PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$2,597.18
|
|
Service Code
|
HCPCS 29845
|
Min. Negotiated Rate |
$1,947.88 |
Max. Negotiated Rate |
$1,947.88 |
Rate for Payer: Cash Price |
$703.49
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,947.88
|
Rate for Payer: SOMOS Essential |
$1,947.88
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$2,208.89
|
|
Service Code
|
HCPCS 29844
|
Min. Negotiated Rate |
$1,656.67 |
Max. Negotiated Rate |
$1,656.67 |
Rate for Payer: Cash Price |
$598.52
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,656.67
|
Rate for Payer: SOMOS Essential |
$1,656.67
|
|
PR ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY
|
Professional
|
Both
|
$2,417.98
|
|
Service Code
|
HCPCS 29847
|
Min. Negotiated Rate |
$1,813.48 |
Max. Negotiated Rate |
$1,813.48 |
Rate for Payer: Cash Price |
$655.66
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,813.48
|
Rate for Payer: SOMOS Essential |
$1,813.48
|
|
PR ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,820.97
|
|
Service Code
|
HCPCS 27610
|
Min. Negotiated Rate |
$2,115.73 |
Max. Negotiated Rate |
$2,115.73 |
Rate for Payer: Cash Price |
$766.95
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,115.73
|
Rate for Payer: SOMOS Essential |
$2,115.73
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Professional
|
Both
|
$1,513.65
|
|
Service Code
|
HCPCS 26100
|
Min. Negotiated Rate |
$1,135.24 |
Max. Negotiated Rate |
$1,135.24 |
Rate for Payer: Cash Price |
$413.59
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,135.24
|
Rate for Payer: SOMOS Essential |
$1,135.24
|
|
PR ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,445.47
|
|
Service Code
|
HCPCS 26110
|
Min. Negotiated Rate |
$1,084.10 |
Max. Negotiated Rate |
$1,084.10 |
Rate for Payer: Cash Price |
$394.66
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,084.10
|
Rate for Payer: SOMOS Essential |
$1,084.10
|
|
PR ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,527.02
|
|
Service Code
|
HCPCS 26105
|
Min. Negotiated Rate |
$1,145.26 |
Max. Negotiated Rate |
$1,145.26 |
Rate for Payer: Cash Price |
$415.77
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,145.26
|
Rate for Payer: SOMOS Essential |
$1,145.26
|
|
PR ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$2,726.05
|
|
Service Code
|
HCPCS 25107
|
Min. Negotiated Rate |
$2,044.54 |
Max. Negotiated Rate |
$2,044.54 |
Rate for Payer: Cash Price |
$742.91
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,044.54
|
Rate for Payer: SOMOS Essential |
$2,044.54
|
|
PR ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$2,726.40
|
|
Service Code
|
HCPCS 24102
|
Min. Negotiated Rate |
$2,044.80 |
Max. Negotiated Rate |
$2,044.80 |
Rate for Payer: Cash Price |
$741.02
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,044.80
|
Rate for Payer: SOMOS Essential |
$2,044.80
|
|
PR ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,871.49
|
|
Service Code
|
HCPCS 24100
|
Min. Negotiated Rate |
$1,403.62 |
Max. Negotiated Rate |
$1,403.62 |
Rate for Payer: Cash Price |
$510.33
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,403.62
|
Rate for Payer: SOMOS Essential |
$1,403.62
|
|
PR ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY
|
Professional
|
Both
|
$2,255.61
|
|
Service Code
|
HCPCS 23100
|
Min. Negotiated Rate |
$1,691.71 |
Max. Negotiated Rate |
$1,691.71 |
Rate for Payer: Cash Price |
$612.61
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,691.71
|
Rate for Payer: SOMOS Essential |
$1,691.71
|
|
PR ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$3,181.15
|
|
Service Code
|
HCPCS 23040
|
Min. Negotiated Rate |
$2,385.86 |
Max. Negotiated Rate |
$2,385.86 |
Rate for Payer: Cash Price |
$859.28
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,385.86
|
Rate for Payer: SOMOS Essential |
$2,385.86
|
|
PR ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$4,295.62
|
|
Service Code
|
HCPCS 27033
|
Min. Negotiated Rate |
$3,221.72 |
Max. Negotiated Rate |
$3,221.72 |
Rate for Payer: Cash Price |
$1,158.09
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,221.72
|
Rate for Payer: SOMOS Essential |
$3,221.72
|
|
PR ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$4,142.81
|
|
Service Code
|
HCPCS 27030
|
Min. Negotiated Rate |
$3,107.11 |
Max. Negotiated Rate |
$3,107.11 |
Rate for Payer: Cash Price |
$1,116.61
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,107.11
|
Rate for Payer: SOMOS Essential |
$3,107.11
|
|
PR ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,882.09
|
|
Service Code
|
HCPCS 27330
|
Min. Negotiated Rate |
$1,411.57 |
Max. Negotiated Rate |
$1,411.57 |
Rate for Payer: Cash Price |
$513.13
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,411.57
|
Rate for Payer: SOMOS Essential |
$1,411.57
|
|
PR ARTHROTOMY TEMPOROMANDIBULAR JOINT
|
Professional
|
Both
|
$3,131.00
|
|
Service Code
|
HCPCS 21010
|
Min. Negotiated Rate |
$2,348.25 |
Max. Negotiated Rate |
$2,348.25 |
Rate for Payer: Cash Price |
$850.67
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,348.25
|
Rate for Payer: SOMOS Essential |
$2,348.25
|
|
PR ARTHROTOMY W/BIOPSY HIP JOINT
|
Professional
|
Both
|
$2,573.13
|
|
Service Code
|
HCPCS 27052
|
Min. Negotiated Rate |
$1,929.85 |
Max. Negotiated Rate |
$1,929.85 |
Rate for Payer: Cash Price |
$698.70
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,929.85
|
Rate for Payer: SOMOS Essential |
$1,929.85
|
|
PR ARTHROTOMY W/BIOPSY SACROILIAC JOINT
|
Professional
|
Both
|
$1,803.80
|
|
Service Code
|
HCPCS 27050
|
Min. Negotiated Rate |
$1,352.85 |
Max. Negotiated Rate |
$1,352.85 |
Rate for Payer: Cash Price |
$492.24
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,352.85
|
Rate for Payer: SOMOS Essential |
$1,352.85
|
|
PR ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,861.39
|
|
Service Code
|
HCPCS 27403
|
Min. Negotiated Rate |
$2,146.04 |
Max. Negotiated Rate |
$2,146.04 |
Rate for Payer: Cash Price |
$776.16
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,146.04
|
Rate for Payer: SOMOS Essential |
$2,146.04
|
|
PR ARTHROTOMY WRIST JOINT WITH BIOPSY
|
Professional
|
Both
|
$1,560.44
|
|
Service Code
|
HCPCS 25100
|
Min. Negotiated Rate |
$1,170.33 |
Max. Negotiated Rate |
$1,170.33 |
Rate for Payer: Cash Price |
$425.29
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,170.33
|
Rate for Payer: SOMOS Essential |
$1,170.33
|
|
PR ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY
|
Professional
|
Both
|
$2,164.30
|
|
Service Code
|
HCPCS 25105
|
Min. Negotiated Rate |
$1,623.22 |
Max. Negotiated Rate |
$1,623.22 |
Rate for Payer: Cash Price |
$587.83
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,623.22
|
Rate for Payer: SOMOS Essential |
$1,623.22
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE
|
Professional
|
Both
|
$2,473.45
|
|
Service Code
|
HCPCS 27625
|
Min. Negotiated Rate |
$1,855.09 |
Max. Negotiated Rate |
$1,855.09 |
Rate for Payer: Cash Price |
$674.48
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,855.09
|
Rate for Payer: SOMOS Essential |
$1,855.09
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$2,637.71
|
|
Service Code
|
HCPCS 27626
|
Min. Negotiated Rate |
$1,978.28 |
Max. Negotiated Rate |
$1,978.28 |
Rate for Payer: Cash Price |
$732.08
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,978.28
|
Rate for Payer: SOMOS Essential |
$1,978.28
|
|
PR ARTHROTOMY W/SYNOVECTOMY HIP JOINT
|
Professional
|
Both
|
$3,062.57
|
|
Service Code
|
HCPCS 27054
|
Min. Negotiated Rate |
$2,296.93 |
Max. Negotiated Rate |
$2,296.93 |
Rate for Payer: Cash Price |
$826.64
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,296.93
|
Rate for Payer: SOMOS Essential |
$2,296.93
|
|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$3,053.02
|
|
Service Code
|
HCPCS 27334
|
Min. Negotiated Rate |
$2,289.76 |
Max. Negotiated Rate |
$2,289.76 |
Rate for Payer: Cash Price |
$824.53
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,289.76
|
Rate for Payer: SOMOS Essential |
$2,289.76
|
|