|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$1,053.80 |
| Max. Negotiated Rate |
$2,155.50 |
| Rate for Payer: Aetna American Axle |
$1,556.75
|
| Rate for Payer: Aetna Commercial |
$2,035.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.75
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$1,676.50
|
| Rate for Payer: Cofinity Commercial |
$2,059.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,676.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Healthscope Commercial |
$2,155.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,676.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,796.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: PHP Commercial |
$2,035.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health SBD |
$1,508.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,053.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,796.25
|
|
|
PR ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29904
|
| Min. Negotiated Rate |
$620.50 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$831.47
|
| Rate for Payer: Aetna Medicare |
$645.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.47
|
| Rate for Payer: BCBS Complete |
$958.00
|
| Rate for Payer: BCBS MAPPO |
$620.50
|
| Rate for Payer: BCN Medicare Advantage |
$620.50
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$893.52
|
| Rate for Payer: Cofinity Commercial |
$831.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.52
|
| Rate for Payer: Nomi Health Commercial |
$744.60
|
| Rate for Payer: PACE SWMI |
$620.50
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: PHP Medicare Advantage |
$620.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health Medicare |
$620.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.50
|
| Rate for Payer: UHC Medicare Advantage |
$620.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,101.70
|
|
|
PR ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29846
|
| Min. Negotiated Rate |
$505.49 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Commercial |
$677.36
|
| Rate for Payer: Aetna Medicare |
$525.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.36
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: BCBS MAPPO |
$505.49
|
| Rate for Payer: BCN Medicare Advantage |
$505.49
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$727.91
|
| Rate for Payer: Cofinity Commercial |
$677.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.76
|
| Rate for Payer: Nomi Health Commercial |
$606.59
|
| Rate for Payer: PACE SWMI |
$505.49
|
| Rate for Payer: PHP Commercial |
$707.69
|
| Rate for Payer: PHP Medicare Advantage |
$505.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health Medicare |
$505.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.49
|
| Rate for Payer: UHC Medicare Advantage |
$505.49
|
| Rate for Payer: UMR Bronson Commercial |
$937.94
|
|
|
PR ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 23044
|
| Min. Negotiated Rate |
$490.00 |
| Max. Negotiated Rate |
$796.25 |
| Rate for Payer: Aetna Commercial |
$727.12
|
| Rate for Payer: Aetna Medicare |
$564.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.12
|
| Rate for Payer: BCBS Complete |
$490.00
|
| Rate for Payer: BCBS MAPPO |
$542.63
|
| Rate for Payer: BCN Medicare Advantage |
$542.63
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cofinity Commercial |
$781.39
|
| Rate for Payer: Cofinity Commercial |
$727.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.76
|
| Rate for Payer: Nomi Health Commercial |
$651.16
|
| Rate for Payer: PACE SWMI |
$542.63
|
| Rate for Payer: PHP Commercial |
$759.68
|
| Rate for Payer: PHP Medicare Advantage |
$542.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.25
|
| Rate for Payer: Priority Health Medicare |
$542.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.63
|
| Rate for Payer: UHC Medicare Advantage |
$542.63
|
| Rate for Payer: UMR Bronson Commercial |
$563.50
|
|
|
PR ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 23101
|
| Min. Negotiated Rate |
$322.00 |
| Max. Negotiated Rate |
$638.31 |
| Rate for Payer: Aetna Commercial |
$593.98
|
| Rate for Payer: Aetna Medicare |
$461.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$638.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.98
|
| Rate for Payer: BCBS Complete |
$322.00
|
| Rate for Payer: BCBS MAPPO |
$443.27
|
| Rate for Payer: BCN Medicare Advantage |
$443.27
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$638.31
|
| Rate for Payer: Cofinity Commercial |
$593.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.43
|
| Rate for Payer: Nomi Health Commercial |
$531.92
|
| Rate for Payer: PACE SWMI |
$443.27
|
| Rate for Payer: PHP Commercial |
$620.58
|
| Rate for Payer: PHP Medicare Advantage |
$443.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health Medicare |
$443.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.27
|
| Rate for Payer: UHC Medicare Advantage |
$443.27
|
| Rate for Payer: UMR Bronson Commercial |
$370.30
|
|
|
PR ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 27620
|
| Min. Negotiated Rate |
$432.11 |
| Max. Negotiated Rate |
$732.55 |
| Rate for Payer: Aetna Commercial |
$579.03
|
| Rate for Payer: Aetna Medicare |
$449.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.03
|
| Rate for Payer: BCBS Complete |
$450.80
|
| Rate for Payer: BCBS MAPPO |
$432.11
|
| Rate for Payer: BCN Medicare Advantage |
$432.11
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$622.24
|
| Rate for Payer: Cofinity Commercial |
$579.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.72
|
| Rate for Payer: Nomi Health Commercial |
$518.53
|
| Rate for Payer: PACE SWMI |
$432.11
|
| Rate for Payer: PHP Commercial |
$604.95
|
| Rate for Payer: PHP Medicare Advantage |
$432.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health Medicare |
$432.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$432.11
|
| Rate for Payer: UHC Medicare Advantage |
$432.11
|
| Rate for Payer: UMR Bronson Commercial |
$518.42
|
|
|
PR ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 24006
|
| Min. Negotiated Rate |
$691.63 |
| Max. Negotiated Rate |
$1,340.95 |
| Rate for Payer: Aetna Commercial |
$926.78
|
| Rate for Payer: Aetna Medicare |
$719.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$926.78
|
| Rate for Payer: BCBS Complete |
$825.20
|
| Rate for Payer: BCBS MAPPO |
$691.63
|
| Rate for Payer: BCN Medicare Advantage |
$691.63
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cofinity Commercial |
$995.95
|
| Rate for Payer: Cofinity Commercial |
$926.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$691.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$726.21
|
| Rate for Payer: Nomi Health Commercial |
$829.96
|
| Rate for Payer: PACE SWMI |
$691.63
|
| Rate for Payer: PHP Commercial |
$968.28
|
| Rate for Payer: PHP Medicare Advantage |
$691.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health Medicare |
$691.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$691.63
|
| Rate for Payer: UHC Medicare Advantage |
$691.63
|
| Rate for Payer: UMR Bronson Commercial |
$948.98
|
|
|
PR ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$464.93 |
| Max. Negotiated Rate |
$1,324.70 |
| Rate for Payer: Aetna Commercial |
$623.01
|
| Rate for Payer: Aetna Medicare |
$483.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.01
|
| Rate for Payer: BCBS Complete |
$815.20
|
| Rate for Payer: BCBS MAPPO |
$464.93
|
| Rate for Payer: BCN Medicare Advantage |
$464.93
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cofinity Commercial |
$669.50
|
| Rate for Payer: Cofinity Commercial |
$623.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.18
|
| Rate for Payer: Nomi Health Commercial |
$557.92
|
| Rate for Payer: PACE SWMI |
$464.93
|
| Rate for Payer: PHP Commercial |
$650.90
|
| Rate for Payer: PHP Medicare Advantage |
$464.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.70
|
| Rate for Payer: Priority Health Medicare |
$464.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.93
|
| Rate for Payer: UHC Medicare Advantage |
$464.93
|
| Rate for Payer: UMR Bronson Commercial |
$937.48
|
|
|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,348.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$487.67 |
| Max. Negotiated Rate |
$876.20 |
| Rate for Payer: Aetna Commercial |
$653.48
|
| Rate for Payer: Aetna Medicare |
$507.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.48
|
| Rate for Payer: BCBS Complete |
$539.20
|
| Rate for Payer: BCBS MAPPO |
$487.67
|
| Rate for Payer: BCN Medicare Advantage |
$487.67
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cofinity Commercial |
$702.24
|
| Rate for Payer: Cofinity Commercial |
$653.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.05
|
| Rate for Payer: Nomi Health Commercial |
$585.20
|
| Rate for Payer: PACE SWMI |
$487.67
|
| Rate for Payer: PHP Commercial |
$682.74
|
| Rate for Payer: PHP Medicare Advantage |
$487.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.20
|
| Rate for Payer: Priority Health Medicare |
$487.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.67
|
| Rate for Payer: UHC Medicare Advantage |
$487.67
|
| Rate for Payer: UMR Bronson Commercial |
$620.08
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$1,290.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$838.50 |
| Rate for Payer: Aetna Commercial |
$419.61
|
| Rate for Payer: Aetna Medicare |
$325.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.61
|
| Rate for Payer: BCBS Complete |
$516.00
|
| Rate for Payer: BCBS MAPPO |
$313.14
|
| Rate for Payer: BCN Medicare Advantage |
$313.14
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cash Price |
$1,032.00
|
| Rate for Payer: Cofinity Commercial |
$450.92
|
| Rate for Payer: Cofinity Commercial |
$419.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.80
|
| Rate for Payer: Nomi Health Commercial |
$375.77
|
| Rate for Payer: PACE SWMI |
$313.14
|
| Rate for Payer: PHP Commercial |
$438.40
|
| Rate for Payer: PHP Medicare Advantage |
$313.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$838.50
|
| Rate for Payer: Priority Health Medicare |
$313.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.14
|
| Rate for Payer: UHC Medicare Advantage |
$313.14
|
| Rate for Payer: UMR Bronson Commercial |
$593.40
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$385.98 |
| Max. Negotiated Rate |
$707.85 |
| Rate for Payer: Aetna Commercial |
$517.21
|
| Rate for Payer: Aetna Medicare |
$401.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$555.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.21
|
| Rate for Payer: BCBS Complete |
$435.60
|
| Rate for Payer: BCBS MAPPO |
$385.98
|
| Rate for Payer: BCN Medicare Advantage |
$385.98
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$555.81
|
| Rate for Payer: Cofinity Commercial |
$517.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$405.28
|
| Rate for Payer: Nomi Health Commercial |
$463.18
|
| Rate for Payer: PACE SWMI |
$385.98
|
| Rate for Payer: PHP Commercial |
$540.37
|
| Rate for Payer: PHP Medicare Advantage |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health Medicare |
$385.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.98
|
| Rate for Payer: UHC Medicare Advantage |
$385.98
|
| Rate for Payer: UMR Bronson Commercial |
$500.94
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$229.20 |
| Max. Negotiated Rate |
$472.36 |
| Rate for Payer: Aetna Commercial |
$439.56
|
| Rate for Payer: Aetna Medicare |
$341.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.56
|
| Rate for Payer: BCBS Complete |
$229.20
|
| Rate for Payer: BCBS MAPPO |
$328.03
|
| Rate for Payer: BCN Medicare Advantage |
$328.03
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$472.36
|
| Rate for Payer: Cofinity Commercial |
$439.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.43
|
| Rate for Payer: Nomi Health Commercial |
$393.64
|
| Rate for Payer: PACE SWMI |
$328.03
|
| Rate for Payer: PHP Commercial |
$459.24
|
| Rate for Payer: PHP Medicare Advantage |
$328.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health Medicare |
$328.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.03
|
| Rate for Payer: UHC Medicare Advantage |
$328.03
|
| Rate for Payer: UMR Bronson Commercial |
$263.58
|
|
|
PR ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 23107
|
| Min. Negotiated Rate |
$502.00 |
| Max. Negotiated Rate |
$925.53 |
| Rate for Payer: Aetna Commercial |
$861.26
|
| Rate for Payer: Aetna Medicare |
$668.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$925.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.26
|
| Rate for Payer: BCBS Complete |
$502.00
|
| Rate for Payer: BCBS MAPPO |
$642.73
|
| Rate for Payer: BCN Medicare Advantage |
$642.73
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cofinity Commercial |
$925.53
|
| Rate for Payer: Cofinity Commercial |
$861.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$642.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.87
|
| Rate for Payer: Nomi Health Commercial |
$771.28
|
| Rate for Payer: PACE SWMI |
$642.73
|
| Rate for Payer: PHP Commercial |
$899.82
|
| Rate for Payer: PHP Medicare Advantage |
$642.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.75
|
| Rate for Payer: Priority Health Medicare |
$642.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$642.73
|
| Rate for Payer: UHC Medicare Advantage |
$642.73
|
| Rate for Payer: UMR Bronson Commercial |
$577.30
|
|
|
PR ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX
|
Professional
|
Both
|
$1,001.00
|
|
|
Service Code
|
HCPCS 23106
|
| Min. Negotiated Rate |
$400.40 |
| Max. Negotiated Rate |
$701.05 |
| Rate for Payer: Aetna Commercial |
$652.37
|
| Rate for Payer: Aetna Medicare |
$506.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.37
|
| Rate for Payer: BCBS Complete |
$400.40
|
| Rate for Payer: BCBS MAPPO |
$486.84
|
| Rate for Payer: BCN Medicare Advantage |
$486.84
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cofinity Commercial |
$701.05
|
| Rate for Payer: Cofinity Commercial |
$652.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.18
|
| Rate for Payer: Nomi Health Commercial |
$584.21
|
| Rate for Payer: PACE SWMI |
$486.84
|
| Rate for Payer: PHP Commercial |
$681.58
|
| Rate for Payer: PHP Medicare Advantage |
$486.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.65
|
| Rate for Payer: Priority Health Medicare |
$486.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.84
|
| Rate for Payer: UHC Medicare Advantage |
$486.84
|
| Rate for Payer: UMR Bronson Commercial |
$460.46
|
|
|
PR ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY
|
Professional
|
Both
|
$1,134.00
|
|
|
Service Code
|
HCPCS 23105
|
| Min. Negotiated Rate |
$453.60 |
| Max. Negotiated Rate |
$893.36 |
| Rate for Payer: Aetna Commercial |
$831.32
|
| Rate for Payer: Aetna Medicare |
$645.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.32
|
| Rate for Payer: BCBS Complete |
$453.60
|
| Rate for Payer: BCBS MAPPO |
$620.39
|
| Rate for Payer: BCN Medicare Advantage |
$620.39
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$893.36
|
| Rate for Payer: Cofinity Commercial |
$831.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.41
|
| Rate for Payer: Nomi Health Commercial |
$744.47
|
| Rate for Payer: PACE SWMI |
$620.39
|
| Rate for Payer: PHP Commercial |
$868.55
|
| Rate for Payer: PHP Medicare Advantage |
$620.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.10
|
| Rate for Payer: Priority Health Medicare |
$620.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.39
|
| Rate for Payer: UHC Medicare Advantage |
$620.39
|
| Rate for Payer: UMR Bronson Commercial |
$521.64
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Facility
|
OP
|
$2,691.00
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$995.67 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$1,749.15
|
| Rate for Payer: Aetna Commercial |
$2,287.35
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,749.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cofinity Commercial |
$1,883.70
|
| Rate for Payer: Cofinity Commercial |
$2,314.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,883.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,152.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$2,421.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,883.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,018.25
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,287.35
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$2,287.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$1,695.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$995.67
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,018.25
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,691.00
|
|
|
Service Code
|
HCPCS 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$708.34 |
| Max. Negotiated Rate |
$1,749.15 |
| Rate for Payer: Aetna Commercial |
$949.18
|
| Rate for Payer: Aetna Medicare |
$736.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.01
|
| Rate for Payer: BCBS Complete |
$1,076.40
|
| Rate for Payer: BCBS MAPPO |
$708.34
|
| Rate for Payer: BCN Medicare Advantage |
$708.34
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cofinity Commercial |
$1,020.01
|
| Rate for Payer: Cofinity Commercial |
$949.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.76
|
| Rate for Payer: Nomi Health Commercial |
$850.01
|
| Rate for Payer: PACE SWMI |
$708.34
|
| Rate for Payer: PHP Commercial |
$991.68
|
| Rate for Payer: PHP Medicare Advantage |
$708.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health Medicare |
$708.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.34
|
| Rate for Payer: UHC Medicare Advantage |
$708.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,237.86
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,691.00
|
|
|
Service Code
|
HCPCS 27310
|
| Min. Negotiated Rate |
$708.34 |
| Max. Negotiated Rate |
$1,749.15 |
| Rate for Payer: Aetna Commercial |
$949.18
|
| Rate for Payer: Aetna Medicare |
$736.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.01
|
| Rate for Payer: BCBS Complete |
$1,076.40
|
| Rate for Payer: BCBS MAPPO |
$708.34
|
| Rate for Payer: BCN Medicare Advantage |
$708.34
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cofinity Commercial |
$949.18
|
| Rate for Payer: Cofinity Commercial |
$1,020.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.76
|
| Rate for Payer: Nomi Health Commercial |
$850.01
|
| Rate for Payer: PACE SWMI |
$708.34
|
| Rate for Payer: PHP Commercial |
$991.68
|
| Rate for Payer: PHP Medicare Advantage |
$708.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health Medicare |
$708.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.34
|
| Rate for Payer: UHC Medicare Advantage |
$708.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,237.86
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Facility
|
IP
|
$2,691.00
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$1,184.04 |
| Max. Negotiated Rate |
$2,421.90 |
| Rate for Payer: Aetna American Axle |
$1,749.15
|
| Rate for Payer: Aetna Commercial |
$2,287.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,749.15
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Cofinity Commercial |
$1,883.70
|
| Rate for Payer: Cofinity Commercial |
$2,314.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,883.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,152.80
|
| Rate for Payer: Healthscope Commercial |
$2,421.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,883.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,018.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,287.35
|
| Rate for Payer: PHP Commercial |
$2,287.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.15
|
| Rate for Payer: Priority Health SBD |
$1,695.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,184.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,018.25
|
|
|
PR ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB
|
Professional
|
Both
|
$1,749.00
|
|
|
Service Code
|
HCPCS 27331
|
| Min. Negotiated Rate |
$463.29 |
| Max. Negotiated Rate |
$1,136.85 |
| Rate for Payer: Aetna Commercial |
$620.81
|
| Rate for Payer: Aetna Medicare |
$481.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.81
|
| Rate for Payer: BCBS Complete |
$699.60
|
| Rate for Payer: BCBS MAPPO |
$463.29
|
| Rate for Payer: BCN Medicare Advantage |
$463.29
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cofinity Commercial |
$667.14
|
| Rate for Payer: Cofinity Commercial |
$620.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.45
|
| Rate for Payer: Nomi Health Commercial |
$555.95
|
| Rate for Payer: PACE SWMI |
$463.29
|
| Rate for Payer: PHP Commercial |
$648.61
|
| Rate for Payer: PHP Medicare Advantage |
$463.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.85
|
| Rate for Payer: Priority Health Medicare |
$463.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$463.29
|
| Rate for Payer: UHC Medicare Advantage |
$463.29
|
| Rate for Payer: UMR Bronson Commercial |
$804.54
|
|
|
PR ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 28052
|
| Min. Negotiated Rate |
$200.00 |
| Max. Negotiated Rate |
$351.04 |
| Rate for Payer: Aetna Commercial |
$326.67
|
| Rate for Payer: Aetna Medicare |
$253.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.67
|
| Rate for Payer: BCBS Complete |
$200.00
|
| Rate for Payer: BCBS MAPPO |
$243.78
|
| Rate for Payer: BCN Medicare Advantage |
$243.78
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$351.04
|
| Rate for Payer: Cofinity Commercial |
$326.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.97
|
| Rate for Payer: Nomi Health Commercial |
$292.54
|
| Rate for Payer: PACE SWMI |
$243.78
|
| Rate for Payer: PHP Commercial |
$341.29
|
| Rate for Payer: PHP Medicare Advantage |
$243.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.00
|
| Rate for Payer: Priority Health Medicare |
$243.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.78
|
| Rate for Payer: UHC Medicare Advantage |
$243.78
|
| Rate for Payer: UMR Bronson Commercial |
$230.00
|
|
|
PR ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH
|
Professional
|
Both
|
$2,169.00
|
|
|
Service Code
|
HCPCS 27612
|
| Min. Negotiated Rate |
$552.77 |
| Max. Negotiated Rate |
$1,409.85 |
| Rate for Payer: Aetna Commercial |
$740.71
|
| Rate for Payer: Aetna Medicare |
$574.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.71
|
| Rate for Payer: BCBS Complete |
$867.60
|
| Rate for Payer: BCBS MAPPO |
$552.77
|
| Rate for Payer: BCN Medicare Advantage |
$552.77
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cash Price |
$1,735.20
|
| Rate for Payer: Cofinity Commercial |
$795.99
|
| Rate for Payer: Cofinity Commercial |
$740.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.41
|
| Rate for Payer: Nomi Health Commercial |
$663.32
|
| Rate for Payer: PACE SWMI |
$552.77
|
| Rate for Payer: PHP Commercial |
$773.88
|
| Rate for Payer: PHP Medicare Advantage |
$552.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.85
|
| Rate for Payer: Priority Health Medicare |
$552.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.77
|
| Rate for Payer: UHC Medicare Advantage |
$552.77
|
| Rate for Payer: UMR Bronson Commercial |
$997.74
|
|
|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,888.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$542.28 |
| Max. Negotiated Rate |
$1,227.20 |
| Rate for Payer: Aetna Commercial |
$726.66
|
| Rate for Payer: Aetna Medicare |
$563.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.66
|
| Rate for Payer: BCBS Complete |
$755.20
|
| Rate for Payer: BCBS MAPPO |
$542.28
|
| Rate for Payer: BCN Medicare Advantage |
$542.28
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$780.88
|
| Rate for Payer: Cofinity Commercial |
$726.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.39
|
| Rate for Payer: Nomi Health Commercial |
$650.74
|
| Rate for Payer: PACE SWMI |
$542.28
|
| Rate for Payer: PHP Commercial |
$759.19
|
| Rate for Payer: PHP Medicare Advantage |
$542.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.20
|
| Rate for Payer: Priority Health Medicare |
$542.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.28
|
| Rate for Payer: UHC Medicare Advantage |
$542.28
|
| Rate for Payer: UMR Bronson Commercial |
$868.48
|
|
|
PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT
|
Professional
|
Both
|
$2,389.00
|
|
|
Service Code
|
HCPCS 27332
|
| Min. Negotiated Rate |
$625.72 |
| Max. Negotiated Rate |
$1,552.85 |
| Rate for Payer: Aetna Commercial |
$838.46
|
| Rate for Payer: Aetna Medicare |
$650.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.46
|
| Rate for Payer: BCBS Complete |
$955.60
|
| Rate for Payer: BCBS MAPPO |
$625.72
|
| Rate for Payer: BCN Medicare Advantage |
$625.72
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cofinity Commercial |
$901.04
|
| Rate for Payer: Cofinity Commercial |
$838.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.01
|
| Rate for Payer: Nomi Health Commercial |
$750.86
|
| Rate for Payer: PACE SWMI |
$625.72
|
| Rate for Payer: PHP Commercial |
$876.01
|
| Rate for Payer: PHP Medicare Advantage |
$625.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.85
|
| Rate for Payer: Priority Health Medicare |
$625.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.72
|
| Rate for Payer: UHC Medicare Advantage |
$625.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.94
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT
|
Professional
|
Both
|
$733.00
|
|
|
Service Code
|
HCPCS 28024
|
| Min. Negotiated Rate |
$293.20 |
| Max. Negotiated Rate |
$476.45 |
| Rate for Payer: Aetna Commercial |
$398.52
|
| Rate for Payer: Aetna Medicare |
$309.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.52
|
| Rate for Payer: BCBS Complete |
$293.20
|
| Rate for Payer: BCBS MAPPO |
$297.40
|
| Rate for Payer: BCN Medicare Advantage |
$297.40
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cofinity Commercial |
$428.26
|
| Rate for Payer: Cofinity Commercial |
$398.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.27
|
| Rate for Payer: Nomi Health Commercial |
$356.88
|
| Rate for Payer: PACE SWMI |
$297.40
|
| Rate for Payer: PHP Commercial |
$416.36
|
| Rate for Payer: PHP Medicare Advantage |
$297.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.45
|
| Rate for Payer: Priority Health Medicare |
$297.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.40
|
| Rate for Payer: UHC Medicare Advantage |
$297.40
|
| Rate for Payer: UMR Bronson Commercial |
$337.18
|
|
