|
| Rate for Payer: Cofinity Commercial |
$1,340.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.82
|
| Rate for Payer: Healthscope Commercial |
$1,116.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,116.98
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$977.36
|
| Rate for Payer: PACE SWMI |
$930.82
|
| Rate for Payer: PHP Medicare Advantage |
$930.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,643.98
|
| Rate for Payer: Priority Health Medicare |
$930.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,643.98
|
| Rate for Payer: UHC Medicare Advantage |
$958.74
|
|
|
PR REALIGNMENT EXTENSOR TENDON HAND EACH TENDON
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26437
|
| Min. Negotiated Rate |
$147.92 |
| Max. Negotiated Rate |
$1,088.50 |
| Rate for Payer: Aetna Commercial |
$874.02
|
| Rate for Payer: Aetna Medicare |
$652.25
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$652.25
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$993.97
|
| Rate for Payer: BCN Medicare Advantage |
$652.25
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$874.02
|
| Rate for Payer: Cofinity Commercial |
$939.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.25
|
| Rate for Payer: Healthscope Commercial |
$782.70
|
| Rate for Payer: Healthscope Whirlpool |
$782.70
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$684.86
|
| Rate for Payer: PACE SWMI |
$652.25
|
| Rate for Payer: PHP Medicare Advantage |
$652.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.67
|
| Rate for Payer: Priority Health Medicare |
$652.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,038.67
|
| Rate for Payer: UHC Medicare Advantage |
$671.82
|
|
