|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna Commercial |
$0.67
|
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.50
|
| Rate for Payer: BCN Medicare Advantage |
$0.50
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.72
|
| Rate for Payer: Cofinity Commercial |
$0.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.50
|
| Rate for Payer: Healthscope Commercial |
$0.60
|
| Rate for Payer: Healthscope Whirlpool |
$0.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.53
|
| Rate for Payer: Nomi Health Commercial |
$0.60
|
| Rate for Payer: PACE SWMI |
$0.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.30
|
| Rate for Payer: Priority Health Medicare |
$0.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.50
|
| Rate for Payer: UHC Medicare Advantage |
$0.50
|
| Rate for Payer: UHCCP DNSP |
$0.50
|
|
|
PR PACKING STRIPS, NON-IMPREG
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS A6407
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: Aetna Medicare |
$2.61
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$2.61
|
| Rate for Payer: BCN Medicare Advantage |
$2.61
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$3.76
|
| Rate for Payer: Cofinity Commercial |
$3.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.61
|
| Rate for Payer: Healthscope Commercial |
$3.13
|
| Rate for Payer: Healthscope Whirlpool |
$3.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.74
|
| Rate for Payer: Nomi Health Commercial |
$3.13
|
| Rate for Payer: PACE SWMI |
$2.61
|
| Rate for Payer: PHP Medicare Advantage |
$2.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
| Rate for Payer: Priority Health Medicare |
$2.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.61
|
| Rate for Payer: UHC Medicare Advantage |
$2.61
|
| Rate for Payer: UHCCP DNSP |
$2.61
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,472.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$652.82 |
| Max. Negotiated Rate |
$1,606.80 |
| Rate for Payer: Aetna Commercial |
$874.78
|
| Rate for Payer: Aetna Medicare |
$652.82
|
| Rate for Payer: BCBS Complete |
$988.80
|
| Rate for Payer: BCBS MAPPO |
$652.82
|
| Rate for Payer: BCN Medicare Advantage |
$652.82
|
| Rate for Payer: Cash Price |
$1,977.60
|
| Rate for Payer: Cash Price |
$1,977.60
|
| Rate for Payer: Cofinity Commercial |
$940.06
|
| Rate for Payer: Cofinity Commercial |
$874.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.82
|
| Rate for Payer: Healthscope Commercial |
$783.38
|
| Rate for Payer: Healthscope Whirlpool |
$783.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.46
|
| Rate for Payer: Nomi Health Commercial |
$783.38
|
| Rate for Payer: PACE SWMI |
$652.82
|
| Rate for Payer: PHP Medicare Advantage |
$652.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.80
|
| Rate for Payer: Priority Health Medicare |
$652.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.82
|
| Rate for Payer: UHC Medicare Advantage |
$652.82
|
| Rate for Payer: UHCCP DNSP |
$652.82
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,598.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$3,039.20 |
| Max. Negotiated Rate |
$4,938.70 |
| Rate for Payer: Aetna Medicare |
$3,799.00
|
| Rate for Payer: BCBS Complete |
$3,039.20
|
| Rate for Payer: Cash Price |
$6,078.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,938.70
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,447.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$1,378.80 |
| Max. Negotiated Rate |
$2,338.95 |
| Rate for Payer: Aetna Commercial |
$2,176.52
|
| Rate for Payer: Aetna Medicare |
$1,624.27
|
| Rate for Payer: BCBS Complete |
$1,378.80
|
| Rate for Payer: BCBS MAPPO |
$1,624.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,624.27
|
| Rate for Payer: Cash Price |
$2,757.60
|
| Rate for Payer: Cash Price |
$2,757.60
|
| Rate for Payer: Cofinity Commercial |
$2,338.95
|
| Rate for Payer: Cofinity Commercial |
$2,176.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,624.27
|
| Rate for Payer: Healthscope Commercial |
$1,949.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,949.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,705.48
|
| Rate for Payer: Nomi Health Commercial |
$1,949.12
|
| Rate for Payer: PACE SWMI |
$1,624.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,624.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,240.55
|
| Rate for Payer: Priority Health Medicare |
$1,624.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,624.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,624.27
|
| Rate for Payer: UHCCP DNSP |
$1,624.27
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,272.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$1,308.80 |
| Max. Negotiated Rate |
$2,126.80 |
| Rate for Payer: Aetna Commercial |
$1,755.16
|
| Rate for Payer: Aetna Medicare |
$1,309.82
|
| Rate for Payer: BCBS Complete |
$1,308.80
|
| Rate for Payer: BCBS MAPPO |
$1,309.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,309.82
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Cofinity Commercial |
$1,886.14
|
| Rate for Payer: Cofinity Commercial |
$1,755.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,309.82
|
| Rate for Payer: Healthscope Commercial |
$1,571.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,571.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,375.31
|
| Rate for Payer: Nomi Health Commercial |
$1,571.78
|
| Rate for Payer: PACE SWMI |
$1,309.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,309.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.80
|
| Rate for Payer: Priority Health Medicare |
$1,309.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,309.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,309.82
|
| Rate for Payer: UHCCP DNSP |
$1,309.82
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,535.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$1,919.59 |
| Rate for Payer: Aetna Commercial |
$1,786.29
|
| Rate for Payer: Aetna Medicare |
$1,333.05
|
| Rate for Payer: BCBS Complete |
$1,014.00
|
| Rate for Payer: BCBS MAPPO |
$1,333.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.05
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cofinity Commercial |
$1,919.59
|
| Rate for Payer: Cofinity Commercial |
$1,786.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.05
|
| Rate for Payer: Healthscope Commercial |
$1,599.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,599.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,399.70
|
| Rate for Payer: Nomi Health Commercial |
$1,599.66
|
| Rate for Payer: PACE SWMI |
$1,333.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.75
|
| Rate for Payer: Priority Health Medicare |
$1,333.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.05
|
| Rate for Payer: UHCCP DNSP |
$1,333.05
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$194.00 |
| Max. Negotiated Rate |
$334.37 |
| Rate for Payer: Aetna Commercial |
$311.15
|
| Rate for Payer: Aetna Medicare |
$232.20
|
| Rate for Payer: BCBS Complete |
$194.00
|
| Rate for Payer: BCBS MAPPO |
$232.20
|
| Rate for Payer: BCN Medicare Advantage |
$232.20
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$334.37
|
| Rate for Payer: Cofinity Commercial |
$311.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.20
|
| Rate for Payer: Healthscope Commercial |
$278.64
|
| Rate for Payer: Healthscope Whirlpool |
$278.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.81
|
| Rate for Payer: Nomi Health Commercial |
$278.64
|
| Rate for Payer: PACE SWMI |
$232.20
|
| Rate for Payer: PHP Medicare Advantage |
$232.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health Medicare |
$232.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.20
|
| Rate for Payer: UHC Medicare Advantage |
$232.20
|
| Rate for Payer: UHCCP DNSP |
$232.20
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$3,507.00
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$937.84 |
| Max. Negotiated Rate |
$2,279.55 |
| Rate for Payer: Aetna Commercial |
$1,256.71
|
| Rate for Payer: Aetna Medicare |
$937.84
|
| Rate for Payer: BCBS Complete |
$1,402.80
|
| Rate for Payer: BCBS MAPPO |
$937.84
|
| Rate for Payer: BCN Medicare Advantage |
$937.84
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cofinity Commercial |
$1,350.49
|
| Rate for Payer: Cofinity Commercial |
$1,256.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.84
|
| Rate for Payer: Healthscope Commercial |
$1,125.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,125.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.73
|
| Rate for Payer: Nomi Health Commercial |
$1,125.41
|
| Rate for Payer: PACE SWMI |
$937.84
|
| Rate for Payer: PHP Medicare Advantage |
$937.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,279.55
|
| Rate for Payer: Priority Health Medicare |
$937.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.84
|
| Rate for Payer: UHC Medicare Advantage |
$937.84
|
| Rate for Payer: UHCCP DNSP |
$937.84
|
|
|
PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR
|
Professional
|
Both
|
$3,879.00
|
|
|
Service Code
|
HCPCS 60502
|
| Min. Negotiated Rate |
$1,262.30 |
| Max. Negotiated Rate |
$2,521.35 |
| Rate for Payer: Aetna Commercial |
$1,691.48
|
| Rate for Payer: Aetna Medicare |
$1,262.30
|
| Rate for Payer: BCBS Complete |
$1,551.60
|
| Rate for Payer: BCBS MAPPO |
$1,262.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.30
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cofinity Commercial |
$1,817.71
|
| Rate for Payer: Cofinity Commercial |
$1,691.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.30
|
| Rate for Payer: Healthscope Commercial |
$1,514.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,514.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,325.41
|
| Rate for Payer: Nomi Health Commercial |
$1,514.76
|
| Rate for Payer: PACE SWMI |
$1,262.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,262.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.35
|
| Rate for Payer: Priority Health Medicare |
$1,262.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,262.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,262.30
|
| Rate for Payer: UHCCP DNSP |
$1,262.30
|
|
|
PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 57285
|
| Min. Negotiated Rate |
$663.43 |
| Max. Negotiated Rate |
$1,254.50 |
| Rate for Payer: Aetna Commercial |
$889.00
|
| Rate for Payer: Aetna Medicare |
$663.43
|
| Rate for Payer: BCBS Complete |
$772.00
|
| Rate for Payer: BCBS MAPPO |
$663.43
|
| Rate for Payer: BCN Medicare Advantage |
$663.43
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$955.34
|
| Rate for Payer: Cofinity Commercial |
$889.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.43
|
| Rate for Payer: Healthscope Commercial |
$796.12
|
| Rate for Payer: Healthscope Whirlpool |
$796.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.60
|
| Rate for Payer: Nomi Health Commercial |
$796.12
|
| Rate for Payer: PACE SWMI |
$663.43
|
| Rate for Payer: PHP Medicare Advantage |
$663.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.50
|
| Rate for Payer: Priority Health Medicare |
$663.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.43
|
| Rate for Payer: UHC Medicare Advantage |
$663.43
|
| Rate for Payer: UHCCP DNSP |
$663.43
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$74.75 |
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: Aetna Medicare |
$14.82
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$14.82
|
| Rate for Payer: BCN Medicare Advantage |
$14.82
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$21.34
|
| Rate for Payer: Cofinity Commercial |
$19.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Healthscope Whirlpool |
$17.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.56
|
| Rate for Payer: Nomi Health Commercial |
$17.78
|
| Rate for Payer: PACE SWMI |
$14.82
|
| Rate for Payer: PHP Medicare Advantage |
$14.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.75
|
| Rate for Payer: Priority Health Medicare |
$14.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.82
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UHCCP DNSP |
$14.82
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$21.23 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$28.45
|
| Rate for Payer: Aetna Medicare |
$21.23
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$21.23
|
| Rate for Payer: BCN Medicare Advantage |
$21.23
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$30.57
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.23
|
| Rate for Payer: Healthscope Commercial |
$25.48
|
| Rate for Payer: Healthscope Whirlpool |
$25.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.29
|
| Rate for Payer: Nomi Health Commercial |
$25.48
|
| Rate for Payer: PACE SWMI |
$21.23
|
| Rate for Payer: PHP Medicare Advantage |
$21.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$21.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.23
|
| Rate for Payer: UHC Medicare Advantage |
$21.23
|
| Rate for Payer: UHCCP DNSP |
$21.23
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Commercial |
$36.13
|
| Rate for Payer: Aetna Medicare |
$26.96
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS MAPPO |
$26.96
|
| Rate for Payer: BCN Medicare Advantage |
$26.96
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$38.82
|
| Rate for Payer: Cofinity Commercial |
$36.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.96
|
| Rate for Payer: Healthscope Commercial |
$32.35
|
| Rate for Payer: Healthscope Whirlpool |
$32.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.31
|
| Rate for Payer: Nomi Health Commercial |
$32.35
|
| Rate for Payer: PACE SWMI |
$26.96
|
| Rate for Payer: PHP Medicare Advantage |
$26.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health Medicare |
$26.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.96
|
| Rate for Payer: UHC Medicare Advantage |
$26.96
|
| Rate for Payer: UHCCP DNSP |
$26.96
|
|
|
PR PARTIAL EXCISION BONE CLAVICLE
|
Professional
|
Both
|
$1,421.00
|
|
|
Service Code
|
HCPCS 23180
|
| Min. Negotiated Rate |
$568.40 |
| Max. Negotiated Rate |
$960.58 |
| Rate for Payer: Aetna Commercial |
$893.87
|
| Rate for Payer: Aetna Medicare |
$667.07
|
| Rate for Payer: BCBS Complete |
$568.40
|
| Rate for Payer: BCBS MAPPO |
$667.07
|
| Rate for Payer: BCN Medicare Advantage |
$667.07
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cofinity Commercial |
$960.58
|
| Rate for Payer: Cofinity Commercial |
$893.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.07
|
| Rate for Payer: Healthscope Commercial |
$800.48
|
| Rate for Payer: Healthscope Whirlpool |
$800.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.42
|
| Rate for Payer: Nomi Health Commercial |
$800.48
|
| Rate for Payer: PACE SWMI |
$667.07
|
| Rate for Payer: PHP Medicare Advantage |
$667.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.65
|
| Rate for Payer: Priority Health Medicare |
$667.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.07
|
| Rate for Payer: UHC Medicare Advantage |
$667.07
|
| Rate for Payer: UHCCP DNSP |
$667.07
|
|
|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$632.08 |
| Max. Negotiated Rate |
$1,550.25 |
| Rate for Payer: Aetna Commercial |
$846.99
|
| Rate for Payer: Aetna Medicare |
$632.08
|
| Rate for Payer: BCBS Complete |
$954.00
|
| Rate for Payer: BCBS MAPPO |
$632.08
|
| Rate for Payer: BCN Medicare Advantage |
$632.08
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cofinity Commercial |
$910.20
|
| Rate for Payer: Cofinity Commercial |
$846.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.08
|
| Rate for Payer: Healthscope Commercial |
$758.50
|
| Rate for Payer: Healthscope Whirlpool |
$758.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.68
|
| Rate for Payer: Nomi Health Commercial |
$758.50
|
| Rate for Payer: PACE SWMI |
$632.08
|
| Rate for Payer: PHP Medicare Advantage |
$632.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health Medicare |
$632.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.08
|
| Rate for Payer: UHC Medicare Advantage |
$632.08
|
| Rate for Payer: UHCCP DNSP |
$632.08
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$1,429.00
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$571.60 |
| Max. Negotiated Rate |
$980.01 |
| Rate for Payer: Aetna Commercial |
$911.95
|
| Rate for Payer: Aetna Medicare |
$680.56
|
| Rate for Payer: BCBS Complete |
$571.60
|
| Rate for Payer: BCBS MAPPO |
$680.56
|
| Rate for Payer: BCN Medicare Advantage |
$680.56
|
| Rate for Payer: Cash Price |
$1,143.20
|
| Rate for Payer: Cash Price |
$1,143.20
|
| Rate for Payer: Cofinity Commercial |
$980.01
|
| Rate for Payer: Cofinity Commercial |
$911.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.56
|
| Rate for Payer: Healthscope Commercial |
$816.67
|
| Rate for Payer: Healthscope Whirlpool |
$816.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.59
|
| Rate for Payer: Nomi Health Commercial |
$816.67
|
| Rate for Payer: PACE SWMI |
$680.56
|
| Rate for Payer: PHP Medicare Advantage |
$680.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.85
|
| Rate for Payer: Priority Health Medicare |
$680.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.56
|
| Rate for Payer: UHC Medicare Advantage |
$680.56
|
| Rate for Payer: UHCCP DNSP |
$680.56
|
|
|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$1,454.00
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$945.10 |
| Rate for Payer: Aetna Commercial |
$650.18
|
| Rate for Payer: Aetna Medicare |
$485.21
|
| Rate for Payer: BCBS Complete |
$581.60
|
| Rate for Payer: BCBS MAPPO |
$485.21
|
| Rate for Payer: BCN Medicare Advantage |
$485.21
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cofinity Commercial |
$698.70
|
| Rate for Payer: Cofinity Commercial |
$650.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.21
|
| Rate for Payer: Healthscope Commercial |
$582.25
|
| Rate for Payer: Healthscope Whirlpool |
$582.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.47
|
| Rate for Payer: Nomi Health Commercial |
$582.25
|
| Rate for Payer: PACE SWMI |
$485.21
|
| Rate for Payer: PHP Medicare Advantage |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.10
|
| Rate for Payer: Priority Health Medicare |
$485.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.21
|
| Rate for Payer: UHC Medicare Advantage |
$485.21
|
| Rate for Payer: UHCCP DNSP |
$485.21
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$592.80 |
| Max. Negotiated Rate |
$963.30 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$606.91
|
| Rate for Payer: BCBS Complete |
$592.80
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Healthscope Commercial |
$728.29
|
| Rate for Payer: Healthscope Whirlpool |
$728.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
| Rate for Payer: UHCCP DNSP |
$606.91
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
OP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$963.30 |
| Max. Negotiated Rate |
$4,904.82 |
| Rate for Payer: Aetna Commercial |
$1,333.80
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$1,437.54
|
| Rate for Payer: ASR Commercial |
$1,437.54
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,213.61
|
| Rate for Payer: BCN Commercial |
$1,148.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,393.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,482.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,437.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$1,333.80
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$1,215.24
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,298.53
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,038.88
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,304.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
IP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$963.30 |
| Max. Negotiated Rate |
$1,482.00 |
| Rate for Payer: Aetna Commercial |
$1,333.80
|
| Rate for Payer: ASR ASR |
$1,437.54
|
| Rate for Payer: ASR Commercial |
$1,437.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,207.68
|
| Rate for Payer: BCN Commercial |
$1,148.99
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,393.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Healthscope Commercial |
$1,482.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,437.54
|
| Rate for Payer: Mclaren Commercial |
$1,333.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$1,215.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,304.16
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$592.80 |
| Max. Negotiated Rate |
$963.30 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$606.91
|
| Rate for Payer: BCBS Complete |
$592.80
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Healthscope Commercial |
$728.29
|
| Rate for Payer: Healthscope Whirlpool |
$728.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
| Rate for Payer: UHCCP DNSP |
$606.91
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$665.60 |
| Max. Negotiated Rate |
$1,081.60 |
| Rate for Payer: Aetna Commercial |
$957.26
|
| Rate for Payer: Aetna Medicare |
$714.37
|
| Rate for Payer: BCBS Complete |
$665.60
|
| Rate for Payer: BCBS MAPPO |
$714.37
|
| Rate for Payer: BCN Medicare Advantage |
$714.37
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$957.26
|
| Rate for Payer: Cofinity Commercial |
$1,028.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.37
|
| Rate for Payer: Healthscope Commercial |
$857.24
|
| Rate for Payer: Healthscope Whirlpool |
$857.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.09
|
| Rate for Payer: Nomi Health Commercial |
$857.24
|
| Rate for Payer: PACE SWMI |
$714.37
|
| Rate for Payer: PHP Medicare Advantage |
$714.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.60
|
| Rate for Payer: Priority Health Medicare |
$714.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.37
|
| Rate for Payer: UHC Medicare Advantage |
$714.37
|
| Rate for Payer: UHCCP DNSP |
$714.37
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$566.75 |
| Max. Negotiated Rate |
$1,487.85 |
| Rate for Payer: Aetna Commercial |
$759.45
|
| Rate for Payer: Aetna Medicare |
$566.75
|
| Rate for Payer: BCBS Complete |
$915.60
|
| Rate for Payer: BCBS MAPPO |
$566.75
|
| Rate for Payer: BCN Medicare Advantage |
$566.75
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$816.12
|
| Rate for Payer: Cofinity Commercial |
$759.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.75
|
| Rate for Payer: Healthscope Commercial |
$680.10
|
| Rate for Payer: Healthscope Whirlpool |
$680.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.09
|
| Rate for Payer: Nomi Health Commercial |
$680.10
|
| Rate for Payer: PACE SWMI |
$566.75
|
| Rate for Payer: PHP Medicare Advantage |
$566.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.85
|
| Rate for Payer: Priority Health Medicare |
$566.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.75
|
| Rate for Payer: UHC Medicare Advantage |
$566.75
|
| Rate for Payer: UHCCP DNSP |
$566.75
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$506.00 |
| Max. Negotiated Rate |
$936.09 |
| Rate for Payer: Aetna Commercial |
$871.08
|
| Rate for Payer: Aetna Medicare |
$650.06
|
| Rate for Payer: BCBS Complete |
$506.00
|
| Rate for Payer: BCBS MAPPO |
$650.06
|
| Rate for Payer: BCN Medicare Advantage |
$650.06
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$936.09
|
| Rate for Payer: Cofinity Commercial |
$871.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.06
|
| Rate for Payer: Healthscope Commercial |
$780.07
|
| Rate for Payer: Healthscope Whirlpool |
$780.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.56
|
| Rate for Payer: Nomi Health Commercial |
$780.07
|
| Rate for Payer: PACE SWMI |
$650.06
|
| Rate for Payer: PHP Medicare Advantage |
$650.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.25
|
| Rate for Payer: Priority Health Medicare |
$650.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.06
|
| Rate for Payer: UHC Medicare Advantage |
$650.06
|
| Rate for Payer: UHCCP DNSP |
$650.06
|
|
