|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$75.95
|
| Rate for Payer: Aetna Medicare |
$58.95
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS MAPPO |
$56.68
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$117.41
|
| Rate for Payer: BCN Medicare Advantage |
$56.68
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Cofinity Commercial |
$75.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.68
|
| Rate for Payer: Mclaren Medicaid |
$37.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.51
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Nomi Health Commercial |
$68.02
|
| Rate for Payer: PACE SWMI |
$56.68
|
| Rate for Payer: PHP Medicare Advantage |
$56.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO |
$89.57
|
| Rate for Payer: Priority Health Medicare |
$57.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.68
|
| Rate for Payer: UHC Exchange |
$56.68
|
| Rate for Payer: UHC Medicare Advantage |
$56.68
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$46.08 |
| Max. Negotiated Rate |
$219.58 |
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: Aetna Medicare |
$50.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.62
|
| Rate for Payer: BCBS Complete |
$219.58
|
| Rate for Payer: BCBS MAPPO |
$48.50
|
| Rate for Payer: BCBS Trust/PPO |
$159.49
|
| Rate for Payer: BCN Commercial |
$150.84
|
| Rate for Payer: BCN Medicare Advantage |
$48.50
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.50
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Mclaren Medicaid |
$209.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.92
|
| Rate for Payer: Meridian Medicaid |
$219.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.90
|
| Rate for Payer: Nomi Health Commercial |
$159.08
|
| Rate for Payer: PACE Senior Care Partners |
$46.08
|
| Rate for Payer: PACE SWMI |
$48.50
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: PHP Medicare Advantage |
$48.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO |
$168.78
|
| Rate for Payer: Priority Health Medicare |
$48.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.98
|
| Rate for Payer: Railroad Medicare Medicare |
$48.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.72
|
| Rate for Payer: UHC Core |
$161.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.50
|
| Rate for Payer: UHC Exchange |
$48.50
|
| Rate for Payer: UHC Medicare Advantage |
$48.50
|
| Rate for Payer: UHCCP Medicaid |
$209.11
|
| Rate for Payer: VA VA |
$48.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 20600
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: Aetna Medicare |
$35.47
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$62.04
|
| Rate for Payer: BCN Medicare Advantage |
$34.11
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$49.12
|
| Rate for Payer: Cofinity Commercial |
$45.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.11
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.82
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Nomi Health Commercial |
$40.93
|
| Rate for Payer: PACE SWMI |
$34.11
|
| Rate for Payer: PHP Medicare Advantage |
$34.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health HMO/PPO |
$54.45
|
| Rate for Payer: Priority Health Medicare |
$34.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.11
|
| Rate for Payer: UHC Exchange |
$34.11
|
| Rate for Payer: UHC Medicare Advantage |
$34.11
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$96.60 |
| Rate for Payer: Aetna Commercial |
$59.68
|
| Rate for Payer: Aetna Medicare |
$46.32
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$44.54
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: BCN Medicare Advantage |
$44.54
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$64.14
|
| Rate for Payer: Cofinity Commercial |
$59.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.54
|
| Rate for Payer: Mclaren Medicaid |
$29.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.77
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Nomi Health Commercial |
$53.45
|
| Rate for Payer: PACE SWMI |
$44.54
|
| Rate for Payer: PHP Medicare Advantage |
$44.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO |
$69.20
|
| Rate for Payer: Priority Health Medicare |
$44.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.54
|
| Rate for Payer: UHC Exchange |
$44.54
|
| Rate for Payer: UHC Medicare Advantage |
$44.54
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,313.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$621.84 |
| Max. Negotiated Rate |
$2,803.45 |
| Rate for Payer: Aetna Commercial |
$1,298.62
|
| Rate for Payer: Aetna Medicare |
$1,007.88
|
| Rate for Payer: BCBS Complete |
$684.82
|
| Rate for Payer: BCBS MAPPO |
$969.12
|
| Rate for Payer: BCBS Trust/PPO |
$621.84
|
| Rate for Payer: BCN Commercial |
$1,477.76
|
| Rate for Payer: BCN Medicare Advantage |
$969.12
|
| Rate for Payer: Cash Price |
$3,450.40
|
| Rate for Payer: Cash Price |
$3,450.40
|
| Rate for Payer: Cofinity Commercial |
$1,395.53
|
| Rate for Payer: Cofinity Commercial |
$1,298.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.12
|
| Rate for Payer: Mclaren Medicaid |
$652.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.58
|
| Rate for Payer: Meridian Medicaid |
$684.82
|
| Rate for Payer: Nomi Health Commercial |
$1,162.94
|
| Rate for Payer: PACE SWMI |
$969.12
|
| Rate for Payer: PHP Medicare Advantage |
$969.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,803.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,548.47
|
| Rate for Payer: Priority Health Medicare |
$978.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,548.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$969.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$969.12
|
| Rate for Payer: UHC Exchange |
$969.12
|
| Rate for Payer: UHC Medicare Advantage |
$969.12
|
| Rate for Payer: UHCCP Medicaid |
$652.21
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,369.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$3,489.85 |
| Rate for Payer: Aetna Commercial |
$2,378.34
|
| Rate for Payer: Aetna Medicare |
$1,845.88
|
| Rate for Payer: BCBS Complete |
$1,234.55
|
| Rate for Payer: BCBS MAPPO |
$1,774.88
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,943.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,774.88
|
| Rate for Payer: Cash Price |
$4,295.20
|
| Rate for Payer: Cash Price |
$4,295.20
|
| Rate for Payer: Cofinity Commercial |
$2,555.83
|
| Rate for Payer: Cofinity Commercial |
$2,378.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,774.88
|
| Rate for Payer: Mclaren Medicaid |
$1,175.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,863.62
|
| Rate for Payer: Meridian Medicaid |
$1,234.55
|
| Rate for Payer: Nomi Health Commercial |
$2,129.86
|
| Rate for Payer: PACE SWMI |
$1,774.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,774.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,175.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,812.98
|
| Rate for Payer: Priority Health Medicare |
$1,792.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,812.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,774.88
|
| Rate for Payer: UHC Exchange |
$1,774.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,774.88
|
| Rate for Payer: UHCCP Medicaid |
$1,175.76
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,469.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$4,204.85 |
| Rate for Payer: Aetna Commercial |
$2,590.70
|
| Rate for Payer: Aetna Medicare |
$2,010.69
|
| Rate for Payer: BCBS Complete |
$1,357.10
|
| Rate for Payer: BCBS MAPPO |
$1,933.36
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,926.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,933.36
|
| Rate for Payer: Cash Price |
$5,175.20
|
| Rate for Payer: Cash Price |
$5,175.20
|
| Rate for Payer: Cofinity Commercial |
$2,784.04
|
| Rate for Payer: Cofinity Commercial |
$2,590.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,933.36
|
| Rate for Payer: Mclaren Medicaid |
$1,292.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,030.03
|
| Rate for Payer: Meridian Medicaid |
$1,357.10
|
| Rate for Payer: Nomi Health Commercial |
$2,320.03
|
| Rate for Payer: PACE SWMI |
$1,933.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,933.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,292.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,204.85
|
| Rate for Payer: Priority Health HMO/PPO |
$3,064.87
|
| Rate for Payer: Priority Health Medicare |
$1,952.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,064.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,933.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,933.36
|
| Rate for Payer: UHC Exchange |
$1,933.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,933.36
|
| Rate for Payer: UHCCP Medicaid |
$1,292.48
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM
|
Professional
|
Both
|
$7,504.00
|
|
|
Service Code
|
HCPCS 22812
|
| Min. Negotiated Rate |
$1,416.45 |
| Max. Negotiated Rate |
$5,139.76 |
| Rate for Payer: Aetna Commercial |
$2,837.48
|
| Rate for Payer: Aetna Medicare |
$2,202.22
|
| Rate for Payer: BCBS Complete |
$1,487.27
|
| Rate for Payer: BCBS MAPPO |
$2,117.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,139.76
|
| Rate for Payer: BCN Commercial |
$3,207.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,117.52
|
| Rate for Payer: Cash Price |
$6,003.20
|
| Rate for Payer: Cash Price |
$6,003.20
|
| Rate for Payer: Cofinity Commercial |
$3,049.23
|
| Rate for Payer: Cofinity Commercial |
$2,837.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,117.52
|
| Rate for Payer: Mclaren Medicaid |
$1,416.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,223.40
|
| Rate for Payer: Meridian Medicaid |
$1,487.27
|
| Rate for Payer: Nomi Health Commercial |
$2,541.02
|
| Rate for Payer: PACE SWMI |
$2,117.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,117.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,416.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,877.60
|
| Rate for Payer: Priority Health HMO/PPO |
$3,358.99
|
| Rate for Payer: Priority Health Medicare |
$2,138.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,358.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,117.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,117.52
|
| Rate for Payer: UHC Exchange |
$2,117.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,117.52
|
| Rate for Payer: UHCCP Medicaid |
$1,416.45
|
|
|
PR ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL
|
Professional
|
Both
|
$1,977.00
|
|
|
Service Code
|
HCPCS 22634
|
| Min. Negotiated Rate |
$310.13 |
| Max. Negotiated Rate |
$1,285.05 |
| Rate for Payer: Aetna Commercial |
$634.70
|
| Rate for Payer: Aetna Medicare |
$492.61
|
| Rate for Payer: BCBS Complete |
$325.64
|
| Rate for Payer: BCBS MAPPO |
$473.66
|
| Rate for Payer: BCBS Trust/PPO |
$950.50
|
| Rate for Payer: BCN Commercial |
$704.67
|
| Rate for Payer: BCN Medicare Advantage |
$473.66
|
| Rate for Payer: Cash Price |
$1,581.60
|
| Rate for Payer: Cash Price |
$1,581.60
|
| Rate for Payer: Cofinity Commercial |
$682.07
|
| Rate for Payer: Cofinity Commercial |
$634.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.66
|
| Rate for Payer: Mclaren Medicaid |
$310.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.34
|
| Rate for Payer: Meridian Medicaid |
$325.64
|
| Rate for Payer: Nomi Health Commercial |
$568.39
|
| Rate for Payer: PACE SWMI |
$473.66
|
| Rate for Payer: PHP Medicare Advantage |
$473.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.05
|
| Rate for Payer: Priority Health HMO/PPO |
$737.35
|
| Rate for Payer: Priority Health Medicare |
$478.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$737.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.66
|
| Rate for Payer: UHC Exchange |
$473.66
|
| Rate for Payer: UHC Medicare Advantage |
$473.66
|
| Rate for Payer: UHCCP Medicaid |
$310.13
|
|
|
PR ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 22633
|
| Min. Negotiated Rate |
$950.50 |
| Max. Negotiated Rate |
$2,782.95 |
| Rate for Payer: Aetna Commercial |
$2,372.68
|
| Rate for Payer: Aetna Medicare |
$1,841.49
|
| Rate for Payer: BCBS Complete |
$1,231.42
|
| Rate for Payer: BCBS MAPPO |
$1,770.66
|
| Rate for Payer: BCBS Trust/PPO |
$950.50
|
| Rate for Payer: BCN Commercial |
$2,652.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,770.66
|
| Rate for Payer: Cash Price |
$3,090.40
|
| Rate for Payer: Cash Price |
$3,090.40
|
| Rate for Payer: Cofinity Commercial |
$2,549.75
|
| Rate for Payer: Cofinity Commercial |
$2,372.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,770.66
|
| Rate for Payer: Mclaren Medicaid |
$1,172.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,859.19
|
| Rate for Payer: Meridian Medicaid |
$1,231.42
|
| Rate for Payer: Nomi Health Commercial |
$2,124.79
|
| Rate for Payer: PACE SWMI |
$1,770.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,770.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,172.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,510.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,782.95
|
| Rate for Payer: Priority Health Medicare |
$1,788.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,782.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,770.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,770.66
|
| Rate for Payer: UHC Exchange |
$1,770.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,770.66
|
| Rate for Payer: UHCCP Medicaid |
$1,172.78
|
|
|
PR ARTHRODESIS ELBOW JOINT LOCAL
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 24800
|
| Min. Negotiated Rate |
$544.22 |
| Max. Negotiated Rate |
$1,289.46 |
| Rate for Payer: Aetna Commercial |
$1,079.36
|
| Rate for Payer: Aetna Medicare |
$837.71
|
| Rate for Payer: BCBS Complete |
$571.43
|
| Rate for Payer: BCBS MAPPO |
$805.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.88
|
| Rate for Payer: BCN Commercial |
$1,227.07
|
| Rate for Payer: BCN Medicare Advantage |
$805.49
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$1,159.91
|
| Rate for Payer: Cofinity Commercial |
$1,079.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.49
|
| Rate for Payer: Mclaren Medicaid |
$544.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.76
|
| Rate for Payer: Meridian Medicaid |
$571.43
|
| Rate for Payer: Nomi Health Commercial |
$966.59
|
| Rate for Payer: PACE SWMI |
$805.49
|
| Rate for Payer: PHP Medicare Advantage |
$805.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,289.46
|
| Rate for Payer: Priority Health Medicare |
$813.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,289.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$805.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.49
|
| Rate for Payer: UHC Exchange |
$805.49
|
| Rate for Payer: UHC Medicare Advantage |
$805.49
|
| Rate for Payer: UHCCP Medicaid |
$544.22
|
|
|
PR ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT
|
Professional
|
Both
|
$4,775.00
|
|
|
Service Code
|
HCPCS 24802
|
| Min. Negotiated Rate |
$343.40 |
| Max. Negotiated Rate |
$3,103.75 |
| Rate for Payer: Aetna Commercial |
$1,296.81
|
| Rate for Payer: Aetna Medicare |
$1,006.48
|
| Rate for Payer: BCBS Complete |
$684.37
|
| Rate for Payer: BCBS MAPPO |
$967.77
|
| Rate for Payer: BCBS Trust/PPO |
$343.40
|
| Rate for Payer: BCN Commercial |
$1,471.41
|
| Rate for Payer: BCN Medicare Advantage |
$967.77
|
| Rate for Payer: Cash Price |
$3,820.00
|
| Rate for Payer: Cash Price |
$3,820.00
|
| Rate for Payer: Cofinity Commercial |
$1,393.59
|
| Rate for Payer: Cofinity Commercial |
$1,296.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.77
|
| Rate for Payer: Mclaren Medicaid |
$651.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,016.16
|
| Rate for Payer: Meridian Medicaid |
$684.37
|
| Rate for Payer: Nomi Health Commercial |
$1,161.32
|
| Rate for Payer: PACE SWMI |
$967.77
|
| Rate for Payer: PHP Medicare Advantage |
$967.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$651.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,103.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,543.37
|
| Rate for Payer: Priority Health Medicare |
$977.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,543.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$967.77
|
| Rate for Payer: UHC Exchange |
$967.77
|
| Rate for Payer: UHC Medicare Advantage |
$967.77
|
| Rate for Payer: UHCCP Medicaid |
$651.78
|
|
|
PR ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,400.00
|
|
|
Service Code
|
HCPCS 28755
|
| Min. Negotiated Rate |
$219.18 |
| Max. Negotiated Rate |
$983.69 |
| Rate for Payer: Aetna Commercial |
$431.73
|
| Rate for Payer: Aetna Medicare |
$335.08
|
| Rate for Payer: BCBS Complete |
$230.14
|
| Rate for Payer: BCBS MAPPO |
$322.19
|
| Rate for Payer: BCBS Trust/PPO |
$983.69
|
| Rate for Payer: BCN Commercial |
$734.48
|
| Rate for Payer: BCN Medicare Advantage |
$322.19
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cofinity Commercial |
$463.95
|
| Rate for Payer: Cofinity Commercial |
$431.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.19
|
| Rate for Payer: Mclaren Medicaid |
$219.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.30
|
| Rate for Payer: Meridian Medicaid |
$230.14
|
| Rate for Payer: Nomi Health Commercial |
$386.63
|
| Rate for Payer: PACE SWMI |
$322.19
|
| Rate for Payer: PHP Medicare Advantage |
$322.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.00
|
| Rate for Payer: Priority Health HMO/PPO |
$516.50
|
| Rate for Payer: Priority Health Medicare |
$325.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$516.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.19
|
| Rate for Payer: UHC Exchange |
$322.19
|
| Rate for Payer: UHC Medicare Advantage |
$322.19
|
| Rate for Payer: UHCCP Medicaid |
$219.18
|
|
|
PR ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$1,975.00
|
|
|
Service Code
|
HCPCS 28750
|
| Min. Negotiated Rate |
$372.75 |
| Max. Negotiated Rate |
$1,283.75 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: BCBS Complete |
$391.39
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCBS Trust/PPO |
$808.30
|
| Rate for Payer: BCN Commercial |
$1,141.06
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Mclaren Medicaid |
$372.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Meridian Medicaid |
$391.39
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.75
|
| Rate for Payer: Priority Health HMO/PPO |
$886.94
|
| Rate for Payer: Priority Health Medicare |
$555.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$886.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Exchange |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP Medicaid |
$372.75
|
|
|
PR ARTHRODESIS HIP JOINT W/OBTAINING GRAFT
|
Professional
|
Both
|
$4,757.00
|
|
|
Service Code
|
HCPCS 27284
|
| Min. Negotiated Rate |
$1,032.41 |
| Max. Negotiated Rate |
$3,092.05 |
| Rate for Payer: Aetna Commercial |
$2,068.73
|
| Rate for Payer: Aetna Medicare |
$1,605.58
|
| Rate for Payer: BCBS Complete |
$1,084.03
|
| Rate for Payer: BCBS MAPPO |
$1,543.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,679.54
|
| Rate for Payer: BCN Commercial |
$2,337.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.83
|
| Rate for Payer: Cash Price |
$3,805.60
|
| Rate for Payer: Cash Price |
$3,805.60
|
| Rate for Payer: Cofinity Commercial |
$2,223.12
|
| Rate for Payer: Cofinity Commercial |
$2,068.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.83
|
| Rate for Payer: Mclaren Medicaid |
$1,032.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,621.02
|
| Rate for Payer: Meridian Medicaid |
$1,084.03
|
| Rate for Payer: Nomi Health Commercial |
$1,852.60
|
| Rate for Payer: PACE SWMI |
$1,543.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,032.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,092.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,448.13
|
| Rate for Payer: Priority Health Medicare |
$1,559.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,448.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,543.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,543.83
|
| Rate for Payer: UHC Exchange |
$1,543.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,543.83
|
| Rate for Payer: UHCCP Medicaid |
$1,032.41
|
|
|
PR ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 26860
|
| Min. Negotiated Rate |
$395.33 |
| Max. Negotiated Rate |
$6,184.28 |
| Rate for Payer: Aetna Commercial |
$761.92
|
| Rate for Payer: Aetna Medicare |
$591.34
|
| Rate for Payer: BCBS Complete |
$415.10
|
| Rate for Payer: BCBS MAPPO |
$568.60
|
| Rate for Payer: BCBS Trust/PPO |
$6,184.28
|
| Rate for Payer: BCN Commercial |
$913.34
|
| Rate for Payer: BCN Medicare Advantage |
$568.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$818.78
|
| Rate for Payer: Cofinity Commercial |
$761.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.60
|
| Rate for Payer: Mclaren Medicaid |
$395.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$597.03
|
| Rate for Payer: Meridian Medicaid |
$415.10
|
| Rate for Payer: Nomi Health Commercial |
$682.32
|
| Rate for Payer: PACE SWMI |
$568.60
|
| Rate for Payer: PHP Medicare Advantage |
$568.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.30
|
| Rate for Payer: Priority Health HMO/PPO |
$950.05
|
| Rate for Payer: Priority Health Medicare |
$574.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$950.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$568.60
|
| Rate for Payer: UHC Exchange |
$568.60
|
| Rate for Payer: UHC Medicare Advantage |
$568.60
|
| Rate for Payer: UHCCP Medicaid |
$395.33
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 26861
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$3,233.72 |
| Rate for Payer: Aetna Commercial |
$130.89
|
| Rate for Payer: Aetna Medicare |
$101.59
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$97.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,233.72
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: BCN Medicare Advantage |
$97.68
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$140.66
|
| Rate for Payer: Cofinity Commercial |
$130.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.68
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.56
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$117.22
|
| Rate for Payer: PACE SWMI |
$97.68
|
| Rate for Payer: PHP Medicare Advantage |
$97.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO |
$154.18
|
| Rate for Payer: Priority Health Medicare |
$98.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.68
|
| Rate for Payer: UHC Exchange |
$97.68
|
| Rate for Payer: UHC Medicare Advantage |
$97.68
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 26863
|
| Min. Negotiated Rate |
$144.63 |
| Max. Negotiated Rate |
$3,239.54 |
| Rate for Payer: Aetna Commercial |
$291.30
|
| Rate for Payer: Aetna Medicare |
$226.09
|
| Rate for Payer: BCBS Complete |
$151.86
|
| Rate for Payer: BCBS MAPPO |
$217.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,239.54
|
| Rate for Payer: BCN Commercial |
$330.35
|
| Rate for Payer: BCN Medicare Advantage |
$217.39
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$313.04
|
| Rate for Payer: Cofinity Commercial |
$291.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.39
|
| Rate for Payer: Mclaren Medicaid |
$144.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.26
|
| Rate for Payer: Meridian Medicaid |
$151.86
|
| Rate for Payer: Nomi Health Commercial |
$260.87
|
| Rate for Payer: PACE SWMI |
$217.39
|
| Rate for Payer: PHP Medicare Advantage |
$217.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.65
|
| Rate for Payer: Priority Health HMO/PPO |
$343.98
|
| Rate for Payer: Priority Health Medicare |
$219.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.39
|
| Rate for Payer: UHC Exchange |
$217.39
|
| Rate for Payer: UHC Medicare Advantage |
$217.39
|
| Rate for Payer: UHCCP Medicaid |
$144.63
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,612.00
|
|
|
Service Code
|
HCPCS 26862
|
| Min. Negotiated Rate |
$495.44 |
| Max. Negotiated Rate |
$2,794.18 |
| Rate for Payer: Aetna Commercial |
$963.63
|
| Rate for Payer: Aetna Medicare |
$747.90
|
| Rate for Payer: BCBS Complete |
$520.21
|
| Rate for Payer: BCBS MAPPO |
$719.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,794.18
|
| Rate for Payer: BCN Commercial |
$1,138.62
|
| Rate for Payer: BCN Medicare Advantage |
$719.13
|
| Rate for Payer: Cash Price |
$2,089.60
|
| Rate for Payer: Cash Price |
$2,089.60
|
| Rate for Payer: Cofinity Commercial |
$963.63
|
| Rate for Payer: Cofinity Commercial |
$1,035.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.13
|
| Rate for Payer: Mclaren Medicaid |
$495.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.09
|
| Rate for Payer: Meridian Medicaid |
$520.21
|
| Rate for Payer: Nomi Health Commercial |
$862.96
|
| Rate for Payer: PACE SWMI |
$719.13
|
| Rate for Payer: PHP Medicare Advantage |
$719.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,697.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,187.18
|
| Rate for Payer: Priority Health Medicare |
$726.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,187.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.13
|
| Rate for Payer: UHC Exchange |
$719.13
|
| Rate for Payer: UHC Medicare Advantage |
$719.13
|
| Rate for Payer: UHCCP Medicaid |
$495.44
|
|
|
PR ARTHRODESIS KNEE ANY TECHNIQUE
|
Professional
|
Both
|
$3,222.00
|
|
|
Service Code
|
HCPCS 27580
|
| Min. Negotiated Rate |
$951.47 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$1,894.21
|
| Rate for Payer: Aetna Medicare |
$1,470.13
|
| Rate for Payer: BCBS Complete |
$999.04
|
| Rate for Payer: BCBS MAPPO |
$1,413.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$2,158.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.59
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cofinity Commercial |
$2,035.57
|
| Rate for Payer: Cofinity Commercial |
$1,894.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.59
|
| Rate for Payer: Mclaren Medicaid |
$951.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.27
|
| Rate for Payer: Meridian Medicaid |
$999.04
|
| Rate for Payer: Nomi Health Commercial |
$1,696.31
|
| Rate for Payer: PACE SWMI |
$1,413.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$951.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.30
|
| Rate for Payer: Priority Health HMO/PPO |
$2,264.42
|
| Rate for Payer: Priority Health Medicare |
$1,427.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,264.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,413.59
|
| Rate for Payer: UHC Exchange |
$1,413.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,413.59
|
| Rate for Payer: UHCCP Medicaid |
$951.47
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR
|
Professional
|
Both
|
$6,054.00
|
|
|
Service Code
|
HCPCS 22533
|
| Min. Negotiated Rate |
$1,076.08 |
| Max. Negotiated Rate |
$3,935.10 |
| Rate for Payer: Aetna Commercial |
$2,163.40
|
| Rate for Payer: Aetna Medicare |
$1,679.06
|
| Rate for Payer: BCBS Complete |
$1,129.88
|
| Rate for Payer: BCBS MAPPO |
$1,614.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.44
|
| Rate for Payer: BCN Commercial |
$2,422.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,614.48
|
| Rate for Payer: Cash Price |
$4,843.20
|
| Rate for Payer: Cash Price |
$4,843.20
|
| Rate for Payer: Cofinity Commercial |
$2,324.85
|
| Rate for Payer: Cofinity Commercial |
$2,163.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,614.48
|
| Rate for Payer: Mclaren Medicaid |
$1,076.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,695.20
|
| Rate for Payer: Meridian Medicaid |
$1,129.88
|
| Rate for Payer: Nomi Health Commercial |
$1,937.38
|
| Rate for Payer: PACE SWMI |
$1,614.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,614.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,076.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,935.10
|
| Rate for Payer: Priority Health HMO/PPO |
$2,552.95
|
| Rate for Payer: Priority Health Medicare |
$1,630.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,552.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,614.48
|
| Rate for Payer: UHC Exchange |
$1,614.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,614.48
|
| Rate for Payer: UHCCP Medicaid |
$1,076.08
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY THORACIC
|
Professional
|
Both
|
$6,049.00
|
|
|
Service Code
|
HCPCS 22532
|
| Min. Negotiated Rate |
$1,161.70 |
| Max. Negotiated Rate |
$3,931.85 |
| Rate for Payer: Aetna Commercial |
$2,346.76
|
| Rate for Payer: Aetna Medicare |
$1,821.36
|
| Rate for Payer: BCBS Complete |
$1,219.78
|
| Rate for Payer: BCBS MAPPO |
$1,751.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.50
|
| Rate for Payer: BCN Commercial |
$2,638.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,751.31
|
| Rate for Payer: Cash Price |
$4,839.20
|
| Rate for Payer: Cash Price |
$4,839.20
|
| Rate for Payer: Cofinity Commercial |
$2,521.89
|
| Rate for Payer: Cofinity Commercial |
$2,346.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,751.31
|
| Rate for Payer: Mclaren Medicaid |
$1,161.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,838.88
|
| Rate for Payer: Meridian Medicaid |
$1,219.78
|
| Rate for Payer: Nomi Health Commercial |
$2,101.57
|
| Rate for Payer: PACE SWMI |
$1,751.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,751.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,161.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,764.64
|
| Rate for Payer: Priority Health Medicare |
$1,768.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,764.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,751.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,751.31
|
| Rate for Payer: UHC Exchange |
$1,751.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,751.31
|
| Rate for Payer: UHCCP Medicaid |
$1,161.70
|
|
|
PR ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$3,010.00
|
|
|
Service Code
|
HCPCS 22534
|
| Min. Negotiated Rate |
$230.89 |
| Max. Negotiated Rate |
$1,956.50 |
| Rate for Payer: Aetna Commercial |
$471.59
|
| Rate for Payer: Aetna Medicare |
$366.01
|
| Rate for Payer: BCBS Complete |
$242.43
|
| Rate for Payer: BCBS MAPPO |
$351.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,499.55
|
| Rate for Payer: BCN Commercial |
$523.37
|
| Rate for Payer: BCN Medicare Advantage |
$351.93
|
| Rate for Payer: Cash Price |
$2,408.00
|
| Rate for Payer: Cash Price |
$2,408.00
|
| Rate for Payer: Cofinity Commercial |
$506.78
|
| Rate for Payer: Cofinity Commercial |
$471.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.93
|
| Rate for Payer: Mclaren Medicaid |
$230.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.53
|
| Rate for Payer: Meridian Medicaid |
$242.43
|
| Rate for Payer: Nomi Health Commercial |
$422.32
|
| Rate for Payer: PACE SWMI |
$351.93
|
| Rate for Payer: PHP Medicare Advantage |
$351.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,956.50
|
| Rate for Payer: Priority Health HMO/PPO |
$548.05
|
| Rate for Payer: Priority Health Medicare |
$355.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$548.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.93
|
| Rate for Payer: UHC Exchange |
$351.93
|
| Rate for Payer: UHC Medicare Advantage |
$351.93
|
| Rate for Payer: UHCCP Medicaid |
$230.89
|
|
|
PR ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 26850
|
| Min. Negotiated Rate |
$474.78 |
| Max. Negotiated Rate |
$4,317.80 |
| Rate for Payer: Aetna Commercial |
$923.03
|
| Rate for Payer: Aetna Medicare |
$716.38
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$688.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,317.80
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$688.83
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cofinity Commercial |
$991.92
|
| Rate for Payer: Cofinity Commercial |
$923.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.83
|
| Rate for Payer: Mclaren Medicaid |
$474.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.27
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Nomi Health Commercial |
$826.60
|
| Rate for Payer: PACE SWMI |
$688.83
|
| Rate for Payer: PHP Medicare Advantage |
$688.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,501.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,136.79
|
| Rate for Payer: Priority Health Medicare |
$695.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,136.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$688.83
|
| Rate for Payer: UHC Exchange |
$688.83
|
| Rate for Payer: UHC Medicare Advantage |
$688.83
|
| Rate for Payer: UHCCP Medicaid |
$474.78
|
|
|
PR ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT
|
Professional
|
Both
|
$2,154.00
|
|
|
Service Code
|
HCPCS 28740
|
| Min. Negotiated Rate |
$399.16 |
| Max. Negotiated Rate |
$1,400.10 |
| Rate for Payer: Aetna Commercial |
$790.13
|
| Rate for Payer: Aetna Medicare |
$613.24
|
| Rate for Payer: BCBS Complete |
$419.12
|
| Rate for Payer: BCBS MAPPO |
$589.65
|
| Rate for Payer: BCBS Trust/PPO |
$673.58
|
| Rate for Payer: BCN Commercial |
$1,207.52
|
| Rate for Payer: BCN Medicare Advantage |
$589.65
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cofinity Commercial |
$849.10
|
| Rate for Payer: Cofinity Commercial |
$790.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.65
|
| Rate for Payer: Mclaren Medicaid |
$399.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.13
|
| Rate for Payer: Meridian Medicaid |
$419.12
|
| Rate for Payer: Nomi Health Commercial |
$707.58
|
| Rate for Payer: PACE SWMI |
$589.65
|
| Rate for Payer: PHP Medicare Advantage |
$589.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.10
|
| Rate for Payer: Priority Health HMO/PPO |
$949.02
|
| Rate for Payer: Priority Health Medicare |
$595.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$949.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$589.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.65
|
| Rate for Payer: UHC Exchange |
$589.65
|
| Rate for Payer: UHC Medicare Advantage |
$589.65
|
| Rate for Payer: UHCCP Medicaid |
$399.16
|
|
