|
PR PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING
|
Professional
|
Both
|
$2,563.00
|
|
|
Service Code
|
HCPCS 55840
|
| Min. Negotiated Rate |
$685.21 |
| Max. Negotiated Rate |
$1,855.04 |
| Rate for Payer: Aetna Commercial |
$1,501.37
|
| Rate for Payer: Aetna Medicare |
$1,281.50
|
| Rate for Payer: BCBS Complete |
$784.12
|
| Rate for Payer: BCBS Trust/PPO |
$685.21
|
| Rate for Payer: BCN Commercial |
$1,680.56
|
| Rate for Payer: Cash Price |
$2,050.40
|
| Rate for Payer: Cash Price |
$2,050.40
|
| Rate for Payer: Meridian Medicaid |
$784.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$746.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,855.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,855.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,620.10
|
| Rate for Payer: UHC Exchange |
$1,620.10
|
| Rate for Payer: UHCCP Medicaid |
$746.78
|
|
|
PR PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES
|
Professional
|
Both
|
$3,269.00
|
|
|
Service Code
|
HCPCS 55821
|
| Min. Negotiated Rate |
$536.12 |
| Max. Negotiated Rate |
$2,124.85 |
| Rate for Payer: Aetna Commercial |
$1,121.76
|
| Rate for Payer: Aetna Medicare |
$1,634.50
|
| Rate for Payer: BCBS Complete |
$562.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.99
|
| Rate for Payer: BCN Commercial |
$1,208.01
|
| Rate for Payer: Cash Price |
$2,615.20
|
| Rate for Payer: Cash Price |
$2,615.20
|
| Rate for Payer: Meridian Medicaid |
$562.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,332.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,332.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,056.36
|
| Rate for Payer: UHC Exchange |
$1,056.36
|
| Rate for Payer: UHCCP Medicaid |
$536.12
|
|
|
PR PROSTATE NEEDLE BIOPSY ANY APPROACH
|
Professional
|
Both
|
$504.00
|
|
|
Service Code
|
HCPCS 55700
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$2,508.90 |
| Rate for Payer: Aetna Commercial |
$167.16
|
| Rate for Payer: Aetna Medicare |
$252.00
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,508.90
|
| Rate for Payer: BCN Commercial |
$352.33
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$327.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.58
|
| Rate for Payer: Priority Health Narrow Network |
$205.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.08
|
| Rate for Payer: UHC Exchange |
$167.08
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
|
|
PR PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED
|
Professional
|
Both
|
$1,070.00
|
|
|
Service Code
|
HCPCS 55725
|
| Min. Negotiated Rate |
$383.83 |
| Max. Negotiated Rate |
$1,726.48 |
| Rate for Payer: Aetna Commercial |
$761.53
|
| Rate for Payer: Aetna Medicare |
$535.00
|
| Rate for Payer: BCBS Complete |
$403.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,726.48
|
| Rate for Payer: BCN Commercial |
$861.54
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Meridian Medicaid |
$403.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$952.82
|
| Rate for Payer: Priority Health Narrow Network |
$952.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.84
|
| Rate for Payer: UHC Exchange |
$706.84
|
| Rate for Payer: UHCCP Medicaid |
$383.83
|
|
|
PR PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX
|
Professional
|
Both
|
$4,213.00
|
|
|
Service Code
|
HCPCS 55842
|
| Min. Negotiated Rate |
$745.07 |
| Max. Negotiated Rate |
$2,738.45 |
| Rate for Payer: Aetna Commercial |
$1,503.98
|
| Rate for Payer: Aetna Medicare |
$2,106.50
|
| Rate for Payer: BCBS Complete |
$782.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,404.82
|
| Rate for Payer: BCN Commercial |
$1,681.54
|
| Rate for Payer: Cash Price |
$3,370.40
|
| Rate for Payer: Cash Price |
$3,370.40
|
| Rate for Payer: Meridian Medicaid |
$782.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,738.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,853.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,853.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,735.99
|
| Rate for Payer: UHC Exchange |
$1,735.99
|
| Rate for Payer: UHCCP Medicaid |
$745.07
|
|
|
PR PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM
|
Professional
|
Both
|
$2,838.00
|
|
|
Service Code
|
HCPCS 55845
|
| Min. Negotiated Rate |
$867.12 |
| Max. Negotiated Rate |
$2,155.44 |
| Rate for Payer: Aetna Commercial |
$1,747.88
|
| Rate for Payer: Aetna Medicare |
$1,419.00
|
| Rate for Payer: BCBS Complete |
$910.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.15
|
| Rate for Payer: BCN Commercial |
$1,954.71
|
| Rate for Payer: Cash Price |
$2,270.40
|
| Rate for Payer: Cash Price |
$2,270.40
|
| Rate for Payer: Meridian Medicaid |
$910.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$867.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,155.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,155.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,985.45
|
| Rate for Payer: UHC Exchange |
$1,985.45
|
| Rate for Payer: UHCCP Medicaid |
$867.12
|
|
|
PR PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT
|
Professional
|
Both
|
$1,967.00
|
|
|
Service Code
|
HCPCS 23335
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$1,942.32 |
| Rate for Payer: Aetna Commercial |
$1,694.09
|
| Rate for Payer: Aetna Medicare |
$983.50
|
| Rate for Payer: BCBS Complete |
$859.27
|
| Rate for Payer: BCBS Trust/PPO |
$47.12
|
| Rate for Payer: BCN Commercial |
$1,852.09
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Meridian Medicaid |
$859.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,278.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,942.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,942.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,609.73
|
| Rate for Payer: UHC Exchange |
$1,609.73
|
| Rate for Payer: UHCCP Medicaid |
$818.35
|
|
|
PR PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 24160
|
| Min. Negotiated Rate |
$87.70 |
| Max. Negotiated Rate |
$1,927.56 |
| Rate for Payer: Aetna Commercial |
$1,679.78
|
| Rate for Payer: Aetna Medicare |
$1,026.00
|
| Rate for Payer: BCBS Complete |
$854.12
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$1,837.43
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Meridian Medicaid |
$854.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,927.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,927.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.23
|
| Rate for Payer: UHC Exchange |
$684.23
|
| Rate for Payer: UHCCP Medicaid |
$813.45
|
|
|
PR PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT
|
Professional
|
Both
|
$2,533.00
|
|
|
Service Code
|
HCPCS 23334
|
| Min. Negotiated Rate |
$89.15 |
| Max. Negotiated Rate |
$1,646.45 |
| Rate for Payer: Aetna Commercial |
$1,422.34
|
| Rate for Payer: Aetna Medicare |
$1,266.50
|
| Rate for Payer: BCBS Complete |
$723.73
|
| Rate for Payer: BCBS Trust/PPO |
$89.15
|
| Rate for Payer: BCN Commercial |
$1,548.13
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Meridian Medicaid |
$723.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$689.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,626.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,626.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,348.79
|
| Rate for Payer: UHC Exchange |
$1,348.79
|
| Rate for Payer: UHCCP Medicaid |
$689.27
|
|
|
PR PROSTHESIS REMOVAL RADIAL HEAD
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 24164
|
| Min. Negotiated Rate |
$98.26 |
| Max. Negotiated Rate |
$1,486.55 |
| Rate for Payer: Aetna Commercial |
$961.44
|
| Rate for Payer: Aetna Medicare |
$1,143.50
|
| Rate for Payer: BCBS Complete |
$497.85
|
| Rate for Payer: BCBS Trust/PPO |
$98.26
|
| Rate for Payer: BCN Commercial |
$1,067.76
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Meridian Medicaid |
$497.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,122.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.06
|
| Rate for Payer: UHC Exchange |
$561.06
|
| Rate for Payer: UHCCP Medicaid |
$474.14
|
|
|
PR PROSTHESIS SERVICE APHAKIA TEMPORARY
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 92358
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$897.05 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$16.12
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.53
|
| Rate for Payer: Priority Health Narrow Network |
$14.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.05
|
| Rate for Payer: UHC Exchange |
$16.05
|
|
|
PR PROTECTOR HEEL OR ELBOW
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS E0191
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$10.47
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.29
|
| Rate for Payer: UHC Exchange |
$6.29
|
|
|
PR PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
HCPCS 62267
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$908.70 |
| Rate for Payer: Aetna Commercial |
$199.28
|
| Rate for Payer: Aetna Medicare |
$699.00
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS Trust/PPO |
$552.60
|
| Rate for Payer: BCN Commercial |
$391.43
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$908.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.77
|
| Rate for Payer: Priority Health Narrow Network |
$258.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.49
|
| Rate for Payer: UHC Exchange |
$196.49
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
|
|
PR PRQ BALLOON VALVULOPLASTY AORTIC VALVE
|
Professional
|
Both
|
$2,680.00
|
|
|
Service Code
|
HCPCS 92986
|
| Min. Negotiated Rate |
$384.07 |
| Max. Negotiated Rate |
$1,889.23 |
| Rate for Payer: Aetna Commercial |
$1,761.54
|
| Rate for Payer: Aetna Medicare |
$1,340.00
|
| Rate for Payer: BCBS Complete |
$874.25
|
| Rate for Payer: BCBS Trust/PPO |
$384.07
|
| Rate for Payer: BCN Commercial |
$1,889.23
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Meridian Medicaid |
$874.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$832.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,742.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,835.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,835.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.36
|
| Rate for Payer: UHC Exchange |
$1,831.36
|
| Rate for Payer: UHCCP Medicaid |
$832.62
|
|
|
PR PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING
|
Professional
|
Both
|
$1,989.00
|
|
|
Service Code
|
HCPCS 64561
|
| Min. Negotiated Rate |
$193.62 |
| Max. Negotiated Rate |
$1,292.85 |
| Rate for Payer: Aetna Commercial |
$390.63
|
| Rate for Payer: Aetna Medicare |
$994.50
|
| Rate for Payer: BCBS Complete |
$203.30
|
| Rate for Payer: BCBS Trust/PPO |
$449.58
|
| Rate for Payer: BCN Commercial |
$1,084.87
|
| Rate for Payer: Cash Price |
$1,591.20
|
| Rate for Payer: Cash Price |
$1,591.20
|
| Rate for Payer: Meridian Medicaid |
$203.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,292.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.25
|
| Rate for Payer: Priority Health Narrow Network |
$515.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$496.92
|
| Rate for Payer: UHC Exchange |
$496.92
|
| Rate for Payer: UHCCP Medicaid |
$193.62
|
|
|
PR PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 64553
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$3,712.00 |
| Rate for Payer: Aetna Commercial |
$465.57
|
| Rate for Payer: Aetna Medicare |
$227.00
|
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: BCBS Trust/PPO |
$264.15
|
| Rate for Payer: BCN Commercial |
$3,712.00
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.41
|
| Rate for Payer: Priority Health Narrow Network |
$781.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.66
|
| Rate for Payer: UHC Exchange |
$187.66
|
|
|
PR PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 64555
|
| Min. Negotiated Rate |
$176.88 |
| Max. Negotiated Rate |
$3,168.10 |
| Rate for Payer: Aetna Commercial |
$436.80
|
| Rate for Payer: Aetna Medicare |
$249.00
|
| Rate for Payer: BCBS Complete |
$219.40
|
| Rate for Payer: BCBS Trust/PPO |
$200.23
|
| Rate for Payer: BCN Commercial |
$3,168.10
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Meridian Medicaid |
$219.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.51
|
| Rate for Payer: Priority Health Narrow Network |
$550.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.88
|
| Rate for Payer: UHC Exchange |
$176.88
|
| Rate for Payer: UHCCP Medicaid |
$208.95
|
|
|
PR PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL
|
Professional
|
Both
|
$5,346.00
|
|
|
Service Code
|
HCPCS 63650
|
| Min. Negotiated Rate |
$227.17 |
| Max. Negotiated Rate |
$3,474.90 |
| Rate for Payer: Aetna Commercial |
$533.30
|
| Rate for Payer: Aetna Medicare |
$2,673.00
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$3,375.79
|
| Rate for Payer: Cash Price |
$4,276.80
|
| Rate for Payer: Cash Price |
$4,276.80
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,474.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$706.34
|
| Rate for Payer: Priority Health Narrow Network |
$706.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.02
|
| Rate for Payer: UHC Exchange |
$479.02
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
|
|
PR PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL
|
Professional
|
Both
|
$2,470.00
|
|
|
Service Code
|
HCPCS 47533
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$2,075.16 |
| Rate for Payer: Aetna Commercial |
$352.38
|
| Rate for Payer: Aetna Medicare |
$1,235.00
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,075.16
|
| Rate for Payer: BCN Commercial |
$1,723.56
|
| Rate for Payer: Cash Price |
$1,976.00
|
| Rate for Payer: Cash Price |
$1,976.00
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$455.80
|
| Rate for Payer: Priority Health Narrow Network |
$455.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$408.20
|
| Rate for Payer: UHC Exchange |
$408.20
|
| Rate for Payer: UHCCP Medicaid |
$164.22
|
|
|
PR PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 28436
|
| Min. Negotiated Rate |
$325.89 |
| Max. Negotiated Rate |
$775.50 |
| Rate for Payer: Aetna Commercial |
$643.78
|
| Rate for Payer: Aetna Medicare |
$571.00
|
| Rate for Payer: BCBS Complete |
$342.18
|
| Rate for Payer: BCBS Trust/PPO |
$387.77
|
| Rate for Payer: BCN Commercial |
$736.93
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Meridian Medicaid |
$342.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$775.50
|
| Rate for Payer: Priority Health Narrow Network |
$775.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$485.42
|
| Rate for Payer: UHC Exchange |
$485.42
|
| Rate for Payer: UHCCP Medicaid |
$325.89
|
|
|
PR PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 27756
|
| Min. Negotiated Rate |
$386.60 |
| Max. Negotiated Rate |
$2,701.20 |
| Rate for Payer: Aetna Commercial |
$767.95
|
| Rate for Payer: Aetna Medicare |
$829.50
|
| Rate for Payer: BCBS Complete |
$405.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,701.20
|
| Rate for Payer: BCN Commercial |
$853.23
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Meridian Medicaid |
$405.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.13
|
| Rate for Payer: Priority Health Narrow Network |
$898.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$649.08
|
| Rate for Payer: UHC Exchange |
$649.08
|
| Rate for Payer: UHCCP Medicaid |
$386.60
|
|
|
PR PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26650
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$639.26
|
| Rate for Payer: Aetna Medicare |
$770.00
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS Trust/PPO |
$34.87
|
| Rate for Payer: BCN Commercial |
$717.37
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.63
|
| Rate for Payer: Priority Health Narrow Network |
$754.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.91
|
| Rate for Payer: UHC Exchange |
$528.91
|
| Rate for Payer: UHCCP Medicaid |
$319.71
|
|
|
PR PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 28406
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$1,368.30 |
| Rate for Payer: Aetna Commercial |
$736.35
|
| Rate for Payer: Aetna Medicare |
$785.50
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,368.30
|
| Rate for Payer: BCN Commercial |
$833.68
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$919.52
|
| Rate for Payer: Priority Health Narrow Network |
$919.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$593.26
|
| Rate for Payer: UHC Exchange |
$593.26
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
|
|
PR PRQ SKELETAL FIXJ FEMORAL FX DISTAL END
|
Professional
|
Both
|
$2,236.00
|
|
|
Service Code
|
HCPCS 27509
|
| Min. Negotiated Rate |
$441.12 |
| Max. Negotiated Rate |
$1,481.35 |
| Rate for Payer: Aetna Commercial |
$894.48
|
| Rate for Payer: Aetna Medicare |
$1,118.00
|
| Rate for Payer: BCBS Complete |
$463.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.35
|
| Rate for Payer: BCN Commercial |
$1,000.32
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Meridian Medicaid |
$463.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,453.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$728.26
|
| Rate for Payer: UHC Exchange |
$728.26
|
| Rate for Payer: UHCCP Medicaid |
$441.12
|
|
|
PR PRQ SKELETAL FIXJ METACARPAL FX EACH BONE
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26608
|
| Min. Negotiated Rate |
$58.11 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$640.23
|
| Rate for Payer: Aetna Medicare |
$770.00
|
| Rate for Payer: BCBS Complete |
$334.13
|
| Rate for Payer: BCBS Trust/PPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$716.89
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Meridian Medicaid |
$334.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.15
|
| Rate for Payer: Priority Health Narrow Network |
$755.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.88
|
| Rate for Payer: UHC Exchange |
$528.88
|
| Rate for Payer: UHCCP Medicaid |
$318.22
|
|
