|
PR RPR LW IMPERFORATE ANUS W/TRPOS FISTULA
|
Professional
|
Both
|
$3,082.00
|
|
|
Service Code
|
HCPCS 46716
|
| Min. Negotiated Rate |
$774.89 |
| Max. Negotiated Rate |
$2,311.50 |
| Rate for Payer: Aetna Commercial |
$1,597.37
|
| Rate for Payer: Aetna Medicare |
$1,192.07
|
| Rate for Payer: BCBS Complete |
$813.63
|
| Rate for Payer: BCBS MAPPO |
$1,192.07
|
| Rate for Payer: BCN Commercial |
$1,873.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.07
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cofinity Commercial |
$1,716.58
|
| Rate for Payer: Cofinity Commercial |
$1,597.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.07
|
| Rate for Payer: Healthscope Commercial |
$1,430.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,430.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.67
|
| Rate for Payer: Meridian Medicaid |
$813.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.28
|
| Rate for Payer: Nomi Health Commercial |
$1,430.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,311.50
|
| Rate for Payer: PACE SWMI |
$1,192.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,282.63
|
| Rate for Payer: Priority Health Medicare |
$1,192.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,282.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,152.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.07
|
| Rate for Payer: UHC Exchange |
$2,152.36
|
| Rate for Payer: UHC Medicaid |
$774.89
|
| Rate for Payer: UHCCP DNSP |
$1,192.07
|
| Rate for Payer: UHCCP Medicaid |
$774.89
|
|
|
PR RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ
|
Professional
|
Both
|
$10,586.00
|
|
|
Service Code
|
HCPCS 39503
|
| Min. Negotiated Rate |
$3,413.33 |
| Max. Negotiated Rate |
$10,686.96 |
| Rate for Payer: Aetna Commercial |
$7,220.64
|
| Rate for Payer: Aetna Medicare |
$5,388.54
|
| Rate for Payer: BCBS Complete |
$3,584.00
|
| Rate for Payer: BCBS MAPPO |
$5,388.54
|
| Rate for Payer: BCN Commercial |
$8,529.42
|
| Rate for Payer: BCN Medicare Advantage |
$5,388.54
|
| Rate for Payer: Cash Price |
$8,468.80
|
| Rate for Payer: Cash Price |
$8,468.80
|
| Rate for Payer: Cofinity Commercial |
$7,759.50
|
| Rate for Payer: Cofinity Commercial |
$7,220.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,388.54
|
| Rate for Payer: Healthscope Commercial |
$6,466.25
|
| Rate for Payer: Healthscope Whirlpool |
$6,466.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,657.97
|
| Rate for Payer: Meridian Medicaid |
$3,584.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,927.39
|
| Rate for Payer: Nomi Health Commercial |
$6,466.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,939.50
|
| Rate for Payer: PACE SWMI |
$5,388.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,388.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,413.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,172.31
|
| Rate for Payer: Priority Health Medicare |
$5,388.54
|
| Rate for Payer: Priority Health Narrow Network |
$9,172.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5,388.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,686.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,388.54
|
| Rate for Payer: UHC Exchange |
$10,686.96
|
| Rate for Payer: UHC Medicaid |
$3,413.33
|
| Rate for Payer: UHCCP DNSP |
$5,388.54
|
| Rate for Payer: UHCCP Medicaid |
$3,413.33
|
|
|
PR RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 53449
|
| Min. Negotiated Rate |
$356.78 |
| Max. Negotiated Rate |
$1,078.09 |
| Rate for Payer: Aetna Commercial |
$737.43
|
| Rate for Payer: Aetna Medicare |
$550.32
|
| Rate for Payer: BCBS Complete |
$374.62
|
| Rate for Payer: BCBS MAPPO |
$550.32
|
| Rate for Payer: BCN Commercial |
$921.26
|
| Rate for Payer: BCN Medicare Advantage |
$550.32
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cofinity Commercial |
$792.46
|
| Rate for Payer: Cofinity Commercial |
$737.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.32
|
| Rate for Payer: Healthscope Commercial |
$660.38
|
| Rate for Payer: Healthscope Whirlpool |
$660.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.84
|
| Rate for Payer: Meridian Medicaid |
$374.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.35
|
| Rate for Payer: Nomi Health Commercial |
$660.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.00
|
| Rate for Payer: PACE SWMI |
$550.32
|
| Rate for Payer: PHP Medicare Advantage |
$550.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,003.56
|
| Rate for Payer: Priority Health Medicare |
$550.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.56
|
| Rate for Payer: Railroad Medicare Medicare |
$550.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,078.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.32
|
| Rate for Payer: UHC Exchange |
$1,078.09
|
| Rate for Payer: UHC Medicaid |
$356.78
|
| Rate for Payer: UHCCP DNSP |
$550.32
|
| Rate for Payer: UHCCP Medicaid |
$356.78
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE
|
Professional
|
Both
|
$3,981.00
|
|
|
Service Code
|
HCPCS 27472
|
| Min. Negotiated Rate |
$737.19 |
| Max. Negotiated Rate |
$2,985.75 |
| Rate for Payer: Aetna Commercial |
$1,522.86
|
| Rate for Payer: Aetna Medicare |
$1,136.46
|
| Rate for Payer: BCBS Complete |
$774.05
|
| Rate for Payer: BCBS MAPPO |
$1,136.46
|
| Rate for Payer: BCN Commercial |
$1,913.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.46
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,636.50
|
| Rate for Payer: Cofinity Commercial |
$1,522.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.46
|
| Rate for Payer: Healthscope Commercial |
$1,363.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,363.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,193.28
|
| Rate for Payer: Meridian Medicaid |
$774.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,250.11
|
| Rate for Payer: Nomi Health Commercial |
$1,363.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,985.75
|
| Rate for Payer: PACE SWMI |
$1,136.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$737.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,045.20
|
| Rate for Payer: Priority Health Medicare |
$1,136.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,136.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,217.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,136.46
|
| Rate for Payer: UHC Exchange |
$2,217.60
|
| Rate for Payer: UHC Medicaid |
$737.19
|
| Rate for Payer: UHCCP DNSP |
$1,136.46
|
| Rate for Payer: UHCCP Medicaid |
$737.19
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/O GRF
|
Professional
|
Both
|
$3,015.00
|
|
|
Service Code
|
HCPCS 27470
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$2,261.25 |
| Rate for Payer: Aetna Commercial |
$1,427.03
|
| Rate for Payer: Aetna Medicare |
$1,064.95
|
| Rate for Payer: BCBS Complete |
$726.64
|
| Rate for Payer: BCBS MAPPO |
$1,064.95
|
| Rate for Payer: BCN Commercial |
$1,787.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.95
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cash Price |
$2,412.00
|
| Rate for Payer: Cofinity Commercial |
$1,533.53
|
| Rate for Payer: Cofinity Commercial |
$1,427.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.95
|
| Rate for Payer: Healthscope Commercial |
$1,277.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,277.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,118.20
|
| Rate for Payer: Meridian Medicaid |
$726.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,171.44
|
| Rate for Payer: Nomi Health Commercial |
$1,277.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,261.25
|
| Rate for Payer: PACE SWMI |
$1,064.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,910.53
|
| Rate for Payer: Priority Health Medicare |
$1,064.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,910.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,064.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,065.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,064.95
|
| Rate for Payer: UHC Exchange |
$2,065.19
|
| Rate for Payer: UHC Medicaid |
$692.04
|
| Rate for Payer: UHCCP DNSP |
$1,064.95
|
| Rate for Payer: UHCCP Medicaid |
$692.04
|
|
|
PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH
|
Professional
|
Both
|
$5,584.00
|
|
|
Service Code
|
HCPCS 27725
|
| Min. Negotiated Rate |
$716.53 |
| Max. Negotiated Rate |
$4,188.00 |
| Rate for Payer: Aetna Commercial |
$1,475.62
|
| Rate for Payer: Aetna Medicare |
$1,101.21
|
| Rate for Payer: BCBS Complete |
$752.36
|
| Rate for Payer: BCBS MAPPO |
$1,101.21
|
| Rate for Payer: BCN Commercial |
$1,845.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.21
|
| Rate for Payer: Cash Price |
$4,467.20
|
| Rate for Payer: Cash Price |
$4,467.20
|
| Rate for Payer: Cofinity Commercial |
$1,585.74
|
| Rate for Payer: Cofinity Commercial |
$1,475.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.21
|
| Rate for Payer: Healthscope Commercial |
$1,321.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,321.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,156.27
|
| Rate for Payer: Meridian Medicaid |
$752.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,211.33
|
| Rate for Payer: Nomi Health Commercial |
$1,321.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,188.00
|
| Rate for Payer: PACE SWMI |
$1,101.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,972.28
|
| Rate for Payer: Priority Health Medicare |
$1,101.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,972.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,101.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,129.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,101.21
|
| Rate for Payer: UHC Exchange |
$2,129.06
|
| Rate for Payer: UHC Medicaid |
$716.53
|
| Rate for Payer: UHCCP DNSP |
$1,101.21
|
| Rate for Payer: UHCCP Medicaid |
$716.53
|
|
|
PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT
|
Professional
|
Both
|
$4,914.00
|
|
|
Service Code
|
HCPCS 27724
|
| Min. Negotiated Rate |
$723.56 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$1,499.73
|
| Rate for Payer: Aetna Medicare |
$1,119.20
|
| Rate for Payer: BCBS Complete |
$759.74
|
| Rate for Payer: BCBS MAPPO |
$1,119.20
|
| Rate for Payer: BCN Commercial |
$1,892.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.20
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,611.65
|
| Rate for Payer: Cofinity Commercial |
$1,499.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.20
|
| Rate for Payer: Healthscope Commercial |
$1,343.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,343.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,175.16
|
| Rate for Payer: Meridian Medicaid |
$759.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,231.12
|
| Rate for Payer: Nomi Health Commercial |
$1,343.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,685.50
|
| Rate for Payer: PACE SWMI |
$1,119.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$723.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,022.85
|
| Rate for Payer: Priority Health Medicare |
$1,119.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,022.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,119.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,216.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,119.20
|
| Rate for Payer: UHC Exchange |
$2,216.12
|
| Rate for Payer: UHC Medicaid |
$723.56
|
| Rate for Payer: UHCCP DNSP |
$1,119.20
|
| Rate for Payer: UHCCP Medicaid |
$723.56
|
|
|
PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 28322
|
| Min. Negotiated Rate |
$344.63 |
| Max. Negotiated Rate |
$1,016.25 |
| Rate for Payer: Aetna Commercial |
$706.23
|
| Rate for Payer: Aetna Medicare |
$527.04
|
| Rate for Payer: BCBS Complete |
$361.86
|
| Rate for Payer: BCBS MAPPO |
$527.04
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: BCN Medicare Advantage |
$527.04
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$758.94
|
| Rate for Payer: Cofinity Commercial |
$706.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.04
|
| Rate for Payer: Healthscope Commercial |
$632.45
|
| Rate for Payer: Healthscope Whirlpool |
$632.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.39
|
| Rate for Payer: Meridian Medicaid |
$361.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.74
|
| Rate for Payer: Nomi Health Commercial |
$632.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,016.25
|
| Rate for Payer: PACE SWMI |
$527.04
|
| Rate for Payer: PHP Medicare Advantage |
$527.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$937.97
|
| Rate for Payer: Priority Health Medicare |
$527.04
|
| Rate for Payer: Priority Health Narrow Network |
$937.97
|
| Rate for Payer: Railroad Medicare Medicare |
$527.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,003.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.04
|
| Rate for Payer: UHC Exchange |
$1,003.58
|
| Rate for Payer: UHC Medicaid |
$344.63
|
| Rate for Payer: UHCCP DNSP |
$527.04
|
| Rate for Payer: UHCCP Medicaid |
$344.63
|
|
|
PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS
|
Professional
|
Both
|
$7,236.00
|
|
|
Service Code
|
HCPCS 33496
|
| Min. Negotiated Rate |
$1,011.75 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Commercial |
$2,121.76
|
| Rate for Payer: Aetna Medicare |
$1,583.40
|
| Rate for Payer: BCBS Complete |
$1,062.34
|
| Rate for Payer: BCBS MAPPO |
$1,583.40
|
| Rate for Payer: BCN Commercial |
$2,446.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,583.40
|
| Rate for Payer: Cash Price |
$5,788.80
|
| Rate for Payer: Cash Price |
$5,788.80
|
| Rate for Payer: Cofinity Commercial |
$2,280.10
|
| Rate for Payer: Cofinity Commercial |
$2,121.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,583.40
|
| Rate for Payer: Healthscope Commercial |
$1,900.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,900.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,662.57
|
| Rate for Payer: Meridian Medicaid |
$1,062.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,741.74
|
| Rate for Payer: Nomi Health Commercial |
$1,900.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,427.00
|
| Rate for Payer: PACE SWMI |
$1,583.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,583.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,011.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,630.98
|
| Rate for Payer: Priority Health Medicare |
$1,583.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,630.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,583.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,963.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,583.40
|
| Rate for Payer: UHC Exchange |
$2,963.53
|
| Rate for Payer: UHC Medicaid |
$1,011.75
|
| Rate for Payer: UHCCP DNSP |
$1,583.40
|
| Rate for Payer: UHCCP Medicaid |
$1,011.75
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$3,338.00
|
|
|
Service Code
|
HCPCS 25405
|
| Min. Negotiated Rate |
$598.96 |
| Max. Negotiated Rate |
$2,503.50 |
| Rate for Payer: Aetna Commercial |
$1,233.79
|
| Rate for Payer: Aetna Medicare |
$920.74
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$920.74
|
| Rate for Payer: BCN Commercial |
$1,577.10
|
| Rate for Payer: BCN Medicare Advantage |
$920.74
|
| Rate for Payer: Cash Price |
$2,670.40
|
| Rate for Payer: Cash Price |
$2,670.40
|
| Rate for Payer: Cofinity Commercial |
$1,325.87
|
| Rate for Payer: Cofinity Commercial |
$1,233.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$920.74
|
| Rate for Payer: Healthscope Commercial |
$1,104.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,104.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$966.78
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,012.81
|
| Rate for Payer: Nomi Health Commercial |
$1,104.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,503.50
|
| Rate for Payer: PACE SWMI |
$920.74
|
| Rate for Payer: PHP Medicare Advantage |
$920.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,685.88
|
| Rate for Payer: Priority Health Medicare |
$920.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,685.88
|
| Rate for Payer: Railroad Medicare Medicare |
$920.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,815.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$920.74
|
| Rate for Payer: UHC Exchange |
$1,815.66
|
| Rate for Payer: UHC Medicaid |
$598.96
|
| Rate for Payer: UHCCP DNSP |
$920.74
|
| Rate for Payer: UHCCP Medicaid |
$598.96
|
|
|
PR RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF
|
Professional
|
Both
|
$3,373.00
|
|
|
Service Code
|
HCPCS 25415
|
| Min. Negotiated Rate |
$571.05 |
| Max. Negotiated Rate |
$2,529.75 |
| Rate for Payer: Aetna Commercial |
$1,175.70
|
| Rate for Payer: Aetna Medicare |
$877.39
|
| Rate for Payer: BCBS Complete |
$599.60
|
| Rate for Payer: BCBS MAPPO |
$877.39
|
| Rate for Payer: BCN Commercial |
$1,471.04
|
| Rate for Payer: BCN Medicare Advantage |
$877.39
|
| Rate for Payer: Cash Price |
$2,698.40
|
| Rate for Payer: Cash Price |
$2,698.40
|
| Rate for Payer: Cofinity Commercial |
$1,263.44
|
| Rate for Payer: Cofinity Commercial |
$1,175.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$877.39
|
| Rate for Payer: Healthscope Commercial |
$1,052.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,052.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$921.26
|
| Rate for Payer: Meridian Medicaid |
$599.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$965.13
|
| Rate for Payer: Nomi Health Commercial |
$1,052.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,529.75
|
| Rate for Payer: PACE SWMI |
$877.39
|
| Rate for Payer: PHP Medicare Advantage |
$877.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,572.50
|
| Rate for Payer: Priority Health Medicare |
$877.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,572.50
|
| Rate for Payer: Railroad Medicare Medicare |
$877.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,695.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$877.39
|
| Rate for Payer: UHC Exchange |
$1,695.21
|
| Rate for Payer: UHC Medicaid |
$571.05
|
| Rate for Payer: UHCCP DNSP |
$877.39
|
| Rate for Payer: UHCCP Medicaid |
$571.05
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT
|
Professional
|
Both
|
$2,712.00
|
|
|
Service Code
|
HCPCS 25400
|
| Min. Negotiated Rate |
$470.09 |
| Max. Negotiated Rate |
$2,034.00 |
| Rate for Payer: Aetna Commercial |
$965.56
|
| Rate for Payer: Aetna Medicare |
$720.57
|
| Rate for Payer: BCBS Complete |
$493.59
|
| Rate for Payer: BCBS MAPPO |
$720.57
|
| Rate for Payer: BCN Commercial |
$1,223.54
|
| Rate for Payer: BCN Medicare Advantage |
$720.57
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cofinity Commercial |
$965.56
|
| Rate for Payer: Cofinity Commercial |
$1,037.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$720.57
|
| Rate for Payer: Healthscope Commercial |
$864.68
|
| Rate for Payer: Healthscope Whirlpool |
$864.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$756.60
|
| Rate for Payer: Meridian Medicaid |
$493.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$792.63
|
| Rate for Payer: Nomi Health Commercial |
$864.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,034.00
|
| Rate for Payer: PACE SWMI |
$720.57
|
| Rate for Payer: PHP Medicare Advantage |
$720.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,307.92
|
| Rate for Payer: Priority Health Medicare |
$720.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.92
|
| Rate for Payer: Railroad Medicare Medicare |
$720.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,402.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$720.57
|
| Rate for Payer: UHC Exchange |
$1,402.49
|
| Rate for Payer: UHC Medicaid |
$470.09
|
| Rate for Payer: UHCCP DNSP |
$720.57
|
| Rate for Payer: UHCCP Medicaid |
$470.09
|
|
|
PR RPR NON-UNION MTCRPL/PHALANX
|
Professional
|
Both
|
$2,172.00
|
|
|
Service Code
|
HCPCS 26546
|
| Min. Negotiated Rate |
$633.46 |
| Max. Negotiated Rate |
$1,730.93 |
| Rate for Payer: Aetna Commercial |
$1,275.92
|
| Rate for Payer: Aetna Medicare |
$952.18
|
| Rate for Payer: BCBS Complete |
$665.13
|
| Rate for Payer: BCBS MAPPO |
$952.18
|
| Rate for Payer: BCN Commercial |
$1,580.09
|
| Rate for Payer: BCN Medicare Advantage |
$952.18
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cofinity Commercial |
$1,371.14
|
| Rate for Payer: Cofinity Commercial |
$1,275.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$952.18
|
| Rate for Payer: Healthscope Commercial |
$1,142.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,142.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$999.79
|
| Rate for Payer: Meridian Medicaid |
$665.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,047.40
|
| Rate for Payer: Nomi Health Commercial |
$1,142.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.00
|
| Rate for Payer: PACE SWMI |
$952.18
|
| Rate for Payer: PHP Medicare Advantage |
$952.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,689.07
|
| Rate for Payer: Priority Health Medicare |
$952.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,689.07
|
| Rate for Payer: Railroad Medicare Medicare |
$952.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,730.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$952.18
|
| Rate for Payer: UHC Exchange |
$1,730.93
|
| Rate for Payer: UHC Medicaid |
$633.46
|
| Rate for Payer: UHCCP DNSP |
$952.18
|
| Rate for Payer: UHCCP Medicaid |
$633.46
|
|
|
PR RPR NONUNION SCAPHOID CARPAL B1 W/WO RDL STYLODC
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 25440
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$1,338.53 |
| Rate for Payer: Aetna Commercial |
$922.08
|
| Rate for Payer: Aetna Medicare |
$688.12
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS MAPPO |
$688.12
|
| Rate for Payer: BCN Commercial |
$1,175.24
|
| Rate for Payer: BCN Medicare Advantage |
$688.12
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cofinity Commercial |
$990.89
|
| Rate for Payer: Cofinity Commercial |
$922.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.12
|
| Rate for Payer: Healthscope Commercial |
$825.74
|
| Rate for Payer: Healthscope Whirlpool |
$825.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.53
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$756.93
|
| Rate for Payer: Nomi Health Commercial |
$825.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,062.75
|
| Rate for Payer: PACE SWMI |
$688.12
|
| Rate for Payer: PHP Medicare Advantage |
$688.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,256.30
|
| Rate for Payer: Priority Health Medicare |
$688.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,256.30
|
| Rate for Payer: Railroad Medicare Medicare |
$688.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,338.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.12
|
| Rate for Payer: UHC Exchange |
$1,338.53
|
| Rate for Payer: UHC Medicaid |
$449.43
|
| Rate for Payer: UHCCP DNSP |
$688.12
|
| Rate for Payer: UHCCP Medicaid |
$449.43
|
|
|
PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
HCPCS 30468
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$192.67
|
| Rate for Payer: Aetna Medicare |
$143.78
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$143.78
|
| Rate for Payer: BCN Commercial |
$253.47
|
| Rate for Payer: BCN Medicare Advantage |
$143.78
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cofinity Commercial |
$207.04
|
| Rate for Payer: Cofinity Commercial |
$192.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.78
|
| Rate for Payer: Healthscope Commercial |
$172.54
|
| Rate for Payer: Healthscope Whirlpool |
$172.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.97
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.16
|
| Rate for Payer: Nomi Health Commercial |
$172.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.00
|
| Rate for Payer: PACE SWMI |
$143.78
|
| Rate for Payer: PHP Medicare Advantage |
$143.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$238.69
|
| Rate for Payer: Priority Health Medicare |
$143.78
|
| Rate for Payer: Priority Health Narrow Network |
$238.69
|
| Rate for Payer: Railroad Medicare Medicare |
$143.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.78
|
| Rate for Payer: UHC Exchange |
$302.57
|
| Rate for Payer: UHC Medicaid |
$92.87
|
| Rate for Payer: UHCCP DNSP |
$143.78
|
| Rate for Payer: UHCCP Medicaid |
$92.87
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$869.89 |
| Max. Negotiated Rate |
$2,606.02 |
| Rate for Payer: Aetna Commercial |
$1,828.12
|
| Rate for Payer: Aetna Medicare |
$1,364.27
|
| Rate for Payer: BCBS Complete |
$913.38
|
| Rate for Payer: BCBS MAPPO |
$1,364.27
|
| Rate for Payer: BCN Commercial |
$2,138.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,364.27
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,964.55
|
| Rate for Payer: Cofinity Commercial |
$1,828.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,364.27
|
| Rate for Payer: Healthscope Commercial |
$1,637.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,637.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,432.48
|
| Rate for Payer: Meridian Medicaid |
$913.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,500.70
|
| Rate for Payer: Nomi Health Commercial |
$1,637.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$1,364.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,364.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$869.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,606.02
|
| Rate for Payer: Priority Health Medicare |
$1,364.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,606.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,364.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,583.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,364.27
|
| Rate for Payer: UHC Exchange |
$2,583.69
|
| Rate for Payer: UHC Medicaid |
$869.89
|
| Rate for Payer: UHCCP DNSP |
$1,364.27
|
| Rate for Payer: UHCCP Medicaid |
$869.89
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$2,182.00
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$687.35 |
| Max. Negotiated Rate |
$2,090.89 |
| Rate for Payer: Aetna Commercial |
$1,440.33
|
| Rate for Payer: Aetna Medicare |
$1,074.87
|
| Rate for Payer: BCBS Complete |
$721.72
|
| Rate for Payer: BCBS MAPPO |
$1,074.87
|
| Rate for Payer: BCN Commercial |
$1,716.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,074.87
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Cofinity Commercial |
$1,547.81
|
| Rate for Payer: Cofinity Commercial |
$1,440.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,074.87
|
| Rate for Payer: Healthscope Commercial |
$1,289.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,289.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,128.61
|
| Rate for Payer: Meridian Medicaid |
$721.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,182.36
|
| Rate for Payer: Nomi Health Commercial |
$1,289.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,636.50
|
| Rate for Payer: PACE SWMI |
$1,074.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,074.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,090.89
|
| Rate for Payer: Priority Health Medicare |
$1,074.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,090.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,074.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,066.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,074.87
|
| Rate for Payer: UHC Exchange |
$2,066.11
|
| Rate for Payer: UHC Medicaid |
$687.35
|
| Rate for Payer: UHCCP DNSP |
$1,074.87
|
| Rate for Payer: UHCCP Medicaid |
$687.35
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH
|
Professional
|
Both
|
$2,885.00
|
|
|
Service Code
|
HCPCS 43335
|
| Min. Negotiated Rate |
$798.96 |
| Max. Negotiated Rate |
$2,397.90 |
| Rate for Payer: Aetna Commercial |
$1,680.63
|
| Rate for Payer: Aetna Medicare |
$1,254.20
|
| Rate for Payer: BCBS Complete |
$838.91
|
| Rate for Payer: BCBS MAPPO |
$1,254.20
|
| Rate for Payer: BCN Commercial |
$1,968.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,254.20
|
| Rate for Payer: Cash Price |
$2,308.00
|
| Rate for Payer: Cash Price |
$2,308.00
|
| Rate for Payer: Cofinity Commercial |
$1,806.05
|
| Rate for Payer: Cofinity Commercial |
$1,680.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,254.20
|
| Rate for Payer: Healthscope Commercial |
$1,505.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,505.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,316.91
|
| Rate for Payer: Meridian Medicaid |
$838.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,379.62
|
| Rate for Payer: Nomi Health Commercial |
$1,505.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,163.75
|
| Rate for Payer: PACE SWMI |
$1,254.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,254.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$798.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,397.90
|
| Rate for Payer: Priority Health Medicare |
$1,254.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,397.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,254.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,383.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,254.20
|
| Rate for Payer: UHC Exchange |
$2,383.31
|
| Rate for Payer: UHC Medicaid |
$798.96
|
| Rate for Payer: UHCCP DNSP |
$1,254.20
|
| Rate for Payer: UHCCP Medicaid |
$798.96
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH
|
Professional
|
Both
|
$3,542.00
|
|
|
Service Code
|
HCPCS 43334
|
| Min. Negotiated Rate |
$744.01 |
| Max. Negotiated Rate |
$2,656.50 |
| Rate for Payer: Aetna Commercial |
$1,564.03
|
| Rate for Payer: Aetna Medicare |
$1,167.19
|
| Rate for Payer: BCBS Complete |
$781.21
|
| Rate for Payer: BCBS MAPPO |
$1,167.19
|
| Rate for Payer: BCN Commercial |
$1,834.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,167.19
|
| Rate for Payer: Cash Price |
$2,833.60
|
| Rate for Payer: Cash Price |
$2,833.60
|
| Rate for Payer: Cofinity Commercial |
$1,680.75
|
| Rate for Payer: Cofinity Commercial |
$1,564.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,167.19
|
| Rate for Payer: Healthscope Commercial |
$1,400.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,400.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,225.55
|
| Rate for Payer: Meridian Medicaid |
$781.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,283.91
|
| Rate for Payer: Nomi Health Commercial |
$1,400.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,656.50
|
| Rate for Payer: PACE SWMI |
$1,167.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,167.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$744.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,234.68
|
| Rate for Payer: Priority Health Medicare |
$1,167.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,234.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,167.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,225.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,167.19
|
| Rate for Payer: UHC Exchange |
$2,225.84
|
| Rate for Payer: UHC Medicaid |
$744.01
|
| Rate for Payer: UHCCP DNSP |
$1,167.19
|
| Rate for Payer: UHCCP Medicaid |
$744.01
|
|
|
PR RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Professional
|
Both
|
$1,597.00
|
|
|
Service Code
|
HCPCS 49621
|
| Min. Negotiated Rate |
$435.80 |
| Max. Negotiated Rate |
$1,373.69 |
| Rate for Payer: Aetna Commercial |
$918.64
|
| Rate for Payer: Aetna Medicare |
$685.55
|
| Rate for Payer: BCBS Complete |
$457.59
|
| Rate for Payer: BCBS MAPPO |
$685.55
|
| Rate for Payer: BCN Commercial |
$1,127.43
|
| Rate for Payer: BCN Medicare Advantage |
$685.55
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cofinity Commercial |
$987.19
|
| Rate for Payer: Cofinity Commercial |
$918.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.55
|
| Rate for Payer: Healthscope Commercial |
$822.66
|
| Rate for Payer: Healthscope Whirlpool |
$822.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.83
|
| Rate for Payer: Meridian Medicaid |
$457.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.11
|
| Rate for Payer: Nomi Health Commercial |
$822.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,197.75
|
| Rate for Payer: PACE SWMI |
$685.55
|
| Rate for Payer: PHP Medicare Advantage |
$685.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,373.69
|
| Rate for Payer: Priority Health Medicare |
$685.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,373.69
|
| Rate for Payer: Railroad Medicare Medicare |
$685.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,358.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$685.55
|
| Rate for Payer: UHC Exchange |
$1,358.97
|
| Rate for Payer: UHC Medicaid |
$435.80
|
| Rate for Payer: UHCCP DNSP |
$685.55
|
| Rate for Payer: UHCCP Medicaid |
$435.80
|
|
|
PR RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,968.00
|
|
|
Service Code
|
HCPCS 49622
|
| Min. Negotiated Rate |
$541.87 |
| Max. Negotiated Rate |
$1,708.63 |
| Rate for Payer: Aetna Commercial |
$1,143.96
|
| Rate for Payer: Aetna Medicare |
$853.70
|
| Rate for Payer: BCBS Complete |
$568.96
|
| Rate for Payer: BCBS MAPPO |
$853.70
|
| Rate for Payer: BCN Commercial |
$1,402.31
|
| Rate for Payer: BCN Medicare Advantage |
$853.70
|
| Rate for Payer: Cash Price |
$1,574.40
|
| Rate for Payer: Cash Price |
$1,574.40
|
| Rate for Payer: Cofinity Commercial |
$1,229.33
|
| Rate for Payer: Cofinity Commercial |
$1,143.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.70
|
| Rate for Payer: Healthscope Commercial |
$1,024.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,024.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$896.38
|
| Rate for Payer: Meridian Medicaid |
$568.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$939.07
|
| Rate for Payer: Nomi Health Commercial |
$1,024.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.00
|
| Rate for Payer: PACE SWMI |
$853.70
|
| Rate for Payer: PHP Medicare Advantage |
$853.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,708.63
|
| Rate for Payer: Priority Health Medicare |
$853.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,708.63
|
| Rate for Payer: Railroad Medicare Medicare |
$853.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,677.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$853.70
|
| Rate for Payer: UHC Exchange |
$1,677.57
|
| Rate for Payer: UHC Medicaid |
$541.87
|
| Rate for Payer: UHCCP DNSP |
$853.70
|
| Rate for Payer: UHCCP Medicaid |
$541.87
|
|
|
PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS
|
Professional
|
Both
|
$7,791.00
|
|
|
Service Code
|
HCPCS 33925
|
| Min. Negotiated Rate |
$1,019.42 |
| Max. Negotiated Rate |
$5,843.25 |
| Rate for Payer: Aetna Commercial |
$2,148.90
|
| Rate for Payer: Aetna Medicare |
$1,603.66
|
| Rate for Payer: BCBS Complete |
$1,070.39
|
| Rate for Payer: BCBS MAPPO |
$1,603.66
|
| Rate for Payer: BCN Commercial |
$2,522.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,603.66
|
| Rate for Payer: Cash Price |
$6,232.80
|
| Rate for Payer: Cash Price |
$6,232.80
|
| Rate for Payer: Cofinity Commercial |
$2,309.27
|
| Rate for Payer: Cofinity Commercial |
$2,148.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,603.66
|
| Rate for Payer: Healthscope Commercial |
$1,924.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,924.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,683.84
|
| Rate for Payer: Meridian Medicaid |
$1,070.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,764.03
|
| Rate for Payer: Nomi Health Commercial |
$1,924.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,843.25
|
| Rate for Payer: PACE SWMI |
$1,603.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,603.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,019.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,712.39
|
| Rate for Payer: Priority Health Medicare |
$1,603.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,712.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,603.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,062.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,603.66
|
| Rate for Payer: UHC Exchange |
$3,062.70
|
| Rate for Payer: UHC Medicaid |
$1,019.42
|
| Rate for Payer: UHCCP DNSP |
$1,603.66
|
| Rate for Payer: UHCCP Medicaid |
$1,019.42
|
|
|
PR RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT
|
Professional
|
Both
|
$6,052.00
|
|
|
Service Code
|
HCPCS 33545
|
| Min. Negotiated Rate |
$1,829.03 |
| Max. Negotiated Rate |
$5,491.77 |
| Rate for Payer: Aetna Commercial |
$3,854.71
|
| Rate for Payer: Aetna Medicare |
$2,876.65
|
| Rate for Payer: BCBS Complete |
$1,920.48
|
| Rate for Payer: BCBS MAPPO |
$2,876.65
|
| Rate for Payer: BCN Commercial |
$4,483.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,876.65
|
| Rate for Payer: Cash Price |
$4,841.60
|
| Rate for Payer: Cash Price |
$4,841.60
|
| Rate for Payer: Cofinity Commercial |
$4,142.38
|
| Rate for Payer: Cofinity Commercial |
$3,854.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,876.65
|
| Rate for Payer: Healthscope Commercial |
$3,451.98
|
| Rate for Payer: Healthscope Whirlpool |
$3,451.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,020.48
|
| Rate for Payer: Meridian Medicaid |
$1,920.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,164.32
|
| Rate for Payer: Nomi Health Commercial |
$3,451.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,539.00
|
| Rate for Payer: PACE SWMI |
$2,876.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,876.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,829.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,821.78
|
| Rate for Payer: Priority Health Medicare |
$2,876.65
|
| Rate for Payer: Priority Health Narrow Network |
$4,821.78
|
| Rate for Payer: Railroad Medicare Medicare |
$2,876.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,491.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,876.65
|
| Rate for Payer: UHC Exchange |
$5,491.77
|
| Rate for Payer: UHC Medicaid |
$1,829.03
|
| Rate for Payer: UHCCP DNSP |
$2,876.65
|
| Rate for Payer: UHCCP Medicaid |
$1,829.03
|
|
|
PR RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL
|
Professional
|
Both
|
$2,010.00
|
|
|
Service Code
|
HCPCS 27695
|
| Min. Negotiated Rate |
$296.92 |
| Max. Negotiated Rate |
$1,507.50 |
| Rate for Payer: Aetna Commercial |
$605.41
|
| Rate for Payer: Aetna Medicare |
$451.80
|
| Rate for Payer: BCBS Complete |
$311.77
|
| Rate for Payer: BCBS MAPPO |
$451.80
|
| Rate for Payer: BCN Commercial |
$742.49
|
| Rate for Payer: BCN Medicare Advantage |
$451.80
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cofinity Commercial |
$650.59
|
| Rate for Payer: Cofinity Commercial |
$605.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.80
|
| Rate for Payer: Healthscope Commercial |
$542.16
|
| Rate for Payer: Healthscope Whirlpool |
$542.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.39
|
| Rate for Payer: Meridian Medicaid |
$311.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$496.98
|
| Rate for Payer: Nomi Health Commercial |
$542.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,507.50
|
| Rate for Payer: PACE SWMI |
$451.80
|
| Rate for Payer: PHP Medicare Advantage |
$451.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$793.71
|
| Rate for Payer: Priority Health Medicare |
$451.80
|
| Rate for Payer: Priority Health Narrow Network |
$793.71
|
| Rate for Payer: Railroad Medicare Medicare |
$451.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$451.80
|
| Rate for Payer: UHC Exchange |
$825.65
|
| Rate for Payer: UHC Medicaid |
$296.92
|
| Rate for Payer: UHCCP DNSP |
$451.80
|
| Rate for Payer: UHCCP Medicaid |
$296.92
|
|
|
PR RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 27652
|
| Min. Negotiated Rate |
$393.20 |
| Max. Negotiated Rate |
$1,165.24 |
| Rate for Payer: Aetna Commercial |
$808.70
|
| Rate for Payer: Aetna Medicare |
$603.51
|
| Rate for Payer: BCBS Complete |
$412.86
|
| Rate for Payer: BCBS MAPPO |
$603.51
|
| Rate for Payer: BCN Commercial |
$1,011.89
|
| Rate for Payer: BCN Medicare Advantage |
$603.51
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$808.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.51
|
| Rate for Payer: Healthscope Commercial |
$724.21
|
| Rate for Payer: Healthscope Whirlpool |
$724.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.69
|
| Rate for Payer: Meridian Medicaid |
$412.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$663.86
|
| Rate for Payer: Nomi Health Commercial |
$724.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$807.75
|
| Rate for Payer: PACE SWMI |
$603.51
|
| Rate for Payer: PHP Medicare Advantage |
$603.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,081.69
|
| Rate for Payer: Priority Health Medicare |
$603.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.69
|
| Rate for Payer: Railroad Medicare Medicare |
$603.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,165.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$603.51
|
| Rate for Payer: UHC Exchange |
$1,165.24
|
| Rate for Payer: UHC Medicaid |
$393.20
|
| Rate for Payer: UHCCP DNSP |
$603.51
|
| Rate for Payer: UHCCP Medicaid |
$393.20
|
|
