|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 28740
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$594.30 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$7,532.12
|
| Rate for Payer: BCN Commercial |
$7,532.12
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$653.73
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$594.30
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
ARTHRODESIS; PANTALAR
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 28705
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,181.20 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$10,230.56
|
| Rate for Payer: BCN Commercial |
$10,230.56
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.32
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$1,181.20
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, INCLUDING LAMINECTOMY AND/OR DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE, LUMBAR;
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 22630
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,545.88 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$29,200.92
|
| Rate for Payer: BCN Commercial |
$29,200.92
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,700.47
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$1,545.88
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, INCLUDING LAMINECTOMY AND/OR DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE, LUMBAR; EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$38,223.71
|
|
|
Service Code
|
CPT 22632
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$317.96 |
| Max. Negotiated Rate |
$38,223.71 |
| Rate for Payer: BCBS Trust/PPO |
$38,223.71
|
| Rate for Payer: BCN Commercial |
$38,223.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.76
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$317.96
|
|
|
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; CERVICAL BELOW C2 SEGMENT
|
Facility
|
OP
|
$14,113.90
|
|
|
Service Code
|
CPT 22600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,287.46 |
| Max. Negotiated Rate |
$14,113.90 |
| Rate for Payer: BCBS Trust/PPO |
$14,113.90
|
| Rate for Payer: BCN Commercial |
$14,113.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.21
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Exchange |
$1,287.46
|
|
|
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$29,357.43
|
|
|
Service Code
|
CPT 22614
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$385.59 |
| Max. Negotiated Rate |
$29,357.43 |
| Rate for Payer: BCBS Trust/PPO |
$29,357.43
|
| Rate for Payer: BCN Commercial |
$29,357.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.15
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$385.59
|
|
|
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 22612
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,551.97 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$22,088.97
|
| Rate for Payer: BCN Commercial |
$22,088.97
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.17
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$1,551.97
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE (INDIRECT VISUALIZATION), WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, AND PLACEMENT OF TRANSFIXATION DEVICE
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 27279
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$776.89 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$14,322.81
|
| Rate for Payer: BCN Commercial |
$14,322.81
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.58
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$776.89
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 28725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$751.28 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$7,344.05
|
| Rate for Payer: BCN Commercial |
$7,344.05
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$826.41
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$751.28
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHRODESIS; TRIPLE
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 28715
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$905.71 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$10,818.01
|
| Rate for Payer: BCN Commercial |
$10,818.01
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$996.28
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$905.71
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHRODESIS, WITH TENDON LENGTHENING AND ADVANCEMENT, MIDTARSAL, TARSAL NAVICULAR-CUNEIFORM (EG, MILLER TYPE PROCEDURE)
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 28737
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$668.25 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,582.62
|
| Rate for Payer: BCN Commercial |
$4,582.62
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.08
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$668.25
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHRODESIS, WRIST; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 25825
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$763.95 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,158.50
|
| Rate for Payer: BCN Commercial |
$5,158.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$840.34
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$763.95
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
ARTHRODESIS, WRIST; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 25810
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$839.93 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$7,754.27
|
| Rate for Payer: BCN Commercial |
$7,754.27
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$923.92
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$839.93
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 27130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,244.02 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$18,057.76
|
| Rate for Payer: BCN Commercial |
$18,057.76
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,368.42
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$1,244.02
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHROPLASTY, ANKLE; WITH IMPLANT (TOTAL ANKLE)
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 27702
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$930.93 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$23,173.41
|
| Rate for Payer: BCN Commercial |
$23,173.41
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,024.02
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$930.93
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (EG, TOTAL ELBOW)
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 24363
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,402.32 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$16,863.60
|
| Rate for Payer: BCN Commercial |
$16,863.60
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,542.55
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$1,402.32
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACEMENT (EG, TOTAL SHOULDER))
|
Facility
|
OP
|
$56,630.92
|
|
|
Service Code
|
CPT 23472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,397.58 |
| Max. Negotiated Rate |
$56,630.92 |
| Rate for Payer: Aetna Medicare |
$18,738.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,522.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,522.75
|
| Rate for Payer: BCBS Complete |
$10,140.64
|
| Rate for Payer: BCBS MAPPO |
$18,018.20
|
| Rate for Payer: BCBS Trust/PPO |
$18,538.72
|
| Rate for Payer: BCN Commercial |
$18,538.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,018.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,018.20
|
| Rate for Payer: Mclaren Medicaid |
$9,657.76
|
| Rate for Payer: Mclaren Medicare |
$18,018.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,919.11
|
| Rate for Payer: Meridian Medicaid |
$10,140.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,720.93
|
| Rate for Payer: Nomi Health Commercial |
$37,838.22
|
| Rate for Payer: PACE Medicare |
$17,117.29
|
| Rate for Payer: PACE SWMI |
$18,018.20
|
| Rate for Payer: PHP Medicare Advantage |
$18,018.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,657.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56,630.92
|
| Rate for Payer: Priority Health Medicare |
$18,018.20
|
| Rate for Payer: Priority Health Narrow Network |
$45,304.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18,018.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,537.34
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,018.20
|
| Rate for Payer: UHC Exchange |
$1,397.58
|
| Rate for Payer: UHC Medicare Advantage |
$18,018.20
|
| Rate for Payer: UHCCP Medicaid |
$9,657.76
|
| Rate for Payer: VA VA |
$18,018.20
|
|
|
ARTHROPLASTY, INTERCARPAL OR CARPOMETACARPAL JOINTS; INTERPOSITION (EG, TENDON)
|
Facility
|
OP
|
$9,991.56
|
|
|
Service Code
|
CPT 25447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$805.86 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,946.93
|
| Rate for Payer: BCN Commercial |
$3,946.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.45
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$805.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
ARTHROPLASTY, INTERPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 26536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$709.49 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,126.82
|
| Rate for Payer: BCN Commercial |
$4,126.82
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.44
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$709.49
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 27447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,242.06 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$17,609.12
|
| Rate for Payer: BCN Commercial |
$17,609.12
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,366.27
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$1,242.06
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL OR LATERAL COMPARTMENT
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 27446
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,111.85 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$17,609.12
|
| Rate for Payer: BCN Commercial |
$17,609.12
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,223.04
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$1,111.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHROPLASTY, METACARPOPHALANGEAL JOINT; EACH JOINT
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 26530
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$526.59 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,531.18
|
| Rate for Payer: BCN Commercial |
$2,531.18
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.25
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$526.59
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 26531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$612.54 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,734.51
|
| Rate for Payer: BCN Commercial |
$5,734.51
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.79
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$612.54
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT
|
Facility
|
OP
|
$39,622.51
|
|
|
Service Code
|
CPT 24366
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$660.29 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$13,227.26
|
| Rate for Payer: BCN Commercial |
$13,227.26
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.32
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$660.29
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUT AUTOGRAFT (INCLUDES OBTAINING GRAFT)
|
Facility
|
OP
|
$18,216.88
|
|
|
Service Code
|
CPT 21240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$994.28 |
| Max. Negotiated Rate |
$18,216.88 |
| Rate for Payer: Aetna Medicare |
$6,027.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,245.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,245.06
|
| Rate for Payer: BCBS Complete |
$3,262.02
|
| Rate for Payer: BCBS MAPPO |
$5,796.05
|
| Rate for Payer: BCBS Trust/PPO |
$10,268.27
|
| Rate for Payer: BCN Commercial |
$10,268.27
|
| Rate for Payer: BCN Medicare Advantage |
$5,796.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,796.05
|
| Rate for Payer: Mclaren Medicaid |
$3,106.68
|
| Rate for Payer: Mclaren Medicare |
$5,796.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,085.85
|
| Rate for Payer: Meridian Medicaid |
$3,262.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,665.46
|
| Rate for Payer: Nomi Health Commercial |
$12,171.70
|
| Rate for Payer: PACE Medicare |
$5,506.25
|
| Rate for Payer: PACE SWMI |
$5,796.05
|
| Rate for Payer: PHP Medicare Advantage |
$5,796.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,106.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,216.88
|
| Rate for Payer: Priority Health Medicare |
$5,796.05
|
| Rate for Payer: Priority Health Narrow Network |
$14,573.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5,796.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.71
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,796.05
|
| Rate for Payer: UHC Exchange |
$994.28
|
| Rate for Payer: UHC Medicare Advantage |
$5,796.05
|
| Rate for Payer: UHCCP Medicaid |
$3,106.68
|
| Rate for Payer: VA VA |
$5,796.05
|
|
