|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS G0289
|
| Min. Negotiated Rate |
$85.90 |
| Max. Negotiated Rate |
$561.05 |
| Rate for Payer: Aetna Commercial |
$85.90
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCBS Trust/PPO |
$561.05
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.19
|
| Rate for Payer: Priority Health Narrow Network |
$129.19
|
| Rate for Payer: Priority Health SBD |
$129.19
|
| Rate for Payer: UMR Bronson Commercial |
$102.12
|
|
|
PR ARTHRO, LOOSE BODY + CHONDRO
|
Facility
|
OP
|
$222.00
|
|
|
Service Code
|
HCPCS G0289
|
| Hospital Charge Code |
G0289
|
| Min. Negotiated Rate |
$82.14 |
| Max. Negotiated Rate |
$304.77 |
| Rate for Payer: Aetna American Axle |
$144.30
|
| Rate for Payer: Aetna Commercial |
$188.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.30
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCBS Trust/PPO |
$304.77
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$155.40
|
| Rate for Payer: Cofinity Commercial |
$190.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.60
|
| Rate for Payer: Healthscope Commercial |
$199.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$155.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$188.70
|
| Rate for Payer: PHP Commercial |
$188.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
| Rate for Payer: Priority Health SBD |
$139.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.49
|
| Rate for Payer: UHC Exchange |
$83.17
|
| Rate for Payer: UMR Bronson Commercial |
$82.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.50
|
|
|
PR ARTHROPLASTY ANKLE
|
Professional
|
Both
|
$2,650.00
|
|
|
Service Code
|
HCPCS 27700
|
| Min. Negotiated Rate |
$461.15 |
| Max. Negotiated Rate |
$1,855.00 |
| Rate for Payer: Aetna Commercial |
$810.77
|
| Rate for Payer: BCBS Complete |
$484.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: Cash Price |
$2,120.00
|
| Rate for Payer: Cash Price |
$2,120.00
|
| Rate for Payer: Meridian Medicaid |
$484.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.51
|
| Rate for Payer: Priority Health Narrow Network |
$935.51
|
| Rate for Payer: Priority Health SBD |
$935.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,219.00
|
|
|
PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE
|
Professional
|
Both
|
$2,004.00
|
|
|
Service Code
|
HCPCS 27703
|
| Min. Negotiated Rate |
$712.91 |
| Max. Negotiated Rate |
$2,923.61 |
| Rate for Payer: Aetna Commercial |
$1,490.55
|
| Rate for Payer: BCBS Complete |
$748.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.61
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Meridian Medicaid |
$748.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$712.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,698.94
|
| Rate for Payer: Priority Health SBD |
$1,698.94
|
| Rate for Payer: UMR Bronson Commercial |
$921.84
|
|
|
PR ARTHROPLASTY ANKLE W/IMPLANT
|
Professional
|
Both
|
$1,937.74
|
|
|
Service Code
|
HCPCS 27702
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$2,899.77 |
| Rate for Payer: Aetna Commercial |
$1,287.42
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.77
|
| Rate for Payer: Cash Price |
$1,550.19
|
| Rate for Payer: Cash Price |
$1,550.19
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,470.67
|
| Rate for Payer: Priority Health SBD |
$1,470.67
|
| Rate for Payer: UMR Bronson Commercial |
$891.36
|
|
|
PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 27442
|
| Min. Negotiated Rate |
$560.62 |
| Max. Negotiated Rate |
$1,338.41 |
| Rate for Payer: Aetna Commercial |
$1,163.41
|
| Rate for Payer: BCBS Complete |
$588.65
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Meridian Medicaid |
$588.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,338.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,338.41
|
| Rate for Payer: Priority Health SBD |
$1,338.41
|
| Rate for Payer: UMR Bronson Commercial |
$701.04
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
IP
|
$4,485.00
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$1,973.40 |
| Max. Negotiated Rate |
$4,036.50 |
| Rate for Payer: Aetna American Axle |
$2,915.25
|
| Rate for Payer: Aetna Commercial |
$3,812.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,915.25
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cofinity Commercial |
$3,139.50
|
| Rate for Payer: Cofinity Commercial |
$3,857.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.00
|
| Rate for Payer: Healthscope Commercial |
$4,036.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,139.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,363.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,812.25
|
| Rate for Payer: PHP Commercial |
$3,812.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health SBD |
$2,825.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,973.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,363.75
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Facility
|
OP
|
$4,485.00
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$1,422.08 |
| Max. Negotiated Rate |
$52,147.99 |
| Rate for Payer: Aetna American Axle |
$2,915.25
|
| Rate for Payer: Aetna Commercial |
$3,812.25
|
| Rate for Payer: Aetna Medicare |
$17,227.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,915.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,706.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,706.49
|
| Rate for Payer: BCBS Complete |
$9,515.05
|
| Rate for Payer: BCBS MAPPO |
$16,565.19
|
| Rate for Payer: BCBS Trust/PPO |
$17,675.92
|
| Rate for Payer: BCN Medicare Advantage |
$16,565.19
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cofinity Commercial |
$3,857.10
|
| Rate for Payer: Cofinity Commercial |
$3,139.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,565.19
|
| Rate for Payer: Healthscope Commercial |
$4,036.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,139.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,363.75
|
| Rate for Payer: Mclaren Medicaid |
$9,061.16
|
| Rate for Payer: Mclaren Medicare |
$16,565.19
|
| Rate for Payer: Meridian Medicaid |
$9,515.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,393.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,049.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,812.25
|
| Rate for Payer: PACE Medicare |
$15,736.93
|
| Rate for Payer: PACE SWMI |
$16,565.19
|
| Rate for Payer: PHP Commercial |
$3,812.25
|
| Rate for Payer: PHP Medicare Advantage |
$16,565.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,061.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52,147.99
|
| Rate for Payer: Priority Health Medicare |
$16,565.19
|
| Rate for Payer: Priority Health Narrow Network |
$41,718.39
|
| Rate for Payer: Priority Health SBD |
$2,825.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16,565.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,565.19
|
| Rate for Payer: UHC Exchange |
$1,422.08
|
| Rate for Payer: UHC Medicare Advantage |
$17,062.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,659.45
|
| Rate for Payer: VA VA |
$16,565.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,363.75
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,485.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
23472
|
| Min. Negotiated Rate |
$197.82 |
| Max. Negotiated Rate |
$3,139.50 |
| Rate for Payer: Aetna Commercial |
$1,937.50
|
| Rate for Payer: BCBS Complete |
$971.31
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Meridian Medicaid |
$971.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,205.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,205.50
|
| Rate for Payer: Priority Health SBD |
$2,205.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,063.10
|
|
|
PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER
|
Professional
|
Both
|
$4,485.00
|
|
|
Service Code
|
HCPCS 23472
|
| Min. Negotiated Rate |
$197.82 |
| Max. Negotiated Rate |
$3,139.50 |
| Rate for Payer: Aetna Commercial |
$1,937.50
|
| Rate for Payer: BCBS Complete |
$971.31
|
| Rate for Payer: BCBS Trust/PPO |
$197.82
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Cash Price |
$3,588.00
|
| Rate for Payer: Meridian Medicaid |
$971.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,205.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,205.50
|
| Rate for Payer: Priority Health SBD |
$2,205.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,063.10
|
|
|
PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY
|
Professional
|
Both
|
$3,398.00
|
|
|
Service Code
|
HCPCS 23470
|
| Min. Negotiated Rate |
$171.92 |
| Max. Negotiated Rate |
$2,378.60 |
| Rate for Payer: Aetna Commercial |
$1,604.69
|
| Rate for Payer: BCBS Complete |
$807.38
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Meridian Medicaid |
$807.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$768.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,378.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,830.69
|
| Rate for Payer: Priority Health SBD |
$1,830.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,563.08
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,657.00
|
|
|
Service Code
|
HCPCS 26535
|
| Min. Negotiated Rate |
$286.70 |
| Max. Negotiated Rate |
$1,159.90 |
| Rate for Payer: Aetna Commercial |
$580.99
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS Trust/PPO |
$943.54
|
| Rate for Payer: Cash Price |
$1,325.60
|
| Rate for Payer: Cash Price |
$1,325.60
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,159.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.16
|
| Rate for Payer: Priority Health Narrow Network |
$679.16
|
| Rate for Payer: Priority Health SBD |
$679.16
|
| Rate for Payer: UMR Bronson Commercial |
$762.22
|
|
|
PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
HCPCS 26536
|
| Min. Negotiated Rate |
$331.24 |
| Max. Negotiated Rate |
$1,702.40 |
| Rate for Payer: Aetna Commercial |
$992.54
|
| Rate for Payer: BCBS Complete |
$509.70
|
| Rate for Payer: BCBS Trust/PPO |
$331.24
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Meridian Medicaid |
$509.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,165.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,165.81
|
| Rate for Payer: Priority Health SBD |
$1,165.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.72
|
|
|
PR ARTHROPLASTY KNEE TIBIAL PLATEAU
|
Professional
|
Both
|
$1,742.00
|
|
|
Service Code
|
HCPCS 27440
|
| Min. Negotiated Rate |
$516.10 |
| Max. Negotiated Rate |
$1,732.82 |
| Rate for Payer: Aetna Commercial |
$1,065.93
|
| Rate for Payer: BCBS Complete |
$541.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: Cash Price |
$1,393.60
|
| Rate for Payer: Cash Price |
$1,393.60
|
| Rate for Payer: Meridian Medicaid |
$541.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,219.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,227.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,227.09
|
| Rate for Payer: Priority Health SBD |
$1,227.09
|
| Rate for Payer: UMR Bronson Commercial |
$801.32
|
|
|
PR ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,771.00
|
|
|
Service Code
|
HCPCS 26530
|
| Min. Negotiated Rate |
$353.79 |
| Max. Negotiated Rate |
$1,277.96 |
| Rate for Payer: Aetna Commercial |
$718.60
|
| Rate for Payer: BCBS Complete |
$371.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.96
|
| Rate for Payer: Cash Price |
$1,416.80
|
| Rate for Payer: Cash Price |
$1,416.80
|
| Rate for Payer: Meridian Medicaid |
$371.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,239.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.42
|
| Rate for Payer: Priority Health Narrow Network |
$835.42
|
| Rate for Payer: Priority Health SBD |
$835.42
|
| Rate for Payer: UMR Bronson Commercial |
$814.66
|
|
|
PR ARTHROPLASTY PATELLA W/O PROSTHESIS
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 27437
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$1,630.86 |
| Rate for Payer: Aetna Commercial |
$882.46
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,630.86
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.26
|
| Rate for Payer: Priority Health SBD |
$1,019.26
|
| Rate for Payer: UMR Bronson Commercial |
$530.38
|
|
|
PR ARTHROPLASTY PATELLA W/PROSTHESIS
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 27438
|
| Min. Negotiated Rate |
$543.15 |
| Max. Negotiated Rate |
$1,651.99 |
| Rate for Payer: Aetna Commercial |
$1,122.35
|
| Rate for Payer: BCBS Complete |
$570.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.99
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Meridian Medicaid |
$570.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$543.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,602.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,290.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,290.93
|
| Rate for Payer: Priority Health SBD |
$1,290.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.94
|
|
|
PR ARTHROPLASTY RADIAL HEAD
|
Professional
|
Both
|
$1,635.00
|
|
|
Service Code
|
HCPCS 24365
|
| Min. Negotiated Rate |
$258.95 |
| Max. Negotiated Rate |
$1,144.50 |
| Rate for Payer: Aetna Commercial |
$857.03
|
| Rate for Payer: BCBS Complete |
$437.24
|
| Rate for Payer: BCBS Trust/PPO |
$258.95
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Meridian Medicaid |
$437.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,144.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$989.14
|
| Rate for Payer: Priority Health Narrow Network |
$989.14
|
| Rate for Payer: Priority Health SBD |
$989.14
|
| Rate for Payer: UMR Bronson Commercial |
$752.10
|
|
|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,465.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$1,725.50 |
| Rate for Payer: Aetna Commercial |
$909.61
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCBS Trust/PPO |
$304.79
|
| Rate for Payer: Cash Price |
$1,972.00
|
| Rate for Payer: Cash Price |
$1,972.00
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,048.36
|
| Rate for Payer: Priority Health SBD |
$1,048.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,133.90
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$467.11 |
| Max. Negotiated Rate |
$1,111.68 |
| Rate for Payer: Aetna Commercial |
$960.91
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$881.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.68
|
| Rate for Payer: Priority Health SBD |
$1,111.68
|
| Rate for Payer: UMR Bronson Commercial |
$579.14
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$605.56 |
| Max. Negotiated Rate |
$1,441.57 |
| Rate for Payer: Aetna Commercial |
$1,253.73
|
| Rate for Payer: BCBS Complete |
$635.84
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Meridian Medicaid |
$635.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,299.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,441.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,441.57
|
| Rate for Payer: Priority Health SBD |
$1,441.57
|
| Rate for Payer: UMR Bronson Commercial |
$853.76
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,596.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,245.99 |
| Rate for Payer: Aetna Commercial |
$1,076.84
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS Trust/PPO |
$863.24
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,245.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,245.99
|
| Rate for Payer: Priority Health SBD |
$1,245.99
|
| Rate for Payer: UMR Bronson Commercial |
$734.16
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,566.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$1,209.73 |
| Rate for Payer: Aetna Commercial |
$1,047.50
|
| Rate for Payer: BCBS Complete |
$534.74
|
| Rate for Payer: BCBS Trust/PPO |
$628.15
|
| Rate for Payer: Cash Price |
$1,252.80
|
| Rate for Payer: Cash Price |
$1,252.80
|
| Rate for Payer: Meridian Medicaid |
$534.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.73
|
| Rate for Payer: Priority Health SBD |
$1,209.73
|
| Rate for Payer: UMR Bronson Commercial |
$720.36
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,055.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$599.38 |
| Max. Negotiated Rate |
$2,138.50 |
| Rate for Payer: Aetna Commercial |
$1,241.59
|
| Rate for Payer: BCBS Complete |
$629.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,262.11
|
| Rate for Payer: Cash Price |
$2,444.00
|
| Rate for Payer: Cash Price |
$2,444.00
|
| Rate for Payer: Meridian Medicaid |
$629.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,138.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,425.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,425.22
|
| Rate for Payer: Priority Health SBD |
$1,425.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,405.30
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,207.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$405.34 |
| Max. Negotiated Rate |
$961.56 |
| Rate for Payer: Aetna Commercial |
$830.82
|
| Rate for Payer: BCBS Complete |
$425.61
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Cash Price |
$965.60
|
| Rate for Payer: Meridian Medicaid |
$425.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.56
|
| Rate for Payer: Priority Health Narrow Network |
$961.56
|
| Rate for Payer: Priority Health SBD |
$961.56
|
| Rate for Payer: UMR Bronson Commercial |
$555.22
|
|
