|
PR ARTHRODESIS ELBOW JOINT LOCAL
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 24800
|
| Min. Negotiated Rate |
$497.99 |
| Max. Negotiated Rate |
$1,451.19 |
| Rate for Payer: Aetna Commercial |
$1,021.60
|
| Rate for Payer: Aetna Medicare |
$792.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.84
|
| Rate for Payer: BCBS Complete |
$522.89
|
| Rate for Payer: BCBS MAPPO |
$762.39
|
| Rate for Payer: BCN Commercial |
$1,272.34
|
| Rate for Payer: BCN Medicare Advantage |
$762.39
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$1,021.60
|
| Rate for Payer: Cofinity Commercial |
$1,097.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$800.51
|
| Rate for Payer: Meridian Medicaid |
$522.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$838.63
|
| Rate for Payer: Nomi Health Commercial |
$914.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$762.39
|
| Rate for Payer: PHP Commercial |
$1,067.35
|
| Rate for Payer: PHP Medicare Advantage |
$762.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,360.09
|
| Rate for Payer: Priority Health Medicare |
$762.39
|
| Rate for Payer: Priority Health SBD |
$1,360.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,360.09
|
| Rate for Payer: Railroad Medicare Medicare |
$762.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,451.19
|
| Rate for Payer: UHC Core |
$1,451.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$762.39
|
| Rate for Payer: UHC Exchange |
$1,451.19
|
| Rate for Payer: UHC Medicaid |
$497.99
|
| Rate for Payer: UHCCP Medicaid |
$497.99
|
| Rate for Payer: UMR Bronson Commercial |
$795.80
|
|
|
PR ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT
|
Professional
|
Both
|
$4,918.00
|
|
|
Service Code
|
HCPCS 24802
|
| Min. Negotiated Rate |
$590.86 |
| Max. Negotiated Rate |
$3,688.50 |
| Rate for Payer: Aetna Commercial |
$1,216.72
|
| Rate for Payer: Aetna Medicare |
$944.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,216.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,307.52
|
| Rate for Payer: BCBS Complete |
$620.40
|
| Rate for Payer: BCBS MAPPO |
$908.00
|
| Rate for Payer: BCN Commercial |
$1,523.83
|
| Rate for Payer: BCN Medicare Advantage |
$908.00
|
| Rate for Payer: Cash Price |
$3,934.40
|
| Rate for Payer: Cash Price |
$3,934.40
|
| Rate for Payer: Cofinity Commercial |
$1,216.72
|
| Rate for Payer: Cofinity Commercial |
$1,307.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$908.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$953.40
|
| Rate for Payer: Meridian Medicaid |
$620.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$998.80
|
| Rate for Payer: Nomi Health Commercial |
$1,089.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,688.50
|
| Rate for Payer: PACE SWMI |
$908.00
|
| Rate for Payer: PHP Commercial |
$1,271.20
|
| Rate for Payer: PHP Medicare Advantage |
$908.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,628.92
|
| Rate for Payer: Priority Health Medicare |
$908.00
|
| Rate for Payer: Priority Health SBD |
$1,628.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,628.92
|
| Rate for Payer: Railroad Medicare Medicare |
$908.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,754.82
|
| Rate for Payer: UHC Core |
$1,754.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$908.00
|
| Rate for Payer: UHC Exchange |
$1,754.82
|
| Rate for Payer: UHC Medicaid |
$590.86
|
| Rate for Payer: UHCCP Medicaid |
$590.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,262.28
|
|
|
PR ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,442.00
|
|
|
Service Code
|
HCPCS 28755
|
| Min. Negotiated Rate |
$297.99 |
| Max. Negotiated Rate |
$1,081.50 |
| Rate for Payer: Aetna Commercial |
$608.94
|
| Rate for Payer: Aetna Medicare |
$472.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.38
|
| Rate for Payer: BCBS Complete |
$312.89
|
| Rate for Payer: BCBS MAPPO |
$454.43
|
| Rate for Payer: BCN Commercial |
$512.43
|
| Rate for Payer: BCN Medicare Advantage |
$454.43
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cofinity Commercial |
$608.94
|
| Rate for Payer: Cofinity Commercial |
$654.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.15
|
| Rate for Payer: Meridian Medicaid |
$312.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$499.87
|
| Rate for Payer: Nomi Health Commercial |
$545.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,081.50
|
| Rate for Payer: PACE SWMI |
$454.43
|
| Rate for Payer: PHP Commercial |
$636.20
|
| Rate for Payer: PHP Medicare Advantage |
$454.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$547.77
|
| Rate for Payer: Priority Health Medicare |
$454.43
|
| Rate for Payer: Priority Health SBD |
$547.77
|
| Rate for Payer: Priority Health Tiered Network |
$547.77
|
| Rate for Payer: Railroad Medicare Medicare |
$454.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.35
|
| Rate for Payer: UHC Core |
$579.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$454.43
|
| Rate for Payer: UHC Exchange |
$579.35
|
| Rate for Payer: UHC Medicaid |
$297.99
|
| Rate for Payer: UHCCP Medicaid |
$297.99
|
| Rate for Payer: UMR Bronson Commercial |
$663.32
|
|
|
PR ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$2,034.00
|
|
|
Service Code
|
HCPCS 28750
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$1,525.50 |
| Rate for Payer: Aetna Commercial |
$700.79
|
| Rate for Payer: Aetna Medicare |
$543.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.09
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$522.98
|
| Rate for Payer: BCN Commercial |
$871.47
|
| Rate for Payer: BCN Medicare Advantage |
$522.98
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cofinity Commercial |
$700.79
|
| Rate for Payer: Cofinity Commercial |
$753.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$549.13
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$575.28
|
| Rate for Payer: Nomi Health Commercial |
$627.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,525.50
|
| Rate for Payer: PACE SWMI |
$522.98
|
| Rate for Payer: PHP Commercial |
$732.17
|
| Rate for Payer: PHP Medicare Advantage |
$522.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$931.57
|
| Rate for Payer: Priority Health Medicare |
$522.98
|
| Rate for Payer: Priority Health SBD |
$931.57
|
| Rate for Payer: Priority Health Tiered Network |
$931.57
|
| Rate for Payer: Railroad Medicare Medicare |
$522.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.69
|
| Rate for Payer: UHC Core |
$1,017.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$522.98
|
| Rate for Payer: UHC Exchange |
$1,017.69
|
| Rate for Payer: UHC Medicaid |
$342.08
|
| Rate for Payer: UHCCP Medicaid |
$342.08
|
| Rate for Payer: UMR Bronson Commercial |
$935.64
|
|
|
PR ARTHRODESIS HIP JOINT W/OBTAINING GRAFT
|
Professional
|
Both
|
$4,900.00
|
|
|
Service Code
|
HCPCS 27284
|
| Min. Negotiated Rate |
$915.90 |
| Max. Negotiated Rate |
$3,675.00 |
| Rate for Payer: Aetna Commercial |
$1,902.42
|
| Rate for Payer: Aetna Medicare |
$1,476.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,902.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.40
|
| Rate for Payer: BCBS Complete |
$961.70
|
| Rate for Payer: BCBS MAPPO |
$1,419.72
|
| Rate for Payer: BCN Commercial |
$2,413.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,419.72
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cofinity Commercial |
$1,902.42
|
| Rate for Payer: Cofinity Commercial |
$2,044.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,419.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,490.71
|
| Rate for Payer: Meridian Medicaid |
$961.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,561.69
|
| Rate for Payer: Nomi Health Commercial |
$1,703.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,675.00
|
| Rate for Payer: PACE SWMI |
$1,419.72
|
| Rate for Payer: PHP Commercial |
$1,987.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,419.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$915.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,580.18
|
| Rate for Payer: Priority Health Medicare |
$1,419.72
|
| Rate for Payer: Priority Health SBD |
$2,580.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,580.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,419.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,838.64
|
| Rate for Payer: UHC Core |
$2,838.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,419.72
|
| Rate for Payer: UHC Exchange |
$2,838.64
|
| Rate for Payer: UHC Medicaid |
$915.90
|
| Rate for Payer: UHCCP Medicaid |
$915.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,254.00
|
|
|
PR ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,124.00
|
|
|
Service Code
|
HCPCS 26860
|
| Min. Negotiated Rate |
$386.81 |
| Max. Negotiated Rate |
$1,593.00 |
| Rate for Payer: Aetna Commercial |
$769.41
|
| Rate for Payer: Aetna Medicare |
$597.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.83
|
| Rate for Payer: BCBS Complete |
$406.15
|
| Rate for Payer: BCBS MAPPO |
$574.19
|
| Rate for Payer: BCN Commercial |
$924.26
|
| Rate for Payer: BCN Medicare Advantage |
$574.19
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cofinity Commercial |
$769.41
|
| Rate for Payer: Cofinity Commercial |
$826.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.90
|
| Rate for Payer: Meridian Medicaid |
$406.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$631.61
|
| Rate for Payer: Nomi Health Commercial |
$689.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.00
|
| Rate for Payer: PACE SWMI |
$574.19
|
| Rate for Payer: PHP Commercial |
$803.87
|
| Rate for Payer: PHP Medicare Advantage |
$574.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$988.00
|
| Rate for Payer: Priority Health Medicare |
$574.19
|
| Rate for Payer: Priority Health SBD |
$988.00
|
| Rate for Payer: Priority Health Tiered Network |
$988.00
|
| Rate for Payer: Railroad Medicare Medicare |
$574.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$986.74
|
| Rate for Payer: UHC Core |
$986.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$574.19
|
| Rate for Payer: UHC Exchange |
$986.74
|
| Rate for Payer: UHC Medicaid |
$386.81
|
| Rate for Payer: UHCCP Medicaid |
$386.81
|
| Rate for Payer: UMR Bronson Commercial |
$977.04
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 26861
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$116.15
|
| Rate for Payer: Aetna Medicare |
$90.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.82
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$86.68
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: BCN Medicare Advantage |
$86.68
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Cofinity Commercial |
$124.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.01
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.35
|
| Rate for Payer: Nomi Health Commercial |
$104.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$86.68
|
| Rate for Payer: PHP Commercial |
$121.35
|
| Rate for Payer: PHP Medicare Advantage |
$86.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$162.37
|
| Rate for Payer: Priority Health Medicare |
$86.68
|
| Rate for Payer: Priority Health SBD |
$162.37
|
| Rate for Payer: Priority Health Tiered Network |
$162.37
|
| Rate for Payer: Railroad Medicare Medicare |
$86.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.14
|
| Rate for Payer: UHC Core |
$182.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.68
|
| Rate for Payer: UHC Exchange |
$182.14
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
| Rate for Payer: UMR Bronson Commercial |
$488.52
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 26863
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$405.25 |
| Rate for Payer: Aetna Commercial |
$256.07
|
| Rate for Payer: Aetna Medicare |
$198.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.18
|
| Rate for Payer: BCBS Complete |
$128.37
|
| Rate for Payer: BCBS MAPPO |
$191.10
|
| Rate for Payer: BCN Commercial |
$338.13
|
| Rate for Payer: BCN Medicare Advantage |
$191.10
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cofinity Commercial |
$256.07
|
| Rate for Payer: Cofinity Commercial |
$275.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.66
|
| Rate for Payer: Meridian Medicaid |
$128.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$210.21
|
| Rate for Payer: Nomi Health Commercial |
$229.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.50
|
| Rate for Payer: PACE SWMI |
$191.10
|
| Rate for Payer: PHP Commercial |
$267.54
|
| Rate for Payer: PHP Medicare Advantage |
$191.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$361.45
|
| Rate for Payer: Priority Health Medicare |
$191.10
|
| Rate for Payer: Priority Health SBD |
$361.45
|
| Rate for Payer: Priority Health Tiered Network |
$361.45
|
| Rate for Payer: Railroad Medicare Medicare |
$191.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.25
|
| Rate for Payer: UHC Core |
$405.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$191.10
|
| Rate for Payer: UHC Exchange |
$405.25
|
| Rate for Payer: UHC Medicaid |
$122.26
|
| Rate for Payer: UHCCP Medicaid |
$122.26
|
| Rate for Payer: UMR Bronson Commercial |
$199.64
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,690.00
|
|
|
Service Code
|
HCPCS 26862
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$2,017.50 |
| Rate for Payer: Aetna Commercial |
$944.39
|
| Rate for Payer: Aetna Medicare |
$732.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.39
|
| Rate for Payer: BCBS Complete |
$493.81
|
| Rate for Payer: BCBS MAPPO |
$704.77
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: BCN Medicare Advantage |
$704.77
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.87
|
| Rate for Payer: Cofinity Commercial |
$944.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.01
|
| Rate for Payer: Meridian Medicaid |
$493.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$775.25
|
| Rate for Payer: Nomi Health Commercial |
$845.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,017.50
|
| Rate for Payer: PACE SWMI |
$704.77
|
| Rate for Payer: PHP Commercial |
$986.68
|
| Rate for Payer: PHP Medicare Advantage |
$704.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,238.19
|
| Rate for Payer: Priority Health Medicare |
$704.77
|
| Rate for Payer: Priority Health SBD |
$1,238.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,238.19
|
| Rate for Payer: Railroad Medicare Medicare |
$704.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.86
|
| Rate for Payer: UHC Core |
$1,264.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$704.77
|
| Rate for Payer: UHC Exchange |
$1,264.86
|
| Rate for Payer: UHC Medicaid |
$470.30
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,237.40
|
|
|
PR ARTHRODESIS KNEE ANY TECHNIQUE
|
Professional
|
Both
|
$3,319.00
|
|
|
Service Code
|
HCPCS 27580
|
| Min. Negotiated Rate |
$863.93 |
| Max. Negotiated Rate |
$2,557.99 |
| Rate for Payer: Aetna Commercial |
$1,779.67
|
| Rate for Payer: Aetna Medicare |
$1,381.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,779.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,912.48
|
| Rate for Payer: BCBS Complete |
$907.13
|
| Rate for Payer: BCBS MAPPO |
$1,328.11
|
| Rate for Payer: BCN Commercial |
$2,224.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,328.11
|
| Rate for Payer: Cash Price |
$2,655.20
|
| Rate for Payer: Cash Price |
$2,655.20
|
| Rate for Payer: Cofinity Commercial |
$1,779.67
|
| Rate for Payer: Cofinity Commercial |
$1,912.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,328.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,394.52
|
| Rate for Payer: Meridian Medicaid |
$907.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,460.92
|
| Rate for Payer: Nomi Health Commercial |
$1,593.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,489.25
|
| Rate for Payer: PACE SWMI |
$1,328.11
|
| Rate for Payer: PHP Commercial |
$1,859.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,328.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$863.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,377.91
|
| Rate for Payer: Priority Health Medicare |
$1,328.11
|
| Rate for Payer: Priority Health SBD |
$2,377.91
|
| Rate for Payer: Priority Health Tiered Network |
$2,377.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,328.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,557.99
|
| Rate for Payer: UHC Core |
$2,557.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,328.11
|
| Rate for Payer: UHC Exchange |
$2,557.99
|
| Rate for Payer: UHC Medicaid |
$863.93
|
| Rate for Payer: UHCCP Medicaid |
$863.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,526.74
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR
|
Professional
|
Both
|
$6,236.00
|
|
|
Service Code
|
HCPCS 22533
|
| Min. Negotiated Rate |
$987.04 |
| Max. Negotiated Rate |
$4,677.00 |
| Rate for Payer: Aetna Commercial |
$2,052.10
|
| Rate for Payer: Aetna Medicare |
$1,592.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,052.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,205.24
|
| Rate for Payer: BCBS Complete |
$1,036.39
|
| Rate for Payer: BCBS MAPPO |
$1,531.42
|
| Rate for Payer: BCN Commercial |
$2,515.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,531.42
|
| Rate for Payer: Cash Price |
$4,988.80
|
| Rate for Payer: Cash Price |
$4,988.80
|
| Rate for Payer: Cofinity Commercial |
$2,052.10
|
| Rate for Payer: Cofinity Commercial |
$2,205.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,531.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,607.99
|
| Rate for Payer: Meridian Medicaid |
$1,036.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,684.56
|
| Rate for Payer: Nomi Health Commercial |
$1,837.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,677.00
|
| Rate for Payer: PACE SWMI |
$1,531.42
|
| Rate for Payer: PHP Commercial |
$2,143.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,531.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$987.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,689.33
|
| Rate for Payer: Priority Health Medicare |
$1,531.42
|
| Rate for Payer: Priority Health SBD |
$2,689.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,689.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,531.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,923.79
|
| Rate for Payer: UHC Core |
$2,923.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,531.42
|
| Rate for Payer: UHC Exchange |
$2,923.79
|
| Rate for Payer: UHC Medicaid |
$987.04
|
| Rate for Payer: UHCCP Medicaid |
$987.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,868.56
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY THORACIC
|
Professional
|
Both
|
$6,230.00
|
|
|
Service Code
|
HCPCS 22532
|
| Min. Negotiated Rate |
$1,104.62 |
| Max. Negotiated Rate |
$4,672.50 |
| Rate for Payer: Aetna Commercial |
$2,302.43
|
| Rate for Payer: Aetna Medicare |
$1,786.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,302.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,474.25
|
| Rate for Payer: BCBS Complete |
$1,159.85
|
| Rate for Payer: BCBS MAPPO |
$1,718.23
|
| Rate for Payer: BCN Commercial |
$2,715.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,718.23
|
| Rate for Payer: Cash Price |
$4,984.00
|
| Rate for Payer: Cash Price |
$4,984.00
|
| Rate for Payer: Cofinity Commercial |
$2,302.43
|
| Rate for Payer: Cofinity Commercial |
$2,474.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,718.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,804.14
|
| Rate for Payer: Meridian Medicaid |
$1,159.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,890.05
|
| Rate for Payer: Nomi Health Commercial |
$2,061.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,672.50
|
| Rate for Payer: PACE SWMI |
$1,718.23
|
| Rate for Payer: PHP Commercial |
$2,405.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,718.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,104.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,903.32
|
| Rate for Payer: Priority Health Medicare |
$1,718.23
|
| Rate for Payer: Priority Health SBD |
$2,903.32
|
| Rate for Payer: Priority Health Tiered Network |
$2,903.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,718.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,174.39
|
| Rate for Payer: UHC Core |
$3,174.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,718.23
|
| Rate for Payer: UHC Exchange |
$3,174.39
|
| Rate for Payer: UHC Medicaid |
$1,104.62
|
| Rate for Payer: UHCCP Medicaid |
$1,104.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,865.80
|
|
|
PR ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 22534
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$2,325.00 |
| Rate for Payer: Aetna Commercial |
$437.18
|
| Rate for Payer: Aetna Medicare |
$339.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.80
|
| Rate for Payer: BCBS Complete |
$216.72
|
| Rate for Payer: BCBS MAPPO |
$326.25
|
| Rate for Payer: BCN Commercial |
$539.81
|
| Rate for Payer: BCN Medicare Advantage |
$326.25
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cofinity Commercial |
$437.18
|
| Rate for Payer: Cofinity Commercial |
$469.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.56
|
| Rate for Payer: Meridian Medicaid |
$216.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$358.88
|
| Rate for Payer: Nomi Health Commercial |
$391.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.00
|
| Rate for Payer: PACE SWMI |
$326.25
|
| Rate for Payer: PHP Commercial |
$456.75
|
| Rate for Payer: PHP Medicare Advantage |
$326.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$577.05
|
| Rate for Payer: Priority Health Medicare |
$326.25
|
| Rate for Payer: Priority Health SBD |
$577.05
|
| Rate for Payer: Priority Health Tiered Network |
$577.05
|
| Rate for Payer: Railroad Medicare Medicare |
$326.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.63
|
| Rate for Payer: UHC Core |
$642.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.25
|
| Rate for Payer: UHC Exchange |
$642.63
|
| Rate for Payer: UHC Medicaid |
$206.40
|
| Rate for Payer: UHCCP Medicaid |
$206.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.00
|
|
|
PR ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,379.00
|
|
|
Service Code
|
HCPCS 26850
|
| Min. Negotiated Rate |
$450.50 |
| Max. Negotiated Rate |
$1,784.25 |
| Rate for Payer: Aetna Commercial |
$904.12
|
| Rate for Payer: Aetna Medicare |
$701.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.60
|
| Rate for Payer: BCBS Complete |
$473.02
|
| Rate for Payer: BCBS MAPPO |
$674.72
|
| Rate for Payer: BCN Commercial |
$1,110.00
|
| Rate for Payer: BCN Medicare Advantage |
$674.72
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cofinity Commercial |
$904.12
|
| Rate for Payer: Cofinity Commercial |
$971.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.46
|
| Rate for Payer: Meridian Medicaid |
$473.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$742.19
|
| Rate for Payer: Nomi Health Commercial |
$809.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.25
|
| Rate for Payer: PACE SWMI |
$674.72
|
| Rate for Payer: PHP Commercial |
$944.61
|
| Rate for Payer: PHP Medicare Advantage |
$674.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,186.55
|
| Rate for Payer: Priority Health Medicare |
$674.72
|
| Rate for Payer: Priority Health SBD |
$1,186.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,186.55
|
| Rate for Payer: Railroad Medicare Medicare |
$674.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,210.07
|
| Rate for Payer: UHC Core |
$1,210.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$674.72
|
| Rate for Payer: UHC Exchange |
$1,210.07
|
| Rate for Payer: UHC Medicaid |
$450.50
|
| Rate for Payer: UHCCP Medicaid |
$450.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,094.34
|
|
|
PR ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT
|
Professional
|
Both
|
$2,219.00
|
|
|
Service Code
|
HCPCS 28740
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$1,664.25 |
| Rate for Payer: Aetna Commercial |
$754.27
|
| Rate for Payer: Aetna Medicare |
$585.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.56
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS MAPPO |
$562.89
|
| Rate for Payer: BCN Commercial |
$933.21
|
| Rate for Payer: BCN Medicare Advantage |
$562.89
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cofinity Commercial |
$754.27
|
| Rate for Payer: Cofinity Commercial |
$810.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.03
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$619.18
|
| Rate for Payer: Nomi Health Commercial |
$675.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.25
|
| Rate for Payer: PACE SWMI |
$562.89
|
| Rate for Payer: PHP Commercial |
$788.05
|
| Rate for Payer: PHP Medicare Advantage |
$562.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$997.58
|
| Rate for Payer: Priority Health Medicare |
$562.89
|
| Rate for Payer: Priority Health SBD |
$997.58
|
| Rate for Payer: Priority Health Tiered Network |
$997.58
|
| Rate for Payer: Railroad Medicare Medicare |
$562.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.68
|
| Rate for Payer: UHC Core |
$1,084.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$562.89
|
| Rate for Payer: UHC Exchange |
$1,084.68
|
| Rate for Payer: UHC Medicaid |
$368.28
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,020.74
|
|
|
PR ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 26852
|
| Min. Negotiated Rate |
$507.15 |
| Max. Negotiated Rate |
$2,209.50 |
| Rate for Payer: Aetna Commercial |
$1,021.58
|
| Rate for Payer: Aetna Medicare |
$792.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.81
|
| Rate for Payer: BCBS Complete |
$532.51
|
| Rate for Payer: BCBS MAPPO |
$762.37
|
| Rate for Payer: BCN Commercial |
$1,261.89
|
| Rate for Payer: BCN Medicare Advantage |
$762.37
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,021.58
|
| Rate for Payer: Cofinity Commercial |
$1,097.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$800.49
|
| Rate for Payer: Meridian Medicaid |
$532.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$838.61
|
| Rate for Payer: Nomi Health Commercial |
$914.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,209.50
|
| Rate for Payer: PACE SWMI |
$762.37
|
| Rate for Payer: PHP Commercial |
$1,067.32
|
| Rate for Payer: PHP Medicare Advantage |
$762.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,348.92
|
| Rate for Payer: Priority Health Medicare |
$762.37
|
| Rate for Payer: Priority Health SBD |
$1,348.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,348.92
|
| Rate for Payer: Railroad Medicare Medicare |
$762.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,388.28
|
| Rate for Payer: UHC Core |
$1,388.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$762.37
|
| Rate for Payer: UHC Exchange |
$1,388.28
|
| Rate for Payer: UHC Medicaid |
$507.15
|
| Rate for Payer: UHCCP Medicaid |
$507.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,355.16
|
|
|
PR ARTHRODESIS PANTALAR
|
Professional
|
Both
|
$4,056.00
|
|
|
Service Code
|
HCPCS 28705
|
| Min. Negotiated Rate |
$705.67 |
| Max. Negotiated Rate |
$3,042.00 |
| Rate for Payer: Aetna Commercial |
$1,461.04
|
| Rate for Payer: Aetna Medicare |
$1,133.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,570.08
|
| Rate for Payer: BCBS Complete |
$740.95
|
| Rate for Payer: BCBS MAPPO |
$1,090.33
|
| Rate for Payer: BCN Commercial |
$1,840.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.33
|
| Rate for Payer: Cash Price |
$3,244.80
|
| Rate for Payer: Cash Price |
$3,244.80
|
| Rate for Payer: Cofinity Commercial |
$1,461.04
|
| Rate for Payer: Cofinity Commercial |
$1,570.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,144.85
|
| Rate for Payer: Meridian Medicaid |
$740.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,199.36
|
| Rate for Payer: Nomi Health Commercial |
$1,308.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,042.00
|
| Rate for Payer: PACE SWMI |
$1,090.33
|
| Rate for Payer: PHP Commercial |
$1,526.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,967.49
|
| Rate for Payer: Priority Health Medicare |
$1,090.33
|
| Rate for Payer: Priority Health SBD |
$1,967.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,967.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,090.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,162.12
|
| Rate for Payer: UHC Core |
$2,162.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,090.33
|
| Rate for Payer: UHC Exchange |
$2,162.12
|
| Rate for Payer: UHC Medicaid |
$705.67
|
| Rate for Payer: UHCCP Medicaid |
$705.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,865.76
|
|
|
PR ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2
|
Professional
|
Both
|
$5,330.00
|
|
|
Service Code
|
HCPCS 22595
|
| Min. Negotiated Rate |
$955.94 |
| Max. Negotiated Rate |
$3,997.50 |
| Rate for Payer: Aetna Commercial |
$1,986.44
|
| Rate for Payer: Aetna Medicare |
$1,541.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,986.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,134.68
|
| Rate for Payer: BCBS Complete |
$1,003.74
|
| Rate for Payer: BCBS MAPPO |
$1,482.42
|
| Rate for Payer: BCN Commercial |
$2,549.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,482.42
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cofinity Commercial |
$1,986.44
|
| Rate for Payer: Cofinity Commercial |
$2,134.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,482.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,556.54
|
| Rate for Payer: Meridian Medicaid |
$1,003.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,630.66
|
| Rate for Payer: Nomi Health Commercial |
$1,778.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,997.50
|
| Rate for Payer: PACE SWMI |
$1,482.42
|
| Rate for Payer: PHP Commercial |
$2,075.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,482.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$955.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,480.65
|
| Rate for Payer: Priority Health Medicare |
$1,482.42
|
| Rate for Payer: Priority Health SBD |
$2,480.65
|
| Rate for Payer: Priority Health Tiered Network |
$2,480.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,482.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,645.37
|
| Rate for Payer: UHC Core |
$2,645.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,482.42
|
| Rate for Payer: UHC Exchange |
$2,645.37
|
| Rate for Payer: UHC Medicaid |
$955.94
|
| Rate for Payer: UHCCP Medicaid |
$955.94
|
| Rate for Payer: UMR Bronson Commercial |
$2,451.80
|
|
|
PR ARTHRODESIS POSTERIOR CRANIOCERVICAL
|
Professional
|
Both
|
$5,497.00
|
|
|
Service Code
|
HCPCS 22590
|
| Min. Negotiated Rate |
$994.28 |
| Max. Negotiated Rate |
$4,122.75 |
| Rate for Payer: Aetna Commercial |
$2,067.95
|
| Rate for Payer: Aetna Medicare |
$1,604.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,067.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,222.28
|
| Rate for Payer: BCBS Complete |
$1,043.99
|
| Rate for Payer: BCBS MAPPO |
$1,543.25
|
| Rate for Payer: BCN Commercial |
$2,668.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.25
|
| Rate for Payer: Cash Price |
$4,397.60
|
| Rate for Payer: Cash Price |
$4,397.60
|
| Rate for Payer: Cofinity Commercial |
$2,067.95
|
| Rate for Payer: Cofinity Commercial |
$2,222.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,620.41
|
| Rate for Payer: Meridian Medicaid |
$1,043.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,697.58
|
| Rate for Payer: Nomi Health Commercial |
$1,851.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,122.75
|
| Rate for Payer: PACE SWMI |
$1,543.25
|
| Rate for Payer: PHP Commercial |
$2,160.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$994.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,596.69
|
| Rate for Payer: Priority Health Medicare |
$1,543.25
|
| Rate for Payer: Priority Health SBD |
$2,596.69
|
| Rate for Payer: Priority Health Tiered Network |
$2,596.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,543.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,776.15
|
| Rate for Payer: UHC Core |
$2,776.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,543.25
|
| Rate for Payer: UHC Exchange |
$2,776.15
|
| Rate for Payer: UHC Medicaid |
$994.28
|
| Rate for Payer: UHCCP Medicaid |
$994.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,528.62
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 22632
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$975.00 |
| Rate for Payer: Aetna Commercial |
$388.96
|
| Rate for Payer: Aetna Medicare |
$301.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.99
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$290.27
|
| Rate for Payer: BCN Commercial |
$527.38
|
| Rate for Payer: BCN Medicare Advantage |
$290.27
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cofinity Commercial |
$388.96
|
| Rate for Payer: Cofinity Commercial |
$417.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.78
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.30
|
| Rate for Payer: Nomi Health Commercial |
$348.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$975.00
|
| Rate for Payer: PACE SWMI |
$290.27
|
| Rate for Payer: PHP Commercial |
$406.38
|
| Rate for Payer: PHP Medicare Advantage |
$290.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$513.16
|
| Rate for Payer: Priority Health Medicare |
$290.27
|
| Rate for Payer: Priority Health SBD |
$513.16
|
| Rate for Payer: Priority Health Tiered Network |
$513.16
|
| Rate for Payer: Railroad Medicare Medicare |
$290.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$574.48
|
| Rate for Payer: UHC Core |
$574.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$290.27
|
| Rate for Payer: UHC Exchange |
$574.48
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
| Rate for Payer: UMR Bronson Commercial |
$598.00
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$6,951.00
|
|
|
Service Code
|
HCPCS 22630
|
| Min. Negotiated Rate |
$963.40 |
| Max. Negotiated Rate |
$5,213.25 |
| Rate for Payer: Aetna Commercial |
$2,008.30
|
| Rate for Payer: Aetna Medicare |
$1,558.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,008.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,158.17
|
| Rate for Payer: BCBS Complete |
$1,011.57
|
| Rate for Payer: BCBS MAPPO |
$1,498.73
|
| Rate for Payer: BCN Commercial |
$2,611.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,498.73
|
| Rate for Payer: Cash Price |
$5,560.80
|
| Rate for Payer: Cash Price |
$5,560.80
|
| Rate for Payer: Cofinity Commercial |
$2,008.30
|
| Rate for Payer: Cofinity Commercial |
$2,158.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,498.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,573.67
|
| Rate for Payer: Meridian Medicaid |
$1,011.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,648.60
|
| Rate for Payer: Nomi Health Commercial |
$1,798.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,213.25
|
| Rate for Payer: PACE SWMI |
$1,498.73
|
| Rate for Payer: PHP Commercial |
$2,098.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,498.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$963.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,541.33
|
| Rate for Payer: Priority Health Medicare |
$1,498.73
|
| Rate for Payer: Priority Health SBD |
$2,541.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,541.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,498.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,774.99
|
| Rate for Payer: UHC Core |
$2,774.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,498.73
|
| Rate for Payer: UHC Exchange |
$2,774.99
|
| Rate for Payer: UHC Medicaid |
$963.40
|
| Rate for Payer: UHCCP Medicaid |
$963.40
|
| Rate for Payer: UMR Bronson Commercial |
$3,197.46
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,398.00
|
|
|
Service Code
|
HCPCS 22612
|
| Min. Negotiated Rate |
$935.92 |
| Max. Negotiated Rate |
$2,801.75 |
| Rate for Payer: Aetna Commercial |
$1,948.86
|
| Rate for Payer: Aetna Medicare |
$1,512.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,948.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,094.29
|
| Rate for Payer: BCBS Complete |
$982.72
|
| Rate for Payer: BCBS MAPPO |
$1,454.37
|
| Rate for Payer: BCN Commercial |
$2,627.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,454.37
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cofinity Commercial |
$1,948.86
|
| Rate for Payer: Cofinity Commercial |
$2,094.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,454.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,527.09
|
| Rate for Payer: Meridian Medicaid |
$982.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,599.81
|
| Rate for Payer: Nomi Health Commercial |
$1,745.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,548.50
|
| Rate for Payer: PACE SWMI |
$1,454.37
|
| Rate for Payer: PHP Commercial |
$2,036.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,454.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,556.77
|
| Rate for Payer: Priority Health Medicare |
$1,454.37
|
| Rate for Payer: Priority Health SBD |
$2,556.77
|
| Rate for Payer: Priority Health Tiered Network |
$2,556.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,454.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,801.75
|
| Rate for Payer: UHC Core |
$2,801.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,454.37
|
| Rate for Payer: UHC Exchange |
$2,801.75
|
| Rate for Payer: UHC Medicaid |
$935.92
|
| Rate for Payer: UHCCP Medicaid |
$935.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,563.08
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC
|
Professional
|
Both
|
$4,415.00
|
|
|
Service Code
|
HCPCS 22610
|
| Min. Negotiated Rate |
$800.67 |
| Max. Negotiated Rate |
$3,311.25 |
| Rate for Payer: Aetna Commercial |
$1,657.54
|
| Rate for Payer: Aetna Medicare |
$1,286.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.24
|
| Rate for Payer: BCBS Complete |
$840.70
|
| Rate for Payer: BCBS MAPPO |
$1,236.97
|
| Rate for Payer: BCN Commercial |
$2,152.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,236.97
|
| Rate for Payer: Cash Price |
$3,532.00
|
| Rate for Payer: Cash Price |
$3,532.00
|
| Rate for Payer: Cofinity Commercial |
$1,657.54
|
| Rate for Payer: Cofinity Commercial |
$1,781.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,236.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,298.82
|
| Rate for Payer: Meridian Medicaid |
$840.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,360.67
|
| Rate for Payer: Nomi Health Commercial |
$1,484.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,311.25
|
| Rate for Payer: PACE SWMI |
$1,236.97
|
| Rate for Payer: PHP Commercial |
$1,731.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,236.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$800.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,094.18
|
| Rate for Payer: Priority Health Medicare |
$1,236.97
|
| Rate for Payer: Priority Health SBD |
$2,094.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,094.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,236.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,225.72
|
| Rate for Payer: UHC Core |
$2,225.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,236.97
|
| Rate for Payer: UHC Exchange |
$2,225.72
|
| Rate for Payer: UHC Medicaid |
$800.67
|
| Rate for Payer: UHCCP Medicaid |
$800.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,030.90
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM
|
Professional
|
Both
|
$5,219.00
|
|
|
Service Code
|
HCPCS 22804
|
| Min. Negotiated Rate |
$1,417.30 |
| Max. Negotiated Rate |
$4,290.14 |
| Rate for Payer: Aetna Commercial |
$2,961.56
|
| Rate for Payer: Aetna Medicare |
$2,298.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,961.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,182.57
|
| Rate for Payer: BCBS Complete |
$1,488.16
|
| Rate for Payer: BCBS MAPPO |
$2,210.12
|
| Rate for Payer: BCN Commercial |
$3,651.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,210.12
|
| Rate for Payer: Cash Price |
$4,175.20
|
| Rate for Payer: Cash Price |
$4,175.20
|
| Rate for Payer: Cofinity Commercial |
$2,961.56
|
| Rate for Payer: Cofinity Commercial |
$3,182.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,210.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,320.63
|
| Rate for Payer: Meridian Medicaid |
$1,488.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,431.13
|
| Rate for Payer: Nomi Health Commercial |
$2,652.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,914.25
|
| Rate for Payer: PACE SWMI |
$2,210.12
|
| Rate for Payer: PHP Commercial |
$3,094.17
|
| Rate for Payer: PHP Medicare Advantage |
$2,210.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,417.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,903.03
|
| Rate for Payer: Priority Health Medicare |
$2,210.12
|
| Rate for Payer: Priority Health SBD |
$3,903.03
|
| Rate for Payer: Priority Health Tiered Network |
$3,903.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,210.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,290.14
|
| Rate for Payer: UHC Core |
$4,290.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,210.12
|
| Rate for Payer: UHC Exchange |
$4,290.14
|
| Rate for Payer: UHC Medicaid |
$1,417.30
|
| Rate for Payer: UHCCP Medicaid |
$1,417.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,400.74
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM
|
Professional
|
Both
|
$2,896.00
|
|
|
Service Code
|
HCPCS 22800
|
| Min. Negotiated Rate |
$837.30 |
| Max. Negotiated Rate |
$2,392.85 |
| Rate for Payer: Aetna Commercial |
$1,736.05
|
| Rate for Payer: Aetna Medicare |
$1,347.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,736.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,865.61
|
| Rate for Payer: BCBS Complete |
$879.16
|
| Rate for Payer: BCBS MAPPO |
$1,295.56
|
| Rate for Payer: BCN Commercial |
$2,078.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,295.56
|
| Rate for Payer: Cash Price |
$2,316.80
|
| Rate for Payer: Cash Price |
$2,316.80
|
| Rate for Payer: Cofinity Commercial |
$1,736.05
|
| Rate for Payer: Cofinity Commercial |
$1,865.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,295.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,360.34
|
| Rate for Payer: Meridian Medicaid |
$879.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,425.12
|
| Rate for Payer: Nomi Health Commercial |
$1,554.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,172.00
|
| Rate for Payer: PACE SWMI |
$1,295.56
|
| Rate for Payer: PHP Commercial |
$1,813.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,295.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,221.93
|
| Rate for Payer: Priority Health Medicare |
$1,295.56
|
| Rate for Payer: Priority Health SBD |
$2,221.93
|
| Rate for Payer: Priority Health Tiered Network |
$2,221.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,295.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,392.85
|
| Rate for Payer: UHC Core |
$2,392.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,295.56
|
| Rate for Payer: UHC Exchange |
$2,392.85
|
| Rate for Payer: UHC Medicaid |
$837.30
|
| Rate for Payer: UHCCP Medicaid |
$837.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,332.16
|
|
