|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 12042
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$454.96 |
| Rate for Payer: Aetna Commercial |
$253.53
|
| Rate for Payer: Aetna Medicare |
$189.20
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$189.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$454.96
|
| Rate for Payer: BCN Medicare Advantage |
$189.20
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cofinity Commercial |
$253.53
|
| Rate for Payer: Cofinity Commercial |
$272.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.20
|
| Rate for Payer: Healthscope Commercial |
$227.04
|
| Rate for Payer: Healthscope Whirlpool |
$227.04
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.66
|
| Rate for Payer: PACE SWMI |
$189.20
|
| Rate for Payer: PHP Medicare Advantage |
$189.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.41
|
| Rate for Payer: Priority Health Medicare |
$189.20
|
| Rate for Payer: Priority Health Narrow Network |
$238.41
|
| Rate for Payer: UHC Medicare Advantage |
$194.88
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM
|
Professional
|
Both
|
$1,123.00
|
|
|
Service Code
|
HCPCS 12047
|
| Min. Negotiated Rate |
$212.16 |
| Max. Negotiated Rate |
$804.85 |
| Rate for Payer: Aetna Commercial |
$465.80
|
| Rate for Payer: Aetna Medicare |
$347.61
|
| Rate for Payer: BCBS Complete |
$237.52
|
| Rate for Payer: BCBS MAPPO |
$347.61
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$804.85
|
| Rate for Payer: BCN Medicare Advantage |
$347.61
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cofinity Commercial |
$500.56
|
| Rate for Payer: Cofinity Commercial |
$465.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.61
|
| Rate for Payer: Healthscope Commercial |
$417.13
|
| Rate for Payer: Healthscope Whirlpool |
$417.13
|
| Rate for Payer: Meridian Medicaid |
$237.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.99
|
| Rate for Payer: PACE SWMI |
$347.61
|
| Rate for Payer: PHP Medicare Advantage |
$347.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.65
|
| Rate for Payer: Priority Health Medicare |
$347.61
|
| Rate for Payer: Priority Health Narrow Network |
$433.65
|
| Rate for Payer: UHC Medicare Advantage |
$358.04
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Professional
|
Both
|
$554.00
|
|
|
Service Code
|
HCPCS 12044
|
| Min. Negotiated Rate |
$136.75 |
| Max. Negotiated Rate |
$560.51 |
| Rate for Payer: Aetna Commercial |
$278.87
|
| Rate for Payer: Aetna Medicare |
$208.11
|
| Rate for Payer: BCBS Complete |
$143.59
|
| Rate for Payer: BCBS MAPPO |
$208.11
|
| Rate for Payer: BCBS Trust/PPO |
$361.61
|
| Rate for Payer: BCN Commercial |
$560.51
|
| Rate for Payer: BCN Medicare Advantage |
$208.11
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cofinity Commercial |
$299.68
|
| Rate for Payer: Cofinity Commercial |
$278.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.11
|
| Rate for Payer: Healthscope Commercial |
$249.73
|
| Rate for Payer: Healthscope Whirlpool |
$249.73
|
| Rate for Payer: Meridian Medicaid |
$143.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.52
|
| Rate for Payer: PACE SWMI |
$208.11
|
| Rate for Payer: PHP Medicare Advantage |
$208.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.01
|
| Rate for Payer: Priority Health Medicare |
$208.11
|
| Rate for Payer: Priority Health Narrow Network |
$261.01
|
| Rate for Payer: UHC Medicare Advantage |
$214.35
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Facility
|
IP
|
$554.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
12044
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$387.80 |
| Max. Negotiated Rate |
$554.00 |
| Rate for Payer: Aetna Commercial |
$498.60
|
| Rate for Payer: ASR ASR |
$537.38
|
| Rate for Payer: BCBS Trust/PPO |
$429.52
|
| Rate for Payer: BCN Commercial |
$429.52
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cofinity Commercial |
$520.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.20
|
| Rate for Payer: Healthscope Commercial |
$554.00
|
| Rate for Payer: Healthscope Whirlpool |
$537.38
|
| Rate for Payer: Mclaren Commercial |
$498.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$470.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.52
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Professional
|
Both
|
$554.00
|
|
|
Service Code
|
HCPCS 12044
|
| Hospital Charge Code |
12044
|
| Min. Negotiated Rate |
$136.75 |
| Max. Negotiated Rate |
$560.51 |
| Rate for Payer: Aetna Commercial |
$278.87
|
| Rate for Payer: Aetna Medicare |
$208.11
|
| Rate for Payer: BCBS Complete |
$143.59
|
| Rate for Payer: BCBS MAPPO |
$208.11
|
| Rate for Payer: BCBS Trust/PPO |
$361.61
|
| Rate for Payer: BCN Commercial |
$560.51
|
| Rate for Payer: BCN Medicare Advantage |
$208.11
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cofinity Commercial |
$299.68
|
| Rate for Payer: Cofinity Commercial |
$278.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.11
|
| Rate for Payer: Healthscope Commercial |
$249.73
|
| Rate for Payer: Healthscope Whirlpool |
$249.73
|
| Rate for Payer: Meridian Medicaid |
$143.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.52
|
| Rate for Payer: PACE SWMI |
$208.11
|
| Rate for Payer: PHP Medicare Advantage |
$208.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.01
|
| Rate for Payer: Priority Health Medicare |
$208.11
|
| Rate for Payer: Priority Health Narrow Network |
$261.01
|
| Rate for Payer: UHC Medicare Advantage |
$214.35
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Facility
|
OP
|
$554.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
12044
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$198.86 |
| Max. Negotiated Rate |
$697.82 |
| Rate for Payer: Aetna Commercial |
$498.60
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$537.38
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$429.52
|
| Rate for Payer: BCN Commercial |
$429.52
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cofinity Commercial |
$520.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$554.00
|
| Rate for Payer: Healthscope Whirlpool |
$537.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$498.60
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$470.90
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.58
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$198.86
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.52
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 12035
|
| Hospital Charge Code |
12035
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: Aetna Commercial |
$315.96
|
| Rate for Payer: Aetna Medicare |
$235.79
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$235.79
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$459.81
|
| Rate for Payer: BCN Medicare Advantage |
$235.79
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$339.54
|
| Rate for Payer: Cofinity Commercial |
$315.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.79
|
| Rate for Payer: Healthscope Commercial |
$282.95
|
| Rate for Payer: Healthscope Whirlpool |
$282.95
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$247.58
|
| Rate for Payer: PACE SWMI |
$235.79
|
| Rate for Payer: PHP Medicare Advantage |
$235.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.13
|
| Rate for Payer: Priority Health Medicare |
$235.79
|
| Rate for Payer: Priority Health Narrow Network |
$295.13
|
| Rate for Payer: UHC Medicare Advantage |
$242.86
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Facility
|
IP
|
$680.00
|
|
|
Service Code
|
CPT 12035
|
| Hospital Charge Code |
12035
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$476.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: ASR ASR |
$659.60
|
| Rate for Payer: BCBS Trust/PPO |
$527.20
|
| Rate for Payer: BCN Commercial |
$527.20
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$639.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.00
|
| Rate for Payer: Healthscope Commercial |
$680.00
|
| Rate for Payer: Healthscope Whirlpool |
$659.60
|
| Rate for Payer: Mclaren Commercial |
$612.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$578.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.40
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Facility
|
OP
|
$680.00
|
|
|
Service Code
|
CPT 12035
|
| Hospital Charge Code |
12035
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$151.05 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$659.60
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$527.20
|
| Rate for Payer: BCN Commercial |
$527.20
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$639.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$680.00
|
| Rate for Payer: Healthscope Whirlpool |
$659.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$612.00
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$578.00
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.81
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$151.05
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.40
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 12035
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: Aetna Commercial |
$315.96
|
| Rate for Payer: Aetna Medicare |
$235.79
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$235.79
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$459.81
|
| Rate for Payer: BCN Medicare Advantage |
$235.79
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$339.54
|
| Rate for Payer: Cofinity Commercial |
$315.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.79
|
| Rate for Payer: Healthscope Commercial |
$282.95
|
| Rate for Payer: Healthscope Whirlpool |
$282.95
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$247.58
|
| Rate for Payer: PACE SWMI |
$235.79
|
| Rate for Payer: PHP Medicare Advantage |
$235.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.13
|
| Rate for Payer: Priority Health Medicare |
$235.79
|
| Rate for Payer: Priority Health Narrow Network |
$295.13
|
| Rate for Payer: UHC Medicare Advantage |
$242.86
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 12036
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$596.40 |
| Rate for Payer: Aetna Commercial |
$370.05
|
| Rate for Payer: Aetna Medicare |
$276.16
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS MAPPO |
$276.16
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$510.07
|
| Rate for Payer: BCN Medicare Advantage |
$276.16
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cofinity Commercial |
$397.67
|
| Rate for Payer: Cofinity Commercial |
$370.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$276.16
|
| Rate for Payer: Healthscope Commercial |
$331.39
|
| Rate for Payer: Healthscope Whirlpool |
$331.39
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$289.97
|
| Rate for Payer: PACE SWMI |
$276.16
|
| Rate for Payer: PHP Medicare Advantage |
$276.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.44
|
| Rate for Payer: Priority Health Medicare |
$276.16
|
| Rate for Payer: Priority Health Narrow Network |
$344.44
|
| Rate for Payer: UHC Medicare Advantage |
$284.44
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Facility
|
OP
|
$386.00
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
12031
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$347.40
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$374.42
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$299.27
|
| Rate for Payer: BCN Commercial |
$299.27
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$362.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$386.00
|
| Rate for Payer: Healthscope Whirlpool |
$374.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$347.40
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$328.10
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.58
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$198.86
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.68
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 12031
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$310.99 |
| Rate for Payer: Aetna Commercial |
$196.52
|
| Rate for Payer: Aetna Medicare |
$146.66
|
| Rate for Payer: BCBS Complete |
$101.54
|
| Rate for Payer: BCBS MAPPO |
$146.66
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$310.99
|
| Rate for Payer: BCN Medicare Advantage |
$146.66
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$196.52
|
| Rate for Payer: Cofinity Commercial |
$211.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.66
|
| Rate for Payer: Healthscope Commercial |
$175.99
|
| Rate for Payer: Healthscope Whirlpool |
$175.99
|
| Rate for Payer: Meridian Medicaid |
$101.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.99
|
| Rate for Payer: PACE SWMI |
$146.66
|
| Rate for Payer: PHP Medicare Advantage |
$146.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.38
|
| Rate for Payer: Priority Health Medicare |
$146.66
|
| Rate for Payer: Priority Health Narrow Network |
$185.38
|
| Rate for Payer: UHC Medicare Advantage |
$151.06
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Facility
|
IP
|
$386.00
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
12031
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$270.20 |
| Max. Negotiated Rate |
$386.00 |
| Rate for Payer: Aetna Commercial |
$347.40
|
| Rate for Payer: ASR ASR |
$374.42
|
| Rate for Payer: BCBS Trust/PPO |
$299.27
|
| Rate for Payer: BCN Commercial |
$299.27
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$362.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.80
|
| Rate for Payer: Healthscope Commercial |
$386.00
|
| Rate for Payer: Healthscope Whirlpool |
$374.42
|
| Rate for Payer: Mclaren Commercial |
$347.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$328.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.68
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 12031
|
| Hospital Charge Code |
12031
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$310.99 |
| Rate for Payer: Aetna Commercial |
$196.52
|
| Rate for Payer: Aetna Medicare |
$146.66
|
| Rate for Payer: BCBS Complete |
$101.54
|
| Rate for Payer: BCBS MAPPO |
$146.66
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$310.99
|
| Rate for Payer: BCN Medicare Advantage |
$146.66
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$211.19
|
| Rate for Payer: Cofinity Commercial |
$196.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.66
|
| Rate for Payer: Healthscope Commercial |
$175.99
|
| Rate for Payer: Healthscope Whirlpool |
$175.99
|
| Rate for Payer: Meridian Medicaid |
$101.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.99
|
| Rate for Payer: PACE SWMI |
$146.66
|
| Rate for Payer: PHP Medicare Advantage |
$146.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.38
|
| Rate for Payer: Priority Health Medicare |
$146.66
|
| Rate for Payer: Priority Health Narrow Network |
$185.38
|
| Rate for Payer: UHC Medicare Advantage |
$151.06
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
HCPCS 12032
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$358.50 |
| Rate for Payer: Aetna Commercial |
$245.68
|
| Rate for Payer: Aetna Medicare |
$183.34
|
| Rate for Payer: BCBS Complete |
$127.48
|
| Rate for Payer: BCBS MAPPO |
$183.34
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$358.50
|
| Rate for Payer: BCN Medicare Advantage |
$183.34
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$264.01
|
| Rate for Payer: Cofinity Commercial |
$245.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.34
|
| Rate for Payer: Healthscope Commercial |
$220.01
|
| Rate for Payer: Healthscope Whirlpool |
$220.01
|
| Rate for Payer: Meridian Medicaid |
$127.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$192.51
|
| Rate for Payer: PACE SWMI |
$183.34
|
| Rate for Payer: PHP Medicare Advantage |
$183.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.82
|
| Rate for Payer: Priority Health Medicare |
$183.34
|
| Rate for Payer: Priority Health Narrow Network |
$231.82
|
| Rate for Payer: UHC Medicare Advantage |
$188.84
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
HCPCS 12032
|
| Hospital Charge Code |
12032
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$358.50 |
| Rate for Payer: Aetna Commercial |
$245.68
|
| Rate for Payer: Aetna Medicare |
$183.34
|
| Rate for Payer: BCBS Complete |
$127.48
|
| Rate for Payer: BCBS MAPPO |
$183.34
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$358.50
|
| Rate for Payer: BCN Medicare Advantage |
$183.34
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$264.01
|
| Rate for Payer: Cofinity Commercial |
$245.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.34
|
| Rate for Payer: Healthscope Commercial |
$220.01
|
| Rate for Payer: Healthscope Whirlpool |
$220.01
|
| Rate for Payer: Meridian Medicaid |
$127.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$192.51
|
| Rate for Payer: PACE SWMI |
$183.34
|
| Rate for Payer: PHP Medicare Advantage |
$183.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.82
|
| Rate for Payer: Priority Health Medicare |
$183.34
|
| Rate for Payer: Priority Health Narrow Network |
$231.82
|
| Rate for Payer: UHC Medicare Advantage |
$188.84
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
12032
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$345.10 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Aetna Commercial |
$443.70
|
| Rate for Payer: ASR ASR |
$478.21
|
| Rate for Payer: BCBS Trust/PPO |
$382.22
|
| Rate for Payer: BCN Commercial |
$382.22
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$463.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.40
|
| Rate for Payer: Healthscope Commercial |
$493.00
|
| Rate for Payer: Healthscope Whirlpool |
$478.21
|
| Rate for Payer: Mclaren Commercial |
$443.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$419.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$433.84
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
12032
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Aetna Commercial |
$443.70
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$478.21
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$382.22
|
| Rate for Payer: BCN Commercial |
$382.22
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$463.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$493.00
|
| Rate for Payer: Healthscope Whirlpool |
$478.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$443.70
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$419.05
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.41
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$357.93
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$433.84
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E >30.0 CM
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 12037
|
| Min. Negotiated Rate |
$209.59 |
| Max. Negotiated Rate |
$1,594.65 |
| Rate for Payer: Aetna Commercial |
$430.69
|
| Rate for Payer: Aetna Medicare |
$321.41
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$321.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.65
|
| Rate for Payer: BCN Commercial |
$571.33
|
| Rate for Payer: BCN Medicare Advantage |
$321.41
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$462.83
|
| Rate for Payer: Cofinity Commercial |
$430.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.41
|
| Rate for Payer: Healthscope Commercial |
$385.69
|
| Rate for Payer: Healthscope Whirlpool |
$385.69
|
| Rate for Payer: Meridian Medicaid |
$220.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$337.48
|
| Rate for Payer: PACE SWMI |
$321.41
|
| Rate for Payer: PHP Medicare Advantage |
$321.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$520.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.35
|
| Rate for Payer: Priority Health Medicare |
$321.41
|
| Rate for Payer: Priority Health Narrow Network |
$400.35
|
| Rate for Payer: UHC Medicare Advantage |
$331.05
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Facility
|
IP
|
$628.00
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
12034
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$628.00 |
| Rate for Payer: Aetna Commercial |
$565.20
|
| Rate for Payer: ASR ASR |
$609.16
|
| Rate for Payer: BCBS Trust/PPO |
$486.89
|
| Rate for Payer: BCN Commercial |
$486.89
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cofinity Commercial |
$590.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.40
|
| Rate for Payer: Healthscope Commercial |
$628.00
|
| Rate for Payer: Healthscope Whirlpool |
$609.16
|
| Rate for Payer: Mclaren Commercial |
$565.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$533.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.64
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Professional
|
Both
|
$628.00
|
|
|
Service Code
|
HCPCS 12034
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$439.60 |
| Rate for Payer: Aetna Commercial |
$267.34
|
| Rate for Payer: Aetna Medicare |
$199.51
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$199.51
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$394.62
|
| Rate for Payer: BCN Medicare Advantage |
$199.51
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cofinity Commercial |
$287.29
|
| Rate for Payer: Cofinity Commercial |
$267.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.51
|
| Rate for Payer: Healthscope Commercial |
$239.41
|
| Rate for Payer: Healthscope Whirlpool |
$239.41
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$209.49
|
| Rate for Payer: PACE SWMI |
$199.51
|
| Rate for Payer: PHP Medicare Advantage |
$199.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.73
|
| Rate for Payer: Priority Health Medicare |
$199.51
|
| Rate for Payer: Priority Health Narrow Network |
$250.73
|
| Rate for Payer: UHC Medicare Advantage |
$205.50
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Facility
|
OP
|
$628.00
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
12034
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$628.00 |
| Rate for Payer: Aetna Commercial |
$565.20
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$609.16
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$486.89
|
| Rate for Payer: BCN Commercial |
$486.89
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cofinity Commercial |
$590.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$628.00
|
| Rate for Payer: Healthscope Whirlpool |
$609.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$565.20
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$533.80
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.58
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$198.86
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.64
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Professional
|
Both
|
$628.00
|
|
|
Service Code
|
HCPCS 12034
|
| Hospital Charge Code |
12034
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$439.60 |
| Rate for Payer: Aetna Commercial |
$267.34
|
| Rate for Payer: Aetna Medicare |
$199.51
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$199.51
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$394.62
|
| Rate for Payer: BCN Medicare Advantage |
$199.51
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cash Price |
$502.40
|
| Rate for Payer: Cofinity Commercial |
$287.29
|
| Rate for Payer: Cofinity Commercial |
$267.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.51
|
| Rate for Payer: Healthscope Commercial |
$239.41
|
| Rate for Payer: Healthscope Whirlpool |
$239.41
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$209.49
|
| Rate for Payer: PACE SWMI |
$199.51
|
| Rate for Payer: PHP Medicare Advantage |
$199.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.73
|
| Rate for Payer: Priority Health Medicare |
$199.51
|
| Rate for Payer: Priority Health Narrow Network |
$250.73
|
| Rate for Payer: UHC Medicare Advantage |
$205.50
|
|
|
PR REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 26591
|
| Min. Negotiated Rate |
$232.45 |
| Max. Negotiated Rate |
$760.36 |
| Rate for Payer: Aetna Commercial |
$634.42
|
| Rate for Payer: Aetna Medicare |
$473.45
|
| Rate for Payer: BCBS Complete |
$333.46
|
| Rate for Payer: BCBS MAPPO |
$473.45
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$727.64
|
| Rate for Payer: BCN Medicare Advantage |
$473.45
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$681.77
|
| Rate for Payer: Cofinity Commercial |
$634.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.45
|
| Rate for Payer: Healthscope Commercial |
$568.14
|
| Rate for Payer: Healthscope Whirlpool |
$568.14
|
| Rate for Payer: Meridian Medicaid |
$333.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$497.12
|
| Rate for Payer: PACE SWMI |
$473.45
|
| Rate for Payer: PHP Medicare Advantage |
$473.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.36
|
| Rate for Payer: Priority Health Medicare |
$473.45
|
| Rate for Payer: Priority Health Narrow Network |
$760.36
|
| Rate for Payer: UHC Medicare Advantage |
$487.65
|
|
