|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$498.63 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,025.23
|
| Rate for Payer: Aetna Medicare |
$795.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.74
|
| Rate for Payer: BCBS Complete |
$523.56
|
| Rate for Payer: BCBS MAPPO |
$765.10
|
| Rate for Payer: BCN Commercial |
$1,281.31
|
| Rate for Payer: BCN Medicare Advantage |
$765.10
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cofinity Commercial |
$1,025.23
|
| Rate for Payer: Cofinity Commercial |
$1,101.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.36
|
| Rate for Payer: Meridian Medicaid |
$523.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$841.61
|
| Rate for Payer: Nomi Health Commercial |
$918.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,803.75
|
| Rate for Payer: PACE SWMI |
$765.10
|
| Rate for Payer: PHP Commercial |
$1,071.14
|
| Rate for Payer: PHP Medicare Advantage |
$765.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,369.69
|
| Rate for Payer: Priority Health Medicare |
$765.10
|
| Rate for Payer: Priority Health SBD |
$1,369.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,369.69
|
| Rate for Payer: Railroad Medicare Medicare |
$765.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,472.61
|
| Rate for Payer: UHC Core |
$1,472.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$765.10
|
| Rate for Payer: UHC Exchange |
$1,472.61
|
| Rate for Payer: UHC Medicaid |
$498.63
|
| Rate for Payer: UHCCP Medicaid |
$498.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.30
|
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,718.00
|
|
|
Service Code
|
HCPCS 24365
|
| Min. Negotiated Rate |
$386.17 |
| Max. Negotiated Rate |
$1,288.50 |
| Rate for Payer: Aetna Commercial |
$790.77
|
| Rate for Payer: Aetna Medicare |
$613.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.79
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS MAPPO |
$590.13
|
| Rate for Payer: BCN Commercial |
$983.01
|
| Rate for Payer: BCN Medicare Advantage |
$590.13
|
| Rate for Payer: Cash Price |
$1,374.40
|
| Rate for Payer: Cash Price |
$1,374.40
|
| Rate for Payer: Cofinity Commercial |
$790.77
|
| Rate for Payer: Cofinity Commercial |
$849.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.64
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$649.14
|
| Rate for Payer: Nomi Health Commercial |
$708.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,288.50
|
| Rate for Payer: PACE SWMI |
$590.13
|
| Rate for Payer: PHP Commercial |
$826.18
|
| Rate for Payer: PHP Medicare Advantage |
$590.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,050.82
|
| Rate for Payer: Priority Health Medicare |
$590.13
|
| Rate for Payer: Priority Health SBD |
$1,050.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,050.82
|
| Rate for Payer: Railroad Medicare Medicare |
$590.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.60
|
| Rate for Payer: UHC Core |
$1,115.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$590.13
|
| Rate for Payer: UHC Exchange |
$1,115.60
|
| Rate for Payer: UHC Medicaid |
$386.17
|
| Rate for Payer: UHCCP Medicaid |
$386.17
|
| Rate for Payer: UMR Bronson Commercial |
$790.28
|
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$1,941.75 |
| Rate for Payer: Aetna Commercial |
$830.65
|
| Rate for Payer: Aetna Medicare |
$644.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$892.64
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS MAPPO |
$619.89
|
| Rate for Payer: BCN Commercial |
$1,042.77
|
| Rate for Payer: BCN Medicare Advantage |
$619.89
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$830.65
|
| Rate for Payer: Cofinity Commercial |
$892.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.88
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$681.88
|
| Rate for Payer: Nomi Health Commercial |
$743.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,941.75
|
| Rate for Payer: PACE SWMI |
$619.89
|
| Rate for Payer: PHP Commercial |
$867.85
|
| Rate for Payer: PHP Medicare Advantage |
$619.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,114.70
|
| Rate for Payer: Priority Health Medicare |
$619.89
|
| Rate for Payer: Priority Health SBD |
$1,114.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,114.70
|
| Rate for Payer: Railroad Medicare Medicare |
$619.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,191.95
|
| Rate for Payer: UHC Core |
$1,191.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$619.89
|
| Rate for Payer: UHC Exchange |
$1,191.95
|
| Rate for Payer: UHC Medicaid |
$405.13
|
| Rate for Payer: UHCCP Medicaid |
$405.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,190.94
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,258.61 |
| Rate for Payer: Aetna Commercial |
$867.84
|
| Rate for Payer: Aetna Medicare |
$673.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.60
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCBS MAPPO |
$647.64
|
| Rate for Payer: BCN Commercial |
$1,103.52
|
| Rate for Payer: BCN Medicare Advantage |
$647.64
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$867.84
|
| Rate for Payer: Cofinity Commercial |
$932.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.02
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.40
|
| Rate for Payer: Nomi Health Commercial |
$777.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$992.25
|
| Rate for Payer: PACE SWMI |
$647.64
|
| Rate for Payer: PHP Commercial |
$906.70
|
| Rate for Payer: PHP Medicare Advantage |
$647.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,179.64
|
| Rate for Payer: Priority Health Medicare |
$647.64
|
| Rate for Payer: Priority Health SBD |
$1,179.64
|
| Rate for Payer: Priority Health Tiered Network |
$1,179.64
|
| Rate for Payer: Railroad Medicare Medicare |
$647.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,258.61
|
| Rate for Payer: UHC Core |
$1,258.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$647.64
|
| Rate for Payer: UHC Exchange |
$1,258.61
|
| Rate for Payer: UHC Medicaid |
$423.44
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
| Rate for Payer: UMR Bronson Commercial |
$608.58
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,950.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$554.23 |
| Max. Negotiated Rate |
$1,640.16 |
| Rate for Payer: Aetna Commercial |
$1,140.31
|
| Rate for Payer: Aetna Medicare |
$885.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,140.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,225.41
|
| Rate for Payer: BCBS Complete |
$581.94
|
| Rate for Payer: BCBS MAPPO |
$850.98
|
| Rate for Payer: BCN Commercial |
$1,428.21
|
| Rate for Payer: BCN Medicare Advantage |
$850.98
|
| Rate for Payer: Cash Price |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,560.00
|
| Rate for Payer: Cofinity Commercial |
$1,140.31
|
| Rate for Payer: Cofinity Commercial |
$1,225.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$850.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$893.53
|
| Rate for Payer: Meridian Medicaid |
$581.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$936.08
|
| Rate for Payer: Nomi Health Commercial |
$1,021.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,462.50
|
| Rate for Payer: PACE SWMI |
$850.98
|
| Rate for Payer: PHP Commercial |
$1,191.37
|
| Rate for Payer: PHP Medicare Advantage |
$850.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,526.72
|
| Rate for Payer: Priority Health Medicare |
$850.98
|
| Rate for Payer: Priority Health SBD |
$1,526.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,526.72
|
| Rate for Payer: Railroad Medicare Medicare |
$850.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,640.16
|
| Rate for Payer: UHC Core |
$1,640.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$850.98
|
| Rate for Payer: UHC Exchange |
$1,640.16
|
| Rate for Payer: UHC Medicaid |
$554.23
|
| Rate for Payer: UHCCP Medicaid |
$554.23
|
| Rate for Payer: UMR Bronson Commercial |
$897.00
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$472.22 |
| Max. Negotiated Rate |
$1,407.38 |
| Rate for Payer: Aetna Commercial |
$967.96
|
| Rate for Payer: Aetna Medicare |
$751.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.96
|
| Rate for Payer: BCBS Complete |
$495.83
|
| Rate for Payer: BCBS MAPPO |
$722.36
|
| Rate for Payer: BCN Commercial |
$1,237.98
|
| Rate for Payer: BCN Medicare Advantage |
$722.36
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,040.20
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.48
|
| Rate for Payer: Meridian Medicaid |
$495.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$794.60
|
| Rate for Payer: Nomi Health Commercial |
$866.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,257.75
|
| Rate for Payer: PACE SWMI |
$722.36
|
| Rate for Payer: PHP Commercial |
$1,011.30
|
| Rate for Payer: PHP Medicare Advantage |
$722.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,323.36
|
| Rate for Payer: Priority Health Medicare |
$722.36
|
| Rate for Payer: Priority Health SBD |
$1,323.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,323.36
|
| Rate for Payer: Railroad Medicare Medicare |
$722.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.38
|
| Rate for Payer: UHC Core |
$1,407.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$722.36
|
| Rate for Payer: UHC Exchange |
$1,407.38
|
| Rate for Payer: UHC Medicaid |
$472.22
|
| Rate for Payer: UHCCP Medicaid |
$472.22
|
| Rate for Payer: UMR Bronson Commercial |
$771.42
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$1,367.21 |
| Rate for Payer: Aetna Commercial |
$963.98
|
| Rate for Payer: Aetna Medicare |
$748.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.98
|
| Rate for Payer: BCBS Complete |
$493.81
|
| Rate for Payer: BCBS MAPPO |
$719.39
|
| Rate for Payer: BCN Commercial |
$1,200.14
|
| Rate for Payer: BCN Medicare Advantage |
$719.39
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$1,035.92
|
| Rate for Payer: Cofinity Commercial |
$963.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.36
|
| Rate for Payer: Meridian Medicaid |
$493.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.33
|
| Rate for Payer: Nomi Health Commercial |
$863.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.75
|
| Rate for Payer: PACE SWMI |
$719.39
|
| Rate for Payer: PHP Commercial |
$1,007.15
|
| Rate for Payer: PHP Medicare Advantage |
$719.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,282.91
|
| Rate for Payer: Priority Health Medicare |
$719.39
|
| Rate for Payer: Priority Health SBD |
$1,282.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,282.91
|
| Rate for Payer: Railroad Medicare Medicare |
$719.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,367.21
|
| Rate for Payer: UHC Core |
$1,367.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.39
|
| Rate for Payer: UHC Exchange |
$1,367.21
|
| Rate for Payer: UHC Medicaid |
$470.30
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
| Rate for Payer: UMR Bronson Commercial |
$756.70
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,209.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$549.54 |
| Max. Negotiated Rate |
$2,406.75 |
| Rate for Payer: Aetna Commercial |
$1,131.20
|
| Rate for Payer: Aetna Medicare |
$877.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,131.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,215.62
|
| Rate for Payer: BCBS Complete |
$577.02
|
| Rate for Payer: BCBS MAPPO |
$844.18
|
| Rate for Payer: BCN Commercial |
$1,414.77
|
| Rate for Payer: BCN Medicare Advantage |
$844.18
|
| Rate for Payer: Cash Price |
$2,567.20
|
| Rate for Payer: Cash Price |
$2,567.20
|
| Rate for Payer: Cofinity Commercial |
$1,131.20
|
| Rate for Payer: Cofinity Commercial |
$1,215.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$844.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$886.39
|
| Rate for Payer: Meridian Medicaid |
$577.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$928.60
|
| Rate for Payer: Nomi Health Commercial |
$1,013.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,406.75
|
| Rate for Payer: PACE SWMI |
$844.18
|
| Rate for Payer: PHP Commercial |
$1,181.85
|
| Rate for Payer: PHP Medicare Advantage |
$844.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,512.34
|
| Rate for Payer: Priority Health Medicare |
$844.18
|
| Rate for Payer: Priority Health SBD |
$1,512.34
|
| Rate for Payer: Priority Health Tiered Network |
$1,512.34
|
| Rate for Payer: Railroad Medicare Medicare |
$844.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,628.50
|
| Rate for Payer: UHC Core |
$1,628.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$844.18
|
| Rate for Payer: UHC Exchange |
$1,628.50
|
| Rate for Payer: UHC Medicaid |
$549.54
|
| Rate for Payer: UHCCP Medicaid |
$549.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,476.14
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,268.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$378.50 |
| Max. Negotiated Rate |
$1,085.90 |
| Rate for Payer: Aetna Commercial |
$774.05
|
| Rate for Payer: Aetna Medicare |
$600.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.82
|
| Rate for Payer: BCBS Complete |
$397.43
|
| Rate for Payer: BCBS MAPPO |
$577.65
|
| Rate for Payer: BCN Commercial |
$957.12
|
| Rate for Payer: BCN Medicare Advantage |
$577.65
|
| Rate for Payer: Cash Price |
$1,014.40
|
| Rate for Payer: Cash Price |
$1,014.40
|
| Rate for Payer: Cofinity Commercial |
$774.05
|
| Rate for Payer: Cofinity Commercial |
$831.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.53
|
| Rate for Payer: Meridian Medicaid |
$397.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.41
|
| Rate for Payer: Nomi Health Commercial |
$693.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$951.00
|
| Rate for Payer: PACE SWMI |
$577.65
|
| Rate for Payer: PHP Commercial |
$808.71
|
| Rate for Payer: PHP Medicare Advantage |
$577.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,023.13
|
| Rate for Payer: Priority Health Medicare |
$577.65
|
| Rate for Payer: Priority Health SBD |
$1,023.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,023.13
|
| Rate for Payer: Railroad Medicare Medicare |
$577.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.90
|
| Rate for Payer: UHC Core |
$1,085.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.65
|
| Rate for Payer: UHC Exchange |
$1,085.90
|
| Rate for Payer: UHC Medicaid |
$378.50
|
| Rate for Payer: UHCCP Medicaid |
$378.50
|
| Rate for Payer: UMR Bronson Commercial |
$583.28
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,267.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$333.98 |
| Max. Negotiated Rate |
$1,700.25 |
| Rate for Payer: Aetna Commercial |
$685.16
|
| Rate for Payer: Aetna Medicare |
$531.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.29
|
| Rate for Payer: BCBS Complete |
$350.68
|
| Rate for Payer: BCBS MAPPO |
$511.31
|
| Rate for Payer: BCN Commercial |
$934.94
|
| Rate for Payer: BCN Medicare Advantage |
$511.31
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cofinity Commercial |
$685.16
|
| Rate for Payer: Cofinity Commercial |
$736.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.88
|
| Rate for Payer: Meridian Medicaid |
$350.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$562.44
|
| Rate for Payer: Nomi Health Commercial |
$613.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,700.25
|
| Rate for Payer: PACE SWMI |
$511.31
|
| Rate for Payer: PHP Commercial |
$715.83
|
| Rate for Payer: PHP Medicare Advantage |
$511.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$909.75
|
| Rate for Payer: Priority Health Medicare |
$511.31
|
| Rate for Payer: Priority Health SBD |
$909.75
|
| Rate for Payer: Priority Health Tiered Network |
$909.75
|
| Rate for Payer: Railroad Medicare Medicare |
$511.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.98
|
| Rate for Payer: UHC Core |
$984.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$511.31
|
| Rate for Payer: UHC Exchange |
$984.98
|
| Rate for Payer: UHC Medicaid |
$333.98
|
| Rate for Payer: UHCCP Medicaid |
$333.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.82
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$296.50 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$607.84
|
| Rate for Payer: Aetna Medicare |
$471.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.20
|
| Rate for Payer: BCBS Complete |
$311.32
|
| Rate for Payer: BCBS MAPPO |
$453.61
|
| Rate for Payer: BCN Commercial |
$749.46
|
| Rate for Payer: BCN Medicare Advantage |
$453.61
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$607.84
|
| Rate for Payer: Cofinity Commercial |
$653.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.29
|
| Rate for Payer: Meridian Medicaid |
$311.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$498.97
|
| Rate for Payer: Nomi Health Commercial |
$544.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PACE SWMI |
$453.61
|
| Rate for Payer: PHP Commercial |
$635.05
|
| Rate for Payer: PHP Medicare Advantage |
$453.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$801.15
|
| Rate for Payer: Priority Health Medicare |
$453.61
|
| Rate for Payer: Priority Health SBD |
$801.15
|
| Rate for Payer: Priority Health Tiered Network |
$801.15
|
| Rate for Payer: Railroad Medicare Medicare |
$453.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.01
|
| Rate for Payer: UHC Core |
$873.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$453.61
|
| Rate for Payer: UHC Exchange |
$873.01
|
| Rate for Payer: UHC Medicaid |
$296.50
|
| Rate for Payer: UHCCP Medicaid |
$296.50
|
| Rate for Payer: UMR Bronson Commercial |
$920.00
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,933.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$276.47 |
| Max. Negotiated Rate |
$1,449.75 |
| Rate for Payer: Aetna Commercial |
$567.03
|
| Rate for Payer: Aetna Medicare |
$440.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.35
|
| Rate for Payer: BCBS Complete |
$290.29
|
| Rate for Payer: BCBS MAPPO |
$423.16
|
| Rate for Payer: BCN Commercial |
$698.67
|
| Rate for Payer: BCN Medicare Advantage |
$423.16
|
| Rate for Payer: Cash Price |
$1,546.40
|
| Rate for Payer: Cash Price |
$1,546.40
|
| Rate for Payer: Cofinity Commercial |
$567.03
|
| Rate for Payer: Cofinity Commercial |
$609.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.32
|
| Rate for Payer: Meridian Medicaid |
$290.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$465.48
|
| Rate for Payer: Nomi Health Commercial |
$507.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,449.75
|
| Rate for Payer: PACE SWMI |
$423.16
|
| Rate for Payer: PHP Commercial |
$592.42
|
| Rate for Payer: PHP Medicare Advantage |
$423.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$746.85
|
| Rate for Payer: Priority Health Medicare |
$423.16
|
| Rate for Payer: Priority Health SBD |
$746.85
|
| Rate for Payer: Priority Health Tiered Network |
$746.85
|
| Rate for Payer: Railroad Medicare Medicare |
$423.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.91
|
| Rate for Payer: UHC Core |
$812.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$423.16
|
| Rate for Payer: UHC Exchange |
$812.91
|
| Rate for Payer: UHC Medicaid |
$276.47
|
| Rate for Payer: UHCCP Medicaid |
$276.47
|
| Rate for Payer: UMR Bronson Commercial |
$889.18
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,182.00
|
|
|
Service Code
|
HCPCS 29899
|
| Min. Negotiated Rate |
$587.45 |
| Max. Negotiated Rate |
$2,386.50 |
| Rate for Payer: Aetna Commercial |
$1,211.60
|
| Rate for Payer: Aetna Medicare |
$940.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,211.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.02
|
| Rate for Payer: BCBS Complete |
$616.82
|
| Rate for Payer: BCBS MAPPO |
$904.18
|
| Rate for Payer: BCN Commercial |
$1,509.88
|
| Rate for Payer: BCN Medicare Advantage |
$904.18
|
| Rate for Payer: Cash Price |
$2,545.60
|
| Rate for Payer: Cash Price |
$2,545.60
|
| Rate for Payer: Cofinity Commercial |
$1,211.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.39
|
| Rate for Payer: Meridian Medicaid |
$616.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.60
|
| Rate for Payer: Nomi Health Commercial |
$1,085.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,386.50
|
| Rate for Payer: PACE SWMI |
$904.18
|
| Rate for Payer: PHP Commercial |
$1,265.85
|
| Rate for Payer: PHP Medicare Advantage |
$904.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,614.02
|
| Rate for Payer: Priority Health Medicare |
$904.18
|
| Rate for Payer: Priority Health SBD |
$1,614.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,614.02
|
| Rate for Payer: Railroad Medicare Medicare |
$904.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,807.29
|
| Rate for Payer: UHC Core |
$1,807.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$904.18
|
| Rate for Payer: UHC Exchange |
$1,807.29
|
| Rate for Payer: UHC Medicaid |
$587.45
|
| Rate for Payer: UHCCP Medicaid |
$587.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,463.72
|
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$302.89 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$620.59
|
| Rate for Payer: Aetna Medicare |
$481.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.91
|
| Rate for Payer: BCBS Complete |
$318.03
|
| Rate for Payer: BCBS MAPPO |
$463.13
|
| Rate for Payer: BCN Commercial |
$770.37
|
| Rate for Payer: BCN Medicare Advantage |
$463.13
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$620.59
|
| Rate for Payer: Cofinity Commercial |
$666.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.29
|
| Rate for Payer: Meridian Medicaid |
$318.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$509.44
|
| Rate for Payer: Nomi Health Commercial |
$555.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PACE SWMI |
$463.13
|
| Rate for Payer: PHP Commercial |
$648.38
|
| Rate for Payer: PHP Medicare Advantage |
$463.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$823.51
|
| Rate for Payer: Priority Health Medicare |
$463.13
|
| Rate for Payer: Priority Health SBD |
$823.51
|
| Rate for Payer: Priority Health Tiered Network |
$823.51
|
| Rate for Payer: Railroad Medicare Medicare |
$463.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.97
|
| Rate for Payer: UHC Core |
$871.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$463.13
|
| Rate for Payer: UHC Exchange |
$871.97
|
| Rate for Payer: UHC Medicaid |
$302.89
|
| Rate for Payer: UHCCP Medicaid |
$302.89
|
| Rate for Payer: UMR Bronson Commercial |
$920.00
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,267.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$356.14 |
| Max. Negotiated Rate |
$1,700.25 |
| Rate for Payer: Aetna Commercial |
$728.02
|
| Rate for Payer: Aetna Medicare |
$565.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.35
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$543.30
|
| Rate for Payer: BCN Commercial |
$910.31
|
| Rate for Payer: BCN Medicare Advantage |
$543.30
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cofinity Commercial |
$728.02
|
| Rate for Payer: Cofinity Commercial |
$782.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.47
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$597.63
|
| Rate for Payer: Nomi Health Commercial |
$651.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,700.25
|
| Rate for Payer: PACE SWMI |
$543.30
|
| Rate for Payer: PHP Commercial |
$760.62
|
| Rate for Payer: PHP Medicare Advantage |
$543.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$973.09
|
| Rate for Payer: Priority Health Medicare |
$543.30
|
| Rate for Payer: Priority Health SBD |
$973.09
|
| Rate for Payer: Priority Health Tiered Network |
$973.09
|
| Rate for Payer: Railroad Medicare Medicare |
$543.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,030.57
|
| Rate for Payer: UHC Core |
$1,030.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$543.30
|
| Rate for Payer: UHC Exchange |
$1,030.57
|
| Rate for Payer: UHC Medicaid |
$356.14
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.82
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,998.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$323.12 |
| Max. Negotiated Rate |
$1,498.50 |
| Rate for Payer: Aetna Commercial |
$660.51
|
| Rate for Payer: Aetna Medicare |
$512.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.80
|
| Rate for Payer: BCBS Complete |
$339.28
|
| Rate for Payer: BCBS MAPPO |
$492.92
|
| Rate for Payer: BCN Commercial |
$797.27
|
| Rate for Payer: BCN Medicare Advantage |
$492.92
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cofinity Commercial |
$660.51
|
| Rate for Payer: Cofinity Commercial |
$709.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.57
|
| Rate for Payer: Meridian Medicaid |
$339.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$542.21
|
| Rate for Payer: Nomi Health Commercial |
$591.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.50
|
| Rate for Payer: PACE SWMI |
$492.92
|
| Rate for Payer: PHP Commercial |
$690.09
|
| Rate for Payer: PHP Medicare Advantage |
$492.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$852.26
|
| Rate for Payer: Priority Health Medicare |
$492.92
|
| Rate for Payer: Priority Health SBD |
$852.26
|
| Rate for Payer: Priority Health Tiered Network |
$852.26
|
| Rate for Payer: Railroad Medicare Medicare |
$492.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.69
|
| Rate for Payer: UHC Core |
$917.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.92
|
| Rate for Payer: UHC Exchange |
$917.69
|
| Rate for Payer: UHC Medicaid |
$323.12
|
| Rate for Payer: UHCCP Medicaid |
$323.12
|
| Rate for Payer: UMR Bronson Commercial |
$919.08
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 29836
|
| Min. Negotiated Rate |
$349.53 |
| Max. Negotiated Rate |
$1,016.51 |
| Rate for Payer: Aetna Commercial |
$713.91
|
| Rate for Payer: Aetna Medicare |
$554.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.19
|
| Rate for Payer: BCBS Complete |
$367.01
|
| Rate for Payer: BCBS MAPPO |
$532.77
|
| Rate for Payer: BCN Commercial |
$897.86
|
| Rate for Payer: BCN Medicare Advantage |
$532.77
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$713.91
|
| Rate for Payer: Cofinity Commercial |
$767.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.41
|
| Rate for Payer: Meridian Medicaid |
$367.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$586.05
|
| Rate for Payer: Nomi Health Commercial |
$639.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$803.25
|
| Rate for Payer: PACE SWMI |
$532.77
|
| Rate for Payer: PHP Commercial |
$745.88
|
| Rate for Payer: PHP Medicare Advantage |
$532.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$959.79
|
| Rate for Payer: Priority Health Medicare |
$532.77
|
| Rate for Payer: Priority Health SBD |
$959.79
|
| Rate for Payer: Priority Health Tiered Network |
$959.79
|
| Rate for Payer: Railroad Medicare Medicare |
$532.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.51
|
| Rate for Payer: UHC Core |
$1,016.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$532.77
|
| Rate for Payer: UHC Exchange |
$1,016.51
|
| Rate for Payer: UHC Medicaid |
$349.53
|
| Rate for Payer: UHCCP Medicaid |
$349.53
|
| Rate for Payer: UMR Bronson Commercial |
$492.66
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$2,028.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$310.55 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$634.05
|
| Rate for Payer: Aetna Medicare |
$492.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.36
|
| Rate for Payer: BCBS Complete |
$326.08
|
| Rate for Payer: BCBS MAPPO |
$473.17
|
| Rate for Payer: BCN Commercial |
$783.32
|
| Rate for Payer: BCN Medicare Advantage |
$473.17
|
| Rate for Payer: Cash Price |
$1,622.40
|
| Rate for Payer: Cash Price |
$1,622.40
|
| Rate for Payer: Cofinity Commercial |
$634.05
|
| Rate for Payer: Cofinity Commercial |
$681.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.83
|
| Rate for Payer: Meridian Medicaid |
$326.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$520.49
|
| Rate for Payer: Nomi Health Commercial |
$567.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.00
|
| Rate for Payer: PACE SWMI |
$473.17
|
| Rate for Payer: PHP Commercial |
$662.44
|
| Rate for Payer: PHP Medicare Advantage |
$473.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$837.35
|
| Rate for Payer: Priority Health Medicare |
$473.17
|
| Rate for Payer: Priority Health SBD |
$837.35
|
| Rate for Payer: Priority Health Tiered Network |
$837.35
|
| Rate for Payer: Railroad Medicare Medicare |
$473.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$885.16
|
| Rate for Payer: UHC Core |
$885.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$473.17
|
| Rate for Payer: UHC Exchange |
$885.16
|
| Rate for Payer: UHC Medicaid |
$310.55
|
| Rate for Payer: UHCCP Medicaid |
$310.55
|
| Rate for Payer: UMR Bronson Commercial |
$932.88
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Aetna Commercial |
$609.87
|
| Rate for Payer: Aetna Medicare |
$473.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.39
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$455.13
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: BCN Medicare Advantage |
$455.13
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$609.87
|
| Rate for Payer: Cofinity Commercial |
$655.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.89
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$500.64
|
| Rate for Payer: Nomi Health Commercial |
$546.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,425.00
|
| Rate for Payer: PACE SWMI |
$455.13
|
| Rate for Payer: PHP Commercial |
$637.18
|
| Rate for Payer: PHP Medicare Advantage |
$455.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$811.27
|
| Rate for Payer: Priority Health Medicare |
$455.13
|
| Rate for Payer: Priority Health SBD |
$811.27
|
| Rate for Payer: Priority Health Tiered Network |
$811.27
|
| Rate for Payer: Railroad Medicare Medicare |
$455.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$856.03
|
| Rate for Payer: UHC Core |
$856.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$455.13
|
| Rate for Payer: UHC Exchange |
$856.03
|
| Rate for Payer: UHC Medicaid |
$298.84
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
| Rate for Payer: UMR Bronson Commercial |
$874.00
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 29861
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,887.75 |
| Rate for Payer: Aetna Commercial |
$860.15
|
| Rate for Payer: Aetna Medicare |
$667.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.34
|
| Rate for Payer: BCBS Complete |
$440.14
|
| Rate for Payer: BCBS MAPPO |
$641.90
|
| Rate for Payer: BCN Commercial |
$1,058.21
|
| Rate for Payer: BCN Medicare Advantage |
$641.90
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cofinity Commercial |
$860.15
|
| Rate for Payer: Cofinity Commercial |
$924.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.00
|
| Rate for Payer: Meridian Medicaid |
$440.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$706.09
|
| Rate for Payer: Nomi Health Commercial |
$770.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,887.75
|
| Rate for Payer: PACE SWMI |
$641.90
|
| Rate for Payer: PHP Commercial |
$898.66
|
| Rate for Payer: PHP Medicare Advantage |
$641.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,131.19
|
| Rate for Payer: Priority Health Medicare |
$641.90
|
| Rate for Payer: Priority Health SBD |
$1,131.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,131.19
|
| Rate for Payer: Railroad Medicare Medicare |
$641.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,260.37
|
| Rate for Payer: UHC Core |
$1,260.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.90
|
| Rate for Payer: UHC Exchange |
$1,260.37
|
| Rate for Payer: UHC Medicaid |
$419.18
|
| Rate for Payer: UHCCP Medicaid |
$419.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.82
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY
|
Professional
|
Both
|
$1,696.00
|
|
|
Service Code
|
HCPCS 29863
|
| Min. Negotiated Rate |
$482.87 |
| Max. Negotiated Rate |
$1,422.43 |
| Rate for Payer: Aetna Commercial |
$989.27
|
| Rate for Payer: Aetna Medicare |
$767.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.27
|
| Rate for Payer: BCBS Complete |
$507.01
|
| Rate for Payer: BCBS MAPPO |
$738.26
|
| Rate for Payer: BCN Commercial |
$1,241.46
|
| Rate for Payer: BCN Medicare Advantage |
$738.26
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,063.09
|
| Rate for Payer: Cofinity Commercial |
$989.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$738.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$775.17
|
| Rate for Payer: Meridian Medicaid |
$507.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$812.09
|
| Rate for Payer: Nomi Health Commercial |
$885.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,272.00
|
| Rate for Payer: PACE SWMI |
$738.26
|
| Rate for Payer: PHP Commercial |
$1,033.56
|
| Rate for Payer: PHP Medicare Advantage |
$738.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,327.10
|
| Rate for Payer: Priority Health Medicare |
$738.26
|
| Rate for Payer: Priority Health SBD |
$1,327.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,327.10
|
| Rate for Payer: Railroad Medicare Medicare |
$738.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,422.43
|
| Rate for Payer: UHC Core |
$1,422.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$738.26
|
| Rate for Payer: UHC Exchange |
$1,422.43
|
| Rate for Payer: UHC Medicaid |
$482.87
|
| Rate for Payer: UHCCP Medicaid |
$482.87
|
| Rate for Payer: UMR Bronson Commercial |
$780.16
|
|
|
PR ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$594.48 |
| Max. Negotiated Rate |
$2,517.75 |
| Rate for Payer: Aetna Commercial |
$1,225.59
|
| Rate for Payer: Aetna Medicare |
$951.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,225.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,317.05
|
| Rate for Payer: BCBS Complete |
$624.20
|
| Rate for Payer: BCBS MAPPO |
$914.62
|
| Rate for Payer: BCN Commercial |
$1,537.27
|
| Rate for Payer: BCN Medicare Advantage |
$914.62
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,225.59
|
| Rate for Payer: Cofinity Commercial |
$1,317.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.35
|
| Rate for Payer: Meridian Medicaid |
$624.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,006.08
|
| Rate for Payer: Nomi Health Commercial |
$1,097.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,517.75
|
| Rate for Payer: PACE SWMI |
$914.62
|
| Rate for Payer: PHP Commercial |
$1,280.47
|
| Rate for Payer: PHP Medicare Advantage |
$914.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,643.30
|
| Rate for Payer: Priority Health Medicare |
$914.62
|
| Rate for Payer: Priority Health SBD |
$1,643.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,643.30
|
| Rate for Payer: Railroad Medicare Medicare |
$914.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.31
|
| Rate for Payer: UHC Core |
$1,794.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$914.62
|
| Rate for Payer: UHC Exchange |
$1,794.31
|
| Rate for Payer: UHC Medicaid |
$594.48
|
| Rate for Payer: UHCCP Medicaid |
$594.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,544.22
|
|
|
PR ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,155.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$583.62 |
| Max. Negotiated Rate |
$2,366.25 |
| Rate for Payer: Aetna Commercial |
$1,202.69
|
| Rate for Payer: Aetna Medicare |
$933.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.44
|
| Rate for Payer: BCBS Complete |
$612.80
|
| Rate for Payer: BCBS MAPPO |
$897.53
|
| Rate for Payer: BCN Commercial |
$1,508.39
|
| Rate for Payer: BCN Medicare Advantage |
$897.53
|
| Rate for Payer: Cash Price |
$2,524.00
|
| Rate for Payer: Cash Price |
$2,524.00
|
| Rate for Payer: Cofinity Commercial |
$1,202.69
|
| Rate for Payer: Cofinity Commercial |
$1,292.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.41
|
| Rate for Payer: Meridian Medicaid |
$612.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.28
|
| Rate for Payer: Nomi Health Commercial |
$1,077.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,366.25
|
| Rate for Payer: PACE SWMI |
$897.53
|
| Rate for Payer: PHP Commercial |
$1,256.54
|
| Rate for Payer: PHP Medicare Advantage |
$897.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,612.43
|
| Rate for Payer: Priority Health Medicare |
$897.53
|
| Rate for Payer: Priority Health SBD |
$1,612.43
|
| Rate for Payer: Priority Health Tiered Network |
$1,612.43
|
| Rate for Payer: Railroad Medicare Medicare |
$897.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,742.96
|
| Rate for Payer: UHC Core |
$1,742.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$897.53
|
| Rate for Payer: UHC Exchange |
$1,742.96
|
| Rate for Payer: UHC Medicaid |
$583.62
|
| Rate for Payer: UHCCP Medicaid |
$583.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,451.30
|
|
|
PR ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,372.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$593.42 |
| Max. Negotiated Rate |
$2,529.00 |
| Rate for Payer: Aetna Commercial |
$1,223.46
|
| Rate for Payer: Aetna Medicare |
$949.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.76
|
| Rate for Payer: BCBS Complete |
$623.09
|
| Rate for Payer: BCBS MAPPO |
$913.03
|
| Rate for Payer: BCN Commercial |
$1,539.26
|
| Rate for Payer: BCN Medicare Advantage |
$913.03
|
| Rate for Payer: Cash Price |
$2,697.60
|
| Rate for Payer: Cash Price |
$2,697.60
|
| Rate for Payer: Cofinity Commercial |
$1,223.46
|
| Rate for Payer: Cofinity Commercial |
$1,314.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$913.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$958.68
|
| Rate for Payer: Meridian Medicaid |
$623.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,004.33
|
| Rate for Payer: Nomi Health Commercial |
$1,095.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,529.00
|
| Rate for Payer: PACE SWMI |
$913.03
|
| Rate for Payer: PHP Commercial |
$1,278.24
|
| Rate for Payer: PHP Medicare Advantage |
$913.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,645.42
|
| Rate for Payer: Priority Health Medicare |
$913.03
|
| Rate for Payer: Priority Health SBD |
$1,645.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,645.42
|
| Rate for Payer: Railroad Medicare Medicare |
$913.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.76
|
| Rate for Payer: UHC Core |
$1,794.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$913.03
|
| Rate for Payer: UHC Exchange |
$1,794.76
|
| Rate for Payer: UHC Medicaid |
$593.42
|
| Rate for Payer: UHCCP Medicaid |
$593.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,551.12
|
|
|
PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$254.96 |
| Max. Negotiated Rate |
$875.25 |
| Rate for Payer: Aetna Commercial |
$518.79
|
| Rate for Payer: Aetna Medicare |
$402.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.51
|
| Rate for Payer: BCBS Complete |
$267.71
|
| Rate for Payer: BCBS MAPPO |
$387.16
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: BCN Medicare Advantage |
$387.16
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cofinity Commercial |
$518.79
|
| Rate for Payer: Cofinity Commercial |
$557.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.52
|
| Rate for Payer: Meridian Medicaid |
$267.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.88
|
| Rate for Payer: Nomi Health Commercial |
$464.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.25
|
| Rate for Payer: PACE SWMI |
$387.16
|
| Rate for Payer: PHP Commercial |
$542.02
|
| Rate for Payer: PHP Medicare Advantage |
$387.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$679.25
|
| Rate for Payer: Priority Health Medicare |
$387.16
|
| Rate for Payer: Priority Health SBD |
$679.25
|
| Rate for Payer: Priority Health Tiered Network |
$679.25
|
| Rate for Payer: Railroad Medicare Medicare |
$387.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.40
|
| Rate for Payer: UHC Core |
$711.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.16
|
| Rate for Payer: UHC Exchange |
$711.40
|
| Rate for Payer: UHC Medicaid |
$254.96
|
| Rate for Payer: UHCCP Medicaid |
$254.96
|
| Rate for Payer: UMR Bronson Commercial |
$536.82
|
|
