|
PR ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE
|
Professional
|
Both
|
$1,737.00
|
|
|
Service Code
|
HCPCS 25830
|
| Min. Negotiated Rate |
$618.98 |
| Max. Negotiated Rate |
$1,685.40 |
| Rate for Payer: Aetna Commercial |
$1,248.91
|
| Rate for Payer: Aetna Medicare |
$969.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.11
|
| Rate for Payer: BCBS Complete |
$649.93
|
| Rate for Payer: BCBS MAPPO |
$932.02
|
| Rate for Payer: BCN Commercial |
$1,552.20
|
| Rate for Payer: BCN Medicare Advantage |
$932.02
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cofinity Commercial |
$1,248.91
|
| Rate for Payer: Cofinity Commercial |
$1,342.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$932.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$978.62
|
| Rate for Payer: Meridian Medicaid |
$649.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,025.22
|
| Rate for Payer: Nomi Health Commercial |
$1,118.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,302.75
|
| Rate for Payer: PACE SWMI |
$932.02
|
| Rate for Payer: PHP Commercial |
$1,304.83
|
| Rate for Payer: PHP Medicare Advantage |
$932.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,659.26
|
| Rate for Payer: Priority Health Medicare |
$932.02
|
| Rate for Payer: Priority Health SBD |
$1,659.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,659.26
|
| Rate for Payer: Railroad Medicare Medicare |
$932.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,685.40
|
| Rate for Payer: UHC Core |
$1,685.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$932.02
|
| Rate for Payer: UHC Exchange |
$1,685.40
|
| Rate for Payer: UHC Medicaid |
$618.98
|
| Rate for Payer: UHCCP Medicaid |
$618.98
|
| Rate for Payer: UMR Bronson Commercial |
$799.02
|
|
|
PR ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT
|
Professional
|
Both
|
$2,958.00
|
|
|
Service Code
|
HCPCS 28735
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$2,218.50 |
| Rate for Payer: Aetna Commercial |
$955.25
|
| Rate for Payer: Aetna Medicare |
$741.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,026.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.25
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS MAPPO |
$712.87
|
| Rate for Payer: BCN Commercial |
$1,181.21
|
| Rate for Payer: BCN Medicare Advantage |
$712.87
|
| Rate for Payer: Cash Price |
$2,366.40
|
| Rate for Payer: Cash Price |
$2,366.40
|
| Rate for Payer: Cofinity Commercial |
$1,026.53
|
| Rate for Payer: Cofinity Commercial |
$955.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$748.51
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$784.16
|
| Rate for Payer: Nomi Health Commercial |
$855.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.50
|
| Rate for Payer: PACE SWMI |
$712.87
|
| Rate for Payer: PHP Commercial |
$998.02
|
| Rate for Payer: PHP Medicare Advantage |
$712.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,262.68
|
| Rate for Payer: Priority Health Medicare |
$712.87
|
| Rate for Payer: Priority Health SBD |
$1,262.68
|
| Rate for Payer: Priority Health Tiered Network |
$1,262.68
|
| Rate for Payer: Railroad Medicare Medicare |
$712.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.05
|
| Rate for Payer: UHC Core |
$1,360.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$712.87
|
| Rate for Payer: UHC Exchange |
$1,360.05
|
| Rate for Payer: UHC Medicaid |
$464.55
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,360.68
|
|
|
PR ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS
|
Professional
|
Both
|
$2,866.00
|
|
|
Service Code
|
HCPCS 28730
|
| Min. Negotiated Rate |
$432.60 |
| Max. Negotiated Rate |
$2,149.50 |
| Rate for Payer: Aetna Commercial |
$886.21
|
| Rate for Payer: Aetna Medicare |
$687.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.34
|
| Rate for Payer: BCBS Complete |
$454.23
|
| Rate for Payer: BCBS MAPPO |
$661.35
|
| Rate for Payer: BCN Commercial |
$1,099.54
|
| Rate for Payer: BCN Medicare Advantage |
$661.35
|
| Rate for Payer: Cash Price |
$2,292.80
|
| Rate for Payer: Cash Price |
$2,292.80
|
| Rate for Payer: Cofinity Commercial |
$886.21
|
| Rate for Payer: Cofinity Commercial |
$952.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.42
|
| Rate for Payer: Meridian Medicaid |
$454.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$727.49
|
| Rate for Payer: Nomi Health Commercial |
$793.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,149.50
|
| Rate for Payer: PACE SWMI |
$661.35
|
| Rate for Payer: PHP Commercial |
$925.89
|
| Rate for Payer: PHP Medicare Advantage |
$661.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,175.38
|
| Rate for Payer: Priority Health Medicare |
$661.35
|
| Rate for Payer: Priority Health SBD |
$1,175.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,175.38
|
| Rate for Payer: Railroad Medicare Medicare |
$661.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,284.40
|
| Rate for Payer: UHC Core |
$1,284.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$661.35
|
| Rate for Payer: UHC Exchange |
$1,284.40
|
| Rate for Payer: UHC Medicaid |
$432.60
|
| Rate for Payer: UHCCP Medicaid |
$432.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,318.36
|
|
|
PR ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT
|
Professional
|
Both
|
$4,498.00
|
|
|
Service Code
|
HCPCS 22600
|
| Min. Negotiated Rate |
$818.13 |
| Max. Negotiated Rate |
$3,373.50 |
| Rate for Payer: Aetna Commercial |
$1,694.32
|
| Rate for Payer: Aetna Medicare |
$1,315.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,820.76
|
| Rate for Payer: BCBS Complete |
$859.04
|
| Rate for Payer: BCBS MAPPO |
$1,264.42
|
| Rate for Payer: BCN Commercial |
$2,186.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,264.42
|
| Rate for Payer: Cash Price |
$3,598.40
|
| Rate for Payer: Cash Price |
$3,598.40
|
| Rate for Payer: Cofinity Commercial |
$1,694.32
|
| Rate for Payer: Cofinity Commercial |
$1,820.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,264.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,327.64
|
| Rate for Payer: Meridian Medicaid |
$859.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,390.86
|
| Rate for Payer: Nomi Health Commercial |
$1,517.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,373.50
|
| Rate for Payer: PACE SWMI |
$1,264.42
|
| Rate for Payer: PHP Commercial |
$1,770.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,264.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,127.71
|
| Rate for Payer: Priority Health Medicare |
$1,264.42
|
| Rate for Payer: Priority Health SBD |
$2,127.71
|
| Rate for Payer: Priority Health Tiered Network |
$2,127.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,264.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,264.30
|
| Rate for Payer: UHC Core |
$2,264.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,264.42
|
| Rate for Payer: UHC Exchange |
$2,264.30
|
| Rate for Payer: UHC Medicaid |
$818.13
|
| Rate for Payer: UHCCP Medicaid |
$818.13
|
| Rate for Payer: UMR Bronson Commercial |
$2,069.08
|
|
|
PR ARTHRD SI JT PLMT TRANSARTICULAR&/I-ARTIC DEVICE
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 27279
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$1,537.88 |
| Rate for Payer: Aetna Commercial |
$999.40
|
| Rate for Payer: Aetna Medicare |
$775.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.40
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS MAPPO |
$745.82
|
| Rate for Payer: BCN Commercial |
$1,216.57
|
| Rate for Payer: BCN Medicare Advantage |
$745.82
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,073.98
|
| Rate for Payer: Cofinity Commercial |
$999.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.11
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$820.40
|
| Rate for Payer: Nomi Health Commercial |
$894.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,016.25
|
| Rate for Payer: PACE SWMI |
$745.82
|
| Rate for Payer: PHP Commercial |
$1,044.15
|
| Rate for Payer: PHP Medicare Advantage |
$745.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,300.47
|
| Rate for Payer: Priority Health Medicare |
$745.82
|
| Rate for Payer: Priority Health SBD |
$1,300.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,300.47
|
| Rate for Payer: Railroad Medicare Medicare |
$745.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,537.88
|
| Rate for Payer: UHC Core |
$1,537.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$745.82
|
| Rate for Payer: UHC Exchange |
$1,537.88
|
| Rate for Payer: UHC Medicaid |
$483.72
|
| Rate for Payer: UHCCP Medicaid |
$483.72
|
| Rate for Payer: UMR Bronson Commercial |
$623.30
|
|
|
PR ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR
|
Professional
|
Both
|
$1,261.00
|
|
|
Service Code
|
HCPCS 28737
|
| Min. Negotiated Rate |
$403.00 |
| Max. Negotiated Rate |
$1,208.80 |
| Rate for Payer: Aetna Commercial |
$827.95
|
| Rate for Payer: Aetna Medicare |
$642.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$827.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$889.73
|
| Rate for Payer: BCBS Complete |
$423.15
|
| Rate for Payer: BCBS MAPPO |
$617.87
|
| Rate for Payer: BCN Commercial |
$1,039.29
|
| Rate for Payer: BCN Medicare Advantage |
$617.87
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cofinity Commercial |
$827.95
|
| Rate for Payer: Cofinity Commercial |
$889.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.76
|
| Rate for Payer: Meridian Medicaid |
$423.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$679.66
|
| Rate for Payer: Nomi Health Commercial |
$741.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$945.75
|
| Rate for Payer: PACE SWMI |
$617.87
|
| Rate for Payer: PHP Commercial |
$865.02
|
| Rate for Payer: PHP Medicare Advantage |
$617.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,110.97
|
| Rate for Payer: Priority Health Medicare |
$617.87
|
| Rate for Payer: Priority Health SBD |
$1,110.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,110.97
|
| Rate for Payer: Railroad Medicare Medicare |
$617.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,208.80
|
| Rate for Payer: UHC Core |
$1,208.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$617.87
|
| Rate for Payer: UHC Exchange |
$1,208.80
|
| Rate for Payer: UHC Medicaid |
$403.00
|
| Rate for Payer: UHCCP Medicaid |
$403.00
|
| Rate for Payer: UMR Bronson Commercial |
$580.06
|
|
|
PR ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 28760
|
| Min. Negotiated Rate |
$342.29 |
| Max. Negotiated Rate |
$1,137.00 |
| Rate for Payer: Aetna Commercial |
$701.52
|
| Rate for Payer: Aetna Medicare |
$544.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.87
|
| Rate for Payer: BCBS Complete |
$359.40
|
| Rate for Payer: BCBS MAPPO |
$523.52
|
| Rate for Payer: BCN Commercial |
$864.49
|
| Rate for Payer: BCN Medicare Advantage |
$523.52
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$701.52
|
| Rate for Payer: Cofinity Commercial |
$753.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$549.70
|
| Rate for Payer: Meridian Medicaid |
$359.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$575.87
|
| Rate for Payer: Nomi Health Commercial |
$628.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,137.00
|
| Rate for Payer: PACE SWMI |
$523.52
|
| Rate for Payer: PHP Commercial |
$732.93
|
| Rate for Payer: PHP Medicare Advantage |
$523.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$924.13
|
| Rate for Payer: Priority Health Medicare |
$523.52
|
| Rate for Payer: Priority Health SBD |
$924.13
|
| Rate for Payer: Priority Health Tiered Network |
$924.13
|
| Rate for Payer: Railroad Medicare Medicare |
$523.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.91
|
| Rate for Payer: UHC Core |
$1,007.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$523.52
|
| Rate for Payer: UHC Exchange |
$1,007.91
|
| Rate for Payer: UHC Medicaid |
$342.29
|
| Rate for Payer: UHCCP Medicaid |
$342.29
|
| Rate for Payer: UMR Bronson Commercial |
$697.36
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 20605
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$42.57
|
| Rate for Payer: Aetna Medicare |
$33.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$31.77
|
| Rate for Payer: BCN Commercial |
$43.20
|
| Rate for Payer: BCN Medicare Advantage |
$31.77
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$42.57
|
| Rate for Payer: Cofinity Commercial |
$45.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.36
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.95
|
| Rate for Payer: Nomi Health Commercial |
$38.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PACE SWMI |
$31.77
|
| Rate for Payer: PHP Commercial |
$44.48
|
| Rate for Payer: PHP Medicare Advantage |
$31.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58.55
|
| Rate for Payer: Priority Health Medicare |
$31.77
|
| Rate for Payer: Priority Health SBD |
$58.55
|
| Rate for Payer: Priority Health Tiered Network |
$58.55
|
| Rate for Payer: Railroad Medicare Medicare |
$31.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.15
|
| Rate for Payer: UHC Core |
$66.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.77
|
| Rate for Payer: UHC Exchange |
$66.15
|
| Rate for Payer: UHC Medicaid |
$20.45
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$113.25 |
| Rate for Payer: Aetna Commercial |
$59.74
|
| Rate for Payer: Aetna Medicare |
$46.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.20
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$44.58
|
| Rate for Payer: BCN Commercial |
$61.26
|
| Rate for Payer: BCN Medicare Advantage |
$44.58
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$59.74
|
| Rate for Payer: Cofinity Commercial |
$64.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.81
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.04
|
| Rate for Payer: Nomi Health Commercial |
$53.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.25
|
| Rate for Payer: PACE SWMI |
$44.58
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: PHP Medicare Advantage |
$44.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.04
|
| Rate for Payer: Priority Health Medicare |
$44.58
|
| Rate for Payer: Priority Health SBD |
$83.04
|
| Rate for Payer: Priority Health Tiered Network |
$83.04
|
| Rate for Payer: Railroad Medicare Medicare |
$44.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.25
|
| Rate for Payer: UHC Core |
$93.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.58
|
| Rate for Payer: UHC Exchange |
$93.25
|
| Rate for Payer: UHC Medicaid |
$28.54
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
| Rate for Payer: UMR Bronson Commercial |
$69.46
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
20610
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$52.88
|
| Rate for Payer: Aetna Medicare |
$41.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.82
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$39.46
|
| Rate for Payer: BCN Commercial |
$53.41
|
| Rate for Payer: BCN Medicare Advantage |
$39.46
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$56.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.43
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.41
|
| Rate for Payer: Nomi Health Commercial |
$47.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$39.46
|
| Rate for Payer: PHP Commercial |
$55.24
|
| Rate for Payer: PHP Medicare Advantage |
$39.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.39
|
| Rate for Payer: Priority Health Medicare |
$39.46
|
| Rate for Payer: Priority Health SBD |
$72.39
|
| Rate for Payer: Priority Health Tiered Network |
$72.39
|
| Rate for Payer: Railroad Medicare Medicare |
$39.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.70
|
| Rate for Payer: UHC Core |
$80.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.46
|
| Rate for Payer: UHC Exchange |
$80.70
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
| Rate for Payer: UMR Bronson Commercial |
$87.40
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna American Axle |
$123.50
|
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.50
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Advantage |
$133.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: Priority Health SBD |
$119.70
|
| Rate for Payer: UMR Bronson Commercial |
$83.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.30 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$123.50
|
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Advantage |
$133.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$119.70
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$70.30
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 20610
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$52.88
|
| Rate for Payer: Aetna Medicare |
$41.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.82
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$39.46
|
| Rate for Payer: BCN Commercial |
$53.41
|
| Rate for Payer: BCN Medicare Advantage |
$39.46
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$56.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.43
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.41
|
| Rate for Payer: Nomi Health Commercial |
$47.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$39.46
|
| Rate for Payer: PHP Commercial |
$55.24
|
| Rate for Payer: PHP Medicare Advantage |
$39.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.39
|
| Rate for Payer: Priority Health Medicare |
$39.46
|
| Rate for Payer: Priority Health SBD |
$72.39
|
| Rate for Payer: Priority Health Tiered Network |
$72.39
|
| Rate for Payer: Railroad Medicare Medicare |
$39.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.70
|
| Rate for Payer: UHC Core |
$80.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.46
|
| Rate for Payer: UHC Exchange |
$80.70
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
| Rate for Payer: UMR Bronson Commercial |
$87.40
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$130.00
|
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Advantage |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$126.00
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$74.00
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna American Axle |
$130.00
|
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Advantage |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: Priority Health SBD |
$126.00
|
| Rate for Payer: UMR Bronson Commercial |
$88.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$66.81
|
| Rate for Payer: Aetna Medicare |
$51.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.80
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$49.86
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$49.86
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$66.81
|
| Rate for Payer: Cofinity Commercial |
$71.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.35
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.85
|
| Rate for Payer: Nomi Health Commercial |
$59.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$49.86
|
| Rate for Payer: PHP Commercial |
$69.80
|
| Rate for Payer: PHP Medicare Advantage |
$49.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.22
|
| Rate for Payer: Priority Health Medicare |
$49.86
|
| Rate for Payer: Priority Health SBD |
$94.22
|
| Rate for Payer: Priority Health Tiered Network |
$94.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.97
|
| Rate for Payer: UHC Core |
$105.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.86
|
| Rate for Payer: UHC Exchange |
$105.97
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
| Rate for Payer: UMR Bronson Commercial |
$92.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$66.81
|
| Rate for Payer: Aetna Medicare |
$51.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.80
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$49.86
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$49.86
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$66.81
|
| Rate for Payer: Cofinity Commercial |
$71.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.35
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.85
|
| Rate for Payer: Nomi Health Commercial |
$59.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$49.86
|
| Rate for Payer: PHP Commercial |
$69.80
|
| Rate for Payer: PHP Medicare Advantage |
$49.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.22
|
| Rate for Payer: Priority Health Medicare |
$49.86
|
| Rate for Payer: Priority Health SBD |
$94.22
|
| Rate for Payer: Priority Health Tiered Network |
$94.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.97
|
| Rate for Payer: UHC Core |
$105.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.86
|
| Rate for Payer: UHC Exchange |
$105.97
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
| Rate for Payer: UMR Bronson Commercial |
$92.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 20600
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare |
$32.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.78
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$31.10
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$31.10
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$41.67
|
| Rate for Payer: Cofinity Commercial |
$44.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.66
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.21
|
| Rate for Payer: Nomi Health Commercial |
$37.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.75
|
| Rate for Payer: PACE SWMI |
$31.10
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: PHP Medicare Advantage |
$31.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56.96
|
| Rate for Payer: Priority Health Medicare |
$31.10
|
| Rate for Payer: Priority Health SBD |
$56.96
|
| Rate for Payer: Priority Health Tiered Network |
$56.96
|
| Rate for Payer: Railroad Medicare Medicare |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.75
|
| Rate for Payer: UHC Core |
$63.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.10
|
| Rate for Payer: UHC Exchange |
$63.75
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
| Rate for Payer: UMR Bronson Commercial |
$61.18
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$53.08
|
| Rate for Payer: Aetna Medicare |
$41.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.04
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCN Commercial |
$54.59
|
| Rate for Payer: BCN Medicare Advantage |
$39.61
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.59
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.57
|
| Rate for Payer: Nomi Health Commercial |
$47.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$39.61
|
| Rate for Payer: PHP Commercial |
$55.45
|
| Rate for Payer: PHP Medicare Advantage |
$39.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.99
|
| Rate for Payer: Priority Health Medicare |
$39.61
|
| Rate for Payer: Priority Health SBD |
$73.99
|
| Rate for Payer: Priority Health Tiered Network |
$73.99
|
| Rate for Payer: Railroad Medicare Medicare |
$39.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.07
|
| Rate for Payer: UHC Core |
$81.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.61
|
| Rate for Payer: UHC Exchange |
$81.07
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
| Rate for Payer: UMR Bronson Commercial |
$57.96
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,442.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$3,331.50 |
| Rate for Payer: Aetna Commercial |
$1,219.68
|
| Rate for Payer: Aetna Medicare |
$946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.70
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCBS MAPPO |
$910.21
|
| Rate for Payer: BCN Commercial |
$1,524.82
|
| Rate for Payer: BCN Medicare Advantage |
$910.21
|
| Rate for Payer: Cash Price |
$3,553.60
|
| Rate for Payer: Cash Price |
$3,553.60
|
| Rate for Payer: Cofinity Commercial |
$1,219.68
|
| Rate for Payer: Cofinity Commercial |
$1,310.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.72
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.23
|
| Rate for Payer: Nomi Health Commercial |
$1,092.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,331.50
|
| Rate for Payer: PACE SWMI |
$910.21
|
| Rate for Payer: PHP Commercial |
$1,274.29
|
| Rate for Payer: PHP Medicare Advantage |
$910.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,629.99
|
| Rate for Payer: Priority Health Medicare |
$910.21
|
| Rate for Payer: Priority Health SBD |
$1,629.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,629.99
|
| Rate for Payer: Railroad Medicare Medicare |
$910.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,791.92
|
| Rate for Payer: UHC Core |
$1,791.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$910.21
|
| Rate for Payer: UHC Exchange |
$1,791.92
|
| Rate for Payer: UHC Medicaid |
$591.71
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
| Rate for Payer: UMR Bronson Commercial |
$2,043.32
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,530.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$1,118.89 |
| Max. Negotiated Rate |
$4,147.50 |
| Rate for Payer: Aetna Commercial |
$2,333.06
|
| Rate for Payer: Aetna Medicare |
$1,810.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,333.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,507.17
|
| Rate for Payer: BCBS Complete |
$1,174.83
|
| Rate for Payer: BCBS MAPPO |
$1,741.09
|
| Rate for Payer: BCN Commercial |
$3,019.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,741.09
|
| Rate for Payer: Cash Price |
$4,424.00
|
| Rate for Payer: Cash Price |
$4,424.00
|
| Rate for Payer: Cofinity Commercial |
$2,333.06
|
| Rate for Payer: Cofinity Commercial |
$2,507.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,741.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,828.14
|
| Rate for Payer: Meridian Medicaid |
$1,174.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,915.20
|
| Rate for Payer: Nomi Health Commercial |
$2,089.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,147.50
|
| Rate for Payer: PACE SWMI |
$1,741.09
|
| Rate for Payer: PHP Commercial |
$2,437.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,741.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,118.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,938.45
|
| Rate for Payer: Priority Health Medicare |
$1,741.09
|
| Rate for Payer: Priority Health SBD |
$2,938.45
|
| Rate for Payer: Priority Health Tiered Network |
$2,938.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,741.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,239.83
|
| Rate for Payer: UHC Core |
$3,239.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,741.09
|
| Rate for Payer: UHC Exchange |
$3,239.83
|
| Rate for Payer: UHC Medicaid |
$1,118.89
|
| Rate for Payer: UHCCP Medicaid |
$1,118.89
|
| Rate for Payer: UMR Bronson Commercial |
$2,543.80
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,663.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$1,145.30 |
| Max. Negotiated Rate |
$4,997.25 |
| Rate for Payer: Aetna Commercial |
$2,380.12
|
| Rate for Payer: Aetna Medicare |
$1,847.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,380.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,557.74
|
| Rate for Payer: BCBS Complete |
$1,202.57
|
| Rate for Payer: BCBS MAPPO |
$1,776.21
|
| Rate for Payer: BCN Commercial |
$3,021.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,776.21
|
| Rate for Payer: Cash Price |
$5,330.40
|
| Rate for Payer: Cash Price |
$5,330.40
|
| Rate for Payer: Cofinity Commercial |
$2,380.12
|
| Rate for Payer: Cofinity Commercial |
$2,557.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,776.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,865.02
|
| Rate for Payer: Meridian Medicaid |
$1,202.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,953.83
|
| Rate for Payer: Nomi Health Commercial |
$2,131.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,997.25
|
| Rate for Payer: PACE SWMI |
$1,776.21
|
| Rate for Payer: PHP Commercial |
$2,486.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,776.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,145.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,230.17
|
| Rate for Payer: Priority Health Medicare |
$1,776.21
|
| Rate for Payer: Priority Health SBD |
$3,230.17
|
| Rate for Payer: Priority Health Tiered Network |
$3,230.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,776.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,632.16
|
| Rate for Payer: UHC Core |
$3,632.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,776.21
|
| Rate for Payer: UHC Exchange |
$3,632.16
|
| Rate for Payer: UHC Medicaid |
$1,145.30
|
| Rate for Payer: UHCCP Medicaid |
$1,145.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,064.98
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM
|
Professional
|
Both
|
$7,729.00
|
|
|
Service Code
|
HCPCS 22812
|
| Min. Negotiated Rate |
$1,256.91 |
| Max. Negotiated Rate |
$5,796.75 |
| Rate for Payer: Aetna Commercial |
$2,610.20
|
| Rate for Payer: Aetna Medicare |
$2,025.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,804.99
|
| Rate for Payer: BCBS Complete |
$1,319.76
|
| Rate for Payer: BCBS MAPPO |
$1,947.91
|
| Rate for Payer: BCN Commercial |
$3,311.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,947.91
|
| Rate for Payer: Cash Price |
$6,183.20
|
| Rate for Payer: Cash Price |
$6,183.20
|
| Rate for Payer: Cofinity Commercial |
$2,610.20
|
| Rate for Payer: Cofinity Commercial |
$2,804.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,947.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,045.31
|
| Rate for Payer: Meridian Medicaid |
$1,319.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,142.70
|
| Rate for Payer: Nomi Health Commercial |
$2,337.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,796.75
|
| Rate for Payer: PACE SWMI |
$1,947.91
|
| Rate for Payer: PHP Commercial |
$2,727.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,947.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,256.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,539.98
|
| Rate for Payer: Priority Health Medicare |
$1,947.91
|
| Rate for Payer: Priority Health SBD |
$3,539.98
|
| Rate for Payer: Priority Health Tiered Network |
$3,539.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,947.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,890.85
|
| Rate for Payer: UHC Core |
$3,890.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,947.91
|
| Rate for Payer: UHC Exchange |
$3,890.85
|
| Rate for Payer: UHC Medicaid |
$1,256.91
|
| Rate for Payer: UHCCP Medicaid |
$1,256.91
|
| Rate for Payer: UMR Bronson Commercial |
$3,555.34
|
|
|
PR ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL
|
Professional
|
Both
|
$2,036.00
|
|
|
Service Code
|
HCPCS 22634
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$1,527.00 |
| Rate for Payer: Aetna Commercial |
$584.33
|
| Rate for Payer: Aetna Medicare |
$453.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.94
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCBS MAPPO |
$436.07
|
| Rate for Payer: BCN Commercial |
$725.06
|
| Rate for Payer: BCN Medicare Advantage |
$436.07
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Cofinity Commercial |
$584.33
|
| Rate for Payer: Cofinity Commercial |
$627.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.87
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$479.68
|
| Rate for Payer: Nomi Health Commercial |
$523.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.00
|
| Rate for Payer: PACE SWMI |
$436.07
|
| Rate for Payer: PHP Commercial |
$610.50
|
| Rate for Payer: PHP Medicare Advantage |
$436.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$775.08
|
| Rate for Payer: Priority Health Medicare |
$436.07
|
| Rate for Payer: Priority Health SBD |
$775.08
|
| Rate for Payer: Priority Health Tiered Network |
$775.08
|
| Rate for Payer: Railroad Medicare Medicare |
$436.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.92
|
| Rate for Payer: UHC Core |
$883.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.07
|
| Rate for Payer: UHC Exchange |
$883.92
|
| Rate for Payer: UHC Medicaid |
$275.84
|
| Rate for Payer: UHCCP Medicaid |
$275.84
|
| Rate for Payer: UMR Bronson Commercial |
$936.56
|
|
|
PR ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,979.00
|
|
|
Service Code
|
HCPCS 22633
|
| Min. Negotiated Rate |
$1,084.17 |
| Max. Negotiated Rate |
$3,273.58 |
| Rate for Payer: Aetna Commercial |
$2,263.47
|
| Rate for Payer: Aetna Medicare |
$1,756.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,263.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,432.39
|
| Rate for Payer: BCBS Complete |
$1,138.38
|
| Rate for Payer: BCBS MAPPO |
$1,689.16
|
| Rate for Payer: BCN Commercial |
$2,741.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.16
|
| Rate for Payer: Cash Price |
$3,183.20
|
| Rate for Payer: Cash Price |
$3,183.20
|
| Rate for Payer: Cofinity Commercial |
$2,263.47
|
| Rate for Payer: Cofinity Commercial |
$2,432.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,773.62
|
| Rate for Payer: Meridian Medicaid |
$1,138.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,858.08
|
| Rate for Payer: Nomi Health Commercial |
$2,026.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,984.25
|
| Rate for Payer: PACE SWMI |
$1,689.16
|
| Rate for Payer: PHP Commercial |
$2,364.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,084.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,931.00
|
| Rate for Payer: Priority Health Medicare |
$1,689.16
|
| Rate for Payer: Priority Health SBD |
$2,931.00
|
| Rate for Payer: Priority Health Tiered Network |
$2,931.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,689.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,273.58
|
| Rate for Payer: UHC Core |
$3,273.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,689.16
|
| Rate for Payer: UHC Exchange |
$3,273.58
|
| Rate for Payer: UHC Medicaid |
$1,084.17
|
| Rate for Payer: UHCCP Medicaid |
$1,084.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,830.34
|
|
