|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$6,951.00
|
|
|
Service Code
|
HCPCS 22630
|
| Min. Negotiated Rate |
$963.40 |
| Max. Negotiated Rate |
$5,213.25 |
| Rate for Payer: Aetna Commercial |
$2,008.30
|
| Rate for Payer: Aetna Medicare |
$1,558.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,008.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,158.17
|
| Rate for Payer: BCBS Complete |
$1,011.57
|
| Rate for Payer: BCBS MAPPO |
$1,498.73
|
| Rate for Payer: BCN Commercial |
$2,611.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,498.73
|
| Rate for Payer: Cash Price |
$5,560.80
|
| Rate for Payer: Cash Price |
$5,560.80
|
| Rate for Payer: Cofinity Commercial |
$2,158.17
|
| Rate for Payer: Cofinity Commercial |
$2,008.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,498.73
|
| Rate for Payer: Healthscope Commercial |
$2,772.65
|
| Rate for Payer: Healthscope Commercial |
$2,397.97
|
| Rate for Payer: Mclaren Medicaid |
$963.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,573.67
|
| Rate for Payer: Meridian Medicaid |
$1,011.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,648.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,804.27
|
| Rate for Payer: Nomi Health Commercial |
$1,798.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,213.25
|
| Rate for Payer: PACE SWMI |
$1,498.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,498.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$963.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,541.33
|
| Rate for Payer: Priority Health Medicare |
$1,498.73
|
| Rate for Payer: Priority Health SBD |
$2,541.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,541.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,498.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,774.99
|
| Rate for Payer: UHC Core |
$2,774.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,498.73
|
| Rate for Payer: UHC Exchange |
$2,774.99
|
| Rate for Payer: UHC Medicaid |
$963.40
|
| Rate for Payer: UHCCP Medicaid |
$963.40
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,398.00
|
|
|
Service Code
|
HCPCS 22612
|
| Min. Negotiated Rate |
$935.92 |
| Max. Negotiated Rate |
$2,834.66 |
| Rate for Payer: Aetna Commercial |
$1,948.86
|
| Rate for Payer: Aetna Medicare |
$1,512.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,948.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,094.29
|
| Rate for Payer: BCBS Complete |
$982.72
|
| Rate for Payer: BCBS MAPPO |
$1,454.37
|
| Rate for Payer: BCN Commercial |
$2,627.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,454.37
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cofinity Commercial |
$2,094.29
|
| Rate for Payer: Cofinity Commercial |
$1,948.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,454.37
|
| Rate for Payer: Healthscope Commercial |
$2,690.58
|
| Rate for Payer: Healthscope Commercial |
$2,326.99
|
| Rate for Payer: Mclaren Medicaid |
$935.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,527.09
|
| Rate for Payer: Meridian Medicaid |
$982.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,599.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,834.66
|
| Rate for Payer: Nomi Health Commercial |
$1,745.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,548.50
|
| Rate for Payer: PACE SWMI |
$1,454.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,454.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,556.77
|
| Rate for Payer: Priority Health Medicare |
$1,454.37
|
| Rate for Payer: Priority Health SBD |
$2,556.77
|
| Rate for Payer: Priority Health Tiered Network |
$2,556.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,454.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,801.75
|
| Rate for Payer: UHC Core |
$2,801.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,454.37
|
| Rate for Payer: UHC Exchange |
$2,801.75
|
| Rate for Payer: UHC Medicaid |
$935.92
|
| Rate for Payer: UHCCP Medicaid |
$935.92
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC
|
Professional
|
Both
|
$4,415.00
|
|
|
Service Code
|
HCPCS 22610
|
| Min. Negotiated Rate |
$800.67 |
| Max. Negotiated Rate |
$3,311.25 |
| Rate for Payer: Aetna Commercial |
$1,657.54
|
| Rate for Payer: Aetna Medicare |
$1,286.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.24
|
| Rate for Payer: BCBS Complete |
$840.70
|
| Rate for Payer: BCBS MAPPO |
$1,236.97
|
| Rate for Payer: BCN Commercial |
$2,152.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,236.97
|
| Rate for Payer: Cash Price |
$3,532.00
|
| Rate for Payer: Cash Price |
$3,532.00
|
| Rate for Payer: Cofinity Commercial |
$1,781.24
|
| Rate for Payer: Cofinity Commercial |
$1,657.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,236.97
|
| Rate for Payer: Healthscope Commercial |
$2,288.39
|
| Rate for Payer: Healthscope Commercial |
$1,979.15
|
| Rate for Payer: Mclaren Medicaid |
$800.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,298.82
|
| Rate for Payer: Meridian Medicaid |
$840.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,360.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,294.64
|
| Rate for Payer: Nomi Health Commercial |
$1,484.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,311.25
|
| Rate for Payer: PACE SWMI |
$1,236.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,236.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$800.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,094.18
|
| Rate for Payer: Priority Health Medicare |
$1,236.97
|
| Rate for Payer: Priority Health SBD |
$2,094.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,094.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,236.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,225.72
|
| Rate for Payer: UHC Core |
$2,225.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,236.97
|
| Rate for Payer: UHC Exchange |
$2,225.72
|
| Rate for Payer: UHC Medicaid |
$800.67
|
| Rate for Payer: UHCCP Medicaid |
$800.67
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM
|
Professional
|
Both
|
$5,219.00
|
|
|
Service Code
|
HCPCS 22804
|
| Min. Negotiated Rate |
$1,417.30 |
| Max. Negotiated Rate |
$4,352.26 |
| Rate for Payer: Aetna Commercial |
$2,961.56
|
| Rate for Payer: Aetna Medicare |
$2,298.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,961.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,182.57
|
| Rate for Payer: BCBS Complete |
$1,488.16
|
| Rate for Payer: BCBS MAPPO |
$2,210.12
|
| Rate for Payer: BCN Commercial |
$3,651.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,210.12
|
| Rate for Payer: Cash Price |
$4,175.20
|
| Rate for Payer: Cash Price |
$4,175.20
|
| Rate for Payer: Cofinity Commercial |
$3,182.57
|
| Rate for Payer: Cofinity Commercial |
$2,961.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,210.12
|
| Rate for Payer: Healthscope Commercial |
$4,088.72
|
| Rate for Payer: Healthscope Commercial |
$3,536.19
|
| Rate for Payer: Mclaren Medicaid |
$1,417.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,320.63
|
| Rate for Payer: Meridian Medicaid |
$1,488.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,431.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,352.26
|
| Rate for Payer: Nomi Health Commercial |
$2,652.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,914.25
|
| Rate for Payer: PACE SWMI |
$2,210.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,210.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,417.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,903.03
|
| Rate for Payer: Priority Health Medicare |
$2,210.12
|
| Rate for Payer: Priority Health SBD |
$3,903.03
|
| Rate for Payer: Priority Health Tiered Network |
$3,903.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,210.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,290.14
|
| Rate for Payer: UHC Core |
$4,290.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,210.12
|
| Rate for Payer: UHC Exchange |
$4,290.14
|
| Rate for Payer: UHC Medicaid |
$1,417.30
|
| Rate for Payer: UHCCP Medicaid |
$1,417.30
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM
|
Professional
|
Both
|
$2,896.00
|
|
|
Service Code
|
HCPCS 22800
|
| Min. Negotiated Rate |
$837.30 |
| Max. Negotiated Rate |
$2,444.51 |
| Rate for Payer: Aetna Commercial |
$1,736.05
|
| Rate for Payer: Aetna Medicare |
$1,347.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,736.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,865.61
|
| Rate for Payer: BCBS Complete |
$879.16
|
| Rate for Payer: BCBS MAPPO |
$1,295.56
|
| Rate for Payer: BCN Commercial |
$2,078.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,295.56
|
| Rate for Payer: Cash Price |
$2,316.80
|
| Rate for Payer: Cash Price |
$2,316.80
|
| Rate for Payer: Cofinity Commercial |
$1,865.61
|
| Rate for Payer: Cofinity Commercial |
$1,736.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,295.56
|
| Rate for Payer: Healthscope Commercial |
$2,396.79
|
| Rate for Payer: Healthscope Commercial |
$2,072.90
|
| Rate for Payer: Mclaren Medicaid |
$837.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,360.34
|
| Rate for Payer: Meridian Medicaid |
$879.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,425.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,444.51
|
| Rate for Payer: Nomi Health Commercial |
$1,554.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,172.00
|
| Rate for Payer: PACE SWMI |
$1,295.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,295.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,221.93
|
| Rate for Payer: Priority Health Medicare |
$1,295.56
|
| Rate for Payer: Priority Health SBD |
$2,221.93
|
| Rate for Payer: Priority Health Tiered Network |
$2,221.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,295.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,392.85
|
| Rate for Payer: UHC Core |
$2,392.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,295.56
|
| Rate for Payer: UHC Exchange |
$2,392.85
|
| Rate for Payer: UHC Medicaid |
$837.30
|
| Rate for Payer: UHCCP Medicaid |
$837.30
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM
|
Professional
|
Both
|
$4,511.00
|
|
|
Service Code
|
HCPCS 22802
|
| Min. Negotiated Rate |
$1,234.76 |
| Max. Negotiated Rate |
$3,789.40 |
| Rate for Payer: Aetna Commercial |
$2,575.84
|
| Rate for Payer: Aetna Medicare |
$1,999.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,575.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,768.07
|
| Rate for Payer: BCBS Complete |
$1,296.50
|
| Rate for Payer: BCBS MAPPO |
$1,922.27
|
| Rate for Payer: BCN Commercial |
$3,181.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,922.27
|
| Rate for Payer: Cash Price |
$3,608.80
|
| Rate for Payer: Cash Price |
$3,608.80
|
| Rate for Payer: Cofinity Commercial |
$2,768.07
|
| Rate for Payer: Cofinity Commercial |
$2,575.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,922.27
|
| Rate for Payer: Healthscope Commercial |
$3,556.20
|
| Rate for Payer: Healthscope Commercial |
$3,075.63
|
| Rate for Payer: Mclaren Medicaid |
$1,234.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,018.38
|
| Rate for Payer: Meridian Medicaid |
$1,296.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,789.40
|
| Rate for Payer: Nomi Health Commercial |
$2,306.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,383.25
|
| Rate for Payer: PACE SWMI |
$1,922.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,922.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,234.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,401.05
|
| Rate for Payer: Priority Health Medicare |
$1,922.27
|
| Rate for Payer: Priority Health SBD |
$3,401.05
|
| Rate for Payer: Priority Health Tiered Network |
$3,401.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,922.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,721.43
|
| Rate for Payer: UHC Core |
$3,721.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,922.27
|
| Rate for Payer: UHC Exchange |
$3,721.43
|
| Rate for Payer: UHC Medicaid |
$1,234.76
|
| Rate for Payer: UHCCP Medicaid |
$1,234.76
|
|
|
PR ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC
|
Professional
|
Both
|
$1,931.00
|
|
|
Service Code
|
HCPCS 22614
|
| Min. Negotiated Rate |
$222.80 |
| Max. Negotiated Rate |
$1,448.25 |
| Rate for Payer: Aetna Commercial |
$471.95
|
| Rate for Payer: Aetna Medicare |
$366.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.17
|
| Rate for Payer: BCBS Complete |
$233.94
|
| Rate for Payer: BCBS MAPPO |
$352.20
|
| Rate for Payer: BCN Commercial |
$643.35
|
| Rate for Payer: BCN Medicare Advantage |
$352.20
|
| Rate for Payer: Cash Price |
$1,544.80
|
| Rate for Payer: Cash Price |
$1,544.80
|
| Rate for Payer: Cofinity Commercial |
$507.17
|
| Rate for Payer: Cofinity Commercial |
$471.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.20
|
| Rate for Payer: Healthscope Commercial |
$651.57
|
| Rate for Payer: Healthscope Commercial |
$563.52
|
| Rate for Payer: Mclaren Medicaid |
$222.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.81
|
| Rate for Payer: Meridian Medicaid |
$233.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$387.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.95
|
| Rate for Payer: Nomi Health Commercial |
$422.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,448.25
|
| Rate for Payer: PACE SWMI |
$352.20
|
| Rate for Payer: PHP Medicare Advantage |
$352.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$626.01
|
| Rate for Payer: Priority Health Medicare |
$352.20
|
| Rate for Payer: Priority Health SBD |
$626.01
|
| Rate for Payer: Priority Health Tiered Network |
$626.01
|
| Rate for Payer: Railroad Medicare Medicare |
$352.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.00
|
| Rate for Payer: UHC Core |
$698.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$352.20
|
| Rate for Payer: UHC Exchange |
$698.00
|
| Rate for Payer: UHC Medicaid |
$222.80
|
| Rate for Payer: UHCCP Medicaid |
$222.80
|
|
|
PR ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ
|
Professional
|
Both
|
$3,337.00
|
|
|
Service Code
|
HCPCS 27280
|
| Min. Negotiated Rate |
$818.56 |
| Max. Negotiated Rate |
$2,502.75 |
| Rate for Payer: Aetna Commercial |
$1,704.69
|
| Rate for Payer: Aetna Medicare |
$1,323.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,704.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,831.91
|
| Rate for Payer: BCBS Complete |
$859.49
|
| Rate for Payer: BCBS MAPPO |
$1,272.16
|
| Rate for Payer: BCN Commercial |
$2,067.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,272.16
|
| Rate for Payer: Cash Price |
$2,669.60
|
| Rate for Payer: Cash Price |
$2,669.60
|
| Rate for Payer: Cofinity Commercial |
$1,831.91
|
| Rate for Payer: Cofinity Commercial |
$1,704.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,272.16
|
| Rate for Payer: Healthscope Commercial |
$2,353.50
|
| Rate for Payer: Healthscope Commercial |
$2,035.46
|
| Rate for Payer: Mclaren Medicaid |
$818.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,335.77
|
| Rate for Payer: Meridian Medicaid |
$859.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,399.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,438.78
|
| Rate for Payer: Nomi Health Commercial |
$1,526.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,502.75
|
| Rate for Payer: PACE SWMI |
$1,272.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,272.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,210.23
|
| Rate for Payer: Priority Health Medicare |
$1,272.16
|
| Rate for Payer: Priority Health SBD |
$2,210.23
|
| Rate for Payer: Priority Health Tiered Network |
$2,210.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,272.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,388.06
|
| Rate for Payer: UHC Core |
$2,388.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,272.16
|
| Rate for Payer: UHC Exchange |
$2,388.06
|
| Rate for Payer: UHC Medicaid |
$818.56
|
| Rate for Payer: UHCCP Medicaid |
$818.56
|
|
|
PR ARTHRODESIS SUBTALAR
|
Professional
|
Both
|
$3,374.00
|
|
|
Service Code
|
HCPCS 28725
|
| Min. Negotiated Rate |
$464.98 |
| Max. Negotiated Rate |
$2,530.50 |
| Rate for Payer: Aetna Commercial |
$952.53
|
| Rate for Payer: Aetna Medicare |
$739.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.53
|
| Rate for Payer: BCBS Complete |
$488.23
|
| Rate for Payer: BCBS MAPPO |
$710.84
|
| Rate for Payer: BCN Commercial |
$1,181.71
|
| Rate for Payer: BCN Medicare Advantage |
$710.84
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cofinity Commercial |
$952.53
|
| Rate for Payer: Cofinity Commercial |
$1,023.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.84
|
| Rate for Payer: Healthscope Commercial |
$1,315.05
|
| Rate for Payer: Healthscope Commercial |
$1,137.34
|
| Rate for Payer: Mclaren Medicaid |
$464.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$746.38
|
| Rate for Payer: Meridian Medicaid |
$488.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$781.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,373.67
|
| Rate for Payer: Nomi Health Commercial |
$853.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,530.50
|
| Rate for Payer: PACE SWMI |
$710.84
|
| Rate for Payer: PHP Medicare Advantage |
$710.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,263.21
|
| Rate for Payer: Priority Health Medicare |
$710.84
|
| Rate for Payer: Priority Health SBD |
$1,263.21
|
| Rate for Payer: Priority Health Tiered Network |
$1,263.21
|
| Rate for Payer: Railroad Medicare Medicare |
$710.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.47
|
| Rate for Payer: UHC Core |
$1,360.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$710.84
|
| Rate for Payer: UHC Exchange |
$1,360.47
|
| Rate for Payer: UHC Medicaid |
$464.98
|
| Rate for Payer: UHCCP Medicaid |
$464.98
|
|
|
PR ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 27282
|
| Min. Negotiated Rate |
$512.27 |
| Max. Negotiated Rate |
$1,527.14 |
| Rate for Payer: Aetna Commercial |
$1,051.62
|
| Rate for Payer: Aetna Medicare |
$816.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,130.10
|
| Rate for Payer: BCBS Complete |
$537.88
|
| Rate for Payer: BCBS MAPPO |
$784.79
|
| Rate for Payer: BCN Commercial |
$1,309.69
|
| Rate for Payer: BCN Medicare Advantage |
$784.79
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,130.10
|
| Rate for Payer: Cofinity Commercial |
$1,051.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.79
|
| Rate for Payer: Healthscope Commercial |
$1,451.86
|
| Rate for Payer: Healthscope Commercial |
$1,255.66
|
| Rate for Payer: Mclaren Medicaid |
$512.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.03
|
| Rate for Payer: Meridian Medicaid |
$537.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$863.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,527.14
|
| Rate for Payer: Nomi Health Commercial |
$941.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,161.00
|
| Rate for Payer: PACE SWMI |
$784.79
|
| Rate for Payer: PHP Medicare Advantage |
$784.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,400.02
|
| Rate for Payer: Priority Health Medicare |
$784.79
|
| Rate for Payer: Priority Health SBD |
$1,400.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,400.02
|
| Rate for Payer: Railroad Medicare Medicare |
$784.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,497.74
|
| Rate for Payer: UHC Core |
$1,497.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$784.79
|
| Rate for Payer: UHC Exchange |
$1,497.74
|
| Rate for Payer: UHC Medicaid |
$512.27
|
| Rate for Payer: UHCCP Medicaid |
$512.27
|
|
|
PR ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL
|
Professional
|
Both
|
$3,095.00
|
|
|
Service Code
|
HCPCS 27871
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$2,321.25 |
| Rate for Payer: Aetna Commercial |
$845.62
|
| Rate for Payer: Aetna Medicare |
$656.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$908.73
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$631.06
|
| Rate for Payer: BCN Commercial |
$1,048.75
|
| Rate for Payer: BCN Medicare Advantage |
$631.06
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cash Price |
$2,476.00
|
| Rate for Payer: Cofinity Commercial |
$908.73
|
| Rate for Payer: Cofinity Commercial |
$845.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.06
|
| Rate for Payer: Healthscope Commercial |
$1,167.46
|
| Rate for Payer: Healthscope Commercial |
$1,009.70
|
| Rate for Payer: Mclaren Medicaid |
$412.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.61
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.09
|
| Rate for Payer: Nomi Health Commercial |
$757.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,321.25
|
| Rate for Payer: PACE SWMI |
$631.06
|
| Rate for Payer: PHP Medicare Advantage |
$631.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,121.09
|
| Rate for Payer: Priority Health Medicare |
$631.06
|
| Rate for Payer: Priority Health SBD |
$1,121.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,121.09
|
| Rate for Payer: Railroad Medicare Medicare |
$631.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,202.53
|
| Rate for Payer: UHC Core |
$1,202.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.06
|
| Rate for Payer: UHC Exchange |
$1,202.53
|
| Rate for Payer: UHC Medicaid |
$412.58
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
|
|
PR ARTHRODESIS TRIPLE
|
Professional
|
Both
|
$4,207.00
|
|
|
Service Code
|
HCPCS 28715
|
| Min. Negotiated Rate |
$563.60 |
| Max. Negotiated Rate |
$3,155.25 |
| Rate for Payer: Aetna Commercial |
$1,154.99
|
| Rate for Payer: Aetna Medicare |
$896.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,154.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.18
|
| Rate for Payer: BCBS Complete |
$591.78
|
| Rate for Payer: BCBS MAPPO |
$861.93
|
| Rate for Payer: BCN Commercial |
$1,428.71
|
| Rate for Payer: BCN Medicare Advantage |
$861.93
|
| Rate for Payer: Cash Price |
$3,365.60
|
| Rate for Payer: Cash Price |
$3,365.60
|
| Rate for Payer: Cofinity Commercial |
$1,241.18
|
| Rate for Payer: Cofinity Commercial |
$1,154.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$861.93
|
| Rate for Payer: Healthscope Commercial |
$1,594.57
|
| Rate for Payer: Healthscope Commercial |
$1,379.09
|
| Rate for Payer: Mclaren Medicaid |
$563.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.03
|
| Rate for Payer: Meridian Medicaid |
$591.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$948.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,661.06
|
| Rate for Payer: Nomi Health Commercial |
$1,034.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,155.25
|
| Rate for Payer: PACE SWMI |
$861.93
|
| Rate for Payer: PHP Medicare Advantage |
$861.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,527.25
|
| Rate for Payer: Priority Health Medicare |
$861.93
|
| Rate for Payer: Priority Health SBD |
$1,527.25
|
| Rate for Payer: Priority Health Tiered Network |
$1,527.25
|
| Rate for Payer: Railroad Medicare Medicare |
$861.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,641.76
|
| Rate for Payer: UHC Core |
$1,641.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$861.93
|
| Rate for Payer: UHC Exchange |
$1,641.76
|
| Rate for Payer: UHC Medicaid |
$563.60
|
| Rate for Payer: UHCCP Medicaid |
$563.60
|
|
|
PR ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT
|
Professional
|
Both
|
$2,533.00
|
|
|
Service Code
|
HCPCS 25800
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$1,899.75 |
| Rate for Payer: Aetna Commercial |
$880.22
|
| Rate for Payer: Aetna Medicare |
$683.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$945.91
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS MAPPO |
$656.88
|
| Rate for Payer: BCN Commercial |
$1,118.96
|
| Rate for Payer: BCN Medicare Advantage |
$656.88
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cofinity Commercial |
$945.91
|
| Rate for Payer: Cofinity Commercial |
$880.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$656.88
|
| Rate for Payer: Healthscope Commercial |
$1,215.23
|
| Rate for Payer: Healthscope Commercial |
$1,051.01
|
| Rate for Payer: Mclaren Medicaid |
$429.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$689.72
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$722.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.65
|
| Rate for Payer: Nomi Health Commercial |
$788.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,899.75
|
| Rate for Payer: PACE SWMI |
$656.88
|
| Rate for Payer: PHP Medicare Advantage |
$656.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,196.15
|
| Rate for Payer: Priority Health Medicare |
$656.88
|
| Rate for Payer: Priority Health SBD |
$1,196.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,196.15
|
| Rate for Payer: Railroad Medicare Medicare |
$656.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,275.66
|
| Rate for Payer: UHC Core |
$1,275.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$656.88
|
| Rate for Payer: UHC Exchange |
$1,275.66
|
| Rate for Payer: UHC Medicaid |
$429.41
|
| Rate for Payer: UHCCP Medicaid |
$429.41
|
|
|
PR ARTHRODESIS WRIST LIMITED W/O BONE GRAFT
|
Professional
|
Both
|
$2,922.00
|
|
|
Service Code
|
HCPCS 25820
|
| Min. Negotiated Rate |
$392.35 |
| Max. Negotiated Rate |
$2,191.50 |
| Rate for Payer: Aetna Commercial |
$795.73
|
| Rate for Payer: Aetna Medicare |
$617.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.12
|
| Rate for Payer: BCBS Complete |
$411.97
|
| Rate for Payer: BCBS MAPPO |
$593.83
|
| Rate for Payer: BCN Commercial |
$992.47
|
| Rate for Payer: BCN Medicare Advantage |
$593.83
|
| Rate for Payer: Cash Price |
$2,337.60
|
| Rate for Payer: Cash Price |
$2,337.60
|
| Rate for Payer: Cofinity Commercial |
$855.12
|
| Rate for Payer: Cofinity Commercial |
$795.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$593.83
|
| Rate for Payer: Healthscope Commercial |
$950.13
|
| Rate for Payer: Healthscope Commercial |
$1,098.59
|
| Rate for Payer: Mclaren Medicaid |
$392.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$623.52
|
| Rate for Payer: Meridian Medicaid |
$411.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$653.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,150.11
|
| Rate for Payer: Nomi Health Commercial |
$712.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,191.50
|
| Rate for Payer: PACE SWMI |
$593.83
|
| Rate for Payer: PHP Medicare Advantage |
$593.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,060.94
|
| Rate for Payer: Priority Health Medicare |
$593.83
|
| Rate for Payer: Priority Health SBD |
$1,060.94
|
| Rate for Payer: Priority Health Tiered Network |
$1,060.94
|
| Rate for Payer: Railroad Medicare Medicare |
$593.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.17
|
| Rate for Payer: UHC Core |
$1,093.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$593.83
|
| Rate for Payer: UHC Exchange |
$1,093.17
|
| Rate for Payer: UHC Medicaid |
$392.35
|
| Rate for Payer: UHCCP Medicaid |
$392.35
|
|
|
PR ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT
|
Professional
|
Both
|
$3,514.00
|
|
|
Service Code
|
HCPCS 25810
|
| Min. Negotiated Rate |
$506.30 |
| Max. Negotiated Rate |
$2,635.50 |
| Rate for Payer: Aetna Commercial |
$1,037.95
|
| Rate for Payer: Aetna Medicare |
$805.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,037.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.41
|
| Rate for Payer: BCBS Complete |
$531.62
|
| Rate for Payer: BCBS MAPPO |
$774.59
|
| Rate for Payer: BCN Commercial |
$1,326.12
|
| Rate for Payer: BCN Medicare Advantage |
$774.59
|
| Rate for Payer: Cash Price |
$2,811.20
|
| Rate for Payer: Cash Price |
$2,811.20
|
| Rate for Payer: Cofinity Commercial |
$1,115.41
|
| Rate for Payer: Cofinity Commercial |
$1,037.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.59
|
| Rate for Payer: Healthscope Commercial |
$1,432.99
|
| Rate for Payer: Healthscope Commercial |
$1,239.34
|
| Rate for Payer: Mclaren Medicaid |
$506.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$813.32
|
| Rate for Payer: Meridian Medicaid |
$531.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$852.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,538.77
|
| Rate for Payer: Nomi Health Commercial |
$929.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,635.50
|
| Rate for Payer: PACE SWMI |
$774.59
|
| Rate for Payer: PHP Medicare Advantage |
$774.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$506.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,417.59
|
| Rate for Payer: Priority Health Medicare |
$774.59
|
| Rate for Payer: Priority Health SBD |
$1,417.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,417.59
|
| Rate for Payer: Railroad Medicare Medicare |
$774.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,511.02
|
| Rate for Payer: UHC Core |
$1,511.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$774.59
|
| Rate for Payer: UHC Exchange |
$1,511.02
|
| Rate for Payer: UHC Medicaid |
$506.30
|
| Rate for Payer: UHCCP Medicaid |
$506.30
|
|
|
PR ARTHRODESIS WRIST WITH AUTOGRAFT
|
Professional
|
Both
|
$14,511.00
|
|
|
Service Code
|
HCPCS 25825
|
| Min. Negotiated Rate |
$474.35 |
| Max. Negotiated Rate |
$10,883.25 |
| Rate for Payer: Aetna Commercial |
$964.13
|
| Rate for Payer: Aetna Medicare |
$748.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,036.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.13
|
| Rate for Payer: BCBS Complete |
$498.07
|
| Rate for Payer: BCBS MAPPO |
$719.50
|
| Rate for Payer: BCN Commercial |
$1,210.59
|
| Rate for Payer: BCN Medicare Advantage |
$719.50
|
| Rate for Payer: Cash Price |
$11,608.80
|
| Rate for Payer: Cash Price |
$11,608.80
|
| Rate for Payer: Cofinity Commercial |
$964.13
|
| Rate for Payer: Cofinity Commercial |
$1,036.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.50
|
| Rate for Payer: Healthscope Commercial |
$1,331.08
|
| Rate for Payer: Healthscope Commercial |
$1,151.20
|
| Rate for Payer: Mclaren Medicaid |
$474.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.48
|
| Rate for Payer: Meridian Medicaid |
$498.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.50
|
| Rate for Payer: Nomi Health Commercial |
$863.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,883.25
|
| Rate for Payer: PACE SWMI |
$719.50
|
| Rate for Payer: PHP Medicare Advantage |
$719.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,294.08
|
| Rate for Payer: Priority Health Medicare |
$719.50
|
| Rate for Payer: Priority Health SBD |
$1,294.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,294.08
|
| Rate for Payer: Railroad Medicare Medicare |
$719.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,343.16
|
| Rate for Payer: UHC Core |
$1,343.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.50
|
| Rate for Payer: UHC Exchange |
$1,343.16
|
| Rate for Payer: UHC Medicaid |
$474.35
|
| Rate for Payer: UHCCP Medicaid |
$474.35
|
|
|
PR ARTHRODESIS WRIST W/SLIDING GRAFT
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 25805
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$2,298.00 |
| Rate for Payer: Aetna Commercial |
$1,037.41
|
| Rate for Payer: Aetna Medicare |
$805.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,037.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,114.83
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS MAPPO |
$774.19
|
| Rate for Payer: BCN Commercial |
$1,292.76
|
| Rate for Payer: BCN Medicare Advantage |
$774.19
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,114.83
|
| Rate for Payer: Cofinity Commercial |
$1,037.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.19
|
| Rate for Payer: Healthscope Commercial |
$1,432.25
|
| Rate for Payer: Healthscope Commercial |
$1,238.70
|
| Rate for Payer: Mclaren Medicaid |
$505.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.90
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$851.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,506.64
|
| Rate for Payer: Nomi Health Commercial |
$929.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,298.00
|
| Rate for Payer: PACE SWMI |
$774.19
|
| Rate for Payer: PHP Medicare Advantage |
$774.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,381.93
|
| Rate for Payer: Priority Health Medicare |
$774.19
|
| Rate for Payer: Priority Health SBD |
$1,381.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,381.93
|
| Rate for Payer: Railroad Medicare Medicare |
$774.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,479.80
|
| Rate for Payer: UHC Core |
$1,479.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$774.19
|
| Rate for Payer: UHC Exchange |
$1,479.80
|
| Rate for Payer: UHC Medicaid |
$505.24
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS G0289
|
| Min. Negotiated Rate |
$72.76 |
| Max. Negotiated Rate |
$174.75 |
| Rate for Payer: Aetna Commercial |
$97.50
|
| Rate for Payer: Aetna Medicare |
$75.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: BCBS MAPPO |
$72.76
|
| Rate for Payer: BCN Commercial |
$126.49
|
| Rate for Payer: BCN Medicare Advantage |
$72.76
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cofinity Commercial |
$97.50
|
| Rate for Payer: Cofinity Commercial |
$104.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.76
|
| Rate for Payer: Healthscope Commercial |
$134.61
|
| Rate for Payer: Healthscope Commercial |
$116.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.29
|
| Rate for Payer: Nomi Health Commercial |
$87.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.75
|
| Rate for Payer: PACE SWMI |
$72.76
|
| Rate for Payer: PHP Medicare Advantage |
$72.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$135.21
|
| Rate for Payer: Priority Health Medicare |
$72.76
|
| Rate for Payer: Priority Health SBD |
$135.21
|
| Rate for Payer: Priority Health Tiered Network |
$135.21
|
| Rate for Payer: Railroad Medicare Medicare |
$72.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.02
|
| Rate for Payer: UHC Core |
$153.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72.76
|
| Rate for Payer: UHC Exchange |
$153.02
|
|
|
PR ARTHROPLASTY ANKLE
|
Professional
|
Both
|
$2,784.00
|
|
|
Service Code
|
HCPCS 27700
|
| Min. Negotiated Rate |
$426.85 |
| Max. Negotiated Rate |
$2,088.00 |
| Rate for Payer: Aetna Commercial |
$874.91
|
| Rate for Payer: Aetna Medicare |
$679.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.20
|
| Rate for Payer: BCBS Complete |
$448.19
|
| Rate for Payer: BCBS MAPPO |
$652.92
|
| Rate for Payer: BCN Commercial |
$1,087.10
|
| Rate for Payer: BCN Medicare Advantage |
$652.92
|
| Rate for Payer: Cash Price |
$2,227.20
|
| Rate for Payer: Cash Price |
$2,227.20
|
| Rate for Payer: Cofinity Commercial |
$940.20
|
| Rate for Payer: Cofinity Commercial |
$874.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.92
|
| Rate for Payer: Healthscope Commercial |
$1,207.90
|
| Rate for Payer: Healthscope Commercial |
$1,044.67
|
| Rate for Payer: Mclaren Medicaid |
$426.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.57
|
| Rate for Payer: Meridian Medicaid |
$448.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$718.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.02
|
| Rate for Payer: Nomi Health Commercial |
$783.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,088.00
|
| Rate for Payer: PACE SWMI |
$652.92
|
| Rate for Payer: PHP Medicare Advantage |
$652.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,162.06
|
| Rate for Payer: Priority Health Medicare |
$652.92
|
| Rate for Payer: Priority Health SBD |
$1,162.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,162.06
|
| Rate for Payer: Railroad Medicare Medicare |
$652.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.69
|
| Rate for Payer: UHC Core |
$1,074.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$652.92
|
| Rate for Payer: UHC Exchange |
$1,074.69
|
| Rate for Payer: UHC Medicaid |
$426.85
|
| Rate for Payer: UHCCP Medicaid |
$426.85
|
|
|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$649.01 |
| Max. Negotiated Rate |
$1,971.52 |
| Rate for Payer: Aetna Commercial |
$1,339.69
|
| Rate for Payer: Aetna Medicare |
$1,039.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,339.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,439.67
|
| Rate for Payer: BCBS Complete |
$681.46
|
| Rate for Payer: BCBS MAPPO |
$999.77
|
| Rate for Payer: BCN Commercial |
$1,684.17
|
| Rate for Payer: BCN Medicare Advantage |
$999.77
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,439.67
|
| Rate for Payer: Cofinity Commercial |
$1,339.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$999.77
|
| Rate for Payer: Healthscope Commercial |
$1,849.57
|
| Rate for Payer: Healthscope Commercial |
$1,599.63
|
| Rate for Payer: Mclaren Medicaid |
$649.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,049.76
|
| Rate for Payer: Meridian Medicaid |
$681.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,099.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,971.52
|
| Rate for Payer: Nomi Health Commercial |
$1,199.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.75
|
| Rate for Payer: PACE SWMI |
$999.77
|
| Rate for Payer: PHP Medicare Advantage |
$999.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,800.33
|
| Rate for Payer: Priority Health Medicare |
$999.77
|
| Rate for Payer: Priority Health SBD |
$1,800.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,800.33
|
| Rate for Payer: Railroad Medicare Medicare |
$999.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,958.75
|
| Rate for Payer: UHC Core |
$1,958.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$999.77
|
| Rate for Payer: UHC Exchange |
$1,958.75
|
| Rate for Payer: UHC Medicaid |
$649.01
|
| Rate for Payer: UHCCP Medicaid |
$649.01
|
|
|
PR ARTHROPLASTY ANKLE W/IMPLANT
|
Professional
|
Both
|
$2,035.00
|
|
|
Service Code
|
HCPCS 27702
|
| Min. Negotiated Rate |
$564.45 |
| Max. Negotiated Rate |
$1,704.42 |
| Rate for Payer: Aetna Commercial |
$1,163.15
|
| Rate for Payer: Aetna Medicare |
$902.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,163.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,249.95
|
| Rate for Payer: BCBS Complete |
$592.67
|
| Rate for Payer: BCBS MAPPO |
$868.02
|
| Rate for Payer: BCN Commercial |
$1,456.09
|
| Rate for Payer: BCN Medicare Advantage |
$868.02
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cofinity Commercial |
$1,249.95
|
| Rate for Payer: Cofinity Commercial |
$1,163.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.02
|
| Rate for Payer: Healthscope Commercial |
$1,605.84
|
| Rate for Payer: Healthscope Commercial |
$1,388.83
|
| Rate for Payer: Mclaren Medicaid |
$564.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.42
|
| Rate for Payer: Meridian Medicaid |
$592.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$954.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,704.42
|
| Rate for Payer: Nomi Health Commercial |
$1,041.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.25
|
| Rate for Payer: PACE SWMI |
$868.02
|
| Rate for Payer: PHP Medicare Advantage |
$868.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,556.52
|
| Rate for Payer: Priority Health Medicare |
$868.02
|
| Rate for Payer: Priority Health SBD |
$1,556.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,556.52
|
| Rate for Payer: Railroad Medicare Medicare |
$868.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.69
|
| Rate for Payer: UHC Core |
$1,690.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$868.02
|
| Rate for Payer: UHC Exchange |
$1,690.69
|
| Rate for Payer: UHC Medicaid |
$564.45
|
| Rate for Payer: UHCCP Medicaid |
$564.45
|
|
|
PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE
|
Professional
|
Both
|
$1,601.00
|
|
|
Service Code
|
HCPCS 27442
|
| Min. Negotiated Rate |
$513.33 |
| Max. Negotiated Rate |
$1,548.56 |
| Rate for Payer: Aetna Commercial |
$1,056.23
|
| Rate for Payer: Aetna Medicare |
$819.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,135.05
|
| Rate for Payer: BCBS Complete |
$539.00
|
| Rate for Payer: BCBS MAPPO |
$788.23
|
| Rate for Payer: BCN Commercial |
$1,327.12
|
| Rate for Payer: BCN Medicare Advantage |
$788.23
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cash Price |
$1,280.80
|
| Rate for Payer: Cofinity Commercial |
$1,135.05
|
| Rate for Payer: Cofinity Commercial |
$1,056.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.23
|
| Rate for Payer: Healthscope Commercial |
$1,458.23
|
| Rate for Payer: Healthscope Commercial |
$1,261.17
|
| Rate for Payer: Mclaren Medicaid |
$513.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.64
|
| Rate for Payer: Meridian Medicaid |
$539.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$867.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,548.56
|
| Rate for Payer: Nomi Health Commercial |
$945.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.75
|
| Rate for Payer: PACE SWMI |
$788.23
|
| Rate for Payer: PHP Medicare Advantage |
$788.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,418.65
|
| Rate for Payer: Priority Health Medicare |
$788.23
|
| Rate for Payer: Priority Health SBD |
$1,418.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,418.65
|
| Rate for Payer: Railroad Medicare Medicare |
$788.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,526.85
|
| Rate for Payer: UHC Core |
$1,526.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$788.23
|
| Rate for Payer: UHC Exchange |
$1,526.85
|
| Rate for Payer: UHC Medicaid |
$513.33
|
| Rate for Payer: UHCCP Medicaid |
$513.33
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,712.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$829.21 |
| Max. Negotiated Rate |
$3,534.00 |
| Rate for Payer: Aetna Commercial |
$1,717.00
|
| Rate for Payer: Aetna Medicare |
$1,332.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,717.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,845.13
|
| Rate for Payer: BCBS Complete |
$870.67
|
| Rate for Payer: BCBS MAPPO |
$1,281.34
|
| Rate for Payer: BCN Commercial |
$2,178.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,281.34
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,845.13
|
| Rate for Payer: Cofinity Commercial |
$1,717.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,281.34
|
| Rate for Payer: Healthscope Commercial |
$2,370.48
|
| Rate for Payer: Healthscope Commercial |
$2,050.14
|
| Rate for Payer: Mclaren Medicaid |
$829.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,345.41
|
| Rate for Payer: Meridian Medicaid |
$870.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,409.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,563.20
|
| Rate for Payer: Nomi Health Commercial |
$1,537.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,534.00
|
| Rate for Payer: PACE SWMI |
$1,281.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,281.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,328.41
|
| Rate for Payer: Priority Health Medicare |
$1,281.34
|
| Rate for Payer: Priority Health SBD |
$2,328.41
|
| Rate for Payer: Priority Health Tiered Network |
$2,328.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,281.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,552.53
|
| Rate for Payer: UHC Core |
$2,552.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,281.34
|
| Rate for Payer: UHC Exchange |
$2,552.53
|
| Rate for Payer: UHC Medicaid |
$829.21
|
| Rate for Payer: UHCCP Medicaid |
$829.21
|
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,570.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$693.74 |
| Max. Negotiated Rate |
$2,677.50 |
| Rate for Payer: Aetna Commercial |
$1,433.25
|
| Rate for Payer: Aetna Medicare |
$1,112.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.21
|
| Rate for Payer: BCBS Complete |
$728.43
|
| Rate for Payer: BCBS MAPPO |
$1,069.59
|
| Rate for Payer: BCN Commercial |
$1,810.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.59
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$1,540.21
|
| Rate for Payer: Cofinity Commercial |
$1,433.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.59
|
| Rate for Payer: Healthscope Commercial |
$1,978.74
|
| Rate for Payer: Healthscope Commercial |
$1,711.34
|
| Rate for Payer: Mclaren Medicaid |
$693.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.07
|
| Rate for Payer: Meridian Medicaid |
$728.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,176.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,123.86
|
| Rate for Payer: Nomi Health Commercial |
$1,283.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.50
|
| Rate for Payer: PACE SWMI |
$1,069.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,935.02
|
| Rate for Payer: Priority Health Medicare |
$1,069.59
|
| Rate for Payer: Priority Health SBD |
$1,935.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,935.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,069.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,108.53
|
| Rate for Payer: UHC Core |
$2,108.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,069.59
|
| Rate for Payer: UHC Exchange |
$2,108.53
|
| Rate for Payer: UHC Medicaid |
$693.74
|
| Rate for Payer: UHCCP Medicaid |
$693.74
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,741.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$267.74 |
| Max. Negotiated Rate |
$1,305.75 |
| Rate for Payer: Aetna Commercial |
$543.84
|
| Rate for Payer: Aetna Medicare |
$422.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.42
|
| Rate for Payer: BCBS Complete |
$281.13
|
| Rate for Payer: BCBS MAPPO |
$405.85
|
| Rate for Payer: BCN Commercial |
$681.74
|
| Rate for Payer: BCN Medicare Advantage |
$405.85
|
| Rate for Payer: Cash Price |
$1,392.80
|
| Rate for Payer: Cash Price |
$1,392.80
|
| Rate for Payer: Cofinity Commercial |
$584.42
|
| Rate for Payer: Cofinity Commercial |
$543.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.85
|
| Rate for Payer: Healthscope Commercial |
$750.82
|
| Rate for Payer: Healthscope Commercial |
$649.36
|
| Rate for Payer: Mclaren Medicaid |
$267.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$426.14
|
| Rate for Payer: Meridian Medicaid |
$281.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$446.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$778.00
|
| Rate for Payer: Nomi Health Commercial |
$487.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,305.75
|
| Rate for Payer: PACE SWMI |
$405.85
|
| Rate for Payer: PHP Medicare Advantage |
$405.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$728.75
|
| Rate for Payer: Priority Health Medicare |
$405.85
|
| Rate for Payer: Priority Health SBD |
$728.75
|
| Rate for Payer: Priority Health Tiered Network |
$728.75
|
| Rate for Payer: Railroad Medicare Medicare |
$405.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$750.76
|
| Rate for Payer: UHC Core |
$750.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.85
|
| Rate for Payer: UHC Exchange |
$750.76
|
| Rate for Payer: UHC Medicaid |
$267.74
|
| Rate for Payer: UHCCP Medicaid |
$267.74
|
|
