|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,158.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$361.25 |
| Max. Negotiated Rate |
$1,510.60 |
| Rate for Payer: Aetna Commercial |
$747.21
|
| Rate for Payer: BCBS Complete |
$379.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.13
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Meridian Medicaid |
$379.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$859.42
|
| Rate for Payer: Priority Health Narrow Network |
$859.42
|
| Rate for Payer: Priority Health SBD |
$859.42
|
| Rate for Payer: UMR Bronson Commercial |
$992.68
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,904.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$1,332.80 |
| Rate for Payer: Aetna Commercial |
$661.76
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.93
|
| Rate for Payer: Priority Health Narrow Network |
$763.93
|
| Rate for Payer: Priority Health SBD |
$763.93
|
| Rate for Payer: UMR Bronson Commercial |
$875.84
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$623.06
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS Trust/PPO |
$911.32
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.31
|
| Rate for Payer: Priority Health Narrow Network |
$710.31
|
| Rate for Payer: Priority Health SBD |
$710.31
|
| Rate for Payer: UMR Bronson Commercial |
$846.40
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,028.00
|
|
|
Service Code
|
HCPCS 29899
|
| Min. Negotiated Rate |
$645.82 |
| Max. Negotiated Rate |
$2,119.60 |
| Rate for Payer: Aetna Commercial |
$1,366.39
|
| Rate for Payer: BCBS Complete |
$678.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.03
|
| Rate for Payer: Cash Price |
$2,422.40
|
| Rate for Payer: Cash Price |
$2,422.40
|
| Rate for Payer: Meridian Medicaid |
$678.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,538.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,538.07
|
| Rate for Payer: Priority Health SBD |
$1,538.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,392.88
|
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,904.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$325.89 |
| Max. Negotiated Rate |
$1,332.80 |
| Rate for Payer: Aetna Commercial |
$663.97
|
| Rate for Payer: BCBS Complete |
$342.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Meridian Medicaid |
$342.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.87
|
| Rate for Payer: Priority Health Narrow Network |
$760.87
|
| Rate for Payer: Priority Health SBD |
$760.87
|
| Rate for Payer: UMR Bronson Commercial |
$875.84
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,158.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$386.17 |
| Max. Negotiated Rate |
$1,510.60 |
| Rate for Payer: Aetna Commercial |
$790.94
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$916.11
|
| Rate for Payer: Priority Health Narrow Network |
$916.11
|
| Rate for Payer: Priority Health SBD |
$916.11
|
| Rate for Payer: UMR Bronson Commercial |
$992.68
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$340.80 |
| Max. Negotiated Rate |
$1,331.40 |
| Rate for Payer: Aetna Commercial |
$704.42
|
| Rate for Payer: BCBS Complete |
$357.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.98
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Meridian Medicaid |
$357.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.46
|
| Rate for Payer: Priority Health Narrow Network |
$813.46
|
| Rate for Payer: Priority Health SBD |
$813.46
|
| Rate for Payer: UMR Bronson Commercial |
$874.92
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,020.00
|
|
|
Service Code
|
HCPCS 29836
|
| Min. Negotiated Rate |
$379.14 |
| Max. Negotiated Rate |
$1,712.22 |
| Rate for Payer: Aetna Commercial |
$777.30
|
| Rate for Payer: BCBS Complete |
$398.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,712.22
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Meridian Medicaid |
$398.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$714.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$902.32
|
| Rate for Payer: Priority Health Narrow Network |
$902.32
|
| Rate for Payer: Priority Health SBD |
$902.32
|
| Rate for Payer: UMR Bronson Commercial |
$469.20
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$331.43 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Aetna Commercial |
$679.61
|
| Rate for Payer: BCBS Complete |
$348.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.65
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Meridian Medicaid |
$348.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,351.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.88
|
| Rate for Payer: Priority Health Narrow Network |
$785.88
|
| Rate for Payer: Priority Health SBD |
$785.88
|
| Rate for Payer: UMR Bronson Commercial |
$887.80
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,809.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$319.29 |
| Max. Negotiated Rate |
$1,694.79 |
| Rate for Payer: Aetna Commercial |
$657.85
|
| Rate for Payer: BCBS Complete |
$335.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.79
|
| Rate for Payer: Cash Price |
$1,447.20
|
| Rate for Payer: Cash Price |
$1,447.20
|
| Rate for Payer: Meridian Medicaid |
$335.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$759.84
|
| Rate for Payer: Priority Health Narrow Network |
$759.84
|
| Rate for Payer: Priority Health SBD |
$759.84
|
| Rate for Payer: UMR Bronson Commercial |
$832.14
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,396.00
|
|
|
Service Code
|
HCPCS 29861
|
| Min. Negotiated Rate |
$461.36 |
| Max. Negotiated Rate |
$1,677.20 |
| Rate for Payer: Aetna Commercial |
$964.85
|
| Rate for Payer: BCBS Complete |
$484.43
|
| Rate for Payer: BCBS Trust/PPO |
$480.75
|
| Rate for Payer: Cash Price |
$1,916.80
|
| Rate for Payer: Cash Price |
$1,916.80
|
| Rate for Payer: Meridian Medicaid |
$484.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,092.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,092.28
|
| Rate for Payer: Priority Health SBD |
$1,092.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,102.16
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY
|
Professional
|
Both
|
$1,615.00
|
|
|
Service Code
|
HCPCS 29863
|
| Min. Negotiated Rate |
$526.32 |
| Max. Negotiated Rate |
$1,244.96 |
| Rate for Payer: Aetna Commercial |
$1,082.78
|
| Rate for Payer: BCBS Complete |
$552.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.17
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Meridian Medicaid |
$552.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,130.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,244.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,244.96
|
| Rate for Payer: Priority Health SBD |
$1,244.96
|
| Rate for Payer: UMR Bronson Commercial |
$742.90
|
|
|
PR ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,195.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$654.55 |
| Max. Negotiated Rate |
$2,236.50 |
| Rate for Payer: Aetna Commercial |
$1,365.58
|
| Rate for Payer: BCBS Complete |
$687.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.26
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Meridian Medicaid |
$687.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,556.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,556.97
|
| Rate for Payer: Priority Health SBD |
$1,556.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,469.70
|
|
|
PR ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,003.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$556.83 |
| Max. Negotiated Rate |
$2,102.10 |
| Rate for Payer: Aetna Commercial |
$1,332.42
|
| Rate for Payer: BCBS Complete |
$670.50
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Meridian Medicaid |
$670.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,102.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,521.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,521.74
|
| Rate for Payer: Priority Health SBD |
$1,521.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,381.38
|
|
|
PR ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,210.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$651.78 |
| Max. Negotiated Rate |
$2,247.00 |
| Rate for Payer: Aetna Commercial |
$1,365.49
|
| Rate for Payer: BCBS Complete |
$684.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.67
|
| Rate for Payer: Cash Price |
$2,568.00
|
| Rate for Payer: Cash Price |
$2,568.00
|
| Rate for Payer: Meridian Medicaid |
$684.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$651.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,558.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,558.51
|
| Rate for Payer: Priority Health SBD |
$1,558.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,476.60
|
|
|
PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,111.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$267.10 |
| Max. Negotiated Rate |
$1,328.67 |
| Rate for Payer: Aetna Commercial |
$540.25
|
| Rate for Payer: BCBS Complete |
$280.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,328.67
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Meridian Medicaid |
$280.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.07
|
| Rate for Payer: Priority Health Narrow Network |
$627.07
|
| Rate for Payer: Priority Health SBD |
$627.07
|
| Rate for Payer: UMR Bronson Commercial |
$511.06
|
|
|
PR ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 29871
|
| Min. Negotiated Rate |
$334.84 |
| Max. Negotiated Rate |
$1,303.32 |
| Rate for Payer: Aetna Commercial |
$684.95
|
| Rate for Payer: BCBS Complete |
$351.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.32
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Meridian Medicaid |
$351.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.08
|
| Rate for Payer: Priority Health Narrow Network |
$795.08
|
| Rate for Payer: Priority Health SBD |
$795.08
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$1,935.00
|
|
|
Service Code
|
HCPCS 29873
|
| Min. Negotiated Rate |
$350.17 |
| Max. Negotiated Rate |
$1,722.26 |
| Rate for Payer: Aetna Commercial |
$709.91
|
| Rate for Payer: BCBS Complete |
$367.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.26
|
| Rate for Payer: Cash Price |
$1,548.00
|
| Rate for Payer: Cash Price |
$1,548.00
|
| Rate for Payer: Meridian Medicaid |
$367.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,354.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.76
|
| Rate for Payer: Priority Health Narrow Network |
$827.76
|
| Rate for Payer: Priority Health SBD |
$827.76
|
| Rate for Payer: UMR Bronson Commercial |
$890.10
|
|
|
PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT
|
Professional
|
Both
|
$2,944.00
|
|
|
Service Code
|
HCPCS 29868
|
| Min. Negotiated Rate |
$818.87 |
| Max. Negotiated Rate |
$2,547.12 |
| Rate for Payer: Aetna Commercial |
$2,231.26
|
| Rate for Payer: BCBS Complete |
$1,122.72
|
| Rate for Payer: BCBS Trust/PPO |
$818.87
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Meridian Medicaid |
$1,122.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,060.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,547.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,547.12
|
| Rate for Payer: Priority Health SBD |
$2,547.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,354.24
|
|
|
PR ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$3,036.00
|
|
|
Service Code
|
HCPCS 29866
|
| Min. Negotiated Rate |
$678.83 |
| Max. Negotiated Rate |
$2,125.20 |
| Rate for Payer: Aetna Commercial |
$1,401.56
|
| Rate for Payer: BCBS Complete |
$712.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.54
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Meridian Medicaid |
$712.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,125.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,613.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,613.15
|
| Rate for Payer: Priority Health SBD |
$1,613.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.56
|
|
|
PR ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT
|
Professional
|
Both
|
$2,221.00
|
|
|
Service Code
|
HCPCS 29867
|
| Min. Negotiated Rate |
$509.81 |
| Max. Negotiated Rate |
$1,956.30 |
| Rate for Payer: Aetna Commercial |
$1,707.15
|
| Rate for Payer: BCBS Complete |
$863.74
|
| Rate for Payer: BCBS Trust/PPO |
$509.81
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Meridian Medicaid |
$863.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$822.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,956.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,956.30
|
| Rate for Payer: Priority Health SBD |
$1,956.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.66
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,999.00
|
|
|
Service Code
|
HCPCS 29874
|
| Min. Negotiated Rate |
$349.32 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$716.98
|
| Rate for Payer: BCBS Complete |
$366.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Meridian Medicaid |
$366.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.21
|
| Rate for Payer: Priority Health Narrow Network |
$825.21
|
| Rate for Payer: Priority Health SBD |
$825.21
|
| Rate for Payer: UMR Bronson Commercial |
$919.54
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Facility
|
OP
|
$1,999.00
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,299.35
|
| Rate for Payer: Aetna Commercial |
$1,699.15
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Cofinity Commercial |
$1,399.30
|
| Rate for Payer: Cofinity Commercial |
$1,719.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,799.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,399.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.25
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,699.15
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,699.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$1,259.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$537.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$739.63
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.25
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,999.00
|
|
|
Service Code
|
HCPCS 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$349.32 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$716.98
|
| Rate for Payer: BCBS Complete |
$366.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Meridian Medicaid |
$366.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.21
|
| Rate for Payer: Priority Health Narrow Network |
$825.21
|
| Rate for Payer: Priority Health SBD |
$825.21
|
| Rate for Payer: UMR Bronson Commercial |
$919.54
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Facility
|
IP
|
$1,999.00
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$879.56 |
| Max. Negotiated Rate |
$1,799.10 |
| Rate for Payer: Aetna American Axle |
$1,299.35
|
| Rate for Payer: Aetna Commercial |
$1,699.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.35
|
| Rate for Payer: Cash Price |
$1,599.20
|
| Rate for Payer: Cofinity Commercial |
$1,399.30
|
| Rate for Payer: Cofinity Commercial |
$1,719.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.20
|
| Rate for Payer: Healthscope Commercial |
$1,799.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,399.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,699.15
|
| Rate for Payer: PHP Commercial |
$1,699.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.30
|
| Rate for Payer: Priority Health SBD |
$1,259.37
|
| Rate for Payer: UMR Bronson Commercial |
$879.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.25
|
|
