|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$1,556.75 |
| Max. Negotiated Rate |
$2,395.00 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| Rate for Payer: ASR ASR |
$2,323.15
|
| Rate for Payer: ASR Commercial |
$2,323.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,951.69
|
| Rate for Payer: BCN Commercial |
$1,856.84
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Healthscope Commercial |
$2,395.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,323.15
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,107.60
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 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
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS
|
Facility
|
OP
|
$2,395.00
|
|
|
Service Code
|
CPT 29876
|
| Hospital Charge Code |
29876
|
| Min. Negotiated Rate |
$1,556.75 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| 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 |
$2,323.15
|
| Rate for Payer: ASR Commercial |
$2,323.15
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,961.27
|
| Rate for Payer: BCN Commercial |
$1,856.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,395.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,323.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| 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 |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| 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 |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,098.50
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,678.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,107.60
|
| 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 SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29875
|
| Min. Negotiated Rate |
$325.46 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$661.47
|
| Rate for Payer: Aetna Medicare |
$938.50
|
| Rate for Payer: BCBS Complete |
$341.73
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: BCN Commercial |
$806.57
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Meridian Medicaid |
$341.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.93
|
| Rate for Payer: Priority Health Narrow Network |
$770.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.37
|
| Rate for Payer: UHC Exchange |
$562.37
|
| Rate for Payer: UHCCP Medicaid |
$325.46
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Facility
|
IP
|
$1,877.00
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$1,220.05 |
| Max. Negotiated Rate |
$1,877.00 |
| Rate for Payer: Aetna Commercial |
$1,689.30
|
| Rate for Payer: ASR ASR |
$1,820.69
|
| Rate for Payer: ASR Commercial |
$1,820.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.57
|
| Rate for Payer: BCN Commercial |
$1,455.24
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$1,764.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,501.60
|
| Rate for Payer: Healthscope Commercial |
$1,877.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,820.69
|
| Rate for Payer: Mclaren Commercial |
$1,689.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,595.45
|
| Rate for Payer: Nomi Health Commercial |
$1,539.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,651.76
|
|
|
PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX
|
Facility
|
OP
|
$1,877.00
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$1,220.05 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,689.30
|
| 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 |
$1,820.69
|
| Rate for Payer: ASR Commercial |
$1,820.69
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.08
|
| Rate for Payer: BCN Commercial |
$1,455.24
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$1,764.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,501.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,877.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,820.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,689.30
|
| 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 |
$1,595.45
|
| Rate for Payer: Nomi Health Commercial |
$1,539.14
|
| 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 |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,644.63
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,315.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,651.76
|
| 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 SYNOVECTOMY LIMITED SPX
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
29875
|
| Min. Negotiated Rate |
$325.46 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$661.47
|
| Rate for Payer: Aetna Medicare |
$938.50
|
| Rate for Payer: BCBS Complete |
$341.73
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: BCN Commercial |
$806.57
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Meridian Medicaid |
$341.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.93
|
| Rate for Payer: Priority Health Narrow Network |
$770.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.37
|
| Rate for Payer: UHC Exchange |
$562.37
|
| Rate for Payer: UHCCP Medicaid |
$325.46
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$825.18
|
| Rate for Payer: Aetna Medicare |
$1,132.50
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.73
|
| Rate for Payer: BCN Commercial |
$912.36
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$959.71
|
| Rate for Payer: Priority Health Narrow Network |
$959.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.33
|
| Rate for Payer: UHC Exchange |
$704.33
|
| Rate for Payer: UHCCP Medicaid |
$405.13
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Facility
|
OP
|
$2,265.00
|
|
|
Service Code
|
CPT 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$1,472.25 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,038.50
|
| 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 |
$2,197.05
|
| Rate for Payer: ASR Commercial |
$2,197.05
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.81
|
| Rate for Payer: BCN Commercial |
$1,756.05
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$2,129.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,812.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,265.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,197.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,038.50
|
| 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 |
$1,925.25
|
| Rate for Payer: Nomi Health Commercial |
$1,857.30
|
| 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 |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,984.59
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,587.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,993.20
|
| 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 W/LYSIS ADHESIONS W/WO MANJ SPX
|
Facility
|
IP
|
$2,265.00
|
|
|
Service Code
|
CPT 29884
|
| Hospital Charge Code |
29884
|
| Min. Negotiated Rate |
$1,472.25 |
| Max. Negotiated Rate |
$2,265.00 |
| Rate for Payer: Aetna Commercial |
$2,038.50
|
| Rate for Payer: ASR ASR |
$2,197.05
|
| Rate for Payer: ASR Commercial |
$2,197.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.75
|
| Rate for Payer: BCN Commercial |
$1,756.05
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cofinity Commercial |
$2,129.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,812.00
|
| Rate for Payer: Healthscope Commercial |
$2,265.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,197.05
|
| Rate for Payer: Mclaren Commercial |
$2,038.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,925.25
|
| Rate for Payer: Nomi Health Commercial |
$1,857.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,993.20
|
|
|
PR ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29884
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$825.18
|
| Rate for Payer: Aetna Medicare |
$1,132.50
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.73
|
| Rate for Payer: BCN Commercial |
$912.36
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$959.71
|
| Rate for Payer: Priority Health Narrow Network |
$959.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.33
|
| Rate for Payer: UHC Exchange |
$704.33
|
| Rate for Payer: UHCCP Medicaid |
$405.13
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Facility
|
OP
|
$2,758.00
|
|
|
Service Code
|
CPT 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$1,703.94 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,482.20
|
| 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 |
$2,675.26
|
| Rate for Payer: ASR Commercial |
$2,675.26
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,258.53
|
| Rate for Payer: BCN Commercial |
$2,138.28
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cofinity Commercial |
$2,592.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,206.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,758.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,675.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,482.20
|
| 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 |
$2,344.30
|
| Rate for Payer: Nomi Health Commercial |
$2,261.56
|
| 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 |
$1,792.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,416.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,933.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,427.04
|
| 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 W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$545.92 |
| Max. Negotiated Rate |
$1,792.70 |
| Rate for Payer: Aetna Commercial |
$1,118.78
|
| Rate for Payer: Aetna Medicare |
$1,379.00
|
| Rate for Payer: BCBS Complete |
$573.22
|
| Rate for Payer: BCBS Trust/PPO |
$654.56
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Meridian Medicaid |
$573.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,300.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$966.14
|
| Rate for Payer: UHC Exchange |
$966.14
|
| Rate for Payer: UHCCP Medicaid |
$545.92
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 29883
|
| Min. Negotiated Rate |
$545.92 |
| Max. Negotiated Rate |
$1,792.70 |
| Rate for Payer: Aetna Commercial |
$1,118.78
|
| Rate for Payer: Aetna Medicare |
$1,379.00
|
| Rate for Payer: BCBS Complete |
$573.22
|
| Rate for Payer: BCBS Trust/PPO |
$654.56
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Meridian Medicaid |
$573.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,300.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$966.14
|
| Rate for Payer: UHC Exchange |
$966.14
|
| Rate for Payer: UHCCP Medicaid |
$545.92
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL
|
Facility
|
IP
|
$2,758.00
|
|
|
Service Code
|
CPT 29883
|
| Hospital Charge Code |
29883
|
| Min. Negotiated Rate |
$1,792.70 |
| Max. Negotiated Rate |
$2,758.00 |
| Rate for Payer: Aetna Commercial |
$2,482.20
|
| Rate for Payer: ASR ASR |
$2,675.26
|
| Rate for Payer: ASR Commercial |
$2,675.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,247.49
|
| Rate for Payer: BCN Commercial |
$2,138.28
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cofinity Commercial |
$2,592.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,206.40
|
| Rate for Payer: Healthscope Commercial |
$2,758.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,675.26
|
| Rate for Payer: Mclaren Commercial |
$2,482.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,344.30
|
| Rate for Payer: Nomi Health Commercial |
$2,261.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,427.04
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29882
|
| Min. Negotiated Rate |
$321.77 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$922.00
|
| Rate for Payer: Aetna Medicare |
$1,214.00
|
| Rate for Payer: BCBS Complete |
$471.45
|
| Rate for Payer: BCBS Trust/PPO |
$321.77
|
| Rate for Payer: BCN Commercial |
$1,116.50
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Meridian Medicaid |
$471.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.15
|
| Rate for Payer: UHC Exchange |
$796.15
|
| Rate for Payer: UHCCP Medicaid |
$449.00
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$321.77 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$922.00
|
| Rate for Payer: Aetna Medicare |
$1,214.00
|
| Rate for Payer: BCBS Complete |
$471.45
|
| Rate for Payer: BCBS Trust/PPO |
$321.77
|
| Rate for Payer: BCN Commercial |
$1,116.50
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Meridian Medicaid |
$471.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.15
|
| Rate for Payer: UHC Exchange |
$796.15
|
| Rate for Payer: UHCCP Medicaid |
$449.00
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Facility
|
IP
|
$2,428.00
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$1,578.20 |
| Max. Negotiated Rate |
$2,428.00 |
| Rate for Payer: Aetna Commercial |
$2,185.20
|
| Rate for Payer: ASR ASR |
$2,355.16
|
| Rate for Payer: ASR Commercial |
$2,355.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,978.58
|
| Rate for Payer: BCN Commercial |
$1,882.43
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$2,282.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,942.40
|
| Rate for Payer: Healthscope Commercial |
$2,428.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,355.16
|
| Rate for Payer: Mclaren Commercial |
$2,185.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,063.80
|
| Rate for Payer: Nomi Health Commercial |
$1,990.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,136.64
|
|
|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Facility
|
OP
|
$2,428.00
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
29882
|
| Min. Negotiated Rate |
$1,578.20 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,185.20
|
| 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 |
$2,355.16
|
| Rate for Payer: ASR Commercial |
$2,355.16
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,988.29
|
| Rate for Payer: BCN Commercial |
$1,882.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$2,282.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,942.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,428.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,355.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,185.20
|
| 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 |
$2,063.80
|
| Rate for Payer: Nomi Health Commercial |
$1,990.96
|
| 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 |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,127.41
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,702.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,136.64
|
| 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 SUBTALAR JOINT WITH DEBRIDEMENT
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29906
|
| Min. Negotiated Rate |
$433.46 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$876.36
|
| Rate for Payer: Aetna Medicare |
$1,214.00
|
| Rate for Payer: BCBS Complete |
$455.13
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: BCN Commercial |
$942.17
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Meridian Medicaid |
$455.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.70
|
| Rate for Payer: UHC Exchange |
$813.70
|
| Rate for Payer: UHCCP Medicaid |
$433.46
|
|
|
PR ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX
|
Professional
|
Both
|
$917.00
|
|
|
Service Code
|
HCPCS 29840
|
| Min. Negotiated Rate |
$299.90 |
| Max. Negotiated Rate |
$1,377.81 |
| Rate for Payer: Aetna Commercial |
$600.40
|
| Rate for Payer: Aetna Medicare |
$458.50
|
| Rate for Payer: BCBS Complete |
$314.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,377.81
|
| Rate for Payer: BCN Commercial |
$668.03
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Meridian Medicaid |
$314.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.70
|
| Rate for Payer: Priority Health Narrow Network |
$700.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$508.61
|
| Rate for Payer: UHC Exchange |
$508.61
|
| Rate for Payer: UHCCP Medicaid |
$299.90
|
|
|
PR ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 29843
|
| Min. Negotiated Rate |
$320.35 |
| Max. Negotiated Rate |
$1,225.90 |
| Rate for Payer: Aetna Commercial |
$648.17
|
| Rate for Payer: Aetna Medicare |
$943.00
|
| Rate for Payer: BCBS Complete |
$336.37
|
| Rate for Payer: BCBS Trust/PPO |
$543.09
|
| Rate for Payer: BCN Commercial |
$719.34
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Meridian Medicaid |
$336.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.69
|
| Rate for Payer: Priority Health Narrow Network |
$757.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$545.48
|
| Rate for Payer: UHC Exchange |
$545.48
|
| Rate for Payer: UHCCP Medicaid |
$320.35
|
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 29845
|
| Min. Negotiated Rate |
$384.25 |
| Max. Negotiated Rate |
$1,319.50 |
| Rate for Payer: Aetna Commercial |
$779.09
|
| Rate for Payer: Aetna Medicare |
$1,015.00
|
| Rate for Payer: BCBS Complete |
$403.46
|
| Rate for Payer: BCN Commercial |
$865.94
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Meridian Medicaid |
$403.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.84
|
| Rate for Payer: Priority Health Narrow Network |
$909.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.74
|
| Rate for Payer: UHC Exchange |
$648.74
|
| Rate for Payer: UHCCP Medicaid |
$384.25
|
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29844
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$665.30
|
| Rate for Payer: Aetna Medicare |
$938.50
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS Trust/PPO |
$730.64
|
| Rate for Payer: BCN Commercial |
$738.88
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$775.00
|
| Rate for Payer: Priority Health Narrow Network |
$775.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.57
|
| Rate for Payer: UHC Exchange |
$562.57
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 29847
|
| Min. Negotiated Rate |
$356.78 |
| Max. Negotiated Rate |
$1,422.20 |
| Rate for Payer: Aetna Commercial |
$726.25
|
| Rate for Payer: Aetna Medicare |
$1,094.00
|
| Rate for Payer: BCBS Complete |
$374.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: BCN Commercial |
$803.39
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Meridian Medicaid |
$374.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,422.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.22
|
| Rate for Payer: Priority Health Narrow Network |
$845.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$618.31
|
| Rate for Payer: UHC Exchange |
$618.31
|
| Rate for Payer: UHCCP Medicaid |
$356.78
|
|
