|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Facility
|
OP
|
$2,977.00
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$1,935.05 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$2,679.30
|
| 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 |
$2,887.69
|
| Rate for Payer: ASR Commercial |
$2,887.69
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,437.87
|
| Rate for Payer: BCN Commercial |
$2,308.07
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cofinity Commercial |
$2,798.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,381.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,977.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,887.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$2,679.30
|
| 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 |
$2,530.45
|
| Rate for Payer: Nomi Health Commercial |
$2,441.14
|
| 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 |
$1,935.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,608.45
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,086.88
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,619.76
|
| 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 SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Facility
|
IP
|
$2,977.00
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$1,935.05 |
| Max. Negotiated Rate |
$2,977.00 |
| Rate for Payer: Aetna Commercial |
$2,679.30
|
| Rate for Payer: ASR ASR |
$2,887.69
|
| Rate for Payer: ASR Commercial |
$2,887.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.96
|
| Rate for Payer: BCN Commercial |
$2,308.07
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cofinity Commercial |
$2,798.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,381.60
|
| Rate for Payer: Healthscope Commercial |
$2,977.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,887.69
|
| Rate for Payer: Mclaren Commercial |
$2,679.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,530.45
|
| Rate for Payer: Nomi Health Commercial |
$2,441.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,935.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,619.76
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$2,977.00
|
|
|
Service Code
|
HCPCS 29828
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$594.27 |
| Max. Negotiated Rate |
$1,935.05 |
| Rate for Payer: Aetna Commercial |
$1,224.94
|
| Rate for Payer: Aetna Medicare |
$1,488.50
|
| Rate for Payer: BCBS Complete |
$623.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.88
|
| Rate for Payer: BCN Commercial |
$1,343.38
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Meridian Medicaid |
$623.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,935.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,410.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,410.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.16
|
| Rate for Payer: UHC Exchange |
$1,055.16
|
| Rate for Payer: UHCCP Medicaid |
$594.27
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$2,977.00
|
|
|
Service Code
|
HCPCS 29828
|
| Min. Negotiated Rate |
$594.27 |
| Max. Negotiated Rate |
$1,935.05 |
| Rate for Payer: Aetna Commercial |
$1,224.94
|
| Rate for Payer: Aetna Medicare |
$1,488.50
|
| Rate for Payer: BCBS Complete |
$623.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.88
|
| Rate for Payer: BCN Commercial |
$1,343.38
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Meridian Medicaid |
$623.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,935.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,410.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,410.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.16
|
| Rate for Payer: UHC Exchange |
$1,055.16
|
| Rate for Payer: UHCCP Medicaid |
$594.27
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Facility
|
OP
|
$3,236.00
|
|
|
Service Code
|
CPT 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$2,103.40 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$2,912.40
|
| 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 |
$3,138.92
|
| Rate for Payer: ASR Commercial |
$3,138.92
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,649.96
|
| Rate for Payer: BCN Commercial |
$2,508.87
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cofinity Commercial |
$3,041.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$3,236.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,138.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$2,912.40
|
| 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 |
$2,750.60
|
| Rate for Payer: Nomi Health Commercial |
$2,653.52
|
| 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 |
$2,103.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,835.38
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,268.44
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,847.68
|
| 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 SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Facility
|
IP
|
$3,236.00
|
|
|
Service Code
|
CPT 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$2,103.40 |
| Max. Negotiated Rate |
$3,236.00 |
| Rate for Payer: Aetna Commercial |
$2,912.40
|
| Rate for Payer: ASR ASR |
$3,138.92
|
| Rate for Payer: ASR Commercial |
$3,138.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,637.02
|
| Rate for Payer: BCN Commercial |
$2,508.87
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cofinity Commercial |
$3,041.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.80
|
| Rate for Payer: Healthscope Commercial |
$3,236.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,138.92
|
| Rate for Payer: Mclaren Commercial |
$2,912.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.60
|
| Rate for Payer: Nomi Health Commercial |
$2,653.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,847.68
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$3,236.00
|
|
|
Service Code
|
HCPCS 29806
|
| Min. Negotiated Rate |
$686.29 |
| Max. Negotiated Rate |
$2,103.40 |
| Rate for Payer: Aetna Commercial |
$1,411.69
|
| Rate for Payer: Aetna Medicare |
$1,618.00
|
| Rate for Payer: BCBS Complete |
$720.60
|
| Rate for Payer: BCBS Trust/PPO |
$846.86
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Meridian Medicaid |
$720.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,629.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,629.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,224.35
|
| Rate for Payer: UHC Exchange |
$1,224.35
|
| Rate for Payer: UHCCP Medicaid |
$686.29
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$3,236.00
|
|
|
Service Code
|
HCPCS 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$686.29 |
| Max. Negotiated Rate |
$2,103.40 |
| Rate for Payer: Aetna Commercial |
$1,411.69
|
| Rate for Payer: Aetna Medicare |
$1,618.00
|
| Rate for Payer: BCBS Complete |
$720.60
|
| Rate for Payer: BCBS Trust/PPO |
$846.86
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Cash Price |
$2,588.80
|
| Rate for Payer: Meridian Medicaid |
$720.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,629.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,629.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,224.35
|
| Rate for Payer: UHC Exchange |
$1,224.35
|
| Rate for Payer: UHCCP Medicaid |
$686.29
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY
|
Professional
|
Both
|
$2,267.00
|
|
|
Service Code
|
HCPCS 29821
|
| Min. Negotiated Rate |
$388.51 |
| Max. Negotiated Rate |
$1,682.64 |
| Rate for Payer: Aetna Commercial |
$793.22
|
| Rate for Payer: Aetna Medicare |
$1,133.50
|
| Rate for Payer: BCBS Complete |
$407.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.64
|
| Rate for Payer: BCN Commercial |
$875.23
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Cash Price |
$1,813.60
|
| Rate for Payer: Meridian Medicaid |
$407.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$917.47
|
| Rate for Payer: Priority Health Narrow Network |
$917.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$674.04
|
| Rate for Payer: UHC Exchange |
$674.04
|
| Rate for Payer: UHCCP Medicaid |
$388.51
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Facility
|
OP
|
$2,103.00
|
|
|
Service Code
|
CPT 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$1,366.95 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,892.70
|
| 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 |
$2,039.91
|
| Rate for Payer: ASR Commercial |
$2,039.91
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.15
|
| Rate for Payer: BCN Commercial |
$1,630.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,976.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,682.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,103.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,039.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,892.70
|
| 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 |
$1,787.55
|
| Rate for Payer: Nomi Health Commercial |
$1,724.46
|
| 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 |
$1,366.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,842.65
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,474.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,850.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Facility
|
IP
|
$2,103.00
|
|
|
Service Code
|
CPT 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$1,366.95 |
| Max. Negotiated Rate |
$2,103.00 |
| Rate for Payer: Aetna Commercial |
$1,892.70
|
| Rate for Payer: ASR ASR |
$2,039.91
|
| Rate for Payer: ASR Commercial |
$2,039.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,713.73
|
| Rate for Payer: BCN Commercial |
$1,630.46
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,976.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,682.40
|
| Rate for Payer: Healthscope Commercial |
$2,103.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,039.91
|
| Rate for Payer: Mclaren Commercial |
$1,892.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,787.55
|
| Rate for Payer: Nomi Health Commercial |
$1,724.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,850.64
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$2,103.00
|
|
|
Service Code
|
HCPCS 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$442.40 |
| Max. Negotiated Rate |
$1,366.95 |
| Rate for Payer: Aetna Commercial |
$901.45
|
| Rate for Payer: Aetna Medicare |
$1,051.50
|
| Rate for Payer: BCBS Complete |
$464.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.60
|
| Rate for Payer: BCN Commercial |
$1,098.74
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Meridian Medicaid |
$464.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.09
|
| Rate for Payer: UHC Exchange |
$769.09
|
| Rate for Payer: UHCCP Medicaid |
$442.40
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$2,103.00
|
|
|
Service Code
|
HCPCS 29824
|
| Min. Negotiated Rate |
$442.40 |
| Max. Negotiated Rate |
$1,366.95 |
| Rate for Payer: Aetna Commercial |
$901.45
|
| Rate for Payer: Aetna Medicare |
$1,051.50
|
| Rate for Payer: BCBS Complete |
$464.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.60
|
| Rate for Payer: BCN Commercial |
$1,098.74
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Meridian Medicaid |
$464.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.09
|
| Rate for Payer: UHC Exchange |
$769.09
|
| Rate for Payer: UHCCP Medicaid |
$442.40
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Facility
|
OP
|
$2,201.00
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$1,430.65 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,980.90
|
| 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 |
$2,134.97
|
| Rate for Payer: ASR Commercial |
$2,134.97
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,802.40
|
| Rate for Payer: BCN Commercial |
$1,706.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$2,068.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,760.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,201.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,134.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,980.90
|
| 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 |
$1,870.85
|
| Rate for Payer: Nomi Health Commercial |
$1,804.82
|
| 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 |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,928.52
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,542.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,936.88
|
| 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 SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Facility
|
IP
|
$2,201.00
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$1,430.65 |
| Max. Negotiated Rate |
$2,201.00 |
| Rate for Payer: Aetna Commercial |
$1,980.90
|
| Rate for Payer: ASR ASR |
$2,134.97
|
| Rate for Payer: ASR Commercial |
$2,134.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.59
|
| Rate for Payer: BCN Commercial |
$1,706.44
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$2,068.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,760.80
|
| Rate for Payer: Healthscope Commercial |
$2,201.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,134.97
|
| Rate for Payer: Mclaren Commercial |
$1,980.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,870.85
|
| Rate for Payer: Nomi Health Commercial |
$1,804.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,936.88
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$354.86 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$721.82
|
| Rate for Payer: Aetna Medicare |
$1,100.50
|
| Rate for Payer: BCBS Complete |
$372.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$878.68
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Meridian Medicaid |
$372.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.61
|
| Rate for Payer: Priority Health Narrow Network |
$839.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.03
|
| Rate for Payer: UHC Exchange |
$655.03
|
| Rate for Payer: UHCCP Medicaid |
$354.86
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 29822
|
| Min. Negotiated Rate |
$354.86 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$721.82
|
| Rate for Payer: Aetna Medicare |
$1,100.50
|
| Rate for Payer: BCBS Complete |
$372.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$878.68
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Meridian Medicaid |
$372.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.61
|
| Rate for Payer: Priority Health Narrow Network |
$839.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.03
|
| Rate for Payer: UHC Exchange |
$655.03
|
| Rate for Payer: UHCCP Medicaid |
$354.86
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Facility
|
OP
|
$1,940.00
|
|
|
Service Code
|
CPT 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$1,261.00 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$1,746.00
|
| 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 |
$1,881.80
|
| Rate for Payer: ASR Commercial |
$1,881.80
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.67
|
| Rate for Payer: BCN Commercial |
$1,504.08
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,823.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$1,940.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,881.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$1,746.00
|
| 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 |
$1,649.00
|
| Rate for Payer: Nomi Health Commercial |
$1,590.80
|
| 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 |
$1,261.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,699.83
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.94
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,707.20
|
| 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 SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$1,598.64 |
| Rate for Payer: Aetna Commercial |
$718.35
|
| Rate for Payer: Aetna Medicare |
$970.00
|
| Rate for Payer: BCBS Complete |
$367.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.64
|
| Rate for Payer: BCN Commercial |
$786.28
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Meridian Medicaid |
$367.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.89
|
| Rate for Payer: Priority Health Narrow Network |
$825.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$615.70
|
| Rate for Payer: UHC Exchange |
$615.70
|
| Rate for Payer: UHCCP Medicaid |
$349.96
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 29820
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$1,598.64 |
| Rate for Payer: Aetna Commercial |
$718.35
|
| Rate for Payer: Aetna Medicare |
$970.00
|
| Rate for Payer: BCBS Complete |
$367.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.64
|
| Rate for Payer: BCN Commercial |
$786.28
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Meridian Medicaid |
$367.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.89
|
| Rate for Payer: Priority Health Narrow Network |
$825.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$615.70
|
| Rate for Payer: UHC Exchange |
$615.70
|
| Rate for Payer: UHCCP Medicaid |
$349.96
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY
|
Facility
|
IP
|
$1,940.00
|
|
|
Service Code
|
CPT 29820
|
| Hospital Charge Code |
29820
|
| Min. Negotiated Rate |
$1,261.00 |
| Max. Negotiated Rate |
$1,940.00 |
| Rate for Payer: Aetna Commercial |
$1,746.00
|
| Rate for Payer: ASR ASR |
$1,881.80
|
| Rate for Payer: ASR Commercial |
$1,881.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.91
|
| Rate for Payer: BCN Commercial |
$1,504.08
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,823.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.00
|
| Rate for Payer: Healthscope Commercial |
$1,940.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,881.80
|
| Rate for Payer: Mclaren Commercial |
$1,746.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.00
|
| Rate for Payer: Nomi Health Commercial |
$1,590.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,707.20
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,006.00
|
|
|
Service Code
|
HCPCS 29819
|
| Min. Negotiated Rate |
$383.40 |
| Max. Negotiated Rate |
$1,434.86 |
| Rate for Payer: Aetna Commercial |
$784.19
|
| Rate for Payer: Aetna Medicare |
$1,003.00
|
| Rate for Payer: BCBS Complete |
$402.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.86
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Meridian Medicaid |
$402.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.34
|
| Rate for Payer: Priority Health Narrow Network |
$909.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$667.80
|
| Rate for Payer: UHC Exchange |
$667.80
|
| Rate for Payer: UHCCP Medicaid |
$383.40
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,006.00
|
|
|
Service Code
|
HCPCS 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$383.40 |
| Max. Negotiated Rate |
$1,434.86 |
| Rate for Payer: Aetna Commercial |
$784.19
|
| Rate for Payer: Aetna Medicare |
$1,003.00
|
| Rate for Payer: BCBS Complete |
$402.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.86
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Meridian Medicaid |
$402.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.34
|
| Rate for Payer: Priority Health Narrow Network |
$909.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$667.80
|
| Rate for Payer: UHC Exchange |
$667.80
|
| Rate for Payer: UHCCP Medicaid |
$383.40
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Facility
|
OP
|
$2,006.00
|
|
|
Service Code
|
CPT 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$1,303.90 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,805.40
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$1,945.82
|
| Rate for Payer: ASR Commercial |
$1,945.82
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,642.71
|
| Rate for Payer: BCN Commercial |
$1,555.25
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Cofinity Commercial |
$1,885.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,604.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,006.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,945.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,805.40
|
| 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 |
$1,705.10
|
| Rate for Payer: Nomi Health Commercial |
$1,644.92
|
| 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 |
$1,303.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.66
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,765.28
|
| 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 SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Facility
|
IP
|
$2,006.00
|
|
|
Service Code
|
CPT 29819
|
| Hospital Charge Code |
29819
|
| Min. Negotiated Rate |
$1,303.90 |
| Max. Negotiated Rate |
$2,006.00 |
| Rate for Payer: Aetna Commercial |
$1,805.40
|
| Rate for Payer: ASR ASR |
$1,945.82
|
| Rate for Payer: ASR Commercial |
$1,945.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,634.69
|
| Rate for Payer: BCN Commercial |
$1,555.25
|
| Rate for Payer: Cash Price |
$1,604.80
|
| Rate for Payer: Cofinity Commercial |
$1,885.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,604.80
|
| Rate for Payer: Healthscope Commercial |
$2,006.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,945.82
|
| Rate for Payer: Mclaren Commercial |
$1,805.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,705.10
|
| Rate for Payer: Nomi Health Commercial |
$1,644.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,765.28
|
|
