|
PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE
|
Professional
|
Both
|
$1,601.00
|
|
|
Service Code
|
HCPCS 64859
|
| Min. Negotiated Rate |
$155.92 |
| Max. Negotiated Rate |
$1,120.70 |
| Rate for Payer: Aetna Commercial |
$325.94
|
| Rate for Payer: Aetna Medicare |
$243.24
|
| Rate for Payer: BCBS Complete |
$163.72
|
| Rate for Payer: BCBS MAPPO |
$243.24
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$357.23
|
| Rate for Payer: BCN Medicare Advantage |
$243.24
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cofinity Commercial |
$350.27
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.24
|
| Rate for Payer: Healthscope Commercial |
$291.89
|
| Rate for Payer: Healthscope Whirlpool |
$291.89
|
| Rate for Payer: Meridian Medicaid |
$163.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$255.40
|
| Rate for Payer: PACE SWMI |
$243.24
|
| Rate for Payer: PHP Medicare Advantage |
$243.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.92
|
| Rate for Payer: Priority Health Medicare |
$243.24
|
| Rate for Payer: Priority Health Narrow Network |
$413.92
|
| Rate for Payer: UHC Medicare Advantage |
$250.54
|
|
|
PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY
|
Professional
|
Both
|
$2,988.00
|
|
|
Service Code
|
HCPCS 47900
|
| Min. Negotiated Rate |
$881.82 |
| Max. Negotiated Rate |
$3,830.18 |
| Rate for Payer: Aetna Commercial |
$1,839.28
|
| Rate for Payer: Aetna Medicare |
$1,372.60
|
| Rate for Payer: BCBS Complete |
$925.91
|
| Rate for Payer: BCBS MAPPO |
$1,372.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,830.18
|
| Rate for Payer: BCN Commercial |
$2,015.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,372.60
|
| Rate for Payer: Cash Price |
$2,390.40
|
| Rate for Payer: Cash Price |
$2,390.40
|
| Rate for Payer: Cofinity Commercial |
$1,839.28
|
| Rate for Payer: Cofinity Commercial |
$1,976.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,372.60
|
| Rate for Payer: Healthscope Commercial |
$1,647.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,647.12
|
| Rate for Payer: Meridian Medicaid |
$925.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,441.23
|
| Rate for Payer: PACE SWMI |
$1,372.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,372.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,091.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,425.39
|
| Rate for Payer: Priority Health Medicare |
$1,372.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,425.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,413.78
|
|
|
PR SUTURE FACIAL NERVE EXTRACRANIAL
|
Professional
|
Both
|
$2,381.00
|
|
|
Service Code
|
HCPCS 64864
|
| Min. Negotiated Rate |
$305.89 |
| Max. Negotiated Rate |
$1,666.70 |
| Rate for Payer: Aetna Commercial |
$1,137.58
|
| Rate for Payer: Aetna Medicare |
$848.94
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS MAPPO |
$848.94
|
| Rate for Payer: BCBS Trust/PPO |
$305.89
|
| Rate for Payer: BCN Commercial |
$1,260.78
|
| Rate for Payer: BCN Medicare Advantage |
$848.94
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cofinity Commercial |
$1,222.47
|
| Rate for Payer: Cofinity Commercial |
$1,137.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.94
|
| Rate for Payer: Healthscope Commercial |
$1,018.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.73
|
| Rate for Payer: Meridian Medicaid |
$576.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$891.39
|
| Rate for Payer: PACE SWMI |
$848.94
|
| Rate for Payer: PHP Medicare Advantage |
$848.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,460.86
|
| Rate for Payer: Priority Health Medicare |
$848.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,460.86
|
| Rate for Payer: UHC Medicare Advantage |
$874.41
|
|
|
PR SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT
|
Professional
|
Both
|
$2,977.00
|
|
|
Service Code
|
HCPCS 64865
|
| Min. Negotiated Rate |
$354.49 |
| Max. Negotiated Rate |
$2,083.90 |
| Rate for Payer: Aetna Commercial |
$1,429.94
|
| Rate for Payer: Aetna Medicare |
$1,067.12
|
| Rate for Payer: BCBS Complete |
$728.88
|
| Rate for Payer: BCBS MAPPO |
$1,067.12
|
| Rate for Payer: BCBS Trust/PPO |
$354.49
|
| Rate for Payer: BCN Commercial |
$1,592.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,067.12
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cofinity Commercial |
$1,429.94
|
| Rate for Payer: Cofinity Commercial |
$1,536.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,067.12
|
| Rate for Payer: Healthscope Commercial |
$1,280.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,280.54
|
| Rate for Payer: Meridian Medicaid |
$728.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,120.48
|
| Rate for Payer: PACE SWMI |
$1,067.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,067.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$694.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,083.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,844.75
|
| Rate for Payer: Priority Health Medicare |
$1,067.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,844.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.13
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
IP
|
$1,521.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$1,064.70 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$1,368.90
|
| Rate for Payer: ASR ASR |
$1,475.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.23
|
| Rate for Payer: BCN Commercial |
$1,179.23
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cofinity Commercial |
$1,429.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.80
|
| Rate for Payer: Healthscope Commercial |
$1,521.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,475.37
|
| Rate for Payer: Mclaren Commercial |
$1,368.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,292.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.48
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,521.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$404.49 |
| Max. Negotiated Rate |
$2,533.73 |
| Rate for Payer: Aetna Commercial |
$822.63
|
| Rate for Payer: Aetna Medicare |
$613.90
|
| Rate for Payer: BCBS Complete |
$424.71
|
| Rate for Payer: BCBS MAPPO |
$613.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,533.73
|
| Rate for Payer: BCN Commercial |
$923.11
|
| Rate for Payer: BCN Medicare Advantage |
$613.90
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cofinity Commercial |
$884.02
|
| Rate for Payer: Cofinity Commercial |
$822.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.90
|
| Rate for Payer: Healthscope Commercial |
$736.68
|
| Rate for Payer: Healthscope Whirlpool |
$736.68
|
| Rate for Payer: Meridian Medicaid |
$424.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$644.60
|
| Rate for Payer: PACE SWMI |
$613.90
|
| Rate for Payer: PHP Medicare Advantage |
$613.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$964.62
|
| Rate for Payer: Priority Health Medicare |
$613.90
|
| Rate for Payer: Priority Health Narrow Network |
$964.62
|
| Rate for Payer: UHC Medicare Advantage |
$632.32
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,521.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$404.49 |
| Max. Negotiated Rate |
$2,533.73 |
| Rate for Payer: Aetna Commercial |
$822.63
|
| Rate for Payer: Aetna Medicare |
$613.90
|
| Rate for Payer: BCBS Complete |
$424.71
|
| Rate for Payer: BCBS MAPPO |
$613.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,533.73
|
| Rate for Payer: BCN Commercial |
$923.11
|
| Rate for Payer: BCN Medicare Advantage |
$613.90
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cofinity Commercial |
$822.63
|
| Rate for Payer: Cofinity Commercial |
$884.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.90
|
| Rate for Payer: Healthscope Commercial |
$736.68
|
| Rate for Payer: Healthscope Whirlpool |
$736.68
|
| Rate for Payer: Meridian Medicaid |
$424.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$644.60
|
| Rate for Payer: PACE SWMI |
$613.90
|
| Rate for Payer: PHP Medicare Advantage |
$613.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$964.62
|
| Rate for Payer: Priority Health Medicare |
$613.90
|
| Rate for Payer: Priority Health Narrow Network |
$964.62
|
| Rate for Payer: UHC Medicare Advantage |
$632.32
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
OP
|
$1,521.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$1,064.70 |
| Max. Negotiated Rate |
$7,948.86 |
| Rate for Payer: Aetna Commercial |
$1,368.90
|
| 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 |
$1,475.37
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.23
|
| Rate for Payer: BCN Commercial |
$1,179.23
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cash Price |
$1,216.80
|
| Rate for Payer: Cofinity Commercial |
$1,429.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$1,521.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,475.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,359.09
|
| Rate for Payer: Mclaren Commercial |
$1,368.90
|
| 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 |
$1,292.85
|
| 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 |
$1,064.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,384.11
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,079.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.48
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$330.19 |
| Max. Negotiated Rate |
$1,358.00 |
| Rate for Payer: Aetna Commercial |
$993.40
|
| Rate for Payer: Aetna Medicare |
$741.34
|
| Rate for Payer: BCBS Complete |
$503.43
|
| Rate for Payer: BCBS MAPPO |
$741.34
|
| Rate for Payer: BCBS Trust/PPO |
$330.19
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| Rate for Payer: BCN Medicare Advantage |
$741.34
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$993.40
|
| Rate for Payer: Cofinity Commercial |
$1,067.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$741.34
|
| Rate for Payer: Healthscope Commercial |
$889.61
|
| Rate for Payer: Healthscope Whirlpool |
$889.61
|
| Rate for Payer: Meridian Medicaid |
$503.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$778.41
|
| Rate for Payer: PACE SWMI |
$741.34
|
| Rate for Payer: PHP Medicare Advantage |
$741.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,358.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,312.35
|
| Rate for Payer: Priority Health Medicare |
$741.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,312.35
|
| Rate for Payer: UHC Medicare Advantage |
$763.58
|
|
|
PR SUTURE NERVE REQ SECONDARY/DELAYED SUTURE
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 64872
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$213.43 |
| Rate for Payer: Aetna Commercial |
$152.52
|
| Rate for Payer: Aetna Medicare |
$113.82
|
| Rate for Payer: BCBS Complete |
$76.49
|
| Rate for Payer: BCBS MAPPO |
$113.82
|
| Rate for Payer: BCBS Trust/PPO |
$213.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$113.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$163.90
|
| Rate for Payer: Cofinity Commercial |
$152.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.82
|
| Rate for Payer: Healthscope Commercial |
$136.58
|
| Rate for Payer: Healthscope Whirlpool |
$136.58
|
| Rate for Payer: Meridian Medicaid |
$76.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.51
|
| Rate for Payer: PACE SWMI |
$113.82
|
| Rate for Payer: PHP Medicare Advantage |
$113.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.64
|
| Rate for Payer: Priority Health Medicare |
$113.82
|
| Rate for Payer: Priority Health Narrow Network |
$193.64
|
| Rate for Payer: UHC Medicare Advantage |
$117.23
|
|
|
PR SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 64874
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$303.24 |
| Rate for Payer: Aetna Commercial |
$227.85
|
| Rate for Payer: Aetna Medicare |
$170.04
|
| Rate for Payer: BCBS Complete |
$114.73
|
| Rate for Payer: BCBS MAPPO |
$170.04
|
| Rate for Payer: BCBS Trust/PPO |
$303.24
|
| Rate for Payer: BCN Commercial |
$249.71
|
| Rate for Payer: BCN Medicare Advantage |
$170.04
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Cofinity Commercial |
$227.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.04
|
| Rate for Payer: Healthscope Commercial |
$204.05
|
| Rate for Payer: Healthscope Whirlpool |
$204.05
|
| Rate for Payer: Meridian Medicaid |
$114.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.54
|
| Rate for Payer: PACE SWMI |
$170.04
|
| Rate for Payer: PHP Medicare Advantage |
$170.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.33
|
| Rate for Payer: Priority Health Medicare |
$170.04
|
| Rate for Payer: Priority Health Narrow Network |
$289.33
|
| Rate for Payer: UHC Medicare Advantage |
$175.14
|
|
|
PR SUTURE PHARYNX WOUND/INJURY
|
Professional
|
Both
|
$611.00
|
|
|
Service Code
|
HCPCS 42900
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$1,110.49 |
| Rate for Payer: Aetna Commercial |
$438.19
|
| Rate for Payer: Aetna Medicare |
$327.01
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$327.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.49
|
| Rate for Payer: BCN Commercial |
$485.75
|
| Rate for Payer: BCN Medicare Advantage |
$327.01
|
| Rate for Payer: Cash Price |
$488.80
|
| Rate for Payer: Cash Price |
$488.80
|
| Rate for Payer: Cofinity Commercial |
$438.19
|
| Rate for Payer: Cofinity Commercial |
$470.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.01
|
| Rate for Payer: Healthscope Commercial |
$392.41
|
| Rate for Payer: Healthscope Whirlpool |
$392.41
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$343.36
|
| Rate for Payer: PACE SWMI |
$327.01
|
| Rate for Payer: PHP Medicare Advantage |
$327.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.45
|
| Rate for Payer: Priority Health Medicare |
$327.01
|
| Rate for Payer: Priority Health Narrow Network |
$584.45
|
| Rate for Payer: UHC Medicare Advantage |
$336.82
|
|
|
PR SUTURE POSTERIOR TIBIAL NERVE
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 64840
|
| Min. Negotiated Rate |
$247.24 |
| Max. Negotiated Rate |
$1,632.99 |
| Rate for Payer: Aetna Commercial |
$1,270.90
|
| Rate for Payer: Aetna Medicare |
$948.43
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS MAPPO |
$948.43
|
| Rate for Payer: BCBS Trust/PPO |
$247.24
|
| Rate for Payer: BCN Commercial |
$1,409.35
|
| Rate for Payer: BCN Medicare Advantage |
$948.43
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,365.74
|
| Rate for Payer: Cofinity Commercial |
$1,270.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$948.43
|
| Rate for Payer: Healthscope Commercial |
$1,138.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,138.12
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$995.85
|
| Rate for Payer: PACE SWMI |
$948.43
|
| Rate for Payer: PHP Medicare Advantage |
$948.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,358.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,632.99
|
| Rate for Payer: Priority Health Medicare |
$948.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.99
|
| Rate for Payer: UHC Medicare Advantage |
$976.88
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,866.00
|
|
|
Service Code
|
HCPCS 27385
|
| Min. Negotiated Rate |
$394.69 |
| Max. Negotiated Rate |
$1,306.20 |
| Rate for Payer: Aetna Commercial |
$798.80
|
| Rate for Payer: Aetna Medicare |
$596.12
|
| Rate for Payer: BCBS Complete |
$414.42
|
| Rate for Payer: BCBS MAPPO |
$596.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$596.12
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cofinity Commercial |
$858.41
|
| Rate for Payer: Cofinity Commercial |
$798.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$596.12
|
| Rate for Payer: Healthscope Commercial |
$715.34
|
| Rate for Payer: Healthscope Whirlpool |
$715.34
|
| Rate for Payer: Meridian Medicaid |
$414.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$625.93
|
| Rate for Payer: PACE SWMI |
$596.12
|
| Rate for Payer: PHP Medicare Advantage |
$596.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.09
|
| Rate for Payer: Priority Health Medicare |
$596.12
|
| Rate for Payer: Priority Health Narrow Network |
$939.09
|
| Rate for Payer: UHC Medicare Advantage |
$614.00
|
|
|
PR SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$5,576.00
|
|
|
Service Code
|
HCPCS 33322
|
| Min. Negotiated Rate |
$484.45 |
| Max. Negotiated Rate |
$3,903.20 |
| Rate for Payer: Aetna Commercial |
$1,825.17
|
| Rate for Payer: Aetna Medicare |
$1,362.07
|
| Rate for Payer: BCBS Complete |
$922.78
|
| Rate for Payer: BCBS MAPPO |
$1,362.07
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,990.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,362.07
|
| Rate for Payer: Cash Price |
$4,460.80
|
| Rate for Payer: Cash Price |
$4,460.80
|
| Rate for Payer: Cofinity Commercial |
$1,961.38
|
| Rate for Payer: Cofinity Commercial |
$1,825.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,362.07
|
| Rate for Payer: Healthscope Commercial |
$1,634.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,634.48
|
| Rate for Payer: Meridian Medicaid |
$922.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,430.17
|
| Rate for Payer: PACE SWMI |
$1,362.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,362.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,903.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.67
|
| Rate for Payer: Priority Health Medicare |
$1,362.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,166.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,402.93
|
|
|
PR SUTURE/REPAIR TESTICULAR INJURY
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 54670
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$2,909.88 |
| Rate for Payer: Aetna Commercial |
$535.00
|
| Rate for Payer: Aetna Medicare |
$399.25
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$399.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,909.88
|
| Rate for Payer: BCN Commercial |
$593.26
|
| Rate for Payer: BCN Medicare Advantage |
$399.25
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$535.00
|
| Rate for Payer: Cofinity Commercial |
$574.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.25
|
| Rate for Payer: Healthscope Commercial |
$479.10
|
| Rate for Payer: Healthscope Whirlpool |
$479.10
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$419.21
|
| Rate for Payer: PACE SWMI |
$399.25
|
| Rate for Payer: PHP Medicare Advantage |
$399.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.99
|
| Rate for Payer: Priority Health Medicare |
$399.25
|
| Rate for Payer: Priority Health Narrow Network |
$655.99
|
| Rate for Payer: UHC Medicare Advantage |
$411.23
|
|
|
PR SUTURE SCIATIC NERVE
|
Professional
|
Both
|
$2,451.00
|
|
|
Service Code
|
HCPCS 64858
|
| Min. Negotiated Rate |
$255.70 |
| Max. Negotiated Rate |
$1,988.01 |
| Rate for Payer: Aetna Commercial |
$1,551.25
|
| Rate for Payer: Aetna Medicare |
$1,157.65
|
| Rate for Payer: BCBS Complete |
$790.38
|
| Rate for Payer: BCBS MAPPO |
$1,157.65
|
| Rate for Payer: BCBS Trust/PPO |
$255.70
|
| Rate for Payer: BCN Commercial |
$1,715.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,157.65
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Cofinity Commercial |
$1,667.02
|
| Rate for Payer: Cofinity Commercial |
$1,551.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,157.65
|
| Rate for Payer: Healthscope Commercial |
$1,389.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,389.18
|
| Rate for Payer: Meridian Medicaid |
$790.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,215.53
|
| Rate for Payer: PACE SWMI |
$1,157.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,157.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$752.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,715.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,988.01
|
| Rate for Payer: Priority Health Medicare |
$1,157.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,988.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,192.38
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY CERVICAL
|
Professional
|
Both
|
$1,558.00
|
|
|
Service Code
|
HCPCS 31800
|
| Min. Negotiated Rate |
$453.48 |
| Max. Negotiated Rate |
$1,267.39 |
| Rate for Payer: Aetna Commercial |
$926.68
|
| Rate for Payer: Aetna Medicare |
$691.55
|
| Rate for Payer: BCBS Complete |
$476.15
|
| Rate for Payer: BCBS MAPPO |
$691.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.39
|
| Rate for Payer: BCN Commercial |
$1,045.28
|
| Rate for Payer: BCN Medicare Advantage |
$691.55
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cofinity Commercial |
$995.83
|
| Rate for Payer: Cofinity Commercial |
$926.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$691.55
|
| Rate for Payer: Healthscope Commercial |
$829.86
|
| Rate for Payer: Healthscope Whirlpool |
$829.86
|
| Rate for Payer: Meridian Medicaid |
$476.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$726.13
|
| Rate for Payer: PACE SWMI |
$691.55
|
| Rate for Payer: PHP Medicare Advantage |
$691.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.46
|
| Rate for Payer: Priority Health Medicare |
$691.55
|
| Rate for Payer: Priority Health Narrow Network |
$990.46
|
| Rate for Payer: UHC Medicare Advantage |
$712.30
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC
|
Professional
|
Both
|
$1,638.00
|
|
|
Service Code
|
HCPCS 31805
|
| Min. Negotiated Rate |
$518.66 |
| Max. Negotiated Rate |
$1,619.77 |
| Rate for Payer: Aetna Commercial |
$1,078.70
|
| Rate for Payer: Aetna Medicare |
$805.00
|
| Rate for Payer: BCBS Complete |
$544.59
|
| Rate for Payer: BCBS MAPPO |
$805.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,619.77
|
| Rate for Payer: BCN Commercial |
$1,181.62
|
| Rate for Payer: BCN Medicare Advantage |
$805.00
|
| Rate for Payer: Cash Price |
$1,310.40
|
| Rate for Payer: Cash Price |
$1,310.40
|
| Rate for Payer: Cofinity Commercial |
$1,078.70
|
| Rate for Payer: Cofinity Commercial |
$1,159.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.00
|
| Rate for Payer: Healthscope Commercial |
$966.00
|
| Rate for Payer: Healthscope Whirlpool |
$966.00
|
| Rate for Payer: Meridian Medicaid |
$544.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$845.25
|
| Rate for Payer: PACE SWMI |
$805.00
|
| Rate for Payer: PHP Medicare Advantage |
$805.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,146.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,119.64
|
| Rate for Payer: Priority Health Medicare |
$805.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,119.64
|
| Rate for Payer: UHC Medicare Advantage |
$829.15
|
|
|
PR SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 99058
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$773.43 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$773.43
|
| Rate for Payer: BCN Commercial |
$42.19
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.75
|
| Rate for Payer: Priority Health Narrow Network |
$28.75
|
|
|
PR SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 99051
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$556.30 |
| Rate for Payer: Aetna Commercial |
$20.02
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.25
|
| Rate for Payer: Priority Health Narrow Network |
$24.25
|
|
|
PR SYMPATHECTOMY CERVICAL
|
Professional
|
Both
|
$1,695.00
|
|
|
Service Code
|
HCPCS 64802
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$1,453.49 |
| Rate for Payer: Aetna Commercial |
$1,135.27
|
| Rate for Payer: Aetna Medicare |
$847.22
|
| Rate for Payer: BCBS Complete |
$581.27
|
| Rate for Payer: BCBS MAPPO |
$847.22
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$1,254.44
|
| Rate for Payer: BCN Medicare Advantage |
$847.22
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cofinity Commercial |
$1,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,135.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$847.22
|
| Rate for Payer: Healthscope Commercial |
$1,016.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.66
|
| Rate for Payer: Meridian Medicaid |
$581.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$889.58
|
| Rate for Payer: PACE SWMI |
$847.22
|
| Rate for Payer: PHP Medicare Advantage |
$847.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,453.49
|
| Rate for Payer: Priority Health Medicare |
$847.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,453.49
|
| Rate for Payer: UHC Medicare Advantage |
$872.64
|
|
|
PR SYMPATHECTOMY LUMBAR
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 64818
|
| Min. Negotiated Rate |
$219.10 |
| Max. Negotiated Rate |
$1,322.69 |
| Rate for Payer: Aetna Commercial |
$1,029.33
|
| Rate for Payer: Aetna Medicare |
$768.16
|
| Rate for Payer: BCBS Complete |
$526.03
|
| Rate for Payer: BCBS MAPPO |
$768.16
|
| Rate for Payer: BCBS Trust/PPO |
$668.83
|
| Rate for Payer: BCN Commercial |
$1,141.55
|
| Rate for Payer: BCN Medicare Advantage |
$768.16
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$1,106.15
|
| Rate for Payer: Cofinity Commercial |
$1,029.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.16
|
| Rate for Payer: Healthscope Commercial |
$921.79
|
| Rate for Payer: Healthscope Whirlpool |
$921.79
|
| Rate for Payer: Meridian Medicaid |
$526.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$806.57
|
| Rate for Payer: PACE SWMI |
$768.16
|
| Rate for Payer: PHP Medicare Advantage |
$768.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,322.69
|
| Rate for Payer: Priority Health Medicare |
$768.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,322.69
|
| Rate for Payer: UHC Medicare Advantage |
$791.20
|
|
|
PR SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 50540
|
| Min. Negotiated Rate |
$726.33 |
| Max. Negotiated Rate |
$2,068.29 |
| Rate for Payer: Aetna Commercial |
$1,498.50
|
| Rate for Payer: Aetna Medicare |
$1,118.28
|
| Rate for Payer: BCBS Complete |
$762.65
|
| Rate for Payer: BCBS MAPPO |
$1,118.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.29
|
| Rate for Payer: BCN Commercial |
$1,647.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,118.28
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$1,610.32
|
| Rate for Payer: Cofinity Commercial |
$1,498.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,118.28
|
| Rate for Payer: Healthscope Commercial |
$1,341.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,341.94
|
| Rate for Payer: Meridian Medicaid |
$762.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,174.19
|
| Rate for Payer: PACE SWMI |
$1,118.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,118.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.55
|
| Rate for Payer: Priority Health Medicare |
$1,118.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,821.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,151.83
|
|
|
PR SYNDACTYLIZATION TOES
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 28280
|
| Min. Negotiated Rate |
$222.37 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$454.65
|
| Rate for Payer: Aetna Medicare |
$339.29
|
| Rate for Payer: BCBS Complete |
$233.49
|
| Rate for Payer: BCBS MAPPO |
$339.29
|
| Rate for Payer: BCBS Trust/PPO |
$756.00
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$339.29
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$488.58
|
| Rate for Payer: Cofinity Commercial |
$454.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.29
|
| Rate for Payer: Healthscope Commercial |
$407.15
|
| Rate for Payer: Healthscope Whirlpool |
$407.15
|
| Rate for Payer: Meridian Medicaid |
$233.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$356.25
|
| Rate for Payer: PACE SWMI |
$339.29
|
| Rate for Payer: PHP Medicare Advantage |
$339.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.54
|
| Rate for Payer: Priority Health Medicare |
$339.29
|
| Rate for Payer: Priority Health Narrow Network |
$529.54
|
| Rate for Payer: UHC Medicare Advantage |
$349.47
|
|
