|
PR ARTHROPLASTY RADIAL HEAD W/IMPLANT
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 24366
|
| Min. Negotiated Rate |
$659.34 |
| Max. Negotiated Rate |
$1,634.10 |
| Rate for Payer: Aetna Commercial |
$883.52
|
| Rate for Payer: Aetna Medicare |
$659.34
|
| Rate for Payer: BCBS Complete |
$1,005.60
|
| Rate for Payer: BCBS MAPPO |
$659.34
|
| Rate for Payer: BCN Medicare Advantage |
$659.34
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$949.45
|
| Rate for Payer: Cofinity Commercial |
$883.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.34
|
| Rate for Payer: Healthscope Commercial |
$791.21
|
| Rate for Payer: Healthscope Whirlpool |
$791.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.31
|
| Rate for Payer: Nomi Health Commercial |
$791.21
|
| Rate for Payer: PACE SWMI |
$659.34
|
| Rate for Payer: PHP Medicare Advantage |
$659.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health Medicare |
$659.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.34
|
| Rate for Payer: UHC Medicare Advantage |
$659.34
|
| Rate for Payer: UHCCP DNSP |
$659.34
|
|
|
PR ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 25445
|
| Min. Negotiated Rate |
$513.60 |
| Max. Negotiated Rate |
$1,004.47 |
| Rate for Payer: Aetna Commercial |
$934.72
|
| Rate for Payer: Aetna Medicare |
$697.55
|
| Rate for Payer: BCBS Complete |
$513.60
|
| Rate for Payer: BCBS MAPPO |
$697.55
|
| Rate for Payer: BCN Medicare Advantage |
$697.55
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cofinity Commercial |
$934.72
|
| Rate for Payer: Cofinity Commercial |
$1,004.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.55
|
| Rate for Payer: Healthscope Commercial |
$837.06
|
| Rate for Payer: Healthscope Whirlpool |
$837.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.43
|
| Rate for Payer: Nomi Health Commercial |
$837.06
|
| Rate for Payer: PACE SWMI |
$697.55
|
| Rate for Payer: PHP Medicare Advantage |
$697.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.60
|
| Rate for Payer: Priority Health Medicare |
$697.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.55
|
| Rate for Payer: UHC Medicare Advantage |
$697.55
|
| Rate for Payer: UHCCP DNSP |
$697.55
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS
|
Professional
|
Both
|
$1,893.00
|
|
|
Service Code
|
HCPCS 25441
|
| Min. Negotiated Rate |
$757.20 |
| Max. Negotiated Rate |
$1,305.40 |
| Rate for Payer: Aetna Commercial |
$1,214.75
|
| Rate for Payer: Aetna Medicare |
$906.53
|
| Rate for Payer: BCBS Complete |
$757.20
|
| Rate for Payer: BCBS MAPPO |
$906.53
|
| Rate for Payer: BCN Medicare Advantage |
$906.53
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cash Price |
$1,514.40
|
| Rate for Payer: Cofinity Commercial |
$1,305.40
|
| Rate for Payer: Cofinity Commercial |
$1,214.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.53
|
| Rate for Payer: Healthscope Commercial |
$1,087.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,087.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.86
|
| Rate for Payer: Nomi Health Commercial |
$1,087.84
|
| Rate for Payer: PACE SWMI |
$906.53
|
| Rate for Payer: PHP Medicare Advantage |
$906.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.45
|
| Rate for Payer: Priority Health Medicare |
$906.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$906.53
|
| Rate for Payer: UHC Medicare Advantage |
$906.53
|
| Rate for Payer: UHCCP DNSP |
$906.53
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 25442
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$1,126.50 |
| Rate for Payer: Aetna Commercial |
$1,048.27
|
| Rate for Payer: Aetna Medicare |
$782.29
|
| Rate for Payer: BCBS Complete |
$651.20
|
| Rate for Payer: BCBS MAPPO |
$782.29
|
| Rate for Payer: BCN Medicare Advantage |
$782.29
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,126.50
|
| Rate for Payer: Cofinity Commercial |
$1,048.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.29
|
| Rate for Payer: Healthscope Commercial |
$938.75
|
| Rate for Payer: Healthscope Whirlpool |
$938.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.40
|
| Rate for Payer: Nomi Health Commercial |
$938.75
|
| Rate for Payer: PACE SWMI |
$782.29
|
| Rate for Payer: PHP Medicare Advantage |
$782.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health Medicare |
$782.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.29
|
| Rate for Payer: UHC Medicare Advantage |
$782.29
|
| Rate for Payer: UHCCP DNSP |
$782.29
|
|
|
PR ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL
|
Professional
|
Both
|
$1,597.00
|
|
|
Service Code
|
HCPCS 25443
|
| Min. Negotiated Rate |
$638.80 |
| Max. Negotiated Rate |
$1,093.32 |
| Rate for Payer: Aetna Commercial |
$1,017.39
|
| Rate for Payer: Aetna Medicare |
$759.25
|
| Rate for Payer: BCBS Complete |
$638.80
|
| Rate for Payer: BCBS MAPPO |
$759.25
|
| Rate for Payer: BCN Medicare Advantage |
$759.25
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cash Price |
$1,277.60
|
| Rate for Payer: Cofinity Commercial |
$1,093.32
|
| Rate for Payer: Cofinity Commercial |
$1,017.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.25
|
| Rate for Payer: Healthscope Commercial |
$911.10
|
| Rate for Payer: Healthscope Whirlpool |
$911.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.21
|
| Rate for Payer: Nomi Health Commercial |
$911.10
|
| Rate for Payer: PACE SWMI |
$759.25
|
| Rate for Payer: PHP Medicare Advantage |
$759.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.05
|
| Rate for Payer: Priority Health Medicare |
$759.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.25
|
| Rate for Payer: UHC Medicare Advantage |
$759.25
|
| Rate for Payer: UHCCP DNSP |
$759.25
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 29851
|
| Min. Negotiated Rate |
$898.49 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,203.98
|
| Rate for Payer: Aetna Medicare |
$898.49
|
| Rate for Payer: BCBS Complete |
$1,246.40
|
| Rate for Payer: BCBS MAPPO |
$898.49
|
| Rate for Payer: BCN Medicare Advantage |
$898.49
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Cofinity Commercial |
$1,293.83
|
| Rate for Payer: Cofinity Commercial |
$1,203.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.49
|
| Rate for Payer: Healthscope Commercial |
$1,078.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,078.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$943.41
|
| Rate for Payer: Nomi Health Commercial |
$1,078.19
|
| Rate for Payer: PACE SWMI |
$898.49
|
| Rate for Payer: PHP Medicare Advantage |
$898.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
| Rate for Payer: Priority Health Medicare |
$898.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.49
|
| Rate for Payer: UHC Medicare Advantage |
$898.49
|
| Rate for Payer: UHCCP DNSP |
$898.49
|
|
|
PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 29850
|
| Min. Negotiated Rate |
$492.40 |
| Max. Negotiated Rate |
$870.60 |
| Rate for Payer: Aetna Commercial |
$810.14
|
| Rate for Payer: Aetna Medicare |
$604.58
|
| Rate for Payer: BCBS Complete |
$492.40
|
| Rate for Payer: BCBS MAPPO |
$604.58
|
| Rate for Payer: BCN Medicare Advantage |
$604.58
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$870.60
|
| Rate for Payer: Cofinity Commercial |
$810.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.58
|
| Rate for Payer: Healthscope Commercial |
$725.50
|
| Rate for Payer: Healthscope Whirlpool |
$725.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$634.81
|
| Rate for Payer: Nomi Health Commercial |
$725.50
|
| Rate for Payer: PACE SWMI |
$604.58
|
| Rate for Payer: PHP Medicare Advantage |
$604.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.15
|
| Rate for Payer: Priority Health Medicare |
$604.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.58
|
| Rate for Payer: UHC Medicare Advantage |
$604.58
|
| Rate for Payer: UHCCP DNSP |
$604.58
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29898
|
| Min. Negotiated Rate |
$538.55 |
| Max. Negotiated Rate |
$1,430.65 |
| Rate for Payer: Aetna Commercial |
$721.66
|
| Rate for Payer: Aetna Medicare |
$538.55
|
| Rate for Payer: BCBS Complete |
$880.40
|
| Rate for Payer: BCBS MAPPO |
$538.55
|
| Rate for Payer: BCN Medicare Advantage |
$538.55
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$775.51
|
| Rate for Payer: Cofinity Commercial |
$721.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.55
|
| Rate for Payer: Healthscope Commercial |
$646.26
|
| Rate for Payer: Healthscope Whirlpool |
$646.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.48
|
| Rate for Payer: Nomi Health Commercial |
$646.26
|
| Rate for Payer: PACE SWMI |
$538.55
|
| Rate for Payer: PHP Medicare Advantage |
$538.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health Medicare |
$538.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.55
|
| Rate for Payer: UHC Medicare Advantage |
$538.55
|
| Rate for Payer: UHCCP DNSP |
$538.55
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29897
|
| Min. Negotiated Rate |
$474.14 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$635.35
|
| Rate for Payer: Aetna Medicare |
$474.14
|
| Rate for Payer: BCBS Complete |
$776.80
|
| Rate for Payer: BCBS MAPPO |
$474.14
|
| Rate for Payer: BCN Medicare Advantage |
$474.14
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$682.76
|
| Rate for Payer: Cofinity Commercial |
$635.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.14
|
| Rate for Payer: Healthscope Commercial |
$568.97
|
| Rate for Payer: Healthscope Whirlpool |
$568.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.85
|
| Rate for Payer: Nomi Health Commercial |
$568.97
|
| Rate for Payer: PACE SWMI |
$474.14
|
| Rate for Payer: PHP Medicare Advantage |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health Medicare |
$474.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.14
|
| Rate for Payer: UHC Medicare Advantage |
$474.14
|
| Rate for Payer: UHCCP DNSP |
$474.14
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29895
|
| Min. Negotiated Rate |
$441.92 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$592.17
|
| Rate for Payer: Aetna Medicare |
$441.92
|
| Rate for Payer: BCBS Complete |
$750.80
|
| Rate for Payer: BCBS MAPPO |
$441.92
|
| Rate for Payer: BCN Medicare Advantage |
$441.92
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$636.36
|
| Rate for Payer: Cofinity Commercial |
$592.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.92
|
| Rate for Payer: Healthscope Commercial |
$530.30
|
| Rate for Payer: Healthscope Whirlpool |
$530.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.02
|
| Rate for Payer: Nomi Health Commercial |
$530.30
|
| Rate for Payer: PACE SWMI |
$441.92
|
| Rate for Payer: PHP Medicare Advantage |
$441.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health Medicare |
$441.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.92
|
| Rate for Payer: UHC Medicare Advantage |
$441.92
|
| Rate for Payer: UHCCP DNSP |
$441.92
|
|
|
PR ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
HCPCS 29899
|
| Min. Negotiated Rate |
$959.94 |
| Max. Negotiated Rate |
$2,007.85 |
| Rate for Payer: Aetna Commercial |
$1,286.32
|
| Rate for Payer: Aetna Medicare |
$959.94
|
| Rate for Payer: BCBS Complete |
$1,235.60
|
| Rate for Payer: BCBS MAPPO |
$959.94
|
| Rate for Payer: BCN Medicare Advantage |
$959.94
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cash Price |
$2,471.20
|
| Rate for Payer: Cofinity Commercial |
$1,382.31
|
| Rate for Payer: Cofinity Commercial |
$1,286.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.94
|
| Rate for Payer: Healthscope Commercial |
$1,151.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,151.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.94
|
| Rate for Payer: Nomi Health Commercial |
$1,151.93
|
| Rate for Payer: PACE SWMI |
$959.94
|
| Rate for Payer: PHP Medicare Advantage |
$959.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.85
|
| Rate for Payer: Priority Health Medicare |
$959.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.94
|
| Rate for Payer: UHC Medicare Advantage |
$959.94
|
| Rate for Payer: UHCCP DNSP |
$959.94
|
|
|
PR ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY
|
Professional
|
Both
|
$1,942.00
|
|
|
Service Code
|
HCPCS 29894
|
| Min. Negotiated Rate |
$487.28 |
| Max. Negotiated Rate |
$1,262.30 |
| Rate for Payer: Aetna Commercial |
$652.96
|
| Rate for Payer: Aetna Medicare |
$487.28
|
| Rate for Payer: BCBS Complete |
$776.80
|
| Rate for Payer: BCBS MAPPO |
$487.28
|
| Rate for Payer: BCN Medicare Advantage |
$487.28
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cash Price |
$1,553.60
|
| Rate for Payer: Cofinity Commercial |
$701.68
|
| Rate for Payer: Cofinity Commercial |
$652.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.28
|
| Rate for Payer: Healthscope Commercial |
$584.74
|
| Rate for Payer: Healthscope Whirlpool |
$584.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.64
|
| Rate for Payer: Nomi Health Commercial |
$584.74
|
| Rate for Payer: PACE SWMI |
$487.28
|
| Rate for Payer: PHP Medicare Advantage |
$487.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.30
|
| Rate for Payer: Priority Health Medicare |
$487.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.28
|
| Rate for Payer: UHC Medicare Advantage |
$487.28
|
| Rate for Payer: UHCCP DNSP |
$487.28
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29838
|
| Min. Negotiated Rate |
$574.32 |
| Max. Negotiated Rate |
$1,430.65 |
| Rate for Payer: Aetna Commercial |
$769.59
|
| Rate for Payer: Aetna Medicare |
$574.32
|
| Rate for Payer: BCBS Complete |
$880.40
|
| Rate for Payer: BCBS MAPPO |
$574.32
|
| Rate for Payer: BCN Medicare Advantage |
$574.32
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$827.02
|
| Rate for Payer: Cofinity Commercial |
$769.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.32
|
| Rate for Payer: Healthscope Commercial |
$689.18
|
| Rate for Payer: Healthscope Whirlpool |
$689.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$603.04
|
| Rate for Payer: Nomi Health Commercial |
$689.18
|
| Rate for Payer: PACE SWMI |
$574.32
|
| Rate for Payer: PHP Medicare Advantage |
$574.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health Medicare |
$574.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.32
|
| Rate for Payer: UHC Medicare Advantage |
$574.32
|
| Rate for Payer: UHCCP DNSP |
$574.32
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 29837
|
| Min. Negotiated Rate |
$503.31 |
| Max. Negotiated Rate |
$1,261.00 |
| Rate for Payer: Aetna Commercial |
$674.44
|
| Rate for Payer: Aetna Medicare |
$503.31
|
| Rate for Payer: BCBS Complete |
$776.00
|
| Rate for Payer: BCBS MAPPO |
$503.31
|
| Rate for Payer: BCN Medicare Advantage |
$503.31
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$724.77
|
| Rate for Payer: Cofinity Commercial |
$674.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.31
|
| Rate for Payer: Healthscope Commercial |
$603.97
|
| Rate for Payer: Healthscope Whirlpool |
$603.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.48
|
| Rate for Payer: Nomi Health Commercial |
$603.97
|
| Rate for Payer: PACE SWMI |
$503.31
|
| Rate for Payer: PHP Medicare Advantage |
$503.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health Medicare |
$503.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.31
|
| Rate for Payer: UHC Medicare Advantage |
$503.31
|
| Rate for Payer: UHCCP DNSP |
$503.31
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$1,040.00
|
|
|
Service Code
|
HCPCS 29836
|
| Min. Negotiated Rate |
$416.00 |
| Max. Negotiated Rate |
$815.50 |
| Rate for Payer: Aetna Commercial |
$758.87
|
| Rate for Payer: Aetna Medicare |
$566.32
|
| Rate for Payer: BCBS Complete |
$416.00
|
| Rate for Payer: BCBS MAPPO |
$566.32
|
| Rate for Payer: BCN Medicare Advantage |
$566.32
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Cofinity Commercial |
$815.50
|
| Rate for Payer: Cofinity Commercial |
$758.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.32
|
| Rate for Payer: Healthscope Commercial |
$679.58
|
| Rate for Payer: Healthscope Whirlpool |
$679.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.64
|
| Rate for Payer: Nomi Health Commercial |
$679.58
|
| Rate for Payer: PACE SWMI |
$566.32
|
| Rate for Payer: PHP Medicare Advantage |
$566.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.00
|
| Rate for Payer: Priority Health Medicare |
$566.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.32
|
| Rate for Payer: UHC Medicare Advantage |
$566.32
|
| Rate for Payer: UHCCP DNSP |
$566.32
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 29835
|
| Min. Negotiated Rate |
$494.19 |
| Max. Negotiated Rate |
$1,279.85 |
| Rate for Payer: Aetna Commercial |
$662.21
|
| Rate for Payer: Aetna Medicare |
$494.19
|
| Rate for Payer: BCBS Complete |
$787.60
|
| Rate for Payer: BCBS MAPPO |
$494.19
|
| Rate for Payer: BCN Medicare Advantage |
$494.19
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$711.63
|
| Rate for Payer: Cofinity Commercial |
$662.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.19
|
| Rate for Payer: Healthscope Commercial |
$593.03
|
| Rate for Payer: Healthscope Whirlpool |
$593.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.90
|
| Rate for Payer: Nomi Health Commercial |
$593.03
|
| Rate for Payer: PACE SWMI |
$494.19
|
| Rate for Payer: PHP Medicare Advantage |
$494.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health Medicare |
$494.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.19
|
| Rate for Payer: UHC Medicare Advantage |
$494.19
|
| Rate for Payer: UHCCP DNSP |
$494.19
|
|
|
PR ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 29834
|
| Min. Negotiated Rate |
$478.16 |
| Max. Negotiated Rate |
$1,199.25 |
| Rate for Payer: Aetna Commercial |
$640.73
|
| Rate for Payer: Aetna Medicare |
$478.16
|
| Rate for Payer: BCBS Complete |
$738.00
|
| Rate for Payer: BCBS MAPPO |
$478.16
|
| Rate for Payer: BCN Medicare Advantage |
$478.16
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Cofinity Commercial |
$688.55
|
| Rate for Payer: Cofinity Commercial |
$640.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.16
|
| Rate for Payer: Healthscope Commercial |
$573.79
|
| Rate for Payer: Healthscope Whirlpool |
$573.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.07
|
| Rate for Payer: Nomi Health Commercial |
$573.79
|
| Rate for Payer: PACE SWMI |
$478.16
|
| Rate for Payer: PHP Medicare Advantage |
$478.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.25
|
| Rate for Payer: Priority Health Medicare |
$478.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.16
|
| Rate for Payer: UHC Medicare Advantage |
$478.16
|
| Rate for Payer: UHCCP DNSP |
$478.16
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,444.00
|
|
|
Service Code
|
HCPCS 29861
|
| Min. Negotiated Rate |
$671.37 |
| Max. Negotiated Rate |
$1,588.60 |
| Rate for Payer: Aetna Commercial |
$899.64
|
| Rate for Payer: Aetna Medicare |
$671.37
|
| Rate for Payer: BCBS Complete |
$977.60
|
| Rate for Payer: BCBS MAPPO |
$671.37
|
| Rate for Payer: BCN Medicare Advantage |
$671.37
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cofinity Commercial |
$966.77
|
| Rate for Payer: Cofinity Commercial |
$899.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.37
|
| Rate for Payer: Healthscope Commercial |
$805.64
|
| Rate for Payer: Healthscope Whirlpool |
$805.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.94
|
| Rate for Payer: Nomi Health Commercial |
$805.64
|
| Rate for Payer: PACE SWMI |
$671.37
|
| Rate for Payer: PHP Medicare Advantage |
$671.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,588.60
|
| Rate for Payer: Priority Health Medicare |
$671.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$671.37
|
| Rate for Payer: UHC Medicare Advantage |
$671.37
|
| Rate for Payer: UHCCP DNSP |
$671.37
|
|
|
PR ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 29863
|
| Min. Negotiated Rate |
$658.80 |
| Max. Negotiated Rate |
$1,131.13 |
| Rate for Payer: Aetna Commercial |
$1,052.58
|
| Rate for Payer: Aetna Medicare |
$785.51
|
| Rate for Payer: BCBS Complete |
$658.80
|
| Rate for Payer: BCBS MAPPO |
$785.51
|
| Rate for Payer: BCN Medicare Advantage |
$785.51
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$1,131.13
|
| Rate for Payer: Cofinity Commercial |
$1,052.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.51
|
| Rate for Payer: Healthscope Commercial |
$942.61
|
| Rate for Payer: Healthscope Whirlpool |
$942.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.79
|
| Rate for Payer: Nomi Health Commercial |
$942.61
|
| Rate for Payer: PACE SWMI |
$785.51
|
| Rate for Payer: PHP Medicare Advantage |
$785.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.55
|
| Rate for Payer: Priority Health Medicare |
$785.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.51
|
| Rate for Payer: UHC Medicare Advantage |
$785.51
|
| Rate for Payer: UHCCP DNSP |
$785.51
|
|
|
PR ARTHROSCOPY HIP W/ACETABULOPLASTY
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 29915
|
| Min. Negotiated Rate |
$977.43 |
| Max. Negotiated Rate |
$2,118.35 |
| Rate for Payer: Aetna Commercial |
$1,309.76
|
| Rate for Payer: Aetna Medicare |
$977.43
|
| Rate for Payer: BCBS Complete |
$1,303.60
|
| Rate for Payer: BCBS MAPPO |
$977.43
|
| Rate for Payer: BCN Medicare Advantage |
$977.43
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cofinity Commercial |
$1,407.50
|
| Rate for Payer: Cofinity Commercial |
$1,309.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$977.43
|
| Rate for Payer: Healthscope Commercial |
$1,172.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,172.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,026.30
|
| Rate for Payer: Nomi Health Commercial |
$1,172.92
|
| Rate for Payer: PACE SWMI |
$977.43
|
| Rate for Payer: PHP Medicare Advantage |
$977.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health Medicare |
$977.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$977.43
|
| Rate for Payer: UHC Medicare Advantage |
$977.43
|
| Rate for Payer: UHCCP DNSP |
$977.43
|
|
|
PR ARTHROSCOPY HIP W/FEMOROPLASTY
|
Professional
|
Both
|
$3,063.00
|
|
|
Service Code
|
HCPCS 29914
|
| Min. Negotiated Rate |
$958.71 |
| Max. Negotiated Rate |
$1,990.95 |
| Rate for Payer: Aetna Commercial |
$1,284.67
|
| Rate for Payer: Aetna Medicare |
$958.71
|
| Rate for Payer: BCBS Complete |
$1,225.20
|
| Rate for Payer: BCBS MAPPO |
$958.71
|
| Rate for Payer: BCN Medicare Advantage |
$958.71
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cash Price |
$2,450.40
|
| Rate for Payer: Cofinity Commercial |
$1,380.54
|
| Rate for Payer: Cofinity Commercial |
$1,284.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.71
|
| Rate for Payer: Healthscope Commercial |
$1,150.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,150.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.65
|
| Rate for Payer: Nomi Health Commercial |
$1,150.45
|
| Rate for Payer: PACE SWMI |
$958.71
|
| Rate for Payer: PHP Medicare Advantage |
$958.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.95
|
| Rate for Payer: Priority Health Medicare |
$958.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.71
|
| Rate for Payer: UHC Medicare Advantage |
$958.71
|
| Rate for Payer: UHCCP DNSP |
$958.71
|
|
|
PR ARTHROSCOPY HIP W/LABRAL REPAIR
|
Professional
|
Both
|
$3,274.00
|
|
|
Service Code
|
HCPCS 29916
|
| Min. Negotiated Rate |
$978.52 |
| Max. Negotiated Rate |
$2,128.10 |
| Rate for Payer: Aetna Commercial |
$1,311.22
|
| Rate for Payer: Aetna Medicare |
$978.52
|
| Rate for Payer: BCBS Complete |
$1,309.60
|
| Rate for Payer: BCBS MAPPO |
$978.52
|
| Rate for Payer: BCN Medicare Advantage |
$978.52
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cofinity Commercial |
$1,409.07
|
| Rate for Payer: Cofinity Commercial |
$1,311.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.52
|
| Rate for Payer: Healthscope Commercial |
$1,174.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,174.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.45
|
| Rate for Payer: Nomi Health Commercial |
$1,174.22
|
| Rate for Payer: PACE SWMI |
$978.52
|
| Rate for Payer: PHP Medicare Advantage |
$978.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.10
|
| Rate for Payer: Priority Health Medicare |
$978.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.52
|
| Rate for Payer: UHC Medicare Advantage |
$978.52
|
| Rate for Payer: UHCCP DNSP |
$978.52
|
|
|
PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 29870
|
| Min. Negotiated Rate |
$399.51 |
| Max. Negotiated Rate |
$736.45 |
| Rate for Payer: Aetna Commercial |
$535.34
|
| Rate for Payer: Aetna Medicare |
$399.51
|
| Rate for Payer: BCBS Complete |
$453.20
|
| Rate for Payer: BCBS MAPPO |
$399.51
|
| Rate for Payer: BCN Medicare Advantage |
$399.51
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$575.29
|
| Rate for Payer: Cofinity Commercial |
$535.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.51
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Healthscope Whirlpool |
$479.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.49
|
| Rate for Payer: Nomi Health Commercial |
$479.41
|
| Rate for Payer: PACE SWMI |
$399.51
|
| Rate for Payer: PHP Medicare Advantage |
$399.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.45
|
| Rate for Payer: Priority Health Medicare |
$399.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.51
|
| Rate for Payer: UHC Medicare Advantage |
$399.51
|
| Rate for Payer: UHCCP DNSP |
$399.51
|
|
|
PR ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 29871
|
| Min. Negotiated Rate |
$498.35 |
| Max. Negotiated Rate |
$1,051.70 |
| Rate for Payer: Aetna Commercial |
$667.79
|
| Rate for Payer: Aetna Medicare |
$498.35
|
| Rate for Payer: BCBS Complete |
$647.20
|
| Rate for Payer: BCBS MAPPO |
$498.35
|
| Rate for Payer: BCN Medicare Advantage |
$498.35
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$717.62
|
| Rate for Payer: Cofinity Commercial |
$667.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.35
|
| Rate for Payer: Healthscope Commercial |
$598.02
|
| Rate for Payer: Healthscope Whirlpool |
$598.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.27
|
| Rate for Payer: Nomi Health Commercial |
$598.02
|
| Rate for Payer: PACE SWMI |
$498.35
|
| Rate for Payer: PHP Medicare Advantage |
$498.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.70
|
| Rate for Payer: Priority Health Medicare |
$498.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.35
|
| Rate for Payer: UHC Medicare Advantage |
$498.35
|
| Rate for Payer: UHCCP DNSP |
$498.35
|
|
|
PR ARTHROSCOPY KNEE LATERAL RELEASE
|
Professional
|
Both
|
$1,974.00
|
|
|
Service Code
|
HCPCS 29873
|
| Min. Negotiated Rate |
$516.84 |
| Max. Negotiated Rate |
$1,283.10 |
| Rate for Payer: Aetna Commercial |
$692.57
|
| Rate for Payer: Aetna Medicare |
$516.84
|
| Rate for Payer: BCBS Complete |
$789.60
|
| Rate for Payer: BCBS MAPPO |
$516.84
|
| Rate for Payer: BCN Medicare Advantage |
$516.84
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cash Price |
$1,579.20
|
| Rate for Payer: Cofinity Commercial |
$744.25
|
| Rate for Payer: Cofinity Commercial |
$692.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.84
|
| Rate for Payer: Healthscope Commercial |
$620.21
|
| Rate for Payer: Healthscope Whirlpool |
$620.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$542.68
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: PACE SWMI |
$516.84
|
| Rate for Payer: PHP Medicare Advantage |
$516.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.10
|
| Rate for Payer: Priority Health Medicare |
$516.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.84
|
| Rate for Payer: UHC Medicare Advantage |
$516.84
|
| Rate for Payer: UHCCP DNSP |
$516.84
|
|
