|
PR REAORT VALV W CP BYPASS
|
Professional
|
Both
|
$7,886.00
|
|
|
Service Code
|
HCPCS 33400
|
| Min. Negotiated Rate |
$3,154.40 |
| Max. Negotiated Rate |
$5,520.20 |
| Rate for Payer: BCBS Complete |
$3,154.40
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,520.20
|
|
|
PR RECMPL WND LID,NOS,EAR <1 CM
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 13150
|
| Min. Negotiated Rate |
$236.40 |
| Max. Negotiated Rate |
$413.70 |
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.70
|
|
|
PR RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX
|
Professional
|
Both
|
$3,397.00
|
|
|
Service Code
|
HCPCS 69310
|
| Min. Negotiated Rate |
$716.53 |
| Max. Negotiated Rate |
$2,377.90 |
| Rate for Payer: Aetna Commercial |
$1,455.86
|
| Rate for Payer: Aetna Medicare |
$1,086.46
|
| Rate for Payer: BCBS Complete |
$752.36
|
| Rate for Payer: BCBS MAPPO |
$1,086.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.63
|
| Rate for Payer: BCN Commercial |
$1,653.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.46
|
| Rate for Payer: Cash Price |
$2,717.60
|
| Rate for Payer: Cash Price |
$2,717.60
|
| Rate for Payer: Cofinity Commercial |
$1,455.86
|
| Rate for Payer: Cofinity Commercial |
$1,564.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.46
|
| Rate for Payer: Healthscope Commercial |
$1,303.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,303.75
|
| Rate for Payer: Meridian Medicaid |
$752.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,140.78
|
| Rate for Payer: PACE SWMI |
$1,086.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,377.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,594.94
|
| Rate for Payer: Priority Health Medicare |
$1,086.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,594.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.05
|
|
|
PR RECONSTRUCTION NAIL BED W/GRAFT
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
HCPCS 11762
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$421.24 |
| Rate for Payer: Aetna Commercial |
$243.80
|
| Rate for Payer: Aetna Medicare |
$181.94
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$181.94
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$421.24
|
| Rate for Payer: BCN Medicare Advantage |
$181.94
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$243.80
|
| Rate for Payer: Cofinity Commercial |
$261.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.94
|
| Rate for Payer: Healthscope Commercial |
$218.33
|
| Rate for Payer: Healthscope Whirlpool |
$218.33
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$191.04
|
| Rate for Payer: PACE SWMI |
$181.94
|
| Rate for Payer: PHP Medicare Advantage |
$181.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.12
|
| Rate for Payer: Priority Health Medicare |
$181.94
|
| Rate for Payer: Priority Health Narrow Network |
$228.12
|
| Rate for Payer: UHC Medicare Advantage |
$187.40
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
OP
|
$3,908.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$2,735.60 |
| Max. Negotiated Rate |
$7,948.86 |
| Rate for Payer: Aetna Commercial |
$3,517.20
|
| 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 |
$3,790.76
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,029.87
|
| Rate for Payer: BCN Commercial |
$3,029.87
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$3,673.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,126.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$3,908.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,790.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,359.09
|
| Rate for Payer: Mclaren Commercial |
$3,517.20
|
| 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 |
$3,321.80
|
| 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 |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,556.28
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,774.68
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,439.04
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
IP
|
$3,908.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$2,735.60 |
| Max. Negotiated Rate |
$3,908.00 |
| Rate for Payer: Aetna Commercial |
$3,517.20
|
| Rate for Payer: ASR ASR |
$3,790.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,029.87
|
| Rate for Payer: BCN Commercial |
$3,029.87
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$3,673.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,126.40
|
| Rate for Payer: Healthscope Commercial |
$3,908.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,790.76
|
| Rate for Payer: Mclaren Commercial |
$3,517.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,321.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,439.04
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,908.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$2,735.60 |
| Rate for Payer: Aetna Commercial |
$1,286.68
|
| Rate for Payer: Aetna Medicare |
$960.21
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCBS MAPPO |
$960.21
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: BCN Medicare Advantage |
$960.21
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$1,382.70
|
| Rate for Payer: Cofinity Commercial |
$1,286.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.21
|
| Rate for Payer: Healthscope Commercial |
$1,152.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,152.25
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,008.22
|
| Rate for Payer: PACE SWMI |
$960.21
|
| Rate for Payer: PHP Medicare Advantage |
$960.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,495.70
|
| Rate for Payer: Priority Health Medicare |
$960.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.70
|
| Rate for Payer: UHC Medicare Advantage |
$989.02
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,908.00
|
|
|
Service Code
|
HCPCS 23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$2,735.60 |
| Rate for Payer: Aetna Commercial |
$1,286.68
|
| Rate for Payer: Aetna Medicare |
$960.21
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCBS MAPPO |
$960.21
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: BCN Medicare Advantage |
$960.21
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$1,382.70
|
| Rate for Payer: Cofinity Commercial |
$1,286.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.21
|
| Rate for Payer: Healthscope Commercial |
$1,152.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,152.25
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,008.22
|
| Rate for Payer: PACE SWMI |
$960.21
|
| Rate for Payer: PHP Medicare Advantage |
$960.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,495.70
|
| Rate for Payer: Priority Health Medicare |
$960.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.70
|
| Rate for Payer: UHC Medicare Advantage |
$989.02
|
|
|
PR RECONSTRUCTION TOE POLYDACTYLY
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 28344
|
| Min. Negotiated Rate |
$180.20 |
| Max. Negotiated Rate |
$2,741.35 |
| Rate for Payer: Aetna Commercial |
$363.76
|
| Rate for Payer: Aetna Medicare |
$271.46
|
| Rate for Payer: BCBS Complete |
$189.21
|
| Rate for Payer: BCBS MAPPO |
$271.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.35
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$271.46
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$390.90
|
| Rate for Payer: Cofinity Commercial |
$363.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.46
|
| Rate for Payer: Healthscope Commercial |
$325.75
|
| Rate for Payer: Healthscope Whirlpool |
$325.75
|
| Rate for Payer: Meridian Medicaid |
$189.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$285.03
|
| Rate for Payer: PACE SWMI |
$271.46
|
| Rate for Payer: PHP Medicare Advantage |
$271.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.83
|
| Rate for Payer: Priority Health Medicare |
$271.46
|
| Rate for Payer: Priority Health Narrow Network |
$423.83
|
| Rate for Payer: UHC Medicare Advantage |
$279.60
|
|
|
PR RECONSTRUCTION VENA CAVA ANY METHOD
|
Professional
|
Both
|
$2,352.00
|
|
|
Service Code
|
HCPCS 34502
|
| Min. Negotiated Rate |
$970.85 |
| Max. Negotiated Rate |
$2,399.01 |
| Rate for Payer: Aetna Commercial |
$2,021.95
|
| Rate for Payer: Aetna Medicare |
$1,508.92
|
| Rate for Payer: BCBS Complete |
$1,019.39
|
| Rate for Payer: BCBS MAPPO |
$1,508.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.01
|
| Rate for Payer: BCN Commercial |
$2,200.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,508.92
|
| Rate for Payer: Cash Price |
$1,881.60
|
| Rate for Payer: Cash Price |
$1,881.60
|
| Rate for Payer: Cofinity Commercial |
$2,172.84
|
| Rate for Payer: Cofinity Commercial |
$2,021.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,508.92
|
| Rate for Payer: Healthscope Commercial |
$1,810.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,810.70
|
| Rate for Payer: Meridian Medicaid |
$1,019.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,584.37
|
| Rate for Payer: PACE SWMI |
$1,508.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,508.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$970.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,394.87
|
| Rate for Payer: Priority Health Medicare |
$1,508.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,394.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,554.19
|
|
|
PR RECTAL SESATION TONE & COMPLIANCE TEST
|
Professional
|
Both
|
$696.00
|
|
|
Service Code
|
HCPCS 91120
|
| Min. Negotiated Rate |
$278.40 |
| Max. Negotiated Rate |
$1,003.77 |
| Rate for Payer: Aetna Commercial |
$638.04
|
| Rate for Payer: Aetna Commercial |
$638.04
|
| Rate for Payer: Aetna Medicare |
$476.15
|
| Rate for Payer: Aetna Medicare |
$476.15
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS Complete |
$278.40
|
| Rate for Payer: BCBS MAPPO |
$476.15
|
| Rate for Payer: BCBS MAPPO |
$476.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Medicare Advantage |
$476.15
|
| Rate for Payer: BCN Medicare Advantage |
$476.15
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cofinity Commercial |
$685.66
|
| Rate for Payer: Cofinity Commercial |
$685.66
|
| Rate for Payer: Cofinity Commercial |
$638.04
|
| Rate for Payer: Cofinity Commercial |
$638.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.15
|
| Rate for Payer: Healthscope Commercial |
$571.38
|
| Rate for Payer: Healthscope Commercial |
$571.38
|
| Rate for Payer: Healthscope Whirlpool |
$571.38
|
| Rate for Payer: Healthscope Whirlpool |
$571.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.96
|
| Rate for Payer: PACE SWMI |
$476.15
|
| Rate for Payer: PACE SWMI |
$476.15
|
| Rate for Payer: PHP Medicare Advantage |
$476.15
|
| Rate for Payer: PHP Medicare Advantage |
$476.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.08
|
| Rate for Payer: Priority Health Medicare |
$476.15
|
| Rate for Payer: Priority Health Medicare |
$476.15
|
| Rate for Payer: Priority Health Narrow Network |
$688.08
|
| Rate for Payer: Priority Health Narrow Network |
$688.08
|
| Rate for Payer: UHC Medicare Advantage |
$490.43
|
| Rate for Payer: UHC Medicare Advantage |
$490.43
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,758.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$4,847.67 |
| Rate for Payer: Aetna Commercial |
$771.30
|
| Rate for Payer: BCBS Complete |
$703.20
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$4,847.67
|
| Rate for Payer: Cash Price |
$1,406.40
|
| Rate for Payer: Cash Price |
$1,406.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,238.26
|
|
|
PR REGION IV LOCAL ANESTH,UPPER/LOWER EXT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01995
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
|
PR REIMPLANTATION ANOMALOUS PULMONARY ARTERY
|
Professional
|
Both
|
$6,572.00
|
|
|
Service Code
|
HCPCS 33788
|
| Min. Negotiated Rate |
$963.19 |
| Max. Negotiated Rate |
$4,600.40 |
| Rate for Payer: Aetna Commercial |
$2,023.39
|
| Rate for Payer: Aetna Medicare |
$1,509.99
|
| Rate for Payer: BCBS Complete |
$1,011.35
|
| Rate for Payer: BCBS MAPPO |
$1,509.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.33
|
| Rate for Payer: BCN Commercial |
$2,201.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,509.99
|
| Rate for Payer: Cash Price |
$5,257.60
|
| Rate for Payer: Cash Price |
$5,257.60
|
| Rate for Payer: Cofinity Commercial |
$2,174.39
|
| Rate for Payer: Cofinity Commercial |
$2,023.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,509.99
|
| Rate for Payer: Healthscope Commercial |
$1,811.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,811.99
|
| Rate for Payer: Meridian Medicaid |
$1,011.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,585.49
|
| Rate for Payer: PACE SWMI |
$1,509.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,509.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$963.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,600.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,395.94
|
| Rate for Payer: Priority Health Medicare |
$1,509.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,395.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,555.29
|
|
|
PR REINSERTION SPINAL FIXATION DEVICE
|
Professional
|
Both
|
$4,902.00
|
|
|
Service Code
|
HCPCS 22849
|
| Min. Negotiated Rate |
$136.69 |
| Max. Negotiated Rate |
$3,431.40 |
| Rate for Payer: Aetna Commercial |
$1,742.35
|
| Rate for Payer: Aetna Medicare |
$1,300.26
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS MAPPO |
$1,300.26
|
| Rate for Payer: BCBS Trust/PPO |
$136.69
|
| Rate for Payer: BCN Commercial |
$2,110.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,300.26
|
| Rate for Payer: Cash Price |
$3,921.60
|
| Rate for Payer: Cash Price |
$3,921.60
|
| Rate for Payer: Cofinity Commercial |
$1,872.37
|
| Rate for Payer: Cofinity Commercial |
$1,742.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,300.26
|
| Rate for Payer: Healthscope Commercial |
$1,560.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,560.31
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,365.27
|
| Rate for Payer: PACE SWMI |
$1,300.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,300.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,431.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,003.27
|
| Rate for Payer: Priority Health Medicare |
$1,300.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,003.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.27
|
|
|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,023.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$390.41 |
| Max. Negotiated Rate |
$1,003.93 |
| Rate for Payer: Aetna Commercial |
$843.07
|
| Rate for Payer: Aetna Medicare |
$629.16
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS MAPPO |
$629.16
|
| Rate for Payer: BCBS Trust/PPO |
$390.41
|
| Rate for Payer: BCN Commercial |
$960.74
|
| Rate for Payer: BCN Medicare Advantage |
$629.16
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$843.07
|
| Rate for Payer: Cofinity Commercial |
$905.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.16
|
| Rate for Payer: Healthscope Commercial |
$754.99
|
| Rate for Payer: Healthscope Whirlpool |
$754.99
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$660.62
|
| Rate for Payer: PACE SWMI |
$629.16
|
| Rate for Payer: PHP Medicare Advantage |
$629.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.93
|
| Rate for Payer: Priority Health Medicare |
$629.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.93
|
| Rate for Payer: UHC Medicare Advantage |
$648.03
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,280.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$443.04 |
| Max. Negotiated Rate |
$1,596.00 |
| Rate for Payer: Aetna Commercial |
$905.37
|
| Rate for Payer: Aetna Medicare |
$675.65
|
| Rate for Payer: BCBS Complete |
$465.19
|
| Rate for Payer: BCBS MAPPO |
$675.65
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,008.63
|
| Rate for Payer: BCN Medicare Advantage |
$675.65
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cofinity Commercial |
$972.94
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.65
|
| Rate for Payer: Healthscope Commercial |
$810.78
|
| Rate for Payer: Healthscope Whirlpool |
$810.78
|
| Rate for Payer: Meridian Medicaid |
$465.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$709.43
|
| Rate for Payer: PACE SWMI |
$675.65
|
| Rate for Payer: PHP Medicare Advantage |
$675.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,596.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.98
|
| Rate for Payer: Priority Health Medicare |
$675.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.98
|
| Rate for Payer: UHC Medicare Advantage |
$695.92
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$184.38 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: Aetna Commercial |
$469.88
|
| Rate for Payer: Aetna Medicare |
$350.66
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$350.66
|
| Rate for Payer: BCBS Trust/PPO |
$184.38
|
| Rate for Payer: BCN Commercial |
$771.63
|
| Rate for Payer: BCN Medicare Advantage |
$350.66
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$504.95
|
| Rate for Payer: Cofinity Commercial |
$469.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.66
|
| Rate for Payer: Healthscope Commercial |
$420.79
|
| Rate for Payer: Healthscope Whirlpool |
$420.79
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$368.19
|
| Rate for Payer: PACE SWMI |
$350.66
|
| Rate for Payer: PHP Medicare Advantage |
$350.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.93
|
| Rate for Payer: Priority Health Medicare |
$350.66
|
| Rate for Payer: Priority Health Narrow Network |
$547.93
|
| Rate for Payer: UHC Medicare Advantage |
$361.18
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$439.21 |
| Max. Negotiated Rate |
$3,420.21 |
| Rate for Payer: Aetna Commercial |
$886.37
|
| Rate for Payer: Aetna Medicare |
$661.47
|
| Rate for Payer: BCBS Complete |
$461.17
|
| Rate for Payer: BCBS MAPPO |
$661.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,420.21
|
| Rate for Payer: BCN Commercial |
$1,007.65
|
| Rate for Payer: BCN Medicare Advantage |
$661.47
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$952.52
|
| Rate for Payer: Cofinity Commercial |
$886.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.47
|
| Rate for Payer: Healthscope Commercial |
$793.76
|
| Rate for Payer: Healthscope Whirlpool |
$793.76
|
| Rate for Payer: Meridian Medicaid |
$461.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$694.54
|
| Rate for Payer: PACE SWMI |
$661.47
|
| Rate for Payer: PHP Medicare Advantage |
$661.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,052.95
|
| Rate for Payer: Priority Health Medicare |
$661.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,052.95
|
| Rate for Payer: UHC Medicare Advantage |
$681.31
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,330.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$257.52 |
| Max. Negotiated Rate |
$1,195.54 |
| Rate for Payer: Aetna Commercial |
$537.66
|
| Rate for Payer: Aetna Medicare |
$401.24
|
| Rate for Payer: BCBS Complete |
$270.40
|
| Rate for Payer: BCBS MAPPO |
$401.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.54
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: BCN Medicare Advantage |
$401.24
|
| Rate for Payer: Cash Price |
$1,064.00
|
| Rate for Payer: Cash Price |
$1,064.00
|
| Rate for Payer: Cofinity Commercial |
$537.66
|
| Rate for Payer: Cofinity Commercial |
$577.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.24
|
| Rate for Payer: Healthscope Commercial |
$481.49
|
| Rate for Payer: Healthscope Whirlpool |
$481.49
|
| Rate for Payer: Meridian Medicaid |
$270.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.30
|
| Rate for Payer: PACE SWMI |
$401.24
|
| Rate for Payer: PHP Medicare Advantage |
$401.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$645.26
|
| Rate for Payer: Priority Health Medicare |
$401.24
|
| Rate for Payer: Priority Health Narrow Network |
$645.26
|
| Rate for Payer: UHC Medicare Advantage |
$413.28
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,128.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$216.83 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: Aetna Commercial |
$448.82
|
| Rate for Payer: Aetna Medicare |
$334.94
|
| Rate for Payer: BCBS Complete |
$227.67
|
| Rate for Payer: BCBS MAPPO |
$334.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,036.00
|
| Rate for Payer: BCN Commercial |
$497.47
|
| Rate for Payer: BCN Medicare Advantage |
$334.94
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cofinity Commercial |
$482.31
|
| Rate for Payer: Cofinity Commercial |
$448.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.94
|
| Rate for Payer: Healthscope Commercial |
$401.93
|
| Rate for Payer: Healthscope Whirlpool |
$401.93
|
| Rate for Payer: Meridian Medicaid |
$227.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$351.69
|
| Rate for Payer: PACE SWMI |
$334.94
|
| Rate for Payer: PHP Medicare Advantage |
$334.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$789.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.53
|
| Rate for Payer: Priority Health Medicare |
$334.94
|
| Rate for Payer: Priority Health Narrow Network |
$541.53
|
| Rate for Payer: UHC Medicare Advantage |
$344.99
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$1,891.84 |
| Rate for Payer: Aetna Commercial |
$33.84
|
| Rate for Payer: Aetna Medicare |
$25.25
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,891.84
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: BCN Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$36.36
|
| Rate for Payer: Cofinity Commercial |
$33.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.25
|
| Rate for Payer: Healthscope Commercial |
$30.30
|
| Rate for Payer: Healthscope Whirlpool |
$30.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: PACE SWMI |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.93
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow Network |
$35.93
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$158.90 |
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.90
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$1,440.67 |
| Rate for Payer: Aetna Commercial |
$39.13
|
| Rate for Payer: Aetna Medicare |
$29.20
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS MAPPO |
$29.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,440.67
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Medicare Advantage |
$29.20
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Commercial |
$39.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.20
|
| Rate for Payer: Healthscope Commercial |
$35.04
|
| Rate for Payer: Healthscope Whirlpool |
$35.04
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.66
|
| Rate for Payer: PACE SWMI |
$29.20
|
| Rate for Payer: PHP Medicare Advantage |
$29.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow Network |
$41.61
|
| Rate for Payer: UHC Medicare Advantage |
$30.08
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$277.89 |
| Rate for Payer: Aetna Commercial |
$27.79
|
| Rate for Payer: Aetna Medicare |
$20.74
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$20.74
|
| Rate for Payer: BCBS Trust/PPO |
$277.89
|
| Rate for Payer: BCN Commercial |
$32.75
|
| Rate for Payer: BCN Medicare Advantage |
$20.74
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$29.87
|
| Rate for Payer: Cofinity Commercial |
$27.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.74
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.78
|
| Rate for Payer: PACE SWMI |
$20.74
|
| Rate for Payer: PHP Medicare Advantage |
$20.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$20.74
|
| Rate for Payer: Priority Health Narrow Network |
$31.68
|
| Rate for Payer: UHC Medicare Advantage |
$21.36
|
|
