|
PR ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 29906
|
| Min. Negotiated Rate |
$421.53 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$876.36
|
| Rate for Payer: BCBS Complete |
$442.61
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Mclaren Medicaid |
$421.53
|
| Rate for Payer: Meridian Medicaid |
$442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$984.54
|
| Rate for Payer: Priority Health Narrow Network |
$984.54
|
| Rate for Payer: Priority Health SBD |
$984.54
|
|
|
PR ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 29840
|
| Min. Negotiated Rate |
$293.30 |
| Max. Negotiated Rate |
$1,377.81 |
| Rate for Payer: Aetna Commercial |
$600.40
|
| Rate for Payer: BCBS Complete |
$307.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,377.81
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Mclaren Medicaid |
$293.30
|
| Rate for Payer: Meridian Medicaid |
$307.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.06
|
| Rate for Payer: Priority Health Narrow Network |
$698.06
|
| Rate for Payer: Priority Health SBD |
$698.06
|
|
|
PR ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 29843
|
| Min. Negotiated Rate |
$317.16 |
| Max. Negotiated Rate |
$1,294.30 |
| Rate for Payer: Aetna Commercial |
$648.17
|
| Rate for Payer: BCBS Complete |
$333.02
|
| Rate for Payer: BCBS Trust/PPO |
$543.09
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Mclaren Medicaid |
$317.16
|
| Rate for Payer: Meridian Medicaid |
$333.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.68
|
| Rate for Payer: Priority Health Narrow Network |
$751.68
|
| Rate for Payer: Priority Health SBD |
$751.68
|
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29844
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$665.30
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS Trust/PPO |
$730.64
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Mclaren Medicaid |
$324.40
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$772.10
|
| Rate for Payer: Priority Health Narrow Network |
$772.10
|
| Rate for Payer: Priority Health SBD |
$772.10
|
|
|
PR ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 29847
|
| Min. Negotiated Rate |
$353.79 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$726.25
|
| Rate for Payer: BCBS Complete |
$371.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Mclaren Medicaid |
$353.79
|
| Rate for Payer: Meridian Medicaid |
$371.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,501.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.52
|
| Rate for Payer: Priority Health Narrow Network |
$839.52
|
| Rate for Payer: Priority Health SBD |
$839.52
|
|
|
PR ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,168.00
|
|
|
Service Code
|
HCPCS 27610
|
| Min. Negotiated Rate |
$417.05 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna Commercial |
$865.59
|
| Rate for Payer: BCBS Complete |
$437.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,605.50
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Mclaren Medicaid |
$417.05
|
| Rate for Payer: Meridian Medicaid |
$437.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.15
|
| Rate for Payer: Priority Health Narrow Network |
$990.15
|
| Rate for Payer: Priority Health SBD |
$990.15
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Facility
|
IP
|
$667.00
|
|
|
Service Code
|
CPT 26100
|
| Hospital Charge Code |
26100
|
| Min. Negotiated Rate |
$420.21 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Aetna Commercial |
$566.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.55
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$466.90
|
| Rate for Payer: Cofinity Commercial |
$573.62
|
| Rate for Payer: Healthscope Commercial |
$600.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$566.95
|
| Rate for Payer: PHP Commercial |
$566.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.90
|
| Rate for Payer: Priority Health SBD |
$420.21
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Facility
|
OP
|
$667.00
|
|
|
Service Code
|
CPT 26100
|
| Hospital Charge Code |
26100
|
| Min. Negotiated Rate |
$343.49 |
| Max. Negotiated Rate |
$3,600.14 |
| Rate for Payer: Aetna Commercial |
$566.95
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$466.90
|
| Rate for Payer: Cofinity Commercial |
$573.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$600.30
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$566.95
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$566.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.90
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health SBD |
$420.21
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$343.49
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
PR ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 26110
|
| Min. Negotiated Rate |
$172.35 |
| Max. Negotiated Rate |
$627.20 |
| Rate for Payer: Aetna Commercial |
$429.75
|
| Rate for Payer: BCBS Complete |
$224.54
|
| Rate for Payer: BCBS Trust/PPO |
$172.35
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Mclaren Medicaid |
$213.85
|
| Rate for Payer: Meridian Medicaid |
$224.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.56
|
| Rate for Payer: Priority Health Narrow Network |
$506.56
|
| Rate for Payer: Priority Health SBD |
$506.56
|
|
|
PR ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 26105
|
| Min. Negotiated Rate |
$152.40 |
| Max. Negotiated Rate |
$532.09 |
| Rate for Payer: Aetna Commercial |
$452.31
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS Trust/PPO |
$152.40
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Mclaren Medicaid |
$224.72
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.09
|
| Rate for Payer: Priority Health Narrow Network |
$532.09
|
| Rate for Payer: Priority Health SBD |
$532.09
|
|
|
PR ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$1,073.00
|
|
|
Service Code
|
HCPCS 25107
|
| Min. Negotiated Rate |
$164.83 |
| Max. Negotiated Rate |
$954.40 |
| Rate for Payer: Aetna Commercial |
$820.03
|
| Rate for Payer: BCBS Complete |
$423.15
|
| Rate for Payer: BCBS Trust/PPO |
$164.83
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Mclaren Medicaid |
$403.00
|
| Rate for Payer: Meridian Medicaid |
$423.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.40
|
| Rate for Payer: Priority Health Narrow Network |
$954.40
|
| Rate for Payer: Priority Health SBD |
$954.40
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$1,829.00
|
|
|
Service Code
|
HCPCS 24102
|
| Min. Negotiated Rate |
$171.17 |
| Max. Negotiated Rate |
$1,280.30 |
| Rate for Payer: Aetna Commercial |
$824.91
|
| Rate for Payer: BCBS Complete |
$421.35
|
| Rate for Payer: BCBS Trust/PPO |
$171.17
|
| Rate for Payer: Cash Price |
$1,463.20
|
| Rate for Payer: Cash Price |
$1,463.20
|
| Rate for Payer: Mclaren Medicaid |
$401.29
|
| Rate for Payer: Meridian Medicaid |
$421.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.83
|
| Rate for Payer: Priority Health Narrow Network |
$950.83
|
| Rate for Payer: Priority Health SBD |
$950.83
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 24100
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$558.36
|
| Rate for Payer: BCBS Complete |
$289.18
|
| Rate for Payer: BCBS Trust/PPO |
$37.78
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Mclaren Medicaid |
$275.41
|
| Rate for Payer: Meridian Medicaid |
$289.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.08
|
| Rate for Payer: Priority Health Narrow Network |
$651.08
|
| Rate for Payer: Priority Health SBD |
$651.08
|
|
|
PR ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 23100
|
| Min. Negotiated Rate |
$330.79 |
| Max. Negotiated Rate |
$784.36 |
| Rate for Payer: Aetna Commercial |
$672.84
|
| Rate for Payer: BCBS Complete |
$347.33
|
| Rate for Payer: BCBS Trust/PPO |
$352.38
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Mclaren Medicaid |
$330.79
|
| Rate for Payer: Meridian Medicaid |
$347.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$784.36
|
| Rate for Payer: Priority Health Narrow Network |
$784.36
|
| Rate for Payer: Priority Health SBD |
$784.36
|
|
|
PR ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,937.00
|
|
|
Service Code
|
HCPCS 23040
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,355.90 |
| Rate for Payer: Aetna Commercial |
$957.15
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,209.28
|
| Rate for Payer: Cash Price |
$1,549.60
|
| Rate for Payer: Cash Price |
$1,549.60
|
| Rate for Payer: Mclaren Medicaid |
$464.55
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,105.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,105.56
|
| Rate for Payer: Priority Health SBD |
$1,105.56
|
|
|
PR ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,710.00
|
|
|
Service Code
|
HCPCS 27033
|
| Min. Negotiated Rate |
$625.37 |
| Max. Negotiated Rate |
$1,489.05 |
| Rate for Payer: Aetna Commercial |
$1,301.05
|
| Rate for Payer: BCBS Complete |
$656.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: Cash Price |
$1,368.00
|
| Rate for Payer: Cash Price |
$1,368.00
|
| Rate for Payer: Mclaren Medicaid |
$625.37
|
| Rate for Payer: Meridian Medicaid |
$656.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$625.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,489.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,489.05
|
| Rate for Payer: Priority Health SBD |
$1,489.05
|
|
|
PR ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$1,641.00
|
|
|
Service Code
|
HCPCS 27030
|
| Min. Negotiated Rate |
$602.79 |
| Max. Negotiated Rate |
$1,435.44 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: BCBS Complete |
$632.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.66
|
| Rate for Payer: Cash Price |
$1,312.80
|
| Rate for Payer: Cash Price |
$1,312.80
|
| Rate for Payer: Mclaren Medicaid |
$602.79
|
| Rate for Payer: Meridian Medicaid |
$632.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,148.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,435.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,435.44
|
| Rate for Payer: Priority Health SBD |
$1,435.44
|
|
|
PR ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$711.00
|
|
|
Service Code
|
HCPCS 27330
|
| Min. Negotiated Rate |
$276.90 |
| Max. Negotiated Rate |
$982.11 |
| Rate for Payer: Aetna Commercial |
$557.61
|
| Rate for Payer: BCBS Complete |
$290.74
|
| Rate for Payer: BCBS Trust/PPO |
$982.11
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Mclaren Medicaid |
$276.90
|
| Rate for Payer: Meridian Medicaid |
$290.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.65
|
| Rate for Payer: Priority Health Narrow Network |
$654.65
|
| Rate for Payer: Priority Health SBD |
$654.65
|
|
|
PR ARTHROTOMY W/BIOPSY HIP JOINT
|
Professional
|
Both
|
$1,982.00
|
|
|
Service Code
|
HCPCS 27052
|
| Min. Negotiated Rate |
$377.22 |
| Max. Negotiated Rate |
$4,201.57 |
| Rate for Payer: Aetna Commercial |
$769.63
|
| Rate for Payer: BCBS Complete |
$396.08
|
| Rate for Payer: BCBS Trust/PPO |
$4,201.57
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Mclaren Medicaid |
$377.22
|
| Rate for Payer: Meridian Medicaid |
$396.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$893.64
|
| Rate for Payer: Priority Health Narrow Network |
$893.64
|
| Rate for Payer: Priority Health SBD |
$893.64
|
|
|
PR ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 27403
|
| Min. Negotiated Rate |
$312.75 |
| Max. Negotiated Rate |
$1,466.50 |
| Rate for Payer: Aetna Commercial |
$860.40
|
| Rate for Payer: BCBS Complete |
$440.14
|
| Rate for Payer: BCBS Trust/PPO |
$312.75
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Mclaren Medicaid |
$419.18
|
| Rate for Payer: Meridian Medicaid |
$440.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,466.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$994.23
|
| Rate for Payer: Priority Health Narrow Network |
$994.23
|
| Rate for Payer: Priority Health SBD |
$994.23
|
|
|
PR ARTHROTOMY WRIST JOINT WITH BIOPSY
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 25100
|
| Min. Negotiated Rate |
$229.83 |
| Max. Negotiated Rate |
$958.34 |
| Rate for Payer: Aetna Commercial |
$463.54
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS Trust/PPO |
$958.34
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Mclaren Medicaid |
$229.83
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.84
|
| Rate for Payer: Priority Health Narrow Network |
$543.84
|
| Rate for Payer: Priority Health SBD |
$543.84
|
|
|
PR ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY
|
Professional
|
Both
|
$1,648.00
|
|
|
Service Code
|
HCPCS 25105
|
| Min. Negotiated Rate |
$318.44 |
| Max. Negotiated Rate |
$1,249.43 |
| Rate for Payer: Aetna Commercial |
$647.14
|
| Rate for Payer: BCBS Complete |
$334.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,249.43
|
| Rate for Payer: Cash Price |
$1,318.40
|
| Rate for Payer: Cash Price |
$1,318.40
|
| Rate for Payer: Mclaren Medicaid |
$318.44
|
| Rate for Payer: Meridian Medicaid |
$334.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.27
|
| Rate for Payer: Priority Health Narrow Network |
$756.27
|
| Rate for Payer: Priority Health SBD |
$756.27
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 27625
|
| Min. Negotiated Rate |
$370.19 |
| Max. Negotiated Rate |
$984.90 |
| Rate for Payer: Aetna Commercial |
$762.69
|
| Rate for Payer: BCBS Complete |
$388.70
|
| Rate for Payer: BCBS Trust/PPO |
$870.11
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Mclaren Medicaid |
$370.19
|
| Rate for Payer: Meridian Medicaid |
$388.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$876.78
|
| Rate for Payer: Priority Health Narrow Network |
$876.78
|
| Rate for Payer: Priority Health SBD |
$876.78
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 27626
|
| Min. Negotiated Rate |
$244.60 |
| Max. Negotiated Rate |
$934.99 |
| Rate for Payer: Aetna Commercial |
$802.28
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Mclaren Medicaid |
$400.23
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$934.99
|
| Rate for Payer: Priority Health Narrow Network |
$934.99
|
| Rate for Payer: Priority Health SBD |
$934.99
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY HIP JOINT
|
Professional
|
Both
|
$1,369.00
|
|
|
Service Code
|
HCPCS 27054
|
| Min. Negotiated Rate |
$446.45 |
| Max. Negotiated Rate |
$4,275.53 |
| Rate for Payer: Aetna Commercial |
$917.33
|
| Rate for Payer: BCBS Complete |
$468.77
|
| Rate for Payer: BCBS Trust/PPO |
$4,275.53
|
| Rate for Payer: Cash Price |
$1,095.20
|
| Rate for Payer: Cash Price |
$1,095.20
|
| Rate for Payer: Mclaren Medicaid |
$446.45
|
| Rate for Payer: Meridian Medicaid |
$468.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,062.66
|
| Rate for Payer: Priority Health SBD |
$1,062.66
|
|
