|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$1,389.40 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,861.80
|
| Rate for Payer: Aetna Medicare |
$1,444.98
|
| Rate for Payer: BCBS Complete |
$1,830.00
|
| Rate for Payer: BCBS MAPPO |
$1,389.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.40
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$2,000.74
|
| Rate for Payer: Cofinity Commercial |
$1,861.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,458.87
|
| Rate for Payer: Nomi Health Commercial |
$1,667.28
|
| Rate for Payer: PACE SWMI |
$1,389.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health Medicare |
$1,403.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,389.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.40
|
| Rate for Payer: UHC Exchange |
$1,389.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.40
|
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,466.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$1,152.31 |
| Max. Negotiated Rate |
$2,252.90 |
| Rate for Payer: Aetna Commercial |
$1,544.10
|
| Rate for Payer: Aetna Medicare |
$1,198.40
|
| Rate for Payer: BCBS Complete |
$1,386.40
|
| Rate for Payer: BCBS MAPPO |
$1,152.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,152.31
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cofinity Commercial |
$1,659.33
|
| Rate for Payer: Cofinity Commercial |
$1,544.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,152.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,209.93
|
| Rate for Payer: Nomi Health Commercial |
$1,382.77
|
| Rate for Payer: PACE SWMI |
$1,152.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,152.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.90
|
| Rate for Payer: Priority Health Medicare |
$1,163.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,152.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,152.31
|
| Rate for Payer: UHC Exchange |
$1,152.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.31
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$427.29 |
| Max. Negotiated Rate |
$1,098.50 |
| Rate for Payer: Aetna Commercial |
$572.57
|
| Rate for Payer: Aetna Medicare |
$444.38
|
| Rate for Payer: BCBS Complete |
$676.00
|
| Rate for Payer: BCBS MAPPO |
$427.29
|
| Rate for Payer: BCN Medicare Advantage |
$427.29
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cofinity Commercial |
$615.30
|
| Rate for Payer: Cofinity Commercial |
$572.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.65
|
| Rate for Payer: Nomi Health Commercial |
$512.75
|
| Rate for Payer: PACE SWMI |
$427.29
|
| Rate for Payer: PHP Medicare Advantage |
$427.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health Medicare |
$431.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.29
|
| Rate for Payer: UHC Exchange |
$427.29
|
| Rate for Payer: UHC Medicare Advantage |
$427.29
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,481.00
|
|
|
Service Code
|
HCPCS 26536
|
| Min. Negotiated Rate |
$698.31 |
| Max. Negotiated Rate |
$1,612.65 |
| Rate for Payer: Aetna Commercial |
$935.74
|
| Rate for Payer: Aetna Medicare |
$726.24
|
| Rate for Payer: BCBS Complete |
$992.40
|
| Rate for Payer: BCBS MAPPO |
$698.31
|
| Rate for Payer: BCN Medicare Advantage |
$698.31
|
| Rate for Payer: Cash Price |
$1,984.80
|
| Rate for Payer: Cash Price |
$1,984.80
|
| Rate for Payer: Cofinity Commercial |
$935.74
|
| Rate for Payer: Cofinity Commercial |
$1,005.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.23
|
| Rate for Payer: Nomi Health Commercial |
$837.97
|
| Rate for Payer: PACE SWMI |
$698.31
|
| Rate for Payer: PHP Medicare Advantage |
$698.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.65
|
| Rate for Payer: Priority Health Medicare |
$705.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.31
|
| Rate for Payer: UHC Exchange |
$698.31
|
| Rate for Payer: UHC Medicare Advantage |
$698.31
|
|
|
PR ARTHROPLASTY KNEE TIBIAL PLATEAU
|
Professional
|
Both
|
$1,777.00
|
|
|
Service Code
|
HCPCS 27440
|
| Min. Negotiated Rate |
$710.80 |
| Max. Negotiated Rate |
$1,155.05 |
| Rate for Payer: Aetna Commercial |
$1,034.01
|
| Rate for Payer: Aetna Medicare |
$802.52
|
| Rate for Payer: BCBS Complete |
$710.80
|
| Rate for Payer: BCBS MAPPO |
$771.65
|
| Rate for Payer: BCN Medicare Advantage |
$771.65
|
| Rate for Payer: Cash Price |
$1,421.60
|
| Rate for Payer: Cash Price |
$1,421.60
|
| Rate for Payer: Cofinity Commercial |
$1,111.18
|
| Rate for Payer: Cofinity Commercial |
$1,034.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.23
|
| Rate for Payer: Nomi Health Commercial |
$925.98
|
| Rate for Payer: PACE SWMI |
$771.65
|
| Rate for Payer: PHP Medicare Advantage |
$771.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.05
|
| Rate for Payer: Priority Health Medicare |
$779.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.65
|
| Rate for Payer: UHC Exchange |
$771.65
|
| Rate for Payer: UHC Medicare Advantage |
$771.65
|
|
|
PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,806.00
|
|
|
Service Code
|
HCPCS 26530
|
| Min. Negotiated Rate |
$525.88 |
| Max. Negotiated Rate |
$1,173.90 |
| Rate for Payer: Aetna Commercial |
$704.68
|
| Rate for Payer: Aetna Medicare |
$546.92
|
| Rate for Payer: BCBS Complete |
$722.40
|
| Rate for Payer: BCBS MAPPO |
$525.88
|
| Rate for Payer: BCN Medicare Advantage |
$525.88
|
| Rate for Payer: Cash Price |
$1,444.80
|
| Rate for Payer: Cash Price |
$1,444.80
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$704.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.17
|
| Rate for Payer: Nomi Health Commercial |
$631.06
|
| Rate for Payer: PACE SWMI |
$525.88
|
| Rate for Payer: PHP Medicare Advantage |
$525.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.90
|
| Rate for Payer: Priority Health Medicare |
$531.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.88
|
| Rate for Payer: UHC Exchange |
$525.88
|
| Rate for Payer: UHC Medicare Advantage |
$525.88
|
|
|
PR ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 27437
|
| Min. Negotiated Rate |
$470.40 |
| Max. Negotiated Rate |
$921.24 |
| Rate for Payer: Aetna Commercial |
$857.26
|
| Rate for Payer: Aetna Medicare |
$665.34
|
| Rate for Payer: BCBS Complete |
$470.40
|
| Rate for Payer: BCBS MAPPO |
$639.75
|
| Rate for Payer: BCN Medicare Advantage |
$639.75
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cofinity Commercial |
$921.24
|
| Rate for Payer: Cofinity Commercial |
$857.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.74
|
| Rate for Payer: Nomi Health Commercial |
$767.70
|
| Rate for Payer: PACE SWMI |
$639.75
|
| Rate for Payer: PHP Medicare Advantage |
$639.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health Medicare |
$646.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$639.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.75
|
| Rate for Payer: UHC Exchange |
$639.75
|
| Rate for Payer: UHC Medicare Advantage |
$639.75
|
|
|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$812.69 |
| Max. Negotiated Rate |
$1,517.75 |
| Rate for Payer: Aetna Commercial |
$1,089.00
|
| Rate for Payer: Aetna Medicare |
$845.20
|
| Rate for Payer: BCBS Complete |
$934.00
|
| Rate for Payer: BCBS MAPPO |
$812.69
|
| Rate for Payer: BCN Medicare Advantage |
$812.69
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$1,170.27
|
| Rate for Payer: Cofinity Commercial |
$1,089.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.32
|
| Rate for Payer: Nomi Health Commercial |
$975.23
|
| Rate for Payer: PACE SWMI |
$812.69
|
| Rate for Payer: PHP Medicare Advantage |
$812.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health Medicare |
$820.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.69
|
| Rate for Payer: UHC Exchange |
$812.69
|
| Rate for Payer: UHC Medicare Advantage |
$812.69
|
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 24365
|
| Min. Negotiated Rate |
$621.51 |
| Max. Negotiated Rate |
$1,084.20 |
| Rate for Payer: Aetna Commercial |
$832.82
|
| Rate for Payer: Aetna Medicare |
$646.37
|
| Rate for Payer: BCBS Complete |
$667.20
|
| Rate for Payer: BCBS MAPPO |
$621.51
|
| Rate for Payer: BCN Medicare Advantage |
$621.51
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$894.97
|
| Rate for Payer: Cofinity Commercial |
$832.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.59
|
| Rate for Payer: Nomi Health Commercial |
$745.81
|
| Rate for Payer: PACE SWMI |
$621.51
|
| Rate for Payer: PHP Medicare Advantage |
$621.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,084.20
|
| Rate for Payer: Priority Health Medicare |
$627.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.51
|
| Rate for Payer: UHC Exchange |
$621.51
|
| Rate for Payer: UHC Medicare Advantage |
$621.51
|
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$659.34 |
| Max. Negotiated Rate |
$1,634.10 |
| Rate for Payer: Aetna Commercial |
$883.52
|
| Rate for Payer: Aetna Medicare |
$685.71
|
| Rate for Payer: BCBS Complete |
$1,005.60
|
| Rate for Payer: BCBS MAPPO |
$659.34
|
| Rate for Payer: BCN Medicare Advantage |
$659.34
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$949.45
|
| Rate for Payer: Cofinity Commercial |
$883.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.31
|
| Rate for Payer: Nomi Health Commercial |
$791.21
|
| Rate for Payer: PACE SWMI |
$659.34
|
| Rate for Payer: PHP Medicare Advantage |
$659.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health Medicare |
$665.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$659.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.34
|
| Rate for Payer: UHC Exchange |
$659.34
|
| Rate for Payer: UHC Medicare Advantage |
$659.34
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$513.60 |
| Max. Negotiated Rate |
$1,004.47 |
| Rate for Payer: Aetna Commercial |
$934.72
|
| Rate for Payer: Aetna Medicare |
$725.45
|
| Rate for Payer: BCBS Complete |
$513.60
|
| Rate for Payer: BCBS MAPPO |
$697.55
|
| Rate for Payer: BCN Medicare Advantage |
$697.55
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cofinity Commercial |
$934.72
|
| Rate for Payer: Cofinity Commercial |
$1,004.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.43
|
| Rate for Payer: Nomi Health Commercial |
$837.06
|
| Rate for Payer: PACE SWMI |
$697.55
|
| Rate for Payer: PHP Medicare Advantage |
$697.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.60
|
| Rate for Payer: Priority Health Medicare |
$704.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.55
|
| Rate for Payer: UHC Exchange |
$697.55
|
| Rate for Payer: UHC Medicare Advantage |
$697.55
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$757.20 |
| Max. Negotiated Rate |
$1,305.40 |
| Rate for Payer: Aetna Commercial |
$1,214.75
|
| Rate for Payer: Aetna Medicare |
$942.79
|
| Rate for Payer: BCBS Complete |
$757.20
|
| Rate for Payer: BCBS MAPPO |
$906.53
|
| Rate for Payer: BCN Medicare Advantage |
$906.53
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cofinity Commercial |
$1,305.40
|
| Rate for Payer: Cofinity Commercial |
$1,214.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.86
|
| Rate for Payer: Nomi Health Commercial |
$1,087.84
|
| Rate for Payer: PACE SWMI |
$906.53
|
| Rate for Payer: PHP Medicare Advantage |
$906.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.45
|
| Rate for Payer: Priority Health Medicare |
$915.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$906.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.53
|
| Rate for Payer: UHC Exchange |
$906.53
|
| Rate for Payer: UHC Medicare Advantage |
$906.53
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$1,126.50 |
| Rate for Payer: Aetna Commercial |
$1,048.27
|
| Rate for Payer: Aetna Medicare |
$813.58
|
| Rate for Payer: BCBS Complete |
$651.20
|
| Rate for Payer: BCBS MAPPO |
$782.29
|
| Rate for Payer: BCN Medicare Advantage |
$782.29
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,126.50
|
| Rate for Payer: Cofinity Commercial |
$1,048.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.40
|
| Rate for Payer: Nomi Health Commercial |
$938.75
|
| Rate for Payer: PACE SWMI |
$782.29
|
| Rate for Payer: PHP Medicare Advantage |
$782.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health Medicare |
$790.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$782.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.29
|
| Rate for Payer: UHC Exchange |
$782.29
|
| Rate for Payer: UHC Medicare Advantage |
$782.29
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,597.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$638.80 |
| Max. Negotiated Rate |
$1,093.32 |
| Rate for Payer: Aetna Commercial |
$1,017.39
|
| Rate for Payer: Aetna Medicare |
$789.62
|
| Rate for Payer: BCBS Complete |
$638.80
|
| Rate for Payer: BCBS MAPPO |
$759.25
|
| Rate for Payer: BCN Medicare Advantage |
$759.25
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cofinity Commercial |
$1,093.32
|
| Rate for Payer: Cofinity Commercial |
$1,017.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.21
|
| Rate for Payer: Nomi Health Commercial |
$911.10
|
| Rate for Payer: PACE SWMI |
$759.25
|
| Rate for Payer: PHP Medicare Advantage |
$759.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.05
|
| Rate for Payer: Priority Health Medicare |
$766.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.25
|
| Rate for Payer: UHC Exchange |
$759.25
|
| Rate for Payer: UHC Medicare Advantage |
$759.25
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$898.49 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,203.98
|
| Rate for Payer: Aetna Medicare |
$934.43
|
| Rate for Payer: BCBS Complete |
$1,246.40
|
| Rate for Payer: BCBS MAPPO |
$898.49
|
| Rate for Payer: BCN Medicare Advantage |
$898.49
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cofinity Commercial |
$1,293.83
|
| Rate for Payer: Cofinity Commercial |
$1,203.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$943.41
|
| Rate for Payer: Nomi Health Commercial |
$1,078.19
|
| Rate for Payer: PACE SWMI |
$898.49
|
| Rate for Payer: PHP Medicare Advantage |
$898.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
| Rate for Payer: Priority Health Medicare |
$907.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.49
|
| Rate for Payer: UHC Exchange |
$898.49
|
| Rate for Payer: UHC Medicare Advantage |
$898.49
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$492.40 |
| Max. Negotiated Rate |
$870.60 |
| Rate for Payer: Aetna Commercial |
$810.14
|
| Rate for Payer: Aetna Medicare |
$628.76
|
| Rate for Payer: BCBS Complete |
$492.40
|
| Rate for Payer: BCBS MAPPO |
$604.58
|
| Rate for Payer: BCN Medicare Advantage |
$604.58
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$870.60
|
| Rate for Payer: Cofinity Commercial |
$810.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$634.81
|
| Rate for Payer: Nomi Health Commercial |
$725.50
|
| Rate for Payer: PACE SWMI |
$604.58
|
| Rate for Payer: PHP Medicare Advantage |
$604.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.15
|
| Rate for Payer: Priority Health Medicare |
$610.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.58
|
| Rate for Payer: UHC Exchange |
$604.58
|
| Rate for Payer: UHC Medicare Advantage |
$604.58
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$538.55 |
| Max. Negotiated Rate |
$1,430.65 |
| Rate for Payer: Aetna Commercial |
$721.66
|
| Rate for Payer: Aetna Medicare |
$560.09
|
| Rate for Payer: BCBS Complete |
$880.40
|
| Rate for Payer: BCBS MAPPO |
$538.55
|
| Rate for Payer: BCN Medicare Advantage |
$538.55
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$775.51
|
| Rate for Payer: Cofinity Commercial |
$721.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.48
|
| Rate for Payer: Nomi Health Commercial |
$646.26
|
| Rate for Payer: PACE SWMI |
$538.55
|
| Rate for Payer: PHP Medicare Advantage |
$538.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health Medicare |
$543.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.55
|
| Rate for Payer: UHC Exchange |
$538.55
|
| Rate for Payer: UHC Medicare Advantage |
$538.55
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$474.14 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$635.35
|
| Rate for Payer: Aetna Medicare |
$493.11
|
| Rate for Payer: BCBS Complete |
$776.80
|
| Rate for Payer: BCBS MAPPO |
$474.14
|
| Rate for Payer: BCN Medicare Advantage |
$474.14
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$682.76
|
| Rate for Payer: Cofinity Commercial |
$635.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.85
|
| Rate for Payer: Nomi Health Commercial |
$568.97
|
| Rate for Payer: PACE SWMI |
$474.14
|
| Rate for Payer: PHP Medicare Advantage |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health Medicare |
$478.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.14
|
| Rate for Payer: UHC Exchange |
$474.14
|
| Rate for Payer: UHC Medicare Advantage |
$474.14
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$441.92 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$592.17
|
| Rate for Payer: Aetna Medicare |
$459.60
|
| Rate for Payer: BCBS Complete |
$750.80
|
| Rate for Payer: BCBS MAPPO |
$441.92
|
| Rate for Payer: BCN Medicare Advantage |
$441.92
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$636.36
|
| Rate for Payer: Cofinity Commercial |
$592.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.02
|
| Rate for Payer: Nomi Health Commercial |
$530.30
|
| Rate for Payer: PACE SWMI |
$441.92
|
| Rate for Payer: PHP Medicare Advantage |
$441.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health Medicare |
$446.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.92
|
| Rate for Payer: UHC Exchange |
$441.92
|
| Rate for Payer: UHC Medicare Advantage |
$441.92
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
HCPCS 29899
|
| Min. Negotiated Rate |
$959.94 |
| Max. Negotiated Rate |
$2,007.85 |
| Rate for Payer: Aetna Commercial |
$1,286.32
|
| Rate for Payer: Aetna Medicare |
$998.34
|
| Rate for Payer: BCBS Complete |
$1,235.60
|
| Rate for Payer: BCBS MAPPO |
$959.94
|
| Rate for Payer: BCN Medicare Advantage |
$959.94
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cofinity Commercial |
$1,382.31
|
| Rate for Payer: Cofinity Commercial |
$1,286.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.94
|
| Rate for Payer: Nomi Health Commercial |
$1,151.93
|
| Rate for Payer: PACE SWMI |
$959.94
|
| Rate for Payer: PHP Medicare Advantage |
$959.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.85
|
| Rate for Payer: Priority Health Medicare |
$969.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.94
|
| Rate for Payer: UHC Exchange |
$959.94
|
| Rate for Payer: UHC Medicare Advantage |
$959.94
|
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$487.28 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$652.96
|
| Rate for Payer: Aetna Medicare |
$506.77
|
| Rate for Payer: BCBS Complete |
$776.80
|
| Rate for Payer: BCBS MAPPO |
$487.28
|
| Rate for Payer: BCN Medicare Advantage |
$487.28
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$701.68
|
| Rate for Payer: Cofinity Commercial |
$652.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.64
|
| Rate for Payer: Nomi Health Commercial |
$584.74
|
| Rate for Payer: PACE SWMI |
$487.28
|
| Rate for Payer: PHP Medicare Advantage |
$487.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health Medicare |
$492.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.28
|
| Rate for Payer: UHC Exchange |
$487.28
|
| Rate for Payer: UHC Medicare Advantage |
$487.28
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$574.32 |
| Max. Negotiated Rate |
$1,430.65 |
| Rate for Payer: Aetna Commercial |
$769.59
|
| Rate for Payer: Aetna Medicare |
$597.29
|
| Rate for Payer: BCBS Complete |
$880.40
|
| Rate for Payer: BCBS MAPPO |
$574.32
|
| Rate for Payer: BCN Medicare Advantage |
$574.32
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$827.02
|
| Rate for Payer: Cofinity Commercial |
$769.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$603.04
|
| Rate for Payer: Nomi Health Commercial |
$689.18
|
| Rate for Payer: PACE SWMI |
$574.32
|
| Rate for Payer: PHP Medicare Advantage |
$574.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health Medicare |
$580.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$574.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.32
|
| Rate for Payer: UHC Exchange |
$574.32
|
| Rate for Payer: UHC Medicare Advantage |
$574.32
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$503.31 |
| Max. Negotiated Rate |
$1,261.00 |
| Rate for Payer: Aetna Commercial |
$674.44
|
| Rate for Payer: Aetna Medicare |
$523.44
|
| Rate for Payer: BCBS Complete |
$776.00
|
| Rate for Payer: BCBS MAPPO |
$503.31
|
| Rate for Payer: BCN Medicare Advantage |
$503.31
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$724.77
|
| Rate for Payer: Cofinity Commercial |
$674.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.48
|
| Rate for Payer: Nomi Health Commercial |
$603.97
|
| Rate for Payer: PACE SWMI |
$503.31
|
| Rate for Payer: PHP Medicare Advantage |
$503.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health Medicare |
$508.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.31
|
| Rate for Payer: UHC Exchange |
$503.31
|
| Rate for Payer: UHC Medicare Advantage |
$503.31
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,040.00
|
|
|
Service Code
|
HCPCS 29836
|
| Min. Negotiated Rate |
$416.00 |
| Max. Negotiated Rate |
$815.50 |
| Rate for Payer: Aetna Commercial |
$758.87
|
| Rate for Payer: Aetna Medicare |
$588.97
|
| Rate for Payer: BCBS Complete |
$416.00
|
| Rate for Payer: BCBS MAPPO |
$566.32
|
| Rate for Payer: BCN Medicare Advantage |
$566.32
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cofinity Commercial |
$815.50
|
| Rate for Payer: Cofinity Commercial |
$758.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.64
|
| Rate for Payer: Nomi Health Commercial |
$679.58
|
| Rate for Payer: PACE SWMI |
$566.32
|
| Rate for Payer: PHP Medicare Advantage |
$566.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.00
|
| Rate for Payer: Priority Health Medicare |
$571.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.32
|
| Rate for Payer: UHC Exchange |
$566.32
|
| Rate for Payer: UHC Medicare Advantage |
$566.32
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$494.19 |
| Max. Negotiated Rate |
$1,279.85 |
| Rate for Payer: Aetna Commercial |
$662.21
|
| Rate for Payer: Aetna Medicare |
$513.96
|
| Rate for Payer: BCBS Complete |
$787.60
|
| Rate for Payer: BCBS MAPPO |
$494.19
|
| Rate for Payer: BCN Medicare Advantage |
$494.19
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$711.63
|
| Rate for Payer: Cofinity Commercial |
$662.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.90
|
| Rate for Payer: Nomi Health Commercial |
$593.03
|
| Rate for Payer: PACE SWMI |
$494.19
|
| Rate for Payer: PHP Medicare Advantage |
$494.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health Medicare |
$499.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.19
|
| Rate for Payer: UHC Exchange |
$494.19
|
| Rate for Payer: UHC Medicare Advantage |
$494.19
|
|
