|
XR Tibia/Fibula 2 Views Left
|
Facility
OP
|
$538.00
|
|
|
Service Code
|
CPT 73590 LT
|
| Hospital Charge Code |
2214290
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.46 |
| Max. Negotiated Rate |
$484.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$484.20
|
| Rate for Payer: Aetna Medicare |
$150.64
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$91.46
|
| Rate for Payer: Amerigroup Medicare |
$91.46
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$200.94
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$91.46
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$91.46
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$351.56
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$139.88
|
| Rate for Payer: Cigna All Products |
$349.70
|
| Rate for Payer: Copperpoint |
$150.91
|
| Rate for Payer: HealthNet Commercial |
$322.80
|
| Rate for Payer: HealthNet Medicare |
$150.64
|
| Rate for Payer: Humana Medicare |
$91.46
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$430.40
|
| Rate for Payer: Veterans (Triwest) |
$91.46
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$313.65
|
| Rate for Payer: United Healthcare Medicare |
$96.84
|
|
|
XR Tibia/Fibula 2 Views Left
|
Facility
IP
|
$538.00
|
|
|
Service Code
|
CPT 73590 LT
|
| Hospital Charge Code |
2214290
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.46 |
| Max. Negotiated Rate |
$484.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$484.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$91.46
|
| Rate for Payer: Amerigroup Medicare |
$91.46
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$91.46
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$91.46
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$351.56
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$139.88
|
| Rate for Payer: Copperpoint |
$150.91
|
| Rate for Payer: Humana Medicare |
$91.46
|
| Rate for Payer: SELF PAY |
$430.40
|
| Rate for Payer: Veterans (Triwest) |
$91.46
|
|
|
XR Tibia/Fibula 2 Views Right
|
Facility
IP
|
$538.00
|
|
|
Service Code
|
CPT 73590 RT
|
| Hospital Charge Code |
2214293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.46 |
| Max. Negotiated Rate |
$484.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$484.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$91.46
|
| Rate for Payer: Amerigroup Medicare |
$91.46
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$91.46
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$91.46
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$351.56
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$139.88
|
| Rate for Payer: Copperpoint |
$150.91
|
| Rate for Payer: Humana Medicare |
$91.46
|
| Rate for Payer: SELF PAY |
$430.40
|
| Rate for Payer: Veterans (Triwest) |
$91.46
|
|
|
XR Tibia/Fibula 2 Views Right
|
Facility
OP
|
$538.00
|
|
|
Service Code
|
CPT 73590 RT
|
| Hospital Charge Code |
2214293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.46 |
| Max. Negotiated Rate |
$484.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$484.20
|
| Rate for Payer: Aetna Medicare |
$150.64
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$91.46
|
| Rate for Payer: Amerigroup Medicare |
$91.46
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$200.94
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$91.46
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$91.46
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$351.56
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$139.88
|
| Rate for Payer: Cigna All Products |
$349.70
|
| Rate for Payer: Copperpoint |
$150.91
|
| Rate for Payer: HealthNet Commercial |
$322.80
|
| Rate for Payer: HealthNet Medicare |
$150.64
|
| Rate for Payer: Humana Medicare |
$91.46
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$430.40
|
| Rate for Payer: Veterans (Triwest) |
$91.46
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$313.65
|
| Rate for Payer: United Healthcare Medicare |
$96.84
|
|
|
XR Toes 2nd Digit Left
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T1
|
| Hospital Charge Code |
823659
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 2nd Digit Left
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T1
|
| Hospital Charge Code |
823659
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 2nd Digit Right
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T6
|
| Hospital Charge Code |
823661
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 2nd Digit Right
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T6
|
| Hospital Charge Code |
823661
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 3rd Digit Left
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T2
|
| Hospital Charge Code |
823663
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 3rd Digit Left
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T2
|
| Hospital Charge Code |
823663
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 3rd Digit Right
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T7
|
| Hospital Charge Code |
823665
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 3rd Digit Right
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T7
|
| Hospital Charge Code |
823665
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 4th Digit Left
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T3
|
| Hospital Charge Code |
823667
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 4th Digit Left
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T3
|
| Hospital Charge Code |
823667
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 4th Digit Right
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T8
|
| Hospital Charge Code |
823669
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 4th Digit Right
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T8
|
| Hospital Charge Code |
823669
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 5th Digit Left
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T4
|
| Hospital Charge Code |
823671
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 5th Digit Left
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T4
|
| Hospital Charge Code |
823671
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes 5th Digit Right
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T9
|
| Hospital Charge Code |
823673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes 5th Digit Right
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T9
|
| Hospital Charge Code |
823673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes Great Left
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 TA
|
| Hospital Charge Code |
823675
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Toes Great Left
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 TA
|
| Hospital Charge Code |
823675
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes Great Right
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T5
|
| Hospital Charge Code |
823677
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|
|
XR Toes Great Right
|
Facility
IP
|
$465.00
|
|
|
Service Code
|
CPT 73660 T5
|
| Hospital Charge Code |
823677
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
|
|
XR Wrist 2 Views Left
|
Facility
OP
|
$465.00
|
|
|
Service Code
|
CPT 73100 LT
|
| Hospital Charge Code |
823685
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$418.50
|
| Rate for Payer: Aetna Medicare |
$130.20
|
| Rate for Payer: AHCCCS Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$117.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.05
|
| Rate for Payer: Amerigroup Medicare |
$79.05
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$173.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$117.30
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.05
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.05
|
| Rate for Payer: Banner University Family Care Medicaid |
$117.30
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$120.90
|
| Rate for Payer: Cigna All Products |
$302.25
|
| Rate for Payer: Copperpoint |
$130.43
|
| Rate for Payer: HealthNet Commercial |
$279.00
|
| Rate for Payer: HealthNet Medicare |
$130.20
|
| Rate for Payer: Humana Medicare |
$79.05
|
| Rate for Payer: Mercy Care Medicaid |
$117.30
|
| Rate for Payer: SELF PAY |
$372.00
|
| Rate for Payer: Veterans (Triwest) |
$79.05
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$271.09
|
| Rate for Payer: United Healthcare Medicare |
$83.70
|
|