|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 38531
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$900.48 |
| Rate for Payer: Aetna Commercial |
$570.52
|
| Rate for Payer: Aetna Medicare |
$425.76
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCBS MAPPO |
$425.76
|
| Rate for Payer: BCN Commercial |
$676.75
|
| Rate for Payer: BCN Medicare Advantage |
$425.76
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$613.09
|
| Rate for Payer: Cofinity Commercial |
$570.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.76
|
| Rate for Payer: Healthscope Commercial |
$510.91
|
| Rate for Payer: Healthscope Whirlpool |
$510.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.05
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.34
|
| Rate for Payer: Nomi Health Commercial |
$510.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$696.00
|
| Rate for Payer: PACE SWMI |
$425.76
|
| Rate for Payer: PHP Medicare Advantage |
$425.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$900.48
|
| Rate for Payer: Priority Health Medicare |
$425.76
|
| Rate for Payer: Priority Health Narrow Network |
$900.48
|
| Rate for Payer: Railroad Medicare Medicare |
$425.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$761.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$425.76
|
| Rate for Payer: UHC Exchange |
$761.22
|
| Rate for Payer: UHC Medicaid |
$275.84
|
| Rate for Payer: UHCCP DNSP |
$425.76
|
| Rate for Payer: UHCCP Medicaid |
$275.84
|
|
|
PR OPEN CLOSURE MAJOR BRONCHIAL FISTULA
|
Professional
|
Both
|
$4,925.00
|
|
|
Service Code
|
HCPCS 32815
|
| Min. Negotiated Rate |
$1,676.52 |
| Max. Negotiated Rate |
$4,976.17 |
| Rate for Payer: Aetna Commercial |
$3,525.41
|
| Rate for Payer: Aetna Medicare |
$2,630.90
|
| Rate for Payer: BCBS Complete |
$1,760.35
|
| Rate for Payer: BCBS MAPPO |
$2,630.90
|
| Rate for Payer: BCN Commercial |
$4,126.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,630.90
|
| Rate for Payer: Cash Price |
$3,940.00
|
| Rate for Payer: Cash Price |
$3,940.00
|
| Rate for Payer: Cofinity Commercial |
$3,788.50
|
| Rate for Payer: Cofinity Commercial |
$3,525.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,630.90
|
| Rate for Payer: Healthscope Commercial |
$3,157.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,157.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,762.45
|
| Rate for Payer: Meridian Medicaid |
$1,760.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,893.99
|
| Rate for Payer: Nomi Health Commercial |
$3,157.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,693.75
|
| Rate for Payer: PACE SWMI |
$2,630.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,630.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,676.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,885.72
|
| Rate for Payer: Priority Health Medicare |
$2,630.90
|
| Rate for Payer: Priority Health Narrow Network |
$3,885.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,630.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,976.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,630.90
|
| Rate for Payer: UHC Exchange |
$4,976.17
|
| Rate for Payer: UHC Medicaid |
$1,676.52
|
| Rate for Payer: UHCCP DNSP |
$2,630.90
|
| Rate for Payer: UHCCP Medicaid |
$1,676.52
|
|
|
PR OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM
|
Professional
|
Both
|
$4,192.00
|
|
|
Service Code
|
HCPCS 49188
|
| Min. Negotiated Rate |
$1,181.30 |
| Max. Negotiated Rate |
$3,686.71 |
| Rate for Payer: Aetna Commercial |
$2,469.22
|
| Rate for Payer: Aetna Medicare |
$1,842.70
|
| Rate for Payer: BCBS Complete |
$1,240.37
|
| Rate for Payer: BCBS MAPPO |
$1,842.70
|
| Rate for Payer: BCN Commercial |
$3,003.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,842.70
|
| Rate for Payer: Cash Price |
$3,353.60
|
| Rate for Payer: Cash Price |
$3,353.60
|
| Rate for Payer: Cofinity Commercial |
$2,653.49
|
| Rate for Payer: Cofinity Commercial |
$2,469.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,842.70
|
| Rate for Payer: Healthscope Commercial |
$2,211.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,211.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,934.84
|
| Rate for Payer: Meridian Medicaid |
$1,240.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,026.97
|
| Rate for Payer: Nomi Health Commercial |
$2,211.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,144.00
|
| Rate for Payer: PACE SWMI |
$1,842.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,842.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,181.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,659.96
|
| Rate for Payer: Priority Health Medicare |
$1,842.70
|
| Rate for Payer: Priority Health Narrow Network |
$3,659.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,842.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,686.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,842.70
|
| Rate for Payer: UHC Exchange |
$3,686.71
|
| Rate for Payer: UHC Medicaid |
$1,181.30
|
| Rate for Payer: UHCCP DNSP |
$1,842.70
|
| Rate for Payer: UHCCP Medicaid |
$1,181.30
|
|
|
PR OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 49186
|
| Min. Negotiated Rate |
$778.94 |
| Max. Negotiated Rate |
$2,410.23 |
| Rate for Payer: Aetna Commercial |
$1,624.68
|
| Rate for Payer: Aetna Medicare |
$1,212.45
|
| Rate for Payer: BCBS Complete |
$817.89
|
| Rate for Payer: BCBS MAPPO |
$1,212.45
|
| Rate for Payer: BCN Commercial |
$1,967.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.45
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,745.93
|
| Rate for Payer: Cofinity Commercial |
$1,624.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.45
|
| Rate for Payer: Healthscope Commercial |
$1,454.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,454.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.07
|
| Rate for Payer: Meridian Medicaid |
$817.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,333.69
|
| Rate for Payer: Nomi Health Commercial |
$1,454.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,081.25
|
| Rate for Payer: PACE SWMI |
$1,212.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,396.70
|
| Rate for Payer: Priority Health Medicare |
$1,212.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,396.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,212.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,410.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,212.45
|
| Rate for Payer: UHC Exchange |
$2,410.23
|
| Rate for Payer: UHC Medicaid |
$778.94
|
| Rate for Payer: UHCCP DNSP |
$1,212.45
|
| Rate for Payer: UHCCP Medicaid |
$778.94
|
|
|
PR OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB
|
Professional
|
Both
|
$1,326.00
|
|
|
Service Code
|
HCPCS 35600
|
| Min. Negotiated Rate |
$107.78 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Commercial |
$228.71
|
| Rate for Payer: Aetna Medicare |
$170.68
|
| Rate for Payer: BCBS Complete |
$113.17
|
| Rate for Payer: BCBS MAPPO |
$170.68
|
| Rate for Payer: BCN Commercial |
$271.40
|
| Rate for Payer: BCN Medicare Advantage |
$170.68
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$245.78
|
| Rate for Payer: Cofinity Commercial |
$228.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$204.82
|
| Rate for Payer: Healthscope Whirlpool |
$204.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.21
|
| Rate for Payer: Meridian Medicaid |
$113.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.75
|
| Rate for Payer: Nomi Health Commercial |
$204.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.50
|
| Rate for Payer: PACE SWMI |
$170.68
|
| Rate for Payer: PHP Medicare Advantage |
$170.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$291.86
|
| Rate for Payer: Priority Health Medicare |
$170.68
|
| Rate for Payer: Priority Health Narrow Network |
$291.86
|
| Rate for Payer: Railroad Medicare Medicare |
$170.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$459.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.68
|
| Rate for Payer: UHC Exchange |
$459.76
|
| Rate for Payer: UHC Medicaid |
$107.78
|
| Rate for Payer: UHCCP DNSP |
$170.68
|
| Rate for Payer: UHCCP Medicaid |
$107.78
|
|
|
PR OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 64568
|
| Min. Negotiated Rate |
$420.89 |
| Max. Negotiated Rate |
$1,497.00 |
| Rate for Payer: Aetna Commercial |
$871.62
|
| Rate for Payer: Aetna Medicare |
$650.46
|
| Rate for Payer: BCBS Complete |
$441.93
|
| Rate for Payer: BCBS MAPPO |
$650.46
|
| Rate for Payer: BCN Commercial |
$913.79
|
| Rate for Payer: BCN Medicare Advantage |
$650.46
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$936.66
|
| Rate for Payer: Cofinity Commercial |
$871.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.46
|
| Rate for Payer: Healthscope Commercial |
$780.55
|
| Rate for Payer: Healthscope Whirlpool |
$780.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.98
|
| Rate for Payer: Meridian Medicaid |
$441.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$715.51
|
| Rate for Payer: Nomi Health Commercial |
$780.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$650.46
|
| Rate for Payer: PHP Medicare Advantage |
$650.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,061.36
|
| Rate for Payer: Priority Health Medicare |
$650.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,061.36
|
| Rate for Payer: Railroad Medicare Medicare |
$650.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,098.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$650.46
|
| Rate for Payer: UHC Exchange |
$1,098.03
|
| Rate for Payer: UHC Medicaid |
$420.89
|
| Rate for Payer: UHCCP DNSP |
$650.46
|
| Rate for Payer: UHCCP Medicaid |
$420.89
|
|
|
PR OPEN IMPLANTATION NEA PERIPHERAL NERVE
|
Professional
|
Both
|
$1,025.00
|
|
|
Service Code
|
HCPCS 64575
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$768.75 |
| Rate for Payer: Aetna Commercial |
$382.64
|
| Rate for Payer: Aetna Medicare |
$285.55
|
| Rate for Payer: BCBS Complete |
$196.59
|
| Rate for Payer: BCBS MAPPO |
$285.55
|
| Rate for Payer: BCN Commercial |
$474.58
|
| Rate for Payer: BCN Medicare Advantage |
$285.55
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cofinity Commercial |
$411.19
|
| Rate for Payer: Cofinity Commercial |
$382.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.55
|
| Rate for Payer: Healthscope Commercial |
$342.66
|
| Rate for Payer: Healthscope Whirlpool |
$342.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.83
|
| Rate for Payer: Meridian Medicaid |
$196.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.11
|
| Rate for Payer: Nomi Health Commercial |
$342.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$768.75
|
| Rate for Payer: PACE SWMI |
$285.55
|
| Rate for Payer: PHP Medicare Advantage |
$285.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$551.21
|
| Rate for Payer: Priority Health Medicare |
$285.55
|
| Rate for Payer: Priority Health Narrow Network |
$551.21
|
| Rate for Payer: Railroad Medicare Medicare |
$285.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.55
|
| Rate for Payer: UHC Exchange |
$592.33
|
| Rate for Payer: UHC Medicaid |
$187.23
|
| Rate for Payer: UHCCP DNSP |
$285.55
|
| Rate for Payer: UHCCP Medicaid |
$187.23
|
|
|
PR OPEN IMPLANTATION NEA SACRAL NERVE
|
Professional
|
Both
|
$1,563.00
|
|
|
Service Code
|
HCPCS 64581
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,174.88 |
| Rate for Payer: Aetna Commercial |
$782.25
|
| Rate for Payer: Aetna Medicare |
$583.77
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$583.77
|
| Rate for Payer: BCN Commercial |
$982.02
|
| Rate for Payer: BCN Medicare Advantage |
$583.77
|
| Rate for Payer: Cash Price |
$1,250.40
|
| Rate for Payer: Cash Price |
$1,250.40
|
| Rate for Payer: Cofinity Commercial |
$840.63
|
| Rate for Payer: Cofinity Commercial |
$782.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.77
|
| Rate for Payer: Healthscope Commercial |
$700.52
|
| Rate for Payer: Healthscope Whirlpool |
$700.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.96
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$642.15
|
| Rate for Payer: Nomi Health Commercial |
$700.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,172.25
|
| Rate for Payer: PACE SWMI |
$583.77
|
| Rate for Payer: PHP Medicare Advantage |
$583.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,140.59
|
| Rate for Payer: Priority Health Medicare |
$583.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.59
|
| Rate for Payer: Railroad Medicare Medicare |
$583.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$583.77
|
| Rate for Payer: UHC Exchange |
$1,174.88
|
| Rate for Payer: UHC Medicaid |
$374.88
|
| Rate for Payer: UHCCP DNSP |
$583.77
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR
|
Professional
|
Both
|
$1,804.00
|
|
|
Service Code
|
HCPCS 64582
|
| Min. Negotiated Rate |
$460.93 |
| Max. Negotiated Rate |
$1,563.56 |
| Rate for Payer: Aetna Commercial |
$956.67
|
| Rate for Payer: Aetna Medicare |
$713.93
|
| Rate for Payer: BCBS Complete |
$483.98
|
| Rate for Payer: BCBS MAPPO |
$713.93
|
| Rate for Payer: BCN Commercial |
$1,255.91
|
| Rate for Payer: BCN Medicare Advantage |
$713.93
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cofinity Commercial |
$956.67
|
| Rate for Payer: Cofinity Commercial |
$1,028.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.93
|
| Rate for Payer: Healthscope Commercial |
$856.72
|
| Rate for Payer: Healthscope Whirlpool |
$856.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$749.63
|
| Rate for Payer: Meridian Medicaid |
$483.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$785.32
|
| Rate for Payer: Nomi Health Commercial |
$856.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,353.00
|
| Rate for Payer: PACE SWMI |
$713.93
|
| Rate for Payer: PHP Medicare Advantage |
$713.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,458.72
|
| Rate for Payer: Priority Health Medicare |
$713.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,458.72
|
| Rate for Payer: Railroad Medicare Medicare |
$713.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,563.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$713.93
|
| Rate for Payer: UHC Exchange |
$1,563.56
|
| Rate for Payer: UHC Medicaid |
$460.93
|
| Rate for Payer: UHCCP DNSP |
$713.93
|
| Rate for Payer: UHCCP Medicaid |
$460.93
|
|
|
PR OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 0816T
|
| Min. Negotiated Rate |
$223.05 |
| Max. Negotiated Rate |
$20,050.50 |
| Rate for Payer: BCBS Complete |
$316.80
|
| Rate for Payer: BCN Commercial |
$20,050.50
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.05
|
| Rate for Payer: UHC Exchange |
$223.05
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL
|
Professional
|
Both
|
$659.00
|
|
|
Service Code
|
HCPCS 37239
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$494.25 |
| Rate for Payer: Aetna Commercial |
$177.99
|
| Rate for Payer: Aetna Medicare |
$132.83
|
| Rate for Payer: BCBS Complete |
$88.12
|
| Rate for Payer: BCBS MAPPO |
$132.83
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Medicare Advantage |
$132.83
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Cofinity Commercial |
$191.28
|
| Rate for Payer: Cofinity Commercial |
$177.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.83
|
| Rate for Payer: Healthscope Commercial |
$159.40
|
| Rate for Payer: Healthscope Whirlpool |
$159.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.47
|
| Rate for Payer: Meridian Medicaid |
$88.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.11
|
| Rate for Payer: Nomi Health Commercial |
$159.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$494.25
|
| Rate for Payer: PACE SWMI |
$132.83
|
| Rate for Payer: PHP Medicare Advantage |
$132.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$236.70
|
| Rate for Payer: Priority Health Medicare |
$132.83
|
| Rate for Payer: Priority Health Narrow Network |
$236.70
|
| Rate for Payer: Railroad Medicare Medicare |
$132.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.83
|
| Rate for Payer: UHC Exchange |
$273.56
|
| Rate for Payer: UHC Medicaid |
$83.92
|
| Rate for Payer: UHCCP DNSP |
$132.83
|
| Rate for Payer: UHCCP Medicaid |
$83.92
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 37237
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$392.25 |
| Rate for Payer: Aetna Commercial |
$255.44
|
| Rate for Payer: Aetna Medicare |
$190.63
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS MAPPO |
$190.63
|
| Rate for Payer: BCN Commercial |
$307.25
|
| Rate for Payer: BCN Medicare Advantage |
$190.63
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cofinity Commercial |
$274.51
|
| Rate for Payer: Cofinity Commercial |
$255.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.63
|
| Rate for Payer: Healthscope Commercial |
$228.76
|
| Rate for Payer: Healthscope Whirlpool |
$228.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.16
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.69
|
| Rate for Payer: Nomi Health Commercial |
$228.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$392.25
|
| Rate for Payer: PACE SWMI |
$190.63
|
| Rate for Payer: PHP Medicare Advantage |
$190.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$330.42
|
| Rate for Payer: Priority Health Medicare |
$190.63
|
| Rate for Payer: Priority Health Narrow Network |
$330.42
|
| Rate for Payer: Railroad Medicare Medicare |
$190.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$382.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$190.63
|
| Rate for Payer: UHC Exchange |
$382.52
|
| Rate for Payer: UHC Medicaid |
$119.71
|
| Rate for Payer: UHCCP DNSP |
$190.63
|
| Rate for Payer: UHCCP Medicaid |
$119.71
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 37236
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$935.25 |
| Rate for Payer: Aetna Commercial |
$529.54
|
| Rate for Payer: Aetna Medicare |
$395.18
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$395.18
|
| Rate for Payer: BCN Commercial |
$641.40
|
| Rate for Payer: BCN Medicare Advantage |
$395.18
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cofinity Commercial |
$569.06
|
| Rate for Payer: Cofinity Commercial |
$529.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.18
|
| Rate for Payer: Healthscope Commercial |
$474.22
|
| Rate for Payer: Healthscope Whirlpool |
$474.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.94
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$434.70
|
| Rate for Payer: Nomi Health Commercial |
$474.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.25
|
| Rate for Payer: PACE SWMI |
$395.18
|
| Rate for Payer: PHP Medicare Advantage |
$395.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$689.74
|
| Rate for Payer: Priority Health Medicare |
$395.18
|
| Rate for Payer: Priority Health Narrow Network |
$689.74
|
| Rate for Payer: Railroad Medicare Medicare |
$395.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$395.18
|
| Rate for Payer: UHC Exchange |
$799.13
|
| Rate for Payer: UHC Medicaid |
$248.78
|
| Rate for Payer: UHCCP DNSP |
$395.18
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST
|
Professional
|
Both
|
$1,324.00
|
|
|
Service Code
|
HCPCS 37238
|
| Min. Negotiated Rate |
$172.74 |
| Max. Negotiated Rate |
$993.00 |
| Rate for Payer: Aetna Commercial |
$366.33
|
| Rate for Payer: Aetna Medicare |
$273.38
|
| Rate for Payer: BCBS Complete |
$181.38
|
| Rate for Payer: BCBS MAPPO |
$273.38
|
| Rate for Payer: BCN Commercial |
$447.18
|
| Rate for Payer: BCN Medicare Advantage |
$273.38
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cofinity Commercial |
$393.67
|
| Rate for Payer: Cofinity Commercial |
$366.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.38
|
| Rate for Payer: Healthscope Commercial |
$328.06
|
| Rate for Payer: Healthscope Whirlpool |
$328.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.05
|
| Rate for Payer: Meridian Medicaid |
$181.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.72
|
| Rate for Payer: Nomi Health Commercial |
$328.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$993.00
|
| Rate for Payer: PACE SWMI |
$273.38
|
| Rate for Payer: PHP Medicare Advantage |
$273.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$480.89
|
| Rate for Payer: Priority Health Medicare |
$273.38
|
| Rate for Payer: Priority Health Narrow Network |
$480.89
|
| Rate for Payer: Railroad Medicare Medicare |
$273.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$548.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$273.38
|
| Rate for Payer: UHC Exchange |
$548.17
|
| Rate for Payer: UHC Medicaid |
$172.74
|
| Rate for Payer: UHCCP DNSP |
$273.38
|
| Rate for Payer: UHCCP Medicaid |
$172.74
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF ACUTE
|
Professional
|
Both
|
$2,694.00
|
|
|
Service Code
|
HCPCS 23410
|
| Min. Negotiated Rate |
$487.77 |
| Max. Negotiated Rate |
$2,020.50 |
| Rate for Payer: Aetna Commercial |
$1,001.26
|
| Rate for Payer: Aetna Medicare |
$747.21
|
| Rate for Payer: BCBS Complete |
$512.16
|
| Rate for Payer: BCBS MAPPO |
$747.21
|
| Rate for Payer: BCN Commercial |
$1,248.44
|
| Rate for Payer: BCN Medicare Advantage |
$747.21
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cofinity Commercial |
$1,075.98
|
| Rate for Payer: Cofinity Commercial |
$1,001.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.21
|
| Rate for Payer: Healthscope Commercial |
$896.65
|
| Rate for Payer: Healthscope Whirlpool |
$896.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.57
|
| Rate for Payer: Meridian Medicaid |
$512.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.93
|
| Rate for Payer: Nomi Health Commercial |
$896.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,020.50
|
| Rate for Payer: PACE SWMI |
$747.21
|
| Rate for Payer: PHP Medicare Advantage |
$747.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,334.55
|
| Rate for Payer: Priority Health Medicare |
$747.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,334.55
|
| Rate for Payer: Railroad Medicare Medicare |
$747.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,433.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$747.21
|
| Rate for Payer: UHC Exchange |
$1,433.06
|
| Rate for Payer: UHC Medicaid |
$487.77
|
| Rate for Payer: UHCCP DNSP |
$747.21
|
| Rate for Payer: UHCCP Medicaid |
$487.77
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,213.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$504.81 |
| Max. Negotiated Rate |
$2,409.75 |
| Rate for Payer: Aetna Commercial |
$1,037.04
|
| Rate for Payer: Aetna Medicare |
$773.91
|
| Rate for Payer: BCBS Complete |
$530.05
|
| Rate for Payer: BCBS MAPPO |
$773.91
|
| Rate for Payer: BCN Commercial |
$1,425.12
|
| Rate for Payer: BCN Medicare Advantage |
$773.91
|
| Rate for Payer: Cash Price |
$2,570.40
|
| Rate for Payer: Cash Price |
$2,570.40
|
| Rate for Payer: Cofinity Commercial |
$1,114.43
|
| Rate for Payer: Cofinity Commercial |
$1,037.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$773.91
|
| Rate for Payer: Healthscope Commercial |
$928.69
|
| Rate for Payer: Healthscope Whirlpool |
$928.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.61
|
| Rate for Payer: Meridian Medicaid |
$530.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$851.30
|
| Rate for Payer: Nomi Health Commercial |
$928.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,409.75
|
| Rate for Payer: PACE SWMI |
$773.91
|
| Rate for Payer: PHP Medicare Advantage |
$773.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,386.72
|
| Rate for Payer: Priority Health Medicare |
$773.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.72
|
| Rate for Payer: Railroad Medicare Medicare |
$773.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,490.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$773.91
|
| Rate for Payer: UHC Exchange |
$1,490.64
|
| Rate for Payer: UHC Medicaid |
$504.81
|
| Rate for Payer: UHCCP DNSP |
$773.91
|
| Rate for Payer: UHCCP Medicaid |
$504.81
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$3,095.00
|
|
|
Service Code
|
HCPCS 27814
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,321.25 |
| Rate for Payer: Aetna Commercial |
$934.09
|
| Rate for Payer: Aetna Medicare |
$697.08
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$697.08
|
| Rate for Payer: BCN Commercial |
$1,161.79
|
| Rate for Payer: BCN Medicare Advantage |
$697.08
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cofinity Commercial |
$934.09
|
| Rate for Payer: Cofinity Commercial |
$1,003.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.08
|
| Rate for Payer: Healthscope Commercial |
$836.50
|
| Rate for Payer: Healthscope Whirlpool |
$836.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.93
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$766.79
|
| Rate for Payer: Nomi Health Commercial |
$836.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,321.25
|
| Rate for Payer: PACE SWMI |
$697.08
|
| Rate for Payer: PHP Medicare Advantage |
$697.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,241.91
|
| Rate for Payer: Priority Health Medicare |
$697.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.91
|
| Rate for Payer: Railroad Medicare Medicare |
$697.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$697.08
|
| Rate for Payer: UHC Exchange |
$1,338.69
|
| Rate for Payer: UHC Medicaid |
$455.61
|
| Rate for Payer: UHCCP DNSP |
$697.08
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,467.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$668.82 |
| Max. Negotiated Rate |
$2,600.25 |
| Rate for Payer: Aetna Commercial |
$1,370.79
|
| Rate for Payer: Aetna Medicare |
$1,022.98
|
| Rate for Payer: BCBS Complete |
$702.26
|
| Rate for Payer: BCBS MAPPO |
$1,022.98
|
| Rate for Payer: BCN Commercial |
$1,695.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,022.98
|
| Rate for Payer: Cash Price |
$2,773.60
|
| Rate for Payer: Cash Price |
$2,773.60
|
| Rate for Payer: Cofinity Commercial |
$1,473.09
|
| Rate for Payer: Cofinity Commercial |
$1,370.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.98
|
| Rate for Payer: Healthscope Commercial |
$1,227.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,227.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.13
|
| Rate for Payer: Meridian Medicaid |
$702.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.28
|
| Rate for Payer: Nomi Health Commercial |
$1,227.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,600.25
|
| Rate for Payer: PACE SWMI |
$1,022.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,022.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,812.58
|
| Rate for Payer: Priority Health Medicare |
$1,022.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,812.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,022.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,954.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,022.98
|
| Rate for Payer: UHC Exchange |
$1,954.99
|
| Rate for Payer: UHC Medicaid |
$668.82
|
| Rate for Payer: UHCCP DNSP |
$1,022.98
|
| Rate for Payer: UHCCP Medicaid |
$668.82
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,291.00
|
|
|
Service Code
|
HCPCS 28420
|
| Min. Negotiated Rate |
$770.85 |
| Max. Negotiated Rate |
$2,243.47 |
| Rate for Payer: Aetna Commercial |
$1,580.45
|
| Rate for Payer: Aetna Medicare |
$1,179.44
|
| Rate for Payer: BCBS Complete |
$809.39
|
| Rate for Payer: BCBS MAPPO |
$1,179.44
|
| Rate for Payer: BCN Commercial |
$1,963.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,179.44
|
| Rate for Payer: Cash Price |
$1,832.80
|
| Rate for Payer: Cash Price |
$1,832.80
|
| Rate for Payer: Cofinity Commercial |
$1,698.39
|
| Rate for Payer: Cofinity Commercial |
$1,580.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,179.44
|
| Rate for Payer: Healthscope Commercial |
$1,415.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,415.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,238.41
|
| Rate for Payer: Meridian Medicaid |
$809.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,297.38
|
| Rate for Payer: Nomi Health Commercial |
$1,415.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,718.25
|
| Rate for Payer: PACE SWMI |
$1,179.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,179.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,098.44
|
| Rate for Payer: Priority Health Medicare |
$1,179.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,098.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,179.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,243.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,179.44
|
| Rate for Payer: UHC Exchange |
$2,243.47
|
| Rate for Payer: UHC Medicaid |
$770.85
|
| Rate for Payer: UHCCP DNSP |
$1,179.44
|
| Rate for Payer: UHCCP Medicaid |
$770.85
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,741.00
|
|
|
Service Code
|
HCPCS 27828
|
| Min. Negotiated Rate |
$784.48 |
| Max. Negotiated Rate |
$3,555.75 |
| Rate for Payer: Aetna Commercial |
$1,610.16
|
| Rate for Payer: Aetna Medicare |
$1,201.61
|
| Rate for Payer: BCBS Complete |
$823.70
|
| Rate for Payer: BCBS MAPPO |
$1,201.61
|
| Rate for Payer: BCN Commercial |
$2,000.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.61
|
| Rate for Payer: Cash Price |
$3,792.80
|
| Rate for Payer: Cash Price |
$3,792.80
|
| Rate for Payer: Cofinity Commercial |
$1,730.32
|
| Rate for Payer: Cofinity Commercial |
$1,610.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.61
|
| Rate for Payer: Healthscope Commercial |
$1,441.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,441.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,261.69
|
| Rate for Payer: Meridian Medicaid |
$823.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,321.77
|
| Rate for Payer: Nomi Health Commercial |
$1,441.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,555.75
|
| Rate for Payer: PACE SWMI |
$1,201.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$784.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,138.36
|
| Rate for Payer: Priority Health Medicare |
$1,201.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,138.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,201.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,306.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,201.61
|
| Rate for Payer: UHC Exchange |
$2,306.04
|
| Rate for Payer: UHC Medicaid |
$784.48
|
| Rate for Payer: UHCCP DNSP |
$1,201.61
|
| Rate for Payer: UHCCP Medicaid |
$784.48
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,194.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$518.44 |
| Max. Negotiated Rate |
$2,395.50 |
| Rate for Payer: Aetna Commercial |
$1,056.95
|
| Rate for Payer: Aetna Medicare |
$788.77
|
| Rate for Payer: BCBS Complete |
$544.36
|
| Rate for Payer: BCBS MAPPO |
$788.77
|
| Rate for Payer: BCN Commercial |
$1,291.76
|
| Rate for Payer: BCN Medicare Advantage |
$788.77
|
| Rate for Payer: Cash Price |
$2,555.20
|
| Rate for Payer: Cash Price |
$2,555.20
|
| Rate for Payer: Cofinity Commercial |
$1,135.83
|
| Rate for Payer: Cofinity Commercial |
$1,056.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.77
|
| Rate for Payer: Healthscope Commercial |
$946.52
|
| Rate for Payer: Healthscope Whirlpool |
$946.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$828.21
|
| Rate for Payer: Meridian Medicaid |
$544.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$867.65
|
| Rate for Payer: Nomi Health Commercial |
$946.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,395.50
|
| Rate for Payer: PACE SWMI |
$788.77
|
| Rate for Payer: PHP Medicare Advantage |
$788.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,380.86
|
| Rate for Payer: Priority Health Medicare |
$788.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,380.86
|
| Rate for Payer: Railroad Medicare Medicare |
$788.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,480.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$788.77
|
| Rate for Payer: UHC Exchange |
$1,480.39
|
| Rate for Payer: UHC Medicaid |
$518.44
|
| Rate for Payer: UHCCP DNSP |
$788.77
|
| Rate for Payer: UHCCP Medicaid |
$518.44
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,493.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$671.59 |
| Max. Negotiated Rate |
$3,369.75 |
| Rate for Payer: Aetna Commercial |
$1,372.99
|
| Rate for Payer: Aetna Medicare |
$1,024.62
|
| Rate for Payer: BCBS Complete |
$705.17
|
| Rate for Payer: BCBS MAPPO |
$1,024.62
|
| Rate for Payer: BCN Commercial |
$1,696.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,024.62
|
| Rate for Payer: Cash Price |
$3,594.40
|
| Rate for Payer: Cash Price |
$3,594.40
|
| Rate for Payer: Cofinity Commercial |
$1,475.45
|
| Rate for Payer: Cofinity Commercial |
$1,372.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,024.62
|
| Rate for Payer: Healthscope Commercial |
$1,229.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,075.85
|
| Rate for Payer: Meridian Medicaid |
$705.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,127.08
|
| Rate for Payer: Nomi Health Commercial |
$1,229.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,369.75
|
| Rate for Payer: PACE SWMI |
$1,024.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,024.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,813.65
|
| Rate for Payer: Priority Health Medicare |
$1,024.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,813.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,024.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,935.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,024.62
|
| Rate for Payer: UHC Exchange |
$1,935.45
|
| Rate for Payer: UHC Medicaid |
$671.59
|
| Rate for Payer: UHCCP DNSP |
$1,024.62
|
| Rate for Payer: UHCCP Medicaid |
$671.59
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$2,076.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$437.29 |
| Max. Negotiated Rate |
$1,557.00 |
| Rate for Payer: Aetna Commercial |
$901.22
|
| Rate for Payer: Aetna Medicare |
$672.55
|
| Rate for Payer: BCBS Complete |
$459.15
|
| Rate for Payer: BCBS MAPPO |
$672.55
|
| Rate for Payer: BCN Commercial |
$1,131.42
|
| Rate for Payer: BCN Medicare Advantage |
$672.55
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cofinity Commercial |
$968.47
|
| Rate for Payer: Cofinity Commercial |
$901.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.55
|
| Rate for Payer: Healthscope Commercial |
$807.06
|
| Rate for Payer: Healthscope Whirlpool |
$807.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.18
|
| Rate for Payer: Meridian Medicaid |
$459.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.80
|
| Rate for Payer: Nomi Health Commercial |
$807.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.00
|
| Rate for Payer: PACE SWMI |
$672.55
|
| Rate for Payer: PHP Medicare Advantage |
$672.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,209.44
|
| Rate for Payer: Priority Health Medicare |
$672.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.44
|
| Rate for Payer: Railroad Medicare Medicare |
$672.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,308.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.55
|
| Rate for Payer: UHC Exchange |
$1,308.15
|
| Rate for Payer: UHC Medicaid |
$437.29
|
| Rate for Payer: UHCCP DNSP |
$672.55
|
| Rate for Payer: UHCCP Medicaid |
$437.29
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,944.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$497.57 |
| Max. Negotiated Rate |
$2,208.00 |
| Rate for Payer: Aetna Commercial |
$1,020.22
|
| Rate for Payer: Aetna Medicare |
$761.36
|
| Rate for Payer: BCBS Complete |
$522.45
|
| Rate for Payer: BCBS MAPPO |
$761.36
|
| Rate for Payer: BCN Commercial |
$1,276.32
|
| Rate for Payer: BCN Medicare Advantage |
$761.36
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cofinity Commercial |
$1,096.36
|
| Rate for Payer: Cofinity Commercial |
$1,020.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.36
|
| Rate for Payer: Healthscope Commercial |
$913.63
|
| Rate for Payer: Healthscope Whirlpool |
$913.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.43
|
| Rate for Payer: Meridian Medicaid |
$522.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$837.50
|
| Rate for Payer: Nomi Health Commercial |
$913.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.00
|
| Rate for Payer: PACE SWMI |
$761.36
|
| Rate for Payer: PHP Medicare Advantage |
$761.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,364.35
|
| Rate for Payer: Priority Health Medicare |
$761.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,364.35
|
| Rate for Payer: Railroad Medicare Medicare |
$761.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,451.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.36
|
| Rate for Payer: UHC Exchange |
$1,451.51
|
| Rate for Payer: UHC Medicaid |
$497.57
|
| Rate for Payer: UHCCP DNSP |
$761.36
|
| Rate for Payer: UHCCP Medicaid |
$497.57
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,008.00
|
|
|
Service Code
|
HCPCS 28675
|
| Min. Negotiated Rate |
$251.34 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$510.30
|
| Rate for Payer: Aetna Medicare |
$380.82
|
| Rate for Payer: BCBS Complete |
$263.91
|
| Rate for Payer: BCBS MAPPO |
$380.82
|
| Rate for Payer: BCN Commercial |
$630.44
|
| Rate for Payer: BCN Medicare Advantage |
$380.82
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cofinity Commercial |
$548.38
|
| Rate for Payer: Cofinity Commercial |
$510.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.82
|
| Rate for Payer: Healthscope Commercial |
$456.98
|
| Rate for Payer: Healthscope Whirlpool |
$456.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.86
|
| Rate for Payer: Meridian Medicaid |
$263.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.90
|
| Rate for Payer: Nomi Health Commercial |
$456.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$756.00
|
| Rate for Payer: PACE SWMI |
$380.82
|
| Rate for Payer: PHP Medicare Advantage |
$380.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$673.93
|
| Rate for Payer: Priority Health Medicare |
$380.82
|
| Rate for Payer: Priority Health Narrow Network |
$673.93
|
| Rate for Payer: Railroad Medicare Medicare |
$380.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$701.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.82
|
| Rate for Payer: UHC Exchange |
$701.10
|
| Rate for Payer: UHC Medicaid |
$251.34
|
| Rate for Payer: UHCCP DNSP |
$380.82
|
| Rate for Payer: UHCCP Medicaid |
$251.34
|
|
