|
PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$478.16 |
| Max. Negotiated Rate |
$1,199.25 |
| Rate for Payer: Aetna Commercial |
$640.73
|
| Rate for Payer: Aetna Medicare |
$497.29
|
| Rate for Payer: BCBS Complete |
$738.00
|
| Rate for Payer: BCBS MAPPO |
$478.16
|
| Rate for Payer: BCN Medicare Advantage |
$478.16
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cofinity Commercial |
$688.55
|
| Rate for Payer: Cofinity Commercial |
$640.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.07
|
| Rate for Payer: Nomi Health Commercial |
$573.79
|
| Rate for Payer: PACE SWMI |
$478.16
|
| Rate for Payer: PHP Medicare Advantage |
$478.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.25
|
| Rate for Payer: Priority Health Medicare |
$482.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.16
|
| Rate for Payer: UHC Exchange |
$478.16
|
| Rate for Payer: UHC Medicare Advantage |
$478.16
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,444.00
|
|
|
Service Code
|
HCPCS 29861
|
| Min. Negotiated Rate |
$671.37 |
| Max. Negotiated Rate |
$1,588.60 |
| Rate for Payer: Aetna Commercial |
$899.64
|
| Rate for Payer: Aetna Medicare |
$698.22
|
| Rate for Payer: BCBS Complete |
$977.60
|
| Rate for Payer: BCBS MAPPO |
$671.37
|
| Rate for Payer: BCN Medicare Advantage |
$671.37
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cofinity Commercial |
$966.77
|
| Rate for Payer: Cofinity Commercial |
$899.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.94
|
| Rate for Payer: Nomi Health Commercial |
$805.64
|
| Rate for Payer: PACE SWMI |
$671.37
|
| Rate for Payer: PHP Medicare Advantage |
$671.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,588.60
|
| Rate for Payer: Priority Health Medicare |
$678.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$671.37
|
| Rate for Payer: UHC Exchange |
$671.37
|
| Rate for Payer: UHC Medicare Advantage |
$671.37
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 29863
|
| Min. Negotiated Rate |
$658.80 |
| Max. Negotiated Rate |
$1,131.13 |
| Rate for Payer: Aetna Commercial |
$1,052.58
|
| Rate for Payer: Aetna Medicare |
$816.93
|
| Rate for Payer: BCBS Complete |
$658.80
|
| Rate for Payer: BCBS MAPPO |
$785.51
|
| Rate for Payer: BCN Medicare Advantage |
$785.51
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$1,131.13
|
| Rate for Payer: Cofinity Commercial |
$1,052.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.79
|
| Rate for Payer: Nomi Health Commercial |
$942.61
|
| Rate for Payer: PACE SWMI |
$785.51
|
| Rate for Payer: PHP Medicare Advantage |
$785.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.55
|
| Rate for Payer: Priority Health Medicare |
$793.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.51
|
| Rate for Payer: UHC Exchange |
$785.51
|
| Rate for Payer: UHC Medicare Advantage |
$785.51
|
|
|
PR ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$977.43 |
| Max. Negotiated Rate |
$2,118.35 |
| Rate for Payer: Aetna Commercial |
$1,309.76
|
| Rate for Payer: Aetna Medicare |
$1,016.53
|
| Rate for Payer: BCBS Complete |
$1,303.60
|
| Rate for Payer: BCBS MAPPO |
$977.43
|
| Rate for Payer: BCN Medicare Advantage |
$977.43
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cofinity Commercial |
$1,407.50
|
| Rate for Payer: Cofinity Commercial |
$1,309.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$977.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,026.30
|
| Rate for Payer: Nomi Health Commercial |
$1,172.92
|
| Rate for Payer: PACE SWMI |
$977.43
|
| Rate for Payer: PHP Medicare Advantage |
$977.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health Medicare |
$987.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$977.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$977.43
|
| Rate for Payer: UHC Exchange |
$977.43
|
| Rate for Payer: UHC Medicare Advantage |
$977.43
|
|
|
PR ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,063.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$958.71 |
| Max. Negotiated Rate |
$1,990.95 |
| Rate for Payer: Aetna Commercial |
$1,284.67
|
| Rate for Payer: Aetna Medicare |
$997.06
|
| Rate for Payer: BCBS Complete |
$1,225.20
|
| Rate for Payer: BCBS MAPPO |
$958.71
|
| Rate for Payer: BCN Medicare Advantage |
$958.71
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cofinity Commercial |
$1,380.54
|
| Rate for Payer: Cofinity Commercial |
$1,284.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.65
|
| Rate for Payer: Nomi Health Commercial |
$1,150.45
|
| Rate for Payer: PACE SWMI |
$958.71
|
| Rate for Payer: PHP Medicare Advantage |
$958.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.95
|
| Rate for Payer: Priority Health Medicare |
$968.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.71
|
| Rate for Payer: UHC Exchange |
$958.71
|
| Rate for Payer: UHC Medicare Advantage |
$958.71
|
|
|
PR ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,274.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$978.52 |
| Max. Negotiated Rate |
$2,128.10 |
| Rate for Payer: Aetna Commercial |
$1,311.22
|
| Rate for Payer: Aetna Medicare |
$1,017.66
|
| Rate for Payer: BCBS Complete |
$1,309.60
|
| Rate for Payer: BCBS MAPPO |
$978.52
|
| Rate for Payer: BCN Medicare Advantage |
$978.52
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cofinity Commercial |
$1,409.07
|
| Rate for Payer: Cofinity Commercial |
$1,311.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.45
|
| Rate for Payer: Nomi Health Commercial |
$1,174.22
|
| Rate for Payer: PACE SWMI |
$978.52
|
| Rate for Payer: PHP Medicare Advantage |
$978.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.10
|
| Rate for Payer: Priority Health Medicare |
$988.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$978.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.52
|
| Rate for Payer: UHC Exchange |
$978.52
|
| Rate for Payer: UHC Medicare Advantage |
$978.52
|
|
|
PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$399.51 |
| Max. Negotiated Rate |
$736.45 |
| Rate for Payer: Aetna Commercial |
$535.34
|
| Rate for Payer: Aetna Medicare |
$415.49
|
| Rate for Payer: BCBS Complete |
$453.20
|
| Rate for Payer: BCBS MAPPO |
$399.51
|
| Rate for Payer: BCN Medicare Advantage |
$399.51
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$575.29
|
| Rate for Payer: Cofinity Commercial |
$535.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.49
|
| Rate for Payer: Nomi Health Commercial |
$479.41
|
| Rate for Payer: PACE SWMI |
$399.51
|
| Rate for Payer: PHP Medicare Advantage |
$399.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.45
|
| Rate for Payer: Priority Health Medicare |
$403.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.51
|
| Rate for Payer: UHC Exchange |
$399.51
|
| Rate for Payer: UHC Medicare Advantage |
$399.51
|
|
|
PR ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 29871
|
| Min. Negotiated Rate |
$498.35 |
| Max. Negotiated Rate |
$1,051.70 |
| Rate for Payer: Aetna Commercial |
$667.79
|
| Rate for Payer: Aetna Medicare |
$518.28
|
| Rate for Payer: BCBS Complete |
$647.20
|
| Rate for Payer: BCBS MAPPO |
$498.35
|
| Rate for Payer: BCN Medicare Advantage |
$498.35
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$717.62
|
| Rate for Payer: Cofinity Commercial |
$667.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.27
|
| Rate for Payer: Nomi Health Commercial |
$598.02
|
| Rate for Payer: PACE SWMI |
$498.35
|
| Rate for Payer: PHP Medicare Advantage |
$498.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.70
|
| Rate for Payer: Priority Health Medicare |
$503.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.35
|
| Rate for Payer: UHC Exchange |
$498.35
|
| Rate for Payer: UHC Medicare Advantage |
$498.35
|
|
|
PR ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$1,974.00
|
|
|
Service Code
|
HCPCS 29873
|
| Min. Negotiated Rate |
$516.84 |
| Max. Negotiated Rate |
$1,283.10 |
| Rate for Payer: Aetna Commercial |
$692.57
|
| Rate for Payer: Aetna Medicare |
$537.51
|
| Rate for Payer: BCBS Complete |
$789.60
|
| Rate for Payer: BCBS MAPPO |
$516.84
|
| Rate for Payer: BCN Medicare Advantage |
$516.84
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cofinity Commercial |
$744.25
|
| Rate for Payer: Cofinity Commercial |
$692.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$542.68
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: PACE SWMI |
$516.84
|
| Rate for Payer: PHP Medicare Advantage |
$516.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.10
|
| Rate for Payer: Priority Health Medicare |
$522.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.84
|
| Rate for Payer: UHC Exchange |
$516.84
|
| Rate for Payer: UHC Medicare Advantage |
$516.84
|
|
|
PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT
|
Professional
|
Both
|
$3,003.00
|
|
|
Service Code
|
HCPCS 29868
|
| Min. Negotiated Rate |
$1,201.20 |
| Max. Negotiated Rate |
$2,313.36 |
| Rate for Payer: Aetna Commercial |
$2,152.71
|
| Rate for Payer: Aetna Medicare |
$1,670.76
|
| Rate for Payer: BCBS Complete |
$1,201.20
|
| Rate for Payer: BCBS MAPPO |
$1,606.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,606.50
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Cofinity Commercial |
$2,313.36
|
| Rate for Payer: Cofinity Commercial |
$2,152.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,606.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,686.83
|
| Rate for Payer: Nomi Health Commercial |
$1,927.80
|
| Rate for Payer: PACE SWMI |
$1,606.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,606.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,951.95
|
| Rate for Payer: Priority Health Medicare |
$1,622.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,606.50
|
| Rate for Payer: UHC Exchange |
$1,606.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,606.50
|
|
|
PR ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$3,097.00
|
|
|
Service Code
|
HCPCS 29866
|
| Min. Negotiated Rate |
$1,015.34 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$1,360.56
|
| Rate for Payer: Aetna Medicare |
$1,055.95
|
| Rate for Payer: BCBS Complete |
$1,238.80
|
| Rate for Payer: BCBS MAPPO |
$1,015.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.34
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,462.09
|
| Rate for Payer: Cofinity Commercial |
$1,360.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.11
|
| Rate for Payer: Nomi Health Commercial |
$1,218.41
|
| Rate for Payer: PACE SWMI |
$1,015.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.05
|
| Rate for Payer: Priority Health Medicare |
$1,025.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,015.34
|
| Rate for Payer: UHC Exchange |
$1,015.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.34
|
|
|
PR ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29867
|
| Min. Negotiated Rate |
$906.00 |
| Max. Negotiated Rate |
$1,774.90 |
| Rate for Payer: Aetna Commercial |
$1,651.64
|
| Rate for Payer: Aetna Medicare |
$1,281.87
|
| Rate for Payer: BCBS Complete |
$906.00
|
| Rate for Payer: BCBS MAPPO |
$1,232.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,232.57
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$1,774.90
|
| Rate for Payer: Cofinity Commercial |
$1,651.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,232.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,294.20
|
| Rate for Payer: Nomi Health Commercial |
$1,479.08
|
| Rate for Payer: PACE SWMI |
$1,232.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,232.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health Medicare |
$1,244.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,232.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,232.57
|
| Rate for Payer: UHC Exchange |
$1,232.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,232.57
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29874
|
| Min. Negotiated Rate |
$517.69 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Commercial |
$693.70
|
| Rate for Payer: Aetna Medicare |
$538.40
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: BCBS MAPPO |
$517.69
|
| Rate for Payer: BCN Medicare Advantage |
$517.69
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$745.47
|
| Rate for Payer: Cofinity Commercial |
$693.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.57
|
| Rate for Payer: Nomi Health Commercial |
$621.23
|
| Rate for Payer: PACE SWMI |
$517.69
|
| Rate for Payer: PHP Medicare Advantage |
$517.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health Medicare |
$522.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.69
|
| Rate for Payer: UHC Exchange |
$517.69
|
| Rate for Payer: UHC Medicare Advantage |
$517.69
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$1,325.35 |
| Max. Negotiated Rate |
$1,835.10 |
| Rate for Payer: Aetna Commercial |
$1,733.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.44
|
| Rate for Payer: BCN Commercial |
$1,575.74
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$1,753.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,631.20
|
| Rate for Payer: Healthscope Commercial |
$1,835.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,529.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,733.15
|
| Rate for Payer: Nomi Health Commercial |
$1,671.98
|
| Rate for Payer: PHP Commercial |
$1,733.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,773.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,366.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.32
|
| Rate for Payer: UHC Core |
$1,702.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,529.25
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$484.26 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$1,733.15
|
| Rate for Payer: Aetna Medicare |
$530.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$637.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$637.19
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$509.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.26
|
| Rate for Payer: BCN Commercial |
$1,585.32
|
| Rate for Payer: BCN Medicare Advantage |
$509.75
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$1,753.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,631.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.75
|
| Rate for Payer: Healthscope Commercial |
$1,835.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,529.25
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.24
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$586.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,733.15
|
| Rate for Payer: Nomi Health Commercial |
$1,671.98
|
| Rate for Payer: PACE Senior Care Partners |
$484.26
|
| Rate for Payer: PACE SWMI |
$509.75
|
| Rate for Payer: PHP Commercial |
$1,733.15
|
| Rate for Payer: PHP Medicare Advantage |
$509.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,773.93
|
| Rate for Payer: Priority Health Medicare |
$514.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,366.13
|
| Rate for Payer: Railroad Medicare Medicare |
$509.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.32
|
| Rate for Payer: UHC Core |
$1,702.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.75
|
| Rate for Payer: UHC Exchange |
$509.75
|
| Rate for Payer: UHC Medicare Advantage |
$509.75
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$509.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,529.25
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$517.69 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Commercial |
$693.70
|
| Rate for Payer: Aetna Medicare |
$538.40
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: BCBS MAPPO |
$517.69
|
| Rate for Payer: BCN Medicare Advantage |
$517.69
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$745.47
|
| Rate for Payer: Cofinity Commercial |
$693.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.57
|
| Rate for Payer: Nomi Health Commercial |
$621.23
|
| Rate for Payer: PACE SWMI |
$517.69
|
| Rate for Payer: PHP Medicare Advantage |
$517.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health Medicare |
$522.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.69
|
| Rate for Payer: UHC Exchange |
$517.69
|
| Rate for Payer: UHC Medicare Advantage |
$517.69
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Facility
|
OP
|
$2,395.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$568.81 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$2,035.75
|
| Rate for Payer: Aetna Medicare |
$622.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$748.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$748.44
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$598.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,968.93
|
| Rate for Payer: BCN Commercial |
$1,862.11
|
| Rate for Payer: BCN Medicare Advantage |
$598.75
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,059.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.75
|
| Rate for Payer: Healthscope Commercial |
$2,155.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,796.25
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.69
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$688.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: PACE Senior Care Partners |
$568.81
|
| Rate for Payer: PACE SWMI |
$598.75
|
| Rate for Payer: PHP Commercial |
$2,035.75
|
| Rate for Payer: PHP Medicare Advantage |
$598.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,083.65
|
| Rate for Payer: Priority Health Medicare |
$604.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.65
|
| Rate for Payer: Railroad Medicare Medicare |
$598.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,107.60
|
| Rate for Payer: UHC Core |
$1,999.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.75
|
| Rate for Payer: UHC Exchange |
$598.75
|
| Rate for Payer: UHC Medicare Advantage |
$598.75
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$598.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,796.25
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$630.77 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$845.23
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$630.77
|
| Rate for Payer: BCN Medicare Advantage |
$630.77
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$908.31
|
| Rate for Payer: Cofinity Commercial |
$845.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.31
|
| Rate for Payer: Nomi Health Commercial |
$756.92
|
| Rate for Payer: PACE SWMI |
$630.77
|
| Rate for Payer: PHP Medicare Advantage |
$630.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$637.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.77
|
| Rate for Payer: UHC Exchange |
$630.77
|
| Rate for Payer: UHC Medicare Advantage |
$630.77
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$1,556.75 |
| Max. Negotiated Rate |
$2,155.50 |
| Rate for Payer: Aetna Commercial |
$2,035.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.04
|
| Rate for Payer: BCN Commercial |
$1,850.86
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,059.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Healthscope Commercial |
$2,155.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,796.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: PHP Commercial |
$2,035.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,083.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,107.60
|
| Rate for Payer: UHC Core |
$1,999.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,796.25
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29876
|
| Min. Negotiated Rate |
$630.77 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$845.23
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$630.77
|
| Rate for Payer: BCN Medicare Advantage |
$630.77
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$908.31
|
| Rate for Payer: Cofinity Commercial |
$845.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.31
|
| Rate for Payer: Nomi Health Commercial |
$756.92
|
| Rate for Payer: PACE SWMI |
$630.77
|
| Rate for Payer: PHP Medicare Advantage |
$630.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$637.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.77
|
| Rate for Payer: UHC Exchange |
$630.77
|
| Rate for Payer: UHC Medicare Advantage |
$630.77
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29875
|
| Min. Negotiated Rate |
$479.77 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$642.89
|
| Rate for Payer: Aetna Medicare |
$498.96
|
| Rate for Payer: BCBS Complete |
$750.80
|
| Rate for Payer: BCBS MAPPO |
$479.77
|
| Rate for Payer: BCN Medicare Advantage |
$479.77
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$690.87
|
| Rate for Payer: Cofinity Commercial |
$642.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.76
|
| Rate for Payer: Nomi Health Commercial |
$575.72
|
| Rate for Payer: PACE SWMI |
$479.77
|
| Rate for Payer: PHP Medicare Advantage |
$479.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health Medicare |
$484.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$479.77
|
| Rate for Payer: UHC Exchange |
$479.77
|
| Rate for Payer: UHC Medicare Advantage |
$479.77
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Facility
|
OP
|
$1,877.00
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$445.79 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$1,595.45
|
| Rate for Payer: Aetna Medicare |
$488.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$586.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$586.56
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$469.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,543.08
|
| Rate for Payer: BCN Commercial |
$1,459.37
|
| Rate for Payer: BCN Medicare Advantage |
$469.25
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$1,614.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,501.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$469.25
|
| Rate for Payer: Healthscope Commercial |
$1,689.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,407.75
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$492.71
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$539.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,595.45
|
| Rate for Payer: Nomi Health Commercial |
$1,539.14
|
| Rate for Payer: PACE Senior Care Partners |
$445.79
|
| Rate for Payer: PACE SWMI |
$469.25
|
| Rate for Payer: PHP Commercial |
$1,595.45
|
| Rate for Payer: PHP Medicare Advantage |
$469.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,632.99
|
| Rate for Payer: Priority Health Medicare |
$473.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,257.59
|
| Rate for Payer: Railroad Medicare Medicare |
$469.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,651.76
|
| Rate for Payer: UHC Core |
$1,567.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$469.25
|
| Rate for Payer: UHC Exchange |
$469.25
|
| Rate for Payer: UHC Medicare Advantage |
$469.25
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$469.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,407.75
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$479.77 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$642.89
|
| Rate for Payer: Aetna Medicare |
$498.96
|
| Rate for Payer: BCBS Complete |
$750.80
|
| Rate for Payer: BCBS MAPPO |
$479.77
|
| Rate for Payer: BCN Medicare Advantage |
$479.77
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$690.87
|
| Rate for Payer: Cofinity Commercial |
$642.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.76
|
| Rate for Payer: Nomi Health Commercial |
$575.72
|
| Rate for Payer: PACE SWMI |
$479.77
|
| Rate for Payer: PHP Medicare Advantage |
$479.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health Medicare |
$484.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$479.77
|
| Rate for Payer: UHC Exchange |
$479.77
|
| Rate for Payer: UHC Medicare Advantage |
$479.77
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Facility
|
IP
|
$1,877.00
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$1,220.05 |
| Max. Negotiated Rate |
$1,689.30 |
| Rate for Payer: Aetna Commercial |
$1,595.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.20
|
| Rate for Payer: BCN Commercial |
$1,450.55
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$1,614.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,501.60
|
| Rate for Payer: Healthscope Commercial |
$1,689.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,407.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,595.45
|
| Rate for Payer: Nomi Health Commercial |
$1,539.14
|
| Rate for Payer: PHP Commercial |
$1,595.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,632.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,257.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,651.76
|
| Rate for Payer: UHC Core |
$1,567.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,407.75
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$598.21 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$801.60
|
| Rate for Payer: Aetna Medicare |
$622.14
|
| Rate for Payer: BCBS Complete |
$906.00
|
| Rate for Payer: BCBS MAPPO |
$598.21
|
| Rate for Payer: BCN Medicare Advantage |
$598.21
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$861.42
|
| Rate for Payer: Cofinity Commercial |
$801.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.12
|
| Rate for Payer: Nomi Health Commercial |
$717.85
|
| Rate for Payer: PACE SWMI |
$598.21
|
| Rate for Payer: PHP Medicare Advantage |
$598.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health Medicare |
$604.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.21
|
| Rate for Payer: UHC Exchange |
$598.21
|
| Rate for Payer: UHC Medicare Advantage |
$598.21
|
|
