|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,078.00
|
|
|
Service Code
|
HCPCS 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
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Facility
|
IP
|
$4,078.00
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$2,650.70 |
| Max. Negotiated Rate |
$4,078.00 |
| Rate for Payer: Aetna Commercial |
$3,670.20
|
| Rate for Payer: ASR ASR |
$3,955.66
|
| Rate for Payer: ASR Commercial |
$3,955.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,323.16
|
| Rate for Payer: BCN Commercial |
$3,161.67
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$3,833.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,262.40
|
| Rate for Payer: Healthscope Commercial |
$4,078.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,955.66
|
| Rate for Payer: Mclaren Commercial |
$3,670.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.30
|
| Rate for Payer: Nomi Health Commercial |
$3,343.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,588.64
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Facility
|
OP
|
$4,078.00
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$2,650.70 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$3,670.20
|
| Rate for Payer: Aetna Medicare |
$6,999.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: ASR ASR |
$3,955.66
|
| Rate for Payer: ASR Commercial |
$3,955.66
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,339.47
|
| Rate for Payer: BCN Commercial |
$3,161.67
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$3,833.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,262.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$4,078.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,955.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$3,670.20
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.30
|
| Rate for Payer: Nomi Health Commercial |
$3,343.96
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$7,699.21
|
| Rate for Payer: PHP Medicaid |
$3,751.61
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,573.14
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,858.68
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,588.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$10,848.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP DNSP |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,237.00
|
|
|
Service Code
|
HCPCS 29889
|
| Min. Negotiated Rate |
$795.34 |
| Max. Negotiated Rate |
$2,754.05 |
| Rate for Payer: Aetna Commercial |
$1,632.85
|
| Rate for Payer: Aetna Medicare |
$2,118.50
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$1,793.94
|
| Rate for Payer: Cash Price |
$3,389.60
|
| Rate for Payer: Cash Price |
$3,389.60
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,754.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,884.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,884.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,403.98
|
| Rate for Payer: UHC Exchange |
$1,403.98
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
|
|
PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX
|
Professional
|
Both
|
$2,688.00
|
|
|
Service Code
|
HCPCS 29892
|
| Min. Negotiated Rate |
$416.84 |
| Max. Negotiated Rate |
$1,747.20 |
| Rate for Payer: Aetna Commercial |
$860.03
|
| Rate for Payer: Aetna Medicare |
$1,344.00
|
| Rate for Payer: BCBS Complete |
$437.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.83
|
| Rate for Payer: BCN Commercial |
$939.24
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Meridian Medicaid |
$437.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.70
|
| Rate for Payer: Priority Health Narrow Network |
$987.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$838.63
|
| Rate for Payer: UHC Exchange |
$838.63
|
| Rate for Payer: UHCCP Medicaid |
$416.84
|
|
|
PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,542.00
|
|
|
Service Code
|
HCPCS 29855
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,652.30 |
| Rate for Payer: Aetna Commercial |
$1,041.85
|
| Rate for Payer: Aetna Medicare |
$1,271.00
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.84
|
| Rate for Payer: BCN Commercial |
$1,147.91
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,652.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,203.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,203.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$900.32
|
| Rate for Payer: UHC Exchange |
$900.32
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
|
|
PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 29856
|
| Min. Negotiated Rate |
$645.18 |
| Max. Negotiated Rate |
$1,644.07 |
| Rate for Payer: Aetna Commercial |
$1,318.77
|
| Rate for Payer: Aetna Medicare |
$893.00
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.07
|
| Rate for Payer: BCN Commercial |
$1,455.28
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,527.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,527.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,152.08
|
| Rate for Payer: UHC Exchange |
$1,152.08
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
|
|
PR ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29891
|
| Min. Negotiated Rate |
$439.21 |
| Max. Negotiated Rate |
$1,590.71 |
| Rate for Payer: Aetna Commercial |
$892.98
|
| Rate for Payer: Aetna Medicare |
$1,214.00
|
| Rate for Payer: BCBS Complete |
$461.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.71
|
| Rate for Payer: BCN Commercial |
$982.73
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Meridian Medicaid |
$461.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,040.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,040.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$795.73
|
| Rate for Payer: UHC Exchange |
$795.73
|
| Rate for Payer: UHCCP Medicaid |
$439.21
|
|
|
PR ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 29862
|
| Min. Negotiated Rate |
$528.24 |
| Max. Negotiated Rate |
$1,792.70 |
| Rate for Payer: Aetna Commercial |
$1,084.46
|
| Rate for Payer: Aetna Medicare |
$1,379.00
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,193.35
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Meridian Medicaid |
$554.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,258.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,258.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$930.65
|
| Rate for Payer: UHC Exchange |
$930.65
|
| Rate for Payer: UHCCP Medicaid |
$528.24
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29879
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$882.28
|
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS Trust/PPO |
$943.02
|
| Rate for Payer: BCN Commercial |
$1,071.84
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.48
|
| Rate for Payer: UHC Exchange |
$755.48
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Facility
|
IP
|
$2,525.00
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$1,641.25 |
| Max. Negotiated Rate |
$2,525.00 |
| Rate for Payer: Aetna Commercial |
$2,272.50
|
| Rate for Payer: ASR ASR |
$2,449.25
|
| Rate for Payer: ASR Commercial |
$2,449.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.62
|
| Rate for Payer: BCN Commercial |
$1,957.63
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$2,373.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,525.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,449.25
|
| Rate for Payer: Mclaren Commercial |
$2,272.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: Nomi Health Commercial |
$2,070.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,222.00
|
|
|
PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Facility
|
OP
|
$2,525.00
|
|
|
Service Code
|
CPT 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$1,641.25 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,272.50
|
| 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 |
$2,449.25
|
| Rate for Payer: ASR Commercial |
$2,449.25
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,067.72
|
| Rate for Payer: BCN Commercial |
$1,957.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$2,373.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,525.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,449.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,272.50
|
| 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 |
$2,146.25
|
| Rate for Payer: Nomi Health Commercial |
$2,070.50
|
| 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 |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,212.40
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,770.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,222.00
|
| 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 ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29879
|
| Hospital Charge Code |
29879
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$882.28
|
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS Trust/PPO |
$943.02
|
| Rate for Payer: BCN Commercial |
$1,071.84
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.48
|
| Rate for Payer: UHC Exchange |
$755.48
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Facility
|
OP
|
$2,265.00
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
29877
|
| 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 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29877
|
| Min. Negotiated Rate |
$405.98 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$828.30
|
| Rate for Payer: Aetna Medicare |
$1,132.50
|
| Rate for Payer: BCBS Complete |
$426.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.49
|
| Rate for Payer: BCN Commercial |
$1,007.27
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Meridian Medicaid |
$426.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.07
|
| Rate for Payer: UHC Exchange |
$706.07
|
| Rate for Payer: UHCCP Medicaid |
$405.98
|
|
|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Facility
|
IP
|
$2,265.00
|
|
|
Service Code
|
CPT 29877
|
| Hospital Charge Code |
29877
|
| 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 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 29877
|
| Hospital Charge Code |
29877
|
| Min. Negotiated Rate |
$405.98 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Commercial |
$828.30
|
| Rate for Payer: Aetna Medicare |
$1,132.50
|
| Rate for Payer: BCBS Complete |
$426.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.49
|
| Rate for Payer: BCN Commercial |
$1,007.27
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Meridian Medicaid |
$426.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.07
|
| Rate for Payer: UHC Exchange |
$706.07
|
| Rate for Payer: UHCCP Medicaid |
$405.98
|
|
|
PR ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 29886
|
| Min. Negotiated Rate |
$417.48 |
| Max. Negotiated Rate |
$1,556.75 |
| Rate for Payer: Aetna Commercial |
$848.21
|
| Rate for Payer: Aetna Medicare |
$1,197.50
|
| Rate for Payer: BCBS Complete |
$438.35
|
| Rate for Payer: BCBS Trust/PPO |
$436.38
|
| Rate for Payer: BCN Commercial |
$938.26
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Meridian Medicaid |
$438.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.19
|
| Rate for Payer: Priority Health Narrow Network |
$987.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$720.59
|
| Rate for Payer: UHC Exchange |
$720.59
|
| Rate for Payer: UHCCP Medicaid |
$417.48
|
|
|
PR ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG
|
Professional
|
Both
|
$2,542.00
|
|
|
Service Code
|
HCPCS 29885
|
| Min. Negotiated Rate |
$494.59 |
| Max. Negotiated Rate |
$1,652.30 |
| Rate for Payer: Aetna Commercial |
$1,007.16
|
| Rate for Payer: Aetna Medicare |
$1,271.00
|
| Rate for Payer: BCBS Complete |
$519.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: BCN Commercial |
$1,112.72
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Meridian Medicaid |
$519.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,652.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,170.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,170.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$854.65
|
| Rate for Payer: UHC Exchange |
$854.65
|
| Rate for Payer: UHCCP Medicaid |
$494.59
|
|
|
PR ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29887
|
| Min. Negotiated Rate |
$492.67 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$1,003.49
|
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: BCBS Complete |
$517.30
|
| Rate for Payer: BCBS Trust/PPO |
$675.17
|
| Rate for Payer: BCN Commercial |
$1,108.32
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Meridian Medicaid |
$517.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,166.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,166.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$849.83
|
| Rate for Payer: UHC Exchange |
$849.83
|
| Rate for Payer: UHCCP Medicaid |
$492.67
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Facility
|
IP
|
$2,589.00
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$1,682.85 |
| Max. Negotiated Rate |
$2,589.00 |
| Rate for Payer: Aetna Commercial |
$2,330.10
|
| Rate for Payer: ASR ASR |
$2,511.33
|
| Rate for Payer: ASR Commercial |
$2,511.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,109.78
|
| Rate for Payer: BCN Commercial |
$2,007.25
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,433.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,071.20
|
| Rate for Payer: Healthscope Commercial |
$2,589.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,511.33
|
| Rate for Payer: Mclaren Commercial |
$2,330.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,200.65
|
| Rate for Payer: Nomi Health Commercial |
$2,122.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,278.32
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 29880
|
| Min. Negotiated Rate |
$367.64 |
| Max. Negotiated Rate |
$1,682.85 |
| Rate for Payer: Aetna Commercial |
$749.27
|
| Rate for Payer: Aetna Medicare |
$1,294.50
|
| Rate for Payer: BCBS Complete |
$386.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: BCN Commercial |
$912.57
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Meridian Medicaid |
$386.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.17
|
| Rate for Payer: Priority Health Narrow Network |
$871.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$788.09
|
| Rate for Payer: UHC Exchange |
$788.09
|
| Rate for Payer: UHCCP Medicaid |
$367.64
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Facility
|
OP
|
$2,589.00
|
|
|
Service Code
|
CPT 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$1,682.85 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$2,330.10
|
| 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 |
$2,511.33
|
| Rate for Payer: ASR Commercial |
$2,511.33
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,120.13
|
| Rate for Payer: BCN Commercial |
$2,007.25
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,433.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,071.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,589.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,511.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$2,330.10
|
| 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 |
$2,200.65
|
| Rate for Payer: Nomi Health Commercial |
$2,122.98
|
| 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 |
$1,682.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,268.48
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,814.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,278.32
|
| 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 ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
29880
|
| Min. Negotiated Rate |
$367.64 |
| Max. Negotiated Rate |
$1,682.85 |
| Rate for Payer: Aetna Commercial |
$749.27
|
| Rate for Payer: Aetna Medicare |
$1,294.50
|
| Rate for Payer: BCBS Complete |
$386.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: BCN Commercial |
$912.57
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Meridian Medicaid |
$386.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.17
|
| Rate for Payer: Priority Health Narrow Network |
$871.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$788.09
|
| Rate for Payer: UHC Exchange |
$788.09
|
| Rate for Payer: UHCCP Medicaid |
$367.64
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 29881
|
| Hospital Charge Code |
29881
|
| 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
|
|
