|
PR ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$1,866.00
|
|
|
Service Code
|
HCPCS 24102
|
| Min. Negotiated Rate |
$597.14 |
| Max. Negotiated Rate |
$1,212.90 |
| Rate for Payer: Aetna Commercial |
$800.17
|
| Rate for Payer: Aetna Medicare |
$621.03
|
| Rate for Payer: BCBS Complete |
$746.40
|
| Rate for Payer: BCBS MAPPO |
$597.14
|
| Rate for Payer: BCN Medicare Advantage |
$597.14
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cofinity Commercial |
$859.88
|
| Rate for Payer: Cofinity Commercial |
$800.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.00
|
| Rate for Payer: Nomi Health Commercial |
$716.57
|
| Rate for Payer: PACE SWMI |
$597.14
|
| Rate for Payer: PHP Medicare Advantage |
$597.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,212.90
|
| Rate for Payer: Priority Health Medicare |
$603.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.14
|
| Rate for Payer: UHC Exchange |
$597.14
|
| Rate for Payer: UHC Medicare Advantage |
$597.14
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,459.00
|
|
|
Service Code
|
HCPCS 24100
|
| Min. Negotiated Rate |
$407.58 |
| Max. Negotiated Rate |
$948.35 |
| Rate for Payer: Aetna Commercial |
$546.16
|
| Rate for Payer: Aetna Medicare |
$423.88
|
| Rate for Payer: BCBS Complete |
$583.60
|
| Rate for Payer: BCBS MAPPO |
$407.58
|
| Rate for Payer: BCN Medicare Advantage |
$407.58
|
| Rate for Payer: Cash Price |
$1,167.20
|
| Rate for Payer: Cash Price |
$1,167.20
|
| Rate for Payer: Cofinity Commercial |
$586.92
|
| Rate for Payer: Cofinity Commercial |
$546.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.96
|
| Rate for Payer: Nomi Health Commercial |
$489.10
|
| Rate for Payer: PACE SWMI |
$407.58
|
| Rate for Payer: PHP Medicare Advantage |
$407.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$948.35
|
| Rate for Payer: Priority Health Medicare |
$411.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.58
|
| Rate for Payer: UHC Exchange |
$407.58
|
| Rate for Payer: UHC Medicare Advantage |
$407.58
|
|
|
PR ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 23100
|
| Min. Negotiated Rate |
$352.40 |
| Max. Negotiated Rate |
$706.55 |
| Rate for Payer: Aetna Commercial |
$657.48
|
| Rate for Payer: Aetna Medicare |
$510.29
|
| Rate for Payer: BCBS Complete |
$352.40
|
| Rate for Payer: BCBS MAPPO |
$490.66
|
| Rate for Payer: BCN Medicare Advantage |
$490.66
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$706.55
|
| Rate for Payer: Cofinity Commercial |
$657.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.19
|
| Rate for Payer: Nomi Health Commercial |
$588.79
|
| Rate for Payer: PACE SWMI |
$490.66
|
| Rate for Payer: PHP Medicare Advantage |
$490.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.65
|
| Rate for Payer: Priority Health Medicare |
$495.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$490.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.66
|
| Rate for Payer: UHC Exchange |
$490.66
|
| Rate for Payer: UHC Medicare Advantage |
$490.66
|
|
|
PR ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 23040
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$1,284.40 |
| Rate for Payer: Aetna Commercial |
$927.33
|
| Rate for Payer: Aetna Medicare |
$719.72
|
| Rate for Payer: BCBS Complete |
$790.40
|
| Rate for Payer: BCBS MAPPO |
$692.04
|
| Rate for Payer: BCN Medicare Advantage |
$692.04
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$996.54
|
| Rate for Payer: Cofinity Commercial |
$927.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$726.64
|
| Rate for Payer: Nomi Health Commercial |
$830.45
|
| Rate for Payer: PACE SWMI |
$692.04
|
| Rate for Payer: PHP Medicare Advantage |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health Medicare |
$698.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$692.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$692.04
|
| Rate for Payer: UHC Exchange |
$692.04
|
| Rate for Payer: UHC Medicare Advantage |
$692.04
|
|
|
PR ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 27033
|
| Min. Negotiated Rate |
$697.60 |
| Max. Negotiated Rate |
$1,351.54 |
| Rate for Payer: Aetna Commercial |
$1,257.68
|
| Rate for Payer: Aetna Medicare |
$976.11
|
| Rate for Payer: BCBS Complete |
$697.60
|
| Rate for Payer: BCBS MAPPO |
$938.57
|
| Rate for Payer: BCN Medicare Advantage |
$938.57
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,351.54
|
| Rate for Payer: Cofinity Commercial |
$1,257.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.50
|
| Rate for Payer: Nomi Health Commercial |
$1,126.28
|
| Rate for Payer: PACE SWMI |
$938.57
|
| Rate for Payer: PHP Medicare Advantage |
$938.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,133.60
|
| Rate for Payer: Priority Health Medicare |
$947.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.57
|
| Rate for Payer: UHC Exchange |
$938.57
|
| Rate for Payer: UHC Medicare Advantage |
$938.57
|
|
|
PR ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$1,674.00
|
|
|
Service Code
|
HCPCS 27030
|
| Min. Negotiated Rate |
$669.60 |
| Max. Negotiated Rate |
$1,300.59 |
| Rate for Payer: Aetna Commercial |
$1,210.27
|
| Rate for Payer: Aetna Medicare |
$939.32
|
| Rate for Payer: BCBS Complete |
$669.60
|
| Rate for Payer: BCBS MAPPO |
$903.19
|
| Rate for Payer: BCN Medicare Advantage |
$903.19
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cofinity Commercial |
$1,300.59
|
| Rate for Payer: Cofinity Commercial |
$1,210.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.35
|
| Rate for Payer: Nomi Health Commercial |
$1,083.83
|
| Rate for Payer: PACE SWMI |
$903.19
|
| Rate for Payer: PHP Medicare Advantage |
$903.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.10
|
| Rate for Payer: Priority Health Medicare |
$912.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$903.19
|
| Rate for Payer: UHC Exchange |
$903.19
|
| Rate for Payer: UHC Medicare Advantage |
$903.19
|
|
|
PR ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$725.00
|
|
|
Service Code
|
HCPCS 27330
|
| Min. Negotiated Rate |
$290.00 |
| Max. Negotiated Rate |
$590.18 |
| Rate for Payer: Aetna Commercial |
$549.20
|
| Rate for Payer: Aetna Medicare |
$426.24
|
| Rate for Payer: BCBS Complete |
$290.00
|
| Rate for Payer: BCBS MAPPO |
$409.85
|
| Rate for Payer: BCN Medicare Advantage |
$409.85
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cofinity Commercial |
$590.18
|
| Rate for Payer: Cofinity Commercial |
$549.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.34
|
| Rate for Payer: Nomi Health Commercial |
$491.82
|
| Rate for Payer: PACE SWMI |
$409.85
|
| Rate for Payer: PHP Medicare Advantage |
$409.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.25
|
| Rate for Payer: Priority Health Medicare |
$413.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.85
|
| Rate for Payer: UHC Exchange |
$409.85
|
| Rate for Payer: UHC Medicare Advantage |
$409.85
|
|
|
PR ARTHROTOMY W/BIOPSY HIP JOINT
|
Professional
|
Both
|
$2,022.00
|
|
|
Service Code
|
HCPCS 27052
|
| Min. Negotiated Rate |
$561.42 |
| Max. Negotiated Rate |
$1,314.30 |
| Rate for Payer: Aetna Commercial |
$752.30
|
| Rate for Payer: Aetna Medicare |
$583.88
|
| Rate for Payer: BCBS Complete |
$808.80
|
| Rate for Payer: BCBS MAPPO |
$561.42
|
| Rate for Payer: BCN Medicare Advantage |
$561.42
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cofinity Commercial |
$808.44
|
| Rate for Payer: Cofinity Commercial |
$752.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.49
|
| Rate for Payer: Nomi Health Commercial |
$673.70
|
| Rate for Payer: PACE SWMI |
$561.42
|
| Rate for Payer: PHP Medicare Advantage |
$561.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,314.30
|
| Rate for Payer: Priority Health Medicare |
$567.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.42
|
| Rate for Payer: UHC Exchange |
$561.42
|
| Rate for Payer: UHC Medicare Advantage |
$561.42
|
|
|
PR ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,137.00
|
|
|
Service Code
|
HCPCS 27403
|
| Min. Negotiated Rate |
$624.87 |
| Max. Negotiated Rate |
$1,389.05 |
| Rate for Payer: Aetna Commercial |
$837.33
|
| Rate for Payer: Aetna Medicare |
$649.86
|
| Rate for Payer: BCBS Complete |
$854.80
|
| Rate for Payer: BCBS MAPPO |
$624.87
|
| Rate for Payer: BCN Medicare Advantage |
$624.87
|
| Rate for Payer: Cash Price |
$1,709.60
|
| Rate for Payer: Cash Price |
$1,709.60
|
| Rate for Payer: Cofinity Commercial |
$899.81
|
| Rate for Payer: Cofinity Commercial |
$837.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.11
|
| Rate for Payer: Nomi Health Commercial |
$749.84
|
| Rate for Payer: PACE SWMI |
$624.87
|
| Rate for Payer: PHP Medicare Advantage |
$624.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,389.05
|
| Rate for Payer: Priority Health Medicare |
$631.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.87
|
| Rate for Payer: UHC Exchange |
$624.87
|
| Rate for Payer: UHC Medicare Advantage |
$624.87
|
|
|
PR ARTHROTOMY WRIST JOINT WITH BIOPSY
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 25100
|
| Min. Negotiated Rate |
$277.60 |
| Max. Negotiated Rate |
$489.20 |
| Rate for Payer: Aetna Commercial |
$455.22
|
| Rate for Payer: Aetna Medicare |
$353.31
|
| Rate for Payer: BCBS Complete |
$277.60
|
| Rate for Payer: BCBS MAPPO |
$339.72
|
| Rate for Payer: BCN Medicare Advantage |
$339.72
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$489.20
|
| Rate for Payer: Cofinity Commercial |
$455.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.71
|
| Rate for Payer: Nomi Health Commercial |
$407.66
|
| Rate for Payer: PACE SWMI |
$339.72
|
| Rate for Payer: PHP Medicare Advantage |
$339.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health Medicare |
$343.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.72
|
| Rate for Payer: UHC Exchange |
$339.72
|
| Rate for Payer: UHC Medicare Advantage |
$339.72
|
|
|
PR ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY
|
Professional
|
Both
|
$1,681.00
|
|
|
Service Code
|
HCPCS 25105
|
| Min. Negotiated Rate |
$472.63 |
| Max. Negotiated Rate |
$1,092.65 |
| Rate for Payer: Aetna Commercial |
$633.32
|
| Rate for Payer: Aetna Medicare |
$491.54
|
| Rate for Payer: BCBS Complete |
$672.40
|
| Rate for Payer: BCBS MAPPO |
$472.63
|
| Rate for Payer: BCN Medicare Advantage |
$472.63
|
| Rate for Payer: Cash Price |
$1,344.80
|
| Rate for Payer: Cash Price |
$1,344.80
|
| Rate for Payer: Cofinity Commercial |
$680.59
|
| Rate for Payer: Cofinity Commercial |
$633.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.26
|
| Rate for Payer: Nomi Health Commercial |
$567.16
|
| Rate for Payer: PACE SWMI |
$472.63
|
| Rate for Payer: PHP Medicare Advantage |
$472.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.65
|
| Rate for Payer: Priority Health Medicare |
$477.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.63
|
| Rate for Payer: UHC Exchange |
$472.63
|
| Rate for Payer: UHC Medicare Advantage |
$472.63
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE
|
Professional
|
Both
|
$1,435.00
|
|
|
Service Code
|
HCPCS 27625
|
| Min. Negotiated Rate |
$548.57 |
| Max. Negotiated Rate |
$932.75 |
| Rate for Payer: Aetna Commercial |
$735.08
|
| Rate for Payer: Aetna Medicare |
$570.51
|
| Rate for Payer: BCBS Complete |
$574.00
|
| Rate for Payer: BCBS MAPPO |
$548.57
|
| Rate for Payer: BCN Medicare Advantage |
$548.57
|
| Rate for Payer: Cash Price |
$1,148.00
|
| Rate for Payer: Cash Price |
$1,148.00
|
| Rate for Payer: Cofinity Commercial |
$789.94
|
| Rate for Payer: Cofinity Commercial |
$735.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.00
|
| Rate for Payer: Nomi Health Commercial |
$658.28
|
| Rate for Payer: PACE SWMI |
$548.57
|
| Rate for Payer: PHP Medicare Advantage |
$548.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$932.75
|
| Rate for Payer: Priority Health Medicare |
$554.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.57
|
| Rate for Payer: UHC Exchange |
$548.57
|
| Rate for Payer: UHC Medicare Advantage |
$548.57
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 27626
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$848.49 |
| Rate for Payer: Aetna Commercial |
$789.57
|
| Rate for Payer: Aetna Medicare |
$612.80
|
| Rate for Payer: BCBS Complete |
$415.20
|
| Rate for Payer: BCBS MAPPO |
$589.23
|
| Rate for Payer: BCN Medicare Advantage |
$589.23
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$848.49
|
| Rate for Payer: Cofinity Commercial |
$789.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.69
|
| Rate for Payer: Nomi Health Commercial |
$707.08
|
| Rate for Payer: PACE SWMI |
$589.23
|
| Rate for Payer: PHP Medicare Advantage |
$589.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health Medicare |
$595.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$589.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.23
|
| Rate for Payer: UHC Exchange |
$589.23
|
| Rate for Payer: UHC Medicare Advantage |
$589.23
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY HIP JOINT
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 27054
|
| Min. Negotiated Rate |
$558.40 |
| Max. Negotiated Rate |
$958.71 |
| Rate for Payer: Aetna Commercial |
$892.13
|
| Rate for Payer: Aetna Medicare |
$692.40
|
| Rate for Payer: BCBS Complete |
$558.40
|
| Rate for Payer: BCBS MAPPO |
$665.77
|
| Rate for Payer: BCN Medicare Advantage |
$665.77
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$958.71
|
| Rate for Payer: Cofinity Commercial |
$892.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.06
|
| Rate for Payer: Nomi Health Commercial |
$798.92
|
| Rate for Payer: PACE SWMI |
$665.77
|
| Rate for Payer: PHP Medicare Advantage |
$665.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$907.40
|
| Rate for Payer: Priority Health Medicare |
$672.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.77
|
| Rate for Payer: UHC Exchange |
$665.77
|
| Rate for Payer: UHC Medicare Advantage |
$665.77
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Facility
|
IP
|
$2,511.00
|
|
|
Service Code
|
CPT 27334
|
| Hospital Charge Code |
27334
|
| Min. Negotiated Rate |
$1,632.15 |
| Max. Negotiated Rate |
$2,259.90 |
| Rate for Payer: Aetna Commercial |
$2,134.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,049.73
|
| Rate for Payer: BCN Commercial |
$1,940.50
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cofinity Commercial |
$2,159.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,008.80
|
| Rate for Payer: Healthscope Commercial |
$2,259.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,883.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,134.35
|
| Rate for Payer: Nomi Health Commercial |
$2,059.02
|
| Rate for Payer: PHP Commercial |
$2,134.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,632.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,184.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,682.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,209.68
|
| Rate for Payer: UHC Core |
$2,096.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,883.25
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$2,511.00
|
|
|
Service Code
|
HCPCS 27334
|
| Min. Negotiated Rate |
$665.04 |
| Max. Negotiated Rate |
$1,632.15 |
| Rate for Payer: Aetna Commercial |
$891.15
|
| Rate for Payer: Aetna Medicare |
$691.64
|
| Rate for Payer: BCBS Complete |
$1,004.40
|
| Rate for Payer: BCBS MAPPO |
$665.04
|
| Rate for Payer: BCN Medicare Advantage |
$665.04
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cofinity Commercial |
$957.66
|
| Rate for Payer: Cofinity Commercial |
$891.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.29
|
| Rate for Payer: Nomi Health Commercial |
$798.05
|
| Rate for Payer: PACE SWMI |
$665.04
|
| Rate for Payer: PHP Medicare Advantage |
$665.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,632.15
|
| Rate for Payer: Priority Health Medicare |
$671.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.04
|
| Rate for Payer: UHC Exchange |
$665.04
|
| Rate for Payer: UHC Medicare Advantage |
$665.04
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$2,511.00
|
|
|
Service Code
|
HCPCS 27334
|
| Hospital Charge Code |
27334
|
| Min. Negotiated Rate |
$665.04 |
| Max. Negotiated Rate |
$1,632.15 |
| Rate for Payer: Aetna Commercial |
$891.15
|
| Rate for Payer: Aetna Medicare |
$691.64
|
| Rate for Payer: BCBS Complete |
$1,004.40
|
| Rate for Payer: BCBS MAPPO |
$665.04
|
| Rate for Payer: BCN Medicare Advantage |
$665.04
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cofinity Commercial |
$957.66
|
| Rate for Payer: Cofinity Commercial |
$891.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.29
|
| Rate for Payer: Nomi Health Commercial |
$798.05
|
| Rate for Payer: PACE SWMI |
$665.04
|
| Rate for Payer: PHP Medicare Advantage |
$665.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,632.15
|
| Rate for Payer: Priority Health Medicare |
$671.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.04
|
| Rate for Payer: UHC Exchange |
$665.04
|
| Rate for Payer: UHC Medicare Advantage |
$665.04
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Facility
|
OP
|
$2,511.00
|
|
|
Service Code
|
CPT 27334
|
| Hospital Charge Code |
27334
|
| Min. Negotiated Rate |
$596.36 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$2,134.35
|
| Rate for Payer: Aetna Medicare |
$652.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$784.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$784.69
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$627.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.29
|
| Rate for Payer: BCN Commercial |
$1,952.30
|
| Rate for Payer: BCN Medicare Advantage |
$627.75
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cofinity Commercial |
$2,159.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,008.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.75
|
| Rate for Payer: Healthscope Commercial |
$2,259.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,883.25
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.14
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,134.35
|
| Rate for Payer: Nomi Health Commercial |
$2,059.02
|
| Rate for Payer: PACE Senior Care Partners |
$596.36
|
| Rate for Payer: PACE SWMI |
$627.75
|
| Rate for Payer: PHP Commercial |
$2,134.35
|
| Rate for Payer: PHP Medicare Advantage |
$627.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,632.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,184.57
|
| Rate for Payer: Priority Health Medicare |
$634.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,682.37
|
| Rate for Payer: Railroad Medicare Medicare |
$627.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,209.68
|
| Rate for Payer: UHC Core |
$2,096.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.75
|
| Rate for Payer: UHC Exchange |
$627.75
|
| Rate for Payer: UHC Medicare Advantage |
$627.75
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$627.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,883.25
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Facility
|
IP
|
$2,794.00
|
|
|
Service Code
|
CPT 27130
|
| Hospital Charge Code |
27130
|
| Min. Negotiated Rate |
$1,816.10 |
| Max. Negotiated Rate |
$2,514.60 |
| Rate for Payer: Aetna Commercial |
$2,374.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,280.74
|
| Rate for Payer: BCN Commercial |
$2,159.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cofinity Commercial |
$2,402.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,235.20
|
| Rate for Payer: Healthscope Commercial |
$2,514.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,095.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,374.90
|
| Rate for Payer: Nomi Health Commercial |
$2,291.08
|
| Rate for Payer: PHP Commercial |
$2,374.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health HMO/PPO |
$2,430.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,871.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,458.72
|
| Rate for Payer: UHC Core |
$2,332.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,095.50
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$2,794.00
|
|
|
Service Code
|
HCPCS 27130
|
| Min. Negotiated Rate |
$1,117.60 |
| Max. Negotiated Rate |
$1,816.10 |
| Rate for Payer: Aetna Commercial |
$1,658.14
|
| Rate for Payer: Aetna Medicare |
$1,286.92
|
| Rate for Payer: BCBS Complete |
$1,117.60
|
| Rate for Payer: BCBS MAPPO |
$1,237.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.42
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cofinity Commercial |
$1,781.88
|
| Rate for Payer: Cofinity Commercial |
$1,658.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.29
|
| Rate for Payer: Nomi Health Commercial |
$1,484.90
|
| Rate for Payer: PACE SWMI |
$1,237.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health Medicare |
$1,249.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.42
|
| Rate for Payer: UHC Exchange |
$1,237.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,237.42
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Facility
|
OP
|
$2,794.00
|
|
|
Service Code
|
CPT 27130
|
| Hospital Charge Code |
27130
|
| Min. Negotiated Rate |
$663.58 |
| Max. Negotiated Rate |
$9,768.49 |
| Rate for Payer: Aetna Commercial |
$2,374.90
|
| Rate for Payer: Aetna Medicare |
$726.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$873.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$873.12
|
| Rate for Payer: BCBS Complete |
$9,768.49
|
| Rate for Payer: BCBS MAPPO |
$698.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,296.95
|
| Rate for Payer: BCN Commercial |
$2,172.34
|
| Rate for Payer: BCN Medicare Advantage |
$698.50
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cofinity Commercial |
$2,402.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,235.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.50
|
| Rate for Payer: Healthscope Commercial |
$2,514.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,095.50
|
| Rate for Payer: Mclaren Medicaid |
$9,302.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.42
|
| Rate for Payer: Meridian Medicaid |
$9,768.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$803.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,374.90
|
| Rate for Payer: Nomi Health Commercial |
$2,291.08
|
| Rate for Payer: PACE Senior Care Partners |
$663.58
|
| Rate for Payer: PACE SWMI |
$698.50
|
| Rate for Payer: PHP Commercial |
$2,374.90
|
| Rate for Payer: PHP Medicare Advantage |
$698.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,302.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health HMO/PPO |
$2,430.78
|
| Rate for Payer: Priority Health Medicare |
$705.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,871.98
|
| Rate for Payer: Railroad Medicare Medicare |
$698.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,458.72
|
| Rate for Payer: UHC Core |
$2,332.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.50
|
| Rate for Payer: UHC Exchange |
$698.50
|
| Rate for Payer: UHC Medicare Advantage |
$698.50
|
| Rate for Payer: UHCCP Medicaid |
$9,302.71
|
| Rate for Payer: VA VA |
$698.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,095.50
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$2,794.00
|
|
|
Service Code
|
HCPCS 27130
|
| Hospital Charge Code |
27130
|
| Min. Negotiated Rate |
$1,117.60 |
| Max. Negotiated Rate |
$1,816.10 |
| Rate for Payer: Aetna Commercial |
$1,658.14
|
| Rate for Payer: Aetna Medicare |
$1,286.92
|
| Rate for Payer: BCBS Complete |
$1,117.60
|
| Rate for Payer: BCBS MAPPO |
$1,237.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.42
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cofinity Commercial |
$1,781.88
|
| Rate for Payer: Cofinity Commercial |
$1,658.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.29
|
| Rate for Payer: Nomi Health Commercial |
$1,484.90
|
| Rate for Payer: PACE SWMI |
$1,237.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health Medicare |
$1,249.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.42
|
| Rate for Payer: UHC Exchange |
$1,237.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,237.42
|
|
|
PR ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM
|
Professional
|
Both
|
$5,189.00
|
|
|
Service Code
|
HCPCS 24363
|
| Min. Negotiated Rate |
$1,394.88 |
| Max. Negotiated Rate |
$3,372.85 |
| Rate for Payer: Aetna Commercial |
$1,869.14
|
| Rate for Payer: Aetna Medicare |
$1,450.68
|
| Rate for Payer: BCBS Complete |
$2,075.60
|
| Rate for Payer: BCBS MAPPO |
$1,394.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,394.88
|
| Rate for Payer: Cash Price |
$4,151.20
|
| Rate for Payer: Cash Price |
$4,151.20
|
| Rate for Payer: Cofinity Commercial |
$2,008.63
|
| Rate for Payer: Cofinity Commercial |
$1,869.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,394.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,464.62
|
| Rate for Payer: Nomi Health Commercial |
$1,673.86
|
| Rate for Payer: PACE SWMI |
$1,394.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,394.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,372.85
|
| Rate for Payer: Priority Health Medicare |
$1,408.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,394.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,394.88
|
| Rate for Payer: UHC Exchange |
$1,394.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,394.88
|
|
|
PR ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL
|
Professional
|
Both
|
$1,457.00
|
|
|
Service Code
|
HCPCS 27443
|
| Min. Negotiated Rate |
$582.80 |
| Max. Negotiated Rate |
$1,136.58 |
| Rate for Payer: Aetna Commercial |
$1,057.65
|
| Rate for Payer: Aetna Medicare |
$820.86
|
| Rate for Payer: BCBS Complete |
$582.80
|
| Rate for Payer: BCBS MAPPO |
$789.29
|
| Rate for Payer: BCN Medicare Advantage |
$789.29
|
| Rate for Payer: Cash Price |
$1,165.60
|
| Rate for Payer: Cash Price |
$1,165.60
|
| Rate for Payer: Cofinity Commercial |
$1,136.58
|
| Rate for Payer: Cofinity Commercial |
$1,057.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$828.75
|
| Rate for Payer: Nomi Health Commercial |
$947.15
|
| Rate for Payer: PACE SWMI |
$789.29
|
| Rate for Payer: PHP Medicare Advantage |
$789.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.05
|
| Rate for Payer: Priority Health Medicare |
$797.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$789.29
|
| Rate for Payer: UHC Exchange |
$789.29
|
| Rate for Payer: UHC Medicare Advantage |
$789.29
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Professional
|
Both
|
$3,039.00
|
|
|
Service Code
|
HCPCS 25447
|
| Min. Negotiated Rate |
$771.24 |
| Max. Negotiated Rate |
$1,975.35 |
| Rate for Payer: Aetna Commercial |
$1,033.46
|
| Rate for Payer: Aetna Medicare |
$802.09
|
| Rate for Payer: BCBS Complete |
$1,215.60
|
| Rate for Payer: BCBS MAPPO |
$771.24
|
| Rate for Payer: BCN Medicare Advantage |
$771.24
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cofinity Commercial |
$1,110.59
|
| Rate for Payer: Cofinity Commercial |
$1,033.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.80
|
| Rate for Payer: Nomi Health Commercial |
$925.49
|
| Rate for Payer: PACE SWMI |
$771.24
|
| Rate for Payer: PHP Medicare Advantage |
$771.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health Medicare |
$778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.24
|
| Rate for Payer: UHC Exchange |
$771.24
|
| Rate for Payer: UHC Medicare Advantage |
$771.24
|
|
