|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Facility
|
IP
|
$3,221.00
|
|
|
Service Code
|
CPT 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$1,417.24 |
| Max. Negotiated Rate |
$2,898.90 |
| Rate for Payer: Aetna American Axle |
$2,093.65
|
| Rate for Payer: Aetna Commercial |
$2,737.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,093.65
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$2,254.70
|
| Rate for Payer: Cofinity Commercial |
$2,770.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,254.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.80
|
| Rate for Payer: Healthscope Commercial |
$2,898.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,254.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,415.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,737.85
|
| Rate for Payer: PHP Commercial |
$2,737.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health SBD |
$2,029.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,417.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,415.75
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$3,221.00
|
|
|
Service Code
|
HCPCS 27446
|
| Min. Negotiated Rate |
$742.73 |
| Max. Negotiated Rate |
$2,093.65 |
| Rate for Payer: Aetna Commercial |
$1,482.39
|
| Rate for Payer: Aetna Medicare |
$1,150.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,593.01
|
| Rate for Payer: BCBS Complete |
$779.87
|
| Rate for Payer: BCBS MAPPO |
$1,106.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.16
|
| Rate for Payer: BCN Commercial |
$1,677.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.26
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$1,482.39
|
| Rate for Payer: Cofinity Commercial |
$1,593.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.57
|
| Rate for Payer: Meridian Medicaid |
$779.87
|
| Rate for Payer: Nomi Health Commercial |
$1,327.51
|
| Rate for Payer: PACE SWMI |
$1,106.26
|
| Rate for Payer: PHP Commercial |
$1,548.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.14
|
| Rate for Payer: Priority Health Medicare |
$1,106.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.14
|
| Rate for Payer: Priority Health SBD |
$1,760.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.26
|
| Rate for Payer: UHCCP Medicaid |
$742.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,481.66
|
|
|
PR ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 27441
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,272.16 |
| Rate for Payer: Aetna Commercial |
$1,067.56
|
| Rate for Payer: Aetna Medicare |
$828.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.23
|
| Rate for Payer: BCBS Complete |
$564.27
|
| Rate for Payer: BCBS MAPPO |
$796.69
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$1,212.41
|
| Rate for Payer: BCN Medicare Advantage |
$796.69
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,067.56
|
| Rate for Payer: Cofinity Commercial |
$1,147.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.52
|
| Rate for Payer: Meridian Medicaid |
$564.27
|
| Rate for Payer: Nomi Health Commercial |
$956.03
|
| Rate for Payer: PACE SWMI |
$796.69
|
| Rate for Payer: PHP Commercial |
$1,115.37
|
| Rate for Payer: PHP Medicare Advantage |
$796.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,272.16
|
| Rate for Payer: Priority Health Medicare |
$796.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,272.16
|
| Rate for Payer: Priority Health SBD |
$1,272.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.69
|
| Rate for Payer: UHC Medicare Advantage |
$796.69
|
| Rate for Payer: UHCCP Medicaid |
$537.40
|
| Rate for Payer: UMR Bronson Commercial |
$777.40
|
|
|
PR ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26531
|
| Min. Negotiated Rate |
$224.00 |
| Max. Negotiated Rate |
$1,417.65 |
| Rate for Payer: Aetna Commercial |
$820.19
|
| Rate for Payer: Aetna Medicare |
$636.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.40
|
| Rate for Payer: BCBS Complete |
$437.01
|
| Rate for Payer: BCBS MAPPO |
$612.08
|
| Rate for Payer: BCBS Trust/PPO |
$224.00
|
| Rate for Payer: BCN Commercial |
$934.35
|
| Rate for Payer: BCN Medicare Advantage |
$612.08
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$820.19
|
| Rate for Payer: Cofinity Commercial |
$881.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$612.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.68
|
| Rate for Payer: Meridian Medicaid |
$437.01
|
| Rate for Payer: Nomi Health Commercial |
$734.50
|
| Rate for Payer: PACE SWMI |
$612.08
|
| Rate for Payer: PHP Commercial |
$856.91
|
| Rate for Payer: PHP Medicare Advantage |
$612.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.10
|
| Rate for Payer: Priority Health Medicare |
$612.08
|
| Rate for Payer: Priority Health Narrow Network |
$982.10
|
| Rate for Payer: Priority Health SBD |
$982.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$612.08
|
| Rate for Payer: UHC Medicare Advantage |
$612.08
|
| Rate for Payer: UHCCP Medicaid |
$416.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,003.26
|
|
|
PR ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/ENTIR CARPS
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 25446
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$1,800.85 |
| Rate for Payer: Aetna Commercial |
$1,513.26
|
| Rate for Payer: Aetna Medicare |
$1,174.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.19
|
| Rate for Payer: BCBS Complete |
$798.21
|
| Rate for Payer: BCBS MAPPO |
$1,129.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.86
|
| Rate for Payer: BCN Commercial |
$1,717.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,129.30
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cofinity Commercial |
$1,513.26
|
| Rate for Payer: Cofinity Commercial |
$1,626.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,129.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.76
|
| Rate for Payer: Meridian Medicaid |
$798.21
|
| Rate for Payer: Nomi Health Commercial |
$1,355.16
|
| Rate for Payer: PACE SWMI |
$1,129.30
|
| Rate for Payer: PHP Commercial |
$1,581.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,129.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$760.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.85
|
| Rate for Payer: Priority Health Medicare |
$1,129.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.85
|
| Rate for Payer: Priority Health SBD |
$1,800.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,129.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,129.30
|
| Rate for Payer: UHCCP Medicaid |
$760.20
|
| Rate for Payer: UMR Bronson Commercial |
$963.24
|
|
|
PR ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ
|
Professional
|
Both
|
$3,684.00
|
|
|
Service Code
|
HCPCS 25332
|
| Min. Negotiated Rate |
$547.85 |
| Max. Negotiated Rate |
$2,394.60 |
| Rate for Payer: Aetna Commercial |
$1,094.11
|
| Rate for Payer: Aetna Medicare |
$849.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,175.76
|
| Rate for Payer: BCBS Complete |
$579.70
|
| Rate for Payer: BCBS MAPPO |
$816.50
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$1,244.17
|
| Rate for Payer: BCN Medicare Advantage |
$816.50
|
| Rate for Payer: Cash Price |
$2,947.20
|
| Rate for Payer: Cash Price |
$2,947.20
|
| Rate for Payer: Cofinity Commercial |
$1,094.11
|
| Rate for Payer: Cofinity Commercial |
$1,175.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.32
|
| Rate for Payer: Meridian Medicaid |
$579.70
|
| Rate for Payer: Nomi Health Commercial |
$979.80
|
| Rate for Payer: PACE SWMI |
$816.50
|
| Rate for Payer: PHP Commercial |
$1,143.10
|
| Rate for Payer: PHP Medicare Advantage |
$816.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,394.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,306.25
|
| Rate for Payer: Priority Health Medicare |
$816.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,306.25
|
| Rate for Payer: Priority Health SBD |
$1,306.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.50
|
| Rate for Payer: UHC Medicare Advantage |
$816.50
|
| Rate for Payer: UHCCP Medicaid |
$552.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,694.64
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,078.00
|
|
|
Service Code
|
HCPCS 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$630.48 |
| Max. Negotiated Rate |
$2,650.70 |
| Rate for Payer: Aetna Commercial |
$1,254.98
|
| Rate for Payer: Aetna Medicare |
$974.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.63
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: BCBS MAPPO |
$936.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$1,573.32
|
| Rate for Payer: BCN Medicare Advantage |
$936.55
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$1,348.63
|
| Rate for Payer: Cofinity Commercial |
$1,254.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.38
|
| Rate for Payer: Meridian Medicaid |
$662.00
|
| Rate for Payer: Nomi Health Commercial |
$1,123.86
|
| Rate for Payer: PACE SWMI |
$936.55
|
| Rate for Payer: PHP Commercial |
$1,311.17
|
| Rate for Payer: PHP Medicare Advantage |
$936.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,497.07
|
| Rate for Payer: Priority Health Medicare |
$936.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,497.07
|
| Rate for Payer: Priority Health SBD |
$1,497.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.55
|
| Rate for Payer: UHC Medicare Advantage |
$936.55
|
| Rate for Payer: UHCCP Medicaid |
$630.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,875.88
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Facility
|
IP
|
$4,078.00
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$1,794.32 |
| Max. Negotiated Rate |
$3,670.20 |
| Rate for Payer: Aetna American Axle |
$2,650.70
|
| Rate for Payer: Aetna Commercial |
$3,466.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,650.70
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$2,854.60
|
| Rate for Payer: Cofinity Commercial |
$3,507.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,854.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,262.40
|
| Rate for Payer: Healthscope Commercial |
$3,670.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,854.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,058.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.30
|
| Rate for Payer: PHP Commercial |
$3,466.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health SBD |
$2,569.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,794.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,058.50
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Facility
|
OP
|
$4,078.00
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$943.03 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna American Axle |
$2,650.70
|
| Rate for Payer: Aetna Commercial |
$3,466.30
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,650.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,866.78
|
| Rate for Payer: BCN Commercial |
$6,866.78
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$2,854.60
|
| Rate for Payer: Cofinity Commercial |
$3,507.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,854.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,262.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$3,670.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,854.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,058.50
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.30
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$3,466.30
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$2,569.14
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.33
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$943.03
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,508.86
|
| Rate for Payer: VA VA |
$6,999.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,058.50
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,078.00
|
|
|
Service Code
|
HCPCS 29888
|
| Min. Negotiated Rate |
$630.48 |
| Max. Negotiated Rate |
$2,650.70 |
| Rate for Payer: Aetna Commercial |
$1,254.98
|
| Rate for Payer: Aetna Medicare |
$974.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.63
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: BCBS MAPPO |
$936.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$1,573.32
|
| Rate for Payer: BCN Medicare Advantage |
$936.55
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$1,254.98
|
| Rate for Payer: Cofinity Commercial |
$1,348.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.38
|
| Rate for Payer: Meridian Medicaid |
$662.00
|
| Rate for Payer: Nomi Health Commercial |
$1,123.86
|
| Rate for Payer: PACE SWMI |
$936.55
|
| Rate for Payer: PHP Commercial |
$1,311.17
|
| Rate for Payer: PHP Medicare Advantage |
$936.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,497.07
|
| Rate for Payer: Priority Health Medicare |
$936.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,497.07
|
| Rate for Payer: Priority Health SBD |
$1,497.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.55
|
| Rate for Payer: UHC Medicare Advantage |
$936.55
|
| Rate for Payer: UHCCP Medicaid |
$630.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,875.88
|
|
|
PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,237.00
|
|
|
Service Code
|
HCPCS 29889
|
| Min. Negotiated Rate |
$795.34 |
| Max. Negotiated Rate |
$2,754.05 |
| Rate for Payer: Aetna Commercial |
$1,581.79
|
| Rate for Payer: Aetna Medicare |
$1,227.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,581.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,699.83
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS MAPPO |
$1,180.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$1,793.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,180.44
|
| Rate for Payer: Cash Price |
$3,389.60
|
| Rate for Payer: Cash Price |
$3,389.60
|
| Rate for Payer: Cofinity Commercial |
$1,581.79
|
| Rate for Payer: Cofinity Commercial |
$1,699.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,180.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,239.46
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Nomi Health Commercial |
$1,416.53
|
| Rate for Payer: PACE SWMI |
$1,180.44
|
| Rate for Payer: PHP Commercial |
$1,652.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,180.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,754.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,884.82
|
| Rate for Payer: Priority Health Medicare |
$1,180.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,884.82
|
| Rate for Payer: Priority Health SBD |
$1,884.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,180.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,180.44
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,949.02
|
|
|
PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX
|
Professional
|
Both
|
$2,688.00
|
|
|
Service Code
|
HCPCS 29892
|
| Min. Negotiated Rate |
$416.84 |
| Max. Negotiated Rate |
$1,747.20 |
| Rate for Payer: Aetna Commercial |
$826.46
|
| Rate for Payer: Aetna Medicare |
$641.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.13
|
| Rate for Payer: BCBS Complete |
$437.68
|
| Rate for Payer: BCBS MAPPO |
$616.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.83
|
| Rate for Payer: BCN Commercial |
$939.24
|
| Rate for Payer: BCN Medicare Advantage |
$616.76
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cofinity Commercial |
$826.46
|
| Rate for Payer: Cofinity Commercial |
$888.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.60
|
| Rate for Payer: Meridian Medicaid |
$437.68
|
| Rate for Payer: Nomi Health Commercial |
$740.11
|
| Rate for Payer: PACE SWMI |
$616.76
|
| Rate for Payer: PHP Commercial |
$863.46
|
| Rate for Payer: PHP Medicare Advantage |
$616.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.70
|
| Rate for Payer: Priority Health Medicare |
$616.76
|
| Rate for Payer: Priority Health Narrow Network |
$987.70
|
| Rate for Payer: Priority Health SBD |
$987.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.76
|
| Rate for Payer: UHC Medicare Advantage |
$616.76
|
| Rate for Payer: UHCCP Medicaid |
$416.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,236.48
|
|
|
PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,542.00
|
|
|
Service Code
|
HCPCS 29855
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,652.30 |
| Rate for Payer: Aetna Commercial |
$1,009.03
|
| Rate for Payer: Aetna Medicare |
$783.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.33
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$753.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.84
|
| Rate for Payer: BCN Commercial |
$1,147.91
|
| Rate for Payer: BCN Medicare Advantage |
$753.01
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cofinity Commercial |
$1,009.03
|
| Rate for Payer: Cofinity Commercial |
$1,084.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.66
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Nomi Health Commercial |
$903.61
|
| Rate for Payer: PACE SWMI |
$753.01
|
| Rate for Payer: PHP Commercial |
$1,054.21
|
| Rate for Payer: PHP Medicare Advantage |
$753.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,652.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,203.96
|
| Rate for Payer: Priority Health Medicare |
$753.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,203.96
|
| Rate for Payer: Priority Health SBD |
$1,203.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$753.01
|
| Rate for Payer: UHC Medicare Advantage |
$753.01
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,169.32
|
|
|
PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 29856
|
| Min. Negotiated Rate |
$645.18 |
| Max. Negotiated Rate |
$1,644.07 |
| Rate for Payer: Aetna Commercial |
$1,284.30
|
| Rate for Payer: Aetna Medicare |
$996.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,380.14
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS MAPPO |
$958.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.07
|
| Rate for Payer: BCN Commercial |
$1,455.28
|
| Rate for Payer: BCN Medicare Advantage |
$958.43
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,284.30
|
| Rate for Payer: Cofinity Commercial |
$1,380.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.35
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Nomi Health Commercial |
$1,150.12
|
| Rate for Payer: PACE SWMI |
$958.43
|
| Rate for Payer: PHP Commercial |
$1,341.80
|
| Rate for Payer: PHP Medicare Advantage |
$958.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,527.09
|
| Rate for Payer: Priority Health Medicare |
$958.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,527.09
|
| Rate for Payer: Priority Health SBD |
$1,527.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.43
|
| Rate for Payer: UHC Medicare Advantage |
$958.43
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
| Rate for Payer: UMR Bronson Commercial |
$821.56
|
|
|
PR ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29891
|
| Min. Negotiated Rate |
$439.21 |
| Max. Negotiated Rate |
$1,590.71 |
| Rate for Payer: Aetna Commercial |
$869.23
|
| Rate for Payer: Aetna Medicare |
$674.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.10
|
| Rate for Payer: BCBS Complete |
$461.17
|
| Rate for Payer: BCBS MAPPO |
$648.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.71
|
| Rate for Payer: BCN Commercial |
$982.73
|
| Rate for Payer: BCN Medicare Advantage |
$648.68
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$869.23
|
| Rate for Payer: Cofinity Commercial |
$934.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.11
|
| Rate for Payer: Meridian Medicaid |
$461.17
|
| Rate for Payer: Nomi Health Commercial |
$778.42
|
| Rate for Payer: PACE SWMI |
$648.68
|
| Rate for Payer: PHP Commercial |
$908.15
|
| Rate for Payer: PHP Medicare Advantage |
$648.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,040.12
|
| Rate for Payer: Priority Health Medicare |
$648.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,040.12
|
| Rate for Payer: Priority Health SBD |
$1,040.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$648.68
|
| Rate for Payer: UHC Medicare Advantage |
$648.68
|
| Rate for Payer: UHCCP Medicaid |
$439.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,116.88
|
|
|
PR ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 29862
|
| Min. Negotiated Rate |
$528.24 |
| Max. Negotiated Rate |
$1,792.70 |
| Rate for Payer: Aetna Commercial |
$1,047.00
|
| Rate for Payer: Aetna Medicare |
$812.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,047.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.13
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS MAPPO |
$781.34
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,193.35
|
| Rate for Payer: BCN Medicare Advantage |
$781.34
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cofinity Commercial |
$1,047.00
|
| Rate for Payer: Cofinity Commercial |
$1,125.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.41
|
| Rate for Payer: Meridian Medicaid |
$554.65
|
| Rate for Payer: Nomi Health Commercial |
$937.61
|
| Rate for Payer: PACE SWMI |
$781.34
|
| Rate for Payer: PHP Commercial |
$1,093.88
|
| Rate for Payer: PHP Medicare Advantage |
$781.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,258.41
|
| Rate for Payer: Priority Health Medicare |
$781.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,258.41
|
| Rate for Payer: Priority Health SBD |
$1,258.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.34
|
| Rate for Payer: UHC Medicare Advantage |
$781.34
|
| Rate for Payer: UHCCP Medicaid |
$528.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,268.68
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: UHCCP Medicaid |
$432.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.50
|
| Rate for Payer: UHC Medicare Advantage |
$639.33
|
| Rate for Payer: Aetna Commercial |
$856.70
|
| Rate for Payer: Aetna Medicare |
$664.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$856.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.64
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$639.33
|
| Rate for Payer: BCBS Trust/PPO |
$943.02
|
| Rate for Payer: BCN Commercial |
$1,071.84
|
| Rate for Payer: BCN Medicare Advantage |
$639.33
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$920.64
|
| Rate for Payer: Cofinity Commercial |
$856.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.30
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Nomi Health Commercial |
$767.20
|
| Rate for Payer: PACE SWMI |
$639.33
|
| Rate for Payer: PHP Commercial |
$895.06
|
| Rate for Payer: PHP Medicare Advantage |
$639.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.82
|
| Rate for Payer: Priority Health Medicare |
$639.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.82
|
| Rate for Payer: Priority Health SBD |
$1,023.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.33
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29879
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$856.70
|
| Rate for Payer: Aetna Medicare |
$664.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$856.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.64
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$639.33
|
| Rate for Payer: BCBS Trust/PPO |
$943.02
|
| Rate for Payer: BCN Commercial |
$1,071.84
|
| Rate for Payer: BCN Medicare Advantage |
$639.33
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$856.70
|
| Rate for Payer: Cofinity Commercial |
$920.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.30
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Nomi Health Commercial |
$767.20
|
| Rate for Payer: PACE SWMI |
$639.33
|
| Rate for Payer: PHP Commercial |
$895.06
|
| Rate for Payer: PHP Medicare Advantage |
$639.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.82
|
| Rate for Payer: Priority Health Medicare |
$639.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.82
|
| Rate for Payer: Priority Health SBD |
$1,023.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.33
|
| Rate for Payer: UHC Medicare Advantage |
$639.33
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.50
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Facility
|
IP
|
$2,525.00
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$1,111.00 |
| Max. Negotiated Rate |
$2,272.50 |
| Rate for Payer: Aetna American Axle |
$1,641.25
|
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,767.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,893.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,893.75
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Facility
|
OP
|
$2,525.00
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$641.91 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$1,641.25
|
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.78
|
| Rate for Payer: BCN Commercial |
$2,214.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,767.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,893.75
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.10
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$641.91
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$934.25
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,893.75
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Facility
|
OP
|
$2,265.00
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$601.92 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$1,472.25
|
| Rate for Payer: Aetna Commercial |
$1,925.25
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,472.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,044.06
|
| Rate for Payer: BCN Commercial |
$3,044.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$1,585.50
|
| Rate for Payer: Cofinity Commercial |
$1,947.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,585.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,812.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,038.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,585.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,698.75
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,925.25
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,925.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,426.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.11
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$601.92
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$838.05
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,698.75
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Facility
|
IP
|
$2,265.00
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$996.60 |
| Max. Negotiated Rate |
$2,038.50 |
| Rate for Payer: Aetna American Axle |
$1,472.25
|
| Rate for Payer: Aetna Commercial |
$1,925.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,472.25
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$1,585.50
|
| Rate for Payer: Cofinity Commercial |
$1,947.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,585.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,812.00
|
| Rate for Payer: Healthscope Commercial |
$2,038.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,585.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,698.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,925.25
|
| Rate for Payer: PHP Commercial |
$1,925.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health SBD |
$1,426.95
|
| Rate for Payer: UMR Bronson Commercial |
$996.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,698.75
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$405.98 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$803.26
|
| Rate for Payer: Aetna Medicare |
$623.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.21
|
| Rate for Payer: BCBS Complete |
$426.28
|
| Rate for Payer: BCBS MAPPO |
$599.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.49
|
| Rate for Payer: BCN Commercial |
$1,007.27
|
| Rate for Payer: BCN Medicare Advantage |
$599.45
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$863.21
|
| Rate for Payer: Cofinity Commercial |
$803.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.42
|
| Rate for Payer: Meridian Medicaid |
$426.28
|
| Rate for Payer: Nomi Health Commercial |
$719.34
|
| Rate for Payer: PACE SWMI |
$599.45
|
| Rate for Payer: PHP Commercial |
$839.23
|
| Rate for Payer: PHP Medicare Advantage |
$599.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Medicare |
$599.45
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: Priority Health SBD |
$961.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.45
|
| Rate for Payer: UHC Medicare Advantage |
$599.45
|
| Rate for Payer: UHCCP Medicaid |
$405.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,041.90
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29877
|
| Min. Negotiated Rate |
$405.98 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$803.26
|
| Rate for Payer: Aetna Medicare |
$623.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.21
|
| Rate for Payer: BCBS Complete |
$426.28
|
| Rate for Payer: BCBS MAPPO |
$599.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.49
|
| Rate for Payer: BCN Commercial |
$1,007.27
|
| Rate for Payer: BCN Medicare Advantage |
$599.45
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$803.26
|
| Rate for Payer: Cofinity Commercial |
$863.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.42
|
| Rate for Payer: Meridian Medicaid |
$426.28
|
| Rate for Payer: Nomi Health Commercial |
$719.34
|
| Rate for Payer: PACE SWMI |
$599.45
|
| Rate for Payer: PHP Commercial |
$839.23
|
| Rate for Payer: PHP Medicare Advantage |
$599.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Medicare |
$599.45
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: Priority Health SBD |
$961.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.45
|
| Rate for Payer: UHC Medicare Advantage |
$599.45
|
| Rate for Payer: UHCCP Medicaid |
$405.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,041.90
|
|
|
PR ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29886
|
| Min. Negotiated Rate |
$417.48 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$826.44
|
| Rate for Payer: Aetna Medicare |
$641.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.12
|
| Rate for Payer: BCBS Complete |
$438.35
|
| Rate for Payer: BCBS MAPPO |
$616.75
|
| Rate for Payer: BCBS Trust/PPO |
$436.38
|
| Rate for Payer: BCN Commercial |
$938.26
|
| Rate for Payer: BCN Medicare Advantage |
$616.75
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$826.44
|
| Rate for Payer: Cofinity Commercial |
$888.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.59
|
| Rate for Payer: Meridian Medicaid |
$438.35
|
| Rate for Payer: Nomi Health Commercial |
$740.10
|
| Rate for Payer: PACE SWMI |
$616.75
|
| Rate for Payer: PHP Commercial |
$863.45
|
| Rate for Payer: PHP Medicare Advantage |
$616.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.19
|
| Rate for Payer: Priority Health Medicare |
$616.75
|
| Rate for Payer: Priority Health Narrow Network |
$987.19
|
| Rate for Payer: Priority Health SBD |
$987.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.75
|
| Rate for Payer: UHC Medicare Advantage |
$616.75
|
| Rate for Payer: UHCCP Medicaid |
$417.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,101.70
|
|
