|
PR REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT
|
Professional
|
Both
|
$3,827.00
|
|
|
Service Code
|
HCPCS 27722
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$2,487.55 |
| Rate for Payer: Aetna Commercial |
$1,193.91
|
| Rate for Payer: Aetna Medicare |
$1,913.50
|
| Rate for Payer: BCBS Complete |
$612.13
|
| Rate for Payer: BCBS Trust/PPO |
$635.54
|
| Rate for Payer: BCN Commercial |
$1,314.06
|
| Rate for Payer: Cash Price |
$3,061.60
|
| Rate for Payer: Cash Price |
$3,061.60
|
| Rate for Payer: Meridian Medicaid |
$612.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,487.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,381.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,012.51
|
| Rate for Payer: UHC Exchange |
$1,012.51
|
| Rate for Payer: UHCCP Medicaid |
$582.98
|
|
|
PR REPAIR OF TRAUMATIC CORPOREAL TEAR(S)
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 54437
|
| Min. Negotiated Rate |
$436.86 |
| Max. Negotiated Rate |
$1,755.01 |
| Rate for Payer: Aetna Commercial |
$867.12
|
| Rate for Payer: Aetna Medicare |
$694.00
|
| Rate for Payer: BCBS Complete |
$458.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.01
|
| Rate for Payer: BCN Commercial |
$979.80
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Meridian Medicaid |
$458.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.58
|
| Rate for Payer: UHC Exchange |
$824.58
|
| Rate for Payer: UHCCP Medicaid |
$436.86
|
|
|
PR REPAIR PATENT DUCTUS ARTERIOSUS BY LIGATION
|
Professional
|
Both
|
$4,402.00
|
|
|
Service Code
|
HCPCS 33820
|
| Min. Negotiated Rate |
$613.23 |
| Max. Negotiated Rate |
$2,861.30 |
| Rate for Payer: Aetna Commercial |
$1,297.11
|
| Rate for Payer: Aetna Medicare |
$2,201.00
|
| Rate for Payer: BCBS Complete |
$643.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.43
|
| Rate for Payer: BCN Commercial |
$1,392.74
|
| Rate for Payer: Cash Price |
$3,521.60
|
| Rate for Payer: Cash Price |
$3,521.60
|
| Rate for Payer: Meridian Medicaid |
$643.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,861.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,524.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,524.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,273.68
|
| Rate for Payer: UHC Exchange |
$1,273.68
|
| Rate for Payer: UHCCP Medicaid |
$613.23
|
|
|
PR REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC
|
Professional
|
Both
|
$4,141.00
|
|
|
Service Code
|
HCPCS 21743
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$3,437.80 |
| Rate for Payer: Aetna Commercial |
$2,118.84
|
| Rate for Payer: Aetna Medicare |
$2,070.50
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,437.80
|
| Rate for Payer: BCN Commercial |
$2,753.41
|
| Rate for Payer: Cash Price |
$3,312.80
|
| Rate for Payer: Cash Price |
$3,312.80
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,691.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,439.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,439.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.00
|
| Rate for Payer: UHC Exchange |
$1,738.00
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR REPAIR PECTUS EXCAVATUM/CARINATUM OPEN
|
Professional
|
Both
|
$4,141.00
|
|
|
Service Code
|
HCPCS 21740
|
| Min. Negotiated Rate |
$654.55 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$1,381.26
|
| Rate for Payer: Aetna Medicare |
$2,070.50
|
| Rate for Payer: BCBS Complete |
$687.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: Cash Price |
$3,312.80
|
| Rate for Payer: Cash Price |
$3,312.80
|
| Rate for Payer: Meridian Medicaid |
$687.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,691.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,556.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,556.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,257.60
|
| Rate for Payer: UHC Exchange |
$1,257.60
|
| Rate for Payer: UHCCP Medicaid |
$654.55
|
|
|
PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON
|
Facility
|
IP
|
$2,602.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
27650
|
| Min. Negotiated Rate |
$1,691.30 |
| Max. Negotiated Rate |
$2,602.00 |
| Rate for Payer: Aetna Commercial |
$2,341.80
|
| Rate for Payer: ASR ASR |
$2,523.94
|
| Rate for Payer: ASR Commercial |
$2,523.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,120.37
|
| Rate for Payer: BCN Commercial |
$2,017.33
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Cofinity Commercial |
$2,445.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.60
|
| Rate for Payer: Healthscope Commercial |
$2,602.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,523.94
|
| Rate for Payer: Mclaren Commercial |
$2,341.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,211.70
|
| Rate for Payer: Nomi Health Commercial |
$2,133.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,691.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,289.76
|
|
|
PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON
|
Facility
|
OP
|
$2,602.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
27650
|
| Min. Negotiated Rate |
$1,691.30 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$2,341.80
|
| Rate for Payer: Aetna Medicare |
$6,999.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: ASR ASR |
$2,523.94
|
| Rate for Payer: ASR Commercial |
$2,523.94
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,130.78
|
| Rate for Payer: BCN Commercial |
$2,017.33
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Cofinity Commercial |
$2,445.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,602.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,523.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$2,341.80
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,211.70
|
| Rate for Payer: Nomi Health Commercial |
$2,133.64
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$7,699.21
|
| Rate for Payer: PHP Medicaid |
$3,751.61
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,691.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,279.87
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,824.00
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,289.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$10,848.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP DNSP |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON
|
Professional
|
Both
|
$2,602.00
|
|
|
Service Code
|
HCPCS 27650
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$1,691.30 |
| Rate for Payer: Aetna Commercial |
$877.03
|
| Rate for Payer: Aetna Medicare |
$1,301.00
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.05
|
| Rate for Payer: BCN Commercial |
$1,063.77
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,691.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,014.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,014.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$767.18
|
| Rate for Payer: UHC Exchange |
$767.18
|
| Rate for Payer: UHCCP Medicaid |
$429.41
|
|
|
PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON
|
Professional
|
Both
|
$2,602.00
|
|
|
Service Code
|
HCPCS 27650
|
| Hospital Charge Code |
27650
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$1,691.30 |
| Rate for Payer: Aetna Commercial |
$877.03
|
| Rate for Payer: Aetna Medicare |
$1,301.00
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.05
|
| Rate for Payer: BCN Commercial |
$1,063.77
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,691.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,014.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,014.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$767.18
|
| Rate for Payer: UHC Exchange |
$767.18
|
| Rate for Payer: UHCCP Medicaid |
$429.41
|
|
|
PR REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT
|
Professional
|
Both
|
$1,814.00
|
|
|
Service Code
|
HCPCS 27407
|
| Min. Negotiated Rate |
$95.09 |
| Max. Negotiated Rate |
$1,232.98 |
| Rate for Payer: Aetna Commercial |
$1,063.01
|
| Rate for Payer: Aetna Medicare |
$907.00
|
| Rate for Payer: BCBS Complete |
$547.05
|
| Rate for Payer: BCBS Trust/PPO |
$95.09
|
| Rate for Payer: BCN Commercial |
$1,173.32
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Meridian Medicaid |
$547.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,232.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,232.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$886.91
|
| Rate for Payer: UHC Exchange |
$886.91
|
| Rate for Payer: UHCCP Medicaid |
$521.00
|
|
|
PR REPAIR RECTOCELE SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,288.00
|
|
|
Service Code
|
HCPCS 45560
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$2,240.52 |
| Rate for Payer: Aetna Commercial |
$927.04
|
| Rate for Payer: Aetna Medicare |
$644.00
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,240.52
|
| Rate for Payer: BCN Commercial |
$1,009.12
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$837.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.55
|
| Rate for Payer: UHC Exchange |
$853.55
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 27654
|
| Min. Negotiated Rate |
$467.11 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$947.16
|
| Rate for Payer: Aetna Medicare |
$1,387.50
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.09
|
| Rate for Payer: BCN Commercial |
$1,047.73
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,103.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$822.61
|
| Rate for Payer: UHC Exchange |
$822.61
|
| Rate for Payer: UHCCP Medicaid |
$467.11
|
|
|
PR REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL
|
Professional
|
Both
|
$2,993.00
|
|
|
Service Code
|
HCPCS 27698
|
| Min. Negotiated Rate |
$414.92 |
| Max. Negotiated Rate |
$1,945.45 |
| Rate for Payer: Aetna Commercial |
$851.31
|
| Rate for Payer: Aetna Medicare |
$1,496.50
|
| Rate for Payer: BCBS Complete |
$435.67
|
| Rate for Payer: BCBS Trust/PPO |
$474.94
|
| Rate for Payer: BCN Commercial |
$938.75
|
| Rate for Payer: Cash Price |
$2,394.40
|
| Rate for Payer: Cash Price |
$2,394.40
|
| Rate for Payer: Meridian Medicaid |
$435.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.61
|
| Rate for Payer: Priority Health Narrow Network |
$982.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$752.11
|
| Rate for Payer: UHC Exchange |
$752.11
|
| Rate for Payer: UHCCP Medicaid |
$414.92
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE COMPLEX
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 26562
|
| Min. Negotiated Rate |
$616.00 |
| Max. Negotiated Rate |
$2,121.45 |
| Rate for Payer: Aetna Commercial |
$1,830.63
|
| Rate for Payer: Aetna Medicare |
$1,130.50
|
| Rate for Payer: BCBS Complete |
$933.96
|
| Rate for Payer: BCBS Trust/PPO |
$616.00
|
| Rate for Payer: BCN Commercial |
$2,031.43
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Meridian Medicaid |
$933.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$889.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,121.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,121.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,376.09
|
| Rate for Payer: UHC Exchange |
$1,376.09
|
| Rate for Payer: UHCCP Medicaid |
$889.49
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26560
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Commercial |
$838.58
|
| Rate for Payer: Aetna Medicare |
$991.50
|
| Rate for Payer: BCBS Complete |
$430.97
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$948.52
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Meridian Medicaid |
$430.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.17
|
| Rate for Payer: Priority Health Narrow Network |
$986.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$630.77
|
| Rate for Payer: UHC Exchange |
$630.77
|
| Rate for Payer: UHCCP Medicaid |
$410.45
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT
|
Professional
|
Both
|
$2,404.00
|
|
|
Service Code
|
HCPCS 26561
|
| Min. Negotiated Rate |
$540.45 |
| Max. Negotiated Rate |
$1,562.60 |
| Rate for Payer: Aetna Commercial |
$1,308.00
|
| Rate for Payer: Aetna Medicare |
$1,202.00
|
| Rate for Payer: BCBS Complete |
$665.58
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$1,457.24
|
| Rate for Payer: Cash Price |
$1,923.20
|
| Rate for Payer: Cash Price |
$1,923.20
|
| Rate for Payer: Meridian Medicaid |
$665.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,516.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,017.16
|
| Rate for Payer: UHC Exchange |
$1,017.16
|
| Rate for Payer: UHCCP Medicaid |
$633.89
|
|
|
PR REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON
|
Professional
|
Both
|
$761.00
|
|
|
Service Code
|
HCPCS 28208
|
| Min. Negotiated Rate |
$208.74 |
| Max. Negotiated Rate |
$902.86 |
| Rate for Payer: Aetna Commercial |
$419.67
|
| Rate for Payer: Aetna Medicare |
$380.50
|
| Rate for Payer: BCBS Complete |
$219.18
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$709.56
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Meridian Medicaid |
$219.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.13
|
| Rate for Payer: Priority Health Narrow Network |
$496.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$358.13
|
| Rate for Payer: UHC Exchange |
$358.13
|
| Rate for Payer: UHCCP Medicaid |
$208.74
|
|
|
PR REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA TDN/MUSC
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 24341
|
| Min. Negotiated Rate |
$91.92 |
| Max. Negotiated Rate |
$1,517.75 |
| Rate for Payer: Aetna Commercial |
$990.50
|
| Rate for Payer: Aetna Medicare |
$1,167.50
|
| Rate for Payer: BCBS Complete |
$515.74
|
| Rate for Payer: BCBS Trust/PPO |
$91.92
|
| Rate for Payer: BCN Commercial |
$1,102.94
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Meridian Medicaid |
$515.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,164.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,164.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$833.27
|
| Rate for Payer: UHC Exchange |
$833.27
|
| Rate for Payer: UHCCP Medicaid |
$491.18
|
|
|
PR REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 33363
|
| Min. Negotiated Rate |
$639.24 |
| Max. Negotiated Rate |
$2,130.49 |
| Rate for Payer: Aetna Commercial |
$1,838.76
|
| Rate for Payer: Aetna Medicare |
$1,287.00
|
| Rate for Payer: BCBS Complete |
$897.51
|
| Rate for Payer: BCBS Trust/PPO |
$639.24
|
| Rate for Payer: BCN Commercial |
$1,948.85
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Meridian Medicaid |
$897.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,130.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,130.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,082.00
|
| Rate for Payer: UHC Exchange |
$2,082.00
|
| Rate for Payer: UHCCP Medicaid |
$854.77
|
|
|
PR REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH
|
Professional
|
Both
|
$4,316.00
|
|
|
Service Code
|
HCPCS 33362
|
| Min. Negotiated Rate |
$618.64 |
| Max. Negotiated Rate |
$2,805.40 |
| Rate for Payer: Aetna Commercial |
$1,772.76
|
| Rate for Payer: Aetna Medicare |
$2,158.00
|
| Rate for Payer: BCBS Complete |
$866.65
|
| Rate for Payer: BCBS Trust/PPO |
$618.64
|
| Rate for Payer: BCN Commercial |
$1,882.38
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Meridian Medicaid |
$866.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$825.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,805.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,010.78
|
| Rate for Payer: UHC Exchange |
$2,010.78
|
| Rate for Payer: UHCCP Medicaid |
$825.38
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH
|
Professional
|
Both
|
$5,215.00
|
|
|
Service Code
|
HCPCS 33365
|
| Min. Negotiated Rate |
$775.54 |
| Max. Negotiated Rate |
$3,389.75 |
| Rate for Payer: Aetna Commercial |
$1,916.59
|
| Rate for Payer: Aetna Medicare |
$2,607.50
|
| Rate for Payer: BCBS Complete |
$934.86
|
| Rate for Payer: BCBS Trust/PPO |
$775.54
|
| Rate for Payer: BCN Commercial |
$2,034.85
|
| Rate for Payer: Cash Price |
$4,172.00
|
| Rate for Payer: Cash Price |
$4,172.00
|
| Rate for Payer: Meridian Medicaid |
$934.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,389.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,219.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,219.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,431.84
|
| Rate for Payer: UHC Exchange |
$2,431.84
|
| Rate for Payer: UHCCP Medicaid |
$890.34
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSTHORACIC APPROACH
|
Professional
|
Both
|
$3,171.00
|
|
|
Service Code
|
HCPCS 0318T
|
| Min. Negotiated Rate |
$1,268.40 |
| Max. Negotiated Rate |
$2,061.15 |
| Rate for Payer: Aetna Medicare |
$1,585.50
|
| Rate for Payer: BCBS Complete |
$1,268.40
|
| Rate for Payer: Cash Price |
$2,536.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.15
|
|
|
PR REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH
|
Professional
|
Both
|
$3,945.00
|
|
|
Service Code
|
HCPCS 33361
|
| Min. Negotiated Rate |
$756.36 |
| Max. Negotiated Rate |
$2,564.25 |
| Rate for Payer: Aetna Commercial |
$1,626.97
|
| Rate for Payer: Aetna Medicare |
$1,972.50
|
| Rate for Payer: BCBS Complete |
$794.18
|
| Rate for Payer: BCBS Trust/PPO |
$920.83
|
| Rate for Payer: BCN Commercial |
$1,725.52
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Meridian Medicaid |
$794.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$756.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,883.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,883.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,837.80
|
| Rate for Payer: UHC Exchange |
$1,837.80
|
| Rate for Payer: UHCCP Medicaid |
$756.36
|
|
|
PR REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 33368
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$1,443.00 |
| Rate for Payer: Aetna Commercial |
$1,000.30
|
| Rate for Payer: Aetna Medicare |
$1,110.00
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS Trust/PPO |
$506.11
|
| Rate for Payer: BCN Commercial |
$1,054.56
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,035.88
|
| Rate for Payer: UHC Exchange |
$1,035.88
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
|
|
PR REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 49451
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$2,113.73 |
| Rate for Payer: Aetna Commercial |
$118.55
|
| Rate for Payer: Aetna Medicare |
$682.50
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,113.73
|
| Rate for Payer: BCN Commercial |
$946.08
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$887.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.92
|
| Rate for Payer: Priority Health Narrow Network |
$153.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.89
|
| Rate for Payer: UHC Exchange |
$122.89
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
