|
PR ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,860.00
|
|
|
Service Code
|
HCPCS 26852
|
| Min. Negotiated Rate |
$539.74 |
| Max. Negotiated Rate |
$5,128.74 |
| Rate for Payer: Aetna Commercial |
$1,052.70
|
| Rate for Payer: Aetna Medicare |
$817.02
|
| Rate for Payer: BCBS Complete |
$566.73
|
| Rate for Payer: BCBS MAPPO |
$785.60
|
| Rate for Payer: BCBS Trust/PPO |
$5,128.74
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: BCN Medicare Advantage |
$785.60
|
| Rate for Payer: Cash Price |
$2,288.00
|
| Rate for Payer: Cash Price |
$2,288.00
|
| Rate for Payer: Cofinity Commercial |
$1,131.26
|
| Rate for Payer: Cofinity Commercial |
$1,052.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.60
|
| Rate for Payer: Mclaren Medicaid |
$539.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.88
|
| Rate for Payer: Meridian Medicaid |
$566.73
|
| Rate for Payer: Nomi Health Commercial |
$942.72
|
| Rate for Payer: PACE SWMI |
$785.60
|
| Rate for Payer: PHP Medicare Advantage |
$785.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,289.96
|
| Rate for Payer: Priority Health Medicare |
$793.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,289.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.60
|
| Rate for Payer: UHC Exchange |
$785.60
|
| Rate for Payer: UHC Medicare Advantage |
$785.60
|
| Rate for Payer: UHCCP Medicaid |
$539.74
|
|
|
PR ARTHRODESIS PANTALAR
|
Professional
|
Both
|
$3,938.00
|
|
|
Service Code
|
HCPCS 28705
|
| Min. Negotiated Rate |
$644.53 |
| Max. Negotiated Rate |
$2,559.70 |
| Rate for Payer: Aetna Commercial |
$1,572.03
|
| Rate for Payer: Aetna Medicare |
$1,220.09
|
| Rate for Payer: BCBS Complete |
$826.61
|
| Rate for Payer: BCBS MAPPO |
$1,173.16
|
| Rate for Payer: BCBS Trust/PPO |
$644.53
|
| Rate for Payer: BCN Commercial |
$1,779.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,173.16
|
| Rate for Payer: Cash Price |
$3,150.40
|
| Rate for Payer: Cash Price |
$3,150.40
|
| Rate for Payer: Cofinity Commercial |
$1,689.35
|
| Rate for Payer: Cofinity Commercial |
$1,572.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,173.16
|
| Rate for Payer: Mclaren Medicaid |
$787.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,231.82
|
| Rate for Payer: Meridian Medicaid |
$826.61
|
| Rate for Payer: Nomi Health Commercial |
$1,407.79
|
| Rate for Payer: PACE SWMI |
$1,173.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,173.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$787.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,559.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,868.54
|
| Rate for Payer: Priority Health Medicare |
$1,184.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,868.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,173.16
|
| Rate for Payer: UHC Exchange |
$1,173.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,173.16
|
| Rate for Payer: UHCCP Medicaid |
$787.25
|
|
|
PR ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2
|
Professional
|
Both
|
$5,175.00
|
|
|
Service Code
|
HCPCS 22595
|
| Min. Negotiated Rate |
$992.58 |
| Max. Negotiated Rate |
$3,363.75 |
| Rate for Payer: Aetna Commercial |
$2,006.13
|
| Rate for Payer: Aetna Medicare |
$1,556.99
|
| Rate for Payer: BCBS Complete |
$1,042.21
|
| Rate for Payer: BCBS MAPPO |
$1,497.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$2,460.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,497.11
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cofinity Commercial |
$2,155.84
|
| Rate for Payer: Cofinity Commercial |
$2,006.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,497.11
|
| Rate for Payer: Mclaren Medicaid |
$992.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,571.97
|
| Rate for Payer: Meridian Medicaid |
$1,042.21
|
| Rate for Payer: Nomi Health Commercial |
$1,796.53
|
| Rate for Payer: PACE SWMI |
$1,497.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,497.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$992.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,363.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,356.02
|
| Rate for Payer: Priority Health Medicare |
$1,512.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,356.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,497.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,497.11
|
| Rate for Payer: UHC Exchange |
$1,497.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,497.11
|
| Rate for Payer: UHCCP Medicaid |
$992.58
|
|
|
PR ARTHRODESIS POSTERIOR CRANIOCERVICAL
|
Professional
|
Both
|
$5,337.00
|
|
|
Service Code
|
HCPCS 22590
|
| Min. Negotiated Rate |
$1,039.01 |
| Max. Negotiated Rate |
$3,469.05 |
| Rate for Payer: Aetna Commercial |
$2,101.75
|
| Rate for Payer: Aetna Medicare |
$1,631.21
|
| Rate for Payer: BCBS Complete |
$1,090.96
|
| Rate for Payer: BCBS MAPPO |
$1,568.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.44
|
| Rate for Payer: BCN Commercial |
$2,579.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.47
|
| Rate for Payer: Cash Price |
$4,269.60
|
| Rate for Payer: Cash Price |
$4,269.60
|
| Rate for Payer: Cofinity Commercial |
$2,258.60
|
| Rate for Payer: Cofinity Commercial |
$2,101.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.47
|
| Rate for Payer: Mclaren Medicaid |
$1,039.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.89
|
| Rate for Payer: Meridian Medicaid |
$1,090.96
|
| Rate for Payer: Nomi Health Commercial |
$1,882.16
|
| Rate for Payer: PACE SWMI |
$1,568.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,039.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,469.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,464.41
|
| Rate for Payer: Priority Health Medicare |
$1,584.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,464.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,568.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.47
|
| Rate for Payer: UHC Exchange |
$1,568.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.47
|
| Rate for Payer: UHCCP Medicaid |
$1,039.01
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 22632
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$820.30 |
| Rate for Payer: Aetna Commercial |
$421.23
|
| Rate for Payer: Aetna Medicare |
$326.92
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$314.35
|
| Rate for Payer: BCBS Trust/PPO |
$650.50
|
| Rate for Payer: BCN Commercial |
$514.40
|
| Rate for Payer: BCN Medicare Advantage |
$314.35
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cofinity Commercial |
$452.66
|
| Rate for Payer: Cofinity Commercial |
$421.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.35
|
| Rate for Payer: Mclaren Medicaid |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.07
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Nomi Health Commercial |
$377.22
|
| Rate for Payer: PACE SWMI |
$314.35
|
| Rate for Payer: PHP Medicare Advantage |
$314.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.30
|
| Rate for Payer: Priority Health HMO/PPO |
$489.53
|
| Rate for Payer: Priority Health Medicare |
$317.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$489.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.35
|
| Rate for Payer: UHC Exchange |
$314.35
|
| Rate for Payer: UHC Medicare Advantage |
$314.35
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$6,749.00
|
|
|
Service Code
|
HCPCS 22630
|
| Min. Negotiated Rate |
$650.50 |
| Max. Negotiated Rate |
$4,386.85 |
| Rate for Payer: Aetna Commercial |
$2,059.46
|
| Rate for Payer: Aetna Medicare |
$1,598.39
|
| Rate for Payer: BCBS Complete |
$1,067.70
|
| Rate for Payer: BCBS MAPPO |
$1,536.91
|
| Rate for Payer: BCBS Trust/PPO |
$650.50
|
| Rate for Payer: BCN Commercial |
$2,524.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,536.91
|
| Rate for Payer: Cash Price |
$5,399.20
|
| Rate for Payer: Cash Price |
$5,399.20
|
| Rate for Payer: Cofinity Commercial |
$2,213.15
|
| Rate for Payer: Cofinity Commercial |
$2,059.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,536.91
|
| Rate for Payer: Mclaren Medicaid |
$1,016.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,613.76
|
| Rate for Payer: Meridian Medicaid |
$1,067.70
|
| Rate for Payer: Nomi Health Commercial |
$1,844.29
|
| Rate for Payer: PACE SWMI |
$1,536.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,536.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,016.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,386.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,411.48
|
| Rate for Payer: Priority Health Medicare |
$1,552.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,411.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,536.91
|
| Rate for Payer: UHC Exchange |
$1,536.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,536.91
|
| Rate for Payer: UHCCP Medicaid |
$1,016.86
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 22612
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$2,556.92 |
| Rate for Payer: Aetna Commercial |
$2,062.72
|
| Rate for Payer: Aetna Medicare |
$1,600.91
|
| Rate for Payer: BCBS Complete |
$1,074.19
|
| Rate for Payer: BCBS MAPPO |
$1,539.34
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,556.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,539.34
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cofinity Commercial |
$2,216.65
|
| Rate for Payer: Cofinity Commercial |
$2,062.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,539.34
|
| Rate for Payer: Mclaren Medicaid |
$1,023.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,616.31
|
| Rate for Payer: Meridian Medicaid |
$1,074.19
|
| Rate for Payer: Nomi Health Commercial |
$1,847.21
|
| Rate for Payer: PACE SWMI |
$1,539.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,539.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,023.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,144.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,431.85
|
| Rate for Payer: Priority Health Medicare |
$1,554.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,431.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,539.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,539.34
|
| Rate for Payer: UHC Exchange |
$1,539.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,539.34
|
| Rate for Payer: UHCCP Medicaid |
$1,023.04
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC
|
Professional
|
Both
|
$4,286.00
|
|
|
Service Code
|
HCPCS 22610
|
| Min. Negotiated Rate |
$837.94 |
| Max. Negotiated Rate |
$4,702.18 |
| Rate for Payer: Aetna Commercial |
$1,685.25
|
| Rate for Payer: Aetna Medicare |
$1,307.96
|
| Rate for Payer: BCBS Complete |
$879.84
|
| Rate for Payer: BCBS MAPPO |
$1,257.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,702.18
|
| Rate for Payer: BCN Commercial |
$2,076.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.65
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,811.02
|
| Rate for Payer: Cofinity Commercial |
$1,685.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.65
|
| Rate for Payer: Mclaren Medicaid |
$837.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.53
|
| Rate for Payer: Meridian Medicaid |
$879.84
|
| Rate for Payer: Nomi Health Commercial |
$1,509.18
|
| Rate for Payer: PACE SWMI |
$1,257.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,785.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,984.55
|
| Rate for Payer: Priority Health Medicare |
$1,270.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,984.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,257.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.65
|
| Rate for Payer: UHC Exchange |
$1,257.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.65
|
| Rate for Payer: UHCCP Medicaid |
$837.94
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM
|
Professional
|
Both
|
$5,067.00
|
|
|
Service Code
|
HCPCS 22804
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$3,730.46 |
| Rate for Payer: Aetna Commercial |
$3,153.15
|
| Rate for Payer: Aetna Medicare |
$2,447.22
|
| Rate for Payer: BCBS Complete |
$1,639.81
|
| Rate for Payer: BCBS MAPPO |
$2,353.10
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$3,559.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,353.10
|
| Rate for Payer: Cash Price |
$4,053.60
|
| Rate for Payer: Cash Price |
$4,053.60
|
| Rate for Payer: Cofinity Commercial |
$3,388.46
|
| Rate for Payer: Cofinity Commercial |
$3,153.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,353.10
|
| Rate for Payer: Mclaren Medicaid |
$1,561.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,470.76
|
| Rate for Payer: Meridian Medicaid |
$1,639.81
|
| Rate for Payer: Nomi Health Commercial |
$2,823.72
|
| Rate for Payer: PACE SWMI |
$2,353.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,353.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,561.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,293.55
|
| Rate for Payer: Priority Health HMO/PPO |
$3,730.46
|
| Rate for Payer: Priority Health Medicare |
$2,376.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,730.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,353.10
|
| Rate for Payer: UHC Exchange |
$2,353.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,353.10
|
| Rate for Payer: UHCCP Medicaid |
$1,561.72
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM
|
Professional
|
Both
|
$2,812.00
|
|
|
Service Code
|
HCPCS 22800
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$2,106.68 |
| Rate for Payer: Aetna Commercial |
$1,786.42
|
| Rate for Payer: Aetna Medicare |
$1,386.48
|
| Rate for Payer: BCBS Complete |
$933.51
|
| Rate for Payer: BCBS MAPPO |
$1,333.15
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,007.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.15
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cofinity Commercial |
$1,919.74
|
| Rate for Payer: Cofinity Commercial |
$1,786.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.15
|
| Rate for Payer: Mclaren Medicaid |
$889.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,399.81
|
| Rate for Payer: Meridian Medicaid |
$933.51
|
| Rate for Payer: Nomi Health Commercial |
$1,599.78
|
| Rate for Payer: PACE SWMI |
$1,333.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$889.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,827.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,106.68
|
| Rate for Payer: Priority Health Medicare |
$1,346.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,106.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.15
|
| Rate for Payer: UHC Exchange |
$1,333.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.15
|
| Rate for Payer: UHCCP Medicaid |
$889.06
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM
|
Professional
|
Both
|
$4,380.00
|
|
|
Service Code
|
HCPCS 22802
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$3,252.64 |
| Rate for Payer: Aetna Commercial |
$2,745.12
|
| Rate for Payer: Aetna Medicare |
$2,130.54
|
| Rate for Payer: BCBS Complete |
$1,428.90
|
| Rate for Payer: BCBS MAPPO |
$2,048.60
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$3,100.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,048.60
|
| Rate for Payer: Cash Price |
$3,504.00
|
| Rate for Payer: Cash Price |
$3,504.00
|
| Rate for Payer: Cofinity Commercial |
$2,949.98
|
| Rate for Payer: Cofinity Commercial |
$2,745.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,048.60
|
| Rate for Payer: Mclaren Medicaid |
$1,360.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,151.03
|
| Rate for Payer: Meridian Medicaid |
$1,428.90
|
| Rate for Payer: Nomi Health Commercial |
$2,458.32
|
| Rate for Payer: PACE SWMI |
$2,048.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,048.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,360.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,847.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,252.64
|
| Rate for Payer: Priority Health Medicare |
$2,069.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,252.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,048.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,048.60
|
| Rate for Payer: UHC Exchange |
$2,048.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,048.60
|
| Rate for Payer: UHCCP Medicaid |
$1,360.86
|
|
|
PR ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC
|
Professional
|
Both
|
$1,875.00
|
|
|
Service Code
|
HCPCS 22614
|
| Min. Negotiated Rate |
$250.49 |
| Max. Negotiated Rate |
$1,218.75 |
| Rate for Payer: Aetna Commercial |
$512.67
|
| Rate for Payer: Aetna Medicare |
$397.89
|
| Rate for Payer: BCBS Complete |
$263.01
|
| Rate for Payer: BCBS MAPPO |
$382.59
|
| Rate for Payer: BCBS Trust/PPO |
$934.38
|
| Rate for Payer: BCN Commercial |
$626.32
|
| Rate for Payer: BCN Medicare Advantage |
$382.59
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$550.93
|
| Rate for Payer: Cofinity Commercial |
$512.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.59
|
| Rate for Payer: Mclaren Medicaid |
$250.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.72
|
| Rate for Payer: Meridian Medicaid |
$263.01
|
| Rate for Payer: Nomi Health Commercial |
$459.11
|
| Rate for Payer: PACE SWMI |
$382.59
|
| Rate for Payer: PHP Medicare Advantage |
$382.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.75
|
| Rate for Payer: Priority Health HMO/PPO |
$595.36
|
| Rate for Payer: Priority Health Medicare |
$386.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$595.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.59
|
| Rate for Payer: UHC Exchange |
$382.59
|
| Rate for Payer: UHC Medicare Advantage |
$382.59
|
| Rate for Payer: UHCCP Medicaid |
$250.49
|
|
|
PR ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE
|
Professional
|
Both
|
$1,316.00
|
|
|
Service Code
|
HCPCS 27279
|
| Min. Negotiated Rate |
$520.36 |
| Max. Negotiated Rate |
$3,376.37 |
| Rate for Payer: Aetna Commercial |
$1,039.38
|
| Rate for Payer: Aetna Medicare |
$806.69
|
| Rate for Payer: BCBS Complete |
$546.38
|
| Rate for Payer: BCBS MAPPO |
$775.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,376.37
|
| Rate for Payer: BCN Commercial |
$1,192.37
|
| Rate for Payer: BCN Medicare Advantage |
$775.66
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,116.95
|
| Rate for Payer: Cofinity Commercial |
$1,039.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.66
|
| Rate for Payer: Mclaren Medicaid |
$520.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.44
|
| Rate for Payer: Meridian Medicaid |
$546.38
|
| Rate for Payer: Nomi Health Commercial |
$930.79
|
| Rate for Payer: PACE SWMI |
$775.66
|
| Rate for Payer: PHP Medicare Advantage |
$775.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$855.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,229.41
|
| Rate for Payer: Priority Health Medicare |
$783.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,229.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.66
|
| Rate for Payer: UHC Exchange |
$775.66
|
| Rate for Payer: UHC Medicare Advantage |
$775.66
|
| Rate for Payer: UHCCP Medicaid |
$520.36
|
|
|
PR ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ
|
Professional
|
Both
|
$3,240.00
|
|
|
Service Code
|
HCPCS 27280
|
| Min. Negotiated Rate |
$884.38 |
| Max. Negotiated Rate |
$3,839.22 |
| Rate for Payer: Aetna Commercial |
$1,784.09
|
| Rate for Payer: Aetna Medicare |
$1,384.67
|
| Rate for Payer: BCBS Complete |
$928.60
|
| Rate for Payer: BCBS MAPPO |
$1,331.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,839.22
|
| Rate for Payer: BCN Commercial |
$1,997.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,331.41
|
| Rate for Payer: Cash Price |
$2,592.00
|
| Rate for Payer: Cash Price |
$2,592.00
|
| Rate for Payer: Cofinity Commercial |
$1,917.23
|
| Rate for Payer: Cofinity Commercial |
$1,784.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,331.41
|
| Rate for Payer: Mclaren Medicaid |
$884.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,397.98
|
| Rate for Payer: Meridian Medicaid |
$928.60
|
| Rate for Payer: Nomi Health Commercial |
$1,597.69
|
| Rate for Payer: PACE SWMI |
$1,331.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,331.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$884.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,106.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,093.46
|
| Rate for Payer: Priority Health Medicare |
$1,344.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,093.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,331.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,331.41
|
| Rate for Payer: UHC Exchange |
$1,331.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,331.41
|
| Rate for Payer: UHCCP Medicaid |
$884.38
|
|
|
PR ARTHRODESIS SUBTALAR
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 28725
|
| Min. Negotiated Rate |
$505.45 |
| Max. Negotiated Rate |
$2,129.40 |
| Rate for Payer: Aetna Commercial |
$1,000.86
|
| Rate for Payer: Aetna Medicare |
$776.79
|
| Rate for Payer: BCBS Complete |
$530.72
|
| Rate for Payer: BCBS MAPPO |
$746.91
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$1,138.62
|
| Rate for Payer: BCN Medicare Advantage |
$746.91
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$1,075.55
|
| Rate for Payer: Cofinity Commercial |
$1,000.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.91
|
| Rate for Payer: Mclaren Medicaid |
$505.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.26
|
| Rate for Payer: Meridian Medicaid |
$530.72
|
| Rate for Payer: Nomi Health Commercial |
$896.29
|
| Rate for Payer: PACE SWMI |
$746.91
|
| Rate for Payer: PHP Medicare Advantage |
$746.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,198.87
|
| Rate for Payer: Priority Health Medicare |
$754.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.91
|
| Rate for Payer: UHC Exchange |
$746.91
|
| Rate for Payer: UHC Medicare Advantage |
$746.91
|
| Rate for Payer: UHCCP Medicaid |
$505.45
|
|
|
PR ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT
|
Professional
|
Both
|
$1,503.00
|
|
|
Service Code
|
HCPCS 27282
|
| Min. Negotiated Rate |
$560.19 |
| Max. Negotiated Rate |
$2,399.54 |
| Rate for Payer: Aetna Commercial |
$1,111.58
|
| Rate for Payer: Aetna Medicare |
$862.72
|
| Rate for Payer: BCBS Complete |
$588.20
|
| Rate for Payer: BCBS MAPPO |
$829.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.54
|
| Rate for Payer: BCN Commercial |
$1,265.19
|
| Rate for Payer: BCN Medicare Advantage |
$829.54
|
| Rate for Payer: Cash Price |
$1,202.40
|
| Rate for Payer: Cash Price |
$1,202.40
|
| Rate for Payer: Cofinity Commercial |
$1,194.54
|
| Rate for Payer: Cofinity Commercial |
$1,111.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.54
|
| Rate for Payer: Mclaren Medicaid |
$560.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$871.02
|
| Rate for Payer: Meridian Medicaid |
$588.20
|
| Rate for Payer: Nomi Health Commercial |
$995.45
|
| Rate for Payer: PACE SWMI |
$829.54
|
| Rate for Payer: PHP Medicare Advantage |
$829.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,327.62
|
| Rate for Payer: Priority Health Medicare |
$837.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,327.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.54
|
| Rate for Payer: UHC Exchange |
$829.54
|
| Rate for Payer: UHC Medicare Advantage |
$829.54
|
| Rate for Payer: UHCCP Medicaid |
$560.19
|
|
|
PR ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27871
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$2,282.01 |
| Rate for Payer: Aetna Commercial |
$888.84
|
| Rate for Payer: Aetna Medicare |
$689.84
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$663.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,282.01
|
| Rate for Payer: BCN Commercial |
$1,016.94
|
| Rate for Payer: BCN Medicare Advantage |
$663.31
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$955.17
|
| Rate for Payer: Cofinity Commercial |
$888.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.31
|
| Rate for Payer: Mclaren Medicaid |
$448.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.48
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PACE SWMI |
$663.31
|
| Rate for Payer: PHP Medicare Advantage |
$663.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,067.59
|
| Rate for Payer: Priority Health Medicare |
$669.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,067.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.31
|
| Rate for Payer: UHC Exchange |
$663.31
|
| Rate for Payer: UHC Medicare Advantage |
$663.31
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
|
|
PR ARTHRODESIS TRIPLE
|
Professional
|
Both
|
$4,084.00
|
|
|
Service Code
|
HCPCS 28715
|
| Min. Negotiated Rate |
$611.10 |
| Max. Negotiated Rate |
$2,654.60 |
| Rate for Payer: Aetna Commercial |
$1,210.88
|
| Rate for Payer: Aetna Medicare |
$939.79
|
| Rate for Payer: BCBS Complete |
$641.66
|
| Rate for Payer: BCBS MAPPO |
$903.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.92
|
| Rate for Payer: BCN Commercial |
$1,376.60
|
| Rate for Payer: BCN Medicare Advantage |
$903.64
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,301.24
|
| Rate for Payer: Cofinity Commercial |
$1,210.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.64
|
| Rate for Payer: Mclaren Medicaid |
$611.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.82
|
| Rate for Payer: Meridian Medicaid |
$641.66
|
| Rate for Payer: Nomi Health Commercial |
$1,084.37
|
| Rate for Payer: PACE SWMI |
$903.64
|
| Rate for Payer: PHP Medicare Advantage |
$903.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$611.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,654.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,444.65
|
| Rate for Payer: Priority Health Medicare |
$912.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$903.64
|
| Rate for Payer: UHC Exchange |
$903.64
|
| Rate for Payer: UHC Medicare Advantage |
$903.64
|
| Rate for Payer: UHCCP Medicaid |
$611.10
|
|
|
PR ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT
|
Professional
|
Both
|
$2,459.00
|
|
|
Service Code
|
HCPCS 25800
|
| Min. Negotiated Rate |
$478.61 |
| Max. Negotiated Rate |
$1,598.35 |
| Rate for Payer: Aetna Commercial |
$947.69
|
| Rate for Payer: Aetna Medicare |
$735.52
|
| Rate for Payer: BCBS Complete |
$502.54
|
| Rate for Payer: BCBS MAPPO |
$707.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,424.30
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: BCN Medicare Advantage |
$707.23
|
| Rate for Payer: Cash Price |
$1,967.20
|
| Rate for Payer: Cash Price |
$1,967.20
|
| Rate for Payer: Cofinity Commercial |
$947.69
|
| Rate for Payer: Cofinity Commercial |
$1,018.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.23
|
| Rate for Payer: Mclaren Medicaid |
$478.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.59
|
| Rate for Payer: Meridian Medicaid |
$502.54
|
| Rate for Payer: Nomi Health Commercial |
$848.68
|
| Rate for Payer: PACE SWMI |
$707.23
|
| Rate for Payer: PHP Medicare Advantage |
$707.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,131.20
|
| Rate for Payer: Priority Health Medicare |
$714.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,131.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$707.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.23
|
| Rate for Payer: UHC Exchange |
$707.23
|
| Rate for Payer: UHC Medicare Advantage |
$707.23
|
| Rate for Payer: UHCCP Medicaid |
$478.61
|
|
|
PR ARTHRODESIS WRIST LIMITED W/O BONE GRAFT
|
Professional
|
Both
|
$2,837.00
|
|
|
Service Code
|
HCPCS 25820
|
| Min. Negotiated Rate |
$424.51 |
| Max. Negotiated Rate |
$1,844.05 |
| Rate for Payer: Aetna Commercial |
$833.13
|
| Rate for Payer: Aetna Medicare |
$646.61
|
| Rate for Payer: BCBS Complete |
$445.74
|
| Rate for Payer: BCBS MAPPO |
$621.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$621.74
|
| Rate for Payer: Cash Price |
$2,269.60
|
| Rate for Payer: Cash Price |
$2,269.60
|
| Rate for Payer: Cofinity Commercial |
$895.31
|
| Rate for Payer: Cofinity Commercial |
$833.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.74
|
| Rate for Payer: Mclaren Medicaid |
$424.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.83
|
| Rate for Payer: Meridian Medicaid |
$445.74
|
| Rate for Payer: Nomi Health Commercial |
$746.09
|
| Rate for Payer: PACE SWMI |
$621.74
|
| Rate for Payer: PHP Medicare Advantage |
$621.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,007.04
|
| Rate for Payer: Priority Health Medicare |
$627.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,007.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.74
|
| Rate for Payer: UHC Exchange |
$621.74
|
| Rate for Payer: UHC Medicare Advantage |
$621.74
|
| Rate for Payer: UHCCP Medicaid |
$424.51
|
|
|
PR ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT
|
Professional
|
Both
|
$3,412.00
|
|
|
Service Code
|
HCPCS 25810
|
| Min. Negotiated Rate |
$567.22 |
| Max. Negotiated Rate |
$2,217.80 |
| Rate for Payer: Aetna Commercial |
$1,123.07
|
| Rate for Payer: Aetna Medicare |
$871.63
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$838.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.11
|
| Rate for Payer: BCN Commercial |
$1,276.43
|
| Rate for Payer: BCN Medicare Advantage |
$838.11
|
| Rate for Payer: Cash Price |
$2,729.60
|
| Rate for Payer: Cash Price |
$2,729.60
|
| Rate for Payer: Cofinity Commercial |
$1,206.88
|
| Rate for Payer: Cofinity Commercial |
$1,123.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.11
|
| Rate for Payer: Mclaren Medicaid |
$567.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.02
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Nomi Health Commercial |
$1,005.73
|
| Rate for Payer: PACE SWMI |
$838.11
|
| Rate for Payer: PHP Medicare Advantage |
$838.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,217.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,340.33
|
| Rate for Payer: Priority Health Medicare |
$846.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,340.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$838.11
|
| Rate for Payer: UHC Exchange |
$838.11
|
| Rate for Payer: UHC Medicare Advantage |
$838.11
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
|
|
PR ARTHRODESIS WRIST WITH AUTOGRAFT
|
Professional
|
Both
|
$14,088.00
|
|
|
Service Code
|
HCPCS 25825
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$9,157.20 |
| Rate for Payer: Aetna Commercial |
$1,017.74
|
| Rate for Payer: Aetna Medicare |
$789.89
|
| Rate for Payer: BCBS Complete |
$543.69
|
| Rate for Payer: BCBS MAPPO |
$759.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,865.96
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| Rate for Payer: BCN Medicare Advantage |
$759.51
|
| Rate for Payer: Cash Price |
$11,270.40
|
| Rate for Payer: Cash Price |
$11,270.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.69
|
| Rate for Payer: Cofinity Commercial |
$1,017.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.51
|
| Rate for Payer: Mclaren Medicaid |
$517.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.49
|
| Rate for Payer: Meridian Medicaid |
$543.69
|
| Rate for Payer: Nomi Health Commercial |
$911.41
|
| Rate for Payer: PACE SWMI |
$759.51
|
| Rate for Payer: PHP Medicare Advantage |
$759.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,157.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,228.39
|
| Rate for Payer: Priority Health Medicare |
$767.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,228.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.51
|
| Rate for Payer: UHC Exchange |
$759.51
|
| Rate for Payer: UHC Medicare Advantage |
$759.51
|
| Rate for Payer: UHCCP Medicaid |
$517.80
|
|
|
PR ARTHRODESIS WRIST W/SLIDING GRAFT
|
Professional
|
Both
|
$2,975.00
|
|
|
Service Code
|
HCPCS 25805
|
| Min. Negotiated Rate |
$552.95 |
| Max. Negotiated Rate |
$1,933.75 |
| Rate for Payer: Aetna Commercial |
$1,097.46
|
| Rate for Payer: Aetna Medicare |
$851.76
|
| Rate for Payer: BCBS Complete |
$580.60
|
| Rate for Payer: BCBS MAPPO |
$819.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.24
|
| Rate for Payer: BCN Commercial |
$1,248.08
|
| Rate for Payer: BCN Medicare Advantage |
$819.00
|
| Rate for Payer: Cash Price |
$2,380.00
|
| Rate for Payer: Cash Price |
$2,380.00
|
| Rate for Payer: Cofinity Commercial |
$1,179.36
|
| Rate for Payer: Cofinity Commercial |
$1,097.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.00
|
| Rate for Payer: Mclaren Medicaid |
$552.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$859.95
|
| Rate for Payer: Meridian Medicaid |
$580.60
|
| Rate for Payer: Nomi Health Commercial |
$982.80
|
| Rate for Payer: PACE SWMI |
$819.00
|
| Rate for Payer: PHP Medicare Advantage |
$819.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,933.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,310.31
|
| Rate for Payer: Priority Health Medicare |
$827.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,310.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$819.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$819.00
|
| Rate for Payer: UHC Exchange |
$819.00
|
| Rate for Payer: UHC Medicare Advantage |
$819.00
|
| Rate for Payer: UHCCP Medicaid |
$552.95
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
OP
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$203.40 |
| Rate for Payer: Aetna Commercial |
$192.10
|
| Rate for Payer: Aetna Medicare |
$58.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.62
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: BCBS MAPPO |
$56.50
|
| Rate for Payer: BCBS Trust/PPO |
$185.79
|
| Rate for Payer: BCN Commercial |
$175.72
|
| Rate for Payer: BCN Medicare Advantage |
$56.50
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$194.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.50
|
| Rate for Payer: Healthscope Commercial |
$203.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.10
|
| Rate for Payer: Nomi Health Commercial |
$185.32
|
| Rate for Payer: PACE Senior Care Partners |
$53.68
|
| Rate for Payer: PACE SWMI |
$56.50
|
| Rate for Payer: PHP Commercial |
$192.10
|
| Rate for Payer: PHP Medicare Advantage |
$56.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO |
$196.62
|
| Rate for Payer: Priority Health Medicare |
$57.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.42
|
| Rate for Payer: Railroad Medicare Medicare |
$56.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.88
|
| Rate for Payer: UHC Core |
$188.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.50
|
| Rate for Payer: UHC Exchange |
$56.50
|
| Rate for Payer: UHC Medicare Advantage |
$56.50
|
| Rate for Payer: VA VA |
$56.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.50
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$146.90 |
| Max. Negotiated Rate |
$203.40 |
| Rate for Payer: Aetna Commercial |
$192.10
|
| Rate for Payer: BCBS Trust/PPO |
$184.48
|
| Rate for Payer: BCN Commercial |
$174.65
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$194.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.80
|
| Rate for Payer: Healthscope Commercial |
$203.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.10
|
| Rate for Payer: Nomi Health Commercial |
$185.32
|
| Rate for Payer: PHP Commercial |
$192.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO |
$196.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.88
|
| Rate for Payer: UHC Core |
$188.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.50
|
|
