|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$2,169.00
|
|
|
Service Code
|
HCPCS 29825
|
| Min. Negotiated Rate |
$566.11 |
| Max. Negotiated Rate |
$1,409.85 |
| Rate for Payer: Aetna Commercial |
$758.59
|
| Rate for Payer: Aetna Medicare |
$588.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$815.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.59
|
| Rate for Payer: BCBS Complete |
$867.60
|
| Rate for Payer: BCBS MAPPO |
$566.11
|
| Rate for Payer: BCN Medicare Advantage |
$566.11
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cofinity Commercial |
$815.20
|
| Rate for Payer: Cofinity Commercial |
$758.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.11
|
| Rate for Payer: Healthscope Commercial |
$1,047.30
|
| Rate for Payer: Healthscope Commercial |
$905.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,409.85
|
| Rate for Payer: Nomi Health Commercial |
$679.33
|
| Rate for Payer: PACE SWMI |
$566.11
|
| Rate for Payer: PHP Medicare Advantage |
$566.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.85
|
| Rate for Payer: Priority Health Medicare |
$566.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.11
|
| Rate for Payer: UHC Medicare Advantage |
$566.11
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Facility
|
IP
|
$2,169.00
|
|
|
Service Code
|
CPT 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$1,366.47 |
| Max. Negotiated Rate |
$1,952.10 |
| Rate for Payer: Aetna Commercial |
$1,843.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.85
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cofinity Commercial |
$1,518.30
|
| Rate for Payer: Cofinity Commercial |
$1,865.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,518.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,735.20
|
| Rate for Payer: Healthscope Commercial |
$1,952.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,843.65
|
| Rate for Payer: PHP Commercial |
$1,843.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.85
|
| Rate for Payer: Priority Health SBD |
$1,366.47
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$2,169.00
|
|
|
Service Code
|
HCPCS 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$566.11 |
| Max. Negotiated Rate |
$1,409.85 |
| Rate for Payer: Aetna Commercial |
$758.59
|
| Rate for Payer: Aetna Medicare |
$588.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$815.20
|
| Rate for Payer: BCBS Complete |
$867.60
|
| Rate for Payer: BCBS MAPPO |
$566.11
|
| Rate for Payer: BCN Medicare Advantage |
$566.11
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cofinity Commercial |
$815.20
|
| Rate for Payer: Cofinity Commercial |
$758.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.11
|
| Rate for Payer: Healthscope Commercial |
$1,047.30
|
| Rate for Payer: Healthscope Commercial |
$905.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,409.85
|
| Rate for Payer: Nomi Health Commercial |
$679.33
|
| Rate for Payer: PACE SWMI |
$566.11
|
| Rate for Payer: PHP Medicare Advantage |
$566.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.85
|
| Rate for Payer: Priority Health Medicare |
$566.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.11
|
| Rate for Payer: UHC Medicare Advantage |
$566.11
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Facility
|
OP
|
$2,169.00
|
|
|
Service Code
|
CPT 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$1,366.47 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$1,843.65
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cofinity Commercial |
$1,518.30
|
| Rate for Payer: Cofinity Commercial |
$1,865.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,518.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,735.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,952.10
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,843.65
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$1,843.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.85
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$1,366.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Facility
|
IP
|
$3,399.00
|
|
|
Service Code
|
CPT 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$2,141.37 |
| Max. Negotiated Rate |
$3,059.10 |
| Rate for Payer: Aetna Commercial |
$2,889.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,209.35
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cofinity Commercial |
$2,379.30
|
| Rate for Payer: Cofinity Commercial |
$2,923.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,379.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,719.20
|
| Rate for Payer: Healthscope Commercial |
$3,059.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,889.15
|
| Rate for Payer: PHP Commercial |
$2,889.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health SBD |
$2,141.37
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Facility
|
OP
|
$3,399.00
|
|
|
Service Code
|
CPT 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$2,141.37 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna Commercial |
$2,889.15
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,209.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cofinity Commercial |
$2,923.14
|
| Rate for Payer: Cofinity Commercial |
$2,379.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,379.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,719.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$3,059.10
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,889.15
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$2,889.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$2,141.37
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,922.50
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,399.00
|
|
|
Service Code
|
HCPCS 29827
|
| Min. Negotiated Rate |
$1,027.37 |
| Max. Negotiated Rate |
$2,209.35 |
| Rate for Payer: Aetna Commercial |
$1,376.68
|
| Rate for Payer: Aetna Medicare |
$1,068.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.68
|
| Rate for Payer: BCBS Complete |
$1,359.60
|
| Rate for Payer: BCBS MAPPO |
$1,027.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.37
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cofinity Commercial |
$1,479.41
|
| Rate for Payer: Cofinity Commercial |
$1,376.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.37
|
| Rate for Payer: Healthscope Commercial |
$1,900.63
|
| Rate for Payer: Healthscope Commercial |
$1,643.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,209.35
|
| Rate for Payer: Nomi Health Commercial |
$1,232.84
|
| Rate for Payer: PACE SWMI |
$1,027.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health Medicare |
$1,027.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.37
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,399.00
|
|
|
Service Code
|
HCPCS 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$1,027.37 |
| Max. Negotiated Rate |
$2,209.35 |
| Rate for Payer: Aetna Commercial |
$1,376.68
|
| Rate for Payer: Aetna Medicare |
$1,068.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.41
|
| Rate for Payer: BCBS Complete |
$1,359.60
|
| Rate for Payer: BCBS MAPPO |
$1,027.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.37
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cofinity Commercial |
$1,479.41
|
| Rate for Payer: Cofinity Commercial |
$1,376.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.37
|
| Rate for Payer: Healthscope Commercial |
$1,643.79
|
| Rate for Payer: Healthscope Commercial |
$1,900.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,209.35
|
| Rate for Payer: Nomi Health Commercial |
$1,232.84
|
| Rate for Payer: PACE SWMI |
$1,027.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health Medicare |
$1,027.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.37
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Facility
|
IP
|
$2,525.00
|
|
|
Service Code
|
CPT 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$1,590.75 |
| Max. Negotiated Rate |
$2,272.50 |
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29823
|
| Min. Negotiated Rate |
$571.54 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$765.86
|
| Rate for Payer: Aetna Medicare |
$594.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.86
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: BCBS MAPPO |
$571.54
|
| Rate for Payer: BCN Medicare Advantage |
$571.54
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$823.02
|
| Rate for Payer: Cofinity Commercial |
$765.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.54
|
| Rate for Payer: Healthscope Commercial |
$1,057.35
|
| Rate for Payer: Healthscope Commercial |
$914.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,641.25
|
| Rate for Payer: Nomi Health Commercial |
$685.85
|
| Rate for Payer: PACE SWMI |
$571.54
|
| Rate for Payer: PHP Medicare Advantage |
$571.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health Medicare |
$571.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.54
|
| Rate for Payer: UHC Medicare Advantage |
$571.54
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Facility
|
OP
|
$2,525.00
|
|
|
Service Code
|
CPT 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$1,590.75 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$571.54 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$765.86
|
| Rate for Payer: Aetna Medicare |
$594.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.02
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: BCBS MAPPO |
$571.54
|
| Rate for Payer: BCN Medicare Advantage |
$571.54
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$823.02
|
| Rate for Payer: Cofinity Commercial |
$765.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.54
|
| Rate for Payer: Healthscope Commercial |
$1,057.35
|
| Rate for Payer: Healthscope Commercial |
$914.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,641.25
|
| Rate for Payer: Nomi Health Commercial |
$685.85
|
| Rate for Payer: PACE SWMI |
$571.54
|
| Rate for Payer: PHP Medicare Advantage |
$571.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health Medicare |
$571.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.54
|
| Rate for Payer: UHC Medicare Advantage |
$571.54
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Facility
|
IP
|
$2,525.00
|
|
|
Service Code
|
CPT 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$1,590.75 |
| Max. Negotiated Rate |
$2,272.50 |
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$165.40 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$221.64
|
| Rate for Payer: Aetna Medicare |
$172.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.18
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: BCBS MAPPO |
$165.40
|
| Rate for Payer: BCN Medicare Advantage |
$165.40
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$221.64
|
| Rate for Payer: Cofinity Commercial |
$238.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.40
|
| Rate for Payer: Healthscope Commercial |
$305.99
|
| Rate for Payer: Healthscope Commercial |
$264.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,641.25
|
| Rate for Payer: Nomi Health Commercial |
$198.48
|
| Rate for Payer: PACE SWMI |
$165.40
|
| Rate for Payer: PHP Medicare Advantage |
$165.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health Medicare |
$165.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.40
|
| Rate for Payer: UHC Medicare Advantage |
$165.40
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29826
|
| Min. Negotiated Rate |
$165.40 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$221.64
|
| Rate for Payer: Aetna Medicare |
$172.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.64
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: BCBS MAPPO |
$165.40
|
| Rate for Payer: BCN Medicare Advantage |
$165.40
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$238.18
|
| Rate for Payer: Cofinity Commercial |
$221.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.40
|
| Rate for Payer: Healthscope Commercial |
$264.64
|
| Rate for Payer: Healthscope Commercial |
$305.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,641.25
|
| Rate for Payer: Nomi Health Commercial |
$198.48
|
| Rate for Payer: PACE SWMI |
$165.40
|
| Rate for Payer: PHP Medicare Advantage |
$165.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health Medicare |
$165.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.40
|
| Rate for Payer: UHC Medicare Advantage |
$165.40
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Facility
|
OP
|
$2,525.00
|
|
|
Service Code
|
CPT 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$1,010.00 |
| Max. Negotiated Rate |
$2,272.50 |
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
|
|
PR SURGICAL TRAYS
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS A4550
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI
|
Professional
|
Both
|
$5,673.00
|
|
|
Service Code
|
HCPCS 69706
|
| Min. Negotiated Rate |
$232.45 |
| Max. Negotiated Rate |
$3,687.45 |
| Rate for Payer: Aetna Commercial |
$311.48
|
| Rate for Payer: Aetna Medicare |
$241.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.73
|
| Rate for Payer: BCBS Complete |
$2,269.20
|
| Rate for Payer: BCBS MAPPO |
$232.45
|
| Rate for Payer: BCN Medicare Advantage |
$232.45
|
| Rate for Payer: Cash Price |
$4,538.40
|
| Rate for Payer: Cash Price |
$4,538.40
|
| Rate for Payer: Cofinity Commercial |
$311.48
|
| Rate for Payer: Cofinity Commercial |
$334.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.45
|
| Rate for Payer: Healthscope Commercial |
$371.92
|
| Rate for Payer: Healthscope Commercial |
$430.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,687.45
|
| Rate for Payer: Nomi Health Commercial |
$278.94
|
| Rate for Payer: PACE SWMI |
$232.45
|
| Rate for Payer: PHP Medicare Advantage |
$232.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,687.45
|
| Rate for Payer: Priority Health Medicare |
$232.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.45
|
| Rate for Payer: UHC Medicare Advantage |
$232.45
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI
|
Professional
|
Both
|
$5,488.00
|
|
|
Service Code
|
HCPCS 69705
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$3,567.20 |
| Rate for Payer: Aetna Commercial |
$222.69
|
| Rate for Payer: Aetna Medicare |
$172.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.69
|
| Rate for Payer: BCBS Complete |
$2,195.20
|
| Rate for Payer: BCBS MAPPO |
$166.19
|
| Rate for Payer: BCN Medicare Advantage |
$166.19
|
| Rate for Payer: Cash Price |
$4,390.40
|
| Rate for Payer: Cash Price |
$4,390.40
|
| Rate for Payer: Cofinity Commercial |
$239.31
|
| Rate for Payer: Cofinity Commercial |
$222.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.19
|
| Rate for Payer: Healthscope Commercial |
$265.90
|
| Rate for Payer: Healthscope Commercial |
$307.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,567.20
|
| Rate for Payer: Nomi Health Commercial |
$199.43
|
| Rate for Payer: PACE SWMI |
$166.19
|
| Rate for Payer: PHP Medicare Advantage |
$166.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,567.20
|
| Rate for Payer: Priority Health Medicare |
$166.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.19
|
| Rate for Payer: UHC Medicare Advantage |
$166.19
|
|
|
PR SURG OPENING,ESOPHAGUS,ABD APPRCH
|
Professional
|
Both
|
$2,787.00
|
|
|
Service Code
|
HCPCS 43350
|
| Min. Negotiated Rate |
$1,114.80 |
| Max. Negotiated Rate |
$1,811.55 |
| Rate for Payer: Aetna Medicare |
$1,393.50
|
| Rate for Payer: BCBS Complete |
$1,114.80
|
| Rate for Payer: Cash Price |
$2,229.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,811.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,811.55
|
|
|
PR SURG TX ANAL FISTULA 2ND STAGE
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 46285
|
| Min. Negotiated Rate |
$388.00 |
| Max. Negotiated Rate |
$752.54 |
| Rate for Payer: Aetna Commercial |
$545.09
|
| Rate for Payer: Aetna Medicare |
$423.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.76
|
| Rate for Payer: BCBS Complete |
$388.00
|
| Rate for Payer: BCBS MAPPO |
$406.78
|
| Rate for Payer: BCN Medicare Advantage |
$406.78
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$545.09
|
| Rate for Payer: Cofinity Commercial |
$585.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.78
|
| Rate for Payer: Healthscope Commercial |
$650.85
|
| Rate for Payer: Healthscope Commercial |
$752.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.50
|
| Rate for Payer: Nomi Health Commercial |
$488.14
|
| Rate for Payer: PACE SWMI |
$406.78
|
| Rate for Payer: PHP Medicare Advantage |
$406.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
| Rate for Payer: Priority Health Medicare |
$406.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.78
|
| Rate for Payer: UHC Medicare Advantage |
$406.78
|
|
|
PR SURG TX ANAL FISTULA INTERSPHINCTERIC
|
Professional
|
Both
|
$1,315.00
|
|
|
Service Code
|
HCPCS 46275
|
| Min. Negotiated Rate |
$404.00 |
| Max. Negotiated Rate |
$854.75 |
| Rate for Payer: Aetna Commercial |
$541.36
|
| Rate for Payer: Aetna Medicare |
$420.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.36
|
| Rate for Payer: BCBS Complete |
$526.00
|
| Rate for Payer: BCBS MAPPO |
$404.00
|
| Rate for Payer: BCN Medicare Advantage |
$404.00
|
| Rate for Payer: Cash Price |
$1,052.00
|
| Rate for Payer: Cash Price |
$1,052.00
|
| Rate for Payer: Cofinity Commercial |
$581.76
|
| Rate for Payer: Cofinity Commercial |
$541.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.00
|
| Rate for Payer: Healthscope Commercial |
$747.40
|
| Rate for Payer: Healthscope Commercial |
$646.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.75
|
| Rate for Payer: Nomi Health Commercial |
$484.80
|
| Rate for Payer: PACE SWMI |
$404.00
|
| Rate for Payer: PHP Medicare Advantage |
$404.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.75
|
| Rate for Payer: Priority Health Medicare |
$404.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.00
|
| Rate for Payer: UHC Medicare Advantage |
$404.00
|
|
|
PR SURG TX ANAL FISTULA SUBQ
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 46270
|
| Min. Negotiated Rate |
$344.80 |
| Max. Negotiated Rate |
$711.95 |
| Rate for Payer: Aetna Commercial |
$515.69
|
| Rate for Payer: Aetna Medicare |
$400.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.69
|
| Rate for Payer: BCBS Complete |
$344.80
|
| Rate for Payer: BCBS MAPPO |
$384.84
|
| Rate for Payer: BCN Medicare Advantage |
$384.84
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$554.17
|
| Rate for Payer: Cofinity Commercial |
$515.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.84
|
| Rate for Payer: Healthscope Commercial |
$615.74
|
| Rate for Payer: Healthscope Commercial |
$711.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.30
|
| Rate for Payer: Nomi Health Commercial |
$461.81
|
| Rate for Payer: PACE SWMI |
$384.84
|
| Rate for Payer: PHP Medicare Advantage |
$384.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.30
|
| Rate for Payer: Priority Health Medicare |
$384.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.84
|
| Rate for Payer: UHC Medicare Advantage |
$384.84
|
|
|
PR SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD
|
Professional
|
Both
|
$11,334.00
|
|
|
Service Code
|
HCPCS 33548
|
| Min. Negotiated Rate |
$2,816.51 |
| Max. Negotiated Rate |
$7,367.10 |
| Rate for Payer: Aetna Commercial |
$3,774.12
|
| Rate for Payer: Aetna Medicare |
$2,929.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,055.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,774.12
|
| Rate for Payer: BCBS Complete |
$4,533.60
|
| Rate for Payer: BCBS MAPPO |
$2,816.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,816.51
|
| Rate for Payer: Cash Price |
$9,067.20
|
| Rate for Payer: Cash Price |
$9,067.20
|
| Rate for Payer: Cofinity Commercial |
$4,055.77
|
| Rate for Payer: Cofinity Commercial |
$3,774.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,816.51
|
| Rate for Payer: Healthscope Commercial |
$5,210.54
|
| Rate for Payer: Healthscope Commercial |
$4,506.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,957.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,367.10
|
| Rate for Payer: Nomi Health Commercial |
$3,379.81
|
| Rate for Payer: PACE SWMI |
$2,816.51
|
| Rate for Payer: PHP Medicare Advantage |
$2,816.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,367.10
|
| Rate for Payer: Priority Health Medicare |
$2,816.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,816.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,816.51
|
|
|
PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 64832
|
| Min. Negotiated Rate |
$316.81 |
| Max. Negotiated Rate |
$859.95 |
| Rate for Payer: Aetna Commercial |
$424.53
|
| Rate for Payer: Aetna Medicare |
$329.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.53
|
| Rate for Payer: BCBS Complete |
$529.20
|
| Rate for Payer: BCBS MAPPO |
$316.81
|
| Rate for Payer: BCN Medicare Advantage |
$316.81
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$456.21
|
| Rate for Payer: Cofinity Commercial |
$424.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.81
|
| Rate for Payer: Healthscope Commercial |
$506.90
|
| Rate for Payer: Healthscope Commercial |
$586.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.95
|
| Rate for Payer: Nomi Health Commercial |
$380.17
|
| Rate for Payer: PACE SWMI |
$316.81
|
| Rate for Payer: PHP Medicare Advantage |
$316.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.95
|
| Rate for Payer: Priority Health Medicare |
$316.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.81
|
| Rate for Payer: UHC Medicare Advantage |
$316.81
|
|
