|
PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29882
|
| Min. Negotiated Rate |
$664.66 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$890.64
|
| Rate for Payer: Aetna Medicare |
$664.66
|
| Rate for Payer: BCBS Complete |
$971.20
|
| Rate for Payer: BCBS MAPPO |
$664.66
|
| Rate for Payer: BCN Medicare Advantage |
$664.66
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$957.11
|
| Rate for Payer: Cofinity Commercial |
$890.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.66
|
| Rate for Payer: Healthscope Commercial |
$797.59
|
| Rate for Payer: Healthscope Whirlpool |
$797.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$697.89
|
| Rate for Payer: Nomi Health Commercial |
$797.59
|
| Rate for Payer: PACE SWMI |
$664.66
|
| Rate for Payer: PHP Medicare Advantage |
$664.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health Medicare |
$664.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$664.66
|
| Rate for Payer: UHC Medicare Advantage |
$664.66
|
| Rate for Payer: UHCCP DNSP |
$664.66
|
|
|
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 SUBTALAR JOINT WITH DEBRIDEMENT
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29906
|
| Min. Negotiated Rate |
$640.67 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$858.50
|
| Rate for Payer: Aetna Medicare |
$640.67
|
| Rate for Payer: BCBS Complete |
$971.20
|
| Rate for Payer: BCBS MAPPO |
$640.67
|
| Rate for Payer: BCN Medicare Advantage |
$640.67
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$922.56
|
| Rate for Payer: Cofinity Commercial |
$858.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.67
|
| Rate for Payer: Healthscope Commercial |
$768.80
|
| Rate for Payer: Healthscope Whirlpool |
$768.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.70
|
| Rate for Payer: Nomi Health Commercial |
$768.80
|
| Rate for Payer: PACE SWMI |
$640.67
|
| Rate for Payer: PHP Medicare Advantage |
$640.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health Medicare |
$640.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.67
|
| Rate for Payer: UHC Medicare Advantage |
$640.67
|
| Rate for Payer: UHCCP DNSP |
$640.67
|
|
|
PR ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX
|
Professional
|
Both
|
$917.00
|
|
|
Service Code
|
HCPCS 29840
|
| Min. Negotiated Rate |
$366.80 |
| Max. Negotiated Rate |
$635.17 |
| Rate for Payer: Aetna Commercial |
$591.06
|
| Rate for Payer: Aetna Medicare |
$441.09
|
| Rate for Payer: BCBS Complete |
$366.80
|
| Rate for Payer: BCBS MAPPO |
$441.09
|
| Rate for Payer: BCN Medicare Advantage |
$441.09
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cofinity Commercial |
$635.17
|
| Rate for Payer: Cofinity Commercial |
$591.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.09
|
| Rate for Payer: Healthscope Commercial |
$529.31
|
| Rate for Payer: Healthscope Whirlpool |
$529.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.14
|
| Rate for Payer: Nomi Health Commercial |
$529.31
|
| Rate for Payer: PACE SWMI |
$441.09
|
| Rate for Payer: PHP Medicare Advantage |
$441.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health Medicare |
$441.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.09
|
| Rate for Payer: UHC Medicare Advantage |
$441.09
|
| Rate for Payer: UHCCP DNSP |
$441.09
|
|
|
PR ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 29843
|
| Min. Negotiated Rate |
$471.58 |
| Max. Negotiated Rate |
$1,225.90 |
| Rate for Payer: Aetna Commercial |
$631.92
|
| Rate for Payer: Aetna Medicare |
$471.58
|
| Rate for Payer: BCBS Complete |
$754.40
|
| Rate for Payer: BCBS MAPPO |
$471.58
|
| Rate for Payer: BCN Medicare Advantage |
$471.58
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$679.08
|
| Rate for Payer: Cofinity Commercial |
$631.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.58
|
| Rate for Payer: Healthscope Commercial |
$565.90
|
| Rate for Payer: Healthscope Whirlpool |
$565.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.16
|
| Rate for Payer: Nomi Health Commercial |
$565.90
|
| Rate for Payer: PACE SWMI |
$471.58
|
| Rate for Payer: PHP Medicare Advantage |
$471.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.90
|
| Rate for Payer: Priority Health Medicare |
$471.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$471.58
|
| Rate for Payer: UHC Medicare Advantage |
$471.58
|
| Rate for Payer: UHCCP DNSP |
$471.58
|
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 29845
|
| Min. Negotiated Rate |
$566.19 |
| Max. Negotiated Rate |
$1,319.50 |
| Rate for Payer: Aetna Commercial |
$758.69
|
| Rate for Payer: Aetna Medicare |
$566.19
|
| Rate for Payer: BCBS Complete |
$812.00
|
| Rate for Payer: BCBS MAPPO |
$566.19
|
| Rate for Payer: BCN Medicare Advantage |
$566.19
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$815.31
|
| Rate for Payer: Cofinity Commercial |
$758.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.19
|
| Rate for Payer: Healthscope Commercial |
$679.43
|
| Rate for Payer: Healthscope Whirlpool |
$679.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.50
|
| Rate for Payer: Nomi Health Commercial |
$679.43
|
| Rate for Payer: PACE SWMI |
$566.19
|
| Rate for Payer: PHP Medicare Advantage |
$566.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.50
|
| Rate for Payer: Priority Health Medicare |
$566.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.19
|
| Rate for Payer: UHC Medicare Advantage |
$566.19
|
| Rate for Payer: UHCCP DNSP |
$566.19
|
|
|
PR ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29844
|
| Min. Negotiated Rate |
$484.99 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$649.89
|
| Rate for Payer: Aetna Medicare |
$484.99
|
| Rate for Payer: BCBS Complete |
$750.80
|
| Rate for Payer: BCBS MAPPO |
$484.99
|
| Rate for Payer: BCN Medicare Advantage |
$484.99
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$698.39
|
| Rate for Payer: Cofinity Commercial |
$649.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.99
|
| Rate for Payer: Healthscope Commercial |
$581.99
|
| Rate for Payer: Healthscope Whirlpool |
$581.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.24
|
| Rate for Payer: Nomi Health Commercial |
$581.99
|
| Rate for Payer: PACE SWMI |
$484.99
|
| Rate for Payer: PHP Medicare Advantage |
$484.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health Medicare |
$484.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.99
|
| Rate for Payer: UHC Medicare Advantage |
$484.99
|
| Rate for Payer: UHCCP DNSP |
$484.99
|
|
|
PR ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 29847
|
| Min. Negotiated Rate |
$526.83 |
| Max. Negotiated Rate |
$1,422.20 |
| Rate for Payer: Aetna Commercial |
$705.95
|
| Rate for Payer: Aetna Medicare |
$526.83
|
| Rate for Payer: BCBS Complete |
$875.20
|
| Rate for Payer: BCBS MAPPO |
$526.83
|
| Rate for Payer: BCN Medicare Advantage |
$526.83
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cofinity Commercial |
$758.64
|
| Rate for Payer: Cofinity Commercial |
$705.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.83
|
| Rate for Payer: Healthscope Commercial |
$632.20
|
| Rate for Payer: Healthscope Whirlpool |
$632.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.17
|
| Rate for Payer: Nomi Health Commercial |
$632.20
|
| Rate for Payer: PACE SWMI |
$526.83
|
| Rate for Payer: PHP Medicare Advantage |
$526.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,422.20
|
| Rate for Payer: Priority Health Medicare |
$526.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.83
|
| Rate for Payer: UHC Medicare Advantage |
$526.83
|
| Rate for Payer: UHCCP DNSP |
$526.83
|
|
|
PR ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
HCPCS 27610
|
| Min. Negotiated Rate |
$621.87 |
| Max. Negotiated Rate |
$1,437.15 |
| Rate for Payer: Aetna Commercial |
$833.31
|
| Rate for Payer: Aetna Medicare |
$621.87
|
| Rate for Payer: BCBS Complete |
$884.40
|
| Rate for Payer: BCBS MAPPO |
$621.87
|
| Rate for Payer: BCN Medicare Advantage |
$621.87
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cofinity Commercial |
$895.49
|
| Rate for Payer: Cofinity Commercial |
$833.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.87
|
| Rate for Payer: Healthscope Commercial |
$746.24
|
| Rate for Payer: Healthscope Whirlpool |
$746.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.96
|
| Rate for Payer: Nomi Health Commercial |
$746.24
|
| Rate for Payer: PACE SWMI |
$621.87
|
| Rate for Payer: PHP Medicare Advantage |
$621.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,437.15
|
| Rate for Payer: Priority Health Medicare |
$621.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.87
|
| Rate for Payer: UHC Medicare Advantage |
$621.87
|
| Rate for Payer: UHCCP DNSP |
$621.87
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Professional
|
Both
|
$680.34
|
|
|
Service Code
|
HCPCS 26100
|
| Hospital Charge Code |
26100
|
| Min. Negotiated Rate |
$272.14 |
| Max. Negotiated Rate |
$475.14 |
| Rate for Payer: Aetna Commercial |
$442.15
|
| Rate for Payer: Aetna Medicare |
$329.96
|
| Rate for Payer: BCBS Complete |
$272.14
|
| Rate for Payer: BCBS MAPPO |
$329.96
|
| Rate for Payer: BCN Medicare Advantage |
$329.96
|
| Rate for Payer: Cash Price |
$544.27
|
| Rate for Payer: Cash Price |
$544.27
|
| Rate for Payer: Cofinity Commercial |
$475.14
|
| Rate for Payer: Cofinity Commercial |
$442.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.96
|
| Rate for Payer: Healthscope Commercial |
$395.95
|
| Rate for Payer: Healthscope Whirlpool |
$395.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.46
|
| Rate for Payer: Nomi Health Commercial |
$395.95
|
| Rate for Payer: PACE SWMI |
$329.96
|
| Rate for Payer: PHP Medicare Advantage |
$329.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.22
|
| Rate for Payer: Priority Health Medicare |
$329.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.96
|
| Rate for Payer: UHC Medicare Advantage |
$329.96
|
| Rate for Payer: UHCCP DNSP |
$329.96
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Facility
|
IP
|
$680.00
|
|
|
Service Code
|
CPT 26100
|
| Hospital Charge Code |
26100
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: ASR ASR |
$659.60
|
| Rate for Payer: ASR Commercial |
$659.60
|
| Rate for Payer: BCBS Trust/PPO |
$554.13
|
| Rate for Payer: BCN Commercial |
$527.20
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$639.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.00
|
| Rate for Payer: Healthscope Commercial |
$680.00
|
| Rate for Payer: Healthscope Whirlpool |
$659.60
|
| Rate for Payer: Mclaren Commercial |
$612.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.00
|
| Rate for Payer: Nomi Health Commercial |
$557.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.40
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Professional
|
Both
|
$680.34
|
|
|
Service Code
|
HCPCS 26100
|
| Min. Negotiated Rate |
$272.14 |
| Max. Negotiated Rate |
$475.14 |
| Rate for Payer: Aetna Commercial |
$442.15
|
| Rate for Payer: Aetna Medicare |
$329.96
|
| Rate for Payer: BCBS Complete |
$272.14
|
| Rate for Payer: BCBS MAPPO |
$329.96
|
| Rate for Payer: BCN Medicare Advantage |
$329.96
|
| Rate for Payer: Cash Price |
$544.27
|
| Rate for Payer: Cash Price |
$544.27
|
| Rate for Payer: Cofinity Commercial |
$475.14
|
| Rate for Payer: Cofinity Commercial |
$442.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.96
|
| Rate for Payer: Healthscope Commercial |
$395.95
|
| Rate for Payer: Healthscope Whirlpool |
$395.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.46
|
| Rate for Payer: Nomi Health Commercial |
$395.95
|
| Rate for Payer: PACE SWMI |
$329.96
|
| Rate for Payer: PHP Medicare Advantage |
$329.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.22
|
| Rate for Payer: Priority Health Medicare |
$329.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.96
|
| Rate for Payer: UHC Medicare Advantage |
$329.96
|
| Rate for Payer: UHCCP DNSP |
$329.96
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Facility
|
OP
|
$680.00
|
|
|
Service Code
|
CPT 26100
|
| Hospital Charge Code |
26100
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$4,904.82 |
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$659.60
|
| Rate for Payer: ASR Commercial |
$659.60
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$556.85
|
| Rate for Payer: BCN Commercial |
$527.20
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$639.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$680.00
|
| Rate for Payer: Healthscope Whirlpool |
$659.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$612.00
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.00
|
| Rate for Payer: Nomi Health Commercial |
$557.60
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$595.82
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$476.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 26110
|
| Min. Negotiated Rate |
$315.16 |
| Max. Negotiated Rate |
$594.10 |
| Rate for Payer: Aetna Commercial |
$422.31
|
| Rate for Payer: Aetna Medicare |
$315.16
|
| Rate for Payer: BCBS Complete |
$365.60
|
| Rate for Payer: BCBS MAPPO |
$315.16
|
| Rate for Payer: BCN Medicare Advantage |
$315.16
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$453.83
|
| Rate for Payer: Cofinity Commercial |
$422.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.16
|
| Rate for Payer: Healthscope Commercial |
$378.19
|
| Rate for Payer: Healthscope Whirlpool |
$378.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.92
|
| Rate for Payer: Nomi Health Commercial |
$378.19
|
| Rate for Payer: PACE SWMI |
$315.16
|
| Rate for Payer: PHP Medicare Advantage |
$315.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health Medicare |
$315.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.16
|
| Rate for Payer: UHC Medicare Advantage |
$315.16
|
| Rate for Payer: UHCCP DNSP |
$315.16
|
|
|
PR ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 26105
|
| Min. Negotiated Rate |
$236.80 |
| Max. Negotiated Rate |
$478.41 |
| Rate for Payer: Aetna Commercial |
$445.19
|
| Rate for Payer: Aetna Medicare |
$332.23
|
| Rate for Payer: BCBS Complete |
$236.80
|
| Rate for Payer: BCBS MAPPO |
$332.23
|
| Rate for Payer: BCN Medicare Advantage |
$332.23
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$478.41
|
| Rate for Payer: Cofinity Commercial |
$445.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.23
|
| Rate for Payer: Healthscope Commercial |
$398.68
|
| Rate for Payer: Healthscope Whirlpool |
$398.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.84
|
| Rate for Payer: Nomi Health Commercial |
$398.68
|
| Rate for Payer: PACE SWMI |
$332.23
|
| Rate for Payer: PHP Medicare Advantage |
$332.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
| Rate for Payer: Priority Health Medicare |
$332.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.23
|
| Rate for Payer: UHC Medicare Advantage |
$332.23
|
| Rate for Payer: UHCCP DNSP |
$332.23
|
|
|
PR ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$1,094.00
|
|
|
Service Code
|
HCPCS 25107
|
| Min. Negotiated Rate |
$437.60 |
| Max. Negotiated Rate |
$863.50 |
| Rate for Payer: Aetna Commercial |
$803.53
|
| Rate for Payer: Aetna Medicare |
$599.65
|
| Rate for Payer: BCBS Complete |
$437.60
|
| Rate for Payer: BCBS MAPPO |
$599.65
|
| Rate for Payer: BCN Medicare Advantage |
$599.65
|
| Rate for Payer: Cash Price |
$875.20
|
| Rate for Payer: Cash Price |
$875.20
|
| Rate for Payer: Cofinity Commercial |
$863.50
|
| Rate for Payer: Cofinity Commercial |
$803.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.65
|
| Rate for Payer: Healthscope Commercial |
$719.58
|
| Rate for Payer: Healthscope Whirlpool |
$719.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.63
|
| Rate for Payer: Nomi Health Commercial |
$719.58
|
| Rate for Payer: PACE SWMI |
$599.65
|
| Rate for Payer: PHP Medicare Advantage |
$599.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.10
|
| Rate for Payer: Priority Health Medicare |
$599.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.65
|
| Rate for Payer: UHC Medicare Advantage |
$599.65
|
| Rate for Payer: UHCCP DNSP |
$599.65
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$1,866.00
|
|
|
Service Code
|
HCPCS 24102
|
| Min. Negotiated Rate |
$597.14 |
| Max. Negotiated Rate |
$1,212.90 |
| Rate for Payer: Aetna Commercial |
$800.17
|
| Rate for Payer: Aetna Medicare |
$597.14
|
| Rate for Payer: BCBS Complete |
$746.40
|
| Rate for Payer: BCBS MAPPO |
$597.14
|
| Rate for Payer: BCN Medicare Advantage |
$597.14
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cofinity Commercial |
$859.88
|
| Rate for Payer: Cofinity Commercial |
$800.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.14
|
| Rate for Payer: Healthscope Commercial |
$716.57
|
| Rate for Payer: Healthscope Whirlpool |
$716.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.00
|
| Rate for Payer: Nomi Health Commercial |
$716.57
|
| Rate for Payer: PACE SWMI |
$597.14
|
| Rate for Payer: PHP Medicare Advantage |
$597.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,212.90
|
| Rate for Payer: Priority Health Medicare |
$597.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.14
|
| Rate for Payer: UHC Medicare Advantage |
$597.14
|
| Rate for Payer: UHCCP DNSP |
$597.14
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,459.00
|
|
|
Service Code
|
HCPCS 24100
|
| Min. Negotiated Rate |
$407.58 |
| Max. Negotiated Rate |
$948.35 |
| Rate for Payer: Aetna Commercial |
$546.16
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: BCBS Complete |
$583.60
|
| Rate for Payer: BCBS MAPPO |
$407.58
|
| Rate for Payer: BCN Medicare Advantage |
$407.58
|
| Rate for Payer: Cash Price |
$1,167.20
|
| Rate for Payer: Cash Price |
$1,167.20
|
| Rate for Payer: Cofinity Commercial |
$586.92
|
| Rate for Payer: Cofinity Commercial |
$546.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.58
|
| Rate for Payer: Healthscope Commercial |
$489.10
|
| Rate for Payer: Healthscope Whirlpool |
$489.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.96
|
| Rate for Payer: Nomi Health Commercial |
$489.10
|
| Rate for Payer: PACE SWMI |
$407.58
|
| Rate for Payer: PHP Medicare Advantage |
$407.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$948.35
|
| Rate for Payer: Priority Health Medicare |
$407.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.58
|
| Rate for Payer: UHC Medicare Advantage |
$407.58
|
| Rate for Payer: UHCCP DNSP |
$407.58
|
|
|
PR ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 23100
|
| Min. Negotiated Rate |
$352.40 |
| Max. Negotiated Rate |
$706.55 |
| Rate for Payer: Aetna Commercial |
$657.48
|
| Rate for Payer: Aetna Medicare |
$490.66
|
| Rate for Payer: BCBS Complete |
$352.40
|
| Rate for Payer: BCBS MAPPO |
$490.66
|
| Rate for Payer: BCN Medicare Advantage |
$490.66
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$706.55
|
| Rate for Payer: Cofinity Commercial |
$657.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.66
|
| Rate for Payer: Healthscope Commercial |
$588.79
|
| Rate for Payer: Healthscope Whirlpool |
$588.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.19
|
| Rate for Payer: Nomi Health Commercial |
$588.79
|
| Rate for Payer: PACE SWMI |
$490.66
|
| Rate for Payer: PHP Medicare Advantage |
$490.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.65
|
| Rate for Payer: Priority Health Medicare |
$490.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.66
|
| Rate for Payer: UHC Medicare Advantage |
$490.66
|
| Rate for Payer: UHCCP DNSP |
$490.66
|
|
|
PR ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 23040
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$1,284.40 |
| Rate for Payer: Aetna Commercial |
$927.33
|
| Rate for Payer: Aetna Medicare |
$692.04
|
| Rate for Payer: BCBS Complete |
$790.40
|
| Rate for Payer: BCBS MAPPO |
$692.04
|
| Rate for Payer: BCN Medicare Advantage |
$692.04
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$996.54
|
| Rate for Payer: Cofinity Commercial |
$927.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.04
|
| Rate for Payer: Healthscope Commercial |
$830.45
|
| Rate for Payer: Healthscope Whirlpool |
$830.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$726.64
|
| Rate for Payer: Nomi Health Commercial |
$830.45
|
| Rate for Payer: PACE SWMI |
$692.04
|
| Rate for Payer: PHP Medicare Advantage |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health Medicare |
$692.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$692.04
|
| Rate for Payer: UHC Medicare Advantage |
$692.04
|
| Rate for Payer: UHCCP DNSP |
$692.04
|
|
|
PR ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 27033
|
| Min. Negotiated Rate |
$697.60 |
| Max. Negotiated Rate |
$1,351.54 |
| Rate for Payer: Aetna Commercial |
$1,257.68
|
| Rate for Payer: Aetna Medicare |
$938.57
|
| Rate for Payer: BCBS Complete |
$697.60
|
| Rate for Payer: BCBS MAPPO |
$938.57
|
| Rate for Payer: BCN Medicare Advantage |
$938.57
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,351.54
|
| Rate for Payer: Cofinity Commercial |
$1,257.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.57
|
| Rate for Payer: Healthscope Commercial |
$1,126.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,126.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.50
|
| Rate for Payer: Nomi Health Commercial |
$1,126.28
|
| Rate for Payer: PACE SWMI |
$938.57
|
| Rate for Payer: PHP Medicare Advantage |
$938.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,133.60
|
| Rate for Payer: Priority Health Medicare |
$938.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.57
|
| Rate for Payer: UHC Medicare Advantage |
$938.57
|
| Rate for Payer: UHCCP DNSP |
$938.57
|
|
|
PR ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$1,674.00
|
|
|
Service Code
|
HCPCS 27030
|
| Min. Negotiated Rate |
$669.60 |
| Max. Negotiated Rate |
$1,300.59 |
| Rate for Payer: Aetna Commercial |
$1,210.27
|
| Rate for Payer: Aetna Medicare |
$903.19
|
| Rate for Payer: BCBS Complete |
$669.60
|
| Rate for Payer: BCBS MAPPO |
$903.19
|
| Rate for Payer: BCN Medicare Advantage |
$903.19
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cofinity Commercial |
$1,300.59
|
| Rate for Payer: Cofinity Commercial |
$1,210.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.19
|
| Rate for Payer: Healthscope Commercial |
$1,083.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,083.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.35
|
| Rate for Payer: Nomi Health Commercial |
$1,083.83
|
| Rate for Payer: PACE SWMI |
$903.19
|
| Rate for Payer: PHP Medicare Advantage |
$903.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.10
|
| Rate for Payer: Priority Health Medicare |
$903.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$903.19
|
| Rate for Payer: UHC Medicare Advantage |
$903.19
|
| Rate for Payer: UHCCP DNSP |
$903.19
|
|
|
PR ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$725.00
|
|
|
Service Code
|
HCPCS 27330
|
| Min. Negotiated Rate |
$290.00 |
| Max. Negotiated Rate |
$590.18 |
| Rate for Payer: Aetna Commercial |
$549.20
|
| Rate for Payer: Aetna Medicare |
$409.85
|
| Rate for Payer: BCBS Complete |
$290.00
|
| Rate for Payer: BCBS MAPPO |
$409.85
|
| Rate for Payer: BCN Medicare Advantage |
$409.85
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cofinity Commercial |
$590.18
|
| Rate for Payer: Cofinity Commercial |
$549.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.85
|
| Rate for Payer: Healthscope Commercial |
$491.82
|
| Rate for Payer: Healthscope Whirlpool |
$491.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.34
|
| Rate for Payer: Nomi Health Commercial |
$491.82
|
| Rate for Payer: PACE SWMI |
$409.85
|
| Rate for Payer: PHP Medicare Advantage |
$409.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.25
|
| Rate for Payer: Priority Health Medicare |
$409.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.85
|
| Rate for Payer: UHC Medicare Advantage |
$409.85
|
| Rate for Payer: UHCCP DNSP |
$409.85
|
|
|
PR ARTHROTOMY W/BIOPSY HIP JOINT
|
Professional
|
Both
|
$2,022.00
|
|
|
Service Code
|
HCPCS 27052
|
| Min. Negotiated Rate |
$561.42 |
| Max. Negotiated Rate |
$1,314.30 |
| Rate for Payer: Aetna Commercial |
$752.30
|
| Rate for Payer: Aetna Medicare |
$561.42
|
| Rate for Payer: BCBS Complete |
$808.80
|
| Rate for Payer: BCBS MAPPO |
$561.42
|
| Rate for Payer: BCN Medicare Advantage |
$561.42
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cofinity Commercial |
$808.44
|
| Rate for Payer: Cofinity Commercial |
$752.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.42
|
| Rate for Payer: Healthscope Commercial |
$673.70
|
| Rate for Payer: Healthscope Whirlpool |
$673.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.49
|
| Rate for Payer: Nomi Health Commercial |
$673.70
|
| Rate for Payer: PACE SWMI |
$561.42
|
| Rate for Payer: PHP Medicare Advantage |
$561.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,314.30
|
| Rate for Payer: Priority Health Medicare |
$561.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.42
|
| Rate for Payer: UHC Medicare Advantage |
$561.42
|
| Rate for Payer: UHCCP DNSP |
$561.42
|
|
|
PR ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,137.00
|
|
|
Service Code
|
HCPCS 27403
|
| Min. Negotiated Rate |
$624.87 |
| Max. Negotiated Rate |
$1,389.05 |
| Rate for Payer: Aetna Commercial |
$837.33
|
| Rate for Payer: Aetna Medicare |
$624.87
|
| Rate for Payer: BCBS Complete |
$854.80
|
| Rate for Payer: BCBS MAPPO |
$624.87
|
| Rate for Payer: BCN Medicare Advantage |
$624.87
|
| Rate for Payer: Cash Price |
$1,709.60
|
| Rate for Payer: Cash Price |
$1,709.60
|
| Rate for Payer: Cofinity Commercial |
$899.81
|
| Rate for Payer: Cofinity Commercial |
$837.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.87
|
| Rate for Payer: Healthscope Commercial |
$749.84
|
| Rate for Payer: Healthscope Whirlpool |
$749.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.11
|
| Rate for Payer: Nomi Health Commercial |
$749.84
|
| Rate for Payer: PACE SWMI |
$624.87
|
| Rate for Payer: PHP Medicare Advantage |
$624.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,389.05
|
| Rate for Payer: Priority Health Medicare |
$624.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.87
|
| Rate for Payer: UHC Medicare Advantage |
$624.87
|
| Rate for Payer: UHCCP DNSP |
$624.87
|
|
