|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$817.60 |
| Max. Negotiated Rate |
$1,543.28 |
| Rate for Payer: Aetna Commercial |
$1,436.10
|
| Rate for Payer: Aetna Medicare |
$1,114.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.10
|
| Rate for Payer: BCBS Complete |
$817.60
|
| Rate for Payer: BCBS MAPPO |
$1,071.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.72
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cofinity Commercial |
$1,543.28
|
| Rate for Payer: Cofinity Commercial |
$1,436.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.31
|
| Rate for Payer: Nomi Health Commercial |
$1,286.06
|
| Rate for Payer: PACE SWMI |
$1,071.72
|
| Rate for Payer: PHP Commercial |
$1,500.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.60
|
| Rate for Payer: Priority Health Medicare |
$1,071.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.72
|
| Rate for Payer: UMR Bronson Commercial |
$940.24
|
|
|
PR ARTHROPLASTY ANKLE W/IMPLANT
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 27702
|
| Min. Negotiated Rate |
$790.40 |
| Max. Negotiated Rate |
$1,332.26 |
| Rate for Payer: Aetna Commercial |
$1,239.74
|
| Rate for Payer: Aetna Medicare |
$962.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,239.74
|
| Rate for Payer: BCBS Complete |
$790.40
|
| Rate for Payer: BCBS MAPPO |
$925.18
|
| Rate for Payer: BCN Medicare Advantage |
$925.18
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$1,332.26
|
| Rate for Payer: Cofinity Commercial |
$1,239.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$971.44
|
| Rate for Payer: Nomi Health Commercial |
$1,110.22
|
| Rate for Payer: PACE SWMI |
$925.18
|
| Rate for Payer: PHP Commercial |
$1,295.25
|
| Rate for Payer: PHP Medicare Advantage |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health Medicare |
$925.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.18
|
| Rate for Payer: UHC Medicare Advantage |
$925.18
|
| Rate for Payer: UMR Bronson Commercial |
$908.96
|
|
|
PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE
|
Professional
|
Both
|
$1,554.00
|
|
|
Service Code
|
HCPCS 27442
|
| Min. Negotiated Rate |
$621.60 |
| Max. Negotiated Rate |
$1,212.77 |
| Rate for Payer: Aetna Commercial |
$1,128.55
|
| Rate for Payer: Aetna Medicare |
$875.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,128.55
|
| Rate for Payer: BCBS Complete |
$621.60
|
| Rate for Payer: BCBS MAPPO |
$842.20
|
| Rate for Payer: BCN Medicare Advantage |
$842.20
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cofinity Commercial |
$1,212.77
|
| Rate for Payer: Cofinity Commercial |
$1,128.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.31
|
| Rate for Payer: Nomi Health Commercial |
$1,010.64
|
| Rate for Payer: PACE SWMI |
$842.20
|
| Rate for Payer: PHP Commercial |
$1,179.08
|
| Rate for Payer: PHP Medicare Advantage |
$842.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health Medicare |
$842.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$842.20
|
| Rate for Payer: UHC Medicare Advantage |
$842.20
|
| Rate for Payer: UMR Bronson Commercial |
$714.84
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$1,389.40 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,861.80
|
| Rate for Payer: Aetna Medicare |
$1,444.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,000.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.80
|
| Rate for Payer: BCBS Complete |
$1,830.00
|
| Rate for Payer: BCBS MAPPO |
$1,389.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.40
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,861.80
|
| Rate for Payer: Cofinity Commercial |
$2,000.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,458.87
|
| Rate for Payer: Nomi Health Commercial |
$1,667.28
|
| Rate for Payer: PACE SWMI |
$1,389.40
|
| Rate for Payer: PHP Commercial |
$1,945.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health Medicare |
$1,389.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.40
|
| Rate for Payer: UMR Bronson Commercial |
$2,104.50
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
IP
|
$4,575.00
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$2,013.00 |
| Max. Negotiated Rate |
$4,117.50 |
| Rate for Payer: Aetna American Axle |
$2,973.75
|
| Rate for Payer: Aetna Commercial |
$3,888.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,973.75
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$3,202.50
|
| Rate for Payer: Cofinity Commercial |
$3,934.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,202.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,660.00
|
| Rate for Payer: Healthscope Commercial |
$4,117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,202.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,431.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,888.75
|
| Rate for Payer: PHP Commercial |
$3,888.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health SBD |
$2,882.25
|
| Rate for Payer: UMR Bronson Commercial |
$2,013.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,431.25
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$1,389.40 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,861.80
|
| Rate for Payer: Aetna Medicare |
$1,444.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,000.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.80
|
| Rate for Payer: BCBS Complete |
$1,830.00
|
| Rate for Payer: BCBS MAPPO |
$1,389.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.40
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$2,000.74
|
| Rate for Payer: Cofinity Commercial |
$1,861.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,458.87
|
| Rate for Payer: Nomi Health Commercial |
$1,667.28
|
| Rate for Payer: PACE SWMI |
$1,389.40
|
| Rate for Payer: PHP Commercial |
$1,945.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health Medicare |
$1,389.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.40
|
| Rate for Payer: UMR Bronson Commercial |
$2,104.50
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
OP
|
$4,575.00
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$1,692.75 |
| Max. Negotiated Rate |
$50,486.50 |
| Rate for Payer: Aetna American Axle |
$2,973.75
|
| Rate for Payer: Aetna Commercial |
$3,888.75
|
| Rate for Payer: Aetna Medicare |
$18,652.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,973.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,419.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,419.31
|
| Rate for Payer: BCBS Complete |
$10,094.07
|
| Rate for Payer: BCBS MAPPO |
$17,935.45
|
| Rate for Payer: BCN Medicare Advantage |
$17,935.45
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$3,202.50
|
| Rate for Payer: Cofinity Commercial |
$3,934.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,202.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,660.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,935.45
|
| Rate for Payer: Healthscope Commercial |
$4,117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,202.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,431.25
|
| Rate for Payer: Mclaren Medicaid |
$9,613.40
|
| Rate for Payer: Mclaren Medicare |
$17,935.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,832.22
|
| Rate for Payer: Meridian Medicaid |
$10,094.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,625.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,888.75
|
| Rate for Payer: PACE Medicare |
$17,038.68
|
| Rate for Payer: PACE SWMI |
$17,935.45
|
| Rate for Payer: PHP Commercial |
$3,888.75
|
| Rate for Payer: PHP Medicare Advantage |
$17,935.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,613.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health Medicare |
$17,935.45
|
| Rate for Payer: Priority Health SBD |
$2,882.25
|
| Rate for Payer: Railroad Medicare Medicare |
$17,935.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,486.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,935.45
|
| Rate for Payer: UHC Exchange |
$34,276.44
|
| Rate for Payer: UHC Medicare Advantage |
$17,935.45
|
| Rate for Payer: UHCCP Medicaid |
$9,613.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,692.75
|
| Rate for Payer: VA VA |
$17,935.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,431.25
|
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,466.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$1,152.31 |
| Max. Negotiated Rate |
$2,252.90 |
| Rate for Payer: Aetna Commercial |
$1,544.10
|
| Rate for Payer: Aetna Medicare |
$1,198.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,659.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,544.10
|
| Rate for Payer: BCBS Complete |
$1,386.40
|
| Rate for Payer: BCBS MAPPO |
$1,152.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,152.31
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cofinity Commercial |
$1,659.33
|
| Rate for Payer: Cofinity Commercial |
$1,544.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,152.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,209.93
|
| Rate for Payer: Nomi Health Commercial |
$1,382.77
|
| Rate for Payer: PACE SWMI |
$1,152.31
|
| Rate for Payer: PHP Commercial |
$1,613.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,152.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.90
|
| Rate for Payer: Priority Health Medicare |
$1,152.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,152.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,594.36
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$427.29 |
| Max. Negotiated Rate |
$1,098.50 |
| Rate for Payer: Aetna Commercial |
$572.57
|
| Rate for Payer: Aetna Medicare |
$444.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.57
|
| Rate for Payer: BCBS Complete |
$676.00
|
| Rate for Payer: BCBS MAPPO |
$427.29
|
| Rate for Payer: BCN Medicare Advantage |
$427.29
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cofinity Commercial |
$615.30
|
| Rate for Payer: Cofinity Commercial |
$572.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.65
|
| Rate for Payer: Nomi Health Commercial |
$512.75
|
| Rate for Payer: PACE SWMI |
$427.29
|
| Rate for Payer: PHP Commercial |
$598.21
|
| Rate for Payer: PHP Medicare Advantage |
$427.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health Medicare |
$427.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.29
|
| Rate for Payer: UHC Medicare Advantage |
$427.29
|
| Rate for Payer: UMR Bronson Commercial |
$777.40
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,481.00
|
|
|
Service Code
|
HCPCS 26536
|
| Min. Negotiated Rate |
$698.31 |
| Max. Negotiated Rate |
$1,612.65 |
| Rate for Payer: Aetna Commercial |
$935.74
|
| Rate for Payer: Aetna Medicare |
$726.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,005.57
|
| Rate for Payer: BCBS Complete |
$992.40
|
| Rate for Payer: BCBS MAPPO |
$698.31
|
| Rate for Payer: BCN Medicare Advantage |
$698.31
|
| Rate for Payer: Cash Price |
$1,984.80
|
| Rate for Payer: Cash Price |
$1,984.80
|
| Rate for Payer: Cofinity Commercial |
$935.74
|
| Rate for Payer: Cofinity Commercial |
$1,005.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.23
|
| Rate for Payer: Nomi Health Commercial |
$837.97
|
| Rate for Payer: PACE SWMI |
$698.31
|
| Rate for Payer: PHP Commercial |
$977.63
|
| Rate for Payer: PHP Medicare Advantage |
$698.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.65
|
| Rate for Payer: Priority Health Medicare |
$698.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.31
|
| Rate for Payer: UHC Medicare Advantage |
$698.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,141.26
|
|
|
PR ARTHROPLASTY KNEE TIBIAL PLATEAU
|
Professional
|
Both
|
$1,777.00
|
|
|
Service Code
|
HCPCS 27440
|
| Min. Negotiated Rate |
$710.80 |
| Max. Negotiated Rate |
$1,155.05 |
| Rate for Payer: Aetna Commercial |
$1,034.01
|
| Rate for Payer: Aetna Medicare |
$802.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.01
|
| Rate for Payer: BCBS Complete |
$710.80
|
| Rate for Payer: BCBS MAPPO |
$771.65
|
| Rate for Payer: BCN Medicare Advantage |
$771.65
|
| Rate for Payer: Cash Price |
$1,421.60
|
| Rate for Payer: Cash Price |
$1,421.60
|
| Rate for Payer: Cofinity Commercial |
$1,111.18
|
| Rate for Payer: Cofinity Commercial |
$1,034.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.23
|
| Rate for Payer: Nomi Health Commercial |
$925.98
|
| Rate for Payer: PACE SWMI |
$771.65
|
| Rate for Payer: PHP Commercial |
$1,080.31
|
| Rate for Payer: PHP Medicare Advantage |
$771.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.05
|
| Rate for Payer: Priority Health Medicare |
$771.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.65
|
| Rate for Payer: UHC Medicare Advantage |
$771.65
|
| Rate for Payer: UMR Bronson Commercial |
$817.42
|
|
|
PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,806.00
|
|
|
Service Code
|
HCPCS 26530
|
| Min. Negotiated Rate |
$525.88 |
| Max. Negotiated Rate |
$1,173.90 |
| Rate for Payer: Aetna Commercial |
$704.68
|
| Rate for Payer: Aetna Medicare |
$546.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.68
|
| Rate for Payer: BCBS Complete |
$722.40
|
| Rate for Payer: BCBS MAPPO |
$525.88
|
| Rate for Payer: BCN Medicare Advantage |
$525.88
|
| Rate for Payer: Cash Price |
$1,444.80
|
| Rate for Payer: Cash Price |
$1,444.80
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$704.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.17
|
| Rate for Payer: Nomi Health Commercial |
$631.06
|
| Rate for Payer: PACE SWMI |
$525.88
|
| Rate for Payer: PHP Commercial |
$736.23
|
| Rate for Payer: PHP Medicare Advantage |
$525.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.90
|
| Rate for Payer: Priority Health Medicare |
$525.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.88
|
| Rate for Payer: UHC Medicare Advantage |
$525.88
|
| Rate for Payer: UMR Bronson Commercial |
$830.76
|
|
|
PR ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 27437
|
| Min. Negotiated Rate |
$470.40 |
| Max. Negotiated Rate |
$921.24 |
| Rate for Payer: Aetna Commercial |
$857.26
|
| Rate for Payer: Aetna Medicare |
$665.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.26
|
| Rate for Payer: BCBS Complete |
$470.40
|
| Rate for Payer: BCBS MAPPO |
$639.75
|
| Rate for Payer: BCN Medicare Advantage |
$639.75
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cofinity Commercial |
$921.24
|
| Rate for Payer: Cofinity Commercial |
$857.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.74
|
| Rate for Payer: Nomi Health Commercial |
$767.70
|
| Rate for Payer: PACE SWMI |
$639.75
|
| Rate for Payer: PHP Commercial |
$895.65
|
| Rate for Payer: PHP Medicare Advantage |
$639.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health Medicare |
$639.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.75
|
| Rate for Payer: UHC Medicare Advantage |
$639.75
|
| Rate for Payer: UMR Bronson Commercial |
$540.96
|
|
|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$812.69 |
| Max. Negotiated Rate |
$1,517.75 |
| Rate for Payer: Aetna Commercial |
$1,089.00
|
| Rate for Payer: Aetna Medicare |
$845.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.00
|
| Rate for Payer: BCBS Complete |
$934.00
|
| Rate for Payer: BCBS MAPPO |
$812.69
|
| Rate for Payer: BCN Medicare Advantage |
$812.69
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$1,170.27
|
| Rate for Payer: Cofinity Commercial |
$1,089.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.32
|
| Rate for Payer: Nomi Health Commercial |
$975.23
|
| Rate for Payer: PACE SWMI |
$812.69
|
| Rate for Payer: PHP Commercial |
$1,137.77
|
| Rate for Payer: PHP Medicare Advantage |
$812.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health Medicare |
$812.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.69
|
| Rate for Payer: UHC Medicare Advantage |
$812.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.10
|
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 24365
|
| Min. Negotiated Rate |
$621.51 |
| Max. Negotiated Rate |
$1,084.20 |
| Rate for Payer: Aetna Commercial |
$832.82
|
| Rate for Payer: Aetna Medicare |
$646.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.82
|
| Rate for Payer: BCBS Complete |
$667.20
|
| Rate for Payer: BCBS MAPPO |
$621.51
|
| Rate for Payer: BCN Medicare Advantage |
$621.51
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$894.97
|
| Rate for Payer: Cofinity Commercial |
$832.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.59
|
| Rate for Payer: Nomi Health Commercial |
$745.81
|
| Rate for Payer: PACE SWMI |
$621.51
|
| Rate for Payer: PHP Commercial |
$870.11
|
| Rate for Payer: PHP Medicare Advantage |
$621.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,084.20
|
| Rate for Payer: Priority Health Medicare |
$621.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.51
|
| Rate for Payer: UHC Medicare Advantage |
$621.51
|
| Rate for Payer: UMR Bronson Commercial |
$767.28
|
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$659.34 |
| Max. Negotiated Rate |
$1,634.10 |
| Rate for Payer: Aetna Commercial |
$883.52
|
| Rate for Payer: Aetna Medicare |
$685.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$883.52
|
| Rate for Payer: BCBS Complete |
$1,005.60
|
| Rate for Payer: BCBS MAPPO |
$659.34
|
| Rate for Payer: BCN Medicare Advantage |
$659.34
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$949.45
|
| Rate for Payer: Cofinity Commercial |
$883.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.31
|
| Rate for Payer: Nomi Health Commercial |
$791.21
|
| Rate for Payer: PACE SWMI |
$659.34
|
| Rate for Payer: PHP Commercial |
$923.08
|
| Rate for Payer: PHP Medicare Advantage |
$659.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health Medicare |
$659.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.34
|
| Rate for Payer: UHC Medicare Advantage |
$659.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,156.44
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$513.60 |
| Max. Negotiated Rate |
$1,004.47 |
| Rate for Payer: Aetna Commercial |
$934.72
|
| Rate for Payer: Aetna Medicare |
$725.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.47
|
| Rate for Payer: BCBS Complete |
$513.60
|
| Rate for Payer: BCBS MAPPO |
$697.55
|
| Rate for Payer: BCN Medicare Advantage |
$697.55
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cofinity Commercial |
$934.72
|
| Rate for Payer: Cofinity Commercial |
$1,004.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.43
|
| Rate for Payer: Nomi Health Commercial |
$837.06
|
| Rate for Payer: PACE SWMI |
$697.55
|
| Rate for Payer: PHP Commercial |
$976.57
|
| Rate for Payer: PHP Medicare Advantage |
$697.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.60
|
| Rate for Payer: Priority Health Medicare |
$697.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.55
|
| Rate for Payer: UHC Medicare Advantage |
$697.55
|
| Rate for Payer: UMR Bronson Commercial |
$590.64
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$757.20 |
| Max. Negotiated Rate |
$1,305.40 |
| Rate for Payer: Aetna Commercial |
$1,214.75
|
| Rate for Payer: Aetna Medicare |
$942.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.75
|
| Rate for Payer: BCBS Complete |
$757.20
|
| Rate for Payer: BCBS MAPPO |
$906.53
|
| Rate for Payer: BCN Medicare Advantage |
$906.53
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cofinity Commercial |
$1,305.40
|
| Rate for Payer: Cofinity Commercial |
$1,214.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.86
|
| Rate for Payer: Nomi Health Commercial |
$1,087.84
|
| Rate for Payer: PACE SWMI |
$906.53
|
| Rate for Payer: PHP Commercial |
$1,269.14
|
| Rate for Payer: PHP Medicare Advantage |
$906.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.45
|
| Rate for Payer: Priority Health Medicare |
$906.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.53
|
| Rate for Payer: UHC Medicare Advantage |
$906.53
|
| Rate for Payer: UMR Bronson Commercial |
$870.78
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$1,126.50 |
| Rate for Payer: Aetna Commercial |
$1,048.27
|
| Rate for Payer: Aetna Medicare |
$813.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,048.27
|
| Rate for Payer: BCBS Complete |
$651.20
|
| Rate for Payer: BCBS MAPPO |
$782.29
|
| Rate for Payer: BCN Medicare Advantage |
$782.29
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,126.50
|
| Rate for Payer: Cofinity Commercial |
$1,048.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.40
|
| Rate for Payer: Nomi Health Commercial |
$938.75
|
| Rate for Payer: PACE SWMI |
$782.29
|
| Rate for Payer: PHP Commercial |
$1,095.21
|
| Rate for Payer: PHP Medicare Advantage |
$782.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health Medicare |
$782.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.29
|
| Rate for Payer: UHC Medicare Advantage |
$782.29
|
| Rate for Payer: UMR Bronson Commercial |
$748.88
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,597.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$638.80 |
| Max. Negotiated Rate |
$1,093.32 |
| Rate for Payer: Aetna Commercial |
$1,017.39
|
| Rate for Payer: Aetna Medicare |
$789.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.39
|
| Rate for Payer: BCBS Complete |
$638.80
|
| Rate for Payer: BCBS MAPPO |
$759.25
|
| Rate for Payer: BCN Medicare Advantage |
$759.25
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cofinity Commercial |
$1,093.32
|
| Rate for Payer: Cofinity Commercial |
$1,017.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.21
|
| Rate for Payer: Nomi Health Commercial |
$911.10
|
| Rate for Payer: PACE SWMI |
$759.25
|
| Rate for Payer: PHP Commercial |
$1,062.95
|
| Rate for Payer: PHP Medicare Advantage |
$759.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.05
|
| Rate for Payer: Priority Health Medicare |
$759.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.25
|
| Rate for Payer: UHC Medicare Advantage |
$759.25
|
| Rate for Payer: UMR Bronson Commercial |
$734.62
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$898.49 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,203.98
|
| Rate for Payer: Aetna Medicare |
$934.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,293.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,203.98
|
| Rate for Payer: BCBS Complete |
$1,246.40
|
| Rate for Payer: BCBS MAPPO |
$898.49
|
| Rate for Payer: BCN Medicare Advantage |
$898.49
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cofinity Commercial |
$1,293.83
|
| Rate for Payer: Cofinity Commercial |
$1,203.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$943.41
|
| Rate for Payer: Nomi Health Commercial |
$1,078.19
|
| Rate for Payer: PACE SWMI |
$898.49
|
| Rate for Payer: PHP Commercial |
$1,257.89
|
| Rate for Payer: PHP Medicare Advantage |
$898.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
| Rate for Payer: Priority Health Medicare |
$898.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.49
|
| Rate for Payer: UHC Medicare Advantage |
$898.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,433.36
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$492.40 |
| Max. Negotiated Rate |
$870.60 |
| Rate for Payer: Aetna Commercial |
$810.14
|
| Rate for Payer: Aetna Medicare |
$628.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$870.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.14
|
| Rate for Payer: BCBS Complete |
$492.40
|
| Rate for Payer: BCBS MAPPO |
$604.58
|
| Rate for Payer: BCN Medicare Advantage |
$604.58
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$870.60
|
| Rate for Payer: Cofinity Commercial |
$810.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$634.81
|
| Rate for Payer: Nomi Health Commercial |
$725.50
|
| Rate for Payer: PACE SWMI |
$604.58
|
| Rate for Payer: PHP Commercial |
$846.41
|
| Rate for Payer: PHP Medicare Advantage |
$604.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.15
|
| Rate for Payer: Priority Health Medicare |
$604.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.58
|
| Rate for Payer: UHC Medicare Advantage |
$604.58
|
| Rate for Payer: UMR Bronson Commercial |
$566.26
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$538.55 |
| Max. Negotiated Rate |
$1,430.65 |
| Rate for Payer: Aetna Commercial |
$721.66
|
| Rate for Payer: Aetna Medicare |
$560.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.66
|
| Rate for Payer: BCBS Complete |
$880.40
|
| Rate for Payer: BCBS MAPPO |
$538.55
|
| Rate for Payer: BCN Medicare Advantage |
$538.55
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$775.51
|
| Rate for Payer: Cofinity Commercial |
$721.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.48
|
| Rate for Payer: Nomi Health Commercial |
$646.26
|
| Rate for Payer: PACE SWMI |
$538.55
|
| Rate for Payer: PHP Commercial |
$753.97
|
| Rate for Payer: PHP Medicare Advantage |
$538.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health Medicare |
$538.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.55
|
| Rate for Payer: UHC Medicare Advantage |
$538.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.46
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$474.14 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$635.35
|
| Rate for Payer: Aetna Medicare |
$493.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$635.35
|
| Rate for Payer: BCBS Complete |
$776.80
|
| Rate for Payer: BCBS MAPPO |
$474.14
|
| Rate for Payer: BCN Medicare Advantage |
$474.14
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$682.76
|
| Rate for Payer: Cofinity Commercial |
$635.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.85
|
| Rate for Payer: Nomi Health Commercial |
$568.97
|
| Rate for Payer: PACE SWMI |
$474.14
|
| Rate for Payer: PHP Commercial |
$663.80
|
| Rate for Payer: PHP Medicare Advantage |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health Medicare |
$474.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.14
|
| Rate for Payer: UHC Medicare Advantage |
$474.14
|
| Rate for Payer: UMR Bronson Commercial |
$893.32
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$441.92 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$592.17
|
| Rate for Payer: Aetna Medicare |
$459.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.17
|
| Rate for Payer: BCBS Complete |
$750.80
|
| Rate for Payer: BCBS MAPPO |
$441.92
|
| Rate for Payer: BCN Medicare Advantage |
$441.92
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$636.36
|
| Rate for Payer: Cofinity Commercial |
$592.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.02
|
| Rate for Payer: Nomi Health Commercial |
$530.30
|
| Rate for Payer: PACE SWMI |
$441.92
|
| Rate for Payer: PHP Commercial |
$618.69
|
| Rate for Payer: PHP Medicare Advantage |
$441.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health Medicare |
$441.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.92
|
| Rate for Payer: UHC Medicare Advantage |
$441.92
|
| Rate for Payer: UMR Bronson Commercial |
$863.42
|
|
