|
PR ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ
|
Professional
|
Both
|
$3,111.00
|
|
|
Service Code
|
HCPCS 26841
|
| Min. Negotiated Rate |
$724.00 |
| Max. Negotiated Rate |
$2,022.15 |
| Rate for Payer: Aetna Commercial |
$970.16
|
| Rate for Payer: Aetna Medicare |
$752.96
|
| Rate for Payer: BCBS Complete |
$1,244.40
|
| Rate for Payer: BCBS MAPPO |
$724.00
|
| Rate for Payer: BCN Medicare Advantage |
$724.00
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$970.16
|
| Rate for Payer: Cofinity Commercial |
$1,042.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.20
|
| Rate for Payer: Nomi Health Commercial |
$868.80
|
| Rate for Payer: PACE SWMI |
$724.00
|
| Rate for Payer: PHP Medicare Advantage |
$724.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health Medicare |
$731.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.00
|
| Rate for Payer: UHC Exchange |
$724.00
|
| Rate for Payer: UHC Medicare Advantage |
$724.00
|
|
|
PR ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT
|
Professional
|
Both
|
$3,300.00
|
|
|
Service Code
|
HCPCS 26842
|
| Min. Negotiated Rate |
$783.25 |
| Max. Negotiated Rate |
$2,145.00 |
| Rate for Payer: Aetna Commercial |
$1,049.56
|
| Rate for Payer: Aetna Medicare |
$814.58
|
| Rate for Payer: BCBS Complete |
$1,320.00
|
| Rate for Payer: BCBS MAPPO |
$783.25
|
| Rate for Payer: BCN Medicare Advantage |
$783.25
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cofinity Commercial |
$1,127.88
|
| Rate for Payer: Cofinity Commercial |
$1,049.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$783.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$822.41
|
| Rate for Payer: Nomi Health Commercial |
$939.90
|
| Rate for Payer: PACE SWMI |
$783.25
|
| Rate for Payer: PHP Medicare Advantage |
$783.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,145.00
|
| Rate for Payer: Priority Health Medicare |
$791.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$783.25
|
| Rate for Payer: UHC Exchange |
$783.25
|
| Rate for Payer: UHC Medicare Advantage |
$783.25
|
|
|
PR ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE
|
Professional
|
Both
|
$1,686.00
|
|
|
Service Code
|
HCPCS 25830
|
| Min. Negotiated Rate |
$674.40 |
| Max. Negotiated Rate |
$1,394.97 |
| Rate for Payer: Aetna Commercial |
$1,298.10
|
| Rate for Payer: Aetna Medicare |
$1,007.48
|
| Rate for Payer: BCBS Complete |
$674.40
|
| Rate for Payer: BCBS MAPPO |
$968.73
|
| Rate for Payer: BCN Medicare Advantage |
$968.73
|
| Rate for Payer: Cash Price |
$1,348.80
|
| Rate for Payer: Cash Price |
$1,348.80
|
| Rate for Payer: Cofinity Commercial |
$1,394.97
|
| Rate for Payer: Cofinity Commercial |
$1,298.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.17
|
| Rate for Payer: Nomi Health Commercial |
$1,162.48
|
| Rate for Payer: PACE SWMI |
$968.73
|
| Rate for Payer: PHP Medicare Advantage |
$968.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.90
|
| Rate for Payer: Priority Health Medicare |
$978.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$968.73
|
| Rate for Payer: UHC Exchange |
$968.73
|
| Rate for Payer: UHC Medicare Advantage |
$968.73
|
|
|
PR ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT
|
Professional
|
Both
|
$2,872.00
|
|
|
Service Code
|
HCPCS 28735
|
| Min. Negotiated Rate |
$749.18 |
| Max. Negotiated Rate |
$1,866.80 |
| Rate for Payer: Aetna Commercial |
$1,003.90
|
| Rate for Payer: Aetna Medicare |
$779.15
|
| Rate for Payer: BCBS Complete |
$1,148.80
|
| Rate for Payer: BCBS MAPPO |
$749.18
|
| Rate for Payer: BCN Medicare Advantage |
$749.18
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cofinity Commercial |
$1,078.82
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$786.64
|
| Rate for Payer: Nomi Health Commercial |
$899.02
|
| Rate for Payer: PACE SWMI |
$749.18
|
| Rate for Payer: PHP Medicare Advantage |
$749.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health Medicare |
$756.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$749.18
|
| Rate for Payer: UHC Exchange |
$749.18
|
| Rate for Payer: UHC Medicare Advantage |
$749.18
|
|
|
PR ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS
|
Professional
|
Both
|
$2,783.00
|
|
|
Service Code
|
HCPCS 28730
|
| Min. Negotiated Rate |
$694.84 |
| Max. Negotiated Rate |
$1,808.95 |
| Rate for Payer: Aetna Commercial |
$931.09
|
| Rate for Payer: Aetna Medicare |
$722.63
|
| Rate for Payer: BCBS Complete |
$1,113.20
|
| Rate for Payer: BCBS MAPPO |
$694.84
|
| Rate for Payer: BCN Medicare Advantage |
$694.84
|
| Rate for Payer: Cash Price |
$2,226.40
|
| Rate for Payer: Cash Price |
$2,226.40
|
| Rate for Payer: Cofinity Commercial |
$931.09
|
| Rate for Payer: Cofinity Commercial |
$1,000.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.58
|
| Rate for Payer: Nomi Health Commercial |
$833.81
|
| Rate for Payer: PACE SWMI |
$694.84
|
| Rate for Payer: PHP Medicare Advantage |
$694.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,808.95
|
| Rate for Payer: Priority Health Medicare |
$701.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.84
|
| Rate for Payer: UHC Exchange |
$694.84
|
| Rate for Payer: UHC Medicare Advantage |
$694.84
|
|
|
PR ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT
|
Professional
|
Both
|
$4,367.00
|
|
|
Service Code
|
HCPCS 22600
|
| Min. Negotiated Rate |
$1,279.19 |
| Max. Negotiated Rate |
$2,838.55 |
| Rate for Payer: Aetna Commercial |
$1,714.11
|
| Rate for Payer: Aetna Medicare |
$1,330.36
|
| Rate for Payer: BCBS Complete |
$1,746.80
|
| Rate for Payer: BCBS MAPPO |
$1,279.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.19
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,842.03
|
| Rate for Payer: Cofinity Commercial |
$1,714.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.15
|
| Rate for Payer: Nomi Health Commercial |
$1,535.03
|
| Rate for Payer: PACE SWMI |
$1,279.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.55
|
| Rate for Payer: Priority Health Medicare |
$1,291.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,279.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,279.19
|
| Rate for Payer: UHC Exchange |
$1,279.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.19
|
|
|
PR ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 28737
|
| Min. Negotiated Rate |
$489.60 |
| Max. Negotiated Rate |
$948.27 |
| Rate for Payer: Aetna Commercial |
$882.42
|
| Rate for Payer: Aetna Medicare |
$684.86
|
| Rate for Payer: BCBS Complete |
$489.60
|
| Rate for Payer: BCBS MAPPO |
$658.52
|
| Rate for Payer: BCN Medicare Advantage |
$658.52
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$948.27
|
| Rate for Payer: Cofinity Commercial |
$882.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.45
|
| Rate for Payer: Nomi Health Commercial |
$790.22
|
| Rate for Payer: PACE SWMI |
$658.52
|
| Rate for Payer: PHP Medicare Advantage |
$658.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
| Rate for Payer: Priority Health Medicare |
$665.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.52
|
| Rate for Payer: UHC Exchange |
$658.52
|
| Rate for Payer: UHC Medicare Advantage |
$658.52
|
|
|
PR ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS 28760
|
| Min. Negotiated Rate |
$546.43 |
| Max. Negotiated Rate |
$956.80 |
| Rate for Payer: Aetna Commercial |
$732.22
|
| Rate for Payer: Aetna Medicare |
$568.29
|
| Rate for Payer: BCBS Complete |
$588.80
|
| Rate for Payer: BCBS MAPPO |
$546.43
|
| Rate for Payer: BCN Medicare Advantage |
$546.43
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cofinity Commercial |
$786.86
|
| Rate for Payer: Cofinity Commercial |
$732.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.75
|
| Rate for Payer: Nomi Health Commercial |
$655.72
|
| Rate for Payer: PACE SWMI |
$546.43
|
| Rate for Payer: PHP Medicare Advantage |
$546.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.80
|
| Rate for Payer: Priority Health Medicare |
$551.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$546.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.43
|
| Rate for Payer: UHC Exchange |
$546.43
|
| Rate for Payer: UHC Medicare Advantage |
$546.43
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 20605
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$80.60 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare |
$36.45
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$35.05
|
| Rate for Payer: BCN Medicare Advantage |
$35.05
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$46.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.80
|
| Rate for Payer: Nomi Health Commercial |
$42.06
|
| Rate for Payer: PACE SWMI |
$35.05
|
| Rate for Payer: PHP Medicare Advantage |
$35.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Medicare |
$35.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.05
|
| Rate for Payer: UHC Exchange |
$35.05
|
| Rate for Payer: UHC Medicare Advantage |
$35.05
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$49.95 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Commercial |
$66.93
|
| Rate for Payer: Aetna Medicare |
$51.95
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS MAPPO |
$49.95
|
| Rate for Payer: BCN Medicare Advantage |
$49.95
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Cofinity Commercial |
$66.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.45
|
| Rate for Payer: Nomi Health Commercial |
$59.94
|
| Rate for Payer: PACE SWMI |
$49.95
|
| Rate for Payer: PHP Medicare Advantage |
$49.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health Medicare |
$50.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.95
|
| Rate for Payer: UHC Exchange |
$49.95
|
| Rate for Payer: UHC Medicare Advantage |
$49.95
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$43.70 |
| Max. Negotiated Rate |
$224.11 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna Medicare |
$47.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.50
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$46.00
|
| Rate for Payer: BCBS Trust/PPO |
$151.27
|
| Rate for Payer: BCN Commercial |
$143.06
|
| Rate for Payer: BCN Medicare Advantage |
$46.00
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.30
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: PACE Senior Care Partners |
$43.70
|
| Rate for Payer: PACE SWMI |
$46.00
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: PHP Medicare Advantage |
$46.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO |
$160.08
|
| Rate for Payer: Priority Health Medicare |
$46.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.28
|
| Rate for Payer: Railroad Medicare Medicare |
$46.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.92
|
| Rate for Payer: UHC Core |
$153.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.00
|
| Rate for Payer: UHC Exchange |
$46.00
|
| Rate for Payer: UHC Medicare Advantage |
$46.00
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$46.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: BCBS Trust/PPO |
$150.20
|
| Rate for Payer: BCN Commercial |
$142.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO |
$160.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.92
|
| Rate for Payer: UHC Core |
$153.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
20610
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$119.60 |
| Rate for Payer: Aetna Commercial |
$58.22
|
| Rate for Payer: Aetna Medicare |
$45.19
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$43.45
|
| Rate for Payer: BCN Medicare Advantage |
$43.45
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$62.57
|
| Rate for Payer: Cofinity Commercial |
$58.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: PACE SWMI |
$43.45
|
| Rate for Payer: PHP Medicare Advantage |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$43.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.45
|
| Rate for Payer: UHC Exchange |
$43.45
|
| Rate for Payer: UHC Medicare Advantage |
$43.45
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 20610
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$119.60 |
| Rate for Payer: Aetna Commercial |
$58.22
|
| Rate for Payer: Aetna Medicare |
$45.19
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$43.45
|
| Rate for Payer: BCN Medicare Advantage |
$43.45
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$62.57
|
| Rate for Payer: Cofinity Commercial |
$58.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: PACE SWMI |
$43.45
|
| Rate for Payer: PHP Medicare Advantage |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$43.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.45
|
| Rate for Payer: UHC Exchange |
$43.45
|
| Rate for Payer: UHC Medicare Advantage |
$43.45
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$56.68 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Commercial |
$75.95
|
| Rate for Payer: Aetna Medicare |
$58.95
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCBS MAPPO |
$56.68
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.51
|
| 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 Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health Medicare |
$57.25
|
| 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
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$56.68 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Commercial |
$75.95
|
| Rate for Payer: Aetna Medicare |
$58.95
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCBS MAPPO |
$56.68
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.51
|
| 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 Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health Medicare |
$57.25
|
| 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
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: BCBS Trust/PPO |
$158.36
|
| Rate for Payer: BCN Commercial |
$149.92
|
| 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: Healthscope Commercial |
$174.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.90
|
| Rate for Payer: Nomi Health Commercial |
$159.08
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO |
$168.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.72
|
| Rate for Payer: UHC Core |
$161.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
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 |
$224.11 |
| 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 |
$224.11
|
| 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 |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.92
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.77
|
| 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 |
$213.42
|
| 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 |
$213.42
|
| 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 |
$34.11 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: Aetna Medicare |
$35.47
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: BCBS MAPPO |
$34.11
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.82
|
| 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 Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health Medicare |
$34.45
|
| 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
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$44.54 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$59.68
|
| Rate for Payer: Aetna Medicare |
$46.32
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$44.54
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.77
|
| 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 Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$44.99
|
| 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
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,313.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$969.12 |
| 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 |
$1,725.20
|
| Rate for Payer: BCBS MAPPO |
$969.12
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.58
|
| 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 Cigna Priority Health |
$2,803.45
|
| Rate for Payer: Priority Health Medicare |
$978.81
|
| 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
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,369.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$1,774.88 |
| 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 |
$2,147.60
|
| Rate for Payer: BCBS MAPPO |
$1,774.88
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,863.62
|
| 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 Cigna Priority Health |
$3,489.85
|
| Rate for Payer: Priority Health Medicare |
$1,792.63
|
| 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
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,469.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$1,933.36 |
| 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 |
$2,587.60
|
| Rate for Payer: BCBS MAPPO |
$1,933.36
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,030.03
|
| 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 Cigna Priority Health |
$4,204.85
|
| Rate for Payer: Priority Health Medicare |
$1,952.69
|
| 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
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM
|
Professional
|
Both
|
$7,504.00
|
|
|
Service Code
|
HCPCS 22812
|
| Min. Negotiated Rate |
$2,117.52 |
| Max. Negotiated Rate |
$4,877.60 |
| Rate for Payer: Aetna Commercial |
$2,837.48
|
| Rate for Payer: Aetna Medicare |
$2,202.22
|
| Rate for Payer: BCBS Complete |
$3,001.60
|
| Rate for Payer: BCBS MAPPO |
$2,117.52
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,223.40
|
| 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 Cigna Priority Health |
$4,877.60
|
| Rate for Payer: Priority Health Medicare |
$2,138.70
|
| 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
|
|
|
PR ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL
|
Professional
|
Both
|
$1,977.00
|
|
|
Service Code
|
HCPCS 22634
|
| Min. Negotiated Rate |
$473.66 |
| 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 |
$790.80
|
| Rate for Payer: BCBS MAPPO |
$473.66
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.34
|
| 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 Cigna Priority Health |
$1,285.05
|
| Rate for Payer: Priority Health Medicare |
$478.40
|
| 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
|
|
