|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$445.48 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$156.66
|
| Rate for Payer: BCN Commercial |
$156.66
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$184.30
|
| Rate for Payer: Healthscope Whirlpool |
$190.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$155.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.48
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$356.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Trust/PPO |
$156.03
|
| Rate for Payer: BCN Commercial |
$156.03
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$184.30
|
| Rate for Payer: Healthscope Whirlpool |
$190.00
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$155.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$66.81
|
| Rate for Payer: Aetna Medicare |
$49.86
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$49.86
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$49.86
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$71.80
|
| Rate for Payer: Cofinity Commercial |
$66.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.86
|
| Rate for Payer: Healthscope Commercial |
$59.83
|
| Rate for Payer: Healthscope Whirlpool |
$59.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.35
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.85
|
| Rate for Payer: Nomi Health Commercial |
$59.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$49.86
|
| Rate for Payer: PHP Medicare Advantage |
$49.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.22
|
| Rate for Payer: Priority Health Medicare |
$49.86
|
| Rate for Payer: Priority Health Narrow Network |
$94.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.86
|
| Rate for Payer: UHC Exchange |
$105.97
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP DNSP |
$49.86
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: ASR ASR |
$194.00
|
| Rate for Payer: BCBS Trust/PPO |
$164.24
|
| Rate for Payer: BCN Commercial |
$164.24
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$194.00
|
| Rate for Payer: Healthscope Whirlpool |
$200.00
|
| Rate for Payer: Mclaren Commercial |
$180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$66.81
|
| Rate for Payer: Aetna Medicare |
$49.86
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$49.86
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$49.86
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$71.80
|
| Rate for Payer: Cofinity Commercial |
$66.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.86
|
| Rate for Payer: Healthscope Commercial |
$59.83
|
| Rate for Payer: Healthscope Whirlpool |
$59.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.35
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.85
|
| Rate for Payer: Nomi Health Commercial |
$59.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$49.86
|
| Rate for Payer: PHP Medicare Advantage |
$49.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.22
|
| Rate for Payer: Priority Health Medicare |
$49.86
|
| Rate for Payer: Priority Health Narrow Network |
$94.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.86
|
| Rate for Payer: UHC Exchange |
$105.97
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP DNSP |
$49.86
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$140.20 |
| Max. Negotiated Rate |
$382.31 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$194.00
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$164.90
|
| Rate for Payer: BCN Commercial |
$164.90
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$194.00
|
| Rate for Payer: Healthscope Whirlpool |
$200.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$180.00
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$175.24
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$140.20
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 20600
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare |
$31.10
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$31.10
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$31.10
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$44.78
|
| Rate for Payer: Cofinity Commercial |
$41.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.10
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Healthscope Whirlpool |
$37.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.66
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.21
|
| Rate for Payer: Nomi Health Commercial |
$37.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.75
|
| Rate for Payer: PACE SWMI |
$31.10
|
| Rate for Payer: PHP Medicare Advantage |
$31.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.96
|
| Rate for Payer: Priority Health Medicare |
$31.10
|
| Rate for Payer: Priority Health Narrow Network |
$56.96
|
| Rate for Payer: Railroad Medicare Medicare |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.10
|
| Rate for Payer: UHC Exchange |
$63.75
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP DNSP |
$31.10
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$53.08
|
| Rate for Payer: Aetna Medicare |
$39.61
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCN Commercial |
$54.59
|
| Rate for Payer: BCN Medicare Advantage |
$39.61
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.61
|
| Rate for Payer: Healthscope Commercial |
$47.53
|
| Rate for Payer: Healthscope Whirlpool |
$47.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.59
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.57
|
| Rate for Payer: Nomi Health Commercial |
$47.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$39.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$73.99
|
| Rate for Payer: Priority Health Medicare |
$39.61
|
| Rate for Payer: Priority Health Narrow Network |
$73.99
|
| Rate for Payer: Railroad Medicare Medicare |
$39.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.61
|
| Rate for Payer: UHC Exchange |
$81.07
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP DNSP |
$39.61
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,442.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$3,331.50 |
| Rate for Payer: Aetna Commercial |
$1,219.68
|
| Rate for Payer: Aetna Medicare |
$910.21
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCBS MAPPO |
$910.21
|
| Rate for Payer: BCN Commercial |
$1,524.82
|
| Rate for Payer: BCN Medicare Advantage |
$910.21
|
| Rate for Payer: Cash Price |
$3,553.60
|
| Rate for Payer: Cash Price |
$3,553.60
|
| Rate for Payer: Cofinity Commercial |
$1,310.70
|
| Rate for Payer: Cofinity Commercial |
$1,219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.21
|
| Rate for Payer: Healthscope Commercial |
$1,092.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,092.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.72
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.23
|
| Rate for Payer: Nomi Health Commercial |
$1,092.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,331.50
|
| Rate for Payer: PACE SWMI |
$910.21
|
| Rate for Payer: PHP Medicare Advantage |
$910.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,629.99
|
| Rate for Payer: Priority Health Medicare |
$910.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,629.99
|
| Rate for Payer: Railroad Medicare Medicare |
$910.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,791.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$910.21
|
| Rate for Payer: UHC Exchange |
$1,791.92
|
| Rate for Payer: UHC Medicaid |
$591.71
|
| Rate for Payer: UHCCP DNSP |
$910.21
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,530.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$1,118.89 |
| Max. Negotiated Rate |
$4,147.50 |
| Rate for Payer: Aetna Commercial |
$2,333.06
|
| Rate for Payer: Aetna Medicare |
$1,741.09
|
| Rate for Payer: BCBS Complete |
$1,174.83
|
| Rate for Payer: BCBS MAPPO |
$1,741.09
|
| Rate for Payer: BCN Commercial |
$3,019.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,741.09
|
| Rate for Payer: Cash Price |
$4,424.00
|
| Rate for Payer: Cash Price |
$4,424.00
|
| Rate for Payer: Cofinity Commercial |
$2,507.17
|
| Rate for Payer: Cofinity Commercial |
$2,333.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,741.09
|
| Rate for Payer: Healthscope Commercial |
$2,089.31
|
| Rate for Payer: Healthscope Whirlpool |
$2,089.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,828.14
|
| Rate for Payer: Meridian Medicaid |
$1,174.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,915.20
|
| Rate for Payer: Nomi Health Commercial |
$2,089.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,147.50
|
| Rate for Payer: PACE SWMI |
$1,741.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,741.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,118.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,938.45
|
| Rate for Payer: Priority Health Medicare |
$1,741.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,938.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,741.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,239.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,741.09
|
| Rate for Payer: UHC Exchange |
$3,239.83
|
| Rate for Payer: UHC Medicaid |
$1,118.89
|
| Rate for Payer: UHCCP DNSP |
$1,741.09
|
| Rate for Payer: UHCCP Medicaid |
$1,118.89
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,663.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$1,145.30 |
| Max. Negotiated Rate |
$4,997.25 |
| Rate for Payer: Aetna Commercial |
$2,380.12
|
| Rate for Payer: Aetna Medicare |
$1,776.21
|
| Rate for Payer: BCBS Complete |
$1,202.57
|
| Rate for Payer: BCBS MAPPO |
$1,776.21
|
| Rate for Payer: BCN Commercial |
$3,021.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,776.21
|
| Rate for Payer: Cash Price |
$5,330.40
|
| Rate for Payer: Cash Price |
$5,330.40
|
| Rate for Payer: Cofinity Commercial |
$2,557.74
|
| Rate for Payer: Cofinity Commercial |
$2,380.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,776.21
|
| Rate for Payer: Healthscope Commercial |
$2,131.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,131.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,865.02
|
| Rate for Payer: Meridian Medicaid |
$1,202.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,953.83
|
| Rate for Payer: Nomi Health Commercial |
$2,131.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,997.25
|
| Rate for Payer: PACE SWMI |
$1,776.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,776.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,145.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,230.17
|
| Rate for Payer: Priority Health Medicare |
$1,776.21
|
| Rate for Payer: Priority Health Narrow Network |
$3,230.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,776.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,632.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,776.21
|
| Rate for Payer: UHC Exchange |
$3,632.16
|
| Rate for Payer: UHC Medicaid |
$1,145.30
|
| Rate for Payer: UHCCP DNSP |
$1,776.21
|
| Rate for Payer: UHCCP Medicaid |
$1,145.30
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM
|
Professional
|
Both
|
$7,729.00
|
|
|
Service Code
|
HCPCS 22812
|
| Min. Negotiated Rate |
$1,256.91 |
| Max. Negotiated Rate |
$5,796.75 |
| Rate for Payer: Aetna Commercial |
$2,610.20
|
| Rate for Payer: Aetna Medicare |
$1,947.91
|
| Rate for Payer: BCBS Complete |
$1,319.76
|
| Rate for Payer: BCBS MAPPO |
$1,947.91
|
| Rate for Payer: BCN Commercial |
$3,311.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,947.91
|
| Rate for Payer: Cash Price |
$6,183.20
|
| Rate for Payer: Cash Price |
$6,183.20
|
| Rate for Payer: Cofinity Commercial |
$2,804.99
|
| Rate for Payer: Cofinity Commercial |
$2,610.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,947.91
|
| Rate for Payer: Healthscope Commercial |
$2,337.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,337.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,045.31
|
| Rate for Payer: Meridian Medicaid |
$1,319.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,142.70
|
| Rate for Payer: Nomi Health Commercial |
$2,337.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,796.75
|
| Rate for Payer: PACE SWMI |
$1,947.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,947.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,256.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,539.98
|
| Rate for Payer: Priority Health Medicare |
$1,947.91
|
| Rate for Payer: Priority Health Narrow Network |
$3,539.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,947.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,890.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,947.91
|
| Rate for Payer: UHC Exchange |
$3,890.85
|
| Rate for Payer: UHC Medicaid |
$1,256.91
|
| Rate for Payer: UHCCP DNSP |
$1,947.91
|
| Rate for Payer: UHCCP Medicaid |
$1,256.91
|
|
|
PR ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL
|
Professional
|
Both
|
$2,036.00
|
|
|
Service Code
|
HCPCS 22634
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$1,527.00 |
| Rate for Payer: Aetna Commercial |
$584.33
|
| Rate for Payer: Aetna Medicare |
$436.07
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCBS MAPPO |
$436.07
|
| Rate for Payer: BCN Commercial |
$725.06
|
| Rate for Payer: BCN Medicare Advantage |
$436.07
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Cofinity Commercial |
$627.94
|
| Rate for Payer: Cofinity Commercial |
$584.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.07
|
| Rate for Payer: Healthscope Commercial |
$523.28
|
| Rate for Payer: Healthscope Whirlpool |
$523.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.87
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$479.68
|
| Rate for Payer: Nomi Health Commercial |
$523.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.00
|
| Rate for Payer: PACE SWMI |
$436.07
|
| Rate for Payer: PHP Medicare Advantage |
$436.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$775.08
|
| Rate for Payer: Priority Health Medicare |
$436.07
|
| Rate for Payer: Priority Health Narrow Network |
$775.08
|
| Rate for Payer: Railroad Medicare Medicare |
$436.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.07
|
| Rate for Payer: UHC Exchange |
$883.92
|
| Rate for Payer: UHC Medicaid |
$275.84
|
| Rate for Payer: UHCCP DNSP |
$436.07
|
| Rate for Payer: UHCCP Medicaid |
$275.84
|
|
|
PR ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,979.00
|
|
|
Service Code
|
HCPCS 22633
|
| Min. Negotiated Rate |
$1,084.17 |
| Max. Negotiated Rate |
$3,273.58 |
| Rate for Payer: Aetna Commercial |
$2,263.47
|
| Rate for Payer: Aetna Medicare |
$1,689.16
|
| Rate for Payer: BCBS Complete |
$1,138.38
|
| Rate for Payer: BCBS MAPPO |
$1,689.16
|
| Rate for Payer: BCN Commercial |
$2,741.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.16
|
| Rate for Payer: Cash Price |
$3,183.20
|
| Rate for Payer: Cash Price |
$3,183.20
|
| Rate for Payer: Cofinity Commercial |
$2,432.39
|
| Rate for Payer: Cofinity Commercial |
$2,263.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.16
|
| Rate for Payer: Healthscope Commercial |
$2,026.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,026.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,773.62
|
| Rate for Payer: Meridian Medicaid |
$1,138.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,858.08
|
| Rate for Payer: Nomi Health Commercial |
$2,026.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,984.25
|
| Rate for Payer: PACE SWMI |
$1,689.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,084.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,931.00
|
| Rate for Payer: Priority Health Medicare |
$1,689.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,931.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,689.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,273.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,689.16
|
| Rate for Payer: UHC Exchange |
$3,273.58
|
| Rate for Payer: UHC Medicaid |
$1,084.17
|
| Rate for Payer: UHCCP DNSP |
$1,689.16
|
| Rate for Payer: UHCCP Medicaid |
$1,084.17
|
|
|
PR ARTHRODESIS ELBOW JOINT LOCAL
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 24800
|
| Min. Negotiated Rate |
$497.99 |
| Max. Negotiated Rate |
$1,451.19 |
| Rate for Payer: Aetna Commercial |
$1,021.60
|
| Rate for Payer: Aetna Medicare |
$762.39
|
| Rate for Payer: BCBS Complete |
$522.89
|
| Rate for Payer: BCBS MAPPO |
$762.39
|
| Rate for Payer: BCN Commercial |
$1,272.34
|
| Rate for Payer: BCN Medicare Advantage |
$762.39
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$1,097.84
|
| Rate for Payer: Cofinity Commercial |
$1,021.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.39
|
| Rate for Payer: Healthscope Commercial |
$914.87
|
| Rate for Payer: Healthscope Whirlpool |
$914.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$800.51
|
| Rate for Payer: Meridian Medicaid |
$522.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$838.63
|
| Rate for Payer: Nomi Health Commercial |
$914.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$762.39
|
| Rate for Payer: PHP Medicare Advantage |
$762.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,360.09
|
| Rate for Payer: Priority Health Medicare |
$762.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.09
|
| Rate for Payer: Railroad Medicare Medicare |
$762.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,451.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$762.39
|
| Rate for Payer: UHC Exchange |
$1,451.19
|
| Rate for Payer: UHC Medicaid |
$497.99
|
| Rate for Payer: UHCCP DNSP |
$762.39
|
| Rate for Payer: UHCCP Medicaid |
$497.99
|
|
|
PR ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT
|
Professional
|
Both
|
$4,918.00
|
|
|
Service Code
|
HCPCS 24802
|
| Min. Negotiated Rate |
$590.86 |
| Max. Negotiated Rate |
$3,688.50 |
| Rate for Payer: Aetna Commercial |
$1,216.72
|
| Rate for Payer: Aetna Medicare |
$908.00
|
| Rate for Payer: BCBS Complete |
$620.40
|
| Rate for Payer: BCBS MAPPO |
$908.00
|
| Rate for Payer: BCN Commercial |
$1,523.83
|
| Rate for Payer: BCN Medicare Advantage |
$908.00
|
| Rate for Payer: Cash Price |
$3,934.40
|
| Rate for Payer: Cash Price |
$3,934.40
|
| Rate for Payer: Cofinity Commercial |
$1,307.52
|
| Rate for Payer: Cofinity Commercial |
$1,216.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$908.00
|
| Rate for Payer: Healthscope Commercial |
$1,089.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$953.40
|
| Rate for Payer: Meridian Medicaid |
$620.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$998.80
|
| Rate for Payer: Nomi Health Commercial |
$1,089.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,688.50
|
| Rate for Payer: PACE SWMI |
$908.00
|
| Rate for Payer: PHP Medicare Advantage |
$908.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,628.92
|
| Rate for Payer: Priority Health Medicare |
$908.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,628.92
|
| Rate for Payer: Railroad Medicare Medicare |
$908.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,754.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$908.00
|
| Rate for Payer: UHC Exchange |
$1,754.82
|
| Rate for Payer: UHC Medicaid |
$590.86
|
| Rate for Payer: UHCCP DNSP |
$908.00
|
| Rate for Payer: UHCCP Medicaid |
$590.86
|
|
|
PR ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,442.00
|
|
|
Service Code
|
HCPCS 28755
|
| Min. Negotiated Rate |
$297.99 |
| Max. Negotiated Rate |
$1,081.50 |
| Rate for Payer: Aetna Commercial |
$608.94
|
| Rate for Payer: Aetna Medicare |
$454.43
|
| Rate for Payer: BCBS Complete |
$312.89
|
| Rate for Payer: BCBS MAPPO |
$454.43
|
| Rate for Payer: BCN Commercial |
$512.43
|
| Rate for Payer: BCN Medicare Advantage |
$454.43
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cash Price |
$1,153.60
|
| Rate for Payer: Cofinity Commercial |
$654.38
|
| Rate for Payer: Cofinity Commercial |
$608.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.43
|
| Rate for Payer: Healthscope Commercial |
$545.32
|
| Rate for Payer: Healthscope Whirlpool |
$545.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.15
|
| Rate for Payer: Meridian Medicaid |
$312.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$499.87
|
| Rate for Payer: Nomi Health Commercial |
$545.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,081.50
|
| Rate for Payer: PACE SWMI |
$454.43
|
| Rate for Payer: PHP Medicare Advantage |
$454.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$547.77
|
| Rate for Payer: Priority Health Medicare |
$454.43
|
| Rate for Payer: Priority Health Narrow Network |
$547.77
|
| Rate for Payer: Railroad Medicare Medicare |
$454.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$579.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$454.43
|
| Rate for Payer: UHC Exchange |
$579.35
|
| Rate for Payer: UHC Medicaid |
$297.99
|
| Rate for Payer: UHCCP DNSP |
$454.43
|
| Rate for Payer: UHCCP Medicaid |
$297.99
|
|
|
PR ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$2,034.00
|
|
|
Service Code
|
HCPCS 28750
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$1,525.50 |
| Rate for Payer: Aetna Commercial |
$700.79
|
| Rate for Payer: Aetna Medicare |
$522.98
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$522.98
|
| Rate for Payer: BCN Commercial |
$871.47
|
| Rate for Payer: BCN Medicare Advantage |
$522.98
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cofinity Commercial |
$753.09
|
| Rate for Payer: Cofinity Commercial |
$700.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.98
|
| Rate for Payer: Healthscope Commercial |
$627.58
|
| Rate for Payer: Healthscope Whirlpool |
$627.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$549.13
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$575.28
|
| Rate for Payer: Nomi Health Commercial |
$627.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,525.50
|
| Rate for Payer: PACE SWMI |
$522.98
|
| Rate for Payer: PHP Medicare Advantage |
$522.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$931.57
|
| Rate for Payer: Priority Health Medicare |
$522.98
|
| Rate for Payer: Priority Health Narrow Network |
$931.57
|
| Rate for Payer: Railroad Medicare Medicare |
$522.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,017.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$522.98
|
| Rate for Payer: UHC Exchange |
$1,017.69
|
| Rate for Payer: UHC Medicaid |
$342.08
|
| Rate for Payer: UHCCP DNSP |
$522.98
|
| Rate for Payer: UHCCP Medicaid |
$342.08
|
|
|
PR ARTHRODESIS HIP JOINT W/OBTAINING GRAFT
|
Professional
|
Both
|
$4,900.00
|
|
|
Service Code
|
HCPCS 27284
|
| Min. Negotiated Rate |
$915.90 |
| Max. Negotiated Rate |
$3,675.00 |
| Rate for Payer: Aetna Commercial |
$1,902.42
|
| Rate for Payer: Aetna Medicare |
$1,419.72
|
| Rate for Payer: BCBS Complete |
$961.70
|
| Rate for Payer: BCBS MAPPO |
$1,419.72
|
| Rate for Payer: BCN Commercial |
$2,413.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,419.72
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,044.40
|
| Rate for Payer: Cofinity Commercial |
$1,902.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,419.72
|
| Rate for Payer: Healthscope Commercial |
$1,703.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,703.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,490.71
|
| Rate for Payer: Meridian Medicaid |
$961.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,561.69
|
| Rate for Payer: Nomi Health Commercial |
$1,703.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,675.00
|
| Rate for Payer: PACE SWMI |
$1,419.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,419.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$915.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,580.18
|
| Rate for Payer: Priority Health Medicare |
$1,419.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,580.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,419.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,838.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,419.72
|
| Rate for Payer: UHC Exchange |
$2,838.64
|
| Rate for Payer: UHC Medicaid |
$915.90
|
| Rate for Payer: UHCCP DNSP |
$1,419.72
|
| Rate for Payer: UHCCP Medicaid |
$915.90
|
|
|
PR ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,124.00
|
|
|
Service Code
|
HCPCS 26860
|
| Min. Negotiated Rate |
$386.81 |
| Max. Negotiated Rate |
$1,593.00 |
| Rate for Payer: Aetna Commercial |
$769.41
|
| Rate for Payer: Aetna Medicare |
$574.19
|
| Rate for Payer: BCBS Complete |
$406.15
|
| Rate for Payer: BCBS MAPPO |
$574.19
|
| Rate for Payer: BCN Commercial |
$924.26
|
| Rate for Payer: BCN Medicare Advantage |
$574.19
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cash Price |
$1,699.20
|
| Rate for Payer: Cofinity Commercial |
$826.83
|
| Rate for Payer: Cofinity Commercial |
$769.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.19
|
| Rate for Payer: Healthscope Commercial |
$689.03
|
| Rate for Payer: Healthscope Whirlpool |
$689.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.90
|
| Rate for Payer: Meridian Medicaid |
$406.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$631.61
|
| Rate for Payer: Nomi Health Commercial |
$689.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.00
|
| Rate for Payer: PACE SWMI |
$574.19
|
| Rate for Payer: PHP Medicare Advantage |
$574.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$988.00
|
| Rate for Payer: Priority Health Medicare |
$574.19
|
| Rate for Payer: Priority Health Narrow Network |
$988.00
|
| Rate for Payer: Railroad Medicare Medicare |
$574.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$986.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$574.19
|
| Rate for Payer: UHC Exchange |
$986.74
|
| Rate for Payer: UHC Medicaid |
$386.81
|
| Rate for Payer: UHCCP DNSP |
$574.19
|
| Rate for Payer: UHCCP Medicaid |
$386.81
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 26861
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$116.15
|
| Rate for Payer: Aetna Medicare |
$86.68
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$86.68
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: BCN Medicare Advantage |
$86.68
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$124.82
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.68
|
| Rate for Payer: Healthscope Commercial |
$104.02
|
| Rate for Payer: Healthscope Whirlpool |
$104.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.01
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.35
|
| Rate for Payer: Nomi Health Commercial |
$104.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$86.68
|
| Rate for Payer: PHP Medicare Advantage |
$86.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$162.37
|
| Rate for Payer: Priority Health Medicare |
$86.68
|
| Rate for Payer: Priority Health Narrow Network |
$162.37
|
| Rate for Payer: Railroad Medicare Medicare |
$86.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.68
|
| Rate for Payer: UHC Exchange |
$182.14
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP DNSP |
$86.68
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 26863
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$405.25 |
| Rate for Payer: Aetna Commercial |
$256.07
|
| Rate for Payer: Aetna Medicare |
$191.10
|
| Rate for Payer: BCBS Complete |
$128.37
|
| Rate for Payer: BCBS MAPPO |
$191.10
|
| Rate for Payer: BCN Commercial |
$338.13
|
| Rate for Payer: BCN Medicare Advantage |
$191.10
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cofinity Commercial |
$275.18
|
| Rate for Payer: Cofinity Commercial |
$256.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.10
|
| Rate for Payer: Healthscope Commercial |
$229.32
|
| Rate for Payer: Healthscope Whirlpool |
$229.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.66
|
| Rate for Payer: Meridian Medicaid |
$128.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$210.21
|
| Rate for Payer: Nomi Health Commercial |
$229.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$325.50
|
| Rate for Payer: PACE SWMI |
$191.10
|
| Rate for Payer: PHP Medicare Advantage |
$191.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$361.45
|
| Rate for Payer: Priority Health Medicare |
$191.10
|
| Rate for Payer: Priority Health Narrow Network |
$361.45
|
| Rate for Payer: Railroad Medicare Medicare |
$191.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$191.10
|
| Rate for Payer: UHC Exchange |
$405.25
|
| Rate for Payer: UHC Medicaid |
$122.26
|
| Rate for Payer: UHCCP DNSP |
$191.10
|
| Rate for Payer: UHCCP Medicaid |
$122.26
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,690.00
|
|
|
Service Code
|
HCPCS 26862
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$2,017.50 |
| Rate for Payer: Aetna Commercial |
$944.39
|
| Rate for Payer: Aetna Medicare |
$704.77
|
| Rate for Payer: BCBS Complete |
$493.81
|
| Rate for Payer: BCBS MAPPO |
$704.77
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: BCN Medicare Advantage |
$704.77
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cofinity Commercial |
$944.39
|
| Rate for Payer: Cofinity Commercial |
$1,014.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.77
|
| Rate for Payer: Healthscope Commercial |
$845.72
|
| Rate for Payer: Healthscope Whirlpool |
$845.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.01
|
| Rate for Payer: Meridian Medicaid |
$493.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$775.25
|
| Rate for Payer: Nomi Health Commercial |
$845.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,017.50
|
| Rate for Payer: PACE SWMI |
$704.77
|
| Rate for Payer: PHP Medicare Advantage |
$704.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,238.19
|
| Rate for Payer: Priority Health Medicare |
$704.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,238.19
|
| Rate for Payer: Railroad Medicare Medicare |
$704.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$704.77
|
| Rate for Payer: UHC Exchange |
$1,264.86
|
| Rate for Payer: UHC Medicaid |
$470.30
|
| Rate for Payer: UHCCP DNSP |
$704.77
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
|
|
PR ARTHRODESIS KNEE ANY TECHNIQUE
|
Professional
|
Both
|
$3,319.00
|
|
|
Service Code
|
HCPCS 27580
|
| Min. Negotiated Rate |
$863.93 |
| Max. Negotiated Rate |
$2,557.99 |
| Rate for Payer: Aetna Commercial |
$1,779.67
|
| Rate for Payer: Aetna Medicare |
$1,328.11
|
| Rate for Payer: BCBS Complete |
$907.13
|
| Rate for Payer: BCBS MAPPO |
$1,328.11
|
| Rate for Payer: BCN Commercial |
$2,224.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,328.11
|
| Rate for Payer: Cash Price |
$2,655.20
|
| Rate for Payer: Cash Price |
$2,655.20
|
| Rate for Payer: Cofinity Commercial |
$1,912.48
|
| Rate for Payer: Cofinity Commercial |
$1,779.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,328.11
|
| Rate for Payer: Healthscope Commercial |
$1,593.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,593.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,394.52
|
| Rate for Payer: Meridian Medicaid |
$907.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,460.92
|
| Rate for Payer: Nomi Health Commercial |
$1,593.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,489.25
|
| Rate for Payer: PACE SWMI |
$1,328.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,328.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$863.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,377.91
|
| Rate for Payer: Priority Health Medicare |
$1,328.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,377.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,328.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,557.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,328.11
|
| Rate for Payer: UHC Exchange |
$2,557.99
|
| Rate for Payer: UHC Medicaid |
$863.93
|
| Rate for Payer: UHCCP DNSP |
$1,328.11
|
| Rate for Payer: UHCCP Medicaid |
$863.93
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR
|
Professional
|
Both
|
$6,236.00
|
|
|
Service Code
|
HCPCS 22533
|
| Min. Negotiated Rate |
$987.04 |
| Max. Negotiated Rate |
$4,677.00 |
| Rate for Payer: Aetna Commercial |
$2,052.10
|
| Rate for Payer: Aetna Medicare |
$1,531.42
|
| Rate for Payer: BCBS Complete |
$1,036.39
|
| Rate for Payer: BCBS MAPPO |
$1,531.42
|
| Rate for Payer: BCN Commercial |
$2,515.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,531.42
|
| Rate for Payer: Cash Price |
$4,988.80
|
| Rate for Payer: Cash Price |
$4,988.80
|
| Rate for Payer: Cofinity Commercial |
$2,205.24
|
| Rate for Payer: Cofinity Commercial |
$2,052.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,531.42
|
| Rate for Payer: Healthscope Commercial |
$1,837.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,837.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,607.99
|
| Rate for Payer: Meridian Medicaid |
$1,036.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,684.56
|
| Rate for Payer: Nomi Health Commercial |
$1,837.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,677.00
|
| Rate for Payer: PACE SWMI |
$1,531.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,531.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$987.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,689.33
|
| Rate for Payer: Priority Health Medicare |
$1,531.42
|
| Rate for Payer: Priority Health Narrow Network |
$2,689.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,531.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,923.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,531.42
|
| Rate for Payer: UHC Exchange |
$2,923.79
|
| Rate for Payer: UHC Medicaid |
$987.04
|
| Rate for Payer: UHCCP DNSP |
$1,531.42
|
| Rate for Payer: UHCCP Medicaid |
$987.04
|
|
