|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$472.01 |
| Max. Negotiated Rate |
$1,115.92 |
| Rate for Payer: Aetna Commercial |
$934.72
|
| Rate for Payer: Aetna Medicare |
$725.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.72
|
| Rate for Payer: BCBS Complete |
$495.61
|
| Rate for Payer: BCBS MAPPO |
$697.55
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: BCN Commercial |
$1,063.85
|
| Rate for Payer: BCN Medicare Advantage |
$697.55
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cofinity Commercial |
$1,004.47
|
| Rate for Payer: Cofinity Commercial |
$934.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.43
|
| Rate for Payer: Meridian Medicaid |
$495.61
|
| Rate for Payer: Nomi Health Commercial |
$837.06
|
| Rate for Payer: PACE SWMI |
$697.55
|
| Rate for Payer: PHP Commercial |
$976.57
|
| Rate for Payer: PHP Medicare Advantage |
$697.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.92
|
| Rate for Payer: Priority Health Medicare |
$697.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.92
|
| Rate for Payer: Priority Health SBD |
$1,115.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.55
|
| Rate for Payer: UHC Medicare Advantage |
$697.55
|
| Rate for Payer: UHCCP Medicaid |
$472.01
|
| Rate for Payer: UMR Bronson Commercial |
$590.64
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$610.88 |
| Max. Negotiated Rate |
$1,446.69 |
| Rate for Payer: Aetna Commercial |
$1,214.75
|
| Rate for Payer: Aetna Medicare |
$942.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.40
|
| Rate for Payer: BCBS Complete |
$641.42
|
| Rate for Payer: BCBS MAPPO |
$906.53
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,379.54
|
| Rate for Payer: BCN Medicare Advantage |
$906.53
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cofinity Commercial |
$1,214.75
|
| Rate for Payer: Cofinity Commercial |
$1,305.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.86
|
| Rate for Payer: Meridian Medicaid |
$641.42
|
| Rate for Payer: Nomi Health Commercial |
$1,087.84
|
| Rate for Payer: PACE SWMI |
$906.53
|
| Rate for Payer: PHP Commercial |
$1,269.14
|
| Rate for Payer: PHP Medicare Advantage |
$906.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,446.69
|
| Rate for Payer: Priority Health Medicare |
$906.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,446.69
|
| Rate for Payer: Priority Health SBD |
$1,446.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.53
|
| Rate for Payer: UHC Medicare Advantage |
$906.53
|
| Rate for Payer: UHCCP Medicaid |
$610.88
|
| Rate for Payer: UMR Bronson Commercial |
$870.78
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$529.52 |
| Max. Negotiated Rate |
$1,250.78 |
| Rate for Payer: Aetna Commercial |
$1,048.27
|
| Rate for Payer: Aetna Medicare |
$813.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,048.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.50
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS MAPPO |
$782.29
|
| Rate for Payer: BCBS Trust/PPO |
$863.24
|
| Rate for Payer: BCN Commercial |
$1,192.37
|
| Rate for Payer: BCN Medicare Advantage |
$782.29
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,048.27
|
| Rate for Payer: Cofinity Commercial |
$1,126.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.40
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Nomi Health Commercial |
$938.75
|
| Rate for Payer: PACE SWMI |
$782.29
|
| Rate for Payer: PHP Commercial |
$1,095.21
|
| Rate for Payer: PHP Medicare Advantage |
$782.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,250.78
|
| Rate for Payer: Priority Health Medicare |
$782.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,250.78
|
| Rate for Payer: Priority Health SBD |
$1,250.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.29
|
| Rate for Payer: UHC Medicare Advantage |
$782.29
|
| Rate for Payer: UHCCP Medicaid |
$529.52
|
| Rate for Payer: UMR Bronson Commercial |
$748.88
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,597.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$513.33 |
| Max. Negotiated Rate |
$1,216.68 |
| Rate for Payer: Aetna Commercial |
$1,017.40
|
| Rate for Payer: Aetna Medicare |
$789.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.32
|
| Rate for Payer: BCBS Complete |
$539.00
|
| Rate for Payer: BCBS MAPPO |
$759.25
|
| Rate for Payer: BCBS Trust/PPO |
$628.15
|
| Rate for Payer: BCN Commercial |
$1,157.67
|
| Rate for Payer: BCN Medicare Advantage |
$759.25
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cofinity Commercial |
$1,017.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.21
|
| Rate for Payer: Meridian Medicaid |
$539.00
|
| Rate for Payer: Nomi Health Commercial |
$911.10
|
| Rate for Payer: PACE SWMI |
$759.25
|
| Rate for Payer: PHP Commercial |
$1,062.95
|
| Rate for Payer: PHP Medicare Advantage |
$759.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.68
|
| Rate for Payer: Priority Health Medicare |
$759.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.68
|
| Rate for Payer: Priority Health SBD |
$1,216.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.25
|
| Rate for Payer: UHC Medicare Advantage |
$759.25
|
| Rate for Payer: UHCCP Medicaid |
$513.33
|
| Rate for Payer: UMR Bronson Commercial |
$734.62
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$605.13 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,203.98
|
| Rate for Payer: Aetna Medicare |
$934.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,203.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,293.83
|
| Rate for Payer: BCBS Complete |
$635.39
|
| Rate for Payer: BCBS MAPPO |
$898.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,262.11
|
| Rate for Payer: BCN Commercial |
$1,363.90
|
| Rate for Payer: BCN Medicare Advantage |
$898.49
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cofinity Commercial |
$1,203.98
|
| Rate for Payer: Cofinity Commercial |
$1,293.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$943.41
|
| Rate for Payer: Meridian Medicaid |
$635.39
|
| Rate for Payer: Nomi Health Commercial |
$1,078.19
|
| Rate for Payer: PACE SWMI |
$898.49
|
| Rate for Payer: PHP Commercial |
$1,257.89
|
| Rate for Payer: PHP Medicare Advantage |
$898.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.93
|
| Rate for Payer: Priority Health Medicare |
$898.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,431.93
|
| Rate for Payer: Priority Health SBD |
$1,431.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.49
|
| Rate for Payer: UHC Medicare Advantage |
$898.49
|
| Rate for Payer: UHCCP Medicaid |
$605.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,433.36
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$409.39 |
| Max. Negotiated Rate |
$968.36 |
| Rate for Payer: Aetna Commercial |
$810.14
|
| Rate for Payer: Aetna Medicare |
$628.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$870.60
|
| Rate for Payer: BCBS Complete |
$429.86
|
| Rate for Payer: BCBS MAPPO |
$604.58
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: BCN Commercial |
$920.18
|
| Rate for Payer: BCN Medicare Advantage |
$604.58
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$810.14
|
| Rate for Payer: Cofinity Commercial |
$870.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$634.81
|
| Rate for Payer: Meridian Medicaid |
$429.86
|
| Rate for Payer: Nomi Health Commercial |
$725.50
|
| Rate for Payer: PACE SWMI |
$604.58
|
| Rate for Payer: PHP Commercial |
$846.41
|
| Rate for Payer: PHP Medicare Advantage |
$604.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.36
|
| Rate for Payer: Priority Health Medicare |
$604.58
|
| Rate for Payer: Priority Health Narrow Network |
$968.36
|
| Rate for Payer: Priority Health SBD |
$968.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.58
|
| Rate for Payer: UHC Medicare Advantage |
$604.58
|
| Rate for Payer: UHCCP Medicaid |
$409.39
|
| Rate for Payer: UMR Bronson Commercial |
$566.26
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$1,477.13 |
| Rate for Payer: Aetna Commercial |
$721.66
|
| Rate for Payer: Aetna Medicare |
$560.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.51
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS MAPPO |
$538.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.13
|
| Rate for Payer: BCN Commercial |
$905.58
|
| Rate for Payer: BCN Medicare Advantage |
$538.55
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$721.66
|
| Rate for Payer: Cofinity Commercial |
$775.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.48
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Nomi Health Commercial |
$646.26
|
| Rate for Payer: PACE SWMI |
$538.55
|
| Rate for Payer: PHP Commercial |
$753.97
|
| Rate for Payer: PHP Medicare Advantage |
$538.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$863.03
|
| Rate for Payer: Priority Health Medicare |
$538.55
|
| Rate for Payer: Priority Health Narrow Network |
$863.03
|
| Rate for Payer: Priority Health SBD |
$863.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.55
|
| Rate for Payer: UHC Medicare Advantage |
$538.55
|
| Rate for Payer: UHCCP Medicaid |
$364.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.46
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$320.57 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$635.35
|
| Rate for Payer: Aetna Medicare |
$493.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$635.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.76
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$474.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
| Rate for Payer: BCN Commercial |
$731.06
|
| Rate for Payer: BCN Medicare Advantage |
$474.14
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$635.35
|
| Rate for Payer: Cofinity Commercial |
$682.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.85
|
| Rate for Payer: Meridian Medicaid |
$336.60
|
| Rate for Payer: Nomi Health Commercial |
$568.97
|
| Rate for Payer: PACE SWMI |
$474.14
|
| Rate for Payer: PHP Commercial |
$663.80
|
| Rate for Payer: PHP Medicare Advantage |
$474.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.31
|
| Rate for Payer: Priority Health Medicare |
$474.14
|
| Rate for Payer: Priority Health Narrow Network |
$764.31
|
| Rate for Payer: Priority Health SBD |
$764.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.14
|
| Rate for Payer: UHC Medicare Advantage |
$474.14
|
| Rate for Payer: UHCCP Medicaid |
$320.57
|
| Rate for Payer: UMR Bronson Commercial |
$893.32
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$592.17
|
| Rate for Payer: Aetna Medicare |
$459.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.36
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$441.92
|
| Rate for Payer: BCBS Trust/PPO |
$911.32
|
| Rate for Payer: BCN Commercial |
$679.75
|
| Rate for Payer: BCN Medicare Advantage |
$441.92
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$592.17
|
| Rate for Payer: Cofinity Commercial |
$636.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.02
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Nomi Health Commercial |
$530.30
|
| Rate for Payer: PACE SWMI |
$441.92
|
| Rate for Payer: PHP Commercial |
$618.69
|
| Rate for Payer: PHP Medicare Advantage |
$441.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$713.93
|
| Rate for Payer: Priority Health Medicare |
$441.92
|
| Rate for Payer: Priority Health Narrow Network |
$713.93
|
| Rate for Payer: Priority Health SBD |
$713.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.92
|
| Rate for Payer: UHC Medicare Advantage |
$441.92
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
| Rate for Payer: UMR Bronson Commercial |
$863.42
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
HCPCS 29899
|
| Min. Negotiated Rate |
$645.82 |
| Max. Negotiated Rate |
$2,007.85 |
| Rate for Payer: Aetna Commercial |
$1,286.32
|
| Rate for Payer: Aetna Medicare |
$998.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,382.31
|
| Rate for Payer: BCBS Complete |
$678.11
|
| Rate for Payer: BCBS MAPPO |
$959.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.03
|
| Rate for Payer: BCN Commercial |
$1,471.90
|
| Rate for Payer: BCN Medicare Advantage |
$959.94
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cofinity Commercial |
$1,286.32
|
| Rate for Payer: Cofinity Commercial |
$1,382.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.94
|
| Rate for Payer: Meridian Medicaid |
$678.11
|
| Rate for Payer: Nomi Health Commercial |
$1,151.93
|
| Rate for Payer: PACE SWMI |
$959.94
|
| Rate for Payer: PHP Commercial |
$1,343.92
|
| Rate for Payer: PHP Medicare Advantage |
$959.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.87
|
| Rate for Payer: Priority Health Medicare |
$959.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,542.87
|
| Rate for Payer: Priority Health SBD |
$1,542.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.94
|
| Rate for Payer: UHC Medicare Advantage |
$959.94
|
| Rate for Payer: UHCCP Medicaid |
$645.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,420.94
|
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$329.51 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$652.96
|
| Rate for Payer: Aetna Medicare |
$506.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.68
|
| Rate for Payer: BCBS Complete |
$345.99
|
| Rate for Payer: BCBS MAPPO |
$487.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: BCN Commercial |
$728.13
|
| Rate for Payer: BCN Medicare Advantage |
$487.28
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$652.96
|
| Rate for Payer: Cofinity Commercial |
$701.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.64
|
| Rate for Payer: Meridian Medicaid |
$345.99
|
| Rate for Payer: Nomi Health Commercial |
$584.74
|
| Rate for Payer: PACE SWMI |
$487.28
|
| Rate for Payer: PHP Commercial |
$682.19
|
| Rate for Payer: PHP Medicare Advantage |
$487.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$778.56
|
| Rate for Payer: Priority Health Medicare |
$487.28
|
| Rate for Payer: Priority Health Narrow Network |
$778.56
|
| Rate for Payer: Priority Health SBD |
$778.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.28
|
| Rate for Payer: UHC Medicare Advantage |
$487.28
|
| Rate for Payer: UHCCP Medicaid |
$329.51
|
| Rate for Payer: UMR Bronson Commercial |
$893.32
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$1,480.30 |
| Rate for Payer: Aetna Commercial |
$769.59
|
| Rate for Payer: Aetna Medicare |
$597.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$827.02
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS MAPPO |
$574.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
| Rate for Payer: BCN Commercial |
$876.69
|
| Rate for Payer: BCN Medicare Advantage |
$574.32
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$769.59
|
| Rate for Payer: Cofinity Commercial |
$827.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$603.04
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Nomi Health Commercial |
$689.18
|
| Rate for Payer: PACE SWMI |
$574.32
|
| Rate for Payer: PHP Commercial |
$804.05
|
| Rate for Payer: PHP Medicare Advantage |
$574.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$922.56
|
| Rate for Payer: Priority Health Medicare |
$574.32
|
| Rate for Payer: Priority Health Narrow Network |
$922.56
|
| Rate for Payer: Priority Health SBD |
$922.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.32
|
| Rate for Payer: UHC Medicare Advantage |
$574.32
|
| Rate for Payer: UHCCP Medicaid |
$389.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.46
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$1,261.00 |
| Rate for Payer: Aetna Commercial |
$674.44
|
| Rate for Payer: Aetna Medicare |
$523.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.77
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$503.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.98
|
| Rate for Payer: BCN Commercial |
$778.46
|
| Rate for Payer: BCN Medicare Advantage |
$503.31
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$674.44
|
| Rate for Payer: Cofinity Commercial |
$724.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.48
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Nomi Health Commercial |
$603.97
|
| Rate for Payer: PACE SWMI |
$503.31
|
| Rate for Payer: PHP Commercial |
$704.63
|
| Rate for Payer: PHP Medicare Advantage |
$503.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$814.18
|
| Rate for Payer: Priority Health Medicare |
$503.31
|
| Rate for Payer: Priority Health Narrow Network |
$814.18
|
| Rate for Payer: Priority Health SBD |
$814.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.31
|
| Rate for Payer: UHC Medicare Advantage |
$503.31
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
| Rate for Payer: UMR Bronson Commercial |
$892.40
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,040.00
|
|
|
Service Code
|
HCPCS 29836
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$1,712.22 |
| Rate for Payer: Aetna Commercial |
$758.87
|
| Rate for Payer: Aetna Medicare |
$588.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$815.50
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS MAPPO |
$566.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,712.22
|
| Rate for Payer: BCN Commercial |
$863.50
|
| Rate for Payer: BCN Medicare Advantage |
$566.32
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cofinity Commercial |
$758.87
|
| Rate for Payer: Cofinity Commercial |
$815.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Nomi Health Commercial |
$679.58
|
| Rate for Payer: PACE SWMI |
$566.32
|
| Rate for Payer: PHP Commercial |
$792.85
|
| Rate for Payer: PHP Medicare Advantage |
$566.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$905.78
|
| Rate for Payer: Priority Health Medicare |
$566.32
|
| Rate for Payer: Priority Health Narrow Network |
$905.78
|
| Rate for Payer: Priority Health SBD |
$905.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.32
|
| Rate for Payer: UHC Medicare Advantage |
$566.32
|
| Rate for Payer: UHCCP Medicaid |
$384.04
|
| Rate for Payer: UMR Bronson Commercial |
$478.40
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$335.05 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Aetna Commercial |
$662.21
|
| Rate for Payer: Aetna Medicare |
$513.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.63
|
| Rate for Payer: BCBS Complete |
$351.80
|
| Rate for Payer: BCBS MAPPO |
$494.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.65
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: BCN Medicare Advantage |
$494.19
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$662.21
|
| Rate for Payer: Cofinity Commercial |
$711.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.90
|
| Rate for Payer: Meridian Medicaid |
$351.80
|
| Rate for Payer: Nomi Health Commercial |
$593.03
|
| Rate for Payer: PACE SWMI |
$494.19
|
| Rate for Payer: PHP Commercial |
$691.87
|
| Rate for Payer: PHP Medicare Advantage |
$494.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.78
|
| Rate for Payer: Priority Health Medicare |
$494.19
|
| Rate for Payer: Priority Health Narrow Network |
$791.78
|
| Rate for Payer: Priority Health SBD |
$791.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.19
|
| Rate for Payer: UHC Medicare Advantage |
$494.19
|
| Rate for Payer: UHCCP Medicaid |
$335.05
|
| Rate for Payer: UMR Bronson Commercial |
$905.74
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$324.61 |
| Max. Negotiated Rate |
$1,694.79 |
| Rate for Payer: Aetna Commercial |
$640.73
|
| Rate for Payer: Aetna Medicare |
$497.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.55
|
| Rate for Payer: BCBS Complete |
$340.84
|
| Rate for Payer: BCBS MAPPO |
$478.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.79
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: BCN Medicare Advantage |
$478.16
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cofinity Commercial |
$640.73
|
| Rate for Payer: Cofinity Commercial |
$688.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.07
|
| Rate for Payer: Meridian Medicaid |
$340.84
|
| Rate for Payer: Nomi Health Commercial |
$573.79
|
| Rate for Payer: PACE SWMI |
$478.16
|
| Rate for Payer: PHP Commercial |
$669.42
|
| Rate for Payer: PHP Medicare Advantage |
$478.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.78
|
| Rate for Payer: Priority Health Medicare |
$478.16
|
| Rate for Payer: Priority Health Narrow Network |
$762.78
|
| Rate for Payer: Priority Health SBD |
$762.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.16
|
| Rate for Payer: UHC Medicare Advantage |
$478.16
|
| Rate for Payer: UHCCP Medicaid |
$324.61
|
| Rate for Payer: UMR Bronson Commercial |
$848.70
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,444.00
|
|
|
Service Code
|
HCPCS 29861
|
| Min. Negotiated Rate |
$452.63 |
| Max. Negotiated Rate |
$1,588.60 |
| Rate for Payer: Aetna Commercial |
$899.64
|
| Rate for Payer: Aetna Medicare |
$698.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.77
|
| Rate for Payer: BCBS Complete |
$475.26
|
| Rate for Payer: BCBS MAPPO |
$671.37
|
| Rate for Payer: BCBS Trust/PPO |
$480.75
|
| Rate for Payer: BCN Commercial |
$1,045.28
|
| Rate for Payer: BCN Medicare Advantage |
$671.37
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cofinity Commercial |
$899.64
|
| Rate for Payer: Cofinity Commercial |
$966.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.94
|
| Rate for Payer: Meridian Medicaid |
$475.26
|
| Rate for Payer: Nomi Health Commercial |
$805.64
|
| Rate for Payer: PACE SWMI |
$671.37
|
| Rate for Payer: PHP Commercial |
$939.92
|
| Rate for Payer: PHP Medicare Advantage |
$671.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,588.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,102.20
|
| Rate for Payer: Priority Health Medicare |
$671.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,102.20
|
| Rate for Payer: Priority Health SBD |
$1,102.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$671.37
|
| Rate for Payer: UHC Medicare Advantage |
$671.37
|
| Rate for Payer: UHCCP Medicaid |
$452.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,124.24
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 29863
|
| Min. Negotiated Rate |
$531.01 |
| Max. Negotiated Rate |
$1,257.39 |
| Rate for Payer: Aetna Commercial |
$1,052.58
|
| Rate for Payer: Aetna Medicare |
$816.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,131.13
|
| Rate for Payer: BCBS Complete |
$557.56
|
| Rate for Payer: BCBS MAPPO |
$785.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.17
|
| Rate for Payer: BCN Commercial |
$1,191.40
|
| Rate for Payer: BCN Medicare Advantage |
$785.51
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$1,052.58
|
| Rate for Payer: Cofinity Commercial |
$1,131.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.79
|
| Rate for Payer: Meridian Medicaid |
$557.56
|
| Rate for Payer: Nomi Health Commercial |
$942.61
|
| Rate for Payer: PACE SWMI |
$785.51
|
| Rate for Payer: PHP Commercial |
$1,099.71
|
| Rate for Payer: PHP Medicare Advantage |
$785.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,257.39
|
| Rate for Payer: Priority Health Medicare |
$785.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,257.39
|
| Rate for Payer: Priority Health SBD |
$1,257.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.51
|
| Rate for Payer: UHC Medicare Advantage |
$785.51
|
| Rate for Payer: UHCCP Medicaid |
$531.01
|
| Rate for Payer: UMR Bronson Commercial |
$757.62
|
|
|
PR ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$657.53 |
| Max. Negotiated Rate |
$2,118.35 |
| Rate for Payer: Aetna Commercial |
$1,309.76
|
| Rate for Payer: Aetna Medicare |
$1,016.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.50
|
| Rate for Payer: BCBS Complete |
$690.41
|
| Rate for Payer: BCBS MAPPO |
$977.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.26
|
| Rate for Payer: BCN Commercial |
$1,489.98
|
| Rate for Payer: BCN Medicare Advantage |
$977.43
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cofinity Commercial |
$1,309.76
|
| Rate for Payer: Cofinity Commercial |
$1,407.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$977.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,026.30
|
| Rate for Payer: Meridian Medicaid |
$690.41
|
| Rate for Payer: Nomi Health Commercial |
$1,172.92
|
| Rate for Payer: PACE SWMI |
$977.43
|
| Rate for Payer: PHP Commercial |
$1,368.40
|
| Rate for Payer: PHP Medicare Advantage |
$977.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,563.72
|
| Rate for Payer: Priority Health Medicare |
$977.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,563.72
|
| Rate for Payer: Priority Health SBD |
$1,563.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$977.43
|
| Rate for Payer: UHC Medicare Advantage |
$977.43
|
| Rate for Payer: UHCCP Medicaid |
$657.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,499.14
|
|
|
PR ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,063.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$556.83 |
| Max. Negotiated Rate |
$1,990.95 |
| Rate for Payer: Aetna Commercial |
$1,284.67
|
| Rate for Payer: Aetna Medicare |
$997.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,380.54
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS MAPPO |
$958.71
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$1,456.26
|
| Rate for Payer: BCN Medicare Advantage |
$958.71
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cofinity Commercial |
$1,284.67
|
| Rate for Payer: Cofinity Commercial |
$1,380.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.65
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Nomi Health Commercial |
$1,150.45
|
| Rate for Payer: PACE SWMI |
$958.71
|
| Rate for Payer: PHP Commercial |
$1,342.19
|
| Rate for Payer: PHP Medicare Advantage |
$958.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.57
|
| Rate for Payer: Priority Health Medicare |
$958.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,525.57
|
| Rate for Payer: Priority Health SBD |
$1,525.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.71
|
| Rate for Payer: UHC Medicare Advantage |
$958.71
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,408.98
|
|
|
PR ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,274.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$658.38 |
| Max. Negotiated Rate |
$2,128.10 |
| Rate for Payer: Aetna Commercial |
$1,311.22
|
| Rate for Payer: Aetna Medicare |
$1,017.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,311.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.07
|
| Rate for Payer: BCBS Complete |
$691.30
|
| Rate for Payer: BCBS MAPPO |
$978.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.67
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$978.52
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cofinity Commercial |
$1,311.22
|
| Rate for Payer: Cofinity Commercial |
$1,409.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.45
|
| Rate for Payer: Meridian Medicaid |
$691.30
|
| Rate for Payer: Nomi Health Commercial |
$1,174.22
|
| Rate for Payer: PACE SWMI |
$978.52
|
| Rate for Payer: PHP Commercial |
$1,369.93
|
| Rate for Payer: PHP Medicare Advantage |
$978.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.12
|
| Rate for Payer: Priority Health Medicare |
$978.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,557.12
|
| Rate for Payer: Priority Health SBD |
$1,557.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.52
|
| Rate for Payer: UHC Medicare Advantage |
$978.52
|
| Rate for Payer: UHCCP Medicaid |
$658.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,506.04
|
|
|
PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$1,328.67 |
| Rate for Payer: Aetna Commercial |
$535.34
|
| Rate for Payer: Aetna Medicare |
$415.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$535.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.29
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$399.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,328.67
|
| Rate for Payer: BCN Commercial |
$810.23
|
| Rate for Payer: BCN Medicare Advantage |
$399.51
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$535.34
|
| Rate for Payer: Cofinity Commercial |
$575.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.49
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Nomi Health Commercial |
$479.41
|
| Rate for Payer: PACE SWMI |
$399.51
|
| Rate for Payer: PHP Commercial |
$559.31
|
| Rate for Payer: PHP Medicare Advantage |
$399.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.12
|
| Rate for Payer: Priority Health Medicare |
$399.51
|
| Rate for Payer: Priority Health Narrow Network |
$638.12
|
| Rate for Payer: Priority Health SBD |
$638.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.51
|
| Rate for Payer: UHC Medicare Advantage |
$399.51
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
| Rate for Payer: UMR Bronson Commercial |
$521.18
|
|
|
PR ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 29871
|
| Min. Negotiated Rate |
$338.03 |
| Max. Negotiated Rate |
$1,303.32 |
| Rate for Payer: Aetna Commercial |
$667.79
|
| Rate for Payer: Aetna Medicare |
$518.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.62
|
| Rate for Payer: BCBS Complete |
$354.93
|
| Rate for Payer: BCBS MAPPO |
$498.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.32
|
| Rate for Payer: BCN Commercial |
$760.87
|
| Rate for Payer: BCN Medicare Advantage |
$498.35
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$667.79
|
| Rate for Payer: Cofinity Commercial |
$717.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.27
|
| Rate for Payer: Meridian Medicaid |
$354.93
|
| Rate for Payer: Nomi Health Commercial |
$598.02
|
| Rate for Payer: PACE SWMI |
$498.35
|
| Rate for Payer: PHP Commercial |
$697.69
|
| Rate for Payer: PHP Medicare Advantage |
$498.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.93
|
| Rate for Payer: Priority Health Medicare |
$498.35
|
| Rate for Payer: Priority Health Narrow Network |
$799.93
|
| Rate for Payer: Priority Health SBD |
$799.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.35
|
| Rate for Payer: UHC Medicare Advantage |
$498.35
|
| Rate for Payer: UHCCP Medicaid |
$338.03
|
| Rate for Payer: UMR Bronson Commercial |
$744.28
|
|
|
PR ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$1,974.00
|
|
|
Service Code
|
HCPCS 29873
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$1,722.26 |
| Rate for Payer: Aetna Commercial |
$692.57
|
| Rate for Payer: Aetna Medicare |
$537.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.25
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$516.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.26
|
| Rate for Payer: BCN Commercial |
$792.14
|
| Rate for Payer: BCN Medicare Advantage |
$516.84
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cofinity Commercial |
$692.57
|
| Rate for Payer: Cofinity Commercial |
$744.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$542.68
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: PACE SWMI |
$516.84
|
| Rate for Payer: PHP Commercial |
$723.58
|
| Rate for Payer: PHP Medicare Advantage |
$516.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$836.57
|
| Rate for Payer: Priority Health Medicare |
$516.84
|
| Rate for Payer: Priority Health Narrow Network |
$836.57
|
| Rate for Payer: Priority Health SBD |
$836.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.84
|
| Rate for Payer: UHC Medicare Advantage |
$516.84
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
| Rate for Payer: UMR Bronson Commercial |
$908.04
|
|
|
PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT
|
Professional
|
Both
|
$3,003.00
|
|
|
Service Code
|
HCPCS 29868
|
| Min. Negotiated Rate |
$818.87 |
| Max. Negotiated Rate |
$2,554.48 |
| Rate for Payer: Aetna Commercial |
$2,152.71
|
| Rate for Payer: Aetna Medicare |
$1,670.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,152.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,313.36
|
| Rate for Payer: BCBS Complete |
$1,131.45
|
| Rate for Payer: BCBS MAPPO |
$1,606.50
|
| Rate for Payer: BCBS Trust/PPO |
$818.87
|
| Rate for Payer: BCN Commercial |
$2,437.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,606.50
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Cofinity Commercial |
$2,152.71
|
| Rate for Payer: Cofinity Commercial |
$2,313.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,606.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,686.82
|
| Rate for Payer: Meridian Medicaid |
$1,131.45
|
| Rate for Payer: Nomi Health Commercial |
$1,927.80
|
| Rate for Payer: PACE SWMI |
$1,606.50
|
| Rate for Payer: PHP Commercial |
$2,249.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,606.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,077.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,951.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,554.48
|
| Rate for Payer: Priority Health Medicare |
$1,606.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,554.48
|
| Rate for Payer: Priority Health SBD |
$2,554.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,606.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,606.50
|
| Rate for Payer: UHCCP Medicaid |
$1,077.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,381.38
|
|
