|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Facility
|
OP
|
$2,158.00
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$540.28 |
| Max. Negotiated Rate |
$3,600.14 |
| Rate for Payer: Aetna Commercial |
$1,834.30
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.70
|
| 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 |
$2,274.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cofinity Commercial |
$1,855.88
|
| Rate for Payer: Cofinity Commercial |
$1,510.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$1,942.20
|
| 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 |
$1,834.30
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$1,834.30
|
| 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 |
$1,510.60
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health SBD |
$1,359.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$540.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,158.00
|
|
|
Service Code
|
HCPCS 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$721.82
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Mclaren Medicaid |
$351.45
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.89
|
| Rate for Payer: Priority Health Narrow Network |
$833.89
|
| Rate for Payer: Priority Health SBD |
$833.89
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,158.00
|
|
|
Service Code
|
HCPCS 29822
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$721.82
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Mclaren Medicaid |
$351.45
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.89
|
| Rate for Payer: Priority Health Narrow Network |
$833.89
|
| Rate for Payer: Priority Health SBD |
$833.89
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Facility
|
IP
|
$2,158.00
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$1,359.54 |
| Max. Negotiated Rate |
$1,942.20 |
| Rate for Payer: Aetna Commercial |
$1,834.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.70
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cofinity Commercial |
$1,855.88
|
| Rate for Payer: Cofinity Commercial |
$1,510.60
|
| Rate for Payer: Healthscope Commercial |
$1,942.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.30
|
| Rate for Payer: PHP Commercial |
$1,834.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health SBD |
$1,359.54
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$1,598.64 |
| Rate for Payer: Aetna Commercial |
$718.35
|
| Rate for Payer: BCBS Complete |
$362.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.64
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Mclaren Medicaid |
$345.70
|
| Rate for Payer: Meridian Medicaid |
$362.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.64
|
| Rate for Payer: Priority Health Narrow Network |
$821.64
|
| Rate for Payer: Priority Health SBD |
$821.64
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 29820
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$1,598.64 |
| Rate for Payer: Aetna Commercial |
$718.35
|
| Rate for Payer: BCBS Complete |
$362.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.64
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Mclaren Medicaid |
$345.70
|
| Rate for Payer: Meridian Medicaid |
$362.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.64
|
| Rate for Payer: Priority Health Narrow Network |
$821.64
|
| Rate for Payer: Priority Health SBD |
$821.64
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Facility
|
OP
|
$1,902.00
|
|
|
Service Code
|
CPT 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$531.44 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Commercial |
$1,616.70
|
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,743.25
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,635.72
|
| Rate for Payer: Cofinity Commercial |
$1,331.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Healthscope Commercial |
$1,711.80
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,616.70
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Commercial |
$1,616.70
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.40
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health SBD |
$1,198.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$584.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$531.44
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Facility
|
IP
|
$1,902.00
|
|
|
Service Code
|
CPT 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$1,198.26 |
| Max. Negotiated Rate |
$1,711.80 |
| Rate for Payer: Aetna Commercial |
$1,616.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.30
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,635.72
|
| Rate for Payer: Cofinity Commercial |
$1,331.40
|
| Rate for Payer: Healthscope Commercial |
$1,711.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,616.70
|
| Rate for Payer: PHP Commercial |
$1,616.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.40
|
| Rate for Payer: Priority Health SBD |
$1,198.26
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,967.00
|
|
|
Service Code
|
HCPCS 29819
|
| Min. Negotiated Rate |
$380.63 |
| Max. Negotiated Rate |
$1,434.86 |
| Rate for Payer: Aetna Commercial |
$784.19
|
| Rate for Payer: BCBS Complete |
$399.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.86
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Mclaren Medicaid |
$380.63
|
| Rate for Payer: Meridian Medicaid |
$399.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,376.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.85
|
| Rate for Payer: Priority Health Narrow Network |
$903.85
|
| Rate for Payer: Priority Health SBD |
$903.85
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Facility
|
IP
|
$1,967.00
|
|
|
Service Code
|
CPT 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$1,239.21 |
| Max. Negotiated Rate |
$1,770.30 |
| Rate for Payer: Aetna Commercial |
$1,671.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.55
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Cofinity Commercial |
$1,376.90
|
| Rate for Payer: Cofinity Commercial |
$1,691.62
|
| Rate for Payer: Healthscope Commercial |
$1,770.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,671.95
|
| Rate for Payer: PHP Commercial |
$1,671.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,376.90
|
| Rate for Payer: Priority Health SBD |
$1,239.21
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,967.00
|
|
|
Service Code
|
HCPCS 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$380.63 |
| Max. Negotiated Rate |
$1,434.86 |
| Rate for Payer: Aetna Commercial |
$784.19
|
| Rate for Payer: BCBS Complete |
$399.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.86
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Mclaren Medicaid |
$380.63
|
| Rate for Payer: Meridian Medicaid |
$399.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,376.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.85
|
| Rate for Payer: Priority Health Narrow Network |
$903.85
|
| Rate for Payer: Priority Health SBD |
$903.85
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Facility
|
OP
|
$1,967.00
|
|
|
Service Code
|
CPT 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$585.14 |
| Max. Negotiated Rate |
$3,600.14 |
| Rate for Payer: Aetna Commercial |
$1,671.95
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.55
|
| 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 |
$1,568.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Cash Price |
$1,573.60
|
| Rate for Payer: Cofinity Commercial |
$1,691.62
|
| Rate for Payer: Cofinity Commercial |
$1,376.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$1,770.30
|
| 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 |
$1,671.95
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$1,671.95
|
| 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 |
$1,376.90
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health SBD |
$1,239.21
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$585.14
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$3,014.00
|
|
|
Service Code
|
HCPCS 29807
|
| Hospital Charge Code |
29807
|
| Min. Negotiated Rate |
$666.05 |
| Max. Negotiated Rate |
$2,109.80 |
| Rate for Payer: Aetna Commercial |
$1,378.96
|
| Rate for Payer: BCBS Complete |
$699.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.18
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Mclaren Medicaid |
$666.05
|
| Rate for Payer: Meridian Medicaid |
$699.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,585.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,585.57
|
| Rate for Payer: Priority Health SBD |
$1,585.57
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Facility
|
IP
|
$3,014.00
|
|
|
Service Code
|
CPT 29807
|
| Hospital Charge Code |
29807
|
| Min. Negotiated Rate |
$1,898.82 |
| Max. Negotiated Rate |
$2,712.60 |
| Rate for Payer: Aetna Commercial |
$2,561.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.10
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Cofinity Commercial |
$2,109.80
|
| Rate for Payer: Cofinity Commercial |
$2,592.04
|
| Rate for Payer: Healthscope Commercial |
$2,712.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,561.90
|
| Rate for Payer: PHP Commercial |
$2,561.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.80
|
| Rate for Payer: Priority Health SBD |
$1,898.82
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Facility
|
OP
|
$3,014.00
|
|
|
Service Code
|
CPT 29807
|
| Hospital Charge Code |
29807
|
| Min. Negotiated Rate |
$1,023.91 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Commercial |
$2,561.90
|
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,222.89
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Cofinity Commercial |
$2,592.04
|
| Rate for Payer: Cofinity Commercial |
$2,109.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Healthscope Commercial |
$2,712.60
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,561.90
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Commercial |
$2,561.90
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.80
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health SBD |
$1,898.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,126.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$1,023.91
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$3,014.00
|
|
|
Service Code
|
HCPCS 29807
|
| Min. Negotiated Rate |
$666.05 |
| Max. Negotiated Rate |
$2,109.80 |
| Rate for Payer: Aetna Commercial |
$1,378.96
|
| Rate for Payer: BCBS Complete |
$699.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.18
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Cash Price |
$2,411.20
|
| Rate for Payer: Mclaren Medicaid |
$666.05
|
| Rate for Payer: Meridian Medicaid |
$699.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,585.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,585.57
|
| Rate for Payer: Priority Health SBD |
$1,585.57
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$2,126.00
|
|
|
Service Code
|
HCPCS 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$379.78 |
| Max. Negotiated Rate |
$2,429.12 |
| Rate for Payer: Aetna Commercial |
$783.73
|
| Rate for Payer: BCBS Complete |
$398.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,429.12
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Mclaren Medicaid |
$379.78
|
| Rate for Payer: Meridian Medicaid |
$398.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,488.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.85
|
| Rate for Payer: Priority Health Narrow Network |
$903.85
|
| Rate for Payer: Priority Health SBD |
$903.85
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$2,126.00
|
|
|
Service Code
|
HCPCS 29825
|
| Min. Negotiated Rate |
$379.78 |
| Max. Negotiated Rate |
$2,429.12 |
| Rate for Payer: Aetna Commercial |
$783.73
|
| Rate for Payer: BCBS Complete |
$398.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,429.12
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Mclaren Medicaid |
$379.78
|
| Rate for Payer: Meridian Medicaid |
$398.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,488.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.85
|
| Rate for Payer: Priority Health Narrow Network |
$903.85
|
| Rate for Payer: Priority Health SBD |
$903.85
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$583.83 |
| Max. Negotiated Rate |
$3,600.14 |
| Rate for Payer: Aetna Commercial |
$1,807.10
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.90
|
| 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 |
$1,568.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cofinity Commercial |
$1,828.36
|
| Rate for Payer: Cofinity Commercial |
$1,488.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$1,913.40
|
| 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 |
$1,807.10
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$1,807.10
|
| 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 |
$1,488.20
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health SBD |
$1,339.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$583.83
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 29825
|
| Hospital Charge Code |
29825
|
| Min. Negotiated Rate |
$1,339.38 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Aetna Commercial |
$1,807.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.90
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cofinity Commercial |
$1,488.20
|
| Rate for Payer: Cofinity Commercial |
$1,828.36
|
| Rate for Payer: Healthscope Commercial |
$1,913.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,807.10
|
| Rate for Payer: PHP Commercial |
$1,807.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,488.20
|
| Rate for Payer: Priority Health SBD |
$1,339.38
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,332.00
|
|
|
Service Code
|
HCPCS 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$687.14 |
| Max. Negotiated Rate |
$2,332.40 |
| Rate for Payer: Aetna Commercial |
$1,428.39
|
| Rate for Payer: BCBS Complete |
$721.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.58
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Mclaren Medicaid |
$687.14
|
| Rate for Payer: Meridian Medicaid |
$721.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,332.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,636.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,636.63
|
| Rate for Payer: Priority Health SBD |
$1,636.63
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,332.00
|
|
|
Service Code
|
HCPCS 29827
|
| Min. Negotiated Rate |
$687.14 |
| Max. Negotiated Rate |
$2,332.40 |
| Rate for Payer: Aetna Commercial |
$1,428.39
|
| Rate for Payer: BCBS Complete |
$721.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.58
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Mclaren Medicaid |
$687.14
|
| Rate for Payer: Meridian Medicaid |
$721.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,332.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,636.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,636.63
|
| Rate for Payer: Priority Health SBD |
$1,636.63
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Facility
|
OP
|
$3,332.00
|
|
|
Service Code
|
CPT 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$1,056.33 |
| Max. Negotiated Rate |
$7,957.04 |
| Rate for Payer: Aetna Commercial |
$2,832.20
|
| Rate for Payer: Aetna Medicare |
$6,620.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,957.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,957.04
|
| Rate for Payer: BCBS Complete |
$3,656.42
|
| Rate for Payer: BCBS MAPPO |
$6,365.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,065.23
|
| Rate for Payer: BCN Medicare Advantage |
$6,365.63
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Cofinity Commercial |
$2,865.52
|
| Rate for Payer: Cofinity Commercial |
$2,332.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,365.63
|
| Rate for Payer: Healthscope Commercial |
$2,998.80
|
| Rate for Payer: Mclaren Medicaid |
$3,482.00
|
| Rate for Payer: Mclaren Medicare |
$6,365.63
|
| Rate for Payer: Meridian Medicaid |
$3,656.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,683.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,320.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,832.20
|
| Rate for Payer: PACE Medicare |
$6,047.35
|
| Rate for Payer: PACE SWMI |
$6,365.63
|
| Rate for Payer: PHP Commercial |
$2,832.20
|
| Rate for Payer: PHP Medicare Advantage |
$6,365.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,482.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,332.40
|
| Rate for Payer: Priority Health Medicare |
$6,365.63
|
| Rate for Payer: Priority Health SBD |
$2,099.16
|
| Rate for Payer: Railroad Medicare Medicare |
$6,365.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,161.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,365.63
|
| Rate for Payer: UHC Exchange |
$1,056.33
|
| Rate for Payer: UHC Medicare Advantage |
$6,556.60
|
| Rate for Payer: VA VA |
$6,365.63
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Facility
|
IP
|
$3,332.00
|
|
|
Service Code
|
CPT 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$2,099.16 |
| Max. Negotiated Rate |
$2,998.80 |
| Rate for Payer: Aetna Commercial |
$2,832.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.80
|
| Rate for Payer: Cash Price |
$2,665.60
|
| Rate for Payer: Cofinity Commercial |
$2,332.40
|
| Rate for Payer: Cofinity Commercial |
$2,865.52
|
| Rate for Payer: Healthscope Commercial |
$2,998.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,832.20
|
| Rate for Payer: PHP Commercial |
$2,832.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,332.40
|
| Rate for Payer: Priority Health SBD |
$2,099.16
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Facility
|
OP
|
$2,475.00
|
|
|
Service Code
|
CPT 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$590.71 |
| Max. Negotiated Rate |
$3,600.14 |
| Rate for Payer: Aetna Commercial |
$2,103.75
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,608.75
|
| 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 |
$2,065.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.50
|
| Rate for Payer: Cofinity Commercial |
$2,128.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$2,227.50
|
| 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 |
$2,103.75
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$2,103.75
|
| 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 |
$1,732.50
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health SBD |
$1,559.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$590.71
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
