|
PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,154.00
|
|
|
Service Code
|
HCPCS 29889
|
| Min. Negotiated Rate |
$788.95 |
| Max. Negotiated Rate |
$2,907.80 |
| Rate for Payer: Aetna Commercial |
$1,632.85
|
| Rate for Payer: BCBS Complete |
$828.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: Cash Price |
$3,323.20
|
| Rate for Payer: Cash Price |
$3,323.20
|
| Rate for Payer: Meridian Medicaid |
$828.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,907.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,874.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,874.60
|
| Rate for Payer: Priority Health SBD |
$1,874.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,910.84
|
|
|
PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX
|
Professional
|
Both
|
$2,635.00
|
|
|
Service Code
|
HCPCS 29892
|
| Min. Negotiated Rate |
$413.43 |
| Max. Negotiated Rate |
$1,844.50 |
| Rate for Payer: Aetna Commercial |
$860.03
|
| Rate for Payer: BCBS Complete |
$434.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.83
|
| Rate for Payer: Cash Price |
$2,108.00
|
| Rate for Payer: Cash Price |
$2,108.00
|
| Rate for Payer: Meridian Medicaid |
$434.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.47
|
| Rate for Payer: Priority Health Narrow Network |
$981.47
|
| Rate for Payer: Priority Health SBD |
$981.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.10
|
|
|
PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,492.00
|
|
|
Service Code
|
HCPCS 29855
|
| Min. Negotiated Rate |
$503.96 |
| Max. Negotiated Rate |
$1,744.40 |
| Rate for Payer: Aetna Commercial |
$1,041.85
|
| Rate for Payer: BCBS Complete |
$529.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.84
|
| Rate for Payer: Cash Price |
$1,993.60
|
| Rate for Payer: Cash Price |
$1,993.60
|
| Rate for Payer: Meridian Medicaid |
$529.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$503.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,199.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.52
|
| Rate for Payer: Priority Health SBD |
$1,199.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,146.32
|
|
|
PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 29856
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$1,644.07 |
| Rate for Payer: Aetna Commercial |
$1,318.77
|
| Rate for Payer: BCBS Complete |
$671.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.07
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Meridian Medicaid |
$671.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,520.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,520.71
|
| Rate for Payer: Priority Health SBD |
$1,520.71
|
| Rate for Payer: UMR Bronson Commercial |
$805.46
|
|
|
PR ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 29891
|
| Min. Negotiated Rate |
$435.37 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$892.98
|
| Rate for Payer: BCBS Complete |
$457.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.71
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Meridian Medicaid |
$457.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,026.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,026.91
|
| Rate for Payer: Priority Health SBD |
$1,026.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,094.80
|
|
|
PR ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 29862
|
| Min. Negotiated Rate |
$526.75 |
| Max. Negotiated Rate |
$1,892.80 |
| Rate for Payer: Aetna Commercial |
$1,084.46
|
| Rate for Payer: BCBS Complete |
$553.09
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Meridian Medicaid |
$553.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,892.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,247.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,247.01
|
| Rate for Payer: Priority Health SBD |
$1,247.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.84
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Facility
|
IP
|
$2,475.00
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$1,089.00 |
| Max. Negotiated Rate |
$2,227.50 |
| Rate for Payer: Aetna American Axle |
$1,608.75
|
| Rate for Payer: Aetna Commercial |
$2,103.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,608.75
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.50
|
| Rate for Payer: Cofinity Commercial |
$2,128.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,980.00
|
| Rate for Payer: Healthscope Commercial |
$2,227.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,732.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,856.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,103.75
|
| Rate for Payer: PHP Commercial |
$2,103.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health SBD |
$1,559.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,089.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,856.25
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 29879
|
| Min. Negotiated Rate |
$428.56 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Commercial |
$882.28
|
| Rate for Payer: BCBS Complete |
$449.99
|
| Rate for Payer: BCBS Trust/PPO |
$943.02
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Meridian Medicaid |
$449.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,017.21
|
| Rate for Payer: Priority Health SBD |
$1,017.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,138.50
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$428.56 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Commercial |
$882.28
|
| Rate for Payer: BCBS Complete |
$449.99
|
| Rate for Payer: BCBS Trust/PPO |
$943.02
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Meridian Medicaid |
$449.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,017.21
|
| Rate for Payer: Priority Health SBD |
$1,017.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,138.50
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Facility
|
OP
|
$2,475.00
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$658.81 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,608.75
|
| Rate for Payer: Aetna Commercial |
$2,103.75
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,608.75
|
| 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 |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.50
|
| Rate for Payer: Cofinity Commercial |
$2,128.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,980.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$2,227.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,732.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,856.25
|
| 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 |
$2,103.75
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$2,103.75
|
| 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 |
$1,732.50
|
| 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 |
$1,559.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$658.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$915.75
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,856.25
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,221.00
|
|
|
Service Code
|
HCPCS 29877
|
| Min. Negotiated Rate |
$402.36 |
| Max. Negotiated Rate |
$1,554.70 |
| Rate for Payer: Aetna Commercial |
$828.30
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.49
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.94
|
| Rate for Payer: Priority Health Narrow Network |
$955.94
|
| Rate for Payer: Priority Health SBD |
$955.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.66
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Facility
|
IP
|
$2,221.00
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
29877
|
| 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 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,221.00
|
|
|
Service Code
|
HCPCS 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$402.36 |
| Max. Negotiated Rate |
$1,554.70 |
| Rate for Payer: Aetna Commercial |
$828.30
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.49
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.94
|
| Rate for Payer: Priority Health Narrow Network |
$955.94
|
| Rate for Payer: Priority Health SBD |
$955.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.66
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Facility
|
OP
|
$2,221.00
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$618.54 |
| 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 |
$2,902.38
|
| 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 |
$1,910.06
|
| Rate for Payer: Cofinity Commercial |
$1,554.70
|
| 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) |
$680.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$618.54
|
| 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 ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION
|
Professional
|
Both
|
$2,348.00
|
|
|
Service Code
|
HCPCS 29886
|
| Min. Negotiated Rate |
$413.22 |
| Max. Negotiated Rate |
$1,643.60 |
| Rate for Payer: Aetna Commercial |
$848.21
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS Trust/PPO |
$436.38
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$980.44
|
| Rate for Payer: Priority Health Narrow Network |
$980.44
|
| Rate for Payer: Priority Health SBD |
$980.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,080.08
|
|
|
PR ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG
|
Professional
|
Both
|
$2,492.00
|
|
|
Service Code
|
HCPCS 29885
|
| Min. Negotiated Rate |
$489.90 |
| Max. Negotiated Rate |
$1,744.40 |
| Rate for Payer: Aetna Commercial |
$1,007.16
|
| Rate for Payer: BCBS Complete |
$514.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: Cash Price |
$1,993.60
|
| Rate for Payer: Cash Price |
$1,993.60
|
| Rate for Payer: Meridian Medicaid |
$514.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,162.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,162.75
|
| Rate for Payer: Priority Health SBD |
$1,162.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,146.32
|
|
|
PR ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 29887
|
| Min. Negotiated Rate |
$488.20 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Commercial |
$1,003.49
|
| Rate for Payer: BCBS Complete |
$512.61
|
| Rate for Payer: BCBS Trust/PPO |
$675.17
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Meridian Medicaid |
$512.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,158.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,158.15
|
| Rate for Payer: Priority Health SBD |
$1,158.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,138.50
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,538.00
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$1,776.60 |
| Rate for Payer: Aetna Commercial |
$749.27
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,776.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.07
|
| Rate for Payer: Priority Health Narrow Network |
$866.07
|
| Rate for Payer: Priority Health SBD |
$866.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,167.48
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Facility
|
OP
|
$2,538.00
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$560.58 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,649.70
|
| Rate for Payer: Aetna Commercial |
$2,157.30
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,649.70
|
| 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 |
$3,282.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Cofinity Commercial |
$1,776.60
|
| Rate for Payer: Cofinity Commercial |
$2,182.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,030.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$2,284.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,776.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,903.50
|
| 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 |
$2,157.30
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$2,157.30
|
| 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 |
$1,776.60
|
| 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 |
$1,598.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$560.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$939.06
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,903.50
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,538.00
|
|
|
Service Code
|
HCPCS 29880
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$1,776.60 |
| Rate for Payer: Aetna Commercial |
$749.27
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,776.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.07
|
| Rate for Payer: Priority Health Narrow Network |
$866.07
|
| Rate for Payer: Priority Health SBD |
$866.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,167.48
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Facility
|
IP
|
$2,538.00
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$1,116.72 |
| Max. Negotiated Rate |
$2,284.20 |
| Rate for Payer: Aetna American Axle |
$1,649.70
|
| Rate for Payer: Aetna Commercial |
$2,157.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,649.70
|
| Rate for Payer: Cash Price |
$2,030.40
|
| Rate for Payer: Cofinity Commercial |
$1,776.60
|
| Rate for Payer: Cofinity Commercial |
$2,182.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,030.40
|
| Rate for Payer: Healthscope Commercial |
$2,284.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,776.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,903.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,157.30
|
| Rate for Payer: PHP Commercial |
$2,157.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,776.60
|
| Rate for Payer: Priority Health SBD |
$1,598.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,116.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,903.50
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
OP
|
$2,348.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$540.28 |
| 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 |
$3,051.08
|
| 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 |
$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: 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) |
$594.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$540.28
|
| 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 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
IP
|
$2,348.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| 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 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,348.00
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
29881
|
| Min. Negotiated Rate |
$126.26 |
| Max. Negotiated Rate |
$1,643.60 |
| Rate for Payer: Aetna Commercial |
$722.25
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS Trust/PPO |
$126.26
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.89
|
| Rate for Payer: Priority Health Narrow Network |
$833.89
|
| Rate for Payer: Priority Health SBD |
$833.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,080.08
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$2,348.00
|
|
|
Service Code
|
HCPCS 29881
|
| Min. Negotiated Rate |
$126.26 |
| Max. Negotiated Rate |
$1,643.60 |
| Rate for Payer: Aetna Commercial |
$722.25
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS Trust/PPO |
$126.26
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.89
|
| Rate for Payer: Priority Health Narrow Network |
$833.89
|
| Rate for Payer: Priority Health SBD |
$833.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,080.08
|
|
