|
PR RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL
|
Professional
|
Both
|
$1,960.00
|
|
|
Service Code
|
HCPCS 27405
|
| Min. Negotiated Rate |
$406.40 |
| Max. Negotiated Rate |
$1,470.00 |
| Rate for Payer: Aetna Commercial |
$831.54
|
| Rate for Payer: Aetna Medicare |
$620.55
|
| Rate for Payer: BCBS Complete |
$426.72
|
| Rate for Payer: BCBS MAPPO |
$620.55
|
| Rate for Payer: BCN Commercial |
$1,033.81
|
| Rate for Payer: BCN Medicare Advantage |
$620.55
|
| Rate for Payer: Cash Price |
$1,568.00
|
| Rate for Payer: Cash Price |
$1,568.00
|
| Rate for Payer: Cofinity Commercial |
$893.59
|
| Rate for Payer: Cofinity Commercial |
$831.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.55
|
| Rate for Payer: Healthscope Commercial |
$744.66
|
| Rate for Payer: Healthscope Whirlpool |
$744.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.58
|
| Rate for Payer: Meridian Medicaid |
$426.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$682.61
|
| Rate for Payer: Nomi Health Commercial |
$744.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,470.00
|
| Rate for Payer: PACE SWMI |
$620.55
|
| Rate for Payer: PHP Medicare Advantage |
$620.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,105.11
|
| Rate for Payer: Priority Health Medicare |
$620.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,105.11
|
| Rate for Payer: Railroad Medicare Medicare |
$620.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,178.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$620.55
|
| Rate for Payer: UHC Exchange |
$1,178.19
|
| Rate for Payer: UHC Medicaid |
$406.40
|
| Rate for Payer: UHCCP DNSP |
$620.55
|
| Rate for Payer: UHCCP Medicaid |
$406.40
|
|
|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,993.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$325.46 |
| Max. Negotiated Rate |
$2,244.75 |
| Rate for Payer: Aetna Commercial |
$667.82
|
| Rate for Payer: Aetna Medicare |
$498.37
|
| Rate for Payer: BCBS Complete |
$341.73
|
| Rate for Payer: BCBS MAPPO |
$498.37
|
| Rate for Payer: BCN Commercial |
$833.62
|
| Rate for Payer: BCN Medicare Advantage |
$498.37
|
| Rate for Payer: Cash Price |
$2,394.40
|
| Rate for Payer: Cash Price |
$2,394.40
|
| Rate for Payer: Cofinity Commercial |
$717.65
|
| Rate for Payer: Cofinity Commercial |
$667.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.37
|
| Rate for Payer: Healthscope Commercial |
$598.04
|
| Rate for Payer: Healthscope Whirlpool |
$598.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.29
|
| Rate for Payer: Meridian Medicaid |
$341.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.21
|
| Rate for Payer: Nomi Health Commercial |
$598.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,244.75
|
| Rate for Payer: PACE SWMI |
$498.37
|
| Rate for Payer: PHP Medicare Advantage |
$498.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$891.12
|
| Rate for Payer: Priority Health Medicare |
$498.37
|
| Rate for Payer: Priority Health Narrow Network |
$891.12
|
| Rate for Payer: Railroad Medicare Medicare |
$498.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$976.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.37
|
| Rate for Payer: UHC Exchange |
$976.21
|
| Rate for Payer: UHC Medicaid |
$325.46
|
| Rate for Payer: UHCCP DNSP |
$498.37
|
| Rate for Payer: UHCCP Medicaid |
$325.46
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,246.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$488.41 |
| Max. Negotiated Rate |
$1,684.50 |
| Rate for Payer: Aetna Commercial |
$982.98
|
| Rate for Payer: Aetna Medicare |
$733.57
|
| Rate for Payer: BCBS Complete |
$512.83
|
| Rate for Payer: BCBS MAPPO |
$733.57
|
| Rate for Payer: BCN Commercial |
$1,209.60
|
| Rate for Payer: BCN Medicare Advantage |
$733.57
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cofinity Commercial |
$982.98
|
| Rate for Payer: Cofinity Commercial |
$1,056.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.57
|
| Rate for Payer: Healthscope Commercial |
$880.28
|
| Rate for Payer: Healthscope Whirlpool |
$880.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.25
|
| Rate for Payer: Meridian Medicaid |
$512.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$806.93
|
| Rate for Payer: Nomi Health Commercial |
$880.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,684.50
|
| Rate for Payer: PACE SWMI |
$733.57
|
| Rate for Payer: PHP Medicare Advantage |
$733.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,293.03
|
| Rate for Payer: Priority Health Medicare |
$733.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,293.03
|
| Rate for Payer: Railroad Medicare Medicare |
$733.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,328.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$733.57
|
| Rate for Payer: UHC Exchange |
$1,328.30
|
| Rate for Payer: UHC Medicaid |
$488.41
|
| Rate for Payer: UHCCP DNSP |
$733.57
|
| Rate for Payer: UHCCP Medicaid |
$488.41
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$372.11 |
| Max. Negotiated Rate |
$1,117.04 |
| Rate for Payer: Aetna Commercial |
$773.33
|
| Rate for Payer: Aetna Medicare |
$577.11
|
| Rate for Payer: BCBS Complete |
$390.72
|
| Rate for Payer: BCBS MAPPO |
$577.11
|
| Rate for Payer: BCN Commercial |
$916.79
|
| Rate for Payer: BCN Medicare Advantage |
$577.11
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$831.04
|
| Rate for Payer: Cofinity Commercial |
$773.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.11
|
| Rate for Payer: Healthscope Commercial |
$692.53
|
| Rate for Payer: Healthscope Whirlpool |
$692.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.97
|
| Rate for Payer: Meridian Medicaid |
$390.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$634.82
|
| Rate for Payer: Nomi Health Commercial |
$692.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$827.25
|
| Rate for Payer: PACE SWMI |
$577.11
|
| Rate for Payer: PHP Medicare Advantage |
$577.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,117.04
|
| Rate for Payer: Priority Health Medicare |
$577.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.04
|
| Rate for Payer: Railroad Medicare Medicare |
$577.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,069.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.11
|
| Rate for Payer: UHC Exchange |
$1,069.80
|
| Rate for Payer: UHC Medicaid |
$372.11
|
| Rate for Payer: UHCCP DNSP |
$577.11
|
| Rate for Payer: UHCCP Medicaid |
$372.11
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,103.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$827.25 |
| Max. Negotiated Rate |
$1,103.00 |
| Rate for Payer: Aetna Commercial |
$992.70
|
| Rate for Payer: ASR ASR |
$1,069.91
|
| Rate for Payer: BCBS Trust/PPO |
$905.78
|
| Rate for Payer: BCN Commercial |
$905.78
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$1,036.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.40
|
| Rate for Payer: Healthscope Commercial |
$1,069.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,103.00
|
| Rate for Payer: Mclaren Commercial |
$992.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$937.55
|
| Rate for Payer: Nomi Health Commercial |
$904.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$827.25
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$372.11 |
| Max. Negotiated Rate |
$1,117.04 |
| Rate for Payer: Aetna Commercial |
$773.33
|
| Rate for Payer: Aetna Medicare |
$577.11
|
| Rate for Payer: BCBS Complete |
$390.72
|
| Rate for Payer: BCBS MAPPO |
$577.11
|
| Rate for Payer: BCN Commercial |
$916.79
|
| Rate for Payer: BCN Medicare Advantage |
$577.11
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$831.04
|
| Rate for Payer: Cofinity Commercial |
$773.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.11
|
| Rate for Payer: Healthscope Commercial |
$692.53
|
| Rate for Payer: Healthscope Whirlpool |
$692.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.97
|
| Rate for Payer: Meridian Medicaid |
$390.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$634.82
|
| Rate for Payer: Nomi Health Commercial |
$692.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$827.25
|
| Rate for Payer: PACE SWMI |
$577.11
|
| Rate for Payer: PHP Medicare Advantage |
$577.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,117.04
|
| Rate for Payer: Priority Health Medicare |
$577.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.04
|
| Rate for Payer: Railroad Medicare Medicare |
$577.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,069.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.11
|
| Rate for Payer: UHC Exchange |
$1,069.80
|
| Rate for Payer: UHC Medicaid |
$372.11
|
| Rate for Payer: UHCCP DNSP |
$577.11
|
| Rate for Payer: UHCCP Medicaid |
$372.11
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$773.20 |
| Max. Negotiated Rate |
$4,459.41 |
| Rate for Payer: Aetna Commercial |
$992.70
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$1,069.91
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$909.42
|
| Rate for Payer: BCN Commercial |
$909.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$1,036.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,069.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,103.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$992.70
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$937.55
|
| Rate for Payer: Nomi Health Commercial |
$904.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$827.25
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$966.45
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$773.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,525.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$441.55 |
| Max. Negotiated Rate |
$1,328.18 |
| Rate for Payer: Aetna Commercial |
$919.74
|
| Rate for Payer: Aetna Medicare |
$686.37
|
| Rate for Payer: BCBS Complete |
$463.63
|
| Rate for Payer: BCBS MAPPO |
$686.37
|
| Rate for Payer: BCN Commercial |
$1,090.08
|
| Rate for Payer: BCN Medicare Advantage |
$686.37
|
| Rate for Payer: Cash Price |
$1,220.00
|
| Rate for Payer: Cash Price |
$1,220.00
|
| Rate for Payer: Cofinity Commercial |
$988.37
|
| Rate for Payer: Cofinity Commercial |
$919.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.37
|
| Rate for Payer: Healthscope Commercial |
$823.64
|
| Rate for Payer: Healthscope Whirlpool |
$823.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.69
|
| Rate for Payer: Meridian Medicaid |
$463.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$755.01
|
| Rate for Payer: Nomi Health Commercial |
$823.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,143.75
|
| Rate for Payer: PACE SWMI |
$686.37
|
| Rate for Payer: PHP Medicare Advantage |
$686.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,328.18
|
| Rate for Payer: Priority Health Medicare |
$686.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.18
|
| Rate for Payer: Railroad Medicare Medicare |
$686.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,287.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.37
|
| Rate for Payer: UHC Exchange |
$1,287.76
|
| Rate for Payer: UHC Medicaid |
$441.55
|
| Rate for Payer: UHCCP DNSP |
$686.37
|
| Rate for Payer: UHCCP Medicaid |
$441.55
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,092.80 |
| Max. Negotiated Rate |
$2,049.00 |
| Rate for Payer: BCBS Complete |
$1,092.80
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,364.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$945.60 |
| Max. Negotiated Rate |
$1,773.00 |
| Rate for Payer: BCBS Complete |
$945.60
|
| Rate for Payer: Cash Price |
$1,891.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,773.00
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,773.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$387.87 |
| Max. Negotiated Rate |
$1,329.75 |
| Rate for Payer: Aetna Commercial |
$806.80
|
| Rate for Payer: Aetna Medicare |
$602.09
|
| Rate for Payer: BCBS Complete |
$407.26
|
| Rate for Payer: BCBS MAPPO |
$602.09
|
| Rate for Payer: BCN Commercial |
$958.62
|
| Rate for Payer: BCN Medicare Advantage |
$602.09
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cofinity Commercial |
$867.01
|
| Rate for Payer: Cofinity Commercial |
$806.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.09
|
| Rate for Payer: Healthscope Commercial |
$722.51
|
| Rate for Payer: Healthscope Whirlpool |
$722.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.19
|
| Rate for Payer: Meridian Medicaid |
$407.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$662.30
|
| Rate for Payer: Nomi Health Commercial |
$722.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,329.75
|
| Rate for Payer: PACE SWMI |
$602.09
|
| Rate for Payer: PHP Medicare Advantage |
$602.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.01
|
| Rate for Payer: Priority Health Medicare |
$602.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,168.01
|
| Rate for Payer: Railroad Medicare Medicare |
$602.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,123.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$602.09
|
| Rate for Payer: UHC Exchange |
$1,123.05
|
| Rate for Payer: UHC Medicaid |
$387.87
|
| Rate for Payer: UHCCP DNSP |
$602.09
|
| Rate for Payer: UHCCP Medicaid |
$387.87
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,773.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,329.75 |
| Max. Negotiated Rate |
$1,773.00 |
| Rate for Payer: Aetna Commercial |
$1,595.70
|
| Rate for Payer: ASR ASR |
$1,719.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,455.99
|
| Rate for Payer: BCN Commercial |
$1,455.99
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cofinity Commercial |
$1,666.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,418.40
|
| Rate for Payer: Healthscope Commercial |
$1,719.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,773.00
|
| Rate for Payer: Mclaren Commercial |
$1,595.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,507.05
|
| Rate for Payer: Nomi Health Commercial |
$1,453.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,329.75
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,773.00
|
|
|
Service Code
|
HCPCS 49520
|
| Min. Negotiated Rate |
$387.87 |
| Max. Negotiated Rate |
$1,329.75 |
| Rate for Payer: Aetna Commercial |
$806.80
|
| Rate for Payer: Aetna Medicare |
$602.09
|
| Rate for Payer: BCBS Complete |
$407.26
|
| Rate for Payer: BCBS MAPPO |
$602.09
|
| Rate for Payer: BCN Commercial |
$958.62
|
| Rate for Payer: BCN Medicare Advantage |
$602.09
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cofinity Commercial |
$867.01
|
| Rate for Payer: Cofinity Commercial |
$806.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.09
|
| Rate for Payer: Healthscope Commercial |
$722.51
|
| Rate for Payer: Healthscope Whirlpool |
$722.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.19
|
| Rate for Payer: Meridian Medicaid |
$407.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$662.30
|
| Rate for Payer: Nomi Health Commercial |
$722.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,329.75
|
| Rate for Payer: PACE SWMI |
$602.09
|
| Rate for Payer: PHP Medicare Advantage |
$602.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.01
|
| Rate for Payer: Priority Health Medicare |
$602.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,168.01
|
| Rate for Payer: Railroad Medicare Medicare |
$602.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,123.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$602.09
|
| Rate for Payer: UHC Exchange |
$1,123.05
|
| Rate for Payer: UHC Medicaid |
$387.87
|
| Rate for Payer: UHCCP DNSP |
$602.09
|
| Rate for Payer: UHCCP Medicaid |
$387.87
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,773.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,242.87 |
| Max. Negotiated Rate |
$4,459.41 |
| Rate for Payer: Aetna Commercial |
$1,595.70
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$1,719.81
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.84
|
| Rate for Payer: BCN Commercial |
$1,461.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cash Price |
$1,418.40
|
| Rate for Payer: Cofinity Commercial |
$1,666.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,418.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,719.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,773.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$1,595.70
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,507.05
|
| Rate for Payer: Nomi Health Commercial |
$1,453.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,329.75
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,553.50
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.87
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,155.00
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
49521
|
| Min. Negotiated Rate |
$436.86 |
| Max. Negotiated Rate |
$1,616.25 |
| Rate for Payer: Aetna Commercial |
$909.91
|
| Rate for Payer: Aetna Medicare |
$679.04
|
| Rate for Payer: BCBS Complete |
$458.70
|
| Rate for Payer: BCBS MAPPO |
$679.04
|
| Rate for Payer: BCN Commercial |
$1,085.60
|
| Rate for Payer: BCN Medicare Advantage |
$679.04
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cofinity Commercial |
$977.82
|
| Rate for Payer: Cofinity Commercial |
$909.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.04
|
| Rate for Payer: Healthscope Commercial |
$814.85
|
| Rate for Payer: Healthscope Whirlpool |
$814.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.99
|
| Rate for Payer: Meridian Medicaid |
$458.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.94
|
| Rate for Payer: Nomi Health Commercial |
$814.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,616.25
|
| Rate for Payer: PACE SWMI |
$679.04
|
| Rate for Payer: PHP Medicare Advantage |
$679.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,322.72
|
| Rate for Payer: Priority Health Medicare |
$679.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,322.72
|
| Rate for Payer: Railroad Medicare Medicare |
$679.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,276.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$679.04
|
| Rate for Payer: UHC Exchange |
$1,276.03
|
| Rate for Payer: UHC Medicaid |
$436.86
|
| Rate for Payer: UHCCP DNSP |
$679.04
|
| Rate for Payer: UHCCP Medicaid |
$436.86
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,155.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,510.65 |
| Max. Negotiated Rate |
$8,063.18 |
| Rate for Payer: Aetna Commercial |
$1,939.50
|
| Rate for Payer: Aetna Medicare |
$6,450.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,063.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,063.18
|
| Rate for Payer: ASR ASR |
$2,090.35
|
| Rate for Payer: BCBS Complete |
$3,542.64
|
| Rate for Payer: BCBS MAPPO |
$6,450.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,776.80
|
| Rate for Payer: BCN Commercial |
$1,776.80
|
| Rate for Payer: BCN Medicare Advantage |
$6,450.54
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cofinity Commercial |
$2,025.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,724.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,450.54
|
| Rate for Payer: Healthscope Commercial |
$2,090.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,155.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,450.54
|
| Rate for Payer: Mclaren Commercial |
$1,939.50
|
| Rate for Payer: Mclaren Medicaid |
$6,450.54
|
| Rate for Payer: Mclaren Medicare |
$6,450.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,773.07
|
| Rate for Payer: Meridian Medicaid |
$3,542.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,418.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,095.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,831.75
|
| Rate for Payer: Nomi Health Commercial |
$1,767.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,616.25
|
| Rate for Payer: PACE Medicare |
$6,128.01
|
| Rate for Payer: PACE SWMI |
$6,450.54
|
| Rate for Payer: PHP Commercial |
$7,095.59
|
| Rate for Payer: PHP Medicaid |
$3,457.49
|
| Rate for Payer: PHP Medicare Advantage |
$6,450.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,373.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,888.21
|
| Rate for Payer: Priority Health Medicare |
$6,450.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,510.65
|
| Rate for Payer: Railroad Medicare Medicare |
$6,450.54
|
| Rate for Payer: UHC Medicaid |
$3,373.63
|
| Rate for Payer: UHCCP DNSP |
$6,450.54
|
| Rate for Payer: UHCCP Medicaid |
$3,373.63
|
| Rate for Payer: VA VA |
$6,450.54
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,155.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,616.25 |
| Max. Negotiated Rate |
$2,155.00 |
| Rate for Payer: Aetna Commercial |
$1,939.50
|
| Rate for Payer: ASR ASR |
$2,090.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,769.69
|
| Rate for Payer: BCN Commercial |
$1,769.69
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cofinity Commercial |
$2,025.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,724.00
|
| Rate for Payer: Healthscope Commercial |
$2,090.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,155.00
|
| Rate for Payer: Mclaren Commercial |
$1,939.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,831.75
|
| Rate for Payer: Nomi Health Commercial |
$1,767.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,616.25
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,155.00
|
|
|
Service Code
|
HCPCS 49521
|
| Min. Negotiated Rate |
$436.86 |
| Max. Negotiated Rate |
$1,616.25 |
| Rate for Payer: Aetna Commercial |
$909.91
|
| Rate for Payer: Aetna Medicare |
$679.04
|
| Rate for Payer: BCBS Complete |
$458.70
|
| Rate for Payer: BCBS MAPPO |
$679.04
|
| Rate for Payer: BCN Commercial |
$1,085.60
|
| Rate for Payer: BCN Medicare Advantage |
$679.04
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cash Price |
$1,724.00
|
| Rate for Payer: Cofinity Commercial |
$977.82
|
| Rate for Payer: Cofinity Commercial |
$909.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.04
|
| Rate for Payer: Healthscope Commercial |
$814.85
|
| Rate for Payer: Healthscope Whirlpool |
$814.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.99
|
| Rate for Payer: Meridian Medicaid |
$458.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.94
|
| Rate for Payer: Nomi Health Commercial |
$814.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,616.25
|
| Rate for Payer: PACE SWMI |
$679.04
|
| Rate for Payer: PHP Medicare Advantage |
$679.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,322.72
|
| Rate for Payer: Priority Health Medicare |
$679.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,322.72
|
| Rate for Payer: Railroad Medicare Medicare |
$679.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,276.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$679.04
|
| Rate for Payer: UHC Exchange |
$1,276.03
|
| Rate for Payer: UHC Medicaid |
$436.86
|
| Rate for Payer: UHCCP DNSP |
$679.04
|
| Rate for Payer: UHCCP Medicaid |
$436.86
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,603.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$766.37 |
| Max. Negotiated Rate |
$3,452.25 |
| Rate for Payer: Aetna Commercial |
$1,608.43
|
| Rate for Payer: Aetna Medicare |
$1,200.32
|
| Rate for Payer: BCBS Complete |
$804.69
|
| Rate for Payer: BCBS MAPPO |
$1,200.32
|
| Rate for Payer: BCN Commercial |
$1,937.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,200.32
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,728.46
|
| Rate for Payer: Cofinity Commercial |
$1,608.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,200.32
|
| Rate for Payer: Healthscope Commercial |
$1,440.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,440.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,260.34
|
| Rate for Payer: Meridian Medicaid |
$804.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,320.35
|
| Rate for Payer: Nomi Health Commercial |
$1,440.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,452.25
|
| Rate for Payer: PACE SWMI |
$1,200.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,200.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$766.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,577.53
|
| Rate for Payer: Priority Health Medicare |
$1,200.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,577.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,200.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,278.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,200.32
|
| Rate for Payer: UHC Exchange |
$2,278.98
|
| Rate for Payer: UHC Medicaid |
$766.37
|
| Rate for Payer: UHCCP DNSP |
$1,200.32
|
| Rate for Payer: UHCCP Medicaid |
$766.37
|
|
|
PR RPR SINUS VALSALVA FISTULA
|
Professional
|
Both
|
$3,326.00
|
|
|
Service Code
|
HCPCS 33702
|
| Min. Negotiated Rate |
$933.37 |
| Max. Negotiated Rate |
$2,748.78 |
| Rate for Payer: Aetna Commercial |
$1,958.64
|
| Rate for Payer: Aetna Medicare |
$1,461.67
|
| Rate for Payer: BCBS Complete |
$980.04
|
| Rate for Payer: BCBS MAPPO |
$1,461.67
|
| Rate for Payer: BCN Commercial |
$2,286.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,461.67
|
| Rate for Payer: Cash Price |
$2,660.80
|
| Rate for Payer: Cash Price |
$2,660.80
|
| Rate for Payer: Cofinity Commercial |
$2,104.80
|
| Rate for Payer: Cofinity Commercial |
$1,958.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,461.67
|
| Rate for Payer: Healthscope Commercial |
$1,754.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,754.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,534.75
|
| Rate for Payer: Meridian Medicaid |
$980.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,607.84
|
| Rate for Payer: Nomi Health Commercial |
$1,754.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,494.50
|
| Rate for Payer: PACE SWMI |
$1,461.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,461.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$933.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,458.56
|
| Rate for Payer: Priority Health Medicare |
$1,461.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,458.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,461.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,748.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,461.67
|
| Rate for Payer: UHC Exchange |
$2,748.78
|
| Rate for Payer: UHC Medicaid |
$933.37
|
| Rate for Payer: UHCCP DNSP |
$1,461.67
|
| Rate for Payer: UHCCP Medicaid |
$933.37
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$448.79 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$933.94
|
| Rate for Payer: Aetna Medicare |
$696.97
|
| Rate for Payer: BCBS Complete |
$471.23
|
| Rate for Payer: BCBS MAPPO |
$696.97
|
| Rate for Payer: BCN Commercial |
$1,112.00
|
| Rate for Payer: BCN Medicare Advantage |
$696.97
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$933.94
|
| Rate for Payer: Cofinity Commercial |
$1,003.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.97
|
| Rate for Payer: Healthscope Commercial |
$836.36
|
| Rate for Payer: Healthscope Whirlpool |
$836.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.82
|
| Rate for Payer: Meridian Medicaid |
$471.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$766.67
|
| Rate for Payer: Nomi Health Commercial |
$836.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,522.50
|
| Rate for Payer: PACE SWMI |
$696.97
|
| Rate for Payer: PHP Medicare Advantage |
$696.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,354.89
|
| Rate for Payer: Priority Health Medicare |
$696.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.89
|
| Rate for Payer: Railroad Medicare Medicare |
$696.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,304.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$696.97
|
| Rate for Payer: UHC Exchange |
$1,304.41
|
| Rate for Payer: UHC Medicaid |
$448.79
|
| Rate for Payer: UHCCP DNSP |
$696.97
|
| Rate for Payer: UHCCP Medicaid |
$448.79
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,675.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$670.00 |
| Max. Negotiated Rate |
$1,256.25 |
| Rate for Payer: BCBS Complete |
$670.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.25
|
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$8,123.00
|
|
|
Service Code
|
HCPCS 38780
|
| Min. Negotiated Rate |
$624.30 |
| Max. Negotiated Rate |
$6,092.25 |
| Rate for Payer: Aetna Commercial |
$1,299.42
|
| Rate for Payer: Aetna Medicare |
$969.72
|
| Rate for Payer: BCBS Complete |
$655.51
|
| Rate for Payer: BCBS MAPPO |
$969.72
|
| Rate for Payer: BCN Commercial |
$1,586.56
|
| Rate for Payer: BCN Medicare Advantage |
$969.72
|
| Rate for Payer: Cash Price |
$6,498.40
|
| Rate for Payer: Cash Price |
$6,498.40
|
| Rate for Payer: Cofinity Commercial |
$1,299.42
|
| Rate for Payer: Cofinity Commercial |
$1,396.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.72
|
| Rate for Payer: Healthscope Commercial |
$1,163.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,163.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.21
|
| Rate for Payer: Meridian Medicaid |
$655.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,066.69
|
| Rate for Payer: Nomi Health Commercial |
$1,163.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,092.25
|
| Rate for Payer: PACE SWMI |
$969.72
|
| Rate for Payer: PHP Medicare Advantage |
$969.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,111.06
|
| Rate for Payer: Priority Health Medicare |
$969.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,111.06
|
| Rate for Payer: Railroad Medicare Medicare |
$969.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,828.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$969.72
|
| Rate for Payer: UHC Exchange |
$1,828.88
|
| Rate for Payer: UHC Medicaid |
$624.30
|
| Rate for Payer: UHCCP DNSP |
$969.72
|
| Rate for Payer: UHCCP Medicaid |
$624.30
|
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 28200
|
| Min. Negotiated Rate |
$199.58 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$406.29
|
| Rate for Payer: Aetna Medicare |
$303.20
|
| Rate for Payer: BCBS Complete |
$209.56
|
| Rate for Payer: BCBS MAPPO |
$303.20
|
| Rate for Payer: BCN Commercial |
$497.98
|
| Rate for Payer: BCN Medicare Advantage |
$303.20
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cofinity Commercial |
$436.61
|
| Rate for Payer: Cofinity Commercial |
$406.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.20
|
| Rate for Payer: Healthscope Commercial |
$363.84
|
| Rate for Payer: Healthscope Whirlpool |
$363.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.36
|
| Rate for Payer: Meridian Medicaid |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.52
|
| Rate for Payer: Nomi Health Commercial |
$363.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: PACE SWMI |
$303.20
|
| Rate for Payer: PHP Medicare Advantage |
$303.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$532.34
|
| Rate for Payer: Priority Health Medicare |
$303.20
|
| Rate for Payer: Priority Health Narrow Network |
$532.34
|
| Rate for Payer: Railroad Medicare Medicare |
$303.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.20
|
| Rate for Payer: UHC Exchange |
$564.13
|
| Rate for Payer: UHC Medicaid |
$199.58
|
| Rate for Payer: UHCCP DNSP |
$303.20
|
| Rate for Payer: UHCCP Medicaid |
$199.58
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,292.00
|
|
|
Service Code
|
HCPCS 25263
|
| Min. Negotiated Rate |
$387.66 |
| Max. Negotiated Rate |
$1,096.57 |
| Rate for Payer: Aetna Commercial |
$790.39
|
| Rate for Payer: Aetna Medicare |
$589.84
|
| Rate for Payer: BCBS Complete |
$407.04
|
| Rate for Payer: BCBS MAPPO |
$589.84
|
| Rate for Payer: BCN Commercial |
$975.05
|
| Rate for Payer: BCN Medicare Advantage |
$589.84
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cofinity Commercial |
$849.37
|
| Rate for Payer: Cofinity Commercial |
$790.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.84
|
| Rate for Payer: Healthscope Commercial |
$707.81
|
| Rate for Payer: Healthscope Whirlpool |
$707.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.33
|
| Rate for Payer: Meridian Medicaid |
$407.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$648.82
|
| Rate for Payer: Nomi Health Commercial |
$707.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.00
|
| Rate for Payer: PACE SWMI |
$589.84
|
| Rate for Payer: PHP Medicare Advantage |
$589.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,042.29
|
| Rate for Payer: Priority Health Medicare |
$589.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.29
|
| Rate for Payer: Railroad Medicare Medicare |
$589.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,096.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$589.84
|
| Rate for Payer: UHC Exchange |
$1,096.57
|
| Rate for Payer: UHC Medicaid |
$387.66
|
| Rate for Payer: UHCCP DNSP |
$589.84
|
| Rate for Payer: UHCCP Medicaid |
$387.66
|
|
