|
PR PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 28496
|
| Min. Negotiated Rate |
$179.13 |
| Max. Negotiated Rate |
$867.00 |
| Rate for Payer: Aetna Commercial |
$357.91
|
| Rate for Payer: Aetna Medicare |
$267.10
|
| Rate for Payer: BCBS Complete |
$188.09
|
| Rate for Payer: BCBS MAPPO |
$267.10
|
| Rate for Payer: BCN Commercial |
$425.28
|
| Rate for Payer: BCN Medicare Advantage |
$267.10
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cofinity Commercial |
$384.62
|
| Rate for Payer: Cofinity Commercial |
$357.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.10
|
| Rate for Payer: Healthscope Commercial |
$320.52
|
| Rate for Payer: Healthscope Whirlpool |
$320.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.45
|
| Rate for Payer: Meridian Medicaid |
$188.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$293.81
|
| Rate for Payer: Nomi Health Commercial |
$320.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.00
|
| Rate for Payer: PACE SWMI |
$267.10
|
| Rate for Payer: PHP Medicare Advantage |
$267.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$454.61
|
| Rate for Payer: Priority Health Medicare |
$267.10
|
| Rate for Payer: Priority Health Narrow Network |
$454.61
|
| Rate for Payer: Railroad Medicare Medicare |
$267.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$413.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$267.10
|
| Rate for Payer: UHC Exchange |
$413.48
|
| Rate for Payer: UHC Medicaid |
$179.13
|
| Rate for Payer: UHCCP DNSP |
$267.10
|
| Rate for Payer: UHCCP Medicaid |
$179.13
|
|
|
PR PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ
|
Professional
|
Both
|
$609.00
|
|
|
Service Code
|
HCPCS 28666
|
| Min. Negotiated Rate |
$104.58 |
| Max. Negotiated Rate |
$456.75 |
| Rate for Payer: Aetna Commercial |
$212.75
|
| Rate for Payer: Aetna Medicare |
$158.77
|
| Rate for Payer: BCBS Complete |
$109.81
|
| Rate for Payer: BCBS MAPPO |
$158.77
|
| Rate for Payer: BCN Commercial |
$262.93
|
| Rate for Payer: BCN Medicare Advantage |
$158.77
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cofinity Commercial |
$228.63
|
| Rate for Payer: Cofinity Commercial |
$212.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.77
|
| Rate for Payer: Healthscope Commercial |
$190.52
|
| Rate for Payer: Healthscope Whirlpool |
$190.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.71
|
| Rate for Payer: Meridian Medicaid |
$109.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.65
|
| Rate for Payer: Nomi Health Commercial |
$190.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.75
|
| Rate for Payer: PACE SWMI |
$158.77
|
| Rate for Payer: PHP Medicare Advantage |
$158.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$281.07
|
| Rate for Payer: Priority Health Medicare |
$158.77
|
| Rate for Payer: Priority Health Narrow Network |
$281.07
|
| Rate for Payer: Railroad Medicare Medicare |
$158.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.77
|
| Rate for Payer: UHC Exchange |
$290.53
|
| Rate for Payer: UHC Medicaid |
$104.58
|
| Rate for Payer: UHCCP DNSP |
$158.77
|
| Rate for Payer: UHCCP Medicaid |
$104.58
|
|
|
PR PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,431.00
|
|
|
Service Code
|
HCPCS 26776
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$1,073.25 |
| Rate for Payer: Aetna Commercial |
$560.00
|
| Rate for Payer: Aetna Medicare |
$417.91
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$417.91
|
| Rate for Payer: BCN Commercial |
$697.17
|
| Rate for Payer: BCN Medicare Advantage |
$417.91
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cofinity Commercial |
$601.79
|
| Rate for Payer: Cofinity Commercial |
$560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.91
|
| Rate for Payer: Healthscope Commercial |
$501.49
|
| Rate for Payer: Healthscope Whirlpool |
$501.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$438.81
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$459.70
|
| Rate for Payer: Nomi Health Commercial |
$501.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,073.25
|
| Rate for Payer: PACE SWMI |
$417.91
|
| Rate for Payer: PHP Medicare Advantage |
$417.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$745.26
|
| Rate for Payer: Priority Health Medicare |
$417.91
|
| Rate for Payer: Priority Health Narrow Network |
$745.26
|
| Rate for Payer: Railroad Medicare Medicare |
$417.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.91
|
| Rate for Payer: UHC Exchange |
$769.15
|
| Rate for Payer: UHC Medicaid |
$277.33
|
| Rate for Payer: UHCCP DNSP |
$417.91
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
|
PR PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 26706
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Aetna Commercial |
$540.38
|
| Rate for Payer: Aetna Medicare |
$403.27
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS MAPPO |
$403.27
|
| Rate for Payer: BCN Commercial |
$694.18
|
| Rate for Payer: BCN Medicare Advantage |
$403.27
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cofinity Commercial |
$580.71
|
| Rate for Payer: Cofinity Commercial |
$540.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.27
|
| Rate for Payer: Healthscope Commercial |
$483.92
|
| Rate for Payer: Healthscope Whirlpool |
$483.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.43
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.60
|
| Rate for Payer: Nomi Health Commercial |
$483.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,062.00
|
| Rate for Payer: PACE SWMI |
$403.27
|
| Rate for Payer: PHP Medicare Advantage |
$403.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$742.06
|
| Rate for Payer: Priority Health Medicare |
$403.27
|
| Rate for Payer: Priority Health Narrow Network |
$742.06
|
| Rate for Payer: Railroad Medicare Medicare |
$403.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.27
|
| Rate for Payer: UHC Exchange |
$763.70
|
| Rate for Payer: UHC Medicaid |
$266.68
|
| Rate for Payer: UHCCP DNSP |
$403.27
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
|
|
PR PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 28636
|
| Min. Negotiated Rate |
$138.66 |
| Max. Negotiated Rate |
$507.75 |
| Rate for Payer: Aetna Commercial |
$282.04
|
| Rate for Payer: Aetna Medicare |
$210.48
|
| Rate for Payer: BCBS Complete |
$145.59
|
| Rate for Payer: BCBS MAPPO |
$210.48
|
| Rate for Payer: BCN Commercial |
$343.11
|
| Rate for Payer: BCN Medicare Advantage |
$210.48
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$303.09
|
| Rate for Payer: Cofinity Commercial |
$282.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.48
|
| Rate for Payer: Healthscope Commercial |
$252.58
|
| Rate for Payer: Healthscope Whirlpool |
$252.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.00
|
| Rate for Payer: Meridian Medicaid |
$145.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.53
|
| Rate for Payer: Nomi Health Commercial |
$252.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.75
|
| Rate for Payer: PACE SWMI |
$210.48
|
| Rate for Payer: PHP Medicare Advantage |
$210.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$366.78
|
| Rate for Payer: Priority Health Medicare |
$210.48
|
| Rate for Payer: Priority Health Narrow Network |
$366.78
|
| Rate for Payer: Railroad Medicare Medicare |
$210.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$210.48
|
| Rate for Payer: UHC Exchange |
$346.76
|
| Rate for Payer: UHC Medicaid |
$138.66
|
| Rate for Payer: UHCCP DNSP |
$210.48
|
| Rate for Payer: UHCCP Medicaid |
$138.66
|
|
|
PR PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26727
|
| Min. Negotiated Rate |
$291.38 |
| Max. Negotiated Rate |
$1,189.50 |
| Rate for Payer: Aetna Commercial |
$589.63
|
| Rate for Payer: Aetna Medicare |
$440.02
|
| Rate for Payer: BCBS Complete |
$305.95
|
| Rate for Payer: BCBS MAPPO |
$440.02
|
| Rate for Payer: BCN Commercial |
$734.53
|
| Rate for Payer: BCN Medicare Advantage |
$440.02
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$633.63
|
| Rate for Payer: Cofinity Commercial |
$589.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.02
|
| Rate for Payer: Healthscope Commercial |
$528.02
|
| Rate for Payer: Healthscope Whirlpool |
$528.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.02
|
| Rate for Payer: Meridian Medicaid |
$305.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$484.02
|
| Rate for Payer: Nomi Health Commercial |
$528.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$440.02
|
| Rate for Payer: PHP Medicare Advantage |
$440.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$785.18
|
| Rate for Payer: Priority Health Medicare |
$440.02
|
| Rate for Payer: Priority Health Narrow Network |
$785.18
|
| Rate for Payer: Railroad Medicare Medicare |
$440.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$440.02
|
| Rate for Payer: UHC Exchange |
$813.19
|
| Rate for Payer: UHC Medicaid |
$291.38
|
| Rate for Payer: UHCCP DNSP |
$440.02
|
| Rate for Payer: UHCCP Medicaid |
$291.38
|
|
|
PR PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,007.00
|
|
|
Service Code
|
HCPCS 28576
|
| Min. Negotiated Rate |
$246.44 |
| Max. Negotiated Rate |
$755.25 |
| Rate for Payer: Aetna Commercial |
$499.55
|
| Rate for Payer: Aetna Medicare |
$372.80
|
| Rate for Payer: BCBS Complete |
$258.76
|
| Rate for Payer: BCBS MAPPO |
$372.80
|
| Rate for Payer: BCN Commercial |
$605.05
|
| Rate for Payer: BCN Medicare Advantage |
$372.80
|
| Rate for Payer: Cash Price |
$805.60
|
| Rate for Payer: Cash Price |
$805.60
|
| Rate for Payer: Cofinity Commercial |
$536.83
|
| Rate for Payer: Cofinity Commercial |
$499.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.80
|
| Rate for Payer: Healthscope Commercial |
$447.36
|
| Rate for Payer: Healthscope Whirlpool |
$447.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.44
|
| Rate for Payer: Meridian Medicaid |
$258.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.08
|
| Rate for Payer: Nomi Health Commercial |
$447.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$755.25
|
| Rate for Payer: PACE SWMI |
$372.80
|
| Rate for Payer: PHP Medicare Advantage |
$372.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$646.78
|
| Rate for Payer: Priority Health Medicare |
$372.80
|
| Rate for Payer: Priority Health Narrow Network |
$646.78
|
| Rate for Payer: Railroad Medicare Medicare |
$372.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$669.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.80
|
| Rate for Payer: UHC Exchange |
$669.38
|
| Rate for Payer: UHC Medicaid |
$246.44
|
| Rate for Payer: UHCCP DNSP |
$372.80
|
| Rate for Payer: UHCCP Medicaid |
$246.44
|
|
|
PR PRQ SKEL FIXJ TARS JT DISLC W/MANJ
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 28606
|
| Min. Negotiated Rate |
$246.87 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: Aetna Commercial |
$501.82
|
| Rate for Payer: Aetna Medicare |
$374.49
|
| Rate for Payer: BCBS Complete |
$259.21
|
| Rate for Payer: BCBS MAPPO |
$374.49
|
| Rate for Payer: BCN Commercial |
$612.52
|
| Rate for Payer: BCN Medicare Advantage |
$374.49
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$539.27
|
| Rate for Payer: Cofinity Commercial |
$501.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.49
|
| Rate for Payer: Healthscope Commercial |
$449.39
|
| Rate for Payer: Healthscope Whirlpool |
$449.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.21
|
| Rate for Payer: Meridian Medicaid |
$259.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$411.94
|
| Rate for Payer: Nomi Health Commercial |
$449.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,039.50
|
| Rate for Payer: PACE SWMI |
$374.49
|
| Rate for Payer: PHP Medicare Advantage |
$374.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$654.76
|
| Rate for Payer: Priority Health Medicare |
$374.49
|
| Rate for Payer: Priority Health Narrow Network |
$654.76
|
| Rate for Payer: Railroad Medicare Medicare |
$374.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$674.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$374.49
|
| Rate for Payer: UHC Exchange |
$674.56
|
| Rate for Payer: UHC Medicaid |
$246.87
|
| Rate for Payer: UHCCP DNSP |
$374.49
|
| Rate for Payer: UHCCP Medicaid |
$246.87
|
|
|
PR PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 28546
|
| Min. Negotiated Rate |
$228.12 |
| Max. Negotiated Rate |
$616.50 |
| Rate for Payer: Aetna Commercial |
$457.34
|
| Rate for Payer: Aetna Medicare |
$341.30
|
| Rate for Payer: BCBS Complete |
$239.53
|
| Rate for Payer: BCBS MAPPO |
$341.30
|
| Rate for Payer: BCN Commercial |
$547.78
|
| Rate for Payer: BCN Medicare Advantage |
$341.30
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$491.47
|
| Rate for Payer: Cofinity Commercial |
$457.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.30
|
| Rate for Payer: Healthscope Commercial |
$409.56
|
| Rate for Payer: Healthscope Whirlpool |
$409.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.37
|
| Rate for Payer: Meridian Medicaid |
$239.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$375.43
|
| Rate for Payer: Nomi Health Commercial |
$409.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$616.50
|
| Rate for Payer: PACE SWMI |
$341.30
|
| Rate for Payer: PHP Medicare Advantage |
$341.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$585.56
|
| Rate for Payer: Priority Health Medicare |
$341.30
|
| Rate for Payer: Priority Health Narrow Network |
$585.56
|
| Rate for Payer: Railroad Medicare Medicare |
$341.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$341.30
|
| Rate for Payer: UHC Exchange |
$587.55
|
| Rate for Payer: UHC Medicaid |
$228.12
|
| Rate for Payer: UHCCP DNSP |
$341.30
|
| Rate for Payer: UHCCP Medicaid |
$228.12
|
|
|
PR PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCN W/MNPJ EA
|
Professional
|
Both
|
$478.00
|
|
|
Service Code
|
HCPCS 28456
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$609.52 |
| Rate for Payer: Aetna Commercial |
$485.68
|
| Rate for Payer: Aetna Medicare |
$362.45
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$362.45
|
| Rate for Payer: BCN Commercial |
$570.19
|
| Rate for Payer: BCN Medicare Advantage |
$362.45
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Cofinity Commercial |
$521.93
|
| Rate for Payer: Cofinity Commercial |
$485.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.45
|
| Rate for Payer: Healthscope Commercial |
$434.94
|
| Rate for Payer: Healthscope Whirlpool |
$434.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.57
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.69
|
| Rate for Payer: Nomi Health Commercial |
$434.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.50
|
| Rate for Payer: PACE SWMI |
$362.45
|
| Rate for Payer: PHP Medicare Advantage |
$362.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$609.52
|
| Rate for Payer: Priority Health Medicare |
$362.45
|
| Rate for Payer: Priority Health Narrow Network |
$609.52
|
| Rate for Payer: Railroad Medicare Medicare |
$362.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.45
|
| Rate for Payer: UHC Exchange |
$577.87
|
| Rate for Payer: UHC Medicaid |
$244.52
|
| Rate for Payer: UHCCP DNSP |
$362.45
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
|
|
PR PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT
|
Professional
|
Both
|
$2,115.00
|
|
|
Service Code
|
HCPCS 93580
|
| Min. Negotiated Rate |
$538.25 |
| Max. Negotiated Rate |
$1,610.82 |
| Rate for Payer: Aetna Commercial |
$1,140.09
|
| Rate for Payer: Aetna Medicare |
$850.81
|
| Rate for Payer: BCBS Complete |
$565.16
|
| Rate for Payer: BCBS MAPPO |
$850.81
|
| Rate for Payer: BCN Commercial |
$1,421.73
|
| Rate for Payer: BCN Medicare Advantage |
$850.81
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cofinity Commercial |
$1,225.17
|
| Rate for Payer: Cofinity Commercial |
$1,140.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$850.81
|
| Rate for Payer: Healthscope Commercial |
$1,020.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,020.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$893.35
|
| Rate for Payer: Meridian Medicaid |
$565.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$935.89
|
| Rate for Payer: Nomi Health Commercial |
$1,020.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,586.25
|
| Rate for Payer: PACE SWMI |
$850.81
|
| Rate for Payer: PHP Medicare Advantage |
$850.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,351.28
|
| Rate for Payer: Priority Health Medicare |
$850.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,351.28
|
| Rate for Payer: Railroad Medicare Medicare |
$850.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,610.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$850.81
|
| Rate for Payer: UHC Exchange |
$1,610.82
|
| Rate for Payer: UHC Medicaid |
$538.25
|
| Rate for Payer: UHCCP DNSP |
$850.81
|
| Rate for Payer: UHCCP Medicaid |
$538.25
|
|
|
PR PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING
|
Professional
|
Both
|
$528.00
|
|
|
Service Code
|
HCPCS 37197
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$539.17 |
| Rate for Payer: Aetna Commercial |
$356.82
|
| Rate for Payer: Aetna Medicare |
$266.28
|
| Rate for Payer: BCBS Complete |
$177.13
|
| Rate for Payer: BCBS MAPPO |
$266.28
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$266.28
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$383.44
|
| Rate for Payer: Cofinity Commercial |
$356.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.28
|
| Rate for Payer: Healthscope Commercial |
$319.54
|
| Rate for Payer: Healthscope Whirlpool |
$319.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.59
|
| Rate for Payer: Meridian Medicaid |
$177.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$292.91
|
| Rate for Payer: Nomi Health Commercial |
$319.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.00
|
| Rate for Payer: PACE SWMI |
$266.28
|
| Rate for Payer: PHP Medicare Advantage |
$266.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$471.25
|
| Rate for Payer: Priority Health Medicare |
$266.28
|
| Rate for Payer: Priority Health Narrow Network |
$471.25
|
| Rate for Payer: Railroad Medicare Medicare |
$266.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$539.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$266.28
|
| Rate for Payer: UHC Exchange |
$539.17
|
| Rate for Payer: UHC Medicaid |
$168.70
|
| Rate for Payer: UHCCP DNSP |
$266.28
|
| Rate for Payer: UHCCP Medicaid |
$168.70
|
|
|
PR PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN
|
Professional
|
Both
|
$1,896.00
|
|
|
Service Code
|
HCPCS 37187
|
| Min. Negotiated Rate |
$220.46 |
| Max. Negotiated Rate |
$1,422.00 |
| Rate for Payer: Aetna Commercial |
$465.15
|
| Rate for Payer: Aetna Medicare |
$347.13
|
| Rate for Payer: BCBS Complete |
$231.48
|
| Rate for Payer: BCBS MAPPO |
$347.13
|
| Rate for Payer: BCN Commercial |
$574.17
|
| Rate for Payer: BCN Medicare Advantage |
$347.13
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cofinity Commercial |
$499.87
|
| Rate for Payer: Cofinity Commercial |
$465.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.13
|
| Rate for Payer: Healthscope Commercial |
$416.56
|
| Rate for Payer: Healthscope Whirlpool |
$416.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.49
|
| Rate for Payer: Meridian Medicaid |
$231.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$381.84
|
| Rate for Payer: Nomi Health Commercial |
$416.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.00
|
| Rate for Payer: PACE SWMI |
$347.13
|
| Rate for Payer: PHP Medicare Advantage |
$347.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$617.46
|
| Rate for Payer: Priority Health Medicare |
$347.13
|
| Rate for Payer: Priority Health Narrow Network |
$617.46
|
| Rate for Payer: Railroad Medicare Medicare |
$347.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$703.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.13
|
| Rate for Payer: UHC Exchange |
$703.13
|
| Rate for Payer: UHC Medicaid |
$220.46
|
| Rate for Payer: UHCCP DNSP |
$347.13
|
| Rate for Payer: UHCCP Medicaid |
$220.46
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH
|
Professional
|
Both
|
$1,110.00
|
|
|
Service Code
|
HCPCS 92921
|
| Min. Negotiated Rate |
$208.27 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: BCBS Complete |
$444.00
|
| Rate for Payer: BCN Commercial |
$208.27
|
| Rate for Payer: Cash Price |
$888.00
|
| Rate for Payer: Cash Price |
$888.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$832.50
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 92938
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: BCN Commercial |
$231.26
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
|
|
PR PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
HCPCS 92934
|
| Min. Negotiated Rate |
$259.76 |
| Max. Negotiated Rate |
$961.50 |
| Rate for Payer: Aetna Commercial |
$273.84
|
| Rate for Payer: BCBS Complete |
$512.80
|
| Rate for Payer: BCN Commercial |
$259.76
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.50
|
|
|
PR PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH
|
Professional
|
Both
|
$1,249.00
|
|
|
Service Code
|
HCPCS 92929
|
| Min. Negotiated Rate |
$231.39 |
| Max. Negotiated Rate |
$936.75 |
| Rate for Payer: Aetna Commercial |
$352.65
|
| Rate for Payer: BCBS Complete |
$499.60
|
| Rate for Payer: BCN Commercial |
$231.39
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$936.75
|
|
|
PR PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 37188
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$499.08 |
| Rate for Payer: Aetna Commercial |
$337.44
|
| Rate for Payer: Aetna Medicare |
$251.82
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$251.82
|
| Rate for Payer: BCN Commercial |
$412.33
|
| Rate for Payer: BCN Medicare Advantage |
$251.82
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cofinity Commercial |
$362.62
|
| Rate for Payer: Cofinity Commercial |
$337.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.82
|
| Rate for Payer: Healthscope Commercial |
$302.18
|
| Rate for Payer: Healthscope Whirlpool |
$302.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$264.41
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$277.00
|
| Rate for Payer: Nomi Health Commercial |
$302.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$418.50
|
| Rate for Payer: PACE SWMI |
$251.82
|
| Rate for Payer: PHP Medicare Advantage |
$251.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$443.41
|
| Rate for Payer: Priority Health Medicare |
$251.82
|
| Rate for Payer: Priority Health Narrow Network |
$443.41
|
| Rate for Payer: Railroad Medicare Medicare |
$251.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$499.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$251.82
|
| Rate for Payer: UHC Exchange |
$499.08
|
| Rate for Payer: UHC Medicaid |
$159.75
|
| Rate for Payer: UHCCP DNSP |
$251.82
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
|
|
PR PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF
|
Professional
|
Both
|
$9,742.00
|
|
|
Service Code
|
HCPCS 43116
|
| Min. Negotiated Rate |
$2,919.59 |
| Max. Negotiated Rate |
$8,946.87 |
| Rate for Payer: Aetna Commercial |
$6,175.39
|
| Rate for Payer: Aetna Medicare |
$4,608.50
|
| Rate for Payer: BCBS Complete |
$3,065.57
|
| Rate for Payer: BCBS MAPPO |
$4,608.50
|
| Rate for Payer: BCN Commercial |
$7,290.44
|
| Rate for Payer: BCN Medicare Advantage |
$4,608.50
|
| Rate for Payer: Cash Price |
$7,793.60
|
| Rate for Payer: Cash Price |
$7,793.60
|
| Rate for Payer: Cofinity Commercial |
$6,636.24
|
| Rate for Payer: Cofinity Commercial |
$6,175.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,608.50
|
| Rate for Payer: Healthscope Commercial |
$5,530.20
|
| Rate for Payer: Healthscope Whirlpool |
$5,530.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,838.93
|
| Rate for Payer: Meridian Medicaid |
$3,065.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,069.35
|
| Rate for Payer: Nomi Health Commercial |
$5,530.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,306.50
|
| Rate for Payer: PACE SWMI |
$4,608.50
|
| Rate for Payer: PHP Medicare Advantage |
$4,608.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,919.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,882.93
|
| Rate for Payer: Priority Health Medicare |
$4,608.50
|
| Rate for Payer: Priority Health Narrow Network |
$8,882.93
|
| Rate for Payer: Railroad Medicare Medicare |
$4,608.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,946.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,608.50
|
| Rate for Payer: UHC Exchange |
$8,946.87
|
| Rate for Payer: UHC Medicaid |
$2,919.59
|
| Rate for Payer: UHCCP DNSP |
$4,608.50
|
| Rate for Payer: UHCCP Medicaid |
$2,919.59
|
|
|
PR PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY
|
Professional
|
Both
|
$6,190.00
|
|
|
Service Code
|
HCPCS 43121
|
| Min. Negotiated Rate |
$1,708.26 |
| Max. Negotiated Rate |
$5,133.16 |
| Rate for Payer: Aetna Commercial |
$3,594.87
|
| Rate for Payer: Aetna Medicare |
$2,682.74
|
| Rate for Payer: BCBS Complete |
$1,793.67
|
| Rate for Payer: BCBS MAPPO |
$2,682.74
|
| Rate for Payer: BCN Commercial |
$4,212.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,682.74
|
| Rate for Payer: Cash Price |
$4,952.00
|
| Rate for Payer: Cash Price |
$4,952.00
|
| Rate for Payer: Cofinity Commercial |
$3,863.15
|
| Rate for Payer: Cofinity Commercial |
$3,594.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,682.74
|
| Rate for Payer: Healthscope Commercial |
$3,219.29
|
| Rate for Payer: Healthscope Whirlpool |
$3,219.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,816.88
|
| Rate for Payer: Meridian Medicaid |
$1,793.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,951.01
|
| Rate for Payer: Nomi Health Commercial |
$3,219.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,642.50
|
| Rate for Payer: PACE SWMI |
$2,682.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,682.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,708.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,133.16
|
| Rate for Payer: Priority Health Medicare |
$2,682.74
|
| Rate for Payer: Priority Health Narrow Network |
$5,133.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,682.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,094.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,682.74
|
| Rate for Payer: UHC Exchange |
$5,094.88
|
| Rate for Payer: UHC Medicaid |
$1,708.26
|
| Rate for Payer: UHCCP DNSP |
$2,682.74
|
| Rate for Payer: UHCCP Medicaid |
$1,708.26
|
|
|
PR PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY
|
Professional
|
Both
|
$6,524.00
|
|
|
Service Code
|
HCPCS 43117
|
| Min. Negotiated Rate |
$1,931.27 |
| Max. Negotiated Rate |
$5,864.31 |
| Rate for Payer: Aetna Commercial |
$4,059.97
|
| Rate for Payer: Aetna Medicare |
$3,029.83
|
| Rate for Payer: BCBS Complete |
$2,027.83
|
| Rate for Payer: BCBS MAPPO |
$3,029.83
|
| Rate for Payer: BCN Commercial |
$4,812.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,029.83
|
| Rate for Payer: Cash Price |
$5,219.20
|
| Rate for Payer: Cash Price |
$5,219.20
|
| Rate for Payer: Cofinity Commercial |
$4,362.96
|
| Rate for Payer: Cofinity Commercial |
$4,059.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,029.83
|
| Rate for Payer: Healthscope Commercial |
$3,635.80
|
| Rate for Payer: Healthscope Whirlpool |
$3,635.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,181.32
|
| Rate for Payer: Meridian Medicaid |
$2,027.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,332.81
|
| Rate for Payer: Nomi Health Commercial |
$3,635.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,893.00
|
| Rate for Payer: PACE SWMI |
$3,029.83
|
| Rate for Payer: PHP Medicare Advantage |
$3,029.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,931.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,864.31
|
| Rate for Payer: Priority Health Medicare |
$3,029.83
|
| Rate for Payer: Priority Health Narrow Network |
$5,864.31
|
| Rate for Payer: Railroad Medicare Medicare |
$3,029.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,799.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,029.83
|
| Rate for Payer: UHC Exchange |
$5,799.47
|
| Rate for Payer: UHC Medicaid |
$1,931.27
|
| Rate for Payer: UHCCP DNSP |
$3,029.83
|
| Rate for Payer: UHCCP Medicaid |
$1,931.27
|
|
|
PR PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
HCPCS 28122
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$961.50 |
| Rate for Payer: Aetna Commercial |
$542.47
|
| Rate for Payer: Aetna Medicare |
$404.83
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$404.83
|
| Rate for Payer: BCN Commercial |
$667.80
|
| Rate for Payer: BCN Medicare Advantage |
$404.83
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cofinity Commercial |
$582.96
|
| Rate for Payer: Cofinity Commercial |
$542.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.83
|
| Rate for Payer: Healthscope Commercial |
$485.80
|
| Rate for Payer: Healthscope Whirlpool |
$485.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.07
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.31
|
| Rate for Payer: Nomi Health Commercial |
$485.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.50
|
| Rate for Payer: PACE SWMI |
$404.83
|
| Rate for Payer: PHP Medicare Advantage |
$404.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$713.86
|
| Rate for Payer: Priority Health Medicare |
$404.83
|
| Rate for Payer: Priority Health Narrow Network |
$713.86
|
| Rate for Payer: Railroad Medicare Medicare |
$404.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$764.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$404.83
|
| Rate for Payer: UHC Exchange |
$764.90
|
| Rate for Payer: UHC Medicaid |
$265.61
|
| Rate for Payer: UHCCP DNSP |
$404.83
|
| Rate for Payer: UHCCP Medicaid |
$265.61
|
|
|
PR PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA
|
Professional
|
Both
|
$3,402.00
|
|
|
Service Code
|
HCPCS 27360
|
| Min. Negotiated Rate |
$546.35 |
| Max. Negotiated Rate |
$2,551.50 |
| Rate for Payer: Aetna Commercial |
$1,114.65
|
| Rate for Payer: Aetna Medicare |
$831.83
|
| Rate for Payer: BCBS Complete |
$573.67
|
| Rate for Payer: BCBS MAPPO |
$831.83
|
| Rate for Payer: BCN Commercial |
$1,367.95
|
| Rate for Payer: BCN Medicare Advantage |
$831.83
|
| Rate for Payer: Cash Price |
$2,721.60
|
| Rate for Payer: Cash Price |
$2,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,197.84
|
| Rate for Payer: Cofinity Commercial |
$1,114.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$831.83
|
| Rate for Payer: Healthscope Commercial |
$998.20
|
| Rate for Payer: Healthscope Whirlpool |
$998.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$873.42
|
| Rate for Payer: Meridian Medicaid |
$573.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$915.01
|
| Rate for Payer: Nomi Health Commercial |
$998.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,551.50
|
| Rate for Payer: PACE SWMI |
$831.83
|
| Rate for Payer: PHP Medicare Advantage |
$831.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,462.31
|
| Rate for Payer: Priority Health Medicare |
$831.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,462.31
|
| Rate for Payer: Railroad Medicare Medicare |
$831.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,528.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$831.83
|
| Rate for Payer: UHC Exchange |
$1,528.45
|
| Rate for Payer: UHC Medicaid |
$546.35
|
| Rate for Payer: UHCCP DNSP |
$831.83
|
| Rate for Payer: UHCCP Medicaid |
$546.35
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV
|
Professional
|
Both
|
$1,823.00
|
|
|
Service Code
|
HCPCS 22100
|
| Min. Negotiated Rate |
$634.10 |
| Max. Negotiated Rate |
$1,554.40 |
| Rate for Payer: Aetna Commercial |
$1,301.88
|
| Rate for Payer: Aetna Medicare |
$971.55
|
| Rate for Payer: BCBS Complete |
$665.80
|
| Rate for Payer: BCBS MAPPO |
$971.55
|
| Rate for Payer: BCN Commercial |
$1,454.10
|
| Rate for Payer: BCN Medicare Advantage |
$971.55
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cofinity Commercial |
$1,399.03
|
| Rate for Payer: Cofinity Commercial |
$1,301.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.55
|
| Rate for Payer: Healthscope Commercial |
$1,165.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,165.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,020.13
|
| Rate for Payer: Meridian Medicaid |
$665.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,068.70
|
| Rate for Payer: Nomi Health Commercial |
$1,165.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,367.25
|
| Rate for Payer: PACE SWMI |
$971.55
|
| Rate for Payer: PHP Medicare Advantage |
$971.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,554.40
|
| Rate for Payer: Priority Health Medicare |
$971.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,554.40
|
| Rate for Payer: Railroad Medicare Medicare |
$971.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,492.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$971.55
|
| Rate for Payer: UHC Exchange |
$1,492.66
|
| Rate for Payer: UHC Medicaid |
$634.10
|
| Rate for Payer: UHCCP DNSP |
$971.55
|
| Rate for Payer: UHCCP Medicaid |
$634.10
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA
|
Professional
|
Both
|
$676.00
|
|
|
Service Code
|
HCPCS 22103
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$507.00 |
| Rate for Payer: Aetna Commercial |
$155.51
|
| Rate for Payer: Aetna Medicare |
$116.05
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$116.05
|
| Rate for Payer: BCN Commercial |
$198.70
|
| Rate for Payer: BCN Medicare Advantage |
$116.05
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cofinity Commercial |
$167.11
|
| Rate for Payer: Cofinity Commercial |
$155.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.05
|
| Rate for Payer: Healthscope Commercial |
$139.26
|
| Rate for Payer: Healthscope Whirlpool |
$139.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.85
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.66
|
| Rate for Payer: Nomi Health Commercial |
$139.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.00
|
| Rate for Payer: PACE SWMI |
$116.05
|
| Rate for Payer: PHP Medicare Advantage |
$116.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$212.39
|
| Rate for Payer: Priority Health Medicare |
$116.05
|
| Rate for Payer: Priority Health Narrow Network |
$212.39
|
| Rate for Payer: Railroad Medicare Medicare |
$116.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$116.05
|
| Rate for Payer: UHC Exchange |
$250.87
|
| Rate for Payer: UHC Medicaid |
$73.91
|
| Rate for Payer: UHCCP DNSP |
$116.05
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
|
