|
PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,612.00
|
|
|
Service Code
|
HCPCS 26862
|
| Min. Negotiated Rate |
$719.13 |
| Max. Negotiated Rate |
$1,697.80 |
| Rate for Payer: Aetna Commercial |
$963.63
|
| Rate for Payer: Aetna Medicare |
$719.13
|
| Rate for Payer: BCBS Complete |
$1,044.80
|
| Rate for Payer: BCBS MAPPO |
$719.13
|
| Rate for Payer: BCN Medicare Advantage |
$719.13
|
| Rate for Payer: Cash Price |
$2,089.60
|
| Rate for Payer: Cash Price |
$2,089.60
|
| Rate for Payer: Cofinity Commercial |
$963.63
|
| Rate for Payer: Cofinity Commercial |
$1,035.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.13
|
| Rate for Payer: Healthscope Commercial |
$862.96
|
| Rate for Payer: Healthscope Whirlpool |
$862.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.09
|
| Rate for Payer: Nomi Health Commercial |
$862.96
|
| Rate for Payer: PACE SWMI |
$719.13
|
| Rate for Payer: PHP Medicare Advantage |
$719.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,697.80
|
| Rate for Payer: Priority Health Medicare |
$719.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.13
|
| Rate for Payer: UHC Medicare Advantage |
$719.13
|
| Rate for Payer: UHCCP DNSP |
$719.13
|
|
|
PR ARTHRODESIS KNEE ANY TECHNIQUE
|
Professional
|
Both
|
$3,222.00
|
|
|
Service Code
|
HCPCS 27580
|
| Min. Negotiated Rate |
$1,288.80 |
| Max. Negotiated Rate |
$2,094.30 |
| Rate for Payer: Aetna Commercial |
$1,894.21
|
| Rate for Payer: Aetna Medicare |
$1,413.59
|
| Rate for Payer: BCBS Complete |
$1,288.80
|
| Rate for Payer: BCBS MAPPO |
$1,413.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.59
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cofinity Commercial |
$2,035.57
|
| Rate for Payer: Cofinity Commercial |
$1,894.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.59
|
| Rate for Payer: Healthscope Commercial |
$1,696.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,696.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.27
|
| Rate for Payer: Nomi Health Commercial |
$1,696.31
|
| Rate for Payer: PACE SWMI |
$1,413.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.30
|
| Rate for Payer: Priority Health Medicare |
$1,413.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,413.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,413.59
|
| Rate for Payer: UHCCP DNSP |
$1,413.59
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR
|
Professional
|
Both
|
$6,054.00
|
|
|
Service Code
|
HCPCS 22533
|
| Min. Negotiated Rate |
$1,614.48 |
| Max. Negotiated Rate |
$3,935.10 |
| Rate for Payer: Aetna Commercial |
$2,163.40
|
| Rate for Payer: Aetna Medicare |
$1,614.48
|
| Rate for Payer: BCBS Complete |
$2,421.60
|
| Rate for Payer: BCBS MAPPO |
$1,614.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,614.48
|
| Rate for Payer: Cash Price |
$4,843.20
|
| Rate for Payer: Cash Price |
$4,843.20
|
| Rate for Payer: Cofinity Commercial |
$2,324.85
|
| Rate for Payer: Cofinity Commercial |
$2,163.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,614.48
|
| Rate for Payer: Healthscope Commercial |
$1,937.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,937.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,695.20
|
| Rate for Payer: Nomi Health Commercial |
$1,937.38
|
| Rate for Payer: PACE SWMI |
$1,614.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,614.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,935.10
|
| Rate for Payer: Priority Health Medicare |
$1,614.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,614.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,614.48
|
| Rate for Payer: UHCCP DNSP |
$1,614.48
|
|
|
PR ARTHRODESIS LATERAL EXTRACAVITARY THORACIC
|
Professional
|
Both
|
$6,049.00
|
|
|
Service Code
|
HCPCS 22532
|
| Min. Negotiated Rate |
$1,751.31 |
| Max. Negotiated Rate |
$3,931.85 |
| Rate for Payer: Aetna Commercial |
$2,346.76
|
| Rate for Payer: Aetna Medicare |
$1,751.31
|
| Rate for Payer: BCBS Complete |
$2,419.60
|
| Rate for Payer: BCBS MAPPO |
$1,751.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,751.31
|
| Rate for Payer: Cash Price |
$4,839.20
|
| Rate for Payer: Cash Price |
$4,839.20
|
| Rate for Payer: Cofinity Commercial |
$2,521.89
|
| Rate for Payer: Cofinity Commercial |
$2,346.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,751.31
|
| Rate for Payer: Healthscope Commercial |
$2,101.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,101.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,838.88
|
| Rate for Payer: Nomi Health Commercial |
$2,101.57
|
| Rate for Payer: PACE SWMI |
$1,751.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,751.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.85
|
| Rate for Payer: Priority Health Medicare |
$1,751.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,751.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,751.31
|
| Rate for Payer: UHCCP DNSP |
$1,751.31
|
|
|
PR ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$3,010.00
|
|
|
Service Code
|
HCPCS 22534
|
| Min. Negotiated Rate |
$351.93 |
| Max. Negotiated Rate |
$1,956.50 |
| Rate for Payer: Aetna Commercial |
$471.59
|
| Rate for Payer: Aetna Medicare |
$351.93
|
| Rate for Payer: BCBS Complete |
$1,204.00
|
| Rate for Payer: BCBS MAPPO |
$351.93
|
| Rate for Payer: BCN Medicare Advantage |
$351.93
|
| Rate for Payer: Cash Price |
$2,408.00
|
| Rate for Payer: Cash Price |
$2,408.00
|
| Rate for Payer: Cofinity Commercial |
$506.78
|
| Rate for Payer: Cofinity Commercial |
$471.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.93
|
| Rate for Payer: Healthscope Commercial |
$422.32
|
| Rate for Payer: Healthscope Whirlpool |
$422.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.53
|
| Rate for Payer: Nomi Health Commercial |
$422.32
|
| Rate for Payer: PACE SWMI |
$351.93
|
| Rate for Payer: PHP Medicare Advantage |
$351.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,956.50
|
| Rate for Payer: Priority Health Medicare |
$351.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.93
|
| Rate for Payer: UHC Medicare Advantage |
$351.93
|
| Rate for Payer: UHCCP DNSP |
$351.93
|
|
|
PR ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 26850
|
| Min. Negotiated Rate |
$688.83 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$923.03
|
| Rate for Payer: Aetna Medicare |
$688.83
|
| Rate for Payer: BCBS Complete |
$924.00
|
| Rate for Payer: BCBS MAPPO |
$688.83
|
| Rate for Payer: BCN Medicare Advantage |
$688.83
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cofinity Commercial |
$991.92
|
| Rate for Payer: Cofinity Commercial |
$923.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.83
|
| Rate for Payer: Healthscope Commercial |
$826.60
|
| Rate for Payer: Healthscope Whirlpool |
$826.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.27
|
| Rate for Payer: Nomi Health Commercial |
$826.60
|
| Rate for Payer: PACE SWMI |
$688.83
|
| Rate for Payer: PHP Medicare Advantage |
$688.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,501.50
|
| Rate for Payer: Priority Health Medicare |
$688.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$688.83
|
| Rate for Payer: UHC Medicare Advantage |
$688.83
|
| Rate for Payer: UHCCP DNSP |
$688.83
|
|
|
PR ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT
|
Professional
|
Both
|
$2,154.00
|
|
|
Service Code
|
HCPCS 28740
|
| Min. Negotiated Rate |
$589.65 |
| Max. Negotiated Rate |
$1,400.10 |
| Rate for Payer: Aetna Commercial |
$790.13
|
| Rate for Payer: Aetna Medicare |
$589.65
|
| Rate for Payer: BCBS Complete |
$861.60
|
| Rate for Payer: BCBS MAPPO |
$589.65
|
| Rate for Payer: BCN Medicare Advantage |
$589.65
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cofinity Commercial |
$849.10
|
| Rate for Payer: Cofinity Commercial |
$790.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.65
|
| Rate for Payer: Healthscope Commercial |
$707.58
|
| Rate for Payer: Healthscope Whirlpool |
$707.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.13
|
| Rate for Payer: Nomi Health Commercial |
$707.58
|
| Rate for Payer: PACE SWMI |
$589.65
|
| Rate for Payer: PHP Medicare Advantage |
$589.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.10
|
| Rate for Payer: Priority Health Medicare |
$589.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.65
|
| Rate for Payer: UHC Medicare Advantage |
$589.65
|
| Rate for Payer: UHCCP DNSP |
$589.65
|
|
|
PR ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT
|
Professional
|
Both
|
$2,860.00
|
|
|
Service Code
|
HCPCS 26852
|
| Min. Negotiated Rate |
$785.60 |
| Max. Negotiated Rate |
$1,859.00 |
| Rate for Payer: Aetna Commercial |
$1,052.70
|
| Rate for Payer: Aetna Medicare |
$785.60
|
| Rate for Payer: BCBS Complete |
$1,144.00
|
| Rate for Payer: BCBS MAPPO |
$785.60
|
| Rate for Payer: BCN Medicare Advantage |
$785.60
|
| Rate for Payer: Cash Price |
$2,288.00
|
| Rate for Payer: Cash Price |
$2,288.00
|
| Rate for Payer: Cofinity Commercial |
$1,131.26
|
| Rate for Payer: Cofinity Commercial |
$1,052.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.60
|
| Rate for Payer: Healthscope Commercial |
$942.72
|
| Rate for Payer: Healthscope Whirlpool |
$942.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.88
|
| Rate for Payer: Nomi Health Commercial |
$942.72
|
| Rate for Payer: PACE SWMI |
$785.60
|
| Rate for Payer: PHP Medicare Advantage |
$785.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.00
|
| Rate for Payer: Priority Health Medicare |
$785.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.60
|
| Rate for Payer: UHC Medicare Advantage |
$785.60
|
| Rate for Payer: UHCCP DNSP |
$785.60
|
|
|
PR ARTHRODESIS PANTALAR
|
Professional
|
Both
|
$3,938.00
|
|
|
Service Code
|
HCPCS 28705
|
| Min. Negotiated Rate |
$1,173.16 |
| Max. Negotiated Rate |
$2,559.70 |
| Rate for Payer: Aetna Commercial |
$1,572.03
|
| Rate for Payer: Aetna Medicare |
$1,173.16
|
| Rate for Payer: BCBS Complete |
$1,575.20
|
| Rate for Payer: BCBS MAPPO |
$1,173.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,173.16
|
| Rate for Payer: Cash Price |
$3,150.40
|
| Rate for Payer: Cash Price |
$3,150.40
|
| Rate for Payer: Cofinity Commercial |
$1,689.35
|
| Rate for Payer: Cofinity Commercial |
$1,572.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,173.16
|
| Rate for Payer: Healthscope Commercial |
$1,407.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,407.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,231.82
|
| Rate for Payer: Nomi Health Commercial |
$1,407.79
|
| Rate for Payer: PACE SWMI |
$1,173.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,173.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,559.70
|
| Rate for Payer: Priority Health Medicare |
$1,173.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,173.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,173.16
|
| Rate for Payer: UHCCP DNSP |
$1,173.16
|
|
|
PR ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2
|
Professional
|
Both
|
$5,175.00
|
|
|
Service Code
|
HCPCS 22595
|
| Min. Negotiated Rate |
$1,497.11 |
| Max. Negotiated Rate |
$3,363.75 |
| Rate for Payer: Aetna Commercial |
$2,006.13
|
| Rate for Payer: Aetna Medicare |
$1,497.11
|
| Rate for Payer: BCBS Complete |
$2,070.00
|
| Rate for Payer: BCBS MAPPO |
$1,497.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,497.11
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cofinity Commercial |
$2,155.84
|
| Rate for Payer: Cofinity Commercial |
$2,006.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,497.11
|
| Rate for Payer: Healthscope Commercial |
$1,796.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,796.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,571.97
|
| Rate for Payer: Nomi Health Commercial |
$1,796.53
|
| Rate for Payer: PACE SWMI |
$1,497.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,497.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,363.75
|
| Rate for Payer: Priority Health Medicare |
$1,497.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,497.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,497.11
|
| Rate for Payer: UHCCP DNSP |
$1,497.11
|
|
|
PR ARTHRODESIS POSTERIOR CRANIOCERVICAL
|
Professional
|
Both
|
$5,337.00
|
|
|
Service Code
|
HCPCS 22590
|
| Min. Negotiated Rate |
$1,568.47 |
| Max. Negotiated Rate |
$3,469.05 |
| Rate for Payer: Aetna Commercial |
$2,101.75
|
| Rate for Payer: Aetna Medicare |
$1,568.47
|
| Rate for Payer: BCBS Complete |
$2,134.80
|
| Rate for Payer: BCBS MAPPO |
$1,568.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.47
|
| Rate for Payer: Cash Price |
$4,269.60
|
| Rate for Payer: Cash Price |
$4,269.60
|
| Rate for Payer: Cofinity Commercial |
$2,258.60
|
| Rate for Payer: Cofinity Commercial |
$2,101.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.47
|
| Rate for Payer: Healthscope Commercial |
$1,882.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,882.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.89
|
| Rate for Payer: Nomi Health Commercial |
$1,882.16
|
| Rate for Payer: PACE SWMI |
$1,568.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,469.05
|
| Rate for Payer: Priority Health Medicare |
$1,568.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.47
|
| Rate for Payer: UHCCP DNSP |
$1,568.47
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 22632
|
| Min. Negotiated Rate |
$314.35 |
| Max. Negotiated Rate |
$820.30 |
| Rate for Payer: Aetna Commercial |
$421.23
|
| Rate for Payer: Aetna Medicare |
$314.35
|
| Rate for Payer: BCBS Complete |
$504.80
|
| Rate for Payer: BCBS MAPPO |
$314.35
|
| Rate for Payer: BCN Medicare Advantage |
$314.35
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cofinity Commercial |
$452.66
|
| Rate for Payer: Cofinity Commercial |
$421.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.35
|
| Rate for Payer: Healthscope Commercial |
$377.22
|
| Rate for Payer: Healthscope Whirlpool |
$377.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.07
|
| Rate for Payer: Nomi Health Commercial |
$377.22
|
| Rate for Payer: PACE SWMI |
$314.35
|
| Rate for Payer: PHP Medicare Advantage |
$314.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.30
|
| Rate for Payer: Priority Health Medicare |
$314.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.35
|
| Rate for Payer: UHC Medicare Advantage |
$314.35
|
| Rate for Payer: UHCCP DNSP |
$314.35
|
|
|
PR ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$6,749.00
|
|
|
Service Code
|
HCPCS 22630
|
| Min. Negotiated Rate |
$1,536.91 |
| Max. Negotiated Rate |
$4,386.85 |
| Rate for Payer: Aetna Commercial |
$2,059.46
|
| Rate for Payer: Aetna Medicare |
$1,536.91
|
| Rate for Payer: BCBS Complete |
$2,699.60
|
| Rate for Payer: BCBS MAPPO |
$1,536.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,536.91
|
| Rate for Payer: Cash Price |
$5,399.20
|
| Rate for Payer: Cash Price |
$5,399.20
|
| Rate for Payer: Cofinity Commercial |
$2,213.15
|
| Rate for Payer: Cofinity Commercial |
$2,059.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,536.91
|
| Rate for Payer: Healthscope Commercial |
$1,844.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,844.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,613.76
|
| Rate for Payer: Nomi Health Commercial |
$1,844.29
|
| Rate for Payer: PACE SWMI |
$1,536.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,536.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,386.85
|
| Rate for Payer: Priority Health Medicare |
$1,536.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,536.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,536.91
|
| Rate for Payer: UHCCP DNSP |
$1,536.91
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 22612
|
| Min. Negotiated Rate |
$1,319.60 |
| Max. Negotiated Rate |
$2,216.65 |
| Rate for Payer: Aetna Commercial |
$2,062.72
|
| Rate for Payer: Aetna Medicare |
$1,539.34
|
| Rate for Payer: BCBS Complete |
$1,319.60
|
| Rate for Payer: BCBS MAPPO |
$1,539.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,539.34
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cofinity Commercial |
$2,216.65
|
| Rate for Payer: Cofinity Commercial |
$2,062.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,539.34
|
| Rate for Payer: Healthscope Commercial |
$1,847.21
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,616.31
|
| Rate for Payer: Nomi Health Commercial |
$1,847.21
|
| Rate for Payer: PACE SWMI |
$1,539.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,539.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,144.35
|
| Rate for Payer: Priority Health Medicare |
$1,539.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,539.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,539.34
|
| Rate for Payer: UHCCP DNSP |
$1,539.34
|
|
|
PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC
|
Professional
|
Both
|
$4,286.00
|
|
|
Service Code
|
HCPCS 22610
|
| Min. Negotiated Rate |
$1,257.65 |
| Max. Negotiated Rate |
$2,785.90 |
| Rate for Payer: Aetna Commercial |
$1,685.25
|
| Rate for Payer: Aetna Medicare |
$1,257.65
|
| Rate for Payer: BCBS Complete |
$1,714.40
|
| Rate for Payer: BCBS MAPPO |
$1,257.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.65
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,811.02
|
| Rate for Payer: Cofinity Commercial |
$1,685.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.65
|
| Rate for Payer: Healthscope Commercial |
$1,509.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,509.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.53
|
| Rate for Payer: Nomi Health Commercial |
$1,509.18
|
| Rate for Payer: PACE SWMI |
$1,257.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,785.90
|
| Rate for Payer: Priority Health Medicare |
$1,257.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.65
|
| Rate for Payer: UHCCP DNSP |
$1,257.65
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM
|
Professional
|
Both
|
$5,067.00
|
|
|
Service Code
|
HCPCS 22804
|
| Min. Negotiated Rate |
$2,026.80 |
| Max. Negotiated Rate |
$3,388.46 |
| Rate for Payer: Aetna Commercial |
$3,153.15
|
| Rate for Payer: Aetna Medicare |
$2,353.10
|
| Rate for Payer: BCBS Complete |
$2,026.80
|
| Rate for Payer: BCBS MAPPO |
$2,353.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,353.10
|
| Rate for Payer: Cash Price |
$4,053.60
|
| Rate for Payer: Cash Price |
$4,053.60
|
| Rate for Payer: Cofinity Commercial |
$3,388.46
|
| Rate for Payer: Cofinity Commercial |
$3,153.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,353.10
|
| Rate for Payer: Healthscope Commercial |
$2,823.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,823.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,470.76
|
| Rate for Payer: Nomi Health Commercial |
$2,823.72
|
| Rate for Payer: PACE SWMI |
$2,353.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,353.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,293.55
|
| Rate for Payer: Priority Health Medicare |
$2,353.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,353.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,353.10
|
| Rate for Payer: UHCCP DNSP |
$2,353.10
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM
|
Professional
|
Both
|
$2,812.00
|
|
|
Service Code
|
HCPCS 22800
|
| Min. Negotiated Rate |
$1,124.80 |
| Max. Negotiated Rate |
$1,919.74 |
| Rate for Payer: Aetna Commercial |
$1,786.42
|
| Rate for Payer: Aetna Medicare |
$1,333.15
|
| Rate for Payer: BCBS Complete |
$1,124.80
|
| Rate for Payer: BCBS MAPPO |
$1,333.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.15
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cofinity Commercial |
$1,919.74
|
| Rate for Payer: Cofinity Commercial |
$1,786.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.15
|
| Rate for Payer: Healthscope Commercial |
$1,599.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,599.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,399.81
|
| Rate for Payer: Nomi Health Commercial |
$1,599.78
|
| Rate for Payer: PACE SWMI |
$1,333.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,827.80
|
| Rate for Payer: Priority Health Medicare |
$1,333.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.15
|
| Rate for Payer: UHCCP DNSP |
$1,333.15
|
|
|
PR ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM
|
Professional
|
Both
|
$4,380.00
|
|
|
Service Code
|
HCPCS 22802
|
| Min. Negotiated Rate |
$1,752.00 |
| Max. Negotiated Rate |
$2,949.98 |
| Rate for Payer: Aetna Commercial |
$2,745.12
|
| Rate for Payer: Aetna Medicare |
$2,048.60
|
| Rate for Payer: BCBS Complete |
$1,752.00
|
| Rate for Payer: BCBS MAPPO |
$2,048.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,048.60
|
| Rate for Payer: Cash Price |
$3,504.00
|
| Rate for Payer: Cash Price |
$3,504.00
|
| Rate for Payer: Cofinity Commercial |
$2,949.98
|
| Rate for Payer: Cofinity Commercial |
$2,745.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,048.60
|
| Rate for Payer: Healthscope Commercial |
$2,458.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,458.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,151.03
|
| Rate for Payer: Nomi Health Commercial |
$2,458.32
|
| Rate for Payer: PACE SWMI |
$2,048.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,048.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,847.00
|
| Rate for Payer: Priority Health Medicare |
$2,048.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,048.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,048.60
|
| Rate for Payer: UHCCP DNSP |
$2,048.60
|
|
|
PR ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC
|
Professional
|
Both
|
$1,875.00
|
|
|
Service Code
|
HCPCS 22614
|
| Min. Negotiated Rate |
$382.59 |
| Max. Negotiated Rate |
$1,218.75 |
| Rate for Payer: Aetna Commercial |
$512.67
|
| Rate for Payer: Aetna Medicare |
$382.59
|
| Rate for Payer: BCBS Complete |
$750.00
|
| Rate for Payer: BCBS MAPPO |
$382.59
|
| Rate for Payer: BCN Medicare Advantage |
$382.59
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$550.93
|
| Rate for Payer: Cofinity Commercial |
$512.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.59
|
| Rate for Payer: Healthscope Commercial |
$459.11
|
| Rate for Payer: Healthscope Whirlpool |
$459.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.72
|
| Rate for Payer: Nomi Health Commercial |
$459.11
|
| Rate for Payer: PACE SWMI |
$382.59
|
| Rate for Payer: PHP Medicare Advantage |
$382.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.75
|
| Rate for Payer: Priority Health Medicare |
$382.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.59
|
| Rate for Payer: UHC Medicare Advantage |
$382.59
|
| Rate for Payer: UHCCP DNSP |
$382.59
|
|
|
PR ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE
|
Professional
|
Both
|
$1,316.00
|
|
|
Service Code
|
HCPCS 27279
|
| Min. Negotiated Rate |
$526.40 |
| Max. Negotiated Rate |
$1,116.95 |
| Rate for Payer: Aetna Commercial |
$1,039.38
|
| Rate for Payer: Aetna Medicare |
$775.66
|
| Rate for Payer: BCBS Complete |
$526.40
|
| Rate for Payer: BCBS MAPPO |
$775.66
|
| Rate for Payer: BCN Medicare Advantage |
$775.66
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,116.95
|
| Rate for Payer: Cofinity Commercial |
$1,039.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.66
|
| Rate for Payer: Healthscope Commercial |
$930.79
|
| Rate for Payer: Healthscope Whirlpool |
$930.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.44
|
| Rate for Payer: Nomi Health Commercial |
$930.79
|
| Rate for Payer: PACE SWMI |
$775.66
|
| Rate for Payer: PHP Medicare Advantage |
$775.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$855.40
|
| Rate for Payer: Priority Health Medicare |
$775.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.66
|
| Rate for Payer: UHC Medicare Advantage |
$775.66
|
| Rate for Payer: UHCCP DNSP |
$775.66
|
|
|
PR ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ
|
Professional
|
Both
|
$3,240.00
|
|
|
Service Code
|
HCPCS 27280
|
| Min. Negotiated Rate |
$1,296.00 |
| Max. Negotiated Rate |
$2,106.00 |
| Rate for Payer: Aetna Commercial |
$1,784.09
|
| Rate for Payer: Aetna Medicare |
$1,331.41
|
| Rate for Payer: BCBS Complete |
$1,296.00
|
| Rate for Payer: BCBS MAPPO |
$1,331.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,331.41
|
| Rate for Payer: Cash Price |
$2,592.00
|
| Rate for Payer: Cash Price |
$2,592.00
|
| Rate for Payer: Cofinity Commercial |
$1,917.23
|
| Rate for Payer: Cofinity Commercial |
$1,784.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,331.41
|
| Rate for Payer: Healthscope Commercial |
$1,597.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,597.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,397.98
|
| Rate for Payer: Nomi Health Commercial |
$1,597.69
|
| Rate for Payer: PACE SWMI |
$1,331.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,331.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,106.00
|
| Rate for Payer: Priority Health Medicare |
$1,331.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,331.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,331.41
|
| Rate for Payer: UHCCP DNSP |
$1,331.41
|
|
|
PR ARTHRODESIS SUBTALAR
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 28725
|
| Min. Negotiated Rate |
$746.91 |
| Max. Negotiated Rate |
$2,129.40 |
| Rate for Payer: Aetna Commercial |
$1,000.86
|
| Rate for Payer: Aetna Medicare |
$746.91
|
| Rate for Payer: BCBS Complete |
$1,310.40
|
| Rate for Payer: BCBS MAPPO |
$746.91
|
| Rate for Payer: BCN Medicare Advantage |
$746.91
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$1,075.55
|
| Rate for Payer: Cofinity Commercial |
$1,000.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.91
|
| Rate for Payer: Healthscope Commercial |
$896.29
|
| Rate for Payer: Healthscope Whirlpool |
$896.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.26
|
| Rate for Payer: Nomi Health Commercial |
$896.29
|
| Rate for Payer: PACE SWMI |
$746.91
|
| Rate for Payer: PHP Medicare Advantage |
$746.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health Medicare |
$746.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.91
|
| Rate for Payer: UHC Medicare Advantage |
$746.91
|
| Rate for Payer: UHCCP DNSP |
$746.91
|
|
|
PR ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT
|
Professional
|
Both
|
$1,503.00
|
|
|
Service Code
|
HCPCS 27282
|
| Min. Negotiated Rate |
$601.20 |
| Max. Negotiated Rate |
$1,194.54 |
| Rate for Payer: Aetna Commercial |
$1,111.58
|
| Rate for Payer: Aetna Medicare |
$829.54
|
| Rate for Payer: BCBS Complete |
$601.20
|
| Rate for Payer: BCBS MAPPO |
$829.54
|
| Rate for Payer: BCN Medicare Advantage |
$829.54
|
| Rate for Payer: Cash Price |
$1,202.40
|
| Rate for Payer: Cash Price |
$1,202.40
|
| Rate for Payer: Cofinity Commercial |
$1,194.54
|
| Rate for Payer: Cofinity Commercial |
$1,111.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.54
|
| Rate for Payer: Healthscope Commercial |
$995.45
|
| Rate for Payer: Healthscope Whirlpool |
$995.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$871.02
|
| Rate for Payer: Nomi Health Commercial |
$995.45
|
| Rate for Payer: PACE SWMI |
$829.54
|
| Rate for Payer: PHP Medicare Advantage |
$829.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.95
|
| Rate for Payer: Priority Health Medicare |
$829.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.54
|
| Rate for Payer: UHC Medicare Advantage |
$829.54
|
| Rate for Payer: UHCCP DNSP |
$829.54
|
|
|
PR ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 27871
|
| Min. Negotiated Rate |
$663.31 |
| Max. Negotiated Rate |
$1,953.25 |
| Rate for Payer: Aetna Commercial |
$888.84
|
| Rate for Payer: Aetna Medicare |
$663.31
|
| Rate for Payer: BCBS Complete |
$1,202.00
|
| Rate for Payer: BCBS MAPPO |
$663.31
|
| Rate for Payer: BCN Medicare Advantage |
$663.31
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$955.17
|
| Rate for Payer: Cofinity Commercial |
$888.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.31
|
| Rate for Payer: Healthscope Commercial |
$795.97
|
| Rate for Payer: Healthscope Whirlpool |
$795.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.48
|
| Rate for Payer: Nomi Health Commercial |
$795.97
|
| Rate for Payer: PACE SWMI |
$663.31
|
| Rate for Payer: PHP Medicare Advantage |
$663.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,953.25
|
| Rate for Payer: Priority Health Medicare |
$663.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.31
|
| Rate for Payer: UHC Medicare Advantage |
$663.31
|
| Rate for Payer: UHCCP DNSP |
$663.31
|
|
|
PR ARTHRODESIS TRIPLE
|
Professional
|
Both
|
$4,084.00
|
|
|
Service Code
|
HCPCS 28715
|
| Min. Negotiated Rate |
$903.64 |
| Max. Negotiated Rate |
$2,654.60 |
| Rate for Payer: Aetna Commercial |
$1,210.88
|
| Rate for Payer: Aetna Medicare |
$903.64
|
| Rate for Payer: BCBS Complete |
$1,633.60
|
| Rate for Payer: BCBS MAPPO |
$903.64
|
| Rate for Payer: BCN Medicare Advantage |
$903.64
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,301.24
|
| Rate for Payer: Cofinity Commercial |
$1,210.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.64
|
| Rate for Payer: Healthscope Commercial |
$1,084.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,084.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.82
|
| Rate for Payer: Nomi Health Commercial |
$1,084.37
|
| Rate for Payer: PACE SWMI |
$903.64
|
| Rate for Payer: PHP Medicare Advantage |
$903.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,654.60
|
| Rate for Payer: Priority Health Medicare |
$903.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$903.64
|
| Rate for Payer: UHC Medicare Advantage |
$903.64
|
| Rate for Payer: UHCCP DNSP |
$903.64
|
|
