|
PR REMV NASAL FOR BODY,GEN ANESTH
|
Professional
|
$383.54
|
|
|
Service Code
|
CPT 30310
|
| Hospital Charge Code |
Z12504
|
| Min. Negotiated Rate |
$181.00 |
| Max. Negotiated Rate |
$460.25 |
| Rate for Payer: Aetna Medicare |
$196.56
|
| Rate for Payer: Anthem Exchange |
$181.00
|
| Rate for Payer: Anthem Medicare |
$196.56
|
| Rate for Payer: Anthem PPO |
$181.00
|
| Rate for Payer: Anthem Traditional |
$181.00
|
| Rate for Payer: Caresource Just 4 Me |
$226.04
|
| Rate for Payer: Caresource Medicare |
$216.22
|
| Rate for Payer: Centivo/Paragon All Products |
$304.67
|
| Rate for Payer: Coventry/First Health All Products |
$460.25
|
| Rate for Payer: Frontpath All Products |
$267.68
|
| Rate for Payer: Humana ChoiceCare |
$383.54
|
| Rate for Payer: Humana Medicare |
$196.56
|
| Rate for Payer: Lucent/Coldwater Veneers |
$334.15
|
| Rate for Payer: Lutheran Preferred All Products |
$314.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$287.66
|
| Rate for Payer: PHP All Products |
$268.47
|
| Rate for Payer: Plain Church Group Ministry All Products |
$196.56
|
| Rate for Payer: Signature Care EPO |
$267.75
|
| Rate for Payer: Signature Care PPO |
$267.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$295.00
|
| Rate for Payer: United Healthcare Commercial |
$215.68
|
| Rate for Payer: United Healthcare Medicare |
$191.77
|
|
|
PR REMV PILONIDAL LESION COMPLIC
|
Professional
|
$1,398.54
|
|
|
Service Code
|
CPT 11772
|
| Hospital Charge Code |
Z12032
|
| Min. Negotiated Rate |
$534.92 |
| Max. Negotiated Rate |
$1,678.25 |
| Rate for Payer: Aetna Medicare |
$534.92
|
| Rate for Payer: Anthem Exchange |
$647.88
|
| Rate for Payer: Anthem Medicare |
$534.92
|
| Rate for Payer: Anthem PPO |
$647.88
|
| Rate for Payer: Anthem Traditional |
$647.88
|
| Rate for Payer: Caresource Just 4 Me |
$615.16
|
| Rate for Payer: Caresource Medicare |
$588.41
|
| Rate for Payer: Centivo/Paragon All Products |
$829.13
|
| Rate for Payer: Coventry/First Health All Products |
$1,678.25
|
| Rate for Payer: Frontpath All Products |
$754.43
|
| Rate for Payer: Humana ChoiceCare |
$1,398.54
|
| Rate for Payer: Humana Medicare |
$534.92
|
| Rate for Payer: Lucent/Coldwater Veneers |
$909.36
|
| Rate for Payer: Lutheran Preferred All Products |
$695.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,048.90
|
| Rate for Payer: PHP All Products |
$730.63
|
| Rate for Payer: Plain Church Group Ministry All Products |
$534.92
|
| Rate for Payer: Signature Care EPO |
$619.99
|
| Rate for Payer: Signature Care PPO |
$619.99
|
| Rate for Payer: Three Rivers Preferred All Products |
$642.00
|
| Rate for Payer: United Healthcare Commercial |
$575.54
|
| Rate for Payer: United Healthcare Medicare |
$699.27
|
|
|
PR REMV PILONIDAL LESION EXTENS
|
Professional
|
$1,136.94
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
Z12031
|
| Min. Negotiated Rate |
$414.12 |
| Max. Negotiated Rate |
$1,364.33 |
| Rate for Payer: Aetna Medicare |
$414.12
|
| Rate for Payer: Anthem Exchange |
$533.87
|
| Rate for Payer: Anthem Medicare |
$414.12
|
| Rate for Payer: Anthem PPO |
$533.87
|
| Rate for Payer: Anthem Traditional |
$533.87
|
| Rate for Payer: Caresource Just 4 Me |
$476.24
|
| Rate for Payer: Caresource Medicare |
$455.53
|
| Rate for Payer: Centivo/Paragon All Products |
$641.89
|
| Rate for Payer: Coventry/First Health All Products |
$1,364.33
|
| Rate for Payer: Frontpath All Products |
$585.62
|
| Rate for Payer: Humana ChoiceCare |
$1,136.94
|
| Rate for Payer: Humana Medicare |
$414.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$704.00
|
| Rate for Payer: Lutheran Preferred All Products |
$538.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$852.71
|
| Rate for Payer: PHP All Products |
$565.63
|
| Rate for Payer: Plain Church Group Ministry All Products |
$414.12
|
| Rate for Payer: Signature Care EPO |
$503.53
|
| Rate for Payer: Signature Care PPO |
$503.53
|
| Rate for Payer: Three Rivers Preferred All Products |
$497.00
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$568.47
|
|
|
PR REMV PILONIDAL LESION SIMPLE
|
Professional
|
$644.38
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
Z12030
|
| Min. Negotiated Rate |
$170.64 |
| Max. Negotiated Rate |
$773.26 |
| Rate for Payer: Aetna Medicare |
$170.64
|
| Rate for Payer: Anthem Exchange |
$269.70
|
| Rate for Payer: Anthem Medicare |
$170.64
|
| Rate for Payer: Anthem PPO |
$269.70
|
| Rate for Payer: Anthem Traditional |
$269.70
|
| Rate for Payer: Caresource Just 4 Me |
$196.24
|
| Rate for Payer: Caresource Medicare |
$187.70
|
| Rate for Payer: Centivo/Paragon All Products |
$264.49
|
| Rate for Payer: Coventry/First Health All Products |
$773.26
|
| Rate for Payer: Frontpath All Products |
$242.44
|
| Rate for Payer: Humana ChoiceCare |
$644.38
|
| Rate for Payer: Humana Medicare |
$170.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$290.09
|
| Rate for Payer: Lutheran Preferred All Products |
$222.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$483.28
|
| Rate for Payer: PHP All Products |
$233.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$170.64
|
| Rate for Payer: Signature Care EPO |
$289.24
|
| Rate for Payer: Signature Care PPO |
$289.24
|
| Rate for Payer: Three Rivers Preferred All Products |
$205.00
|
| Rate for Payer: United Healthcare Commercial |
$190.80
|
| Rate for Payer: United Healthcare Medicare |
$322.19
|
|
|
PR REMV TARSAL/METATARSAL BENIGN BONE LESN
|
Professional
|
$953.04
|
|
|
Service Code
|
CPT 28104
|
| Hospital Charge Code |
Z12419
|
| Min. Negotiated Rate |
$332.53 |
| Max. Negotiated Rate |
$1,143.65 |
| Rate for Payer: Aetna Medicare |
$332.53
|
| Rate for Payer: Anthem Exchange |
$490.01
|
| Rate for Payer: Anthem Medicare |
$332.53
|
| Rate for Payer: Anthem PPO |
$490.01
|
| Rate for Payer: Anthem Traditional |
$490.01
|
| Rate for Payer: Caresource Just 4 Me |
$382.41
|
| Rate for Payer: Caresource Medicare |
$365.78
|
| Rate for Payer: Centivo/Paragon All Products |
$515.42
|
| Rate for Payer: Coventry/First Health All Products |
$1,143.65
|
| Rate for Payer: Frontpath All Products |
$451.83
|
| Rate for Payer: Humana ChoiceCare |
$953.04
|
| Rate for Payer: Humana Medicare |
$332.53
|
| Rate for Payer: Lucent/Coldwater Veneers |
$565.30
|
| Rate for Payer: Lutheran Preferred All Products |
$532.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$714.78
|
| Rate for Payer: PHP All Products |
$564.49
|
| Rate for Payer: Plain Church Group Ministry All Products |
$332.53
|
| Rate for Payer: Signature Care EPO |
$658.75
|
| Rate for Payer: Signature Care PPO |
$658.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$499.00
|
| Rate for Payer: United Healthcare Commercial |
$398.49
|
| Rate for Payer: United Healthcare Medicare |
$476.52
|
|
|
PR REOPEN FALLOPIAN TUBE,CHROMOTUBATION
|
Professional
|
$282.36
|
|
|
Service Code
|
CPT 58350
|
| Hospital Charge Code |
Z12746
|
| Min. Negotiated Rate |
$86.93 |
| Max. Negotiated Rate |
$338.83 |
| Rate for Payer: Humana Medicare |
$89.45
|
| Rate for Payer: Aetna Medicare |
$89.45
|
| Rate for Payer: Anthem Exchange |
$128.25
|
| Rate for Payer: Anthem Medicare |
$89.45
|
| Rate for Payer: Anthem PPO |
$128.25
|
| Rate for Payer: Anthem Traditional |
$128.25
|
| Rate for Payer: Caresource Just 4 Me |
$102.87
|
| Rate for Payer: Caresource Medicare |
$98.40
|
| Rate for Payer: Centivo/Paragon All Products |
$138.65
|
| Rate for Payer: Coventry/First Health All Products |
$338.83
|
| Rate for Payer: Frontpath All Products |
$123.08
|
| Rate for Payer: Humana ChoiceCare |
$282.36
|
| Rate for Payer: Lucent/Coldwater Veneers |
$152.06
|
| Rate for Payer: Lutheran Preferred All Products |
$125.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$211.77
|
| Rate for Payer: PHP All Products |
$115.19
|
| Rate for Payer: Plain Church Group Ministry All Products |
$89.45
|
| Rate for Payer: Signature Care EPO |
$124.98
|
| Rate for Payer: Signature Care PPO |
$124.98
|
| Rate for Payer: Three Rivers Preferred All Products |
$116.00
|
| Rate for Payer: United Healthcare Commercial |
$86.93
|
| Rate for Payer: United Healthcare Medicare |
$141.18
|
|
|
PR REOPEN RECENT ABD EXPLORATORY
|
Professional
|
$1,856.84
|
|
|
Service Code
|
CPT 49002
|
| Hospital Charge Code |
Z12658
|
| Min. Negotiated Rate |
$835.80 |
| Max. Negotiated Rate |
$2,228.21 |
| Rate for Payer: Caresource Medicare |
$1,046.79
|
| Rate for Payer: Aetna Medicare |
$951.63
|
| Rate for Payer: Anthem Exchange |
$835.80
|
| Rate for Payer: Anthem Medicare |
$951.63
|
| Rate for Payer: Anthem PPO |
$835.80
|
| Rate for Payer: Anthem Traditional |
$835.80
|
| Rate for Payer: Caresource Just 4 Me |
$1,094.37
|
| Rate for Payer: Centivo/Paragon All Products |
$1,475.03
|
| Rate for Payer: Coventry/First Health All Products |
$2,228.21
|
| Rate for Payer: Frontpath All Products |
$1,378.64
|
| Rate for Payer: Humana ChoiceCare |
$1,856.84
|
| Rate for Payer: Humana Medicare |
$951.63
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,617.77
|
| Rate for Payer: Lutheran Preferred All Products |
$1,427.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,392.63
|
| Rate for Payer: PHP All Products |
$1,624.73
|
| Rate for Payer: Plain Church Group Ministry All Products |
$951.63
|
| Rate for Payer: Signature Care EPO |
$898.45
|
| Rate for Payer: Signature Care PPO |
$898.45
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,332.00
|
| Rate for Payer: United Healthcare Commercial |
$1,087.29
|
| Rate for Payer: United Healthcare Medicare |
$928.42
|
|
|
PR REPAIR 1 COLLAT ANKLE LIGMNT,PRIMARY
|
Professional
|
$887.66
|
|
|
Service Code
|
CPT 27695
|
| Hospital Charge Code |
Z12384
|
| Min. Negotiated Rate |
$443.83 |
| Max. Negotiated Rate |
$1,065.19 |
| Rate for Payer: Aetna Medicare |
$454.93
|
| Rate for Payer: Anthem Medicare |
$454.93
|
| Rate for Payer: Caresource Just 4 Me |
$523.17
|
| Rate for Payer: Caresource Medicare |
$500.42
|
| Rate for Payer: Centivo/Paragon All Products |
$705.14
|
| Rate for Payer: Coventry/First Health All Products |
$1,065.19
|
| Rate for Payer: Frontpath All Products |
$618.85
|
| Rate for Payer: Humana ChoiceCare |
$887.66
|
| Rate for Payer: Humana Medicare |
$454.93
|
| Rate for Payer: Lucent/Coldwater Veneers |
$773.38
|
| Rate for Payer: PHCS/Multiplan All Products |
$665.75
|
| Rate for Payer: Plain Church Group Ministry All Products |
$454.93
|
| Rate for Payer: United Healthcare Commercial |
$537.73
|
| Rate for Payer: United Healthcare Medicare |
$443.83
|
|
|
PR REPAIR ACHILLES TENDON,PRIMARY
|
Professional
|
$1,205.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
Z12378
|
| Min. Negotiated Rate |
$602.50 |
| Max. Negotiated Rate |
$1,446.00 |
| Rate for Payer: Aetna Medicare |
$617.56
|
| Rate for Payer: Anthem Exchange |
$926.70
|
| Rate for Payer: Anthem Medicare |
$617.56
|
| Rate for Payer: Anthem PPO |
$926.70
|
| Rate for Payer: Anthem Traditional |
$926.70
|
| Rate for Payer: Caresource Just 4 Me |
$710.19
|
| Rate for Payer: Caresource Medicare |
$679.32
|
| Rate for Payer: Centivo/Paragon All Products |
$957.22
|
| Rate for Payer: Coventry/First Health All Products |
$1,446.00
|
| Rate for Payer: Frontpath All Products |
$850.77
|
| Rate for Payer: Humana ChoiceCare |
$1,205.00
|
| Rate for Payer: Humana Medicare |
$617.56
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,049.85
|
| Rate for Payer: Lutheran Preferred All Products |
$988.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$903.75
|
| Rate for Payer: PHP All Products |
$1,048.35
|
| Rate for Payer: Plain Church Group Ministry All Products |
$617.56
|
| Rate for Payer: Signature Care EPO |
$1,008.10
|
| Rate for Payer: Signature Care PPO |
$1,008.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$926.00
|
| Rate for Payer: United Healthcare Commercial |
$734.25
|
| Rate for Payer: United Healthcare Medicare |
$602.50
|
|
|
PR REPAIR BICEPS LONG TENDON
|
Professional
|
$1,354.46
|
|
|
Service Code
|
CPT 23430
|
| Hospital Charge Code |
Z12165
|
| Min. Negotiated Rate |
$677.23 |
| Max. Negotiated Rate |
$1,625.35 |
| Rate for Payer: Caresource Medicare |
$763.58
|
| Rate for Payer: Aetna Medicare |
$694.16
|
| Rate for Payer: Anthem Exchange |
$942.70
|
| Rate for Payer: Anthem Medicare |
$694.16
|
| Rate for Payer: Anthem PPO |
$942.70
|
| Rate for Payer: Anthem Traditional |
$942.70
|
| Rate for Payer: Caresource Just 4 Me |
$798.28
|
| Rate for Payer: Centivo/Paragon All Products |
$1,075.95
|
| Rate for Payer: Coventry/First Health All Products |
$1,625.35
|
| Rate for Payer: Frontpath All Products |
$966.37
|
| Rate for Payer: Humana ChoiceCare |
$1,354.46
|
| Rate for Payer: Humana Medicare |
$694.16
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,180.07
|
| Rate for Payer: Lutheran Preferred All Products |
$1,111.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,015.85
|
| Rate for Payer: PHP All Products |
$1,178.37
|
| Rate for Payer: Plain Church Group Ministry All Products |
$694.16
|
| Rate for Payer: Signature Care EPO |
$1,058.25
|
| Rate for Payer: Signature Care PPO |
$1,058.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,041.00
|
| Rate for Payer: United Healthcare Commercial |
$800.95
|
| Rate for Payer: United Healthcare Medicare |
$677.23
|
|
|
PR REPAIR BLEED LIVER/SUTURE WOUND
|
Professional
|
$2,438.12
|
|
|
Service Code
|
CPT 47350
|
| Hospital Charge Code |
Z12654
|
| Min. Negotiated Rate |
$1,004.60 |
| Max. Negotiated Rate |
$2,925.74 |
| Rate for Payer: Aetna Medicare |
$1,249.54
|
| Rate for Payer: Anthem Exchange |
$1,004.60
|
| Rate for Payer: Anthem Medicare |
$1,249.54
|
| Rate for Payer: Anthem PPO |
$1,004.60
|
| Rate for Payer: Anthem Traditional |
$1,004.60
|
| Rate for Payer: Caresource Just 4 Me |
$1,436.97
|
| Rate for Payer: Caresource Medicare |
$1,374.49
|
| Rate for Payer: Centivo/Paragon All Products |
$1,936.79
|
| Rate for Payer: Coventry/First Health All Products |
$2,925.74
|
| Rate for Payer: Frontpath All Products |
$1,807.66
|
| Rate for Payer: Humana ChoiceCare |
$2,438.12
|
| Rate for Payer: Humana Medicare |
$1,249.54
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,124.22
|
| Rate for Payer: Lutheran Preferred All Products |
$1,874.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,828.59
|
| Rate for Payer: PHP All Products |
$2,133.36
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,249.54
|
| Rate for Payer: Signature Care EPO |
$1,625.20
|
| Rate for Payer: Signature Care PPO |
$1,625.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,749.00
|
| Rate for Payer: United Healthcare Commercial |
$1,456.69
|
| Rate for Payer: United Healthcare Medicare |
$1,219.06
|
|
|
PR REPAIR COLLAT LIGAMT/CAPSULE,KNEE
|
Professional
|
$1,230.94
|
|
|
Service Code
|
CPT 27405
|
| Hospital Charge Code |
Z12344
|
| Min. Negotiated Rate |
$615.47 |
| Max. Negotiated Rate |
$1,477.13 |
| Rate for Payer: Aetna Medicare |
$630.86
|
| Rate for Payer: Anthem Medicare |
$630.86
|
| Rate for Payer: Caresource Just 4 Me |
$725.49
|
| Rate for Payer: Caresource Medicare |
$693.95
|
| Rate for Payer: Centivo/Paragon All Products |
$977.83
|
| Rate for Payer: Coventry/First Health All Products |
$1,477.13
|
| Rate for Payer: Frontpath All Products |
$879.32
|
| Rate for Payer: Humana ChoiceCare |
$1,230.94
|
| Rate for Payer: Humana Medicare |
$630.86
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,072.46
|
| Rate for Payer: PHCS/Multiplan All Products |
$923.21
|
| Rate for Payer: Plain Church Group Ministry All Products |
$630.86
|
| Rate for Payer: United Healthcare Commercial |
$727.81
|
| Rate for Payer: United Healthcare Medicare |
$615.47
|
|
|
PR REPAIR EXTEN LEG TENDON,PRIM,EA
|
Professional
|
$885.32
|
|
|
Service Code
|
CPT 28208
|
| Hospital Charge Code |
Z12427
|
| Min. Negotiated Rate |
$303.07 |
| Max. Negotiated Rate |
$1,062.38 |
| Rate for Payer: Aetna Medicare |
$303.07
|
| Rate for Payer: Anthem Exchange |
$427.87
|
| Rate for Payer: Anthem Medicare |
$303.07
|
| Rate for Payer: Anthem PPO |
$427.87
|
| Rate for Payer: Anthem Traditional |
$427.87
|
| Rate for Payer: Caresource Just 4 Me |
$348.53
|
| Rate for Payer: Caresource Medicare |
$333.38
|
| Rate for Payer: Centivo/Paragon All Products |
$469.76
|
| Rate for Payer: Coventry/First Health All Products |
$1,062.38
|
| Rate for Payer: Frontpath All Products |
$408.72
|
| Rate for Payer: Humana ChoiceCare |
$885.32
|
| Rate for Payer: Humana Medicare |
$303.07
|
| Rate for Payer: Lucent/Coldwater Veneers |
$515.22
|
| Rate for Payer: Lutheran Preferred All Products |
$485.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$663.99
|
| Rate for Payer: PHP All Products |
$514.49
|
| Rate for Payer: Plain Church Group Ministry All Products |
$303.07
|
| Rate for Payer: Signature Care EPO |
$578.85
|
| Rate for Payer: Signature Care PPO |
$578.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$455.00
|
| Rate for Payer: United Healthcare Commercial |
$347.36
|
| Rate for Payer: United Healthcare Medicare |
$442.66
|
|
|
PR REPAIR EXTEN TENDON,DISTAL INSERT,OPEN
|
Professional
|
$1,055.82
|
|
|
Service Code
|
CPT 26433
|
| Hospital Charge Code |
Z12275
|
| Min. Negotiated Rate |
$527.91 |
| Max. Negotiated Rate |
$1,266.98 |
| Rate for Payer: Aetna Medicare |
$541.11
|
| Rate for Payer: Anthem Exchange |
$589.10
|
| Rate for Payer: Anthem Medicare |
$541.11
|
| Rate for Payer: Anthem PPO |
$589.10
|
| Rate for Payer: Anthem Traditional |
$589.10
|
| Rate for Payer: Caresource Just 4 Me |
$622.28
|
| Rate for Payer: Caresource Medicare |
$595.22
|
| Rate for Payer: Centivo/Paragon All Products |
$838.72
|
| Rate for Payer: Coventry/First Health All Products |
$1,266.98
|
| Rate for Payer: Frontpath All Products |
$740.74
|
| Rate for Payer: Humana ChoiceCare |
$1,055.82
|
| Rate for Payer: Humana Medicare |
$541.11
|
| Rate for Payer: Lucent/Coldwater Veneers |
$919.89
|
| Rate for Payer: Lutheran Preferred All Products |
$866.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$791.87
|
| Rate for Payer: PHP All Products |
$918.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$541.11
|
| Rate for Payer: Signature Care EPO |
$842.47
|
| Rate for Payer: Signature Care PPO |
$842.47
|
| Rate for Payer: Three Rivers Preferred All Products |
$812.00
|
| Rate for Payer: United Healthcare Commercial |
$555.48
|
| Rate for Payer: United Healthcare Medicare |
$527.91
|
|
|
PR REPAIR EXTEN TENDON,DORSUM FINGR,EA
|
Professional
|
$1,150.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
Z12274
|
| Min. Negotiated Rate |
$575.09 |
| Max. Negotiated Rate |
$1,380.22 |
| Rate for Payer: Aetna Medicare |
$589.46
|
| Rate for Payer: Anthem Exchange |
$767.97
|
| Rate for Payer: Anthem Medicare |
$589.46
|
| Rate for Payer: Anthem PPO |
$767.97
|
| Rate for Payer: Anthem Traditional |
$767.97
|
| Rate for Payer: Caresource Just 4 Me |
$677.88
|
| Rate for Payer: Caresource Medicare |
$648.41
|
| Rate for Payer: Centivo/Paragon All Products |
$913.66
|
| Rate for Payer: Coventry/First Health All Products |
$1,380.22
|
| Rate for Payer: Frontpath All Products |
$803.60
|
| Rate for Payer: Humana ChoiceCare |
$1,150.18
|
| Rate for Payer: Humana Medicare |
$589.46
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,002.08
|
| Rate for Payer: Lutheran Preferred All Products |
$943.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$862.63
|
| Rate for Payer: PHP All Products |
$1,000.65
|
| Rate for Payer: Plain Church Group Ministry All Products |
$589.46
|
| Rate for Payer: Signature Care EPO |
$914.14
|
| Rate for Payer: Signature Care PPO |
$914.14
|
| Rate for Payer: Three Rivers Preferred All Products |
$884.00
|
| Rate for Payer: United Healthcare Commercial |
$592.40
|
| Rate for Payer: United Healthcare Medicare |
$575.09
|
|
|
PR REPAIR EXTEN TENDON,DORSUM HAND,EA
|
Professional
|
$1,108.36
|
|
|
Service Code
|
CPT 26410
|
| Hospital Charge Code |
Z12273
|
| Min. Negotiated Rate |
$554.18 |
| Max. Negotiated Rate |
$1,330.03 |
| Rate for Payer: Aetna Medicare |
$568.03
|
| Rate for Payer: Anthem Exchange |
$931.64
|
| Rate for Payer: Anthem Medicare |
$568.03
|
| Rate for Payer: Anthem PPO |
$931.64
|
| Rate for Payer: Anthem Traditional |
$931.64
|
| Rate for Payer: Caresource Just 4 Me |
$653.23
|
| Rate for Payer: Caresource Medicare |
$624.83
|
| Rate for Payer: Centivo/Paragon All Products |
$880.45
|
| Rate for Payer: Coventry/First Health All Products |
$1,330.03
|
| Rate for Payer: Frontpath All Products |
$777.66
|
| Rate for Payer: Humana ChoiceCare |
$1,108.36
|
| Rate for Payer: Humana Medicare |
$568.03
|
| Rate for Payer: Lucent/Coldwater Veneers |
$965.65
|
| Rate for Payer: Lutheran Preferred All Products |
$909.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$831.27
|
| Rate for Payer: PHP All Products |
$964.27
|
| Rate for Payer: Plain Church Group Ministry All Products |
$568.03
|
| Rate for Payer: Signature Care EPO |
$894.32
|
| Rate for Payer: Signature Care PPO |
$894.32
|
| Rate for Payer: Three Rivers Preferred All Products |
$852.00
|
| Rate for Payer: United Healthcare Commercial |
$591.18
|
| Rate for Payer: United Healthcare Medicare |
$554.18
|
|
|
PR REPAIR FLEX FOOT TENDON,EA
|
Professional
|
$899.62
|
|
|
Service Code
|
CPT 28200
|
| Hospital Charge Code |
Z12426
|
| Min. Negotiated Rate |
$307.93 |
| Max. Negotiated Rate |
$1,079.54 |
| Rate for Payer: Aetna Medicare |
$307.93
|
| Rate for Payer: Anthem Exchange |
$449.57
|
| Rate for Payer: Anthem Medicare |
$307.93
|
| Rate for Payer: Anthem PPO |
$449.57
|
| Rate for Payer: Anthem Traditional |
$449.57
|
| Rate for Payer: Caresource Just 4 Me |
$354.12
|
| Rate for Payer: Caresource Medicare |
$338.72
|
| Rate for Payer: Centivo/Paragon All Products |
$477.29
|
| Rate for Payer: Coventry/First Health All Products |
$1,079.54
|
| Rate for Payer: Frontpath All Products |
$419.47
|
| Rate for Payer: Humana ChoiceCare |
$899.62
|
| Rate for Payer: Humana Medicare |
$307.93
|
| Rate for Payer: Lucent/Coldwater Veneers |
$523.48
|
| Rate for Payer: Lutheran Preferred All Products |
$493.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$674.72
|
| Rate for Payer: PHP All Products |
$522.73
|
| Rate for Payer: Plain Church Group Ministry All Products |
$307.93
|
| Rate for Payer: Signature Care EPO |
$603.50
|
| Rate for Payer: Signature Care PPO |
$603.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$462.00
|
| Rate for Payer: United Healthcare Commercial |
$361.86
|
| Rate for Payer: United Healthcare Medicare |
$449.81
|
|
|
PR REPAIR FLEX LEG TENDON,PRIM,EA
|
Professional
|
$678.32
|
|
|
Service Code
|
CPT 27658
|
| Hospital Charge Code |
Z12380
|
| Min. Negotiated Rate |
$339.16 |
| Max. Negotiated Rate |
$813.98 |
| Rate for Payer: Aetna Medicare |
$347.64
|
| Rate for Payer: Anthem Medicare |
$347.64
|
| Rate for Payer: Caresource Just 4 Me |
$399.79
|
| Rate for Payer: Caresource Medicare |
$382.40
|
| Rate for Payer: Centivo/Paragon All Products |
$538.84
|
| Rate for Payer: Coventry/First Health All Products |
$813.98
|
| Rate for Payer: Frontpath All Products |
$474.93
|
| Rate for Payer: Humana ChoiceCare |
$678.32
|
| Rate for Payer: Humana Medicare |
$347.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$590.99
|
| Rate for Payer: PHCS/Multiplan All Products |
$508.74
|
| Rate for Payer: Plain Church Group Ministry All Products |
$347.64
|
| Rate for Payer: United Healthcare Commercial |
$416.14
|
| Rate for Payer: United Healthcare Medicare |
$339.16
|
|
|
PR REPAIR FLEX TENDON,ZONE 2,HAND
|
Professional
|
$1,455.70
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
Z12272
|
| Min. Negotiated Rate |
$727.85 |
| Max. Negotiated Rate |
$1,746.84 |
| Rate for Payer: Aetna Medicare |
$746.05
|
| Rate for Payer: Anthem Exchange |
$1,168.03
|
| Rate for Payer: Anthem Medicare |
$746.05
|
| Rate for Payer: Anthem PPO |
$1,168.03
|
| Rate for Payer: Anthem Traditional |
$1,168.03
|
| Rate for Payer: Caresource Just 4 Me |
$857.96
|
| Rate for Payer: Caresource Medicare |
$820.65
|
| Rate for Payer: Centivo/Paragon All Products |
$1,156.38
|
| Rate for Payer: Coventry/First Health All Products |
$1,746.84
|
| Rate for Payer: Frontpath All Products |
$1,024.96
|
| Rate for Payer: Humana ChoiceCare |
$1,455.70
|
| Rate for Payer: Humana Medicare |
$746.05
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,268.28
|
| Rate for Payer: Lutheran Preferred All Products |
$1,194.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,091.78
|
| Rate for Payer: PHP All Products |
$1,266.46
|
| Rate for Payer: Plain Church Group Ministry All Products |
$746.05
|
| Rate for Payer: Signature Care EPO |
$1,265.02
|
| Rate for Payer: Signature Care PPO |
$1,265.02
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,119.00
|
| Rate for Payer: United Healthcare Commercial |
$1,109.68
|
| Rate for Payer: United Healthcare Medicare |
$727.85
|
|
|
PR REPAIR/GRAFT ACHILLES TENDON
|
Professional
|
$1,220.76
|
|
|
Service Code
|
CPT 27652
|
| Hospital Charge Code |
Z12379
|
| Min. Negotiated Rate |
$610.38 |
| Max. Negotiated Rate |
$1,464.91 |
| Rate for Payer: Aetna Medicare |
$625.64
|
| Rate for Payer: Anthem Exchange |
$996.20
|
| Rate for Payer: Anthem Medicare |
$625.64
|
| Rate for Payer: Anthem PPO |
$996.20
|
| Rate for Payer: Anthem Traditional |
$996.20
|
| Rate for Payer: Caresource Just 4 Me |
$719.49
|
| Rate for Payer: Caresource Medicare |
$688.20
|
| Rate for Payer: Centivo/Paragon All Products |
$969.74
|
| Rate for Payer: Coventry/First Health All Products |
$1,464.91
|
| Rate for Payer: Frontpath All Products |
$854.14
|
| Rate for Payer: Humana ChoiceCare |
$1,220.76
|
| Rate for Payer: Humana Medicare |
$625.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,063.59
|
| Rate for Payer: Lutheran Preferred All Products |
$1,001.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$915.57
|
| Rate for Payer: PHP All Products |
$1,062.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$625.64
|
| Rate for Payer: Signature Care EPO |
$1,063.16
|
| Rate for Payer: Signature Care PPO |
$1,063.16
|
| Rate for Payer: Three Rivers Preferred All Products |
$938.00
|
| Rate for Payer: United Healthcare Commercial |
$811.29
|
| Rate for Payer: United Healthcare Medicare |
$610.38
|
|
|
PR REPAIR ING HERNIA,5+Y/O,STRANG
|
Professional
|
$1,052.70
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
Z12669
|
| Min. Negotiated Rate |
$526.35 |
| Max. Negotiated Rate |
$1,263.24 |
| Rate for Payer: Aetna Medicare |
$539.51
|
| Rate for Payer: Anthem Exchange |
$677.70
|
| Rate for Payer: Anthem Medicare |
$539.51
|
| Rate for Payer: Anthem PPO |
$677.70
|
| Rate for Payer: Anthem Traditional |
$677.70
|
| Rate for Payer: Caresource Just 4 Me |
$620.44
|
| Rate for Payer: Caresource Medicare |
$593.46
|
| Rate for Payer: Centivo/Paragon All Products |
$836.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,263.24
|
| Rate for Payer: Frontpath All Products |
$775.81
|
| Rate for Payer: Humana ChoiceCare |
$1,052.70
|
| Rate for Payer: Humana Medicare |
$539.51
|
| Rate for Payer: Lucent/Coldwater Veneers |
$917.17
|
| Rate for Payer: Lutheran Preferred All Products |
$809.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$789.53
|
| Rate for Payer: PHP All Products |
$921.11
|
| Rate for Payer: Plain Church Group Ministry All Products |
$539.51
|
| Rate for Payer: Signature Care EPO |
$811.75
|
| Rate for Payer: Signature Care PPO |
$811.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$755.00
|
| Rate for Payer: United Healthcare Commercial |
$672.50
|
| Rate for Payer: United Healthcare Medicare |
$526.35
|
|
|
PR REPAIR INTERCARP/CARP-METACARP JT
|
Professional
|
$1,517.22
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
Z12231
|
| Min. Negotiated Rate |
$758.61 |
| Max. Negotiated Rate |
$1,820.66 |
| Rate for Payer: Aetna Medicare |
$777.57
|
| Rate for Payer: Anthem Exchange |
$1,014.40
|
| Rate for Payer: Anthem Medicare |
$777.57
|
| Rate for Payer: Anthem PPO |
$1,014.40
|
| Rate for Payer: Anthem Traditional |
$1,014.40
|
| Rate for Payer: Caresource Just 4 Me |
$894.21
|
| Rate for Payer: Caresource Medicare |
$855.33
|
| Rate for Payer: Centivo/Paragon All Products |
$1,205.23
|
| Rate for Payer: Coventry/First Health All Products |
$1,820.66
|
| Rate for Payer: Frontpath All Products |
$1,074.09
|
| Rate for Payer: Humana ChoiceCare |
$1,517.22
|
| Rate for Payer: Humana Medicare |
$777.57
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,321.87
|
| Rate for Payer: Lutheran Preferred All Products |
$1,244.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,137.91
|
| Rate for Payer: PHP All Products |
$1,319.98
|
| Rate for Payer: Plain Church Group Ministry All Products |
$777.57
|
| Rate for Payer: Signature Care EPO |
$1,101.60
|
| Rate for Payer: Signature Care PPO |
$1,101.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,166.00
|
| Rate for Payer: United Healthcare Commercial |
$878.58
|
| Rate for Payer: United Healthcare Medicare |
$758.61
|
|
|
PR REPAIR NON/MALUNION METATARSAL
|
Professional
|
$1,431.86
|
|
|
Service Code
|
CPT 28322
|
| Hospital Charge Code |
Z12430
|
| Min. Negotiated Rate |
$542.12 |
| Max. Negotiated Rate |
$1,718.23 |
| Rate for Payer: Aetna Medicare |
$542.12
|
| Rate for Payer: Anthem Exchange |
$711.50
|
| Rate for Payer: Anthem Medicare |
$542.12
|
| Rate for Payer: Anthem PPO |
$711.50
|
| Rate for Payer: Anthem Traditional |
$711.50
|
| Rate for Payer: Caresource Just 4 Me |
$623.44
|
| Rate for Payer: Caresource Medicare |
$596.33
|
| Rate for Payer: Centivo/Paragon All Products |
$840.29
|
| Rate for Payer: Coventry/First Health All Products |
$1,718.23
|
| Rate for Payer: Frontpath All Products |
$743.80
|
| Rate for Payer: Humana ChoiceCare |
$1,431.86
|
| Rate for Payer: Humana Medicare |
$542.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$921.60
|
| Rate for Payer: Lutheran Preferred All Products |
$867.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,073.89
|
| Rate for Payer: PHP All Products |
$920.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$542.12
|
| Rate for Payer: Signature Care EPO |
$1,064.20
|
| Rate for Payer: Signature Care PPO |
$1,064.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$813.00
|
| Rate for Payer: United Healthcare Commercial |
$645.21
|
| Rate for Payer: United Healthcare Medicare |
$715.93
|
|
|
PR REPAIR NONUNION RADIUS OR ULNA
|
Professional
|
$1,462.12
|
|
|
Service Code
|
CPT 25400
|
| Hospital Charge Code |
Z12230
|
| Min. Negotiated Rate |
$731.06 |
| Max. Negotiated Rate |
$1,754.54 |
| Rate for Payer: Aetna Medicare |
$749.34
|
| Rate for Payer: Anthem Exchange |
$1,185.20
|
| Rate for Payer: Anthem Medicare |
$749.34
|
| Rate for Payer: Anthem PPO |
$1,185.20
|
| Rate for Payer: Anthem Traditional |
$1,185.20
|
| Rate for Payer: Caresource Just 4 Me |
$861.74
|
| Rate for Payer: Caresource Medicare |
$824.27
|
| Rate for Payer: Centivo/Paragon All Products |
$1,161.48
|
| Rate for Payer: Coventry/First Health All Products |
$1,754.54
|
| Rate for Payer: Frontpath All Products |
$1,041.85
|
| Rate for Payer: Humana ChoiceCare |
$1,462.12
|
| Rate for Payer: Humana Medicare |
$749.34
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,273.88
|
| Rate for Payer: Lutheran Preferred All Products |
$1,199.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,096.59
|
| Rate for Payer: PHP All Products |
$1,272.05
|
| Rate for Payer: Plain Church Group Ministry All Products |
$749.34
|
| Rate for Payer: Signature Care EPO |
$1,274.15
|
| Rate for Payer: Signature Care PPO |
$1,274.15
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,124.00
|
| Rate for Payer: United Healthcare Commercial |
$943.65
|
| Rate for Payer: United Healthcare Medicare |
$731.06
|
|
|
PR REPAIR OF BICEPS TENDON AT ELBOW
|
Professional
|
$1,098.44
|
|
|
Service Code
|
CPT 24340
|
| Hospital Charge Code |
Z12193
|
| Min. Negotiated Rate |
$549.22 |
| Max. Negotiated Rate |
$1,318.13 |
| Rate for Payer: Caresource Just 4 Me |
$647.39
|
| Rate for Payer: Caresource Medicare |
$619.25
|
| Rate for Payer: Aetna Medicare |
$562.95
|
| Rate for Payer: Anthem Exchange |
$743.40
|
| Rate for Payer: Anthem Medicare |
$562.95
|
| Rate for Payer: Anthem PPO |
$743.40
|
| Rate for Payer: Anthem Traditional |
$743.40
|
| Rate for Payer: Centivo/Paragon All Products |
$872.57
|
| Rate for Payer: Coventry/First Health All Products |
$1,318.13
|
| Rate for Payer: Frontpath All Products |
$802.80
|
| Rate for Payer: Humana ChoiceCare |
$1,098.44
|
| Rate for Payer: Humana Medicare |
$562.95
|
| Rate for Payer: Lucent/Coldwater Veneers |
$957.02
|
| Rate for Payer: Lutheran Preferred All Products |
$901.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$823.83
|
| Rate for Payer: PHP All Products |
$955.64
|
| Rate for Payer: Plain Church Group Ministry All Products |
$562.95
|
| Rate for Payer: Signature Care EPO |
$862.75
|
| Rate for Payer: Signature Care PPO |
$862.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$844.00
|
| Rate for Payer: United Healthcare Commercial |
$657.15
|
| Rate for Payer: United Healthcare Medicare |
$549.22
|
|
