|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$49.95 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Commercial |
$66.93
|
| Rate for Payer: Aetna Medicare |
$49.95
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS MAPPO |
$49.95
|
| Rate for Payer: BCN Medicare Advantage |
$49.95
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Cofinity Commercial |
$66.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.95
|
| Rate for Payer: Healthscope Commercial |
$59.94
|
| Rate for Payer: Healthscope Whirlpool |
$59.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.45
|
| Rate for Payer: Nomi Health Commercial |
$59.94
|
| Rate for Payer: PACE SWMI |
$49.95
|
| Rate for Payer: PHP Medicare Advantage |
$49.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health Medicare |
$49.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.95
|
| Rate for Payer: UHC Medicare Advantage |
$49.95
|
| Rate for Payer: UHCCP DNSP |
$49.95
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$446.23 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$150.68
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.22
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$128.98
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 20610
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$119.60 |
| Rate for Payer: Aetna Commercial |
$58.22
|
| Rate for Payer: Aetna Medicare |
$43.45
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$43.45
|
| Rate for Payer: BCN Medicare Advantage |
$43.45
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$62.57
|
| Rate for Payer: Cofinity Commercial |
$58.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.45
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: PACE SWMI |
$43.45
|
| Rate for Payer: PHP Medicare Advantage |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$43.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.45
|
| Rate for Payer: UHC Medicare Advantage |
$43.45
|
| Rate for Payer: UHCCP DNSP |
$43.45
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
20610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Trust/PPO |
$149.94
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
20610
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$119.60 |
| Rate for Payer: Aetna Commercial |
$58.22
|
| Rate for Payer: Aetna Medicare |
$43.45
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$43.45
|
| Rate for Payer: BCN Medicare Advantage |
$43.45
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$58.22
|
| Rate for Payer: Cofinity Commercial |
$62.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.45
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: PACE SWMI |
$43.45
|
| Rate for Payer: PHP Medicare Advantage |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$43.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.45
|
| Rate for Payer: UHC Medicare Advantage |
$43.45
|
| Rate for Payer: UHCCP DNSP |
$43.45
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Min. Negotiated Rate |
$56.68 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Commercial |
$75.95
|
| Rate for Payer: Aetna Medicare |
$56.68
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCBS MAPPO |
$56.68
|
| Rate for Payer: BCN Medicare Advantage |
$56.68
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Cofinity Commercial |
$75.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.68
|
| Rate for Payer: Healthscope Commercial |
$68.02
|
| Rate for Payer: Healthscope Whirlpool |
$68.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.51
|
| Rate for Payer: Nomi Health Commercial |
$68.02
|
| Rate for Payer: PACE SWMI |
$56.68
|
| Rate for Payer: PHP Medicare Advantage |
$56.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health Medicare |
$56.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.68
|
| Rate for Payer: UHC Medicare Advantage |
$56.68
|
| Rate for Payer: UHCCP DNSP |
$56.68
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$446.23 |
| Rate for Payer: Aetna Commercial |
$174.60
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$188.18
|
| Rate for Payer: ASR Commercial |
$188.18
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$158.87
|
| Rate for Payer: BCN Commercial |
$150.41
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$182.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$194.00
|
| Rate for Payer: Healthscope Whirlpool |
$188.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$174.60
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.90
|
| Rate for Payer: Nomi Health Commercial |
$159.08
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.98
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$135.99
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
20611
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$194.00 |
| Rate for Payer: Aetna Commercial |
$174.60
|
| Rate for Payer: ASR ASR |
$188.18
|
| Rate for Payer: ASR Commercial |
$188.18
|
| Rate for Payer: BCBS Trust/PPO |
$158.09
|
| Rate for Payer: BCN Commercial |
$150.41
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$182.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Healthscope Commercial |
$194.00
|
| Rate for Payer: Healthscope Whirlpool |
$188.18
|
| Rate for Payer: Mclaren Commercial |
$174.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.90
|
| Rate for Payer: Nomi Health Commercial |
$159.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.72
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 20611
|
| Hospital Charge Code |
20611
|
| Min. Negotiated Rate |
$56.68 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Commercial |
$75.95
|
| Rate for Payer: Aetna Medicare |
$56.68
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCBS MAPPO |
$56.68
|
| Rate for Payer: BCN Medicare Advantage |
$56.68
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Cofinity Commercial |
$75.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.68
|
| Rate for Payer: Healthscope Commercial |
$68.02
|
| Rate for Payer: Healthscope Whirlpool |
$68.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.51
|
| Rate for Payer: Nomi Health Commercial |
$68.02
|
| Rate for Payer: PACE SWMI |
$56.68
|
| Rate for Payer: PHP Medicare Advantage |
$56.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health Medicare |
$56.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.68
|
| Rate for Payer: UHC Medicare Advantage |
$56.68
|
| Rate for Payer: UHCCP DNSP |
$56.68
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 20600
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: Aetna Medicare |
$34.11
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: BCBS MAPPO |
$34.11
|
| Rate for Payer: BCN Medicare Advantage |
$34.11
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$49.12
|
| Rate for Payer: Cofinity Commercial |
$45.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.11
|
| Rate for Payer: Healthscope Commercial |
$40.93
|
| Rate for Payer: Healthscope Whirlpool |
$40.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.82
|
| Rate for Payer: Nomi Health Commercial |
$40.93
|
| Rate for Payer: PACE SWMI |
$34.11
|
| Rate for Payer: PHP Medicare Advantage |
$34.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health Medicare |
$34.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.11
|
| Rate for Payer: UHC Medicare Advantage |
$34.11
|
| Rate for Payer: UHCCP DNSP |
$34.11
|
|
|
PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 20604
|
| Min. Negotiated Rate |
$44.54 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$59.68
|
| Rate for Payer: Aetna Medicare |
$44.54
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$44.54
|
| Rate for Payer: BCN Medicare Advantage |
$44.54
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$64.14
|
| Rate for Payer: Cofinity Commercial |
$59.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$53.45
|
| Rate for Payer: Healthscope Whirlpool |
$53.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.77
|
| Rate for Payer: Nomi Health Commercial |
$53.45
|
| Rate for Payer: PACE SWMI |
$44.54
|
| Rate for Payer: PHP Medicare Advantage |
$44.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$44.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.54
|
| Rate for Payer: UHC Medicare Advantage |
$44.54
|
| Rate for Payer: UHCCP DNSP |
$44.54
|
|
|
PR ARTHRODESIS ANKLE OPEN
|
Professional
|
Both
|
$4,313.00
|
|
|
Service Code
|
HCPCS 27870
|
| Min. Negotiated Rate |
$969.12 |
| Max. Negotiated Rate |
$2,803.45 |
| Rate for Payer: Aetna Commercial |
$1,298.62
|
| Rate for Payer: Aetna Medicare |
$969.12
|
| Rate for Payer: BCBS Complete |
$1,725.20
|
| Rate for Payer: BCBS MAPPO |
$969.12
|
| Rate for Payer: BCN Medicare Advantage |
$969.12
|
| Rate for Payer: Cash Price |
$3,450.40
|
| Rate for Payer: Cash Price |
$3,450.40
|
| Rate for Payer: Cofinity Commercial |
$1,395.53
|
| Rate for Payer: Cofinity Commercial |
$1,298.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.12
|
| Rate for Payer: Healthscope Commercial |
$1,162.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,162.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.58
|
| Rate for Payer: Nomi Health Commercial |
$1,162.94
|
| Rate for Payer: PACE SWMI |
$969.12
|
| Rate for Payer: PHP Medicare Advantage |
$969.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,803.45
|
| Rate for Payer: Priority Health Medicare |
$969.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$969.12
|
| Rate for Payer: UHC Medicare Advantage |
$969.12
|
| Rate for Payer: UHCCP DNSP |
$969.12
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM
|
Professional
|
Both
|
$5,369.00
|
|
|
Service Code
|
HCPCS 22808
|
| Min. Negotiated Rate |
$1,774.88 |
| Max. Negotiated Rate |
$3,489.85 |
| Rate for Payer: Aetna Commercial |
$2,378.34
|
| Rate for Payer: Aetna Medicare |
$1,774.88
|
| Rate for Payer: BCBS Complete |
$2,147.60
|
| Rate for Payer: BCBS MAPPO |
$1,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,774.88
|
| Rate for Payer: Cash Price |
$4,295.20
|
| Rate for Payer: Cash Price |
$4,295.20
|
| Rate for Payer: Cofinity Commercial |
$2,555.83
|
| Rate for Payer: Cofinity Commercial |
$2,378.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,774.88
|
| Rate for Payer: Healthscope Commercial |
$2,129.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,129.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,863.62
|
| Rate for Payer: Nomi Health Commercial |
$2,129.86
|
| Rate for Payer: PACE SWMI |
$1,774.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,774.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.85
|
| Rate for Payer: Priority Health Medicare |
$1,774.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,774.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,774.88
|
| Rate for Payer: UHCCP DNSP |
$1,774.88
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM
|
Professional
|
Both
|
$6,469.00
|
|
|
Service Code
|
HCPCS 22810
|
| Min. Negotiated Rate |
$1,933.36 |
| Max. Negotiated Rate |
$4,204.85 |
| Rate for Payer: Aetna Commercial |
$2,590.70
|
| Rate for Payer: Aetna Medicare |
$1,933.36
|
| Rate for Payer: BCBS Complete |
$2,587.60
|
| Rate for Payer: BCBS MAPPO |
$1,933.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,933.36
|
| Rate for Payer: Cash Price |
$5,175.20
|
| Rate for Payer: Cash Price |
$5,175.20
|
| Rate for Payer: Cofinity Commercial |
$2,784.04
|
| Rate for Payer: Cofinity Commercial |
$2,590.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,933.36
|
| Rate for Payer: Healthscope Commercial |
$2,320.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,320.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,030.03
|
| Rate for Payer: Nomi Health Commercial |
$2,320.03
|
| Rate for Payer: PACE SWMI |
$1,933.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,933.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,204.85
|
| Rate for Payer: Priority Health Medicare |
$1,933.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,933.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,933.36
|
| Rate for Payer: UHCCP DNSP |
$1,933.36
|
|
|
PR ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM
|
Professional
|
Both
|
$7,504.00
|
|
|
Service Code
|
HCPCS 22812
|
| Min. Negotiated Rate |
$2,117.52 |
| Max. Negotiated Rate |
$4,877.60 |
| Rate for Payer: Aetna Commercial |
$2,837.48
|
| Rate for Payer: Aetna Medicare |
$2,117.52
|
| Rate for Payer: BCBS Complete |
$3,001.60
|
| Rate for Payer: BCBS MAPPO |
$2,117.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,117.52
|
| Rate for Payer: Cash Price |
$6,003.20
|
| Rate for Payer: Cash Price |
$6,003.20
|
| Rate for Payer: Cofinity Commercial |
$3,049.23
|
| Rate for Payer: Cofinity Commercial |
$2,837.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,117.52
|
| Rate for Payer: Healthscope Commercial |
$2,541.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,541.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,223.40
|
| Rate for Payer: Nomi Health Commercial |
$2,541.02
|
| Rate for Payer: PACE SWMI |
$2,117.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,117.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,877.60
|
| Rate for Payer: Priority Health Medicare |
$2,117.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,117.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,117.52
|
| Rate for Payer: UHCCP DNSP |
$2,117.52
|
|
|
PR ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL
|
Professional
|
Both
|
$1,977.00
|
|
|
Service Code
|
HCPCS 22634
|
| Min. Negotiated Rate |
$473.66 |
| Max. Negotiated Rate |
$1,285.05 |
| Rate for Payer: Aetna Commercial |
$634.70
|
| Rate for Payer: Aetna Medicare |
$473.66
|
| Rate for Payer: BCBS Complete |
$790.80
|
| Rate for Payer: BCBS MAPPO |
$473.66
|
| Rate for Payer: BCN Medicare Advantage |
$473.66
|
| Rate for Payer: Cash Price |
$1,581.60
|
| Rate for Payer: Cash Price |
$1,581.60
|
| Rate for Payer: Cofinity Commercial |
$682.07
|
| Rate for Payer: Cofinity Commercial |
$634.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.66
|
| Rate for Payer: Healthscope Commercial |
$568.39
|
| Rate for Payer: Healthscope Whirlpool |
$568.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.34
|
| Rate for Payer: Nomi Health Commercial |
$568.39
|
| Rate for Payer: PACE SWMI |
$473.66
|
| Rate for Payer: PHP Medicare Advantage |
$473.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.05
|
| Rate for Payer: Priority Health Medicare |
$473.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.66
|
| Rate for Payer: UHC Medicare Advantage |
$473.66
|
| Rate for Payer: UHCCP DNSP |
$473.66
|
|
|
PR ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 22633
|
| Min. Negotiated Rate |
$1,545.20 |
| Max. Negotiated Rate |
$2,549.75 |
| Rate for Payer: Aetna Commercial |
$2,372.68
|
| Rate for Payer: Aetna Medicare |
$1,770.66
|
| Rate for Payer: BCBS Complete |
$1,545.20
|
| Rate for Payer: BCBS MAPPO |
$1,770.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,770.66
|
| Rate for Payer: Cash Price |
$3,090.40
|
| Rate for Payer: Cash Price |
$3,090.40
|
| Rate for Payer: Cofinity Commercial |
$2,549.75
|
| Rate for Payer: Cofinity Commercial |
$2,372.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,770.66
|
| Rate for Payer: Healthscope Commercial |
$2,124.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,124.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,859.19
|
| Rate for Payer: Nomi Health Commercial |
$2,124.79
|
| Rate for Payer: PACE SWMI |
$1,770.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,770.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,510.95
|
| Rate for Payer: Priority Health Medicare |
$1,770.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,770.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,770.66
|
| Rate for Payer: UHCCP DNSP |
$1,770.66
|
|
|
PR ARTHRODESIS ELBOW JOINT LOCAL
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 24800
|
| Min. Negotiated Rate |
$672.00 |
| Max. Negotiated Rate |
$1,159.91 |
| Rate for Payer: Aetna Commercial |
$1,079.36
|
| Rate for Payer: Aetna Medicare |
$805.49
|
| Rate for Payer: BCBS Complete |
$672.00
|
| Rate for Payer: BCBS MAPPO |
$805.49
|
| Rate for Payer: BCN Medicare Advantage |
$805.49
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$1,159.91
|
| Rate for Payer: Cofinity Commercial |
$1,079.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.49
|
| Rate for Payer: Healthscope Commercial |
$966.59
|
| Rate for Payer: Healthscope Whirlpool |
$966.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.76
|
| Rate for Payer: Nomi Health Commercial |
$966.59
|
| Rate for Payer: PACE SWMI |
$805.49
|
| Rate for Payer: PHP Medicare Advantage |
$805.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health Medicare |
$805.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.49
|
| Rate for Payer: UHC Medicare Advantage |
$805.49
|
| Rate for Payer: UHCCP DNSP |
$805.49
|
|
|
PR ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT
|
Professional
|
Both
|
$4,775.00
|
|
|
Service Code
|
HCPCS 24802
|
| Min. Negotiated Rate |
$967.77 |
| Max. Negotiated Rate |
$3,103.75 |
| Rate for Payer: Aetna Commercial |
$1,296.81
|
| Rate for Payer: Aetna Medicare |
$967.77
|
| Rate for Payer: BCBS Complete |
$1,910.00
|
| Rate for Payer: BCBS MAPPO |
$967.77
|
| Rate for Payer: BCN Medicare Advantage |
$967.77
|
| Rate for Payer: Cash Price |
$3,820.00
|
| Rate for Payer: Cash Price |
$3,820.00
|
| Rate for Payer: Cofinity Commercial |
$1,393.59
|
| Rate for Payer: Cofinity Commercial |
$1,296.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.77
|
| Rate for Payer: Healthscope Commercial |
$1,161.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,016.16
|
| Rate for Payer: Nomi Health Commercial |
$1,161.32
|
| Rate for Payer: PACE SWMI |
$967.77
|
| Rate for Payer: PHP Medicare Advantage |
$967.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,103.75
|
| Rate for Payer: Priority Health Medicare |
$967.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$967.77
|
| Rate for Payer: UHC Medicare Advantage |
$967.77
|
| Rate for Payer: UHCCP DNSP |
$967.77
|
|
|
PR ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,400.00
|
|
|
Service Code
|
HCPCS 28755
|
| Min. Negotiated Rate |
$322.19 |
| Max. Negotiated Rate |
$910.00 |
| Rate for Payer: Aetna Commercial |
$431.73
|
| Rate for Payer: Aetna Medicare |
$322.19
|
| Rate for Payer: BCBS Complete |
$560.00
|
| Rate for Payer: BCBS MAPPO |
$322.19
|
| Rate for Payer: BCN Medicare Advantage |
$322.19
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cash Price |
$1,120.00
|
| Rate for Payer: Cofinity Commercial |
$463.95
|
| Rate for Payer: Cofinity Commercial |
$431.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.19
|
| Rate for Payer: Healthscope Commercial |
$386.63
|
| Rate for Payer: Healthscope Whirlpool |
$386.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.30
|
| Rate for Payer: Nomi Health Commercial |
$386.63
|
| Rate for Payer: PACE SWMI |
$322.19
|
| Rate for Payer: PHP Medicare Advantage |
$322.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.00
|
| Rate for Payer: Priority Health Medicare |
$322.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.19
|
| Rate for Payer: UHC Medicare Advantage |
$322.19
|
| Rate for Payer: UHCCP DNSP |
$322.19
|
|
|
PR ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$1,975.00
|
|
|
Service Code
|
HCPCS 28750
|
| Min. Negotiated Rate |
$549.93 |
| Max. Negotiated Rate |
$1,283.75 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$549.93
|
| Rate for Payer: BCBS Complete |
$790.00
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Healthscope Commercial |
$659.92
|
| Rate for Payer: Healthscope Whirlpool |
$659.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.75
|
| Rate for Payer: Priority Health Medicare |
$549.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP DNSP |
$549.93
|
|
|
PR ARTHRODESIS HIP JOINT W/OBTAINING GRAFT
|
Professional
|
Both
|
$4,757.00
|
|
|
Service Code
|
HCPCS 27284
|
| Min. Negotiated Rate |
$1,543.83 |
| Max. Negotiated Rate |
$3,092.05 |
| Rate for Payer: Aetna Commercial |
$2,068.73
|
| Rate for Payer: Aetna Medicare |
$1,543.83
|
| Rate for Payer: BCBS Complete |
$1,902.80
|
| Rate for Payer: BCBS MAPPO |
$1,543.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.83
|
| Rate for Payer: Cash Price |
$3,805.60
|
| Rate for Payer: Cash Price |
$3,805.60
|
| Rate for Payer: Cofinity Commercial |
$2,223.12
|
| Rate for Payer: Cofinity Commercial |
$2,068.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.83
|
| Rate for Payer: Healthscope Commercial |
$1,852.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,852.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,621.02
|
| Rate for Payer: Nomi Health Commercial |
$1,852.60
|
| Rate for Payer: PACE SWMI |
$1,543.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,092.05
|
| Rate for Payer: Priority Health Medicare |
$1,543.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,543.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,543.83
|
| Rate for Payer: UHCCP DNSP |
$1,543.83
|
|
|
PR ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 26860
|
| Min. Negotiated Rate |
$568.60 |
| Max. Negotiated Rate |
$1,340.30 |
| Rate for Payer: Aetna Commercial |
$761.92
|
| Rate for Payer: Aetna Medicare |
$568.60
|
| Rate for Payer: BCBS Complete |
$824.80
|
| Rate for Payer: BCBS MAPPO |
$568.60
|
| Rate for Payer: BCN Medicare Advantage |
$568.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$818.78
|
| Rate for Payer: Cofinity Commercial |
$761.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.60
|
| Rate for Payer: Healthscope Commercial |
$682.32
|
| Rate for Payer: Healthscope Whirlpool |
$682.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$597.03
|
| Rate for Payer: Nomi Health Commercial |
$682.32
|
| Rate for Payer: PACE SWMI |
$568.60
|
| Rate for Payer: PHP Medicare Advantage |
$568.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.30
|
| Rate for Payer: Priority Health Medicare |
$568.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$568.60
|
| Rate for Payer: UHC Medicare Advantage |
$568.60
|
| Rate for Payer: UHCCP DNSP |
$568.60
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 26861
|
| Min. Negotiated Rate |
$97.68 |
| Max. Negotiated Rate |
$670.15 |
| Rate for Payer: Aetna Commercial |
$130.89
|
| Rate for Payer: Aetna Medicare |
$97.68
|
| Rate for Payer: BCBS Complete |
$412.40
|
| Rate for Payer: BCBS MAPPO |
$97.68
|
| Rate for Payer: BCN Medicare Advantage |
$97.68
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$140.66
|
| Rate for Payer: Cofinity Commercial |
$130.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.68
|
| Rate for Payer: Healthscope Commercial |
$117.22
|
| Rate for Payer: Healthscope Whirlpool |
$117.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.56
|
| Rate for Payer: Nomi Health Commercial |
$117.22
|
| Rate for Payer: PACE SWMI |
$97.68
|
| Rate for Payer: PHP Medicare Advantage |
$97.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health Medicare |
$97.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.68
|
| Rate for Payer: UHC Medicare Advantage |
$97.68
|
| Rate for Payer: UHCCP DNSP |
$97.68
|
|
|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 26863
|
| Min. Negotiated Rate |
$168.40 |
| Max. Negotiated Rate |
$313.04 |
| Rate for Payer: Aetna Commercial |
$291.30
|
| Rate for Payer: Aetna Medicare |
$217.39
|
| Rate for Payer: BCBS Complete |
$168.40
|
| Rate for Payer: BCBS MAPPO |
$217.39
|
| Rate for Payer: BCN Medicare Advantage |
$217.39
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$313.04
|
| Rate for Payer: Cofinity Commercial |
$291.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.39
|
| Rate for Payer: Healthscope Commercial |
$260.87
|
| Rate for Payer: Healthscope Whirlpool |
$260.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.26
|
| Rate for Payer: Nomi Health Commercial |
$260.87
|
| Rate for Payer: PACE SWMI |
$217.39
|
| Rate for Payer: PHP Medicare Advantage |
$217.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.65
|
| Rate for Payer: Priority Health Medicare |
$217.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.39
|
| Rate for Payer: UHC Medicare Advantage |
$217.39
|
| Rate for Payer: UHCCP DNSP |
$217.39
|
|
