|
PR ARTHRODESIS WRIST LIMITED W/O BONE GRAFT
|
Professional
|
Both
|
$2,837.00
|
|
|
Service Code
|
HCPCS 25820
|
| Min. Negotiated Rate |
$424.51 |
| Max. Negotiated Rate |
$1,844.05 |
| Rate for Payer: Aetna Commercial |
$833.13
|
| Rate for Payer: Aetna Medicare |
$646.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$833.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.31
|
| Rate for Payer: BCBS Complete |
$445.74
|
| Rate for Payer: BCBS MAPPO |
$621.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$621.74
|
| Rate for Payer: Cash Price |
$2,269.60
|
| Rate for Payer: Cash Price |
$2,269.60
|
| Rate for Payer: Cofinity Commercial |
$833.13
|
| Rate for Payer: Cofinity Commercial |
$895.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.83
|
| Rate for Payer: Meridian Medicaid |
$445.74
|
| Rate for Payer: Nomi Health Commercial |
$746.09
|
| Rate for Payer: PACE SWMI |
$621.74
|
| Rate for Payer: PHP Commercial |
$870.44
|
| Rate for Payer: PHP Medicare Advantage |
$621.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.04
|
| Rate for Payer: Priority Health Medicare |
$621.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.04
|
| Rate for Payer: Priority Health SBD |
$1,007.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.74
|
| Rate for Payer: UHC Medicare Advantage |
$621.74
|
| Rate for Payer: UHCCP Medicaid |
$424.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,305.02
|
|
|
PR ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT
|
Professional
|
Both
|
$3,412.00
|
|
|
Service Code
|
HCPCS 25810
|
| Min. Negotiated Rate |
$567.22 |
| Max. Negotiated Rate |
$2,217.80 |
| Rate for Payer: Aetna Commercial |
$1,123.07
|
| Rate for Payer: Aetna Medicare |
$871.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.88
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$838.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.11
|
| Rate for Payer: BCN Commercial |
$1,276.43
|
| Rate for Payer: BCN Medicare Advantage |
$838.11
|
| Rate for Payer: Cash Price |
$2,729.60
|
| Rate for Payer: Cash Price |
$2,729.60
|
| Rate for Payer: Cofinity Commercial |
$1,123.07
|
| Rate for Payer: Cofinity Commercial |
$1,206.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.02
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Nomi Health Commercial |
$1,005.73
|
| Rate for Payer: PACE SWMI |
$838.11
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: PHP Medicare Advantage |
$838.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,217.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,340.33
|
| Rate for Payer: Priority Health Medicare |
$838.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,340.33
|
| Rate for Payer: Priority Health SBD |
$1,340.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$838.11
|
| Rate for Payer: UHC Medicare Advantage |
$838.11
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,569.52
|
|
|
PR ARTHRODESIS WRIST WITH AUTOGRAFT
|
Professional
|
Both
|
$14,088.00
|
|
|
Service Code
|
HCPCS 25825
|
| Min. Negotiated Rate |
$517.80 |
| Max. Negotiated Rate |
$9,157.20 |
| Rate for Payer: Aetna Commercial |
$1,017.74
|
| Rate for Payer: Aetna Medicare |
$789.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.69
|
| Rate for Payer: BCBS Complete |
$543.69
|
| Rate for Payer: BCBS MAPPO |
$759.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,865.96
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| Rate for Payer: BCN Medicare Advantage |
$759.51
|
| Rate for Payer: Cash Price |
$11,270.40
|
| Rate for Payer: Cash Price |
$11,270.40
|
| Rate for Payer: Cofinity Commercial |
$1,017.74
|
| Rate for Payer: Cofinity Commercial |
$1,093.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.49
|
| Rate for Payer: Meridian Medicaid |
$543.69
|
| Rate for Payer: Nomi Health Commercial |
$911.41
|
| Rate for Payer: PACE SWMI |
$759.51
|
| Rate for Payer: PHP Commercial |
$1,063.31
|
| Rate for Payer: PHP Medicare Advantage |
$759.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,157.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.39
|
| Rate for Payer: Priority Health Medicare |
$759.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,228.39
|
| Rate for Payer: Priority Health SBD |
$1,228.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.51
|
| Rate for Payer: UHC Medicare Advantage |
$759.51
|
| Rate for Payer: UHCCP Medicaid |
$517.80
|
| Rate for Payer: UMR Bronson Commercial |
$6,480.48
|
|
|
PR ARTHRODESIS WRIST W/SLIDING GRAFT
|
Professional
|
Both
|
$2,975.00
|
|
|
Service Code
|
HCPCS 25805
|
| Min. Negotiated Rate |
$552.95 |
| Max. Negotiated Rate |
$1,933.75 |
| Rate for Payer: Aetna Commercial |
$1,097.46
|
| Rate for Payer: Aetna Medicare |
$851.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,179.36
|
| Rate for Payer: BCBS Complete |
$580.60
|
| Rate for Payer: BCBS MAPPO |
$819.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.24
|
| Rate for Payer: BCN Commercial |
$1,248.08
|
| Rate for Payer: BCN Medicare Advantage |
$819.00
|
| Rate for Payer: Cash Price |
$2,380.00
|
| Rate for Payer: Cash Price |
$2,380.00
|
| Rate for Payer: Cofinity Commercial |
$1,097.46
|
| Rate for Payer: Cofinity Commercial |
$1,179.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$859.95
|
| Rate for Payer: Meridian Medicaid |
$580.60
|
| Rate for Payer: Nomi Health Commercial |
$982.80
|
| Rate for Payer: PACE SWMI |
$819.00
|
| Rate for Payer: PHP Commercial |
$1,146.60
|
| Rate for Payer: PHP Medicare Advantage |
$819.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,933.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,310.31
|
| Rate for Payer: Priority Health Medicare |
$819.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,310.31
|
| Rate for Payer: Priority Health SBD |
$1,310.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$819.00
|
| Rate for Payer: UHC Medicare Advantage |
$819.00
|
| Rate for Payer: UHCCP Medicaid |
$552.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,368.50
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$561.05 |
| Rate for Payer: Aetna Commercial |
$109.30
|
| Rate for Payer: Aetna Medicare |
$84.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.46
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: BCBS MAPPO |
$81.57
|
| Rate for Payer: BCBS Trust/PPO |
$561.05
|
| Rate for Payer: BCN Commercial |
$123.64
|
| Rate for Payer: BCN Medicare Advantage |
$81.57
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Cofinity Commercial |
$117.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.65
|
| Rate for Payer: Nomi Health Commercial |
$97.88
|
| Rate for Payer: PACE SWMI |
$81.57
|
| Rate for Payer: PHP Commercial |
$114.20
|
| Rate for Payer: PHP Medicare Advantage |
$81.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.25
|
| Rate for Payer: Priority Health Medicare |
$81.57
|
| Rate for Payer: Priority Health Narrow Network |
$129.25
|
| Rate for Payer: Priority Health SBD |
$129.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.57
|
| Rate for Payer: UHC Medicare Advantage |
$81.57
|
| Rate for Payer: UMR Bronson Commercial |
$103.96
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
OP
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$82.65 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$146.90
|
| Rate for Payer: Aetna Commercial |
$192.10
|
| Rate for Payer: Aetna Medicare |
$113.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.90
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: BCBS Trust/PPO |
$319.64
|
| Rate for Payer: BCN Commercial |
$319.64
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$158.20
|
| Rate for Payer: Cofinity Commercial |
$194.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$158.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.80
|
| Rate for Payer: Healthscope Commercial |
$203.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.10
|
| Rate for Payer: PHP Commercial |
$192.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health SBD |
$142.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.92
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$82.65
|
| Rate for Payer: UMR Bronson Commercial |
$83.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.50
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$99.44 |
| Max. Negotiated Rate |
$203.40 |
| Rate for Payer: Aetna American Axle |
$146.90
|
| Rate for Payer: Aetna Commercial |
$192.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.90
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$158.20
|
| Rate for Payer: Cofinity Commercial |
$194.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$158.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.80
|
| Rate for Payer: Healthscope Commercial |
$203.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.10
|
| Rate for Payer: PHP Commercial |
$192.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health SBD |
$142.38
|
| Rate for Payer: UMR Bronson Commercial |
$99.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.50
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS G0289
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$561.05 |
| Rate for Payer: Aetna Commercial |
$109.30
|
| Rate for Payer: Aetna Medicare |
$84.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.46
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: BCBS MAPPO |
$81.57
|
| Rate for Payer: BCBS Trust/PPO |
$561.05
|
| Rate for Payer: BCN Commercial |
$123.64
|
| Rate for Payer: BCN Medicare Advantage |
$81.57
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$117.46
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.65
|
| Rate for Payer: Nomi Health Commercial |
$97.88
|
| Rate for Payer: PACE SWMI |
$81.57
|
| Rate for Payer: PHP Commercial |
$114.20
|
| Rate for Payer: PHP Medicare Advantage |
$81.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.25
|
| Rate for Payer: Priority Health Medicare |
$81.57
|
| Rate for Payer: Priority Health Narrow Network |
$129.25
|
| Rate for Payer: Priority Health SBD |
$129.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.57
|
| Rate for Payer: UHC Medicare Advantage |
$81.57
|
| Rate for Payer: UMR Bronson Commercial |
$103.96
|
|
|
PR ARTHROPLASTY ANKLE
|
Professional
|
Both
|
$2,703.00
|
|
|
Service Code
|
HCPCS 27700
|
| Min. Negotiated Rate |
$464.98 |
| Max. Negotiated Rate |
$1,756.95 |
| Rate for Payer: Aetna Commercial |
$921.75
|
| Rate for Payer: Aetna Medicare |
$715.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.75
|
| Rate for Payer: BCBS Complete |
$488.23
|
| Rate for Payer: BCBS MAPPO |
$687.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: BCN Medicare Advantage |
$687.87
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cofinity Commercial |
$990.53
|
| Rate for Payer: Cofinity Commercial |
$921.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.26
|
| Rate for Payer: Meridian Medicaid |
$488.23
|
| Rate for Payer: Nomi Health Commercial |
$825.44
|
| Rate for Payer: PACE SWMI |
$687.87
|
| Rate for Payer: PHP Commercial |
$963.02
|
| Rate for Payer: PHP Medicare Advantage |
$687.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.68
|
| Rate for Payer: Priority Health Medicare |
$687.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,101.68
|
| Rate for Payer: Priority Health SBD |
$1,101.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.87
|
| Rate for Payer: UHC Medicare Advantage |
$687.87
|
| Rate for Payer: UHCCP Medicaid |
$464.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.38
|
|
|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$720.37 |
| Max. Negotiated Rate |
$2,923.61 |
| Rate for Payer: Aetna Commercial |
$1,436.10
|
| Rate for Payer: Aetna Medicare |
$1,114.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.28
|
| Rate for Payer: BCBS Complete |
$756.39
|
| Rate for Payer: BCBS MAPPO |
$1,071.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.61
|
| Rate for Payer: BCN Commercial |
$1,625.83
|
| 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 |
$1,436.10
|
| Rate for Payer: Cofinity Commercial |
$1,543.28
|
| 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: Meridian Medicaid |
$756.39
|
| 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 Choice Medicaid |
$720.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.15
|
| Rate for Payer: Priority Health Medicare |
$1,071.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,703.15
|
| Rate for Payer: Priority Health SBD |
$1,703.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.72
|
| Rate for Payer: UHCCP Medicaid |
$720.37
|
| 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 |
$622.81 |
| Max. Negotiated Rate |
$2,899.77 |
| Rate for Payer: Aetna Commercial |
$1,239.74
|
| Rate for Payer: Aetna Medicare |
$962.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,239.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.26
|
| Rate for Payer: BCBS Complete |
$653.95
|
| Rate for Payer: BCBS MAPPO |
$925.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.77
|
| Rate for Payer: BCN Commercial |
$1,407.39
|
| 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 |
$1,239.74
|
| Rate for Payer: Cofinity Commercial |
$1,332.26
|
| 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: Meridian Medicaid |
$653.95
|
| 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 Choice Medicaid |
$622.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,477.73
|
| Rate for Payer: Priority Health Medicare |
$925.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,477.73
|
| Rate for Payer: Priority Health SBD |
$1,477.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.18
|
| Rate for Payer: UHC Medicare Advantage |
$925.18
|
| Rate for Payer: UHCCP Medicaid |
$622.81
|
| 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 |
$567.65 |
| Max. Negotiated Rate |
$1,339.33 |
| Rate for Payer: Aetna Commercial |
$1,128.55
|
| Rate for Payer: Aetna Medicare |
$875.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,128.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.77
|
| Rate for Payer: BCBS Complete |
$596.03
|
| Rate for Payer: BCBS MAPPO |
$842.20
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$1,280.82
|
| 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 |
$1,128.55
|
| Rate for Payer: Cofinity Commercial |
$1,212.77
|
| 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: Meridian Medicaid |
$596.03
|
| 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 Choice Medicaid |
$567.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,339.33
|
| Rate for Payer: Priority Health Medicare |
$842.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,339.33
|
| Rate for Payer: Priority Health SBD |
$1,339.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$842.20
|
| Rate for Payer: UHC Medicare Advantage |
$842.20
|
| Rate for Payer: UHCCP Medicaid |
$567.65
|
| 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 |
$197.82 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: BCN Commercial |
$2,110.60
|
| 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: Aetna Commercial |
$1,861.80
|
| Rate for Payer: Aetna Medicare |
$1,444.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,000.74
|
| Rate for Payer: BCBS Complete |
$978.24
|
| Rate for Payer: BCBS MAPPO |
$1,389.40
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| 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: Meridian Medicaid |
$978.24
|
| 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 Choice Medicaid |
$931.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,209.99
|
| Rate for Payer: Priority Health Medicare |
$1,389.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,209.99
|
| Rate for Payer: Priority Health SBD |
$2,209.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.40
|
| Rate for Payer: UHCCP Medicaid |
$931.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,104.50
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$197.82 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Aetna Commercial |
$1,861.80
|
| Rate for Payer: Aetna Medicare |
$1,444.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,000.74
|
| Rate for Payer: BCBS Complete |
$978.24
|
| Rate for Payer: BCBS MAPPO |
$1,389.40
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| Rate for Payer: BCN Commercial |
$2,110.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.40
|
| 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: Meridian Medicaid |
$978.24
|
| 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 Choice Medicaid |
$931.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,209.99
|
| Rate for Payer: Priority Health Medicare |
$1,389.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,209.99
|
| Rate for Payer: Priority Health SBD |
$2,209.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.40
|
| Rate for Payer: UHCCP Medicaid |
$931.66
|
| 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 |
$1,397.58 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna American Axle |
$2,973.75
|
| Rate for Payer: Aetna Commercial |
$3,888.75
|
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,973.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$18,538.72
|
| Rate for Payer: BCN Commercial |
$18,538.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Cash Price |
$3,660.00
|
| 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 |
$18,018.20
|
| 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 |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,888.75
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Commercial |
$3,888.75
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Priority Health SBD |
$2,882.25
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,537.34
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$1,397.58
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,692.75
|
| Rate for Payer: VA VA |
$18,018.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,431.25
|
|
|
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 GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,466.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$171.92 |
| 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) |
$1,544.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,659.33
|
| Rate for Payer: BCBS Complete |
$812.97
|
| Rate for Payer: BCBS MAPPO |
$1,152.31
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: BCN Commercial |
$1,751.91
|
| 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 |
$1,544.10
|
| Rate for Payer: Cofinity Commercial |
$1,659.33
|
| 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: Meridian Medicaid |
$812.97
|
| 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 Choice Medicaid |
$774.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,836.99
|
| Rate for Payer: Priority Health Medicare |
$1,152.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,836.99
|
| Rate for Payer: Priority Health SBD |
$1,836.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,152.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.31
|
| Rate for Payer: UHCCP Medicaid |
$774.26
|
| 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 |
$291.60 |
| 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) |
$572.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.30
|
| Rate for Payer: BCBS Complete |
$306.18
|
| Rate for Payer: BCBS MAPPO |
$427.29
|
| Rate for Payer: BCBS Trust/PPO |
$943.54
|
| Rate for Payer: BCN Commercial |
$649.94
|
| 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 |
$572.57
|
| Rate for Payer: Cofinity Commercial |
$615.30
|
| 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: Meridian Medicaid |
$306.18
|
| 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 Choice Medicaid |
$291.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.93
|
| Rate for Payer: Priority Health Medicare |
$427.29
|
| Rate for Payer: Priority Health Narrow Network |
$684.93
|
| Rate for Payer: Priority Health SBD |
$684.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.29
|
| Rate for Payer: UHC Medicare Advantage |
$427.29
|
| Rate for Payer: UHCCP Medicaid |
$291.60
|
| 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 |
$331.24 |
| 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) |
$1,005.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.74
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS MAPPO |
$698.31
|
| Rate for Payer: BCBS Trust/PPO |
$331.24
|
| Rate for Payer: BCN Commercial |
$1,115.65
|
| 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 |
$1,005.57
|
| Rate for Payer: Cofinity Commercial |
$935.74
|
| 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: Meridian Medicaid |
$507.69
|
| 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 Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,159.69
|
| Rate for Payer: Priority Health Medicare |
$698.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.69
|
| Rate for Payer: Priority Health SBD |
$1,159.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.31
|
| Rate for Payer: UHC Medicare Advantage |
$698.31
|
| Rate for Payer: UHCCP Medicaid |
$483.51
|
| 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 |
$520.79 |
| Max. Negotiated Rate |
$1,732.82 |
| Rate for Payer: Aetna Commercial |
$1,034.01
|
| Rate for Payer: Aetna Medicare |
$802.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.18
|
| Rate for Payer: BCBS Complete |
$546.83
|
| Rate for Payer: BCBS MAPPO |
$771.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: BCN Commercial |
$1,174.29
|
| 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 |
$1,034.01
|
| Rate for Payer: Cofinity Commercial |
$1,111.18
|
| 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: Meridian Medicaid |
$546.83
|
| 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 Choice Medicaid |
$520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,232.98
|
| Rate for Payer: Priority Health Medicare |
$771.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,232.98
|
| Rate for Payer: Priority Health SBD |
$1,232.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.65
|
| Rate for Payer: UHC Medicare Advantage |
$771.65
|
| Rate for Payer: UHCCP Medicaid |
$520.79
|
| 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 |
$357.84 |
| Max. Negotiated Rate |
$1,277.96 |
| Rate for Payer: Aetna Commercial |
$704.68
|
| Rate for Payer: Aetna Medicare |
$546.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.27
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$525.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.96
|
| Rate for Payer: BCN Commercial |
$799.48
|
| 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 |
$704.68
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| 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: Meridian Medicaid |
$375.73
|
| 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 Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.22
|
| Rate for Payer: Priority Health Medicare |
$525.88
|
| Rate for Payer: Priority Health Narrow Network |
$845.22
|
| Rate for Payer: Priority Health SBD |
$845.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.88
|
| Rate for Payer: UHC Medicare Advantage |
$525.88
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
| 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 |
$432.82 |
| Max. Negotiated Rate |
$1,630.86 |
| Rate for Payer: Aetna Commercial |
$857.26
|
| Rate for Payer: Aetna Medicare |
$665.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.24
|
| Rate for Payer: BCBS Complete |
$454.46
|
| Rate for Payer: BCBS MAPPO |
$639.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,630.86
|
| Rate for Payer: BCN Commercial |
$975.40
|
| 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 |
$857.26
|
| Rate for Payer: Cofinity Commercial |
$921.24
|
| 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: Meridian Medicaid |
$454.46
|
| 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 Choice Medicaid |
$432.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.87
|
| Rate for Payer: Priority Health Medicare |
$639.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.87
|
| Rate for Payer: Priority Health SBD |
$1,025.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.75
|
| Rate for Payer: UHC Medicare Advantage |
$639.75
|
| Rate for Payer: UHCCP Medicaid |
$432.82
|
| 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 |
$548.05 |
| Max. Negotiated Rate |
$1,651.99 |
| Rate for Payer: Aetna Commercial |
$1,089.00
|
| Rate for Payer: Aetna Medicare |
$845.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.27
|
| Rate for Payer: BCBS Complete |
$575.45
|
| Rate for Payer: BCBS MAPPO |
$812.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.99
|
| Rate for Payer: BCN Commercial |
$1,235.37
|
| 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 |
$1,089.00
|
| Rate for Payer: Cofinity Commercial |
$1,170.27
|
| 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: Meridian Medicaid |
$575.45
|
| 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 Choice Medicaid |
$548.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,297.59
|
| Rate for Payer: Priority Health Medicare |
$812.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,297.59
|
| Rate for Payer: Priority Health SBD |
$1,297.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.69
|
| Rate for Payer: UHC Medicare Advantage |
$812.69
|
| Rate for Payer: UHCCP Medicaid |
$548.05
|
| 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 |
$258.95 |
| 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) |
$832.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.97
|
| Rate for Payer: BCBS Complete |
$441.48
|
| Rate for Payer: BCBS MAPPO |
$621.51
|
| Rate for Payer: BCBS Trust/PPO |
$258.95
|
| Rate for Payer: BCN Commercial |
$946.57
|
| 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 |
$832.82
|
| Rate for Payer: Cofinity Commercial |
$894.97
|
| 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: Meridian Medicaid |
$441.48
|
| 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 Choice Medicaid |
$420.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,084.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$994.82
|
| Rate for Payer: Priority Health Medicare |
$621.51
|
| Rate for Payer: Priority Health Narrow Network |
$994.82
|
| Rate for Payer: Priority Health SBD |
$994.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.51
|
| Rate for Payer: UHC Medicare Advantage |
$621.51
|
| Rate for Payer: UHCCP Medicaid |
$420.46
|
| 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 |
$304.79 |
| 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) |
$883.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.45
|
| Rate for Payer: BCBS Complete |
$468.32
|
| Rate for Payer: BCBS MAPPO |
$659.34
|
| Rate for Payer: BCBS Trust/PPO |
$304.79
|
| Rate for Payer: BCN Commercial |
$1,003.26
|
| 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 |
$883.52
|
| Rate for Payer: Cofinity Commercial |
$949.45
|
| 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: Meridian Medicaid |
$468.32
|
| 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 Choice Medicaid |
$446.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.34
|
| Rate for Payer: Priority Health Medicare |
$659.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.34
|
| Rate for Payer: Priority Health SBD |
$1,053.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.34
|
| Rate for Payer: UHC Medicare Advantage |
$659.34
|
| Rate for Payer: UHCCP Medicaid |
$446.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,156.44
|
|
