|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,348.00
|
|
|
Service Code
|
HCPCS 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$422.81 |
| Max. Negotiated Rate |
$1,643.60 |
| Rate for Payer: Aetna Commercial |
$871.38
|
| Rate for Payer: BCBS Complete |
$443.95
|
| Rate for Payer: BCBS Trust/PPO |
$769.20
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Meridian Medicaid |
$443.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.42
|
| Rate for Payer: Priority Health SBD |
$1,003.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,080.08
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,348.00
|
|
|
Service Code
|
HCPCS 29876
|
| Min. Negotiated Rate |
$422.81 |
| Max. Negotiated Rate |
$1,643.60 |
| Rate for Payer: Aetna Commercial |
$871.38
|
| Rate for Payer: BCBS Complete |
$443.95
|
| Rate for Payer: BCBS Trust/PPO |
$769.20
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Meridian Medicaid |
$443.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.42
|
| Rate for Payer: Priority Health SBD |
$1,003.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,080.08
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Facility
|
IP
|
$2,348.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$1,033.12 |
| Max. Negotiated Rate |
$2,113.20 |
| Rate for Payer: Aetna American Axle |
$1,526.20
|
| Rate for Payer: Aetna Commercial |
$1,995.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,526.20
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cofinity Commercial |
$1,643.60
|
| Rate for Payer: Cofinity Commercial |
$2,019.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,878.40
|
| Rate for Payer: Healthscope Commercial |
$2,113.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,643.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,761.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,995.80
|
| Rate for Payer: PHP Commercial |
$1,995.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.60
|
| Rate for Payer: Priority Health SBD |
$1,479.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,033.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,761.00
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Facility
|
OP
|
$2,348.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$649.97 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,526.20
|
| Rate for Payer: Aetna Commercial |
$1,995.80
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,526.20
|
| 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 |
$3,431.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cofinity Commercial |
$2,019.28
|
| Rate for Payer: Cofinity Commercial |
$1,643.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,878.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$2,113.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,643.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,761.00
|
| 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 |
$1,995.80
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,995.80
|
| 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 |
$1,643.60
|
| 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 |
$1,479.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$714.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$649.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$868.76
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,761.00
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29875
|
| Min. Negotiated Rate |
$322.70 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$661.47
|
| Rate for Payer: BCBS Complete |
$338.84
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Meridian Medicaid |
$338.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.47
|
| Rate for Payer: Priority Health Narrow Network |
$765.47
|
| Rate for Payer: Priority Health SBD |
$765.47
|
| Rate for Payer: UMR Bronson Commercial |
$846.40
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Facility
|
IP
|
$1,840.00
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$809.60 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna American Axle |
$1,196.00
|
| Rate for Payer: Aetna Commercial |
$1,564.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.00
|
| Rate for Payer: Cofinity Commercial |
$1,582.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,472.00
|
| Rate for Payer: Healthscope Commercial |
$1,656.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,288.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,564.00
|
| Rate for Payer: PHP Commercial |
$1,564.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health SBD |
$1,159.20
|
| Rate for Payer: UMR Bronson Commercial |
$809.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,380.00
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$322.70 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$661.47
|
| Rate for Payer: BCBS Complete |
$338.84
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Meridian Medicaid |
$338.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.47
|
| Rate for Payer: Priority Health Narrow Network |
$765.47
|
| Rate for Payer: Priority Health SBD |
$765.47
|
| Rate for Payer: UMR Bronson Commercial |
$846.40
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Facility
|
OP
|
$1,840.00
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$496.07 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,196.00
|
| Rate for Payer: Aetna Commercial |
$1,564.00
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.00
|
| 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 |
$3,243.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$1,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,288.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,472.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,656.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,288.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,380.00
|
| 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 |
$1,564.00
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,564.00
|
| 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 |
$1,288.00
|
| 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 |
$1,159.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$496.07
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$680.80
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,380.00
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Facility
|
IP
|
$2,221.00
|
|
|
Service Code
|
CPT 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$977.24 |
| Max. Negotiated Rate |
$1,998.90 |
| Rate for Payer: Aetna American Axle |
$1,443.65
|
| Rate for Payer: Aetna Commercial |
$1,887.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.65
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cofinity Commercial |
$1,554.70
|
| Rate for Payer: Cofinity Commercial |
$1,910.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,776.80
|
| Rate for Payer: Healthscope Commercial |
$1,998.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,554.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,665.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,887.85
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
| Rate for Payer: Priority Health SBD |
$1,399.23
|
| Rate for Payer: UMR Bronson Commercial |
$977.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,665.75
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,221.00
|
|
|
Service Code
|
HCPCS 29884
|
| Min. Negotiated Rate |
$401.72 |
| Max. Negotiated Rate |
$1,554.70 |
| Rate for Payer: Aetna Commercial |
$825.18
|
| Rate for Payer: BCBS Complete |
$421.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.73
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Meridian Medicaid |
$421.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$953.38
|
| Rate for Payer: Priority Health Narrow Network |
$953.38
|
| Rate for Payer: Priority Health SBD |
$953.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.66
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Facility
|
OP
|
$2,221.00
|
|
|
Service Code
|
CPT 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$617.56 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,443.65
|
| Rate for Payer: Aetna Commercial |
$1,887.85
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.65
|
| 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 |
$1,776.80
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cofinity Commercial |
$1,554.70
|
| Rate for Payer: Cofinity Commercial |
$1,910.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,776.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,998.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,554.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,665.75
|
| 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 |
$1,887.85
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,887.85
|
| 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 |
$1,554.70
|
| 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 |
$1,399.23
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$617.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$821.77
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,665.75
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,221.00
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$401.72 |
| Max. Negotiated Rate |
$1,554.70 |
| Rate for Payer: Aetna Commercial |
$825.18
|
| Rate for Payer: BCBS Complete |
$421.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.73
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Meridian Medicaid |
$421.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$953.38
|
| Rate for Payer: Priority Health Narrow Network |
$953.38
|
| Rate for Payer: Priority Health SBD |
$953.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.66
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 29883
|
| Min. Negotiated Rate |
$544.43 |
| Max. Negotiated Rate |
$1,892.80 |
| Rate for Payer: Aetna Commercial |
$1,118.78
|
| Rate for Payer: BCBS Complete |
$571.65
|
| Rate for Payer: BCBS Trust/PPO |
$654.56
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Meridian Medicaid |
$571.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,892.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,295.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,295.01
|
| Rate for Payer: Priority Health SBD |
$1,295.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.84
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Facility
|
IP
|
$2,704.00
|
|
|
Service Code
|
CPT 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$1,189.76 |
| Max. Negotiated Rate |
$2,433.60 |
| Rate for Payer: Aetna American Axle |
$1,757.60
|
| Rate for Payer: Aetna Commercial |
$2,298.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,757.60
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cofinity Commercial |
$2,325.44
|
| Rate for Payer: Cofinity Commercial |
$1,892.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,163.20
|
| Rate for Payer: Healthscope Commercial |
$2,433.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,892.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,028.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,298.40
|
| Rate for Payer: PHP Commercial |
$2,298.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,892.80
|
| Rate for Payer: Priority Health SBD |
$1,703.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,189.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,028.00
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Facility
|
OP
|
$2,704.00
|
|
|
Service Code
|
CPT 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$836.94 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,757.60
|
| Rate for Payer: Aetna Commercial |
$2,298.40
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,757.60
|
| 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 |
$2,439.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cofinity Commercial |
$2,325.44
|
| Rate for Payer: Cofinity Commercial |
$1,892.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$2,433.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,892.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,028.00
|
| 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 |
$2,298.40
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$2,298.40
|
| 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 |
$1,892.80
|
| 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 |
$1,703.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$836.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,000.48
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,028.00
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$544.43 |
| Max. Negotiated Rate |
$1,892.80 |
| Rate for Payer: Aetna Commercial |
$1,118.78
|
| Rate for Payer: BCBS Complete |
$571.65
|
| Rate for Payer: BCBS Trust/PPO |
$654.56
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Meridian Medicaid |
$571.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,892.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,295.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,295.01
|
| Rate for Payer: Priority Health SBD |
$1,295.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.84
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Facility
|
OP
|
$2,380.00
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$684.35 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,547.00
|
| Rate for Payer: Aetna Commercial |
$2,023.00
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,547.00
|
| 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 |
$4,469.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cofinity Commercial |
$1,666.00
|
| Rate for Payer: Cofinity Commercial |
$2,046.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,904.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$2,142.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,666.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,785.00
|
| 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 |
$2,023.00
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$2,023.00
|
| 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 |
$1,666.00
|
| 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 |
$1,499.40
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$684.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$880.60
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,785.00
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Facility
|
IP
|
$2,380.00
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$1,047.20 |
| Max. Negotiated Rate |
$2,142.00 |
| Rate for Payer: Aetna American Axle |
$1,547.00
|
| Rate for Payer: Aetna Commercial |
$2,023.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,547.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cofinity Commercial |
$1,666.00
|
| Rate for Payer: Cofinity Commercial |
$2,046.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,904.00
|
| Rate for Payer: Healthscope Commercial |
$2,142.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,666.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,785.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,023.00
|
| Rate for Payer: PHP Commercial |
$2,023.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health SBD |
$1,499.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,047.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,785.00
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$321.77 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$922.00
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS Trust/PPO |
$321.77
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,059.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,059.60
|
| Rate for Payer: Priority Health SBD |
$1,059.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,094.80
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 29882
|
| Min. Negotiated Rate |
$321.77 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$922.00
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS Trust/PPO |
$321.77
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,059.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,059.60
|
| Rate for Payer: Priority Health SBD |
$1,059.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,094.80
|
|
|
PR ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 29906
|
| Min. Negotiated Rate |
$421.53 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$876.36
|
| Rate for Payer: BCBS Complete |
$442.61
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Meridian Medicaid |
$442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$984.54
|
| Rate for Payer: Priority Health Narrow Network |
$984.54
|
| Rate for Payer: Priority Health SBD |
$984.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,094.80
|
|
|
PR ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 29840
|
| Min. Negotiated Rate |
$293.30 |
| Max. Negotiated Rate |
$1,377.81 |
| Rate for Payer: Aetna Commercial |
$600.40
|
| Rate for Payer: BCBS Complete |
$307.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,377.81
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Meridian Medicaid |
$307.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.06
|
| Rate for Payer: Priority Health Narrow Network |
$698.06
|
| Rate for Payer: Priority Health SBD |
$698.06
|
| Rate for Payer: UMR Bronson Commercial |
$413.54
|
|
|
PR ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 29843
|
| Min. Negotiated Rate |
$317.16 |
| Max. Negotiated Rate |
$1,294.30 |
| Rate for Payer: Aetna Commercial |
$648.17
|
| Rate for Payer: BCBS Complete |
$333.02
|
| Rate for Payer: BCBS Trust/PPO |
$543.09
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Meridian Medicaid |
$333.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.68
|
| Rate for Payer: Priority Health Narrow Network |
$751.68
|
| Rate for Payer: Priority Health SBD |
$751.68
|
| Rate for Payer: UMR Bronson Commercial |
$850.54
|
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29844
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$665.30
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS Trust/PPO |
$730.64
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$772.10
|
| Rate for Payer: Priority Health Narrow Network |
$772.10
|
| Rate for Payer: Priority Health SBD |
$772.10
|
| Rate for Payer: UMR Bronson Commercial |
$846.40
|
|
|
PR ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 29847
|
| Min. Negotiated Rate |
$353.79 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$726.25
|
| Rate for Payer: BCBS Complete |
$371.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Meridian Medicaid |
$371.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,501.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.52
|
| Rate for Payer: Priority Health Narrow Network |
$839.52
|
| Rate for Payer: Priority Health SBD |
$839.52
|
| Rate for Payer: UMR Bronson Commercial |
$986.70
|
|
