|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Facility
|
OP
|
$2,511.00
|
|
|
Service Code
|
CPT 27334
|
| Hospital Charge Code |
27334
|
| Min. Negotiated Rate |
$1,632.15 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,259.90
|
| 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 |
$2,435.67
|
| Rate for Payer: ASR Commercial |
$2,435.67
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,056.26
|
| Rate for Payer: BCN Commercial |
$1,946.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cofinity Commercial |
$2,360.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,008.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,511.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,435.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,259.90
|
| 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 |
$2,134.35
|
| Rate for Payer: Nomi Health Commercial |
$2,059.02
|
| 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 |
$1,632.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,200.14
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,209.68
|
| 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 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$2,794.00
|
|
|
Service Code
|
HCPCS 27130
|
| Hospital Charge Code |
27130
|
| Min. Negotiated Rate |
$568.98 |
| Max. Negotiated Rate |
$2,065.66 |
| Rate for Payer: Aetna Commercial |
$1,721.08
|
| Rate for Payer: Aetna Medicare |
$1,397.00
|
| Rate for Payer: BCBS Complete |
$870.67
|
| Rate for Payer: BCBS Trust/PPO |
$568.98
|
| Rate for Payer: BCN Commercial |
$2,065.66
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Meridian Medicaid |
$870.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,965.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,965.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,679.10
|
| Rate for Payer: UHC Exchange |
$1,679.10
|
| Rate for Payer: UHCCP Medicaid |
$829.21
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Facility
|
OP
|
$2,794.00
|
|
|
Service Code
|
CPT 27130
|
| Hospital Charge Code |
27130
|
| Min. Negotiated Rate |
$1,816.10 |
| Max. Negotiated Rate |
$19,540.31 |
| Rate for Payer: Aetna Commercial |
$2,514.60
|
| Rate for Payer: Aetna Medicare |
$12,606.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: ASR ASR |
$2,710.18
|
| Rate for Payer: ASR Commercial |
$2,710.18
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.01
|
| Rate for Payer: BCN Commercial |
$2,166.19
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cofinity Commercial |
$2,626.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,235.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Healthscope Commercial |
$2,794.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,710.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,606.65
|
| Rate for Payer: Mclaren Commercial |
$2,514.60
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,374.90
|
| Rate for Payer: Nomi Health Commercial |
$2,291.08
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Commercial |
$13,867.32
|
| Rate for Payer: PHP Medicaid |
$6,757.16
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,448.10
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,958.59
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,458.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$19,540.31
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP DNSP |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$2,794.00
|
|
|
Service Code
|
HCPCS 27130
|
| Min. Negotiated Rate |
$568.98 |
| Max. Negotiated Rate |
$2,065.66 |
| Rate for Payer: Aetna Commercial |
$1,721.08
|
| Rate for Payer: Aetna Medicare |
$1,397.00
|
| Rate for Payer: BCBS Complete |
$870.67
|
| Rate for Payer: BCBS Trust/PPO |
$568.98
|
| Rate for Payer: BCN Commercial |
$2,065.66
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Meridian Medicaid |
$870.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,965.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,965.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,679.10
|
| Rate for Payer: UHC Exchange |
$1,679.10
|
| Rate for Payer: UHCCP Medicaid |
$829.21
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Facility
|
IP
|
$2,794.00
|
|
|
Service Code
|
CPT 27130
|
| Hospital Charge Code |
27130
|
| Min. Negotiated Rate |
$1,816.10 |
| Max. Negotiated Rate |
$2,794.00 |
| Rate for Payer: Aetna Commercial |
$2,514.60
|
| Rate for Payer: ASR ASR |
$2,710.18
|
| Rate for Payer: ASR Commercial |
$2,710.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.83
|
| Rate for Payer: BCN Commercial |
$2,166.19
|
| Rate for Payer: Cash Price |
$2,235.20
|
| Rate for Payer: Cofinity Commercial |
$2,626.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,235.20
|
| Rate for Payer: Healthscope Commercial |
$2,794.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,710.18
|
| Rate for Payer: Mclaren Commercial |
$2,514.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,374.90
|
| Rate for Payer: Nomi Health Commercial |
$2,291.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,816.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,458.72
|
|
|
PR ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM
|
Professional
|
Both
|
$5,189.00
|
|
|
Service Code
|
HCPCS 24363
|
| Min. Negotiated Rate |
$239.42 |
| Max. Negotiated Rate |
$3,372.85 |
| Rate for Payer: Aetna Commercial |
$1,937.56
|
| Rate for Payer: Aetna Medicare |
$2,594.50
|
| Rate for Payer: BCBS Complete |
$982.95
|
| Rate for Payer: BCBS Trust/PPO |
$239.42
|
| Rate for Payer: BCN Commercial |
$2,116.46
|
| Rate for Payer: Cash Price |
$4,151.20
|
| Rate for Payer: Cash Price |
$4,151.20
|
| Rate for Payer: Meridian Medicaid |
$982.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$936.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,372.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,219.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,219.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,734.29
|
| Rate for Payer: UHC Exchange |
$1,734.29
|
| Rate for Payer: UHCCP Medicaid |
$936.14
|
|
|
PR ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL
|
Professional
|
Both
|
$1,457.00
|
|
|
Service Code
|
HCPCS 27443
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,261.47 |
| Rate for Payer: Aetna Commercial |
$1,090.60
|
| Rate for Payer: Aetna Medicare |
$728.50
|
| Rate for Payer: BCBS Complete |
$559.12
|
| Rate for Payer: BCBS Trust/PPO |
$833.66
|
| Rate for Payer: BCN Commercial |
$1,200.68
|
| Rate for Payer: Cash Price |
$1,165.60
|
| Rate for Payer: Cash Price |
$1,165.60
|
| Rate for Payer: Meridian Medicaid |
$559.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,261.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$934.25
|
| Rate for Payer: UHC Exchange |
$934.25
|
| Rate for Payer: UHCCP Medicaid |
$532.50
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Professional
|
Both
|
$3,039.00
|
|
|
Service Code
|
HCPCS 25447
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$1,103.99
|
| Rate for Payer: Aetna Medicare |
$1,519.50
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$1,226.09
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,288.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,288.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$933.10
|
| Rate for Payer: UHC Exchange |
$933.10
|
| Rate for Payer: UHCCP Medicaid |
$523.55
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
25447
|
| Min. Negotiated Rate |
$1,975.35 |
| Max. Negotiated Rate |
$3,039.00 |
| Rate for Payer: Aetna Commercial |
$2,735.10
|
| Rate for Payer: ASR ASR |
$2,947.83
|
| Rate for Payer: ASR Commercial |
$2,947.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,476.48
|
| Rate for Payer: BCN Commercial |
$2,356.14
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cofinity Commercial |
$2,856.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,431.20
|
| Rate for Payer: Healthscope Commercial |
$3,039.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,947.83
|
| Rate for Payer: Mclaren Commercial |
$2,735.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,583.15
|
| Rate for Payer: Nomi Health Commercial |
$2,491.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,674.32
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Professional
|
Both
|
$3,039.00
|
|
|
Service Code
|
HCPCS 25447
|
| Hospital Charge Code |
25447
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$1,103.99
|
| Rate for Payer: Aetna Medicare |
$1,519.50
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$1,226.09
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,288.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,288.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$933.10
|
| Rate for Payer: UHC Exchange |
$933.10
|
| Rate for Payer: UHCCP Medicaid |
$523.55
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
25447
|
| Min. Negotiated Rate |
$1,703.94 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,735.10
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$2,947.83
|
| Rate for Payer: ASR Commercial |
$2,947.83
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,488.64
|
| Rate for Payer: BCN Commercial |
$2,356.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cofinity Commercial |
$2,856.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,431.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$3,039.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,947.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,735.10
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,583.15
|
| Rate for Payer: Nomi Health Commercial |
$2,491.98
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,662.77
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,130.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,674.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 25448
|
| Min. Negotiated Rate |
$578.08 |
| Max. Negotiated Rate |
$1,664.00 |
| Rate for Payer: Aetna Medicare |
$1,280.00
|
| Rate for Payer: BCBS Complete |
$606.98
|
| Rate for Payer: Cash Price |
$2,048.00
|
| Rate for Payer: Cash Price |
$2,048.00
|
| Rate for Payer: Meridian Medicaid |
$606.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,664.00
|
| Rate for Payer: UHCCP Medicaid |
$578.08
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Facility
|
IP
|
$5,007.00
|
|
|
Service Code
|
CPT 27447
|
| Hospital Charge Code |
27447
|
| Min. Negotiated Rate |
$3,254.55 |
| Max. Negotiated Rate |
$5,007.00 |
| Rate for Payer: Aetna Commercial |
$4,506.30
|
| Rate for Payer: ASR ASR |
$4,856.79
|
| Rate for Payer: ASR Commercial |
$4,856.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,080.20
|
| Rate for Payer: BCN Commercial |
$3,881.93
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cofinity Commercial |
$4,706.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.60
|
| Rate for Payer: Healthscope Commercial |
$5,007.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,856.79
|
| Rate for Payer: Mclaren Commercial |
$4,506.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.95
|
| Rate for Payer: Nomi Health Commercial |
$4,105.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,406.16
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Facility
|
OP
|
$5,007.00
|
|
|
Service Code
|
CPT 27447
|
| Hospital Charge Code |
27447
|
| Min. Negotiated Rate |
$3,254.55 |
| Max. Negotiated Rate |
$19,540.31 |
| Rate for Payer: Aetna Commercial |
$4,506.30
|
| Rate for Payer: Aetna Medicare |
$12,606.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: ASR ASR |
$4,856.79
|
| Rate for Payer: ASR Commercial |
$4,856.79
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,100.23
|
| Rate for Payer: BCN Commercial |
$3,881.93
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cofinity Commercial |
$4,706.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Healthscope Commercial |
$5,007.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,856.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,606.65
|
| Rate for Payer: Mclaren Commercial |
$4,506.30
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.95
|
| Rate for Payer: Nomi Health Commercial |
$4,105.74
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Commercial |
$13,867.32
|
| Rate for Payer: PHP Medicaid |
$6,757.16
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,387.13
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,509.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,406.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$19,540.31
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP DNSP |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Professional
|
Both
|
$5,007.00
|
|
|
Service Code
|
HCPCS 27447
|
| Min. Negotiated Rate |
$828.14 |
| Max. Negotiated Rate |
$3,254.55 |
| Rate for Payer: Aetna Commercial |
$1,718.87
|
| Rate for Payer: Aetna Medicare |
$2,503.50
|
| Rate for Payer: BCBS Complete |
$869.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,016.52
|
| Rate for Payer: BCN Commercial |
$2,063.51
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Meridian Medicaid |
$869.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,962.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,962.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,795.48
|
| Rate for Payer: UHC Exchange |
$1,795.48
|
| Rate for Payer: UHCCP Medicaid |
$828.14
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Professional
|
Both
|
$5,007.00
|
|
|
Service Code
|
HCPCS 27447
|
| Hospital Charge Code |
27447
|
| Min. Negotiated Rate |
$828.14 |
| Max. Negotiated Rate |
$3,254.55 |
| Rate for Payer: Aetna Commercial |
$1,718.87
|
| Rate for Payer: Aetna Medicare |
$2,503.50
|
| Rate for Payer: BCBS Complete |
$869.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,016.52
|
| Rate for Payer: BCN Commercial |
$2,063.51
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Meridian Medicaid |
$869.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,962.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,962.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,795.48
|
| Rate for Payer: UHC Exchange |
$1,795.48
|
| Rate for Payer: UHCCP Medicaid |
$828.14
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$3,221.00
|
|
|
Service Code
|
HCPCS 27446
|
| Min. Negotiated Rate |
$742.73 |
| Max. Negotiated Rate |
$2,093.65 |
| Rate for Payer: Aetna Commercial |
$1,544.64
|
| Rate for Payer: Aetna Medicare |
$1,610.50
|
| Rate for Payer: BCBS Complete |
$779.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.16
|
| Rate for Payer: BCN Commercial |
$1,677.63
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Meridian Medicaid |
$779.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,287.84
|
| Rate for Payer: UHC Exchange |
$1,287.84
|
| Rate for Payer: UHCCP Medicaid |
$742.73
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Facility
|
OP
|
$3,221.00
|
|
|
Service Code
|
CPT 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$2,093.65 |
| Max. Negotiated Rate |
$19,540.31 |
| Rate for Payer: Aetna Commercial |
$2,898.90
|
| Rate for Payer: Aetna Medicare |
$12,606.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: ASR ASR |
$3,124.37
|
| Rate for Payer: ASR Commercial |
$3,124.37
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,637.68
|
| Rate for Payer: BCN Commercial |
$2,497.24
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$3,027.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Healthscope Commercial |
$3,221.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,124.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,606.65
|
| Rate for Payer: Mclaren Commercial |
$2,898.90
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,737.85
|
| Rate for Payer: Nomi Health Commercial |
$2,641.22
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Commercial |
$13,867.32
|
| Rate for Payer: PHP Medicaid |
$6,757.16
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,822.24
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,257.92
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,834.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$19,540.31
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP DNSP |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: VA VA |
$12,606.65
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Facility
|
IP
|
$3,221.00
|
|
|
Service Code
|
CPT 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$2,093.65 |
| Max. Negotiated Rate |
$3,221.00 |
| Rate for Payer: Aetna Commercial |
$2,898.90
|
| Rate for Payer: ASR ASR |
$3,124.37
|
| Rate for Payer: ASR Commercial |
$3,124.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,624.79
|
| Rate for Payer: BCN Commercial |
$2,497.24
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$3,027.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.80
|
| Rate for Payer: Healthscope Commercial |
$3,221.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,124.37
|
| Rate for Payer: Mclaren Commercial |
$2,898.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,737.85
|
| Rate for Payer: Nomi Health Commercial |
$2,641.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,834.48
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$3,221.00
|
|
|
Service Code
|
HCPCS 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$742.73 |
| Max. Negotiated Rate |
$2,093.65 |
| Rate for Payer: Aetna Commercial |
$1,544.64
|
| Rate for Payer: Aetna Medicare |
$1,610.50
|
| Rate for Payer: BCBS Complete |
$779.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.16
|
| Rate for Payer: BCN Commercial |
$1,677.63
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Meridian Medicaid |
$779.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,287.84
|
| Rate for Payer: UHC Exchange |
$1,287.84
|
| Rate for Payer: UHCCP Medicaid |
$742.73
|
|
|
PR ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 27441
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,272.16 |
| Rate for Payer: Aetna Commercial |
$1,100.22
|
| Rate for Payer: Aetna Medicare |
$845.00
|
| Rate for Payer: BCBS Complete |
$564.27
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$1,212.41
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Meridian Medicaid |
$564.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,272.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,272.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$919.20
|
| Rate for Payer: UHC Exchange |
$919.20
|
| Rate for Payer: UHCCP Medicaid |
$537.40
|
|
|
PR ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26531
|
| Min. Negotiated Rate |
$224.00 |
| Max. Negotiated Rate |
$1,417.65 |
| Rate for Payer: Aetna Commercial |
$837.81
|
| Rate for Payer: Aetna Medicare |
$1,090.50
|
| Rate for Payer: BCBS Complete |
$437.01
|
| Rate for Payer: BCBS Trust/PPO |
$224.00
|
| Rate for Payer: BCN Commercial |
$934.35
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Meridian Medicaid |
$437.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.10
|
| Rate for Payer: Priority Health Narrow Network |
$982.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$700.61
|
| Rate for Payer: UHC Exchange |
$700.61
|
| Rate for Payer: UHCCP Medicaid |
$416.20
|
|
|
PR ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/ENTIR CARPS
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 25446
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$1,800.85 |
| Rate for Payer: Aetna Commercial |
$1,564.29
|
| Rate for Payer: Aetna Medicare |
$1,047.00
|
| Rate for Payer: BCBS Complete |
$798.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.86
|
| Rate for Payer: BCN Commercial |
$1,717.22
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Meridian Medicaid |
$798.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$760.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,350.89
|
| Rate for Payer: UHC Exchange |
$1,350.89
|
| Rate for Payer: UHCCP Medicaid |
$760.20
|
|
|
PR ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ
|
Professional
|
Both
|
$3,684.00
|
|
|
Service Code
|
HCPCS 25332
|
| Min. Negotiated Rate |
$547.85 |
| Max. Negotiated Rate |
$2,394.60 |
| Rate for Payer: Aetna Commercial |
$1,126.09
|
| Rate for Payer: Aetna Medicare |
$1,842.00
|
| Rate for Payer: BCBS Complete |
$579.70
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$1,244.17
|
| Rate for Payer: Cash Price |
$2,947.20
|
| Rate for Payer: Cash Price |
$2,947.20
|
| Rate for Payer: Meridian Medicaid |
$579.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,394.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,306.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,306.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$963.06
|
| Rate for Payer: UHC Exchange |
$963.06
|
| Rate for Payer: UHCCP Medicaid |
$552.10
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,078.00
|
|
|
Service Code
|
HCPCS 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$630.48 |
| Max. Negotiated Rate |
$2,650.70 |
| Rate for Payer: Aetna Commercial |
$1,306.22
|
| Rate for Payer: Aetna Medicare |
$2,039.00
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$1,573.32
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Meridian Medicaid |
$662.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,497.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,497.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.92
|
| Rate for Payer: UHC Exchange |
$1,143.92
|
| Rate for Payer: UHCCP Medicaid |
$630.48
|
|
