|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$148.45 |
| Max. Negotiated Rate |
$901.69 |
| Rate for Payer: Aetna Commercial |
$772.36
|
| Rate for Payer: Aetna Medicare |
$514.50
|
| Rate for Payer: BCBS Complete |
$400.33
|
| Rate for Payer: BCBS Trust/PPO |
$148.45
|
| Rate for Payer: BCN Commercial |
$856.16
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Meridian Medicaid |
$400.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$901.69
|
| Rate for Payer: Priority Health Narrow Network |
$901.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$654.11
|
| Rate for Payer: UHC Exchange |
$654.11
|
| Rate for Payer: UHCCP Medicaid |
$381.27
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$875.71 |
| Rate for Payer: Aetna Commercial |
$384.81
|
| Rate for Payer: Aetna Medicare |
$590.00
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.95
|
| Rate for Payer: Priority Health Narrow Network |
$456.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.36
|
| Rate for Payer: UHC Exchange |
$331.36
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$767.00 |
| Max. Negotiated Rate |
$2,430.48 |
| Rate for Payer: Aetna Commercial |
$1,062.00
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$1,144.60
|
| Rate for Payer: ASR Commercial |
$1,144.60
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$966.30
|
| Rate for Payer: BCN Commercial |
$914.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,109.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,144.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$1,062.00
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: Nomi Health Commercial |
$967.60
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.92
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$827.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,038.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$875.71 |
| Rate for Payer: Aetna Commercial |
$384.81
|
| Rate for Payer: Aetna Medicare |
$590.00
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.95
|
| Rate for Payer: Priority Health Narrow Network |
$456.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.36
|
| Rate for Payer: UHC Exchange |
$331.36
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$767.00 |
| Max. Negotiated Rate |
$1,180.00 |
| Rate for Payer: Aetna Commercial |
$1,062.00
|
| Rate for Payer: ASR ASR |
$1,144.60
|
| Rate for Payer: ASR Commercial |
$1,144.60
|
| Rate for Payer: BCBS Trust/PPO |
$961.58
|
| Rate for Payer: BCN Commercial |
$914.85
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,109.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Healthscope Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,144.60
|
| Rate for Payer: Mclaren Commercial |
$1,062.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: Nomi Health Commercial |
$967.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,038.40
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$560.83 |
| Max. Negotiated Rate |
$1,346.45 |
| Rate for Payer: Aetna Commercial |
$1,159.57
|
| Rate for Payer: Aetna Medicare |
$709.50
|
| Rate for Payer: BCBS Complete |
$588.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.41
|
| Rate for Payer: BCN Commercial |
$1,293.53
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Meridian Medicaid |
$588.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,346.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.16
|
| Rate for Payer: UHC Exchange |
$935.16
|
| Rate for Payer: UHCCP Medicaid |
$560.83
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$86.64 |
| Max. Negotiated Rate |
$927.65 |
| Rate for Payer: Aetna Commercial |
$824.71
|
| Rate for Payer: Aetna Medicare |
$546.00
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS Trust/PPO |
$86.64
|
| Rate for Payer: BCN Commercial |
$886.46
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.90
|
| Rate for Payer: UHC Exchange |
$694.90
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$420.46 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$857.34
|
| Rate for Payer: Aetna Medicare |
$507.50
|
| Rate for Payer: BCBS Complete |
$441.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$972.47
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Meridian Medicaid |
$441.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,011.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,011.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$651.95
|
| Rate for Payer: UHC Exchange |
$651.95
|
| Rate for Payer: UHCCP Medicaid |
$420.46
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,357.00
|
|
|
Service Code
|
HCPCS 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$106.55 |
| Max. Negotiated Rate |
$1,532.05 |
| Rate for Payer: Aetna Commercial |
$992.48
|
| Rate for Payer: Aetna Medicare |
$1,178.50
|
| Rate for Payer: BCBS Complete |
$509.70
|
| Rate for Payer: BCBS Trust/PPO |
$106.55
|
| Rate for Payer: BCN Commercial |
$1,096.11
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Meridian Medicaid |
$509.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$843.84
|
| Rate for Payer: UHC Exchange |
$843.84
|
| Rate for Payer: UHCCP Medicaid |
$485.43
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
IP
|
$2,357.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$1,532.05 |
| Max. Negotiated Rate |
$2,357.00 |
| Rate for Payer: Aetna Commercial |
$2,121.30
|
| Rate for Payer: ASR ASR |
$2,286.29
|
| Rate for Payer: ASR Commercial |
$2,286.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,920.72
|
| Rate for Payer: BCN Commercial |
$1,827.38
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$2,215.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.60
|
| Rate for Payer: Healthscope Commercial |
$2,357.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,286.29
|
| Rate for Payer: Mclaren Commercial |
$2,121.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,003.45
|
| Rate for Payer: Nomi Health Commercial |
$1,932.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,074.16
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Facility
|
OP
|
$2,357.00
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
23430
|
| Min. Negotiated Rate |
$1,532.05 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$2,121.30
|
| 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 |
$2,286.29
|
| Rate for Payer: ASR Commercial |
$2,286.29
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.15
|
| Rate for Payer: BCN Commercial |
$1,827.38
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$2,215.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,357.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,286.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$2,121.30
|
| 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 |
$2,003.45
|
| Rate for Payer: Nomi Health Commercial |
$1,932.74
|
| 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 |
$1,532.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,065.20
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,652.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,074.16
|
| 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 TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,357.00
|
|
|
Service Code
|
HCPCS 23430
|
| Min. Negotiated Rate |
$106.55 |
| Max. Negotiated Rate |
$1,532.05 |
| Rate for Payer: Aetna Commercial |
$992.48
|
| Rate for Payer: Aetna Medicare |
$1,178.50
|
| Rate for Payer: BCBS Complete |
$509.70
|
| Rate for Payer: BCBS Trust/PPO |
$106.55
|
| Rate for Payer: BCN Commercial |
$1,096.11
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Meridian Medicaid |
$509.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$843.84
|
| Rate for Payer: UHC Exchange |
$843.84
|
| Rate for Payer: UHCCP Medicaid |
$485.43
|
|
|
PR TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26471
|
| Min. Negotiated Rate |
$427.07 |
| Max. Negotiated Rate |
$1,867.54 |
| Rate for Payer: Aetna Commercial |
$869.56
|
| Rate for Payer: Aetna Medicare |
$991.50
|
| Rate for Payer: BCBS Complete |
$448.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.54
|
| Rate for Payer: BCN Commercial |
$983.22
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Meridian Medicaid |
$448.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,022.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,022.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$674.18
|
| Rate for Payer: UHC Exchange |
$674.18
|
| Rate for Payer: UHCCP Medicaid |
$427.07
|
|
|
PR TENODESIS WRIST EXTENSORS FINGERS
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 25301
|
| Min. Negotiated Rate |
$232.45 |
| Max. Negotiated Rate |
$999.91 |
| Rate for Payer: Aetna Commercial |
$858.14
|
| Rate for Payer: Aetna Medicare |
$655.50
|
| Rate for Payer: BCBS Complete |
$443.28
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$950.96
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Meridian Medicaid |
$443.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$999.91
|
| Rate for Payer: Priority Health Narrow Network |
$999.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.56
|
| Rate for Payer: UHC Exchange |
$736.56
|
| Rate for Payer: UHCCP Medicaid |
$422.17
|
|
|
PR TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA
|
Professional
|
Both
|
$1,844.00
|
|
|
Service Code
|
HCPCS 26449
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$1,435.39 |
| Rate for Payer: Aetna Commercial |
$924.13
|
| Rate for Payer: Aetna Medicare |
$922.00
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,435.39
|
| Rate for Payer: BCN Commercial |
$1,033.07
|
| Rate for Payer: Cash Price |
$1,475.20
|
| Rate for Payer: Cash Price |
$1,475.20
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,198.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,088.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.23
|
| Rate for Payer: UHC Exchange |
$837.23
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
|
|
PR TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 28226
|
| Min. Negotiated Rate |
$262.84 |
| Max. Negotiated Rate |
$1,180.75 |
| Rate for Payer: Aetna Commercial |
$526.36
|
| Rate for Payer: Aetna Medicare |
$398.00
|
| Rate for Payer: BCBS Complete |
$275.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.75
|
| Rate for Payer: BCN Commercial |
$906.98
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Meridian Medicaid |
$275.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.82
|
| Rate for Payer: Priority Health Narrow Network |
$621.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$361.69
|
| Rate for Payer: UHC Exchange |
$361.69
|
| Rate for Payer: UHCCP Medicaid |
$262.84
|
|
|
PR TENOLYSIS EXTENSOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 28225
|
| Min. Negotiated Rate |
$173.17 |
| Max. Negotiated Rate |
$1,072.98 |
| Rate for Payer: Aetna Commercial |
$349.34
|
| Rate for Payer: Aetna Medicare |
$325.00
|
| Rate for Payer: BCBS Complete |
$181.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.98
|
| Rate for Payer: BCN Commercial |
$601.07
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Meridian Medicaid |
$181.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.12
|
| Rate for Payer: Priority Health Narrow Network |
$409.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.19
|
| Rate for Payer: UHC Exchange |
$297.19
|
| Rate for Payer: UHCCP Medicaid |
$173.17
|
|
|
PR TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH
|
Professional
|
Both
|
$1,229.00
|
|
|
Service Code
|
HCPCS 26445
|
| Min. Negotiated Rate |
$388.94 |
| Max. Negotiated Rate |
$1,045.51 |
| Rate for Payer: Aetna Commercial |
$805.18
|
| Rate for Payer: Aetna Medicare |
$614.50
|
| Rate for Payer: BCBS Complete |
$408.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,045.51
|
| Rate for Payer: BCN Commercial |
$905.52
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Meridian Medicaid |
$408.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.28
|
| Rate for Payer: Priority Health Narrow Network |
$935.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$630.72
|
| Rate for Payer: UHC Exchange |
$630.72
|
| Rate for Payer: UHCCP Medicaid |
$388.94
|
|
|
PR TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 28222
|
| Min. Negotiated Rate |
$240.26 |
| Max. Negotiated Rate |
$1,051.85 |
| Rate for Payer: Aetna Commercial |
$475.18
|
| Rate for Payer: Aetna Medicare |
$418.50
|
| Rate for Payer: BCBS Complete |
$252.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,051.85
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Meridian Medicaid |
$252.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.95
|
| Rate for Payer: Priority Health Narrow Network |
$570.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$422.86
|
| Rate for Payer: UHC Exchange |
$422.86
|
| Rate for Payer: UHCCP Medicaid |
$240.26
|
|
|
PR TENOLYSIS FLEXOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 28220
|
| Min. Negotiated Rate |
$198.30 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$400.31
|
| Rate for Payer: Aetna Medicare |
$494.00
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$653.85
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.20
|
| Rate for Payer: Priority Health Narrow Network |
$471.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$356.80
|
| Rate for Payer: UHC Exchange |
$356.80
|
| Rate for Payer: UHCCP Medicaid |
$198.30
|
|
|
PR TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 26442
|
| Min. Negotiated Rate |
$640.49 |
| Max. Negotiated Rate |
$1,530.15 |
| Rate for Payer: Aetna Commercial |
$1,311.01
|
| Rate for Payer: Aetna Medicare |
$892.50
|
| Rate for Payer: BCBS Complete |
$672.51
|
| Rate for Payer: BCBS Trust/PPO |
$688.90
|
| Rate for Payer: BCN Commercial |
$1,468.96
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Meridian Medicaid |
$672.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$640.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,530.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,530.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,058.03
|
| Rate for Payer: UHC Exchange |
$1,058.03
|
| Rate for Payer: UHCCP Medicaid |
$640.49
|
|
|
PR TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 26440
|
| Min. Negotiated Rate |
$418.33 |
| Max. Negotiated Rate |
$1,006.53 |
| Rate for Payer: Aetna Commercial |
$863.93
|
| Rate for Payer: Aetna Medicare |
$594.50
|
| Rate for Payer: BCBS Complete |
$439.25
|
| Rate for Payer: BCBS Trust/PPO |
$497.66
|
| Rate for Payer: BCN Commercial |
$970.51
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Meridian Medicaid |
$439.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,006.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,006.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$680.50
|
| Rate for Payer: UHC Exchange |
$680.50
|
| Rate for Payer: UHCCP Medicaid |
$418.33
|
|
|
PR TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27680
|
| Min. Negotiated Rate |
$276.90 |
| Max. Negotiated Rate |
$3,794.78 |
| Rate for Payer: Aetna Commercial |
$557.39
|
| Rate for Payer: Aetna Medicare |
$650.50
|
| Rate for Payer: BCBS Complete |
$290.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,794.78
|
| Rate for Payer: BCN Commercial |
$614.26
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Meridian Medicaid |
$290.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.34
|
| Rate for Payer: Priority Health Narrow Network |
$651.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$493.46
|
| Rate for Payer: UHC Exchange |
$493.46
|
| Rate for Payer: UHCCP Medicaid |
$276.90
|
|
|
PR TENOLYSIS TRICEPS
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 24332
|
| Min. Negotiated Rate |
$227.17 |
| Max. Negotiated Rate |
$958.18 |
| Rate for Payer: Aetna Commercial |
$819.67
|
| Rate for Payer: Aetna Medicare |
$709.50
|
| Rate for Payer: BCBS Complete |
$425.61
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$910.40
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Meridian Medicaid |
$425.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.18
|
| Rate for Payer: Priority Health Narrow Network |
$958.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$688.12
|
| Rate for Payer: UHC Exchange |
$688.12
|
| Rate for Payer: UHCCP Medicaid |
$405.34
|
|
|
PR TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX
|
Professional
|
Both
|
$2,879.00
|
|
|
Service Code
|
HCPCS 27006
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$1,871.35 |
| Rate for Payer: Aetna Commercial |
$958.69
|
| Rate for Payer: Aetna Medicare |
$1,439.50
|
| Rate for Payer: BCBS Complete |
$488.45
|
| Rate for Payer: BCBS Trust/PPO |
$146.80
|
| Rate for Payer: BCN Commercial |
$1,046.26
|
| Rate for Payer: Cash Price |
$2,303.20
|
| Rate for Payer: Cash Price |
$2,303.20
|
| Rate for Payer: Meridian Medicaid |
$488.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,871.35
|
| 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 |
$840.28
|
| Rate for Payer: UHC Exchange |
$840.28
|
| Rate for Payer: UHCCP Medicaid |
$465.19
|
|
