|
PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH
|
Professional
|
Both
|
$5,421.00
|
|
|
Service Code
|
HCPCS 27725
|
| Min. Negotiated Rate |
$789.17 |
| Max. Negotiated Rate |
$3,523.65 |
| Rate for Payer: Aetna Commercial |
$1,621.26
|
| Rate for Payer: Aetna Medicare |
$2,710.50
|
| Rate for Payer: BCBS Complete |
$828.63
|
| Rate for Payer: BCBS Trust/PPO |
$800.37
|
| Rate for Payer: BCN Commercial |
$1,779.76
|
| Rate for Payer: Cash Price |
$4,336.80
|
| Rate for Payer: Cash Price |
$4,336.80
|
| Rate for Payer: Meridian Medicaid |
$828.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,523.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,870.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,870.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.42
|
| Rate for Payer: UHC Exchange |
$1,396.42
|
| Rate for Payer: UHCCP Medicaid |
$789.17
|
|
|
PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT
|
Professional
|
Both
|
$4,771.00
|
|
|
Service Code
|
HCPCS 27724
|
| Min. Negotiated Rate |
$322.79 |
| Max. Negotiated Rate |
$3,101.15 |
| Rate for Payer: Aetna Commercial |
$1,683.13
|
| Rate for Payer: Aetna Medicare |
$2,385.50
|
| Rate for Payer: BCBS Complete |
$849.87
|
| Rate for Payer: BCBS Trust/PPO |
$322.79
|
| Rate for Payer: BCN Commercial |
$1,834.50
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Meridian Medicaid |
$849.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$809.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,486.56
|
| Rate for Payer: UHC Exchange |
$1,486.56
|
| Rate for Payer: UHCCP Medicaid |
$809.40
|
|
|
PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT
|
Professional
|
Both
|
$1,316.00
|
|
|
Service Code
|
HCPCS 28322
|
| Min. Negotiated Rate |
$375.31 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$766.29
|
| Rate for Payer: Aetna Medicare |
$658.00
|
| Rate for Payer: BCBS Complete |
$394.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,150.84
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Meridian Medicaid |
$394.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$855.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$892.03
|
| Rate for Payer: Priority Health Narrow Network |
$892.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$673.30
|
| Rate for Payer: UHC Exchange |
$673.30
|
| Rate for Payer: UHCCP Medicaid |
$375.31
|
|
|
PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS
|
Professional
|
Both
|
$7,025.00
|
|
|
Service Code
|
HCPCS 33496
|
| Min. Negotiated Rate |
$807.24 |
| Max. Negotiated Rate |
$4,566.25 |
| Rate for Payer: Aetna Commercial |
$2,234.49
|
| Rate for Payer: Aetna Medicare |
$3,512.50
|
| Rate for Payer: BCBS Complete |
$1,098.79
|
| Rate for Payer: BCBS Trust/PPO |
$807.24
|
| Rate for Payer: BCN Commercial |
$2,383.77
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Meridian Medicaid |
$1,098.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,566.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,599.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,599.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,191.00
|
| Rate for Payer: UHC Exchange |
$2,191.00
|
| Rate for Payer: UHCCP Medicaid |
$1,046.47
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$3,241.00
|
|
|
Service Code
|
HCPCS 25405
|
| Min. Negotiated Rate |
$25.89 |
| Max. Negotiated Rate |
$2,106.65 |
| Rate for Payer: Aetna Commercial |
$1,384.02
|
| Rate for Payer: Aetna Medicare |
$1,620.50
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$1,520.76
|
| Rate for Payer: Cash Price |
$2,592.80
|
| Rate for Payer: Cash Price |
$2,592.80
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,106.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,594.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,594.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,246.58
|
| Rate for Payer: UHC Exchange |
$1,246.58
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
|
|
PR RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF
|
Professional
|
Both
|
$3,275.00
|
|
|
Service Code
|
HCPCS 25415
|
| Min. Negotiated Rate |
$272.95 |
| Max. Negotiated Rate |
$2,128.75 |
| Rate for Payer: Aetna Commercial |
$1,294.84
|
| Rate for Payer: Aetna Medicare |
$1,637.50
|
| Rate for Payer: BCBS Complete |
$660.66
|
| Rate for Payer: BCBS Trust/PPO |
$272.95
|
| Rate for Payer: BCN Commercial |
$1,422.05
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Meridian Medicaid |
$660.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,491.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,177.24
|
| Rate for Payer: UHC Exchange |
$1,177.24
|
| Rate for Payer: UHCCP Medicaid |
$629.20
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT
|
Professional
|
Both
|
$2,633.00
|
|
|
Service Code
|
HCPCS 25400
|
| Min. Negotiated Rate |
$211.32 |
| Max. Negotiated Rate |
$1,711.45 |
| Rate for Payer: Aetna Commercial |
$1,071.92
|
| Rate for Payer: Aetna Medicare |
$1,316.50
|
| Rate for Payer: BCBS Complete |
$549.51
|
| Rate for Payer: BCBS Trust/PPO |
$211.32
|
| Rate for Payer: BCN Commercial |
$1,182.60
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Meridian Medicaid |
$549.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,711.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$974.20
|
| Rate for Payer: UHC Exchange |
$974.20
|
| Rate for Payer: UHCCP Medicaid |
$523.34
|
|
|
PR RPR NON-UNION MTCRPL/PHALANX
|
Professional
|
Both
|
$2,109.00
|
|
|
Service Code
|
HCPCS 26546
|
| Min. Negotiated Rate |
$243.55 |
| Max. Negotiated Rate |
$1,603.93 |
| Rate for Payer: Aetna Commercial |
$1,364.30
|
| Rate for Payer: Aetna Medicare |
$1,054.50
|
| Rate for Payer: BCBS Complete |
$709.64
|
| Rate for Payer: BCBS Trust/PPO |
$243.55
|
| Rate for Payer: BCN Commercial |
$1,538.85
|
| Rate for Payer: Cash Price |
$1,687.20
|
| Rate for Payer: Cash Price |
$1,687.20
|
| Rate for Payer: Meridian Medicaid |
$709.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,603.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,603.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,089.65
|
| Rate for Payer: UHC Exchange |
$1,089.65
|
| Rate for Payer: UHCCP Medicaid |
$675.85
|
|
|
PR RPR NONUNION SCAPHOID CARPAL B1 W/WO RDL STYLODC
|
Professional
|
Both
|
$1,376.00
|
|
|
Service Code
|
HCPCS 25440
|
| Min. Negotiated Rate |
$502.68 |
| Max. Negotiated Rate |
$1,264.75 |
| Rate for Payer: Aetna Commercial |
$1,024.99
|
| Rate for Payer: Aetna Medicare |
$688.00
|
| Rate for Payer: BCBS Complete |
$527.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,264.75
|
| Rate for Payer: BCN Commercial |
$1,131.77
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Meridian Medicaid |
$527.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,189.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,189.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$882.25
|
| Rate for Payer: UHC Exchange |
$882.25
|
| Rate for Payer: UHCCP Medicaid |
$502.68
|
|
|
PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 30468
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$3,788.72 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: BCBS Trust/PPO |
$627.09
|
| Rate for Payer: BCN Commercial |
$3,788.72
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Meridian Medicaid |
$113.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.51
|
| Rate for Payer: Priority Health Narrow Network |
$234.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.25
|
| Rate for Payer: UHC Exchange |
$209.25
|
| Rate for Payer: UHCCP Medicaid |
$108.42
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$914.84 |
| Max. Negotiated Rate |
$2,555.81 |
| Rate for Payer: Aetna Commercial |
$1,952.76
|
| Rate for Payer: Aetna Medicare |
$1,362.50
|
| Rate for Payer: BCBS Complete |
$960.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.04
|
| Rate for Payer: BCN Commercial |
$2,085.19
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Meridian Medicaid |
$960.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,555.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,078.44
|
| Rate for Payer: UHC Exchange |
$2,078.44
|
| Rate for Payer: UHCCP Medicaid |
$914.84
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$2,118.00
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$734.00 |
| Max. Negotiated Rate |
$2,050.49 |
| Rate for Payer: Aetna Commercial |
$1,555.18
|
| Rate for Payer: Aetna Medicare |
$1,059.00
|
| Rate for Payer: BCBS Complete |
$770.70
|
| Rate for Payer: BCBS Trust/PPO |
$822.56
|
| Rate for Payer: BCN Commercial |
$1,667.86
|
| Rate for Payer: Cash Price |
$1,694.40
|
| Rate for Payer: Cash Price |
$1,694.40
|
| Rate for Payer: Meridian Medicaid |
$770.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,376.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,050.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,050.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,601.59
|
| Rate for Payer: UHC Exchange |
$1,601.59
|
| Rate for Payer: UHCCP Medicaid |
$734.00
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH
|
Professional
|
Both
|
$2,801.00
|
|
|
Service Code
|
HCPCS 43335
|
| Min. Negotiated Rate |
$841.78 |
| Max. Negotiated Rate |
$2,352.97 |
| Rate for Payer: Aetna Commercial |
$1,798.20
|
| Rate for Payer: Aetna Medicare |
$1,400.50
|
| Rate for Payer: BCBS Complete |
$883.87
|
| Rate for Payer: BCBS Trust/PPO |
$871.97
|
| Rate for Payer: BCN Commercial |
$1,919.03
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Meridian Medicaid |
$883.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,352.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,352.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,896.23
|
| Rate for Payer: UHC Exchange |
$1,896.23
|
| Rate for Payer: UHCCP Medicaid |
$841.78
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH
|
Professional
|
Both
|
$3,439.00
|
|
|
Service Code
|
HCPCS 43334
|
| Min. Negotiated Rate |
$784.48 |
| Max. Negotiated Rate |
$2,235.35 |
| Rate for Payer: Aetna Commercial |
$1,680.36
|
| Rate for Payer: Aetna Medicare |
$1,719.50
|
| Rate for Payer: BCBS Complete |
$823.70
|
| Rate for Payer: BCBS Trust/PPO |
$940.03
|
| Rate for Payer: BCN Commercial |
$1,789.53
|
| Rate for Payer: Cash Price |
$2,751.20
|
| Rate for Payer: Cash Price |
$2,751.20
|
| Rate for Payer: Meridian Medicaid |
$823.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$784.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,235.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,190.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,190.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,759.68
|
| Rate for Payer: UHC Exchange |
$1,759.68
|
| Rate for Payer: UHCCP Medicaid |
$784.48
|
|
|
PR RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 49621
|
| Min. Negotiated Rate |
$482.23 |
| Max. Negotiated Rate |
$3,534.33 |
| Rate for Payer: Aetna Commercial |
$999.36
|
| Rate for Payer: Aetna Medicare |
$775.00
|
| Rate for Payer: BCBS Complete |
$506.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,534.33
|
| Rate for Payer: BCN Commercial |
$1,080.46
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Meridian Medicaid |
$506.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,007.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,020.69
|
| Rate for Payer: UHC Exchange |
$1,020.69
|
| Rate for Payer: UHCCP Medicaid |
$482.23
|
|
|
PR RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49622
|
| Min. Negotiated Rate |
$599.81 |
| Max. Negotiated Rate |
$2,705.42 |
| Rate for Payer: Aetna Commercial |
$1,233.64
|
| Rate for Payer: Aetna Medicare |
$955.50
|
| Rate for Payer: BCBS Complete |
$629.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,705.42
|
| Rate for Payer: BCN Commercial |
$1,333.11
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Meridian Medicaid |
$629.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,632.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,259.60
|
| Rate for Payer: UHC Exchange |
$1,259.60
|
| Rate for Payer: UHCCP Medicaid |
$599.81
|
|
|
PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS
|
Professional
|
Both
|
$7,564.00
|
|
|
Service Code
|
HCPCS 33925
|
| Min. Negotiated Rate |
$843.70 |
| Max. Negotiated Rate |
$4,916.60 |
| Rate for Payer: Aetna Commercial |
$2,306.29
|
| Rate for Payer: Aetna Medicare |
$3,782.00
|
| Rate for Payer: BCBS Complete |
$1,132.79
|
| Rate for Payer: BCBS Trust/PPO |
$843.70
|
| Rate for Payer: BCN Commercial |
$2,460.00
|
| Rate for Payer: Cash Price |
$6,051.20
|
| Rate for Payer: Cash Price |
$6,051.20
|
| Rate for Payer: Meridian Medicaid |
$1,132.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,078.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,916.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,686.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,686.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,275.20
|
| Rate for Payer: UHC Exchange |
$2,275.20
|
| Rate for Payer: UHCCP Medicaid |
$1,078.85
|
|
|
PR RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT
|
Professional
|
Both
|
$5,876.00
|
|
|
Service Code
|
HCPCS 33545
|
| Min. Negotiated Rate |
$1,600.75 |
| Max. Negotiated Rate |
$4,769.40 |
| Rate for Payer: Aetna Commercial |
$4,126.09
|
| Rate for Payer: Aetna Medicare |
$2,938.00
|
| Rate for Payer: BCBS Complete |
$2,013.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.75
|
| Rate for Payer: BCN Commercial |
$4,379.04
|
| Rate for Payer: Cash Price |
$4,700.80
|
| Rate for Payer: Cash Price |
$4,700.80
|
| Rate for Payer: Meridian Medicaid |
$2,013.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,917.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,819.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,769.40
|
| Rate for Payer: Priority Health Narrow Network |
$4,769.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,030.83
|
| Rate for Payer: UHC Exchange |
$4,030.83
|
| Rate for Payer: UHCCP Medicaid |
$1,917.85
|
|
|
PR RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL
|
Professional
|
Both
|
$1,951.00
|
|
|
Service Code
|
HCPCS 27695
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$2,507.31 |
| Rate for Payer: Aetna Commercial |
$631.52
|
| Rate for Payer: Aetna Medicare |
$975.50
|
| Rate for Payer: BCBS Complete |
$333.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.31
|
| Rate for Payer: BCN Commercial |
$712.00
|
| Rate for Payer: Cash Price |
$1,560.80
|
| Rate for Payer: Cash Price |
$1,560.80
|
| Rate for Payer: Meridian Medicaid |
$333.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,268.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.60
|
| Rate for Payer: Priority Health Narrow Network |
$752.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.61
|
| Rate for Payer: UHC Exchange |
$561.61
|
| Rate for Payer: UHCCP Medicaid |
$317.58
|
|
|
PR RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 27652
|
| Min. Negotiated Rate |
$432.82 |
| Max. Negotiated Rate |
$1,373.05 |
| Rate for Payer: Aetna Commercial |
$885.74
|
| Rate for Payer: Aetna Medicare |
$523.00
|
| Rate for Payer: BCBS Complete |
$454.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,373.05
|
| Rate for Payer: BCN Commercial |
$969.54
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Meridian Medicaid |
$454.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.00
|
| Rate for Payer: UHC Exchange |
$829.00
|
| Rate for Payer: UHCCP Medicaid |
$432.82
|
|
|
PR RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27405
|
| Min. Negotiated Rate |
$442.19 |
| Max. Negotiated Rate |
$1,236.95 |
| Rate for Payer: Aetna Commercial |
$901.97
|
| Rate for Payer: Aetna Medicare |
$951.50
|
| Rate for Payer: BCBS Complete |
$464.30
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: BCN Commercial |
$996.90
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Meridian Medicaid |
$464.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,048.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$770.22
|
| Rate for Payer: UHC Exchange |
$770.22
|
| Rate for Payer: UHCCP Medicaid |
$442.19
|
|
|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,906.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$356.56 |
| Max. Negotiated Rate |
$1,888.90 |
| Rate for Payer: Aetna Commercial |
$735.71
|
| Rate for Payer: Aetna Medicare |
$1,453.00
|
| Rate for Payer: BCBS Complete |
$374.39
|
| Rate for Payer: BCBS Trust/PPO |
$620.09
|
| Rate for Payer: BCN Commercial |
$803.87
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Meridian Medicaid |
$374.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,888.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.22
|
| Rate for Payer: Priority Health Narrow Network |
$845.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$660.02
|
| Rate for Payer: UHC Exchange |
$660.02
|
| Rate for Payer: UHCCP Medicaid |
$356.56
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$1,417.65 |
| Rate for Payer: Aetna Commercial |
$1,057.57
|
| Rate for Payer: Aetna Medicare |
$1,090.50
|
| Rate for Payer: BCBS Complete |
$543.25
|
| Rate for Payer: BCBS Trust/PPO |
$89.28
|
| Rate for Payer: BCN Commercial |
$1,189.44
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Meridian Medicaid |
$543.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,237.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$846.77
|
| Rate for Payer: UHC Exchange |
$846.77
|
| Rate for Payer: UHCCP Medicaid |
$517.38
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$696.15 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: ASR ASR |
$1,038.87
|
| Rate for Payer: ASR Commercial |
$1,038.87
|
| Rate for Payer: BCBS Trust/PPO |
$872.76
|
| Rate for Payer: BCN Commercial |
$830.35
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$1,006.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,038.87
|
| Rate for Payer: Mclaren Commercial |
$963.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: Nomi Health Commercial |
$878.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$2,967.99 |
| Rate for Payer: Aetna Commercial |
$813.50
|
| Rate for Payer: Aetna Medicare |
$535.50
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: BCN Commercial |
$887.93
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,090.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$713.58
|
| Rate for Payer: UHC Exchange |
$713.58
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
