|
PR PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES
|
Professional
|
Both
|
$3,367.00
|
|
|
Service Code
|
HCPCS 55821
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$2,525.25 |
| Rate for Payer: Aetna Commercial |
$1,000.02
|
| Rate for Payer: Aetna Medicare |
$746.28
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$746.28
|
| Rate for Payer: BCN Commercial |
$1,253.41
|
| Rate for Payer: BCN Medicare Advantage |
$746.28
|
| Rate for Payer: Cash Price |
$2,693.60
|
| Rate for Payer: Cash Price |
$2,693.60
|
| Rate for Payer: Cofinity Commercial |
$1,000.02
|
| Rate for Payer: Cofinity Commercial |
$1,074.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.28
|
| Rate for Payer: Healthscope Commercial |
$895.54
|
| Rate for Payer: Healthscope Whirlpool |
$895.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.59
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$820.91
|
| Rate for Payer: Nomi Health Commercial |
$895.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,525.25
|
| Rate for Payer: PACE SWMI |
$746.28
|
| Rate for Payer: PHP Medicare Advantage |
$746.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,365.38
|
| Rate for Payer: Priority Health Medicare |
$746.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,365.38
|
| Rate for Payer: Railroad Medicare Medicare |
$746.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,543.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$746.28
|
| Rate for Payer: UHC Exchange |
$1,543.97
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP DNSP |
$746.28
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
|
|
PR PROSTATE NEEDLE BIOPSY ANY APPROACH
|
Professional
|
Both
|
$519.00
|
|
|
Service Code
|
HCPCS 55700
|
| Min. Negotiated Rate |
$167.16 |
| Max. Negotiated Rate |
$389.25 |
| Rate for Payer: Aetna Commercial |
$167.16
|
| Rate for Payer: BCBS Complete |
$207.60
|
| Rate for Payer: BCN Commercial |
$192.22
|
| Rate for Payer: Cash Price |
$415.20
|
| Rate for Payer: Cash Price |
$415.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$389.25
|
|
|
PR PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED
|
Professional
|
Both
|
$1,102.00
|
|
|
Service Code
|
HCPCS 55725
|
| Min. Negotiated Rate |
$348.68 |
| Max. Negotiated Rate |
$1,044.54 |
| Rate for Payer: Aetna Commercial |
$719.37
|
| Rate for Payer: Aetna Medicare |
$536.84
|
| Rate for Payer: BCBS Complete |
$366.11
|
| Rate for Payer: BCBS MAPPO |
$536.84
|
| Rate for Payer: BCN Commercial |
$897.37
|
| Rate for Payer: BCN Medicare Advantage |
$536.84
|
| Rate for Payer: Cash Price |
$881.60
|
| Rate for Payer: Cash Price |
$881.60
|
| Rate for Payer: Cofinity Commercial |
$773.05
|
| Rate for Payer: Cofinity Commercial |
$719.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.84
|
| Rate for Payer: Healthscope Commercial |
$644.21
|
| Rate for Payer: Healthscope Whirlpool |
$644.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.68
|
| Rate for Payer: Meridian Medicaid |
$366.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$590.52
|
| Rate for Payer: Nomi Health Commercial |
$644.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$826.50
|
| Rate for Payer: PACE SWMI |
$536.84
|
| Rate for Payer: PHP Medicare Advantage |
$536.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$977.51
|
| Rate for Payer: Priority Health Medicare |
$536.84
|
| Rate for Payer: Priority Health Narrow Network |
$977.51
|
| Rate for Payer: Railroad Medicare Medicare |
$536.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,044.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$536.84
|
| Rate for Payer: UHC Exchange |
$1,044.54
|
| Rate for Payer: UHC Medicaid |
$348.68
|
| Rate for Payer: UHCCP DNSP |
$536.84
|
| Rate for Payer: UHCCP Medicaid |
$348.68
|
|
|
PR PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX
|
Professional
|
Both
|
$4,339.00
|
|
|
Service Code
|
HCPCS 55842
|
| Min. Negotiated Rate |
$664.99 |
| Max. Negotiated Rate |
$3,254.25 |
| Rate for Payer: Aetna Commercial |
$1,382.77
|
| Rate for Payer: Aetna Medicare |
$1,031.92
|
| Rate for Payer: BCBS Complete |
$698.24
|
| Rate for Payer: BCBS MAPPO |
$1,031.92
|
| Rate for Payer: BCN Commercial |
$1,741.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,031.92
|
| Rate for Payer: Cash Price |
$3,471.20
|
| Rate for Payer: Cash Price |
$3,471.20
|
| Rate for Payer: Cofinity Commercial |
$1,485.96
|
| Rate for Payer: Cofinity Commercial |
$1,382.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,031.92
|
| Rate for Payer: Healthscope Commercial |
$1,238.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,238.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,083.52
|
| Rate for Payer: Meridian Medicaid |
$698.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,135.11
|
| Rate for Payer: Nomi Health Commercial |
$1,238.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,254.25
|
| Rate for Payer: PACE SWMI |
$1,031.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,031.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,897.54
|
| Rate for Payer: Priority Health Medicare |
$1,031.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,897.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,031.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,070.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,031.92
|
| Rate for Payer: UHC Exchange |
$2,070.97
|
| Rate for Payer: UHC Medicaid |
$664.99
|
| Rate for Payer: UHCCP DNSP |
$1,031.92
|
| Rate for Payer: UHCCP Medicaid |
$664.99
|
|
|
PR PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM
|
Professional
|
Both
|
$2,923.00
|
|
|
Service Code
|
HCPCS 55845
|
| Min. Negotiated Rate |
$771.27 |
| Max. Negotiated Rate |
$2,412.51 |
| Rate for Payer: Aetna Commercial |
$1,605.90
|
| Rate for Payer: Aetna Medicare |
$1,198.43
|
| Rate for Payer: BCBS Complete |
$809.83
|
| Rate for Payer: BCBS MAPPO |
$1,198.43
|
| Rate for Payer: BCN Commercial |
$2,027.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,198.43
|
| Rate for Payer: Cash Price |
$2,338.40
|
| Rate for Payer: Cash Price |
$2,338.40
|
| Rate for Payer: Cofinity Commercial |
$1,725.74
|
| Rate for Payer: Cofinity Commercial |
$1,605.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,198.43
|
| Rate for Payer: Healthscope Commercial |
$1,438.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,438.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,258.35
|
| Rate for Payer: Meridian Medicaid |
$809.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,318.27
|
| Rate for Payer: Nomi Health Commercial |
$1,438.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.25
|
| Rate for Payer: PACE SWMI |
$1,198.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,198.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$771.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,208.37
|
| Rate for Payer: Priority Health Medicare |
$1,198.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,208.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,198.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,412.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,198.43
|
| Rate for Payer: UHC Exchange |
$2,412.51
|
| Rate for Payer: UHC Medicaid |
$771.27
|
| Rate for Payer: UHCCP DNSP |
$1,198.43
|
| Rate for Payer: UHCCP Medicaid |
$771.27
|
|
|
PR PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT
|
Professional
|
Both
|
$2,026.00
|
|
|
Service Code
|
HCPCS 23335
|
| Min. Negotiated Rate |
$732.29 |
| Max. Negotiated Rate |
$2,232.16 |
| Rate for Payer: Aetna Commercial |
$1,513.29
|
| Rate for Payer: Aetna Medicare |
$1,129.32
|
| Rate for Payer: BCBS Complete |
$768.90
|
| Rate for Payer: BCBS MAPPO |
$1,129.32
|
| Rate for Payer: BCN Commercial |
$1,913.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,129.32
|
| Rate for Payer: Cash Price |
$1,620.80
|
| Rate for Payer: Cash Price |
$1,620.80
|
| Rate for Payer: Cofinity Commercial |
$1,626.22
|
| Rate for Payer: Cofinity Commercial |
$1,513.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,129.32
|
| Rate for Payer: Healthscope Commercial |
$1,355.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,355.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.79
|
| Rate for Payer: Meridian Medicaid |
$768.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,242.25
|
| Rate for Payer: Nomi Health Commercial |
$1,355.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,519.50
|
| Rate for Payer: PACE SWMI |
$1,129.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,129.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,045.20
|
| Rate for Payer: Priority Health Medicare |
$1,129.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,129.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,129.32
|
| Rate for Payer: UHC Exchange |
$2,232.16
|
| Rate for Payer: UHC Medicaid |
$732.29
|
| Rate for Payer: UHCCP DNSP |
$1,129.32
|
| Rate for Payer: UHCCP Medicaid |
$732.29
|
|
|
PR PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS
|
Professional
|
Both
|
$2,114.00
|
|
|
Service Code
|
HCPCS 24160
|
| Min. Negotiated Rate |
$732.29 |
| Max. Negotiated Rate |
$2,205.89 |
| Rate for Payer: Aetna Commercial |
$1,513.10
|
| Rate for Payer: Aetna Medicare |
$1,129.18
|
| Rate for Payer: BCBS Complete |
$768.90
|
| Rate for Payer: BCBS MAPPO |
$1,129.18
|
| Rate for Payer: BCN Commercial |
$1,901.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,129.18
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cofinity Commercial |
$1,626.02
|
| Rate for Payer: Cofinity Commercial |
$1,513.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,129.18
|
| Rate for Payer: Healthscope Commercial |
$1,355.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,355.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.64
|
| Rate for Payer: Meridian Medicaid |
$768.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,242.10
|
| Rate for Payer: Nomi Health Commercial |
$1,355.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.50
|
| Rate for Payer: PACE SWMI |
$1,129.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,129.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,032.95
|
| Rate for Payer: Priority Health Medicare |
$1,129.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,032.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,129.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,205.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,129.18
|
| Rate for Payer: UHC Exchange |
$2,205.89
|
| Rate for Payer: UHC Medicaid |
$732.29
|
| Rate for Payer: UHCCP DNSP |
$1,129.18
|
| Rate for Payer: UHCCP Medicaid |
$732.29
|
|
|
PR PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT
|
Professional
|
Both
|
$2,609.00
|
|
|
Service Code
|
HCPCS 23334
|
| Min. Negotiated Rate |
$622.39 |
| Max. Negotiated Rate |
$1,956.75 |
| Rate for Payer: Aetna Commercial |
$1,282.45
|
| Rate for Payer: Aetna Medicare |
$957.05
|
| Rate for Payer: BCBS Complete |
$653.51
|
| Rate for Payer: BCBS MAPPO |
$957.05
|
| Rate for Payer: BCN Commercial |
$1,611.46
|
| Rate for Payer: BCN Medicare Advantage |
$957.05
|
| Rate for Payer: Cash Price |
$2,087.20
|
| Rate for Payer: Cash Price |
$2,087.20
|
| Rate for Payer: Cofinity Commercial |
$1,378.15
|
| Rate for Payer: Cofinity Commercial |
$1,282.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$957.05
|
| Rate for Payer: Healthscope Commercial |
$1,148.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,148.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.90
|
| Rate for Payer: Meridian Medicaid |
$653.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,052.76
|
| Rate for Payer: Nomi Health Commercial |
$1,148.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.75
|
| Rate for Payer: PACE SWMI |
$957.05
|
| Rate for Payer: PHP Medicare Advantage |
$957.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,722.61
|
| Rate for Payer: Priority Health Medicare |
$957.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,722.61
|
| Rate for Payer: Railroad Medicare Medicare |
$957.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,869.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$957.05
|
| Rate for Payer: UHC Exchange |
$1,869.11
|
| Rate for Payer: UHC Medicaid |
$622.39
|
| Rate for Payer: UHCCP DNSP |
$957.05
|
| Rate for Payer: UHCCP Medicaid |
$622.39
|
|
|
PR PROSTHESIS REMOVAL RADIAL HEAD
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 24164
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$892.91
|
| Rate for Payer: Aetna Medicare |
$666.35
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS MAPPO |
$666.35
|
| Rate for Payer: BCN Commercial |
$1,108.51
|
| Rate for Payer: BCN Medicare Advantage |
$666.35
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$959.54
|
| Rate for Payer: Cofinity Commercial |
$892.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.35
|
| Rate for Payer: Healthscope Commercial |
$799.62
|
| Rate for Payer: Healthscope Whirlpool |
$799.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.67
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$732.99
|
| Rate for Payer: Nomi Health Commercial |
$799.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: PACE SWMI |
$666.35
|
| Rate for Payer: PHP Medicare Advantage |
$666.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,184.96
|
| Rate for Payer: Priority Health Medicare |
$666.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.96
|
| Rate for Payer: Railroad Medicare Medicare |
$666.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,259.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$666.35
|
| Rate for Payer: UHC Exchange |
$1,259.41
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP DNSP |
$666.35
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
|
|
PR PROSTHESIS SERVICE APHAKIA TEMPORARY
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 92358
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$17.43 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14.91
|
| Rate for Payer: Priority Health Narrow Network |
$14.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
|
|
PR PROTECTOR HEEL OR ELBOW
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS E0191
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$10.47
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCN Commercial |
$13.63
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.64
|
| Rate for Payer: UHC Exchange |
$4.64
|
|
|
PR PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 62267
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Aetna Commercial |
$179.68
|
| Rate for Payer: Aetna Medicare |
$134.09
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$134.09
|
| Rate for Payer: BCN Commercial |
$228.07
|
| Rate for Payer: BCN Medicare Advantage |
$134.09
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Cofinity Commercial |
$193.09
|
| Rate for Payer: Cofinity Commercial |
$179.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.09
|
| Rate for Payer: Healthscope Commercial |
$160.91
|
| Rate for Payer: Healthscope Whirlpool |
$160.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.79
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.50
|
| Rate for Payer: Nomi Health Commercial |
$160.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.00
|
| Rate for Payer: PACE SWMI |
$134.09
|
| Rate for Payer: PHP Medicare Advantage |
$134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$264.91
|
| Rate for Payer: Priority Health Medicare |
$134.09
|
| Rate for Payer: Priority Health Narrow Network |
$264.91
|
| Rate for Payer: Railroad Medicare Medicare |
$134.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.09
|
| Rate for Payer: UHC Exchange |
$278.30
|
| Rate for Payer: UHC Medicaid |
$86.05
|
| Rate for Payer: UHCCP DNSP |
$134.09
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
|
|
PR PRQ BALLOON VALVULOPLASTY AORTIC VALVE
|
Professional
|
Both
|
$2,760.00
|
|
|
Service Code
|
HCPCS 92986
|
| Min. Negotiated Rate |
$744.86 |
| Max. Negotiated Rate |
$2,165.77 |
| Rate for Payer: Aetna Commercial |
$1,564.80
|
| Rate for Payer: Aetna Medicare |
$1,167.76
|
| Rate for Payer: BCBS Complete |
$782.10
|
| Rate for Payer: BCBS MAPPO |
$1,167.76
|
| Rate for Payer: BCN Commercial |
$1,946.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,167.76
|
| Rate for Payer: Cash Price |
$2,208.00
|
| Rate for Payer: Cash Price |
$2,208.00
|
| Rate for Payer: Cofinity Commercial |
$1,681.57
|
| Rate for Payer: Cofinity Commercial |
$1,564.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,167.76
|
| Rate for Payer: Healthscope Commercial |
$1,401.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,401.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,226.15
|
| Rate for Payer: Meridian Medicaid |
$782.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,284.54
|
| Rate for Payer: Nomi Health Commercial |
$1,401.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,070.00
|
| Rate for Payer: PACE SWMI |
$1,167.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,167.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$744.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,850.15
|
| Rate for Payer: Priority Health Medicare |
$1,167.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,850.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,167.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,165.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,167.76
|
| Rate for Payer: UHC Exchange |
$2,165.77
|
| Rate for Payer: UHC Medicaid |
$744.86
|
| Rate for Payer: UHCCP DNSP |
$1,167.76
|
| Rate for Payer: UHCCP Medicaid |
$744.86
|
|
|
PR PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING
|
Professional
|
Both
|
$2,049.00
|
|
|
Service Code
|
HCPCS 64561
|
| Min. Negotiated Rate |
$172.96 |
| Max. Negotiated Rate |
$1,536.75 |
| Rate for Payer: Aetna Commercial |
$359.70
|
| Rate for Payer: Aetna Medicare |
$268.43
|
| Rate for Payer: BCBS Complete |
$181.61
|
| Rate for Payer: BCBS MAPPO |
$268.43
|
| Rate for Payer: BCN Commercial |
$452.66
|
| Rate for Payer: BCN Medicare Advantage |
$268.43
|
| Rate for Payer: Cash Price |
$1,639.20
|
| Rate for Payer: Cash Price |
$1,639.20
|
| Rate for Payer: Cofinity Commercial |
$386.54
|
| Rate for Payer: Cofinity Commercial |
$359.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.43
|
| Rate for Payer: Healthscope Commercial |
$322.12
|
| Rate for Payer: Healthscope Whirlpool |
$322.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.85
|
| Rate for Payer: Meridian Medicaid |
$181.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.27
|
| Rate for Payer: Nomi Health Commercial |
$322.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,536.75
|
| Rate for Payer: PACE SWMI |
$268.43
|
| Rate for Payer: PHP Medicare Advantage |
$268.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$525.76
|
| Rate for Payer: Priority Health Medicare |
$268.43
|
| Rate for Payer: Priority Health Narrow Network |
$525.76
|
| Rate for Payer: Railroad Medicare Medicare |
$268.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$536.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.43
|
| Rate for Payer: UHC Exchange |
$536.42
|
| Rate for Payer: UHC Medicaid |
$172.96
|
| Rate for Payer: UHCCP DNSP |
$268.43
|
| Rate for Payer: UHCCP Medicaid |
$172.96
|
|
|
PR PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 64553
|
| Min. Negotiated Rate |
$187.20 |
| Max. Negotiated Rate |
$797.61 |
| Rate for Payer: Aetna Commercial |
$599.30
|
| Rate for Payer: Aetna Medicare |
$447.24
|
| Rate for Payer: BCBS Complete |
$187.20
|
| Rate for Payer: BCBS MAPPO |
$447.24
|
| Rate for Payer: BCN Commercial |
$686.72
|
| Rate for Payer: BCN Medicare Advantage |
$447.24
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cofinity Commercial |
$644.03
|
| Rate for Payer: Cofinity Commercial |
$599.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.24
|
| Rate for Payer: Healthscope Commercial |
$536.69
|
| Rate for Payer: Healthscope Whirlpool |
$536.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.96
|
| Rate for Payer: Nomi Health Commercial |
$536.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.00
|
| Rate for Payer: PACE SWMI |
$447.24
|
| Rate for Payer: PHP Medicare Advantage |
$447.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$797.61
|
| Rate for Payer: Priority Health Medicare |
$447.24
|
| Rate for Payer: Priority Health Narrow Network |
$797.61
|
| Rate for Payer: Railroad Medicare Medicare |
$447.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$447.24
|
| Rate for Payer: UHC Exchange |
$628.71
|
| Rate for Payer: UHCCP DNSP |
$447.24
|
|
|
PR PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 64555
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$602.02 |
| Rate for Payer: Aetna Commercial |
$387.09
|
| Rate for Payer: Aetna Medicare |
$288.87
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS MAPPO |
$288.87
|
| Rate for Payer: BCN Commercial |
$488.52
|
| Rate for Payer: BCN Medicare Advantage |
$288.87
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$415.97
|
| Rate for Payer: Cofinity Commercial |
$387.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.87
|
| Rate for Payer: Healthscope Commercial |
$346.64
|
| Rate for Payer: Healthscope Whirlpool |
$346.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.31
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.76
|
| Rate for Payer: Nomi Health Commercial |
$346.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.75
|
| Rate for Payer: PACE SWMI |
$288.87
|
| Rate for Payer: PHP Medicare Advantage |
$288.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$567.41
|
| Rate for Payer: Priority Health Medicare |
$288.87
|
| Rate for Payer: Priority Health Narrow Network |
$567.41
|
| Rate for Payer: Railroad Medicare Medicare |
$288.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$602.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.87
|
| Rate for Payer: UHC Exchange |
$602.02
|
| Rate for Payer: UHC Medicaid |
$187.44
|
| Rate for Payer: UHCCP DNSP |
$288.87
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
|
|
PR PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL
|
Professional
|
Both
|
$5,506.00
|
|
|
Service Code
|
HCPCS 63650
|
| Min. Negotiated Rate |
$239.41 |
| Max. Negotiated Rate |
$4,129.50 |
| Rate for Payer: Aetna Commercial |
$494.08
|
| Rate for Payer: Aetna Medicare |
$368.72
|
| Rate for Payer: BCBS Complete |
$251.38
|
| Rate for Payer: BCBS MAPPO |
$368.72
|
| Rate for Payer: BCN Commercial |
$621.48
|
| Rate for Payer: BCN Medicare Advantage |
$368.72
|
| Rate for Payer: Cash Price |
$4,404.80
|
| Rate for Payer: Cash Price |
$4,404.80
|
| Rate for Payer: Cofinity Commercial |
$530.96
|
| Rate for Payer: Cofinity Commercial |
$494.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.72
|
| Rate for Payer: Healthscope Commercial |
$442.46
|
| Rate for Payer: Healthscope Whirlpool |
$442.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.16
|
| Rate for Payer: Meridian Medicaid |
$251.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$405.59
|
| Rate for Payer: Nomi Health Commercial |
$442.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,129.50
|
| Rate for Payer: PACE SWMI |
$368.72
|
| Rate for Payer: PHP Medicare Advantage |
$368.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$721.83
|
| Rate for Payer: Priority Health Medicare |
$368.72
|
| Rate for Payer: Priority Health Narrow Network |
$721.83
|
| Rate for Payer: Railroad Medicare Medicare |
$368.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$727.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$368.72
|
| Rate for Payer: UHC Exchange |
$727.70
|
| Rate for Payer: UHC Medicaid |
$239.41
|
| Rate for Payer: UHCCP DNSP |
$368.72
|
| Rate for Payer: UHCCP Medicaid |
$239.41
|
|
|
PR PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL
|
Professional
|
Both
|
$2,544.00
|
|
|
Service Code
|
HCPCS 47533
|
| Min. Negotiated Rate |
$144.63 |
| Max. Negotiated Rate |
$1,908.00 |
| Rate for Payer: Aetna Commercial |
$303.42
|
| Rate for Payer: Aetna Medicare |
$226.43
|
| Rate for Payer: BCBS Complete |
$151.86
|
| Rate for Payer: BCBS MAPPO |
$226.43
|
| Rate for Payer: BCN Commercial |
$383.94
|
| Rate for Payer: BCN Medicare Advantage |
$226.43
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cofinity Commercial |
$326.06
|
| Rate for Payer: Cofinity Commercial |
$303.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.43
|
| Rate for Payer: Healthscope Commercial |
$271.72
|
| Rate for Payer: Healthscope Whirlpool |
$271.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.75
|
| Rate for Payer: Meridian Medicaid |
$151.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$249.07
|
| Rate for Payer: Nomi Health Commercial |
$271.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,908.00
|
| Rate for Payer: PACE SWMI |
$226.43
|
| Rate for Payer: PHP Medicare Advantage |
$226.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$467.81
|
| Rate for Payer: Priority Health Medicare |
$226.43
|
| Rate for Payer: Priority Health Narrow Network |
$467.81
|
| Rate for Payer: Railroad Medicare Medicare |
$226.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$474.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.43
|
| Rate for Payer: UHC Exchange |
$474.83
|
| Rate for Payer: UHC Medicaid |
$144.63
|
| Rate for Payer: UHCCP DNSP |
$226.43
|
| Rate for Payer: UHCCP Medicaid |
$144.63
|
|
|
PR PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 27756
|
| Min. Negotiated Rate |
$359.97 |
| Max. Negotiated Rate |
$1,281.75 |
| Rate for Payer: Aetna Commercial |
$733.65
|
| Rate for Payer: Aetna Medicare |
$547.50
|
| Rate for Payer: BCBS Complete |
$377.97
|
| Rate for Payer: BCBS MAPPO |
$547.50
|
| Rate for Payer: BCN Commercial |
$903.84
|
| Rate for Payer: BCN Medicare Advantage |
$547.50
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cofinity Commercial |
$788.40
|
| Rate for Payer: Cofinity Commercial |
$733.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.50
|
| Rate for Payer: Healthscope Commercial |
$657.00
|
| Rate for Payer: Healthscope Whirlpool |
$657.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.88
|
| Rate for Payer: Meridian Medicaid |
$377.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.25
|
| Rate for Payer: Nomi Health Commercial |
$657.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.75
|
| Rate for Payer: PACE SWMI |
$547.50
|
| Rate for Payer: PHP Medicare Advantage |
$547.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$966.18
|
| Rate for Payer: Priority Health Medicare |
$547.50
|
| Rate for Payer: Priority Health Narrow Network |
$966.18
|
| Rate for Payer: Railroad Medicare Medicare |
$547.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$999.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.50
|
| Rate for Payer: UHC Exchange |
$999.33
|
| Rate for Payer: UHC Medicaid |
$359.97
|
| Rate for Payer: UHCCP DNSP |
$547.50
|
| Rate for Payer: UHCCP Medicaid |
$359.97
|
|
|
PR PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26650
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$606.15
|
| Rate for Payer: Aetna Medicare |
$452.35
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$452.35
|
| Rate for Payer: BCN Commercial |
$747.47
|
| Rate for Payer: BCN Medicare Advantage |
$452.35
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$651.38
|
| Rate for Payer: Cofinity Commercial |
$606.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.35
|
| Rate for Payer: Healthscope Commercial |
$542.82
|
| Rate for Payer: Healthscope Whirlpool |
$542.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.97
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$497.58
|
| Rate for Payer: Nomi Health Commercial |
$542.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$452.35
|
| Rate for Payer: PHP Medicare Advantage |
$452.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$799.02
|
| Rate for Payer: Priority Health Medicare |
$452.35
|
| Rate for Payer: Priority Health Narrow Network |
$799.02
|
| Rate for Payer: Railroad Medicare Medicare |
$452.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$452.35
|
| Rate for Payer: UHC Exchange |
$824.99
|
| Rate for Payer: UHC Medicaid |
$300.12
|
| Rate for Payer: UHCCP DNSP |
$452.35
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
|
|
PR PRQ SKELETAL FIXJ FEMORAL FX DISTAL END
|
Professional
|
Both
|
$2,303.00
|
|
|
Service Code
|
HCPCS 27509
|
| Min. Negotiated Rate |
$416.20 |
| Max. Negotiated Rate |
$1,727.25 |
| Rate for Payer: Aetna Commercial |
$845.43
|
| Rate for Payer: Aetna Medicare |
$630.92
|
| Rate for Payer: BCBS Complete |
$437.01
|
| Rate for Payer: BCBS MAPPO |
$630.92
|
| Rate for Payer: BCN Commercial |
$1,031.31
|
| Rate for Payer: BCN Medicare Advantage |
$630.92
|
| Rate for Payer: Cash Price |
$1,842.40
|
| Rate for Payer: Cash Price |
$1,842.40
|
| Rate for Payer: Cofinity Commercial |
$908.52
|
| Rate for Payer: Cofinity Commercial |
$845.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.92
|
| Rate for Payer: Healthscope Commercial |
$757.10
|
| Rate for Payer: Healthscope Whirlpool |
$757.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.47
|
| Rate for Payer: Meridian Medicaid |
$437.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.01
|
| Rate for Payer: Nomi Health Commercial |
$757.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.25
|
| Rate for Payer: PACE SWMI |
$630.92
|
| Rate for Payer: PHP Medicare Advantage |
$630.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,102.46
|
| Rate for Payer: Priority Health Medicare |
$630.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,102.46
|
| Rate for Payer: Railroad Medicare Medicare |
$630.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,147.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$630.92
|
| Rate for Payer: UHC Exchange |
$1,147.67
|
| Rate for Payer: UHC Medicaid |
$416.20
|
| Rate for Payer: UHCCP DNSP |
$630.92
|
| Rate for Payer: UHCCP Medicaid |
$416.20
|
|
|
PR PRQ SKELETAL FIXJ METACARPAL FX EACH BONE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26608
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$599.41
|
| Rate for Payer: Aetna Medicare |
$447.32
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$447.32
|
| Rate for Payer: BCN Commercial |
$743.98
|
| Rate for Payer: BCN Medicare Advantage |
$447.32
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$644.14
|
| Rate for Payer: Cofinity Commercial |
$599.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.32
|
| Rate for Payer: Healthscope Commercial |
$536.78
|
| Rate for Payer: Healthscope Whirlpool |
$536.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.69
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$492.05
|
| Rate for Payer: Nomi Health Commercial |
$536.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$447.32
|
| Rate for Payer: PHP Medicare Advantage |
$447.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$795.30
|
| Rate for Payer: Priority Health Medicare |
$447.32
|
| Rate for Payer: Priority Health Narrow Network |
$795.30
|
| Rate for Payer: Railroad Medicare Medicare |
$447.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$827.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$447.32
|
| Rate for Payer: UHC Exchange |
$827.93
|
| Rate for Payer: UHC Medicaid |
$296.07
|
| Rate for Payer: UHCCP DNSP |
$447.32
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
|
|
PR PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 26676
|
| Min. Negotiated Rate |
$311.83 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Aetna Commercial |
$630.39
|
| Rate for Payer: Aetna Medicare |
$470.44
|
| Rate for Payer: BCBS Complete |
$327.42
|
| Rate for Payer: BCBS MAPPO |
$470.44
|
| Rate for Payer: BCN Commercial |
$789.79
|
| Rate for Payer: BCN Medicare Advantage |
$470.44
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$677.43
|
| Rate for Payer: Cofinity Commercial |
$630.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.44
|
| Rate for Payer: Healthscope Commercial |
$564.53
|
| Rate for Payer: Healthscope Whirlpool |
$564.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.96
|
| Rate for Payer: Meridian Medicaid |
$327.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.48
|
| Rate for Payer: Nomi Health Commercial |
$564.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,275.00
|
| Rate for Payer: PACE SWMI |
$470.44
|
| Rate for Payer: PHP Medicare Advantage |
$470.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$844.28
|
| Rate for Payer: Priority Health Medicare |
$470.44
|
| Rate for Payer: Priority Health Narrow Network |
$844.28
|
| Rate for Payer: Railroad Medicare Medicare |
$470.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$871.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.44
|
| Rate for Payer: UHC Exchange |
$871.57
|
| Rate for Payer: UHC Medicaid |
$311.83
|
| Rate for Payer: UHCCP DNSP |
$470.44
|
| Rate for Payer: UHCCP Medicaid |
$311.83
|
|
|
PR PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 26756
|
| Min. Negotiated Rate |
$264.55 |
| Max. Negotiated Rate |
$849.75 |
| Rate for Payer: Aetna Commercial |
$533.33
|
| Rate for Payer: Aetna Medicare |
$398.01
|
| Rate for Payer: BCBS Complete |
$277.78
|
| Rate for Payer: BCBS MAPPO |
$398.01
|
| Rate for Payer: BCN Commercial |
$656.84
|
| Rate for Payer: BCN Medicare Advantage |
$398.01
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$573.13
|
| Rate for Payer: Cofinity Commercial |
$533.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.01
|
| Rate for Payer: Healthscope Commercial |
$477.61
|
| Rate for Payer: Healthscope Whirlpool |
$477.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.91
|
| Rate for Payer: Meridian Medicaid |
$277.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.81
|
| Rate for Payer: Nomi Health Commercial |
$477.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$849.75
|
| Rate for Payer: PACE SWMI |
$398.01
|
| Rate for Payer: PHP Medicare Advantage |
$398.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$702.14
|
| Rate for Payer: Priority Health Medicare |
$398.01
|
| Rate for Payer: Priority Health Narrow Network |
$702.14
|
| Rate for Payer: Railroad Medicare Medicare |
$398.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$725.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.01
|
| Rate for Payer: UHC Exchange |
$725.16
|
| Rate for Payer: UHC Medicaid |
$264.55
|
| Rate for Payer: UHCCP DNSP |
$398.01
|
| Rate for Payer: UHCCP Medicaid |
$264.55
|
|
|
PR PRQ SKEL FIXJ FEMORAL FX PROX END NECK
|
Professional
|
Both
|
$3,460.00
|
|
|
Service Code
|
HCPCS 27235
|
| Min. Negotiated Rate |
$533.35 |
| Max. Negotiated Rate |
$2,595.00 |
| Rate for Payer: Aetna Commercial |
$1,098.12
|
| Rate for Payer: Aetna Medicare |
$819.49
|
| Rate for Payer: BCBS Complete |
$560.02
|
| Rate for Payer: BCBS MAPPO |
$819.49
|
| Rate for Payer: BCN Commercial |
$1,512.64
|
| Rate for Payer: BCN Medicare Advantage |
$819.49
|
| Rate for Payer: Cash Price |
$2,768.00
|
| Rate for Payer: Cash Price |
$2,768.00
|
| Rate for Payer: Cofinity Commercial |
$1,180.07
|
| Rate for Payer: Cofinity Commercial |
$1,098.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.49
|
| Rate for Payer: Healthscope Commercial |
$983.39
|
| Rate for Payer: Healthscope Whirlpool |
$983.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.46
|
| Rate for Payer: Meridian Medicaid |
$560.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$901.44
|
| Rate for Payer: Nomi Health Commercial |
$983.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,595.00
|
| Rate for Payer: PACE SWMI |
$819.49
|
| Rate for Payer: PHP Medicare Advantage |
$819.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,471.89
|
| Rate for Payer: Priority Health Medicare |
$819.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.89
|
| Rate for Payer: Railroad Medicare Medicare |
$819.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,590.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$819.49
|
| Rate for Payer: UHC Exchange |
$1,590.03
|
| Rate for Payer: UHC Medicaid |
$533.35
|
| Rate for Payer: UHCCP DNSP |
$819.49
|
| Rate for Payer: UHCCP Medicaid |
$533.35
|
|
