|
PR PART REMV BONE,DISTAL PHALANX
|
Professional
|
$808.70
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
Z12270
|
| Min. Negotiated Rate |
$404.35 |
| Max. Negotiated Rate |
$970.44 |
| Rate for Payer: Aetna Medicare |
$414.45
|
| Rate for Payer: Anthem Exchange |
$599.90
|
| Rate for Payer: Anthem Medicare |
$414.45
|
| Rate for Payer: Anthem PPO |
$599.90
|
| Rate for Payer: Anthem Traditional |
$599.90
|
| Rate for Payer: Caresource Just 4 Me |
$476.62
|
| Rate for Payer: Caresource Medicare |
$455.90
|
| Rate for Payer: Centivo/Paragon All Products |
$642.40
|
| Rate for Payer: Coventry/First Health All Products |
$970.44
|
| Rate for Payer: Frontpath All Products |
$571.61
|
| Rate for Payer: Humana ChoiceCare |
$808.70
|
| Rate for Payer: Humana Medicare |
$414.45
|
| Rate for Payer: Lucent/Coldwater Veneers |
$704.56
|
| Rate for Payer: Lutheran Preferred All Products |
$663.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$606.53
|
| Rate for Payer: PHP All Products |
$703.56
|
| Rate for Payer: Plain Church Group Ministry All Products |
$414.45
|
| Rate for Payer: Signature Care EPO |
$612.85
|
| Rate for Payer: Signature Care PPO |
$612.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$622.00
|
| Rate for Payer: United Healthcare Commercial |
$464.70
|
| Rate for Payer: United Healthcare Medicare |
$404.35
|
|
|
PR PART REMV BONE METATARSAL HEAD,EA
|
Professional
|
$1,098.54
|
|
|
Service Code
|
CPT 28288
|
| Hospital Charge Code |
Z12428
|
| Min. Negotiated Rate |
$408.64 |
| Max. Negotiated Rate |
$1,318.25 |
| Rate for Payer: Aetna Medicare |
$408.64
|
| Rate for Payer: Anthem Exchange |
$492.00
|
| Rate for Payer: Anthem Medicare |
$408.64
|
| Rate for Payer: Anthem PPO |
$492.00
|
| Rate for Payer: Anthem Traditional |
$492.00
|
| Rate for Payer: Caresource Just 4 Me |
$469.94
|
| Rate for Payer: Caresource Medicare |
$449.50
|
| Rate for Payer: Centivo/Paragon All Products |
$633.39
|
| Rate for Payer: Coventry/First Health All Products |
$1,318.25
|
| Rate for Payer: Frontpath All Products |
$553.54
|
| Rate for Payer: Humana ChoiceCare |
$1,098.54
|
| Rate for Payer: Humana Medicare |
$408.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$694.69
|
| Rate for Payer: Lutheran Preferred All Products |
$654.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$823.90
|
| Rate for Payer: PHP All Products |
$693.70
|
| Rate for Payer: Plain Church Group Ministry All Products |
$408.64
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$613.00
|
| Rate for Payer: United Healthcare Commercial |
$473.18
|
| Rate for Payer: United Healthcare Medicare |
$549.27
|
|
|
PR PART REMV PHALANX OF TOE
|
Professional
|
$867.88
|
|
|
Service Code
|
CPT 28124
|
| Hospital Charge Code |
Z12422
|
| Min. Negotiated Rate |
$315.13 |
| Max. Negotiated Rate |
$1,041.46 |
| Rate for Payer: Aetna Medicare |
$315.13
|
| Rate for Payer: Anthem Exchange |
$455.01
|
| Rate for Payer: Anthem Medicare |
$315.13
|
| Rate for Payer: Anthem PPO |
$455.01
|
| Rate for Payer: Anthem Traditional |
$455.01
|
| Rate for Payer: Caresource Just 4 Me |
$362.40
|
| Rate for Payer: Caresource Medicare |
$346.64
|
| Rate for Payer: Centivo/Paragon All Products |
$488.45
|
| Rate for Payer: Coventry/First Health All Products |
$1,041.46
|
| Rate for Payer: Frontpath All Products |
$424.45
|
| Rate for Payer: Humana ChoiceCare |
$867.88
|
| Rate for Payer: Humana Medicare |
$315.13
|
| Rate for Payer: Lucent/Coldwater Veneers |
$535.72
|
| Rate for Payer: Lutheran Preferred All Products |
$504.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$650.91
|
| Rate for Payer: PHP All Products |
$534.95
|
| Rate for Payer: Plain Church Group Ministry All Products |
$315.13
|
| Rate for Payer: Signature Care EPO |
$624.75
|
| Rate for Payer: Signature Care PPO |
$624.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$473.00
|
| Rate for Payer: United Healthcare Commercial |
$379.83
|
| Rate for Payer: United Healthcare Medicare |
$433.94
|
|
|
PR PART SIMPLE REMV VULVA
|
Professional
|
$1,071.46
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
Z12693
|
| Min. Negotiated Rate |
$535.73 |
| Max. Negotiated Rate |
$1,285.75 |
| Rate for Payer: Aetna Medicare |
$549.12
|
| Rate for Payer: Anthem Exchange |
$644.17
|
| Rate for Payer: Anthem Medicare |
$549.12
|
| Rate for Payer: Anthem PPO |
$644.17
|
| Rate for Payer: Anthem Traditional |
$644.17
|
| Rate for Payer: Caresource Just 4 Me |
$631.49
|
| Rate for Payer: Caresource Medicare |
$604.03
|
| Rate for Payer: Centivo/Paragon All Products |
$851.14
|
| Rate for Payer: Coventry/First Health All Products |
$1,285.75
|
| Rate for Payer: Frontpath All Products |
$758.77
|
| Rate for Payer: Humana ChoiceCare |
$1,071.46
|
| Rate for Payer: Humana Medicare |
$549.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$933.50
|
| Rate for Payer: Lutheran Preferred All Products |
$769.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$803.60
|
| Rate for Payer: PHP All Products |
$707.16
|
| Rate for Payer: Plain Church Group Ministry All Products |
$549.12
|
| Rate for Payer: Signature Care EPO |
$611.15
|
| Rate for Payer: Signature Care PPO |
$611.15
|
| Rate for Payer: Three Rivers Preferred All Products |
$714.00
|
| Rate for Payer: United Healthcare Commercial |
$551.84
|
| Rate for Payer: United Healthcare Medicare |
$535.73
|
|
|
PR PELVIC EXAMINATION W ANESTH
|
Professional
|
$191.66
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
Z12713
|
| Min. Negotiated Rate |
$95.83 |
| Max. Negotiated Rate |
$229.99 |
| Rate for Payer: Aetna Medicare |
$98.22
|
| Rate for Payer: Anthem Exchange |
$193.35
|
| Rate for Payer: Anthem Medicare |
$98.22
|
| Rate for Payer: Anthem PPO |
$193.35
|
| Rate for Payer: Anthem Traditional |
$193.35
|
| Rate for Payer: Caresource Just 4 Me |
$112.95
|
| Rate for Payer: Caresource Medicare |
$108.04
|
| Rate for Payer: Centivo/Paragon All Products |
$152.24
|
| Rate for Payer: Coventry/First Health All Products |
$229.99
|
| Rate for Payer: Frontpath All Products |
$136.79
|
| Rate for Payer: Humana ChoiceCare |
$191.66
|
| Rate for Payer: Humana Medicare |
$98.22
|
| Rate for Payer: Lucent/Coldwater Veneers |
$166.97
|
| Rate for Payer: Lutheran Preferred All Products |
$138.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$143.75
|
| Rate for Payer: PHP All Products |
$126.49
|
| Rate for Payer: Plain Church Group Ministry All Products |
$98.22
|
| Rate for Payer: Signature Care EPO |
$168.05
|
| Rate for Payer: Signature Care PPO |
$168.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$128.00
|
| Rate for Payer: United Healthcare Commercial |
$120.59
|
| Rate for Payer: United Healthcare Medicare |
$95.83
|
|
|
PR PELVIS/HIP JOINT SURGERY UNLISTED
|
Professional
|
$1,312.41
|
|
|
Service Code
|
CPT 27299
|
| Hospital Charge Code |
Z12328
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,574.89 |
| Rate for Payer: Anthem Exchange |
$0.01
|
| Rate for Payer: Anthem PPO |
$0.01
|
| Rate for Payer: Anthem Traditional |
$0.01
|
| Rate for Payer: Coventry/First Health All Products |
$1,574.89
|
| Rate for Payer: Humana ChoiceCare |
$1,312.41
|
| Rate for Payer: Lutheran Preferred All Products |
$1,115.55
|
| Rate for Payer: PHCS/Multiplan All Products |
$984.31
|
| Rate for Payer: Signature Care EPO |
$836.66
|
| Rate for Payer: Signature Care PPO |
$836.66
|
| Rate for Payer: Three Rivers Preferred All Products |
$787.45
|
|
|
PR PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS
|
Professional
|
$7.00
|
|
|
Service Code
|
CPT 95004
|
| Hospital Charge Code |
Z13130
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna Medicare |
$3.59
|
| Rate for Payer: Anthem Exchange |
$6.07
|
| Rate for Payer: Anthem Medicare |
$3.59
|
| Rate for Payer: Anthem PPO |
$6.07
|
| Rate for Payer: Anthem Traditional |
$6.07
|
| Rate for Payer: Caresource Just 4 Me |
$4.13
|
| Rate for Payer: Caresource Medicare |
$3.95
|
| Rate for Payer: Centivo/Paragon All Products |
$5.56
|
| Rate for Payer: Coventry/First Health All Products |
$8.40
|
| Rate for Payer: Frontpath All Products |
$4.70
|
| Rate for Payer: Humana ChoiceCare |
$7.00
|
| Rate for Payer: Humana Medicare |
$3.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$6.10
|
| Rate for Payer: Lutheran Preferred All Products |
$5.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$5.25
|
| Rate for Payer: PHP All Products |
$4.02
|
| Rate for Payer: Plain Church Group Ministry All Products |
$3.59
|
| Rate for Payer: Signature Care EPO |
$4.97
|
| Rate for Payer: Signature Care PPO |
$4.97
|
| Rate for Payer: Three Rivers Preferred All Products |
$4.00
|
| Rate for Payer: United Healthcare Commercial |
$6.51
|
| Rate for Payer: United Healthcare Medicare |
$3.50
|
|
|
PR PERCUT FIX CARPOMETACAR DISLOC,NON-THUMB
|
Professional
|
$938.70
|
|
|
Service Code
|
CPT 26676
|
| Hospital Charge Code |
Z12286
|
| Min. Negotiated Rate |
$469.35 |
| Max. Negotiated Rate |
$1,126.44 |
| Rate for Payer: Aetna Medicare |
$481.08
|
| Rate for Payer: Anthem Exchange |
$585.80
|
| Rate for Payer: Anthem Medicare |
$481.08
|
| Rate for Payer: Anthem PPO |
$585.80
|
| Rate for Payer: Anthem Traditional |
$585.80
|
| Rate for Payer: Caresource Just 4 Me |
$553.24
|
| Rate for Payer: Caresource Medicare |
$529.19
|
| Rate for Payer: Centivo/Paragon All Products |
$745.67
|
| Rate for Payer: Coventry/First Health All Products |
$1,126.44
|
| Rate for Payer: Frontpath All Products |
$656.73
|
| Rate for Payer: Humana ChoiceCare |
$938.70
|
| Rate for Payer: Humana Medicare |
$481.08
|
| Rate for Payer: Lucent/Coldwater Veneers |
$817.84
|
| Rate for Payer: Lutheran Preferred All Products |
$770.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$704.03
|
| Rate for Payer: PHP All Products |
$816.66
|
| Rate for Payer: Plain Church Group Ministry All Products |
$481.08
|
| Rate for Payer: Signature Care EPO |
$708.05
|
| Rate for Payer: Signature Care PPO |
$708.05
|
| Rate for Payer: Three Rivers Preferred All Products |
$722.00
|
| Rate for Payer: United Healthcare Commercial |
$522.05
|
| Rate for Payer: United Healthcare Medicare |
$469.35
|
|
|
PR PERCUT FIX DISTAL FEMUR
|
Professional
|
$1,234.82
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
Z12359
|
| Min. Negotiated Rate |
$617.41 |
| Max. Negotiated Rate |
$1,481.78 |
| Rate for Payer: Aetna Medicare |
$632.84
|
| Rate for Payer: Anthem Exchange |
$691.30
|
| Rate for Payer: Anthem Medicare |
$632.84
|
| Rate for Payer: Anthem PPO |
$691.30
|
| Rate for Payer: Anthem Traditional |
$691.30
|
| Rate for Payer: Caresource Just 4 Me |
$727.77
|
| Rate for Payer: Caresource Medicare |
$696.12
|
| Rate for Payer: Centivo/Paragon All Products |
$980.90
|
| Rate for Payer: Coventry/First Health All Products |
$1,481.78
|
| Rate for Payer: Frontpath All Products |
$878.28
|
| Rate for Payer: Humana ChoiceCare |
$1,234.82
|
| Rate for Payer: Humana Medicare |
$632.84
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,075.83
|
| Rate for Payer: Lutheran Preferred All Products |
$1,013.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$926.12
|
| Rate for Payer: PHP All Products |
$1,074.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$632.84
|
| Rate for Payer: Signature Care EPO |
$905.25
|
| Rate for Payer: Signature Care PPO |
$905.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$949.00
|
| Rate for Payer: United Healthcare Commercial |
$688.29
|
| Rate for Payer: United Healthcare Medicare |
$617.41
|
|
|
PR PERCUT FIX HUM SUPRACONDYLAR FX
|
Professional
|
$1,439.44
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
Z12204
|
| Min. Negotiated Rate |
$719.72 |
| Max. Negotiated Rate |
$1,727.33 |
| Rate for Payer: Aetna Medicare |
$737.87
|
| Rate for Payer: Anthem Exchange |
$906.10
|
| Rate for Payer: Anthem Medicare |
$737.87
|
| Rate for Payer: Anthem PPO |
$906.10
|
| Rate for Payer: Anthem Traditional |
$906.10
|
| Rate for Payer: Caresource Just 4 Me |
$848.55
|
| Rate for Payer: Caresource Medicare |
$811.66
|
| Rate for Payer: Centivo/Paragon All Products |
$1,143.70
|
| Rate for Payer: Coventry/First Health All Products |
$1,727.33
|
| Rate for Payer: Frontpath All Products |
$1,025.60
|
| Rate for Payer: Humana ChoiceCare |
$1,439.44
|
| Rate for Payer: Humana Medicare |
$737.87
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,254.38
|
| Rate for Payer: Lutheran Preferred All Products |
$1,181.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,079.58
|
| Rate for Payer: PHP All Products |
$1,252.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$737.87
|
| Rate for Payer: Signature Care EPO |
$1,052.30
|
| Rate for Payer: Signature Care PPO |
$1,052.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,107.00
|
| Rate for Payer: United Healthcare Commercial |
$798.78
|
| Rate for Payer: United Healthcare Medicare |
$719.72
|
|
|
PR PERCUT FIX PROX/NECK FEMUR FX
|
Professional
|
$1,641.14
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
Z12318
|
| Min. Negotiated Rate |
$820.57 |
| Max. Negotiated Rate |
$1,969.37 |
| Rate for Payer: Aetna Medicare |
$841.08
|
| Rate for Payer: Anthem Exchange |
$1,202.00
|
| Rate for Payer: Anthem Medicare |
$841.08
|
| Rate for Payer: Anthem PPO |
$1,202.00
|
| Rate for Payer: Anthem Traditional |
$1,202.00
|
| Rate for Payer: Caresource Just 4 Me |
$967.24
|
| Rate for Payer: Caresource Medicare |
$925.19
|
| Rate for Payer: Centivo/Paragon All Products |
$1,303.67
|
| Rate for Payer: Coventry/First Health All Products |
$1,969.37
|
| Rate for Payer: Frontpath All Products |
$1,179.89
|
| Rate for Payer: Humana ChoiceCare |
$1,641.14
|
| Rate for Payer: Humana Medicare |
$841.08
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,429.84
|
| Rate for Payer: Lutheran Preferred All Products |
$1,346.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,230.86
|
| Rate for Payer: PHP All Products |
$1,427.79
|
| Rate for Payer: Plain Church Group Ministry All Products |
$841.08
|
| Rate for Payer: Signature Care EPO |
$1,263.10
|
| Rate for Payer: Signature Care PPO |
$1,263.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,262.00
|
| Rate for Payer: United Healthcare Commercial |
$993.44
|
| Rate for Payer: United Healthcare Medicare |
$820.57
|
|
|
PR PERCUT RX DIST FINGR FX
|
Professional
|
$783.12
|
|
|
Service Code
|
CPT 26756
|
| Hospital Charge Code |
Z12297
|
| Min. Negotiated Rate |
$391.56 |
| Max. Negotiated Rate |
$939.74 |
| Rate for Payer: Aetna Medicare |
$401.35
|
| Rate for Payer: Anthem Exchange |
$432.40
|
| Rate for Payer: Anthem Medicare |
$401.35
|
| Rate for Payer: Anthem PPO |
$432.40
|
| Rate for Payer: Anthem Traditional |
$432.40
|
| Rate for Payer: Caresource Just 4 Me |
$461.55
|
| Rate for Payer: Caresource Medicare |
$441.49
|
| Rate for Payer: Centivo/Paragon All Products |
$622.09
|
| Rate for Payer: Coventry/First Health All Products |
$939.74
|
| Rate for Payer: Frontpath All Products |
$547.88
|
| Rate for Payer: Humana ChoiceCare |
$783.12
|
| Rate for Payer: Humana Medicare |
$401.35
|
| Rate for Payer: Lucent/Coldwater Veneers |
$682.30
|
| Rate for Payer: Lutheran Preferred All Products |
$642.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$587.34
|
| Rate for Payer: PHP All Products |
$681.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$401.35
|
| Rate for Payer: Signature Care EPO |
$595.85
|
| Rate for Payer: Signature Care PPO |
$595.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$602.00
|
| Rate for Payer: United Healthcare Commercial |
$430.90
|
| Rate for Payer: United Healthcare Medicare |
$391.56
|
|
|
PR PERCUT RX I-P JT,TOE DISLOC
|
Professional
|
$327.34
|
|
|
Service Code
|
CPT 28666
|
| Hospital Charge Code |
Z12444
|
| Min. Negotiated Rate |
$163.67 |
| Max. Negotiated Rate |
$392.81 |
| Rate for Payer: Aetna Medicare |
$167.76
|
| Rate for Payer: Anthem Exchange |
$238.88
|
| Rate for Payer: Anthem Medicare |
$167.76
|
| Rate for Payer: Anthem PPO |
$238.88
|
| Rate for Payer: Anthem Traditional |
$238.88
|
| Rate for Payer: Caresource Just 4 Me |
$192.92
|
| Rate for Payer: Caresource Medicare |
$184.54
|
| Rate for Payer: Centivo/Paragon All Products |
$260.03
|
| Rate for Payer: Coventry/First Health All Products |
$392.81
|
| Rate for Payer: Frontpath All Products |
$228.18
|
| Rate for Payer: Humana ChoiceCare |
$327.34
|
| Rate for Payer: Humana Medicare |
$167.76
|
| Rate for Payer: Lucent/Coldwater Veneers |
$285.19
|
| Rate for Payer: Lutheran Preferred All Products |
$268.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$245.50
|
| Rate for Payer: PHP All Products |
$284.78
|
| Rate for Payer: Plain Church Group Ministry All Products |
$167.76
|
| Rate for Payer: Signature Care EPO |
$288.78
|
| Rate for Payer: Signature Care PPO |
$288.78
|
| Rate for Payer: Three Rivers Preferred All Products |
$252.00
|
| Rate for Payer: United Healthcare Commercial |
$214.31
|
| Rate for Payer: United Healthcare Medicare |
$163.67
|
|
|
PR PERCUT RX PROX/MID FING SHFT FX
|
Professional
|
$873.20
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
Z12291
|
| Min. Negotiated Rate |
$436.60 |
| Max. Negotiated Rate |
$1,047.84 |
| Rate for Payer: Aetna Medicare |
$447.51
|
| Rate for Payer: Anthem Exchange |
$499.00
|
| Rate for Payer: Anthem Medicare |
$447.51
|
| Rate for Payer: Anthem PPO |
$499.00
|
| Rate for Payer: Anthem Traditional |
$499.00
|
| Rate for Payer: Caresource Just 4 Me |
$514.64
|
| Rate for Payer: Caresource Medicare |
$492.26
|
| Rate for Payer: Centivo/Paragon All Products |
$693.64
|
| Rate for Payer: Coventry/First Health All Products |
$1,047.84
|
| Rate for Payer: Frontpath All Products |
$612.27
|
| Rate for Payer: Humana ChoiceCare |
$873.20
|
| Rate for Payer: Humana Medicare |
$447.51
|
| Rate for Payer: Lucent/Coldwater Veneers |
$760.77
|
| Rate for Payer: Lutheran Preferred All Products |
$716.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$654.90
|
| Rate for Payer: PHP All Products |
$759.68
|
| Rate for Payer: Plain Church Group Ministry All Products |
$447.51
|
| Rate for Payer: Signature Care EPO |
$668.10
|
| Rate for Payer: Signature Care PPO |
$668.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$671.00
|
| Rate for Payer: United Healthcare Commercial |
$489.66
|
| Rate for Payer: United Healthcare Medicare |
$436.60
|
|
|
PR PERCUT SKELETAL FIX, DISTAL RADIUS FX
|
Professional
|
$1,221.12
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
Z12245
|
| Min. Negotiated Rate |
$610.56 |
| Max. Negotiated Rate |
$1,465.34 |
| Rate for Payer: Aetna Medicare |
$625.50
|
| Rate for Payer: Anthem Exchange |
$753.20
|
| Rate for Payer: Anthem Medicare |
$625.50
|
| Rate for Payer: Anthem PPO |
$753.20
|
| Rate for Payer: Anthem Traditional |
$753.20
|
| Rate for Payer: Caresource Just 4 Me |
$719.32
|
| Rate for Payer: Caresource Medicare |
$688.05
|
| Rate for Payer: Centivo/Paragon All Products |
$969.52
|
| Rate for Payer: Coventry/First Health All Products |
$1,465.34
|
| Rate for Payer: Frontpath All Products |
$863.99
|
| Rate for Payer: Humana ChoiceCare |
$1,221.12
|
| Rate for Payer: Humana Medicare |
$625.50
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,063.35
|
| Rate for Payer: Lutheran Preferred All Products |
$1,001.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$915.84
|
| Rate for Payer: PHP All Products |
$1,062.38
|
| Rate for Payer: Plain Church Group Ministry All Products |
$625.50
|
| Rate for Payer: Signature Care EPO |
$916.30
|
| Rate for Payer: Signature Care PPO |
$916.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$938.00
|
| Rate for Payer: United Healthcare Commercial |
$704.64
|
| Rate for Payer: United Healthcare Medicare |
$610.56
|
|
|
PR PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
$84.32
|
|
|
Service Code
|
CPT 93286
|
| Hospital Charge Code |
Z13099
|
| Min. Negotiated Rate |
$31.99 |
| Max. Negotiated Rate |
$101.18 |
| Rate for Payer: Aetna Medicare |
$43.21
|
| Rate for Payer: Anthem Exchange |
$38.13
|
| Rate for Payer: Anthem Medicare |
$43.21
|
| Rate for Payer: Anthem PPO |
$38.13
|
| Rate for Payer: Anthem Traditional |
$38.13
|
| Rate for Payer: Caresource Just 4 Me |
$49.69
|
| Rate for Payer: Caresource Medicare |
$47.53
|
| Rate for Payer: Centivo/Paragon All Products |
$66.98
|
| Rate for Payer: Coventry/First Health All Products |
$101.18
|
| Rate for Payer: Frontpath All Products |
$50.48
|
| Rate for Payer: Humana ChoiceCare |
$84.32
|
| Rate for Payer: Humana Medicare |
$43.21
|
| Rate for Payer: Lucent/Coldwater Veneers |
$73.46
|
| Rate for Payer: Lutheran Preferred All Products |
$69.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$63.24
|
| Rate for Payer: PHP All Products |
$61.97
|
| Rate for Payer: Plain Church Group Ministry All Products |
$43.21
|
| Rate for Payer: Signature Care EPO |
$39.15
|
| Rate for Payer: Signature Care PPO |
$39.15
|
| Rate for Payer: Three Rivers Preferred All Products |
$65.00
|
| Rate for Payer: United Healthcare Commercial |
$31.99
|
|
|
PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Professional
|
$98.46
|
|
|
Service Code
|
CPT 93287
|
| Hospital Charge Code |
Z13100
|
| Min. Negotiated Rate |
$42.33 |
| Max. Negotiated Rate |
$118.15 |
| Rate for Payer: Aetna Medicare |
$50.46
|
| Rate for Payer: Anthem Exchange |
$50.45
|
| Rate for Payer: Anthem Medicare |
$50.46
|
| Rate for Payer: Anthem PPO |
$50.45
|
| Rate for Payer: Anthem Traditional |
$50.45
|
| Rate for Payer: Caresource Just 4 Me |
$58.03
|
| Rate for Payer: Caresource Medicare |
$55.51
|
| Rate for Payer: Centivo/Paragon All Products |
$78.21
|
| Rate for Payer: Coventry/First Health All Products |
$118.15
|
| Rate for Payer: Frontpath All Products |
$58.70
|
| Rate for Payer: Humana ChoiceCare |
$98.46
|
| Rate for Payer: Humana Medicare |
$50.46
|
| Rate for Payer: Lucent/Coldwater Veneers |
$85.78
|
| Rate for Payer: Lutheran Preferred All Products |
$81.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$73.84
|
| Rate for Payer: PHP All Products |
$72.36
|
| Rate for Payer: Plain Church Group Ministry All Products |
$50.46
|
| Rate for Payer: Signature Care EPO |
$51.82
|
| Rate for Payer: Signature Care PPO |
$51.82
|
| Rate for Payer: Three Rivers Preferred All Products |
$76.00
|
| Rate for Payer: United Healthcare Commercial |
$42.33
|
|
|
PR PERITONEAL LAVAGE W/WO IMAGING GUIDANCE
|
Professional
|
$190.64
|
|
|
Service Code
|
CPT 49084
|
| Hospital Charge Code |
Z12661
|
| Min. Negotiated Rate |
$95.32 |
| Max. Negotiated Rate |
$228.77 |
| Rate for Payer: Aetna Medicare |
$97.70
|
| Rate for Payer: Anthem Exchange |
$116.70
|
| Rate for Payer: Anthem Medicare |
$97.70
|
| Rate for Payer: Anthem PPO |
$116.70
|
| Rate for Payer: Anthem Traditional |
$116.70
|
| Rate for Payer: Caresource Just 4 Me |
$112.35
|
| Rate for Payer: Caresource Medicare |
$107.47
|
| Rate for Payer: Centivo/Paragon All Products |
$151.44
|
| Rate for Payer: Coventry/First Health All Products |
$228.77
|
| Rate for Payer: Frontpath All Products |
$141.04
|
| Rate for Payer: Humana ChoiceCare |
$190.64
|
| Rate for Payer: Humana Medicare |
$97.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$166.09
|
| Rate for Payer: Lutheran Preferred All Products |
$147.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$142.98
|
| Rate for Payer: PHP All Products |
$166.81
|
| Rate for Payer: Plain Church Group Ministry All Products |
$97.70
|
| Rate for Payer: Signature Care EPO |
$104.02
|
| Rate for Payer: Signature Care PPO |
$104.02
|
| Rate for Payer: Three Rivers Preferred All Products |
$137.00
|
| Rate for Payer: United Healthcare Commercial |
$124.41
|
| Rate for Payer: United Healthcare Medicare |
$95.32
|
|
|
PR PESSARY, NON RUBBER,ANY TYPE
|
Professional
|
$216.00
|
|
|
Service Code
|
CPT A4562
|
| Hospital Charge Code |
Z13245
|
| Min. Negotiated Rate |
$31.06 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Anthem Exchange |
$31.06
|
| Rate for Payer: Anthem PPO |
$31.06
|
| Rate for Payer: Anthem Traditional |
$31.06
|
| Rate for Payer: Coventry/First Health All Products |
$259.20
|
| Rate for Payer: Humana ChoiceCare |
$216.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$162.00
|
| Rate for Payer: PHP All Products |
$50.79
|
| Rate for Payer: Signature Care EPO |
$44.55
|
| Rate for Payer: Signature Care PPO |
$44.55
|
| Rate for Payer: United Healthcare Commercial |
$45.45
|
|
|
PR PESSARY RUBBER, ANY TYPE
|
Professional
|
$216.00
|
|
|
Service Code
|
CPT A4561
|
| Hospital Charge Code |
Z13244
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Anthem Exchange |
$12.46
|
| Rate for Payer: Anthem PPO |
$12.46
|
| Rate for Payer: Anthem Traditional |
$12.46
|
| Rate for Payer: Coventry/First Health All Products |
$259.20
|
| Rate for Payer: Humana ChoiceCare |
$216.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$162.00
|
| Rate for Payer: PHP All Products |
$20.45
|
| Rate for Payer: Signature Care EPO |
$17.93
|
| Rate for Payer: Signature Care PPO |
$17.93
|
| Rate for Payer: United Healthcare Commercial |
$18.28
|
|
|
PR PHYSICIAN TELEPHONE EVALUATION 21-30 MIN
|
Professional
|
$234.94
|
|
|
Service Code
|
CPT 99443
|
| Hospital Charge Code |
Z13226
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$281.93 |
| Rate for Payer: Aetna Medicare |
$92.31
|
| Rate for Payer: Anthem Exchange |
$46.57
|
| Rate for Payer: Anthem Medicare |
$92.31
|
| Rate for Payer: Anthem PPO |
$46.57
|
| Rate for Payer: Anthem Traditional |
$46.57
|
| Rate for Payer: Caresource Just 4 Me |
$106.16
|
| Rate for Payer: Caresource Medicare |
$101.54
|
| Rate for Payer: Centivo/Paragon All Products |
$143.08
|
| Rate for Payer: Coventry/First Health All Products |
$281.93
|
| Rate for Payer: Frontpath All Products |
$100.78
|
| Rate for Payer: Humana ChoiceCare |
$234.94
|
| Rate for Payer: Humana Medicare |
$92.31
|
| Rate for Payer: Lucent/Coldwater Veneers |
$156.93
|
| Rate for Payer: Lutheran Preferred All Products |
$97.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$176.20
|
| Rate for Payer: PHP All Products |
$92.76
|
| Rate for Payer: Plain Church Group Ministry All Products |
$92.31
|
| Rate for Payer: Signature Care EPO |
$103.39
|
| Rate for Payer: Signature Care PPO |
$103.39
|
| Rate for Payer: Three Rivers Preferred All Products |
$95.00
|
| Rate for Payer: United Healthcare Commercial |
$37.78
|
| Rate for Payer: United Healthcare Medicare |
$117.47
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 11-20 MIN
|
Professional
|
$166.20
|
|
|
Service Code
|
CPT 99442
|
| Hospital Charge Code |
Z13225
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$199.44 |
| Rate for Payer: Aetna Medicare |
$62.64
|
| Rate for Payer: Anthem Exchange |
$31.40
|
| Rate for Payer: Anthem Medicare |
$62.64
|
| Rate for Payer: Anthem PPO |
$31.40
|
| Rate for Payer: Anthem Traditional |
$31.40
|
| Rate for Payer: Caresource Just 4 Me |
$72.04
|
| Rate for Payer: Caresource Medicare |
$68.90
|
| Rate for Payer: Centivo/Paragon All Products |
$97.09
|
| Rate for Payer: Coventry/First Health All Products |
$199.44
|
| Rate for Payer: Frontpath All Products |
$68.40
|
| Rate for Payer: Humana ChoiceCare |
$166.20
|
| Rate for Payer: Humana Medicare |
$62.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$106.49
|
| Rate for Payer: Lutheran Preferred All Products |
$66.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$124.65
|
| Rate for Payer: PHP All Products |
$62.95
|
| Rate for Payer: Plain Church Group Ministry All Products |
$62.64
|
| Rate for Payer: Signature Care EPO |
$72.83
|
| Rate for Payer: Signature Care PPO |
$72.83
|
| Rate for Payer: Three Rivers Preferred All Products |
$65.00
|
| Rate for Payer: United Healthcare Commercial |
$25.29
|
| Rate for Payer: United Healthcare Medicare |
$83.10
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 5-10 MIN
|
Professional
|
$102.96
|
|
|
Service Code
|
CPT 99441
|
| Hospital Charge Code |
Z13224
|
| Min. Negotiated Rate |
$12.71 |
| Max. Negotiated Rate |
$123.55 |
| Rate for Payer: Aetna Medicare |
$33.32
|
| Rate for Payer: Anthem Exchange |
$16.00
|
| Rate for Payer: Anthem Medicare |
$33.32
|
| Rate for Payer: Anthem PPO |
$16.00
|
| Rate for Payer: Anthem Traditional |
$16.00
|
| Rate for Payer: Caresource Just 4 Me |
$38.32
|
| Rate for Payer: Caresource Medicare |
$36.65
|
| Rate for Payer: Centivo/Paragon All Products |
$51.65
|
| Rate for Payer: Coventry/First Health All Products |
$123.55
|
| Rate for Payer: Frontpath All Products |
$36.69
|
| Rate for Payer: Humana ChoiceCare |
$102.96
|
| Rate for Payer: Humana Medicare |
$33.32
|
| Rate for Payer: Lucent/Coldwater Veneers |
$56.64
|
| Rate for Payer: Lutheran Preferred All Products |
$35.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$77.22
|
| Rate for Payer: PHP All Products |
$33.48
|
| Rate for Payer: Plain Church Group Ministry All Products |
$33.32
|
| Rate for Payer: Signature Care EPO |
$44.84
|
| Rate for Payer: Signature Care PPO |
$44.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$34.00
|
| Rate for Payer: United Healthcare Commercial |
$12.71
|
| Rate for Payer: United Healthcare Medicare |
$51.48
|
|
|
PR PLACEMENT,SETON
|
Professional
|
$209.88
|
|
|
Service Code
|
CPT 46020
|
| Hospital Charge Code |
Z12638
|
| Min. Negotiated Rate |
$104.94 |
| Max. Negotiated Rate |
$291.20 |
| Rate for Payer: Aetna Medicare |
$107.56
|
| Rate for Payer: Anthem Exchange |
$291.20
|
| Rate for Payer: Anthem Medicare |
$107.56
|
| Rate for Payer: Anthem PPO |
$291.20
|
| Rate for Payer: Anthem Traditional |
$291.20
|
| Rate for Payer: Caresource Just 4 Me |
$123.69
|
| Rate for Payer: Caresource Medicare |
$118.32
|
| Rate for Payer: Centivo/Paragon All Products |
$166.72
|
| Rate for Payer: Coventry/First Health All Products |
$251.86
|
| Rate for Payer: Frontpath All Products |
$150.53
|
| Rate for Payer: Humana ChoiceCare |
$209.88
|
| Rate for Payer: Humana Medicare |
$107.56
|
| Rate for Payer: Lucent/Coldwater Veneers |
$182.85
|
| Rate for Payer: Lutheran Preferred All Products |
$161.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$157.41
|
| Rate for Payer: PHP All Products |
$183.64
|
| Rate for Payer: Plain Church Group Ministry All Products |
$107.56
|
| Rate for Payer: Signature Care EPO |
$183.33
|
| Rate for Payer: Signature Care PPO |
$183.33
|
| Rate for Payer: Three Rivers Preferred All Products |
$151.00
|
| Rate for Payer: United Healthcare Commercial |
$231.96
|
| Rate for Payer: United Healthcare Medicare |
$104.94
|
|
|
PR PLASTY KNEE,MED OR LAT COMPARTMT
|
Professional
|
$2,070.42
|
|
|
Service Code
|
CPT 27446
|
| Hospital Charge Code |
Z12351
|
| Min. Negotiated Rate |
$1,035.21 |
| Max. Negotiated Rate |
$2,484.50 |
| Rate for Payer: Caresource Medicare |
$1,167.20
|
| Rate for Payer: Aetna Medicare |
$1,061.09
|
| Rate for Payer: Anthem Medicare |
$1,061.09
|
| Rate for Payer: Caresource Just 4 Me |
$1,220.25
|
| Rate for Payer: Centivo/Paragon All Products |
$1,644.69
|
| Rate for Payer: Coventry/First Health All Products |
$2,484.50
|
| Rate for Payer: Frontpath All Products |
$1,501.40
|
| Rate for Payer: Humana ChoiceCare |
$2,070.42
|
| Rate for Payer: Humana Medicare |
$1,061.09
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,803.85
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,552.82
|
| Rate for Payer: PHP All Products |
$1,801.27
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,061.09
|
| Rate for Payer: Signature Care EPO |
$1,586.95
|
| Rate for Payer: Signature Care PPO |
$1,586.95
|
| Rate for Payer: United Healthcare Commercial |
$1,226.53
|
| Rate for Payer: United Healthcare Medicare |
$1,035.21
|
|
