|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$320.57 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$661.76
|
| Rate for Payer: Aetna Medicare |
$971.00
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
| Rate for Payer: BCN Commercial |
$731.06
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Meridian Medicaid |
$336.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.31
|
| Rate for Payer: Priority Health Narrow Network |
$764.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$597.36
|
| Rate for Payer: UHC Exchange |
$597.36
|
| Rate for Payer: UHCCP Medicaid |
$320.57
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$623.06
|
| Rate for Payer: Aetna Medicare |
$938.50
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS Trust/PPO |
$911.32
|
| Rate for Payer: BCN Commercial |
$679.75
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$713.93
|
| Rate for Payer: Priority Health Narrow Network |
$713.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$568.51
|
| Rate for Payer: UHC Exchange |
$568.51
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
HCPCS 29899
|
| Min. Negotiated Rate |
$645.82 |
| Max. Negotiated Rate |
$2,007.85 |
| Rate for Payer: Aetna Commercial |
$1,366.39
|
| Rate for Payer: Aetna Medicare |
$1,544.50
|
| Rate for Payer: BCBS Complete |
$678.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.03
|
| Rate for Payer: BCN Commercial |
$1,471.90
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Meridian Medicaid |
$678.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,542.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,215.86
|
| Rate for Payer: UHC Exchange |
$1,215.86
|
| Rate for Payer: UHCCP Medicaid |
$645.82
|
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$329.51 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$663.97
|
| Rate for Payer: Aetna Medicare |
$971.00
|
| Rate for Payer: BCBS Complete |
$345.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: BCN Commercial |
$728.13
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Meridian Medicaid |
$345.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$778.56
|
| Rate for Payer: Priority Health Narrow Network |
$778.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$591.40
|
| Rate for Payer: UHC Exchange |
$591.40
|
| Rate for Payer: UHCCP Medicaid |
$329.51
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$1,480.30 |
| Rate for Payer: Aetna Commercial |
$790.94
|
| Rate for Payer: Aetna Medicare |
$1,100.50
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
| Rate for Payer: BCN Commercial |
$876.69
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$922.56
|
| Rate for Payer: Priority Health Narrow Network |
$922.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$673.38
|
| Rate for Payer: UHC Exchange |
$673.38
|
| Rate for Payer: UHCCP Medicaid |
$389.36
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$1,261.00 |
| Rate for Payer: Aetna Commercial |
$704.42
|
| Rate for Payer: Aetna Medicare |
$970.00
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.98
|
| Rate for Payer: BCN Commercial |
$778.46
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$814.18
|
| Rate for Payer: Priority Health Narrow Network |
$814.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$602.00
|
| Rate for Payer: UHC Exchange |
$602.00
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,040.00
|
|
|
Service Code
|
HCPCS 29836
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$1,712.22 |
| Rate for Payer: Aetna Commercial |
$777.30
|
| Rate for Payer: Aetna Medicare |
$520.00
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,712.22
|
| Rate for Payer: BCN Commercial |
$863.50
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$905.78
|
| Rate for Payer: Priority Health Narrow Network |
$905.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$663.85
|
| Rate for Payer: UHC Exchange |
$663.85
|
| Rate for Payer: UHCCP Medicaid |
$384.04
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$335.05 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Aetna Commercial |
$679.61
|
| Rate for Payer: Aetna Medicare |
$984.50
|
| Rate for Payer: BCBS Complete |
$351.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.65
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Meridian Medicaid |
$351.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.78
|
| Rate for Payer: Priority Health Narrow Network |
$791.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$574.26
|
| Rate for Payer: UHC Exchange |
$574.26
|
| Rate for Payer: UHCCP Medicaid |
$335.05
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$324.61 |
| Max. Negotiated Rate |
$1,694.79 |
| Rate for Payer: Aetna Commercial |
$657.85
|
| Rate for Payer: Aetna Medicare |
$922.50
|
| Rate for Payer: BCBS Complete |
$340.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.79
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Meridian Medicaid |
$340.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.78
|
| Rate for Payer: Priority Health Narrow Network |
$762.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$559.18
|
| Rate for Payer: UHC Exchange |
$559.18
|
| Rate for Payer: UHCCP Medicaid |
$324.61
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,444.00
|
|
|
Service Code
|
HCPCS 29861
|
| Min. Negotiated Rate |
$452.63 |
| Max. Negotiated Rate |
$1,588.60 |
| Rate for Payer: Aetna Commercial |
$964.85
|
| Rate for Payer: Aetna Medicare |
$1,222.00
|
| Rate for Payer: BCBS Complete |
$475.26
|
| Rate for Payer: BCBS Trust/PPO |
$480.75
|
| Rate for Payer: BCN Commercial |
$1,045.28
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Meridian Medicaid |
$475.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,588.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,102.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,102.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.25
|
| Rate for Payer: UHC Exchange |
$829.25
|
| Rate for Payer: UHCCP Medicaid |
$452.63
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 29863
|
| Min. Negotiated Rate |
$531.01 |
| Max. Negotiated Rate |
$1,257.39 |
| Rate for Payer: Aetna Commercial |
$1,082.78
|
| Rate for Payer: Aetna Medicare |
$823.50
|
| Rate for Payer: BCBS Complete |
$557.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.17
|
| Rate for Payer: BCN Commercial |
$1,191.40
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Meridian Medicaid |
$557.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,257.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,257.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$929.00
|
| Rate for Payer: UHC Exchange |
$929.00
|
| Rate for Payer: UHCCP Medicaid |
$531.01
|
|
|
PR ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$657.53 |
| Max. Negotiated Rate |
$2,118.35 |
| Rate for Payer: Aetna Commercial |
$1,365.58
|
| Rate for Payer: Aetna Medicare |
$1,629.50
|
| Rate for Payer: BCBS Complete |
$690.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.26
|
| Rate for Payer: BCN Commercial |
$1,489.98
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Meridian Medicaid |
$690.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,563.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,563.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,355.88
|
| Rate for Payer: UHC Exchange |
$1,355.88
|
| Rate for Payer: UHCCP Medicaid |
$657.53
|
|
|
PR ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,063.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$556.83 |
| Max. Negotiated Rate |
$1,990.95 |
| Rate for Payer: Aetna Commercial |
$1,332.42
|
| Rate for Payer: Aetna Medicare |
$1,531.50
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$1,456.26
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,525.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,330.85
|
| Rate for Payer: UHC Exchange |
$1,330.85
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
|
|
PR ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,274.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$658.38 |
| Max. Negotiated Rate |
$2,128.10 |
| Rate for Payer: Aetna Commercial |
$1,365.49
|
| Rate for Payer: Aetna Medicare |
$1,637.00
|
| Rate for Payer: BCBS Complete |
$691.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.67
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Meridian Medicaid |
$691.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,557.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,355.88
|
| Rate for Payer: UHC Exchange |
$1,355.88
|
| Rate for Payer: UHCCP Medicaid |
$658.38
|
|
|
PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$1,328.67 |
| Rate for Payer: Aetna Commercial |
$540.25
|
| Rate for Payer: Aetna Medicare |
$566.50
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,328.67
|
| Rate for Payer: BCN Commercial |
$810.23
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.12
|
| Rate for Payer: Priority Health Narrow Network |
$638.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$463.51
|
| Rate for Payer: UHC Exchange |
$463.51
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
|
|
PR ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 29871
|
| Min. Negotiated Rate |
$338.03 |
| Max. Negotiated Rate |
$1,303.32 |
| Rate for Payer: Aetna Commercial |
$684.95
|
| Rate for Payer: Aetna Medicare |
$809.00
|
| Rate for Payer: BCBS Complete |
$354.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.32
|
| Rate for Payer: BCN Commercial |
$760.87
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Meridian Medicaid |
$354.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.93
|
| Rate for Payer: Priority Health Narrow Network |
$799.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$581.24
|
| Rate for Payer: UHC Exchange |
$581.24
|
| Rate for Payer: UHCCP Medicaid |
$338.03
|
|
|
PR ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$1,974.00
|
|
|
Service Code
|
HCPCS 29873
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$1,722.26 |
| Rate for Payer: Aetna Commercial |
$709.91
|
| Rate for Payer: Aetna Medicare |
$987.00
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.26
|
| Rate for Payer: BCN Commercial |
$792.14
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$836.57
|
| Rate for Payer: Priority Health Narrow Network |
$836.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.14
|
| Rate for Payer: UHC Exchange |
$583.14
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
|
|
PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT
|
Professional
|
Both
|
$3,003.00
|
|
|
Service Code
|
HCPCS 29868
|
| Min. Negotiated Rate |
$818.87 |
| Max. Negotiated Rate |
$2,554.48 |
| Rate for Payer: Aetna Commercial |
$2,231.26
|
| Rate for Payer: Aetna Medicare |
$1,501.50
|
| Rate for Payer: BCBS Complete |
$1,131.45
|
| Rate for Payer: BCBS Trust/PPO |
$818.87
|
| Rate for Payer: BCN Commercial |
$2,437.52
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Cash Price |
$2,402.40
|
| Rate for Payer: Meridian Medicaid |
$1,131.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,077.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,951.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,554.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,554.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,941.41
|
| Rate for Payer: UHC Exchange |
$1,941.41
|
| Rate for Payer: UHCCP Medicaid |
$1,077.57
|
|
|
PR ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST
|
Professional
|
Both
|
$3,097.00
|
|
|
Service Code
|
HCPCS 29866
|
| Min. Negotiated Rate |
$685.01 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$1,401.56
|
| Rate for Payer: Aetna Medicare |
$1,548.50
|
| Rate for Payer: BCBS Complete |
$719.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.54
|
| Rate for Payer: BCN Commercial |
$1,543.73
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Meridian Medicaid |
$719.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,621.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,621.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,202.44
|
| Rate for Payer: UHC Exchange |
$1,202.44
|
| Rate for Payer: UHCCP Medicaid |
$685.01
|
|
|
PR ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29867
|
| Min. Negotiated Rate |
$509.81 |
| Max. Negotiated Rate |
$1,965.22 |
| Rate for Payer: Aetna Commercial |
$1,707.15
|
| Rate for Payer: Aetna Medicare |
$1,132.50
|
| Rate for Payer: BCBS Complete |
$871.12
|
| Rate for Payer: BCBS Trust/PPO |
$509.81
|
| Rate for Payer: BCN Commercial |
$1,872.13
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Meridian Medicaid |
$871.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,965.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,965.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.02
|
| Rate for Payer: UHC Exchange |
$1,466.02
|
| Rate for Payer: UHCCP Medicaid |
$829.64
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29874
|
| Min. Negotiated Rate |
$350.60 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$716.98
|
| Rate for Payer: Aetna Medicare |
$1,019.50
|
| Rate for Payer: BCBS Complete |
$368.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$869.53
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Meridian Medicaid |
$368.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.54
|
| Rate for Payer: Priority Health Narrow Network |
$834.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.25
|
| Rate for Payer: UHC Exchange |
$612.25
|
| Rate for Payer: UHCCP Medicaid |
$350.60
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Facility
|
OP
|
$2,039.00
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$1,325.35 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,835.10
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$1,977.83
|
| Rate for Payer: ASR Commercial |
$1,977.83
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,669.74
|
| Rate for Payer: BCN Commercial |
$1,580.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$1,916.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,631.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,039.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,977.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,835.10
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,733.15
|
| Rate for Payer: Nomi Health Commercial |
$1,671.98
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,786.57
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,429.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,794.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Facility
|
IP
|
$2,039.00
|
|
|
Service Code
|
CPT 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$1,325.35 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Aetna Commercial |
$1,835.10
|
| Rate for Payer: ASR ASR |
$1,977.83
|
| Rate for Payer: ASR Commercial |
$1,977.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,661.58
|
| Rate for Payer: BCN Commercial |
$1,580.84
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cofinity Commercial |
$1,916.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,631.20
|
| Rate for Payer: Healthscope Commercial |
$2,039.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,977.83
|
| Rate for Payer: Mclaren Commercial |
$1,835.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,733.15
|
| Rate for Payer: Nomi Health Commercial |
$1,671.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,794.32
|
|
|
PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 29874
|
| Hospital Charge Code |
29874
|
| Min. Negotiated Rate |
$350.60 |
| Max. Negotiated Rate |
$1,725.43 |
| Rate for Payer: Aetna Commercial |
$716.98
|
| Rate for Payer: Aetna Medicare |
$1,019.50
|
| Rate for Payer: BCBS Complete |
$368.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.43
|
| Rate for Payer: BCN Commercial |
$869.53
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Meridian Medicaid |
$368.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.54
|
| Rate for Payer: Priority Health Narrow Network |
$834.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.25
|
| Rate for Payer: UHC Exchange |
$612.25
|
| Rate for Payer: UHCCP Medicaid |
$350.60
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$871.38
|
| Rate for Payer: Aetna Medicare |
$1,197.50
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS Trust/PPO |
$769.20
|
| Rate for Payer: BCN Commercial |
$1,057.31
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$746.24
|
| Rate for Payer: UHC Exchange |
$746.24
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
|
