|
PR ARTHRODESIS KNEE ANY TECHNIQUE
|
Professional
|
Both
|
$3,222.00
|
|
|
Service Code
|
HCPCS 27580
|
| Min. Negotiated Rate |
$951.47 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$1,894.21
|
| Rate for Payer: Aetna Medicare |
$1,470.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,894.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,035.57
|
| Rate for Payer: BCBS Complete |
$999.04
|
| Rate for Payer: BCBS MAPPO |
$1,413.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$2,158.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.59
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cofinity Commercial |
$1,894.21
|
| Rate for Payer: Cofinity Commercial |
$2,035.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.27
|
| Rate for Payer: Meridian Medicaid |
$999.04
|
| Rate for Payer: Nomi Health Commercial |
$1,696.31
|
| Rate for Payer: PACE SWMI |
$1,413.59
|
| Rate for Payer: PHP Commercial |
$1,979.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$951.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,264.42
|
| Rate for Payer: Priority Health Medicare |
$1,413.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,264.42
|
| Rate for Payer: Priority Health SBD |
$2,264.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,413.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,413.59
|
| Rate for Payer: UHCCP Medicaid |
$951.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,482.12
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR
|
Professional
|
Both
|
$6,054.00
|
|
|
Service Code
|
HCPCS 22533
|
| Min. Negotiated Rate |
$1,076.08 |
| Max. Negotiated Rate |
$3,935.10 |
| Rate for Payer: Aetna Commercial |
$2,163.40
|
| Rate for Payer: Aetna Medicare |
$1,679.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,163.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,324.85
|
| Rate for Payer: BCBS Complete |
$1,129.88
|
| Rate for Payer: BCBS MAPPO |
$1,614.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.44
|
| Rate for Payer: BCN Commercial |
$2,422.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,614.48
|
| Rate for Payer: Cash Price |
$4,843.20
|
| Rate for Payer: Cash Price |
$4,843.20
|
| Rate for Payer: Cofinity Commercial |
$2,163.40
|
| Rate for Payer: Cofinity Commercial |
$2,324.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,614.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,695.20
|
| Rate for Payer: Meridian Medicaid |
$1,129.88
|
| Rate for Payer: Nomi Health Commercial |
$1,937.38
|
| Rate for Payer: PACE SWMI |
$1,614.48
|
| Rate for Payer: PHP Commercial |
$2,260.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,614.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,076.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,935.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,552.95
|
| Rate for Payer: Priority Health Medicare |
$1,614.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.95
|
| Rate for Payer: Priority Health SBD |
$2,552.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,614.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,614.48
|
| Rate for Payer: UHCCP Medicaid |
$1,076.08
|
| Rate for Payer: UMR Bronson Commercial |
$2,784.84
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY THORACIC
|
Professional
|
Both
|
$6,049.00
|
|
|
Service Code
|
HCPCS 22532
|
| Min. Negotiated Rate |
$1,161.70 |
| Max. Negotiated Rate |
$3,931.85 |
| Rate for Payer: Aetna Commercial |
$2,346.76
|
| Rate for Payer: Aetna Medicare |
$1,821.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,346.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,521.89
|
| Rate for Payer: BCBS Complete |
$1,219.78
|
| Rate for Payer: BCBS MAPPO |
$1,751.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.50
|
| Rate for Payer: BCN Commercial |
$2,638.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,751.31
|
| Rate for Payer: Cash Price |
$4,839.20
|
| Rate for Payer: Cash Price |
$4,839.20
|
| Rate for Payer: Cofinity Commercial |
$2,346.76
|
| Rate for Payer: Cofinity Commercial |
$2,521.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,751.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,838.88
|
| Rate for Payer: Meridian Medicaid |
$1,219.78
|
| Rate for Payer: Nomi Health Commercial |
$2,101.57
|
| Rate for Payer: PACE SWMI |
$1,751.31
|
| Rate for Payer: PHP Commercial |
$2,451.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,751.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,161.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,764.64
|
| Rate for Payer: Priority Health Medicare |
$1,751.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,764.64
|
| Rate for Payer: Priority Health SBD |
$2,764.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,751.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,751.31
|
| Rate for Payer: UHCCP Medicaid |
$1,161.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,782.54
|
|
|
PR ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$3,010.00
|
|
|
Service Code
|
HCPCS 22534
|
| Min. Negotiated Rate |
$230.89 |
| Max. Negotiated Rate |
$1,956.50 |
| Rate for Payer: Aetna Commercial |
$471.59
|
| Rate for Payer: Aetna Medicare |
$366.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.78
|
| Rate for Payer: BCBS Complete |
$242.43
|
| Rate for Payer: BCBS MAPPO |
$351.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,499.55
|
| Rate for Payer: BCN Commercial |
$523.37
|
| Rate for Payer: BCN Medicare Advantage |
$351.93
|
| Rate for Payer: Cash Price |
$2,408.00
|
| Rate for Payer: Cash Price |
$2,408.00
|
| Rate for Payer: Cofinity Commercial |
$471.59
|
| Rate for Payer: Cofinity Commercial |
$506.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.53
|
| Rate for Payer: Meridian Medicaid |
$242.43
|
| Rate for Payer: Nomi Health Commercial |
$422.32
|
| Rate for Payer: PACE SWMI |
$351.93
|
| Rate for Payer: PHP Commercial |
$492.70
|
| Rate for Payer: PHP Medicare Advantage |
$351.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,956.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.05
|
| Rate for Payer: Priority Health Medicare |
$351.93
|
| Rate for Payer: Priority Health Narrow Network |
$548.05
|
| Rate for Payer: Priority Health SBD |
$548.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.93
|
| Rate for Payer: UHC Medicare Advantage |
$351.93
|
| Rate for Payer: UHCCP Medicaid |
$230.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,384.60
|
|
|
PR ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 26850
|
| Min. Negotiated Rate |
$474.78 |
| Max. Negotiated Rate |
$4,317.80 |
| Rate for Payer: Aetna Commercial |
$923.03
|
| Rate for Payer: Aetna Medicare |
$716.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.92
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$688.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,317.80
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$688.83
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cofinity Commercial |
$923.03
|
| Rate for Payer: Cofinity Commercial |
$991.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.27
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Nomi Health Commercial |
$826.60
|
| Rate for Payer: PACE SWMI |
$688.83
|
| Rate for Payer: PHP Commercial |
$964.36
|
| Rate for Payer: PHP Medicare Advantage |
$688.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,501.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.79
|
| Rate for Payer: Priority Health Medicare |
$688.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.79
|
| Rate for Payer: Priority Health SBD |
$1,136.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$688.83
|
| Rate for Payer: UHC Medicare Advantage |
$688.83
|
| Rate for Payer: UHCCP Medicaid |
$474.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,062.60
|
|
|
PR ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT
|
Professional
|
Both
|
$2,154.00
|
|
|
Service Code
|
HCPCS 28740
|
| Min. Negotiated Rate |
$399.16 |
| Max. Negotiated Rate |
$1,400.10 |
| Rate for Payer: Aetna Commercial |
$790.13
|
| Rate for Payer: Aetna Medicare |
$613.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.10
|
| Rate for Payer: BCBS Complete |
$419.12
|
| Rate for Payer: BCBS MAPPO |
$589.65
|
| Rate for Payer: BCBS Trust/PPO |
$673.58
|
| Rate for Payer: BCN Commercial |
$1,207.52
|
| Rate for Payer: BCN Medicare Advantage |
$589.65
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cofinity Commercial |
$790.13
|
| Rate for Payer: Cofinity Commercial |
$849.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.13
|
| Rate for Payer: Meridian Medicaid |
$419.12
|
| Rate for Payer: Nomi Health Commercial |
$707.58
|
| Rate for Payer: PACE SWMI |
$589.65
|
| Rate for Payer: PHP Commercial |
$825.51
|
| Rate for Payer: PHP Medicare Advantage |
$589.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$949.02
|
| Rate for Payer: Priority Health Medicare |
$589.65
|
| Rate for Payer: Priority Health Narrow Network |
$949.02
|
| Rate for Payer: Priority Health SBD |
$949.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.65
|
| Rate for Payer: UHC Medicare Advantage |
$589.65
|
| Rate for Payer: UHCCP Medicaid |
$399.16
|
| Rate for Payer: UMR Bronson Commercial |
$990.84
|
|
|
PR ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,860.00
|
|
|
Service Code
|
HCPCS 26852
|
| Min. Negotiated Rate |
$539.74 |
| Max. Negotiated Rate |
$5,128.74 |
| Rate for Payer: Aetna Commercial |
$1,052.70
|
| Rate for Payer: Aetna Medicare |
$817.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,131.26
|
| Rate for Payer: BCBS Complete |
$566.73
|
| Rate for Payer: BCBS MAPPO |
$785.60
|
| Rate for Payer: BCBS Trust/PPO |
$5,128.74
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: BCN Medicare Advantage |
$785.60
|
| Rate for Payer: Cash Price |
$2,288.00
|
| Rate for Payer: Cash Price |
$2,288.00
|
| Rate for Payer: Cofinity Commercial |
$1,052.70
|
| Rate for Payer: Cofinity Commercial |
$1,131.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.88
|
| Rate for Payer: Meridian Medicaid |
$566.73
|
| Rate for Payer: Nomi Health Commercial |
$942.72
|
| Rate for Payer: PACE SWMI |
$785.60
|
| Rate for Payer: PHP Commercial |
$1,099.84
|
| Rate for Payer: PHP Medicare Advantage |
$785.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.96
|
| Rate for Payer: Priority Health Medicare |
$785.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,289.96
|
| Rate for Payer: Priority Health SBD |
$1,289.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.60
|
| Rate for Payer: UHC Medicare Advantage |
$785.60
|
| Rate for Payer: UHCCP Medicaid |
$539.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,315.60
|
|
|
PR ARTHRODESIS PANTALAR
|
Professional
|
Both
|
$3,938.00
|
|
|
Service Code
|
HCPCS 28705
|
| Min. Negotiated Rate |
$644.53 |
| Max. Negotiated Rate |
$2,559.70 |
| Rate for Payer: Aetna Commercial |
$1,572.03
|
| Rate for Payer: Aetna Medicare |
$1,220.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,572.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,689.35
|
| Rate for Payer: BCBS Complete |
$826.61
|
| Rate for Payer: BCBS MAPPO |
$1,173.16
|
| Rate for Payer: BCBS Trust/PPO |
$644.53
|
| Rate for Payer: BCN Commercial |
$1,779.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,173.16
|
| Rate for Payer: Cash Price |
$3,150.40
|
| Rate for Payer: Cash Price |
$3,150.40
|
| Rate for Payer: Cofinity Commercial |
$1,572.03
|
| Rate for Payer: Cofinity Commercial |
$1,689.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,173.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,231.82
|
| Rate for Payer: Meridian Medicaid |
$826.61
|
| Rate for Payer: Nomi Health Commercial |
$1,407.79
|
| Rate for Payer: PACE SWMI |
$1,173.16
|
| Rate for Payer: PHP Commercial |
$1,642.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,173.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$787.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,559.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,868.54
|
| Rate for Payer: Priority Health Medicare |
$1,173.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,868.54
|
| Rate for Payer: Priority Health SBD |
$1,868.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,173.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,173.16
|
| Rate for Payer: UHCCP Medicaid |
$787.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,811.48
|
|
|
PR ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2
|
Professional
|
Both
|
$5,175.00
|
|
|
Service Code
|
HCPCS 22595
|
| Min. Negotiated Rate |
$992.58 |
| Max. Negotiated Rate |
$3,363.75 |
| Rate for Payer: Aetna Commercial |
$2,006.13
|
| Rate for Payer: Aetna Medicare |
$1,556.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,006.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,155.84
|
| Rate for Payer: BCBS Complete |
$1,042.21
|
| Rate for Payer: BCBS MAPPO |
$1,497.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$2,460.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,497.11
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cofinity Commercial |
$2,006.13
|
| Rate for Payer: Cofinity Commercial |
$2,155.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,497.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,571.97
|
| Rate for Payer: Meridian Medicaid |
$1,042.21
|
| Rate for Payer: Nomi Health Commercial |
$1,796.53
|
| Rate for Payer: PACE SWMI |
$1,497.11
|
| Rate for Payer: PHP Commercial |
$2,095.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,497.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$992.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,363.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,356.02
|
| Rate for Payer: Priority Health Medicare |
$1,497.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,356.02
|
| Rate for Payer: Priority Health SBD |
$2,356.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,497.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,497.11
|
| Rate for Payer: UHCCP Medicaid |
$992.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,380.50
|
|
|
PR ARTHRODESIS POSTERIOR CRANIOCERVICAL
|
Professional
|
Both
|
$5,337.00
|
|
|
Service Code
|
HCPCS 22590
|
| Min. Negotiated Rate |
$1,039.01 |
| Max. Negotiated Rate |
$3,469.05 |
| Rate for Payer: Aetna Commercial |
$2,101.75
|
| Rate for Payer: Aetna Medicare |
$1,631.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,101.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,258.60
|
| Rate for Payer: BCBS Complete |
$1,090.96
|
| Rate for Payer: BCBS MAPPO |
$1,568.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.44
|
| Rate for Payer: BCN Commercial |
$2,579.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.47
|
| Rate for Payer: Cash Price |
$4,269.60
|
| Rate for Payer: Cash Price |
$4,269.60
|
| Rate for Payer: Cofinity Commercial |
$2,101.75
|
| Rate for Payer: Cofinity Commercial |
$2,258.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.89
|
| Rate for Payer: Meridian Medicaid |
$1,090.96
|
| Rate for Payer: Nomi Health Commercial |
$1,882.16
|
| Rate for Payer: PACE SWMI |
$1,568.47
|
| Rate for Payer: PHP Commercial |
$2,195.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,039.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,469.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,464.41
|
| Rate for Payer: Priority Health Medicare |
$1,568.47
|
| Rate for Payer: Priority Health Narrow Network |
$2,464.41
|
| Rate for Payer: Priority Health SBD |
$2,464.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.47
|
| Rate for Payer: UHCCP Medicaid |
$1,039.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,455.02
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 22632
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$820.30 |
| Rate for Payer: Aetna Commercial |
$421.23
|
| Rate for Payer: Aetna Medicare |
$326.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.66
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$314.35
|
| Rate for Payer: BCBS Trust/PPO |
$650.50
|
| Rate for Payer: BCN Commercial |
$514.40
|
| Rate for Payer: BCN Medicare Advantage |
$314.35
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cofinity Commercial |
$421.23
|
| Rate for Payer: Cofinity Commercial |
$452.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.07
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Nomi Health Commercial |
$377.22
|
| Rate for Payer: PACE SWMI |
$314.35
|
| Rate for Payer: PHP Commercial |
$440.09
|
| Rate for Payer: PHP Medicare Advantage |
$314.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.53
|
| Rate for Payer: Priority Health Medicare |
$314.35
|
| Rate for Payer: Priority Health Narrow Network |
$489.53
|
| Rate for Payer: Priority Health SBD |
$489.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.35
|
| Rate for Payer: UHC Medicare Advantage |
$314.35
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$580.52
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$6,749.00
|
|
|
Service Code
|
HCPCS 22630
|
| Min. Negotiated Rate |
$650.50 |
| Max. Negotiated Rate |
$4,386.85 |
| Rate for Payer: Aetna Commercial |
$2,059.46
|
| Rate for Payer: Aetna Medicare |
$1,598.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,059.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,213.15
|
| Rate for Payer: BCBS Complete |
$1,067.70
|
| Rate for Payer: BCBS MAPPO |
$1,536.91
|
| Rate for Payer: BCBS Trust/PPO |
$650.50
|
| Rate for Payer: BCN Commercial |
$2,524.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,536.91
|
| Rate for Payer: Cash Price |
$5,399.20
|
| Rate for Payer: Cash Price |
$5,399.20
|
| Rate for Payer: Cofinity Commercial |
$2,059.46
|
| Rate for Payer: Cofinity Commercial |
$2,213.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,536.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,613.76
|
| Rate for Payer: Meridian Medicaid |
$1,067.70
|
| Rate for Payer: Nomi Health Commercial |
$1,844.29
|
| Rate for Payer: PACE SWMI |
$1,536.91
|
| Rate for Payer: PHP Commercial |
$2,151.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,536.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,016.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,386.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,411.48
|
| Rate for Payer: Priority Health Medicare |
$1,536.91
|
| Rate for Payer: Priority Health Narrow Network |
$2,411.48
|
| Rate for Payer: Priority Health SBD |
$2,411.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,536.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,536.91
|
| Rate for Payer: UHCCP Medicaid |
$1,016.86
|
| Rate for Payer: UMR Bronson Commercial |
$3,104.54
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 22612
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$2,556.92 |
| Rate for Payer: Aetna Commercial |
$2,062.72
|
| Rate for Payer: Aetna Medicare |
$1,600.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,062.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,216.65
|
| Rate for Payer: BCBS Complete |
$1,074.19
|
| Rate for Payer: BCBS MAPPO |
$1,539.34
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,556.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,539.34
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cofinity Commercial |
$2,062.72
|
| Rate for Payer: Cofinity Commercial |
$2,216.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,539.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,616.31
|
| Rate for Payer: Meridian Medicaid |
$1,074.19
|
| Rate for Payer: Nomi Health Commercial |
$1,847.21
|
| Rate for Payer: PACE SWMI |
$1,539.34
|
| Rate for Payer: PHP Commercial |
$2,155.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,539.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,023.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,144.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,431.85
|
| Rate for Payer: Priority Health Medicare |
$1,539.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,431.85
|
| Rate for Payer: Priority Health SBD |
$2,431.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,539.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,539.34
|
| Rate for Payer: UHCCP Medicaid |
$1,023.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,517.54
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC
|
Professional
|
Both
|
$4,286.00
|
|
|
Service Code
|
HCPCS 22610
|
| Min. Negotiated Rate |
$837.94 |
| Max. Negotiated Rate |
$4,702.18 |
| Rate for Payer: Aetna Commercial |
$1,685.25
|
| Rate for Payer: Aetna Medicare |
$1,307.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.02
|
| Rate for Payer: BCBS Complete |
$879.84
|
| Rate for Payer: BCBS MAPPO |
$1,257.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,702.18
|
| Rate for Payer: BCN Commercial |
$2,076.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.65
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,685.25
|
| Rate for Payer: Cofinity Commercial |
$1,811.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.53
|
| Rate for Payer: Meridian Medicaid |
$879.84
|
| Rate for Payer: Nomi Health Commercial |
$1,509.18
|
| Rate for Payer: PACE SWMI |
$1,257.65
|
| Rate for Payer: PHP Commercial |
$1,760.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,785.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,984.55
|
| Rate for Payer: Priority Health Medicare |
$1,257.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,984.55
|
| Rate for Payer: Priority Health SBD |
$1,984.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.65
|
| Rate for Payer: UHCCP Medicaid |
$837.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,971.56
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM
|
Professional
|
Both
|
$5,067.00
|
|
|
Service Code
|
HCPCS 22804
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$3,730.46 |
| Rate for Payer: Cash Price |
$4,053.60
|
| Rate for Payer: Aetna Commercial |
$3,153.15
|
| Rate for Payer: Aetna Medicare |
$2,447.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,153.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,388.46
|
| Rate for Payer: BCBS Complete |
$1,639.81
|
| Rate for Payer: BCBS MAPPO |
$2,353.10
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$3,559.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,353.10
|
| Rate for Payer: Cash Price |
$4,053.60
|
| Rate for Payer: Cofinity Commercial |
$3,153.15
|
| Rate for Payer: Cofinity Commercial |
$3,388.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,353.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,470.76
|
| Rate for Payer: Meridian Medicaid |
$1,639.81
|
| Rate for Payer: Nomi Health Commercial |
$2,823.72
|
| Rate for Payer: PACE SWMI |
$2,353.10
|
| Rate for Payer: PHP Commercial |
$3,294.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,353.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,561.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,293.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,730.46
|
| Rate for Payer: Priority Health Medicare |
$2,353.10
|
| Rate for Payer: Priority Health Narrow Network |
$3,730.46
|
| Rate for Payer: Priority Health SBD |
$3,730.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,353.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,353.10
|
| Rate for Payer: UHCCP Medicaid |
$1,561.72
|
| Rate for Payer: UMR Bronson Commercial |
$2,330.82
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM
|
Professional
|
Both
|
$2,812.00
|
|
|
Service Code
|
HCPCS 22800
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$2,106.68 |
| Rate for Payer: Aetna Commercial |
$1,786.42
|
| Rate for Payer: Aetna Medicare |
$1,386.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,786.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,919.74
|
| Rate for Payer: BCBS Complete |
$933.51
|
| Rate for Payer: BCBS MAPPO |
$1,333.15
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$2,007.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.15
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cofinity Commercial |
$1,786.42
|
| Rate for Payer: Cofinity Commercial |
$1,919.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,399.81
|
| Rate for Payer: Meridian Medicaid |
$933.51
|
| Rate for Payer: Nomi Health Commercial |
$1,599.78
|
| Rate for Payer: PACE SWMI |
$1,333.15
|
| Rate for Payer: PHP Commercial |
$1,866.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$889.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,827.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,106.68
|
| Rate for Payer: Priority Health Medicare |
$1,333.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,106.68
|
| Rate for Payer: Priority Health SBD |
$2,106.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.15
|
| Rate for Payer: UHCCP Medicaid |
$889.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,293.52
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM
|
Professional
|
Both
|
$4,380.00
|
|
|
Service Code
|
HCPCS 22802
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$3,252.64 |
| Rate for Payer: Aetna Commercial |
$2,745.12
|
| Rate for Payer: Aetna Medicare |
$2,130.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,745.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,949.98
|
| Rate for Payer: BCBS Complete |
$1,428.90
|
| Rate for Payer: BCBS MAPPO |
$2,048.60
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$3,100.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,048.60
|
| Rate for Payer: Cash Price |
$3,504.00
|
| Rate for Payer: Cash Price |
$3,504.00
|
| Rate for Payer: Cofinity Commercial |
$2,745.12
|
| Rate for Payer: Cofinity Commercial |
$2,949.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,048.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,151.03
|
| Rate for Payer: Meridian Medicaid |
$1,428.90
|
| Rate for Payer: Nomi Health Commercial |
$2,458.32
|
| Rate for Payer: PACE SWMI |
$2,048.60
|
| Rate for Payer: PHP Commercial |
$2,868.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,048.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,360.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,847.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,252.64
|
| Rate for Payer: Priority Health Medicare |
$2,048.60
|
| Rate for Payer: Priority Health Narrow Network |
$3,252.64
|
| Rate for Payer: Priority Health SBD |
$3,252.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,048.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,048.60
|
| Rate for Payer: UHCCP Medicaid |
$1,360.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,014.80
|
|
|
PR ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC
|
Professional
|
Both
|
$1,875.00
|
|
|
Service Code
|
HCPCS 22614
|
| Min. Negotiated Rate |
$250.49 |
| Max. Negotiated Rate |
$1,218.75 |
| Rate for Payer: Aetna Commercial |
$512.67
|
| Rate for Payer: Aetna Medicare |
$397.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.93
|
| Rate for Payer: BCBS Complete |
$263.01
|
| Rate for Payer: BCBS MAPPO |
$382.59
|
| Rate for Payer: BCBS Trust/PPO |
$934.38
|
| Rate for Payer: BCN Commercial |
$626.32
|
| Rate for Payer: BCN Medicare Advantage |
$382.59
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$512.67
|
| Rate for Payer: Cofinity Commercial |
$550.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.72
|
| Rate for Payer: Meridian Medicaid |
$263.01
|
| Rate for Payer: Nomi Health Commercial |
$459.11
|
| Rate for Payer: PACE SWMI |
$382.59
|
| Rate for Payer: PHP Commercial |
$535.63
|
| Rate for Payer: PHP Medicare Advantage |
$382.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$595.36
|
| Rate for Payer: Priority Health Medicare |
$382.59
|
| Rate for Payer: Priority Health Narrow Network |
$595.36
|
| Rate for Payer: Priority Health SBD |
$595.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.59
|
| Rate for Payer: UHC Medicare Advantage |
$382.59
|
| Rate for Payer: UHCCP Medicaid |
$250.49
|
| Rate for Payer: UMR Bronson Commercial |
$862.50
|
|
|
PR ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE
|
Professional
|
Both
|
$1,316.00
|
|
|
Service Code
|
HCPCS 27279
|
| Min. Negotiated Rate |
$520.36 |
| Max. Negotiated Rate |
$3,376.37 |
| Rate for Payer: Aetna Commercial |
$1,039.38
|
| Rate for Payer: Aetna Medicare |
$806.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,116.95
|
| Rate for Payer: BCBS Complete |
$546.38
|
| Rate for Payer: BCBS MAPPO |
$775.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,376.37
|
| Rate for Payer: BCN Commercial |
$1,192.37
|
| Rate for Payer: BCN Medicare Advantage |
$775.66
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,039.38
|
| Rate for Payer: Cofinity Commercial |
$1,116.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.44
|
| Rate for Payer: Meridian Medicaid |
$546.38
|
| Rate for Payer: Nomi Health Commercial |
$930.79
|
| Rate for Payer: PACE SWMI |
$775.66
|
| Rate for Payer: PHP Commercial |
$1,085.92
|
| Rate for Payer: PHP Medicare Advantage |
$775.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$855.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,229.41
|
| Rate for Payer: Priority Health Medicare |
$775.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,229.41
|
| Rate for Payer: Priority Health SBD |
$1,229.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.66
|
| Rate for Payer: UHC Medicare Advantage |
$775.66
|
| Rate for Payer: UHCCP Medicaid |
$520.36
|
| Rate for Payer: UMR Bronson Commercial |
$605.36
|
|
|
PR ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ
|
Professional
|
Both
|
$3,240.00
|
|
|
Service Code
|
HCPCS 27280
|
| Min. Negotiated Rate |
$884.38 |
| Max. Negotiated Rate |
$3,839.22 |
| Rate for Payer: Aetna Commercial |
$1,784.09
|
| Rate for Payer: Aetna Medicare |
$1,384.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,784.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,917.23
|
| Rate for Payer: BCBS Complete |
$928.60
|
| Rate for Payer: BCBS MAPPO |
$1,331.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,839.22
|
| Rate for Payer: BCN Commercial |
$1,997.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,331.41
|
| Rate for Payer: Cash Price |
$2,592.00
|
| Rate for Payer: Cash Price |
$2,592.00
|
| Rate for Payer: Cofinity Commercial |
$1,784.09
|
| Rate for Payer: Cofinity Commercial |
$1,917.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,331.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,397.98
|
| Rate for Payer: Meridian Medicaid |
$928.60
|
| Rate for Payer: Nomi Health Commercial |
$1,597.69
|
| Rate for Payer: PACE SWMI |
$1,331.41
|
| Rate for Payer: PHP Commercial |
$1,863.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,331.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$884.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,106.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,093.46
|
| Rate for Payer: Priority Health Medicare |
$1,331.41
|
| Rate for Payer: Priority Health Narrow Network |
$2,093.46
|
| Rate for Payer: Priority Health SBD |
$2,093.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,331.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,331.41
|
| Rate for Payer: UHCCP Medicaid |
$884.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,490.40
|
|
|
PR ARTHRODESIS SUBTALAR
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 28725
|
| Min. Negotiated Rate |
$505.45 |
| Max. Negotiated Rate |
$2,129.40 |
| Rate for Payer: Aetna Commercial |
$1,000.86
|
| Rate for Payer: Aetna Medicare |
$776.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.55
|
| Rate for Payer: BCBS Complete |
$530.72
|
| Rate for Payer: BCBS MAPPO |
$746.91
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$1,138.62
|
| Rate for Payer: BCN Medicare Advantage |
$746.91
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$1,000.86
|
| Rate for Payer: Cofinity Commercial |
$1,075.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.26
|
| Rate for Payer: Meridian Medicaid |
$530.72
|
| Rate for Payer: Nomi Health Commercial |
$896.29
|
| Rate for Payer: PACE SWMI |
$746.91
|
| Rate for Payer: PHP Commercial |
$1,045.67
|
| Rate for Payer: PHP Medicare Advantage |
$746.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,198.87
|
| Rate for Payer: Priority Health Medicare |
$746.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,198.87
|
| Rate for Payer: Priority Health SBD |
$1,198.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.91
|
| Rate for Payer: UHC Medicare Advantage |
$746.91
|
| Rate for Payer: UHCCP Medicaid |
$505.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,506.96
|
|
|
PR ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT
|
Professional
|
Both
|
$1,503.00
|
|
|
Service Code
|
HCPCS 27282
|
| Min. Negotiated Rate |
$560.19 |
| Max. Negotiated Rate |
$2,399.54 |
| Rate for Payer: Aetna Commercial |
$1,111.58
|
| Rate for Payer: Aetna Medicare |
$862.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,194.54
|
| Rate for Payer: BCBS Complete |
$588.20
|
| Rate for Payer: BCBS MAPPO |
$829.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.54
|
| Rate for Payer: BCN Commercial |
$1,265.19
|
| Rate for Payer: BCN Medicare Advantage |
$829.54
|
| Rate for Payer: Cash Price |
$1,202.40
|
| Rate for Payer: Cash Price |
$1,202.40
|
| Rate for Payer: Cofinity Commercial |
$1,111.58
|
| Rate for Payer: Cofinity Commercial |
$1,194.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$871.02
|
| Rate for Payer: Meridian Medicaid |
$588.20
|
| Rate for Payer: Nomi Health Commercial |
$995.45
|
| Rate for Payer: PACE SWMI |
$829.54
|
| Rate for Payer: PHP Commercial |
$1,161.36
|
| Rate for Payer: PHP Medicare Advantage |
$829.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.62
|
| Rate for Payer: Priority Health Medicare |
$829.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,327.62
|
| Rate for Payer: Priority Health SBD |
$1,327.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.54
|
| Rate for Payer: UHC Medicare Advantage |
$829.54
|
| Rate for Payer: UHCCP Medicaid |
$560.19
|
| Rate for Payer: UMR Bronson Commercial |
$691.38
|
|
|
PR ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27871
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$2,282.01 |
| Rate for Payer: Aetna Commercial |
$888.84
|
| Rate for Payer: Aetna Medicare |
$689.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.17
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$663.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,282.01
|
| Rate for Payer: BCN Commercial |
$1,016.94
|
| Rate for Payer: BCN Medicare Advantage |
$663.31
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$888.84
|
| Rate for Payer: Cofinity Commercial |
$955.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.48
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PACE SWMI |
$663.31
|
| Rate for Payer: PHP Commercial |
$928.63
|
| Rate for Payer: PHP Medicare Advantage |
$663.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.59
|
| Rate for Payer: Priority Health Medicare |
$663.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.59
|
| Rate for Payer: Priority Health SBD |
$1,067.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.31
|
| Rate for Payer: UHC Medicare Advantage |
$663.31
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,382.30
|
|
|
PR ARTHRODESIS TRIPLE
|
Professional
|
Both
|
$4,084.00
|
|
|
Service Code
|
HCPCS 28715
|
| Min. Negotiated Rate |
$611.10 |
| Max. Negotiated Rate |
$2,654.60 |
| Rate for Payer: Aetna Commercial |
$1,210.88
|
| Rate for Payer: Aetna Medicare |
$939.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,210.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.24
|
| Rate for Payer: BCBS Complete |
$641.66
|
| Rate for Payer: BCBS MAPPO |
$903.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.92
|
| Rate for Payer: BCN Commercial |
$1,376.60
|
| Rate for Payer: BCN Medicare Advantage |
$903.64
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,210.88
|
| Rate for Payer: Cofinity Commercial |
$1,301.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.82
|
| Rate for Payer: Meridian Medicaid |
$641.66
|
| Rate for Payer: Nomi Health Commercial |
$1,084.37
|
| Rate for Payer: PACE SWMI |
$903.64
|
| Rate for Payer: PHP Commercial |
$1,265.10
|
| Rate for Payer: PHP Medicare Advantage |
$903.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$611.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,654.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,444.65
|
| Rate for Payer: Priority Health Medicare |
$903.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,444.65
|
| Rate for Payer: Priority Health SBD |
$1,444.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$903.64
|
| Rate for Payer: UHC Medicare Advantage |
$903.64
|
| Rate for Payer: UHCCP Medicaid |
$611.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,878.64
|
|
|
PR ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT
|
Professional
|
Both
|
$2,459.00
|
|
|
Service Code
|
HCPCS 25800
|
| Min. Negotiated Rate |
$478.61 |
| Max. Negotiated Rate |
$1,598.35 |
| Rate for Payer: Aetna Commercial |
$947.69
|
| Rate for Payer: Aetna Medicare |
$735.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.69
|
| Rate for Payer: BCBS Complete |
$502.54
|
| Rate for Payer: BCBS MAPPO |
$707.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,424.30
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: BCN Medicare Advantage |
$707.23
|
| Rate for Payer: Cash Price |
$1,967.20
|
| Rate for Payer: Cash Price |
$1,967.20
|
| Rate for Payer: Cofinity Commercial |
$1,018.41
|
| Rate for Payer: Cofinity Commercial |
$947.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.59
|
| Rate for Payer: Meridian Medicaid |
$502.54
|
| Rate for Payer: Nomi Health Commercial |
$848.68
|
| Rate for Payer: PACE SWMI |
$707.23
|
| Rate for Payer: PHP Commercial |
$990.12
|
| Rate for Payer: PHP Medicare Advantage |
$707.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.20
|
| Rate for Payer: Priority Health Medicare |
$707.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.20
|
| Rate for Payer: Priority Health SBD |
$1,131.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.23
|
| Rate for Payer: UHC Medicare Advantage |
$707.23
|
| Rate for Payer: UHCCP Medicaid |
$478.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,131.14
|
|
