|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$2,586.00
|
|
|
Service Code
|
HCPCS 27334
|
| Min. Negotiated Rate |
$414.50 |
| Max. Negotiated Rate |
$1,939.50 |
| Rate for Payer: Aetna Commercial |
$848.46
|
| Rate for Payer: Aetna Medicare |
$633.18
|
| Rate for Payer: BCBS Complete |
$435.23
|
| Rate for Payer: BCBS MAPPO |
$633.18
|
| Rate for Payer: BCN Commercial |
$1,052.23
|
| Rate for Payer: BCN Medicare Advantage |
$633.18
|
| Rate for Payer: Cash Price |
$2,068.80
|
| Rate for Payer: Cash Price |
$2,068.80
|
| Rate for Payer: Cofinity Commercial |
$911.78
|
| Rate for Payer: Cofinity Commercial |
$848.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.18
|
| Rate for Payer: Healthscope Commercial |
$759.82
|
| Rate for Payer: Healthscope Whirlpool |
$759.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.84
|
| Rate for Payer: Meridian Medicaid |
$435.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$696.50
|
| Rate for Payer: Nomi Health Commercial |
$759.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,939.50
|
| Rate for Payer: PACE SWMI |
$633.18
|
| Rate for Payer: PHP Medicare Advantage |
$633.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,124.81
|
| Rate for Payer: Priority Health Medicare |
$633.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.81
|
| Rate for Payer: Railroad Medicare Medicare |
$633.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,193.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$633.18
|
| Rate for Payer: UHC Exchange |
$1,193.92
|
| Rate for Payer: UHC Medicaid |
$414.50
|
| Rate for Payer: UHCCP DNSP |
$633.18
|
| Rate for Payer: UHCCP Medicaid |
$414.50
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$2,878.00
|
|
|
Service Code
|
HCPCS 27130
|
| Min. Negotiated Rate |
$741.03 |
| Max. Negotiated Rate |
$2,385.21 |
| Rate for Payer: Aetna Commercial |
$1,535.20
|
| Rate for Payer: Aetna Medicare |
$1,145.67
|
| Rate for Payer: BCBS Complete |
$778.08
|
| Rate for Payer: BCBS MAPPO |
$1,145.67
|
| Rate for Payer: BCN Commercial |
$2,129.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,145.67
|
| Rate for Payer: Cash Price |
$2,302.40
|
| Rate for Payer: Cash Price |
$2,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,649.76
|
| Rate for Payer: Cofinity Commercial |
$1,535.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,145.67
|
| Rate for Payer: Healthscope Commercial |
$1,374.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,374.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,202.95
|
| Rate for Payer: Meridian Medicaid |
$778.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.24
|
| Rate for Payer: Nomi Health Commercial |
$1,374.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,158.50
|
| Rate for Payer: PACE SWMI |
$1,145.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,145.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,072.35
|
| Rate for Payer: Priority Health Medicare |
$1,145.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,072.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,145.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,385.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,145.67
|
| Rate for Payer: UHC Exchange |
$2,385.21
|
| Rate for Payer: UHC Medicaid |
$741.03
|
| Rate for Payer: UHCCP DNSP |
$1,145.67
|
| Rate for Payer: UHCCP Medicaid |
$741.03
|
|
|
PR ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM
|
Professional
|
Both
|
$5,345.00
|
|
|
Service Code
|
HCPCS 24363
|
| Min. Negotiated Rate |
$829.42 |
| Max. Negotiated Rate |
$4,008.75 |
| Rate for Payer: Aetna Commercial |
$1,716.61
|
| Rate for Payer: Aetna Medicare |
$1,281.05
|
| Rate for Payer: BCBS Complete |
$870.89
|
| Rate for Payer: BCBS MAPPO |
$1,281.05
|
| Rate for Payer: BCN Commercial |
$2,188.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,281.05
|
| Rate for Payer: Cash Price |
$4,276.00
|
| Rate for Payer: Cash Price |
$4,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,844.71
|
| Rate for Payer: Cofinity Commercial |
$1,716.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,281.05
|
| Rate for Payer: Healthscope Commercial |
$1,537.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,537.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,345.10
|
| Rate for Payer: Meridian Medicaid |
$870.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,409.15
|
| Rate for Payer: Nomi Health Commercial |
$1,537.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,008.75
|
| Rate for Payer: PACE SWMI |
$1,281.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,281.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,339.58
|
| Rate for Payer: Priority Health Medicare |
$1,281.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,339.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,281.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,551.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,281.05
|
| Rate for Payer: UHC Exchange |
$2,551.88
|
| Rate for Payer: UHC Medicaid |
$829.42
|
| Rate for Payer: UHCCP DNSP |
$1,281.05
|
| Rate for Payer: UHCCP Medicaid |
$829.42
|
|
|
PR ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL
|
Professional
|
Both
|
$1,501.00
|
|
|
Service Code
|
HCPCS 27443
|
| Min. Negotiated Rate |
$485.85 |
| Max. Negotiated Rate |
$1,421.21 |
| Rate for Payer: Aetna Commercial |
$998.30
|
| Rate for Payer: Aetna Medicare |
$745.00
|
| Rate for Payer: BCBS Complete |
$510.14
|
| Rate for Payer: BCBS MAPPO |
$745.00
|
| Rate for Payer: BCN Commercial |
$1,244.95
|
| Rate for Payer: BCN Medicare Advantage |
$745.00
|
| Rate for Payer: Cash Price |
$1,200.80
|
| Rate for Payer: Cash Price |
$1,200.80
|
| Rate for Payer: Cofinity Commercial |
$998.30
|
| Rate for Payer: Cofinity Commercial |
$1,072.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.00
|
| Rate for Payer: Healthscope Commercial |
$894.00
|
| Rate for Payer: Healthscope Whirlpool |
$894.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.25
|
| Rate for Payer: Meridian Medicaid |
$510.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$819.50
|
| Rate for Payer: Nomi Health Commercial |
$894.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.75
|
| Rate for Payer: PACE SWMI |
$745.00
|
| Rate for Payer: PHP Medicare Advantage |
$745.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,330.82
|
| Rate for Payer: Priority Health Medicare |
$745.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,330.82
|
| Rate for Payer: Railroad Medicare Medicare |
$745.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,421.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$745.00
|
| Rate for Payer: UHC Exchange |
$1,421.21
|
| Rate for Payer: UHC Medicaid |
$485.85
|
| Rate for Payer: UHCCP DNSP |
$745.00
|
| Rate for Payer: UHCCP Medicaid |
$485.85
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Professional
|
Both
|
$3,130.00
|
|
|
Service Code
|
HCPCS 25447
|
| Min. Negotiated Rate |
$474.35 |
| Max. Negotiated Rate |
$2,347.50 |
| Rate for Payer: Aetna Commercial |
$968.85
|
| Rate for Payer: Aetna Medicare |
$723.02
|
| Rate for Payer: BCBS Complete |
$498.07
|
| Rate for Payer: BCBS MAPPO |
$723.02
|
| Rate for Payer: BCN Commercial |
$1,224.04
|
| Rate for Payer: BCN Medicare Advantage |
$723.02
|
| Rate for Payer: Cash Price |
$2,504.00
|
| Rate for Payer: Cash Price |
$2,504.00
|
| Rate for Payer: Cofinity Commercial |
$968.85
|
| Rate for Payer: Cofinity Commercial |
$1,041.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$723.02
|
| Rate for Payer: Healthscope Commercial |
$867.62
|
| Rate for Payer: Healthscope Whirlpool |
$867.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.17
|
| Rate for Payer: Meridian Medicaid |
$498.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$795.32
|
| Rate for Payer: Nomi Health Commercial |
$867.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,347.50
|
| Rate for Payer: PACE SWMI |
$723.02
|
| Rate for Payer: PHP Medicare Advantage |
$723.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,308.47
|
| Rate for Payer: Priority Health Medicare |
$723.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,308.47
|
| Rate for Payer: Railroad Medicare Medicare |
$723.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,442.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$723.02
|
| Rate for Payer: UHC Exchange |
$1,442.01
|
| Rate for Payer: UHC Medicaid |
$474.35
|
| Rate for Payer: UHCCP DNSP |
$723.02
|
| Rate for Payer: UHCCP Medicaid |
$474.35
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION
|
Professional
|
Both
|
$2,637.00
|
|
|
Service Code
|
HCPCS 25448
|
| Min. Negotiated Rate |
$522.49 |
| Max. Negotiated Rate |
$1,977.75 |
| Rate for Payer: Aetna Commercial |
$1,068.62
|
| Rate for Payer: Aetna Medicare |
$797.48
|
| Rate for Payer: BCBS Complete |
$548.61
|
| Rate for Payer: BCBS MAPPO |
$797.48
|
| Rate for Payer: BCN Commercial |
$1,351.52
|
| Rate for Payer: BCN Medicare Advantage |
$797.48
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cofinity Commercial |
$1,148.37
|
| Rate for Payer: Cofinity Commercial |
$1,068.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$797.48
|
| Rate for Payer: Healthscope Commercial |
$956.98
|
| Rate for Payer: Healthscope Whirlpool |
$956.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.35
|
| Rate for Payer: Meridian Medicaid |
$548.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$877.23
|
| Rate for Payer: Nomi Health Commercial |
$956.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,977.75
|
| Rate for Payer: PACE SWMI |
$797.48
|
| Rate for Payer: PHP Medicare Advantage |
$797.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,444.73
|
| Rate for Payer: Priority Health Medicare |
$797.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,444.73
|
| Rate for Payer: Railroad Medicare Medicare |
$797.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,634.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$797.48
|
| Rate for Payer: UHC Exchange |
$1,634.43
|
| Rate for Payer: UHC Medicaid |
$522.49
|
| Rate for Payer: UHCCP DNSP |
$797.48
|
| Rate for Payer: UHCCP Medicaid |
$522.49
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION
|
Facility
|
OP
|
$2,637.00
|
|
|
Service Code
|
CPT 25448
|
| Hospital Charge Code |
25448
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$5,053.36 |
| Rate for Payer: Aetna Commercial |
$2,373.30
|
| Rate for Payer: Aetna Medicare |
$3,260.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: ASR ASR |
$2,557.89
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,174.21
|
| Rate for Payer: BCN Commercial |
$2,174.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cofinity Commercial |
$2,478.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,109.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$2,557.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,637.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,260.23
|
| Rate for Payer: Mclaren Commercial |
$2,373.30
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$1,790.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,241.45
|
| Rate for Payer: Nomi Health Commercial |
$2,162.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,977.75
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$3,586.25
|
| Rate for Payer: PHP Medicaid |
$1,747.48
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,577.18
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,861.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,320.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$5,053.36
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP DNSP |
$3,260.23
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION
|
Professional
|
Both
|
$2,637.00
|
|
|
Service Code
|
HCPCS 25448
|
| Hospital Charge Code |
25448
|
| Min. Negotiated Rate |
$522.49 |
| Max. Negotiated Rate |
$1,977.75 |
| Rate for Payer: Aetna Commercial |
$1,068.62
|
| Rate for Payer: Aetna Medicare |
$797.48
|
| Rate for Payer: BCBS Complete |
$548.61
|
| Rate for Payer: BCBS MAPPO |
$797.48
|
| Rate for Payer: BCN Commercial |
$1,351.52
|
| Rate for Payer: BCN Medicare Advantage |
$797.48
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cofinity Commercial |
$1,148.37
|
| Rate for Payer: Cofinity Commercial |
$1,068.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$797.48
|
| Rate for Payer: Healthscope Commercial |
$956.98
|
| Rate for Payer: Healthscope Whirlpool |
$956.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.35
|
| Rate for Payer: Meridian Medicaid |
$548.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$877.23
|
| Rate for Payer: Nomi Health Commercial |
$956.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,977.75
|
| Rate for Payer: PACE SWMI |
$797.48
|
| Rate for Payer: PHP Medicare Advantage |
$797.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,444.73
|
| Rate for Payer: Priority Health Medicare |
$797.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,444.73
|
| Rate for Payer: Railroad Medicare Medicare |
$797.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,634.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$797.48
|
| Rate for Payer: UHC Exchange |
$1,634.43
|
| Rate for Payer: UHC Medicaid |
$522.49
|
| Rate for Payer: UHCCP DNSP |
$797.48
|
| Rate for Payer: UHCCP Medicaid |
$522.49
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION
|
Facility
|
IP
|
$2,637.00
|
|
|
Service Code
|
CPT 25448
|
| Hospital Charge Code |
25448
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$1,977.75 |
| Max. Negotiated Rate |
$2,637.00 |
| Rate for Payer: Aetna Commercial |
$2,373.30
|
| Rate for Payer: ASR ASR |
$2,557.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,165.50
|
| Rate for Payer: BCN Commercial |
$2,165.50
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cofinity Commercial |
$2,478.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,109.60
|
| Rate for Payer: Healthscope Commercial |
$2,557.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,637.00
|
| Rate for Payer: Mclaren Commercial |
$2,373.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,241.45
|
| Rate for Payer: Nomi Health Commercial |
$2,162.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,977.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,320.56
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Professional
|
Both
|
$5,157.00
|
|
|
Service Code
|
HCPCS 27447
|
| Min. Negotiated Rate |
$739.32 |
| Max. Negotiated Rate |
$3,867.75 |
| Rate for Payer: Aetna Commercial |
$1,531.65
|
| Rate for Payer: Aetna Medicare |
$1,143.02
|
| Rate for Payer: BCBS Complete |
$776.29
|
| Rate for Payer: BCBS MAPPO |
$1,143.02
|
| Rate for Payer: BCN Commercial |
$2,127.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,143.02
|
| Rate for Payer: Cash Price |
$4,125.60
|
| Rate for Payer: Cash Price |
$4,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,645.95
|
| Rate for Payer: Cofinity Commercial |
$1,531.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,143.02
|
| Rate for Payer: Healthscope Commercial |
$1,371.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,371.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,200.17
|
| Rate for Payer: Meridian Medicaid |
$776.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,257.32
|
| Rate for Payer: Nomi Health Commercial |
$1,371.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,867.75
|
| Rate for Payer: PACE SWMI |
$1,143.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,143.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$739.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,069.69
|
| Rate for Payer: Priority Health Medicare |
$1,143.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,069.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,143.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,382.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,143.02
|
| Rate for Payer: UHC Exchange |
$2,382.23
|
| Rate for Payer: UHC Medicaid |
$739.32
|
| Rate for Payer: UHCCP DNSP |
$1,143.02
|
| Rate for Payer: UHCCP Medicaid |
$739.32
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$3,318.00
|
|
|
Service Code
|
HCPCS 27446
|
| Min. Negotiated Rate |
$667.97 |
| Max. Negotiated Rate |
$2,488.50 |
| Rate for Payer: Aetna Commercial |
$1,380.63
|
| Rate for Payer: Aetna Medicare |
$1,030.32
|
| Rate for Payer: BCBS Complete |
$701.37
|
| Rate for Payer: BCBS MAPPO |
$1,030.32
|
| Rate for Payer: BCN Commercial |
$1,736.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,030.32
|
| Rate for Payer: Cash Price |
$2,654.40
|
| Rate for Payer: Cash Price |
$2,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,483.66
|
| Rate for Payer: Cofinity Commercial |
$1,380.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,030.32
|
| Rate for Payer: Healthscope Commercial |
$1,236.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,236.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,081.84
|
| Rate for Payer: Meridian Medicaid |
$701.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,133.35
|
| Rate for Payer: Nomi Health Commercial |
$1,236.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,488.50
|
| Rate for Payer: PACE SWMI |
$1,030.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,030.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,856.22
|
| Rate for Payer: Priority Health Medicare |
$1,030.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,856.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,030.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,035.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,030.32
|
| Rate for Payer: UHC Exchange |
$2,035.73
|
| Rate for Payer: UHC Medicaid |
$667.97
|
| Rate for Payer: UHCCP DNSP |
$1,030.32
|
| Rate for Payer: UHCCP Medicaid |
$667.97
|
|
|
PR ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT
|
Professional
|
Both
|
$1,741.00
|
|
|
Service Code
|
HCPCS 27441
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$1,441.19 |
| Rate for Payer: Aetna Commercial |
$1,007.28
|
| Rate for Payer: Aetna Medicare |
$751.70
|
| Rate for Payer: BCBS Complete |
$514.62
|
| Rate for Payer: BCBS MAPPO |
$751.70
|
| Rate for Payer: BCN Commercial |
$1,256.41
|
| Rate for Payer: BCN Medicare Advantage |
$751.70
|
| Rate for Payer: Cash Price |
$1,392.80
|
| Rate for Payer: Cash Price |
$1,392.80
|
| Rate for Payer: Cofinity Commercial |
$1,082.45
|
| Rate for Payer: Cofinity Commercial |
$1,007.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.70
|
| Rate for Payer: Healthscope Commercial |
$902.04
|
| Rate for Payer: Healthscope Whirlpool |
$902.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$789.28
|
| Rate for Payer: Meridian Medicaid |
$514.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$826.87
|
| Rate for Payer: Nomi Health Commercial |
$902.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,305.75
|
| Rate for Payer: PACE SWMI |
$751.70
|
| Rate for Payer: PHP Medicare Advantage |
$751.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,343.06
|
| Rate for Payer: Priority Health Medicare |
$751.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,343.06
|
| Rate for Payer: Railroad Medicare Medicare |
$751.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,441.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$751.70
|
| Rate for Payer: UHC Exchange |
$1,441.19
|
| Rate for Payer: UHC Medicaid |
$490.11
|
| Rate for Payer: UHCCP DNSP |
$751.70
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
|
|
PR ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT
|
Professional
|
Both
|
$2,246.00
|
|
|
Service Code
|
HCPCS 26531
|
| Min. Negotiated Rate |
$375.09 |
| Max. Negotiated Rate |
$1,684.50 |
| Rate for Payer: Aetna Commercial |
$764.89
|
| Rate for Payer: Aetna Medicare |
$570.81
|
| Rate for Payer: BCBS Complete |
$393.84
|
| Rate for Payer: BCBS MAPPO |
$570.81
|
| Rate for Payer: BCN Commercial |
$973.05
|
| Rate for Payer: BCN Medicare Advantage |
$570.81
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cash Price |
$1,796.80
|
| Rate for Payer: Cofinity Commercial |
$821.97
|
| Rate for Payer: Cofinity Commercial |
$764.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.81
|
| Rate for Payer: Healthscope Commercial |
$684.97
|
| Rate for Payer: Healthscope Whirlpool |
$684.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.35
|
| Rate for Payer: Meridian Medicaid |
$393.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$627.89
|
| Rate for Payer: Nomi Health Commercial |
$684.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,684.50
|
| Rate for Payer: PACE SWMI |
$570.81
|
| Rate for Payer: PHP Medicare Advantage |
$570.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,040.17
|
| Rate for Payer: Priority Health Medicare |
$570.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,040.17
|
| Rate for Payer: Railroad Medicare Medicare |
$570.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,089.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$570.81
|
| Rate for Payer: UHC Exchange |
$1,089.26
|
| Rate for Payer: UHC Medicaid |
$375.09
|
| Rate for Payer: UHCCP DNSP |
$570.81
|
| Rate for Payer: UHCCP Medicaid |
$375.09
|
|
|
PR ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/ENTIR CARPS
|
Professional
|
Both
|
$2,157.00
|
|
|
Service Code
|
HCPCS 25446
|
| Min. Negotiated Rate |
$670.74 |
| Max. Negotiated Rate |
$2,054.38 |
| Rate for Payer: Aetna Commercial |
$1,384.18
|
| Rate for Payer: Aetna Medicare |
$1,032.97
|
| Rate for Payer: BCBS Complete |
$704.28
|
| Rate for Payer: BCBS MAPPO |
$1,032.97
|
| Rate for Payer: BCN Commercial |
$1,777.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,032.97
|
| Rate for Payer: Cash Price |
$1,725.60
|
| Rate for Payer: Cash Price |
$1,725.60
|
| Rate for Payer: Cofinity Commercial |
$1,487.48
|
| Rate for Payer: Cofinity Commercial |
$1,384.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,032.97
|
| Rate for Payer: Healthscope Commercial |
$1,239.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,084.62
|
| Rate for Payer: Meridian Medicaid |
$704.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,136.27
|
| Rate for Payer: Nomi Health Commercial |
$1,239.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,617.75
|
| Rate for Payer: PACE SWMI |
$1,032.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,032.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,899.88
|
| Rate for Payer: Priority Health Medicare |
$1,032.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,899.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,032.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,054.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,032.97
|
| Rate for Payer: UHC Exchange |
$2,054.38
|
| Rate for Payer: UHC Medicaid |
$670.74
|
| Rate for Payer: UHCCP DNSP |
$1,032.97
|
| Rate for Payer: UHCCP Medicaid |
$670.74
|
|
|
PR ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ
|
Professional
|
Both
|
$3,795.00
|
|
|
Service Code
|
HCPCS 25332
|
| Min. Negotiated Rate |
$494.16 |
| Max. Negotiated Rate |
$2,846.25 |
| Rate for Payer: Aetna Commercial |
$1,014.07
|
| Rate for Payer: Aetna Medicare |
$756.77
|
| Rate for Payer: BCBS Complete |
$518.87
|
| Rate for Payer: BCBS MAPPO |
$756.77
|
| Rate for Payer: BCN Commercial |
$1,290.77
|
| Rate for Payer: BCN Medicare Advantage |
$756.77
|
| Rate for Payer: Cash Price |
$3,036.00
|
| Rate for Payer: Cash Price |
$3,036.00
|
| Rate for Payer: Cofinity Commercial |
$1,089.75
|
| Rate for Payer: Cofinity Commercial |
$1,014.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.77
|
| Rate for Payer: Healthscope Commercial |
$908.12
|
| Rate for Payer: Healthscope Whirlpool |
$908.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.61
|
| Rate for Payer: Meridian Medicaid |
$518.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$832.45
|
| Rate for Payer: Nomi Health Commercial |
$908.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,846.25
|
| Rate for Payer: PACE SWMI |
$756.77
|
| Rate for Payer: PHP Medicare Advantage |
$756.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,379.79
|
| Rate for Payer: Priority Health Medicare |
$756.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,379.79
|
| Rate for Payer: Railroad Medicare Medicare |
$756.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,470.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$756.77
|
| Rate for Payer: UHC Exchange |
$1,470.82
|
| Rate for Payer: UHC Medicaid |
$494.16
|
| Rate for Payer: UHCCP DNSP |
$756.77
|
| Rate for Payer: UHCCP Medicaid |
$494.16
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 29888
|
| Min. Negotiated Rate |
$567.22 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$1,168.96
|
| Rate for Payer: Aetna Medicare |
$872.36
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$872.36
|
| Rate for Payer: BCN Commercial |
$1,619.33
|
| Rate for Payer: BCN Medicare Advantage |
$872.36
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,256.20
|
| Rate for Payer: Cofinity Commercial |
$1,168.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.36
|
| Rate for Payer: Healthscope Commercial |
$1,046.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,046.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.98
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$959.60
|
| Rate for Payer: Nomi Health Commercial |
$1,046.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,150.00
|
| Rate for Payer: PACE SWMI |
$872.36
|
| Rate for Payer: PHP Medicare Advantage |
$872.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,575.70
|
| Rate for Payer: Priority Health Medicare |
$872.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.70
|
| Rate for Payer: Railroad Medicare Medicare |
$872.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,717.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$872.36
|
| Rate for Payer: UHC Exchange |
$1,717.90
|
| Rate for Payer: UHC Medicaid |
$567.22
|
| Rate for Payer: UHCCP DNSP |
$872.36
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
|
|
PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,364.00
|
|
|
Service Code
|
HCPCS 29889
|
| Min. Negotiated Rate |
$722.07 |
| Max. Negotiated Rate |
$3,273.00 |
| Rate for Payer: Aetna Commercial |
$1,486.25
|
| Rate for Payer: Aetna Medicare |
$1,109.14
|
| Rate for Payer: BCBS Complete |
$758.17
|
| Rate for Payer: BCBS MAPPO |
$1,109.14
|
| Rate for Payer: BCN Commercial |
$1,859.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.14
|
| Rate for Payer: Cash Price |
$3,491.20
|
| Rate for Payer: Cash Price |
$3,491.20
|
| Rate for Payer: Cofinity Commercial |
$1,597.16
|
| Rate for Payer: Cofinity Commercial |
$1,486.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.14
|
| Rate for Payer: Healthscope Commercial |
$1,330.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,330.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,164.60
|
| Rate for Payer: Meridian Medicaid |
$758.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,220.05
|
| Rate for Payer: Nomi Health Commercial |
$1,330.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,273.00
|
| Rate for Payer: PACE SWMI |
$1,109.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,987.71
|
| Rate for Payer: Priority Health Medicare |
$1,109.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,987.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,109.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,140.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,109.14
|
| Rate for Payer: UHC Exchange |
$2,140.55
|
| Rate for Payer: UHC Medicaid |
$722.07
|
| Rate for Payer: UHCCP DNSP |
$1,109.14
|
| Rate for Payer: UHCCP Medicaid |
$722.07
|
|
|
PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX
|
Professional
|
Both
|
$2,769.00
|
|
|
Service Code
|
HCPCS 29892
|
| Min. Negotiated Rate |
$381.06 |
| Max. Negotiated Rate |
$2,076.75 |
| Rate for Payer: Aetna Commercial |
$782.20
|
| Rate for Payer: Aetna Medicare |
$583.73
|
| Rate for Payer: BCBS Complete |
$400.11
|
| Rate for Payer: BCBS MAPPO |
$583.73
|
| Rate for Payer: BCN Commercial |
$974.55
|
| Rate for Payer: BCN Medicare Advantage |
$583.73
|
| Rate for Payer: Cash Price |
$2,215.20
|
| Rate for Payer: Cash Price |
$2,215.20
|
| Rate for Payer: Cofinity Commercial |
$840.57
|
| Rate for Payer: Cofinity Commercial |
$782.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.73
|
| Rate for Payer: Healthscope Commercial |
$700.48
|
| Rate for Payer: Healthscope Whirlpool |
$700.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.92
|
| Rate for Payer: Meridian Medicaid |
$400.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$642.10
|
| Rate for Payer: Nomi Health Commercial |
$700.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,076.75
|
| Rate for Payer: PACE SWMI |
$583.73
|
| Rate for Payer: PHP Medicare Advantage |
$583.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,041.76
|
| Rate for Payer: Priority Health Medicare |
$583.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,041.76
|
| Rate for Payer: Railroad Medicare Medicare |
$583.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,140.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$583.73
|
| Rate for Payer: UHC Exchange |
$1,140.48
|
| Rate for Payer: UHC Medicaid |
$381.06
|
| Rate for Payer: UHCCP DNSP |
$583.73
|
| Rate for Payer: UHCCP Medicaid |
$381.06
|
|
|
PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,618.00
|
|
|
Service Code
|
HCPCS 29855
|
| Min. Negotiated Rate |
$465.41 |
| Max. Negotiated Rate |
$1,963.50 |
| Rate for Payer: Aetna Commercial |
$954.59
|
| Rate for Payer: Aetna Medicare |
$712.38
|
| Rate for Payer: BCBS Complete |
$488.68
|
| Rate for Payer: BCBS MAPPO |
$712.38
|
| Rate for Payer: BCN Commercial |
$1,189.68
|
| Rate for Payer: BCN Medicare Advantage |
$712.38
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cofinity Commercial |
$954.59
|
| Rate for Payer: Cofinity Commercial |
$1,025.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.38
|
| Rate for Payer: Healthscope Commercial |
$854.86
|
| Rate for Payer: Healthscope Whirlpool |
$854.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$748.00
|
| Rate for Payer: Meridian Medicaid |
$488.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$783.62
|
| Rate for Payer: Nomi Health Commercial |
$854.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,963.50
|
| Rate for Payer: PACE SWMI |
$712.38
|
| Rate for Payer: PHP Medicare Advantage |
$712.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,271.73
|
| Rate for Payer: Priority Health Medicare |
$712.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,271.73
|
| Rate for Payer: Railroad Medicare Medicare |
$712.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,365.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$712.38
|
| Rate for Payer: UHC Exchange |
$1,365.19
|
| Rate for Payer: UHC Medicaid |
$465.41
|
| Rate for Payer: UHCCP DNSP |
$712.38
|
| Rate for Payer: UHCCP Medicaid |
$465.41
|
|
|
PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29856
|
| Min. Negotiated Rate |
$585.32 |
| Max. Negotiated Rate |
$1,734.29 |
| Rate for Payer: Aetna Commercial |
$1,205.84
|
| Rate for Payer: Aetna Medicare |
$899.88
|
| Rate for Payer: BCBS Complete |
$614.59
|
| Rate for Payer: BCBS MAPPO |
$899.88
|
| Rate for Payer: BCN Commercial |
$1,508.39
|
| Rate for Payer: BCN Medicare Advantage |
$899.88
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$1,295.83
|
| Rate for Payer: Cofinity Commercial |
$1,205.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$899.88
|
| Rate for Payer: Healthscope Commercial |
$1,079.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,079.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$944.87
|
| Rate for Payer: Meridian Medicaid |
$614.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$989.87
|
| Rate for Payer: Nomi Health Commercial |
$1,079.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,380.00
|
| Rate for Payer: PACE SWMI |
$899.88
|
| Rate for Payer: PHP Medicare Advantage |
$899.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$585.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,612.43
|
| Rate for Payer: Priority Health Medicare |
$899.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,612.43
|
| Rate for Payer: Railroad Medicare Medicare |
$899.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,734.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$899.88
|
| Rate for Payer: UHC Exchange |
$1,734.29
|
| Rate for Payer: UHC Medicaid |
$585.32
|
| Rate for Payer: UHCCP DNSP |
$899.88
|
| Rate for Payer: UHCCP Medicaid |
$585.32
|
|
|
PR ARTHRS ANKLE EXC OSTCHNDRL DFCT TALUS&/TIB DRLG
|
Professional
|
Both
|
$2,501.00
|
|
|
Service Code
|
HCPCS 29891
|
| Min. Negotiated Rate |
$404.27 |
| Max. Negotiated Rate |
$1,875.75 |
| Rate for Payer: Aetna Commercial |
$827.48
|
| Rate for Payer: Aetna Medicare |
$617.52
|
| Rate for Payer: BCBS Complete |
$424.48
|
| Rate for Payer: BCBS MAPPO |
$617.52
|
| Rate for Payer: BCN Commercial |
$1,026.84
|
| Rate for Payer: BCN Medicare Advantage |
$617.52
|
| Rate for Payer: Cash Price |
$2,000.80
|
| Rate for Payer: Cash Price |
$2,000.80
|
| Rate for Payer: Cofinity Commercial |
$889.23
|
| Rate for Payer: Cofinity Commercial |
$827.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.52
|
| Rate for Payer: Healthscope Commercial |
$741.02
|
| Rate for Payer: Healthscope Whirlpool |
$741.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.40
|
| Rate for Payer: Meridian Medicaid |
$424.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$679.27
|
| Rate for Payer: Nomi Health Commercial |
$741.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,875.75
|
| Rate for Payer: PACE SWMI |
$617.52
|
| Rate for Payer: PHP Medicare Advantage |
$617.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,097.65
|
| Rate for Payer: Priority Health Medicare |
$617.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,097.65
|
| Rate for Payer: Railroad Medicare Medicare |
$617.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,169.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$617.52
|
| Rate for Payer: UHC Exchange |
$1,169.63
|
| Rate for Payer: UHC Medicaid |
$404.27
|
| Rate for Payer: UHCCP DNSP |
$617.52
|
| Rate for Payer: UHCCP Medicaid |
$404.27
|
|
|
PR ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$2,841.00
|
|
|
Service Code
|
HCPCS 29862
|
| Min. Negotiated Rate |
$484.58 |
| Max. Negotiated Rate |
$2,130.75 |
| Rate for Payer: Aetna Commercial |
$993.02
|
| Rate for Payer: Aetna Medicare |
$741.06
|
| Rate for Payer: BCBS Complete |
$508.81
|
| Rate for Payer: BCBS MAPPO |
$741.06
|
| Rate for Payer: BCN Commercial |
$1,234.99
|
| Rate for Payer: BCN Medicare Advantage |
$741.06
|
| Rate for Payer: Cash Price |
$2,272.80
|
| Rate for Payer: Cash Price |
$2,272.80
|
| Rate for Payer: Cofinity Commercial |
$993.02
|
| Rate for Payer: Cofinity Commercial |
$1,067.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$741.06
|
| Rate for Payer: Healthscope Commercial |
$889.27
|
| Rate for Payer: Healthscope Whirlpool |
$889.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$778.11
|
| Rate for Payer: Meridian Medicaid |
$508.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$815.17
|
| Rate for Payer: Nomi Health Commercial |
$889.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,130.75
|
| Rate for Payer: PACE SWMI |
$741.06
|
| Rate for Payer: PHP Medicare Advantage |
$741.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,320.17
|
| Rate for Payer: Priority Health Medicare |
$741.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,320.17
|
| Rate for Payer: Railroad Medicare Medicare |
$741.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,418.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$741.06
|
| Rate for Payer: UHC Exchange |
$1,418.26
|
| Rate for Payer: UHC Medicaid |
$484.58
|
| Rate for Payer: UHCCP DNSP |
$741.06
|
| Rate for Payer: UHCCP Medicaid |
$484.58
|
|
|
PR ARTHRS KNEE SURG DEBRIDEMENT/SHVG ARTCLR CRTLG
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 29877
|
| Min. Negotiated Rate |
$374.24 |
| Max. Negotiated Rate |
$1,749.75 |
| Rate for Payer: Aetna Commercial |
$765.52
|
| Rate for Payer: Aetna Medicare |
$571.28
|
| Rate for Payer: BCBS Complete |
$392.95
|
| Rate for Payer: BCBS MAPPO |
$571.28
|
| Rate for Payer: BCN Commercial |
$1,042.71
|
| Rate for Payer: BCN Medicare Advantage |
$571.28
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$822.64
|
| Rate for Payer: Cofinity Commercial |
$765.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.28
|
| Rate for Payer: Healthscope Commercial |
$685.54
|
| Rate for Payer: Healthscope Whirlpool |
$685.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.84
|
| Rate for Payer: Meridian Medicaid |
$392.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$628.41
|
| Rate for Payer: Nomi Health Commercial |
$685.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.75
|
| Rate for Payer: PACE SWMI |
$571.28
|
| Rate for Payer: PHP Medicare Advantage |
$571.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,014.61
|
| Rate for Payer: Priority Health Medicare |
$571.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,014.61
|
| Rate for Payer: Railroad Medicare Medicare |
$571.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$571.28
|
| Rate for Payer: UHC Exchange |
$1,081.88
|
| Rate for Payer: UHC Medicaid |
$374.24
|
| Rate for Payer: UHCCP DNSP |
$571.28
|
| Rate for Payer: UHCCP Medicaid |
$374.24
|
|
|
PR ARTHRS KNEE SURG DRILLING NTC OSTEO DISS LESION
|
Professional
|
Both
|
$2,467.00
|
|
|
Service Code
|
HCPCS 29886
|
| Min. Negotiated Rate |
$385.74 |
| Max. Negotiated Rate |
$1,850.25 |
| Rate for Payer: Aetna Commercial |
$789.29
|
| Rate for Payer: Aetna Medicare |
$589.02
|
| Rate for Payer: BCBS Complete |
$405.03
|
| Rate for Payer: BCBS MAPPO |
$589.02
|
| Rate for Payer: BCN Commercial |
$976.05
|
| Rate for Payer: BCN Medicare Advantage |
$589.02
|
| Rate for Payer: Cash Price |
$1,973.60
|
| Rate for Payer: Cash Price |
$1,973.60
|
| Rate for Payer: Cofinity Commercial |
$848.19
|
| Rate for Payer: Cofinity Commercial |
$789.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.02
|
| Rate for Payer: Healthscope Commercial |
$706.82
|
| Rate for Payer: Healthscope Whirlpool |
$706.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.47
|
| Rate for Payer: Meridian Medicaid |
$405.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$647.92
|
| Rate for Payer: Nomi Health Commercial |
$706.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,850.25
|
| Rate for Payer: PACE SWMI |
$589.02
|
| Rate for Payer: PHP Medicare Advantage |
$589.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,043.36
|
| Rate for Payer: Priority Health Medicare |
$589.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.36
|
| Rate for Payer: Railroad Medicare Medicare |
$589.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,108.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$589.02
|
| Rate for Payer: UHC Exchange |
$1,108.54
|
| Rate for Payer: UHC Medicaid |
$385.74
|
| Rate for Payer: UHCCP DNSP |
$589.02
|
| Rate for Payer: UHCCP Medicaid |
$385.74
|
|
|
PR ARTHRS KNEE SURG DRLG OSTEO DISS GRFG W/WO FIXJ
|
Professional
|
Both
|
$2,618.00
|
|
|
Service Code
|
HCPCS 29885
|
| Min. Negotiated Rate |
$454.33 |
| Max. Negotiated Rate |
$1,963.50 |
| Rate for Payer: Aetna Commercial |
$930.86
|
| Rate for Payer: Aetna Medicare |
$694.67
|
| Rate for Payer: BCBS Complete |
$477.05
|
| Rate for Payer: BCBS MAPPO |
$694.67
|
| Rate for Payer: BCN Commercial |
$1,156.31
|
| Rate for Payer: BCN Medicare Advantage |
$694.67
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cofinity Commercial |
$930.86
|
| Rate for Payer: Cofinity Commercial |
$1,000.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.67
|
| Rate for Payer: Healthscope Commercial |
$833.60
|
| Rate for Payer: Healthscope Whirlpool |
$833.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.40
|
| Rate for Payer: Meridian Medicaid |
$477.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.14
|
| Rate for Payer: Nomi Health Commercial |
$833.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,963.50
|
| Rate for Payer: PACE SWMI |
$694.67
|
| Rate for Payer: PHP Medicare Advantage |
$694.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,236.07
|
| Rate for Payer: Priority Health Medicare |
$694.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,236.07
|
| Rate for Payer: Railroad Medicare Medicare |
$694.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,316.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.67
|
| Rate for Payer: UHC Exchange |
$1,316.01
|
| Rate for Payer: UHC Medicaid |
$454.33
|
| Rate for Payer: UHCCP DNSP |
$694.67
|
| Rate for Payer: UHCCP Medicaid |
$454.33
|
|
