|
PR ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS
|
Professional
|
Both
|
$433.00
|
|
|
Service Code
|
HCPCS 33987
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$321.84 |
| Rate for Payer: Aetna Commercial |
$281.69
|
| Rate for Payer: BCBS Complete |
$135.53
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Meridian Medicaid |
$135.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.84
|
| Rate for Payer: Priority Health Narrow Network |
$321.84
|
| Rate for Payer: Priority Health SBD |
$321.84
|
| Rate for Payer: UMR Bronson Commercial |
$199.18
|
|
|
PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2
|
Professional
|
Both
|
$4,329.00
|
|
|
Service Code
|
HCPCS 22551
|
| Min. Negotiated Rate |
$1,096.95 |
| Max. Negotiated Rate |
$12,500.50 |
| Rate for Payer: Aetna Commercial |
$2,284.82
|
| Rate for Payer: BCBS Complete |
$1,151.80
|
| Rate for Payer: BCBS Trust/PPO |
$12,500.50
|
| Rate for Payer: Cash Price |
$3,463.20
|
| Rate for Payer: Cash Price |
$3,463.20
|
| Rate for Payer: Meridian Medicaid |
$1,151.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,096.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,030.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,610.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,610.95
|
| Rate for Payer: Priority Health SBD |
$2,610.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,991.34
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2
|
Professional
|
Both
|
$4,820.00
|
|
|
Service Code
|
HCPCS 22554
|
| Min. Negotiated Rate |
$407.75 |
| Max. Negotiated Rate |
$3,374.00 |
| Rate for Payer: Aetna Commercial |
$1,684.41
|
| Rate for Payer: BCBS Complete |
$857.47
|
| Rate for Payer: BCBS Trust/PPO |
$407.75
|
| Rate for Payer: Cash Price |
$3,856.00
|
| Rate for Payer: Cash Price |
$3,856.00
|
| Rate for Payer: Meridian Medicaid |
$857.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$816.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,374.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,939.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,939.45
|
| Rate for Payer: Priority Health SBD |
$1,939.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,217.20
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC LUMBAR
|
Professional
|
Both
|
$3,127.92
|
|
|
Service Code
|
HCPCS 22558
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,336.74 |
| Rate for Payer: Aetna Commercial |
$2,054.27
|
| Rate for Payer: BCBS Complete |
$1,029.91
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: Cash Price |
$2,502.34
|
| Rate for Payer: Cash Price |
$2,502.34
|
| Rate for Payer: Meridian Medicaid |
$1,029.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$980.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,336.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,336.74
|
| Rate for Payer: Priority Health SBD |
$2,336.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,438.84
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC THORACIC
|
Professional
|
Both
|
$5,866.00
|
|
|
Service Code
|
HCPCS 22556
|
| Min. Negotiated Rate |
$350.50 |
| Max. Negotiated Rate |
$4,106.20 |
| Rate for Payer: Aetna Commercial |
$2,232.24
|
| Rate for Payer: BCBS Complete |
$1,141.74
|
| Rate for Payer: BCBS Trust/PPO |
$350.50
|
| Rate for Payer: Cash Price |
$4,692.80
|
| Rate for Payer: Cash Price |
$4,692.80
|
| Rate for Payer: Meridian Medicaid |
$1,141.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,087.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,106.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,562.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,562.95
|
| Rate for Payer: Priority Health SBD |
$2,562.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,698.36
|
|
|
PR ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 22552
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$707.70 |
| Rate for Payer: Aetna Commercial |
$532.98
|
| Rate for Payer: BCBS Complete |
$265.03
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Meridian Medicaid |
$265.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$602.57
|
| Rate for Payer: Priority Health Narrow Network |
$602.57
|
| Rate for Payer: Priority Health SBD |
$602.57
|
| Rate for Payer: UMR Bronson Commercial |
$465.06
|
|
|
PR ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 22585
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$1,143.80 |
| Rate for Payer: Aetna Commercial |
$439.49
|
| Rate for Payer: BCBS Complete |
$216.72
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Meridian Medicaid |
$216.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.31
|
| Rate for Payer: Priority Health Narrow Network |
$494.31
|
| Rate for Payer: Priority Health SBD |
$494.31
|
| Rate for Payer: UMR Bronson Commercial |
$751.64
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 26843
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$2,135.00 |
| Rate for Payer: Aetna Commercial |
$1,037.06
|
| Rate for Payer: BCBS Complete |
$532.29
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Meridian Medicaid |
$532.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$506.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,215.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,215.85
|
| Rate for Payer: Priority Health SBD |
$1,215.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,403.00
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT
|
Professional
|
Both
|
$3,282.00
|
|
|
Service Code
|
HCPCS 26844
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$2,297.40 |
| Rate for Payer: Aetna Commercial |
$1,141.96
|
| Rate for Payer: BCBS Complete |
$584.85
|
| Rate for Payer: BCBS Trust/PPO |
$195.47
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Meridian Medicaid |
$584.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,335.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,335.86
|
| Rate for Payer: Priority Health SBD |
$1,335.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,509.72
|
|
|
PR ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 26841
|
| Min. Negotiated Rate |
$223.47 |
| Max. Negotiated Rate |
$2,135.00 |
| Rate for Payer: Aetna Commercial |
$1,018.84
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCBS Trust/PPO |
$223.47
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Cash Price |
$2,440.00
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,200.03
|
| Rate for Payer: Priority Health SBD |
$1,200.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,403.00
|
|
|
PR ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT
|
Professional
|
Both
|
$3,235.00
|
|
|
Service Code
|
HCPCS 26842
|
| Min. Negotiated Rate |
$161.13 |
| Max. Negotiated Rate |
$2,264.50 |
| Rate for Payer: Aetna Commercial |
$1,103.54
|
| Rate for Payer: BCBS Complete |
$565.83
|
| Rate for Payer: BCBS Trust/PPO |
$161.13
|
| Rate for Payer: Cash Price |
$2,588.00
|
| Rate for Payer: Cash Price |
$2,588.00
|
| Rate for Payer: Meridian Medicaid |
$565.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,264.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,292.96
|
| Rate for Payer: Priority Health SBD |
$1,292.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,488.10
|
|
|
PR ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE
|
Professional
|
Both
|
$1,653.00
|
|
|
Service Code
|
HCPCS 25830
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,565.65 |
| Rate for Payer: Aetna Commercial |
$1,340.21
|
| Rate for Payer: BCBS Complete |
$698.24
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Meridian Medicaid |
$698.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,565.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,565.65
|
| Rate for Payer: Priority Health SBD |
$1,565.65
|
| Rate for Payer: UMR Bronson Commercial |
$760.38
|
|
|
PR ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 28735
|
| Min. Negotiated Rate |
$499.06 |
| Max. Negotiated Rate |
$1,971.20 |
| Rate for Payer: Aetna Commercial |
$1,039.96
|
| Rate for Payer: BCBS Complete |
$524.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.09
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Meridian Medicaid |
$524.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,971.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,191.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,191.35
|
| Rate for Payer: Priority Health SBD |
$1,191.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,295.36
|
|
|
PR ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS
|
Professional
|
Both
|
$2,728.00
|
|
|
Service Code
|
HCPCS 28730
|
| Min. Negotiated Rate |
$467.11 |
| Max. Negotiated Rate |
$1,909.60 |
| Rate for Payer: Aetna Commercial |
$976.15
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS Trust/PPO |
$872.22
|
| Rate for Payer: Cash Price |
$2,182.40
|
| Rate for Payer: Cash Price |
$2,182.40
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,909.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.73
|
| Rate for Payer: Priority Health SBD |
$1,113.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,254.88
|
|
|
PR ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT
|
Professional
|
Both
|
$4,281.00
|
|
|
Service Code
|
HCPCS 22600
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$2,996.70 |
| Rate for Payer: Aetna Commercial |
$1,732.46
|
| Rate for Payer: BCBS Complete |
$887.89
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: Cash Price |
$3,424.80
|
| Rate for Payer: Cash Price |
$3,424.80
|
| Rate for Payer: Meridian Medicaid |
$887.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$845.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,996.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,005.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,005.32
|
| Rate for Payer: Priority Health SBD |
$2,005.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,969.26
|
|
|
PR ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 28737
|
| Min. Negotiated Rate |
$444.96 |
| Max. Negotiated Rate |
$2,092.60 |
| Rate for Payer: Aetna Commercial |
$910.09
|
| Rate for Payer: BCBS Complete |
$467.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.60
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Meridian Medicaid |
$467.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.32
|
| Rate for Payer: Priority Health SBD |
$1,046.32
|
| Rate for Payer: UMR Bronson Commercial |
$552.00
|
|
|
PR ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK
|
Professional
|
Both
|
$1,443.00
|
|
|
Service Code
|
HCPCS 28760
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,010.10 |
| Rate for Payer: Aetna Commercial |
$754.22
|
| Rate for Payer: BCBS Complete |
$387.14
|
| Rate for Payer: BCBS Trust/PPO |
$579.02
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Meridian Medicaid |
$387.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.45
|
| Rate for Payer: Priority Health Narrow Network |
$860.45
|
| Rate for Payer: Priority Health SBD |
$860.45
|
| Rate for Payer: UMR Bronson Commercial |
$663.78
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 20605
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$85.40 |
| Rate for Payer: Aetna Commercial |
$49.91
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.18
|
| Rate for Payer: Priority Health Narrow Network |
$56.18
|
| Rate for Payer: Priority Health SBD |
$56.18
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$262.93 |
| Rate for Payer: Aetna Commercial |
$71.12
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS Trust/PPO |
$262.93
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Narrow Network |
$78.65
|
| Rate for Payer: Priority Health SBD |
$78.65
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
20610
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$721.72 |
| Rate for Payer: Aetna Commercial |
$61.23
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$721.72
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.43
|
| Rate for Payer: Priority Health Narrow Network |
$68.43
|
| Rate for Payer: Priority Health SBD |
$68.43
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 20610
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$721.72 |
| Rate for Payer: Aetna Commercial |
$61.23
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$721.72
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.43
|
| Rate for Payer: Priority Health Narrow Network |
$68.43
|
| Rate for Payer: Priority Health SBD |
$68.43
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$117.00
|
| Rate for Payer: Aetna Commercial |
$153.00
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$126.00
|
| Rate for Payer: Cofinity Commercial |
$154.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$162.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.00
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.00
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$153.00
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$113.40
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$44.53
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$66.60
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Aetna American Axle |
$117.00
|
| Rate for Payer: Aetna Commercial |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$154.80
|
| Rate for Payer: Cofinity Commercial |
$126.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Healthscope Commercial |
$162.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.00
|
| Rate for Payer: PHP Commercial |
$153.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health SBD |
$113.40
|
| Rate for Payer: UMR Bronson Commercial |
$79.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$80.62
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.90
|
| Rate for Payer: Priority Health Narrow Network |
$90.90
|
| Rate for Payer: Priority Health SBD |
$90.90
|
| Rate for Payer: UMR Bronson Commercial |
$87.40
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$123.50
|
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$119.70
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$70.30
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
