|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$139.20 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: BCBS Trust/PPO |
$165.18
|
| Rate for Payer: BCN Commercial |
$165.18
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.20
|
| Rate for Payer: UHC Core |
$167.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: Aetna Medicare |
$100.00
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Mclaren Medicaid |
$31.95
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.22
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: Aetna Medicare |
$100.00
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Mclaren Medicaid |
$31.95
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.22
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 20600
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$48.11
|
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Mclaren Medicaid |
$20.02
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.96
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$61.98
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCN Commercial |
$54.59
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Mclaren Medicaid |
$25.35
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.99
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,442.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$3,331.50 |
| Rate for Payer: Aetna Commercial |
$1,354.88
|
| Rate for Payer: Aetna Medicare |
$2,221.00
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCN Commercial |
$1,524.82
|
| Rate for Payer: Cash Price |
$3,553.60
|
| Rate for Payer: Cash Price |
$3,553.60
|
| Rate for Payer: Mclaren Medicaid |
$591.71
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,331.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,629.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,629.99
|
| Rate for Payer: UHC Medicaid |
$591.71
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,530.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$1,118.89 |
| Max. Negotiated Rate |
$4,147.50 |
| Rate for Payer: Aetna Commercial |
$2,445.31
|
| Rate for Payer: Aetna Medicare |
$2,765.00
|
| Rate for Payer: BCBS Complete |
$1,174.83
|
| Rate for Payer: BCN Commercial |
$3,019.82
|
| Rate for Payer: Cash Price |
$4,424.00
|
| Rate for Payer: Cash Price |
$4,424.00
|
| Rate for Payer: Mclaren Medicaid |
$1,118.89
|
| Rate for Payer: Meridian Medicaid |
$1,174.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,147.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,118.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,938.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,938.45
|
| Rate for Payer: UHC Medicaid |
$1,118.89
|
| Rate for Payer: UHCCP Medicaid |
$1,118.89
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,663.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$1,145.30 |
| Max. Negotiated Rate |
$4,997.25 |
| Rate for Payer: Aetna Commercial |
$2,798.66
|
| Rate for Payer: Aetna Medicare |
$3,331.50
|
| Rate for Payer: BCBS Complete |
$1,202.57
|
| Rate for Payer: BCN Commercial |
$3,021.75
|
| Rate for Payer: Cash Price |
$5,330.40
|
| Rate for Payer: Cash Price |
$5,330.40
|
| Rate for Payer: Mclaren Medicaid |
$1,145.30
|
| Rate for Payer: Meridian Medicaid |
$1,202.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,997.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,145.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,230.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,230.17
|
| Rate for Payer: UHC Medicaid |
$1,145.30
|
| Rate for Payer: UHCCP Medicaid |
$1,145.30
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM
|
Professional
|
Both
|
$7,729.00
|
|
|
Service Code
|
HCPCS 22812
|
| Min. Negotiated Rate |
$1,256.91 |
| Max. Negotiated Rate |
$5,796.75 |
| Rate for Payer: Aetna Commercial |
$2,950.14
|
| Rate for Payer: Aetna Medicare |
$3,864.50
|
| Rate for Payer: BCBS Complete |
$1,319.76
|
| Rate for Payer: BCN Commercial |
$3,311.57
|
| Rate for Payer: Cash Price |
$6,183.20
|
| Rate for Payer: Cash Price |
$6,183.20
|
| Rate for Payer: Mclaren Medicaid |
$1,256.91
|
| Rate for Payer: Meridian Medicaid |
$1,319.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,796.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,256.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,539.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,539.98
|
| Rate for Payer: UHC Medicaid |
$1,256.91
|
| Rate for Payer: UHCCP Medicaid |
$1,256.91
|
|
|
PR ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL
|
Professional
|
Both
|
$2,036.00
|
|
|
Service Code
|
HCPCS 22634
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$1,527.00 |
| Rate for Payer: Aetna Commercial |
$667.05
|
| Rate for Payer: Aetna Medicare |
$1,018.00
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCN Commercial |
$725.06
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Mclaren Medicaid |
$275.84
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$775.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.08
|
| Rate for Payer: UHC Medicaid |
$275.84
|
| Rate for Payer: UHCCP Medicaid |
$275.84
|
|
|
PR ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,979.00
|
|
|
Service Code
|
HCPCS 22633
|
| Min. Negotiated Rate |
$1,084.17 |
| Max. Negotiated Rate |
$2,984.25 |
| Rate for Payer: Aetna Commercial |
$2,484.90
|
| Rate for Payer: Aetna Medicare |
$1,989.50
|
| Rate for Payer: BCBS Complete |
$1,138.38
|
| Rate for Payer: BCN Commercial |
$2,741.89
|
| Rate for Payer: Cash Price |
$3,183.20
|
| Rate for Payer: Cash Price |
$3,183.20
|
| Rate for Payer: Mclaren Medicaid |
$1,084.17
|
| Rate for Payer: Meridian Medicaid |
$1,138.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,984.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,084.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,931.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,931.00
|
| Rate for Payer: UHC Medicaid |
$1,084.17
|
| Rate for Payer: UHCCP Medicaid |
$1,084.17
|
|
|
PR ARTHRODESIS ELBOW JOINT LOCAL
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 24800
|
| Min. Negotiated Rate |
$497.99 |
| Max. Negotiated Rate |
$1,360.09 |
| Rate for Payer: Aetna Commercial |
$1,111.63
|
| Rate for Payer: Aetna Medicare |
$865.00
|
| Rate for Payer: BCBS Complete |
$522.89
|
| Rate for Payer: BCN Commercial |
$1,272.34
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Mclaren Medicaid |
$497.99
|
| Rate for Payer: Meridian Medicaid |
$522.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,360.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,360.09
|
| Rate for Payer: UHC Medicaid |
$497.99
|
| Rate for Payer: UHCCP Medicaid |
$497.99
|
|
|
PR ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT
|
Professional
|
Both
|
$4,918.00
|
|
|
Service Code
|
HCPCS 24802
|
| Min. Negotiated Rate |
$590.86 |
| Max. Negotiated Rate |
$3,688.50 |
| Rate for Payer: Aetna Commercial |
$1,339.86
|
| Rate for Payer: Aetna Medicare |
$2,459.00
|
| Rate for Payer: BCBS Complete |
$620.40
|
| Rate for Payer: BCN Commercial |
$1,523.83
|
| Rate for Payer: Cash Price |
$3,934.40
|
| Rate for Payer: Cash Price |
$3,934.40
|
| Rate for Payer: Mclaren Medicaid |
$590.86
|
| Rate for Payer: Meridian Medicaid |
$620.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,688.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,628.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,628.92
|
| Rate for Payer: UHC Medicaid |
$590.86
|
| Rate for Payer: UHCCP Medicaid |
$590.86
|
|
|
PR ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,442.00
|
|
|
Service Code
|
HCPCS 28755
|
| Min. Negotiated Rate |
$297.99 |
| Max. Negotiated Rate |
$1,081.50 |
| Rate for Payer: Aetna Commercial |
$441.02
|
| Rate for Payer: Aetna Medicare |
$721.00
|
| Rate for Payer: BCBS Complete |
$312.89
|
| Rate for Payer: BCN Commercial |
$512.43
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Mclaren Medicaid |
$297.99
|
| Rate for Payer: Meridian Medicaid |
$312.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,081.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$547.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.77
|
| Rate for Payer: UHC Medicaid |
$297.99
|
| Rate for Payer: UHCCP Medicaid |
$297.99
|
|
|
PR ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$2,034.00
|
|
|
Service Code
|
HCPCS 28750
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$1,525.50 |
| Rate for Payer: Aetna Commercial |
$771.32
|
| Rate for Payer: Aetna Medicare |
$1,017.00
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCN Commercial |
$871.47
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Mclaren Medicaid |
$342.08
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,525.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$931.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$931.57
|
| Rate for Payer: UHC Medicaid |
$342.08
|
| Rate for Payer: UHCCP Medicaid |
$342.08
|
|
|
PR ARTHRODESIS HIP JOINT W/OBTAINING GRAFT
|
Professional
|
Both
|
$4,900.00
|
|
|
Service Code
|
HCPCS 27284
|
| Min. Negotiated Rate |
$915.90 |
| Max. Negotiated Rate |
$3,675.00 |
| Rate for Payer: Aetna Commercial |
$2,150.84
|
| Rate for Payer: Aetna Medicare |
$2,450.00
|
| Rate for Payer: BCBS Complete |
$961.70
|
| Rate for Payer: BCN Commercial |
$2,413.71
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Mclaren Medicaid |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$961.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,675.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$915.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,580.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,580.18
|
| Rate for Payer: UHC Medicaid |
$915.90
|
| Rate for Payer: UHCCP Medicaid |
$915.90
|
|
|
PR ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,124.00
|
|
|
Service Code
|
HCPCS 26860
|
| Min. Negotiated Rate |
$386.81 |
| Max. Negotiated Rate |
$1,593.00 |
| Rate for Payer: Aetna Commercial |
$801.26
|
| Rate for Payer: Aetna Medicare |
$1,062.00
|
| Rate for Payer: BCBS Complete |
$406.15
|
| Rate for Payer: BCN Commercial |
$924.26
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Mclaren Medicaid |
$386.81
|
| Rate for Payer: Meridian Medicaid |
$406.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$988.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$988.00
|
| Rate for Payer: UHC Medicaid |
$386.81
|
| Rate for Payer: UHCCP Medicaid |
$386.81
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 26861
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$137.49
|
| Rate for Payer: Aetna Medicare |
$531.00
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$162.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.37
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 26863
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$361.45 |
| Rate for Payer: Aetna Commercial |
$303.69
|
| Rate for Payer: Aetna Medicare |
$217.00
|
| Rate for Payer: BCBS Complete |
$128.37
|
| Rate for Payer: BCN Commercial |
$338.13
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Mclaren Medicaid |
$122.26
|
| Rate for Payer: Meridian Medicaid |
$128.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$361.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$361.45
|
| Rate for Payer: UHC Medicaid |
$122.26
|
| Rate for Payer: UHCCP Medicaid |
$122.26
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,690.00
|
|
|
Service Code
|
HCPCS 26862
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$2,017.50 |
| Rate for Payer: Aetna Commercial |
$1,012.26
|
| Rate for Payer: Aetna Medicare |
$1,345.00
|
| Rate for Payer: BCBS Complete |
$493.81
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Mclaren Medicaid |
$470.30
|
| Rate for Payer: Meridian Medicaid |
$493.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,017.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,238.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,238.19
|
| Rate for Payer: UHC Medicaid |
$470.30
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
|
|
PR ARTHRODESIS KNEE ANY TECHNIQUE
|
Professional
|
Both
|
$3,319.00
|
|
|
Service Code
|
HCPCS 27580
|
| Min. Negotiated Rate |
$863.93 |
| Max. Negotiated Rate |
$2,489.25 |
| Rate for Payer: Aetna Commercial |
$1,960.49
|
| Rate for Payer: Aetna Medicare |
$1,659.50
|
| Rate for Payer: BCBS Complete |
$907.13
|
| Rate for Payer: BCN Commercial |
$2,224.48
|
| Rate for Payer: Cash Price |
$2,655.20
|
| Rate for Payer: Cash Price |
$2,655.20
|
| Rate for Payer: Mclaren Medicaid |
$863.93
|
| Rate for Payer: Meridian Medicaid |
$907.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,489.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$863.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,377.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,377.91
|
| Rate for Payer: UHC Medicaid |
$863.93
|
| Rate for Payer: UHCCP Medicaid |
$863.93
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR
|
Professional
|
Both
|
$6,236.00
|
|
|
Service Code
|
HCPCS 22533
|
| Min. Negotiated Rate |
$987.04 |
| Max. Negotiated Rate |
$4,677.00 |
| Rate for Payer: Aetna Commercial |
$2,219.33
|
| Rate for Payer: Aetna Medicare |
$3,118.00
|
| Rate for Payer: BCBS Complete |
$1,036.39
|
| Rate for Payer: BCN Commercial |
$2,515.80
|
| Rate for Payer: Cash Price |
$4,988.80
|
| Rate for Payer: Cash Price |
$4,988.80
|
| Rate for Payer: Mclaren Medicaid |
$987.04
|
| Rate for Payer: Meridian Medicaid |
$1,036.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,677.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$987.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,689.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,689.33
|
| Rate for Payer: UHC Medicaid |
$987.04
|
| Rate for Payer: UHCCP Medicaid |
$987.04
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY THORACIC
|
Professional
|
Both
|
$6,230.00
|
|
|
Service Code
|
HCPCS 22532
|
| Min. Negotiated Rate |
$1,104.62 |
| Max. Negotiated Rate |
$4,672.50 |
| Rate for Payer: Aetna Commercial |
$2,409.30
|
| Rate for Payer: Aetna Medicare |
$3,115.00
|
| Rate for Payer: BCBS Complete |
$1,159.85
|
| Rate for Payer: BCN Commercial |
$2,715.99
|
| Rate for Payer: Cash Price |
$4,984.00
|
| Rate for Payer: Cash Price |
$4,984.00
|
| Rate for Payer: Mclaren Medicaid |
$1,104.62
|
| Rate for Payer: Meridian Medicaid |
$1,159.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,672.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,104.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,903.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,903.32
|
| Rate for Payer: UHC Medicaid |
$1,104.62
|
| Rate for Payer: UHCCP Medicaid |
$1,104.62
|
|
|
PR ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 22534
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$2,325.00 |
| Rate for Payer: Aetna Commercial |
$483.90
|
| Rate for Payer: Aetna Medicare |
$1,550.00
|
| Rate for Payer: BCBS Complete |
$216.72
|
| Rate for Payer: BCN Commercial |
$539.81
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Mclaren Medicaid |
$206.40
|
| Rate for Payer: Meridian Medicaid |
$216.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$577.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$577.05
|
| Rate for Payer: UHC Medicaid |
$206.40
|
| Rate for Payer: UHCCP Medicaid |
$206.40
|
|
|
PR ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,379.00
|
|
|
Service Code
|
HCPCS 26850
|
| Min. Negotiated Rate |
$450.50 |
| Max. Negotiated Rate |
$1,784.25 |
| Rate for Payer: Aetna Commercial |
$970.00
|
| Rate for Payer: Aetna Medicare |
$1,189.50
|
| Rate for Payer: BCBS Complete |
$473.02
|
| Rate for Payer: BCN Commercial |
$1,110.00
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Mclaren Medicaid |
$450.50
|
| Rate for Payer: Meridian Medicaid |
$473.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,186.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,186.55
|
| Rate for Payer: UHC Medicaid |
$450.50
|
| Rate for Payer: UHCCP Medicaid |
$450.50
|
|
