|
PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Professional
|
Both
|
$856.00
|
|
|
Service Code
|
HCPCS 28111
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$642.00 |
| Rate for Payer: Aetna Commercial |
$394.68
|
| Rate for Payer: Aetna Medicare |
$306.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.14
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$294.54
|
| Rate for Payer: BCN Commercial |
$483.54
|
| Rate for Payer: BCN Medicare Advantage |
$294.54
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$424.14
|
| Rate for Payer: Cofinity Commercial |
$394.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.54
|
| Rate for Payer: Healthscope Commercial |
$544.90
|
| Rate for Payer: Healthscope Commercial |
$471.26
|
| Rate for Payer: Mclaren Medicaid |
$192.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.27
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$323.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$562.86
|
| Rate for Payer: Nomi Health Commercial |
$353.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$642.00
|
| Rate for Payer: PACE SWMI |
$294.54
|
| Rate for Payer: PHP Medicare Advantage |
$294.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$516.88
|
| Rate for Payer: Priority Health Medicare |
$294.54
|
| Rate for Payer: Priority Health SBD |
$516.88
|
| Rate for Payer: Priority Health Tiered Network |
$516.88
|
| Rate for Payer: Railroad Medicare Medicare |
$294.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.53
|
| Rate for Payer: UHC Core |
$566.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$294.54
|
| Rate for Payer: UHC Exchange |
$566.53
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
|
|
PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Professional
|
Both
|
$1,065.00
|
|
|
Service Code
|
HCPCS 28113
|
| Min. Negotiated Rate |
$259.22 |
| Max. Negotiated Rate |
$798.75 |
| Rate for Payer: Aetna Commercial |
$526.31
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.59
|
| Rate for Payer: BCBS Complete |
$272.18
|
| Rate for Payer: BCBS MAPPO |
$392.77
|
| Rate for Payer: BCN Commercial |
$651.85
|
| Rate for Payer: BCN Medicare Advantage |
$392.77
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cofinity Commercial |
$565.59
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.77
|
| Rate for Payer: Healthscope Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Mclaren Medicaid |
$259.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.41
|
| Rate for Payer: Meridian Medicaid |
$272.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$432.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.38
|
| Rate for Payer: Nomi Health Commercial |
$471.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$798.75
|
| Rate for Payer: PACE SWMI |
$392.77
|
| Rate for Payer: PHP Medicare Advantage |
$392.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$696.82
|
| Rate for Payer: Priority Health Medicare |
$392.77
|
| Rate for Payer: Priority Health SBD |
$696.82
|
| Rate for Payer: Priority Health Tiered Network |
$696.82
|
| Rate for Payer: Railroad Medicare Medicare |
$392.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.62
|
| Rate for Payer: UHC Core |
$735.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$392.77
|
| Rate for Payer: UHC Exchange |
$735.62
|
| Rate for Payer: UHC Medicaid |
$259.22
|
| Rate for Payer: UHCCP Medicaid |
$259.22
|
|
|
PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
HCPCS 28112
|
| Min. Negotiated Rate |
$189.36 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Aetna Commercial |
$385.57
|
| Rate for Payer: Aetna Medicare |
$299.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.35
|
| Rate for Payer: BCBS Complete |
$198.83
|
| Rate for Payer: BCBS MAPPO |
$287.74
|
| Rate for Payer: BCN Commercial |
$477.56
|
| Rate for Payer: BCN Medicare Advantage |
$287.74
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$414.35
|
| Rate for Payer: Cofinity Commercial |
$385.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.74
|
| Rate for Payer: Healthscope Commercial |
$532.32
|
| Rate for Payer: Healthscope Commercial |
$460.38
|
| Rate for Payer: Mclaren Medicaid |
$189.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.13
|
| Rate for Payer: Meridian Medicaid |
$198.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$316.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.39
|
| Rate for Payer: Nomi Health Commercial |
$345.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$750.00
|
| Rate for Payer: PACE SWMI |
$287.74
|
| Rate for Payer: PHP Medicare Advantage |
$287.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$510.50
|
| Rate for Payer: Priority Health Medicare |
$287.74
|
| Rate for Payer: Priority Health SBD |
$510.50
|
| Rate for Payer: Priority Health Tiered Network |
$510.50
|
| Rate for Payer: Railroad Medicare Medicare |
$287.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$544.53
|
| Rate for Payer: UHC Core |
$544.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$287.74
|
| Rate for Payer: UHC Exchange |
$544.53
|
| Rate for Payer: UHC Medicaid |
$189.36
|
| Rate for Payer: UHCCP Medicaid |
$189.36
|
|
|
PR OSTECTOMY PRTL 5TH METAR HEAD SPX
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 28110
|
| Min. Negotiated Rate |
$179.99 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Aetna Commercial |
$365.74
|
| Rate for Payer: Aetna Medicare |
$283.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.03
|
| Rate for Payer: BCBS Complete |
$188.99
|
| Rate for Payer: BCBS MAPPO |
$272.94
|
| Rate for Payer: BCN Commercial |
$450.17
|
| Rate for Payer: BCN Medicare Advantage |
$272.94
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$393.03
|
| Rate for Payer: Cofinity Commercial |
$365.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.94
|
| Rate for Payer: Healthscope Commercial |
$504.94
|
| Rate for Payer: Healthscope Commercial |
$436.70
|
| Rate for Payer: Mclaren Medicaid |
$179.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.59
|
| Rate for Payer: Meridian Medicaid |
$188.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.68
|
| Rate for Payer: Nomi Health Commercial |
$327.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.75
|
| Rate for Payer: PACE SWMI |
$272.94
|
| Rate for Payer: PHP Medicare Advantage |
$272.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$481.22
|
| Rate for Payer: Priority Health Medicare |
$272.94
|
| Rate for Payer: Priority Health SBD |
$481.22
|
| Rate for Payer: Priority Health Tiered Network |
$481.22
|
| Rate for Payer: Railroad Medicare Medicare |
$272.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.57
|
| Rate for Payer: UHC Core |
$504.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.94
|
| Rate for Payer: UHC Exchange |
$504.57
|
| Rate for Payer: UHC Medicaid |
$179.99
|
| Rate for Payer: UHCCP Medicaid |
$179.99
|
|
|
PR OSTECTOMY STERNUM PARTIAL
|
Professional
|
Both
|
$4,072.00
|
|
|
Service Code
|
HCPCS 21620
|
| Min. Negotiated Rate |
$319.07 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Aetna Commercial |
$656.41
|
| Rate for Payer: Aetna Medicare |
$509.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.40
|
| Rate for Payer: BCBS Complete |
$335.02
|
| Rate for Payer: BCBS MAPPO |
$489.86
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: BCN Medicare Advantage |
$489.86
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cofinity Commercial |
$705.40
|
| Rate for Payer: Cofinity Commercial |
$656.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.86
|
| Rate for Payer: Healthscope Commercial |
$906.24
|
| Rate for Payer: Healthscope Commercial |
$783.78
|
| Rate for Payer: Mclaren Medicaid |
$319.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.35
|
| Rate for Payer: Meridian Medicaid |
$335.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$538.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.41
|
| Rate for Payer: Nomi Health Commercial |
$587.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,054.00
|
| Rate for Payer: PACE SWMI |
$489.86
|
| Rate for Payer: PHP Medicare Advantage |
$489.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$811.27
|
| Rate for Payer: Priority Health Medicare |
$489.86
|
| Rate for Payer: Priority Health SBD |
$811.27
|
| Rate for Payer: Priority Health Tiered Network |
$811.27
|
| Rate for Payer: Railroad Medicare Medicare |
$489.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.81
|
| Rate for Payer: UHC Core |
$886.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$489.86
|
| Rate for Payer: UHC Exchange |
$886.81
|
| Rate for Payer: UHC Medicaid |
$319.07
|
| Rate for Payer: UHCCP Medicaid |
$319.07
|
|
|
PR OSTECTOMY TARSAL COALITION
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 28116
|
| Min. Negotiated Rate |
$309.70 |
| Max. Negotiated Rate |
$1,111.50 |
| Rate for Payer: Aetna Commercial |
$636.19
|
| Rate for Payer: Aetna Medicare |
$493.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.67
|
| Rate for Payer: BCBS Complete |
$325.19
|
| Rate for Payer: BCBS MAPPO |
$474.77
|
| Rate for Payer: BCN Commercial |
$788.80
|
| Rate for Payer: BCN Medicare Advantage |
$474.77
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$683.67
|
| Rate for Payer: Cofinity Commercial |
$636.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.77
|
| Rate for Payer: Healthscope Commercial |
$878.32
|
| Rate for Payer: Healthscope Commercial |
$759.63
|
| Rate for Payer: Mclaren Medicaid |
$309.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.51
|
| Rate for Payer: Meridian Medicaid |
$325.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,040.65
|
| Rate for Payer: Nomi Health Commercial |
$569.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.50
|
| Rate for Payer: PACE SWMI |
$474.77
|
| Rate for Payer: PHP Medicare Advantage |
$474.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$843.21
|
| Rate for Payer: Priority Health Medicare |
$474.77
|
| Rate for Payer: Priority Health SBD |
$843.21
|
| Rate for Payer: Priority Health Tiered Network |
$843.21
|
| Rate for Payer: Railroad Medicare Medicare |
$474.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.23
|
| Rate for Payer: UHC Core |
$1,009.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$474.77
|
| Rate for Payer: UHC Exchange |
$1,009.23
|
| Rate for Payer: UHC Medicaid |
$309.70
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
|
|
PR OSTEOCHONDRAL ALLOGRAFT KNEE OPEN
|
Professional
|
Both
|
$4,712.00
|
|
|
Service Code
|
HCPCS 27415
|
| Min. Negotiated Rate |
$802.58 |
| Max. Negotiated Rate |
$3,534.00 |
| Rate for Payer: Aetna Commercial |
$1,655.78
|
| Rate for Payer: Aetna Medicare |
$1,285.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,655.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,779.35
|
| Rate for Payer: BCBS Complete |
$842.71
|
| Rate for Payer: BCBS MAPPO |
$1,235.66
|
| Rate for Payer: BCN Commercial |
$2,079.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.66
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,779.35
|
| Rate for Payer: Cofinity Commercial |
$1,655.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.66
|
| Rate for Payer: Healthscope Commercial |
$2,285.97
|
| Rate for Payer: Healthscope Commercial |
$1,977.06
|
| Rate for Payer: Mclaren Medicaid |
$802.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,297.44
|
| Rate for Payer: Meridian Medicaid |
$842.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,359.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,432.43
|
| Rate for Payer: Nomi Health Commercial |
$1,482.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,534.00
|
| Rate for Payer: PACE SWMI |
$1,235.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$802.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,222.47
|
| Rate for Payer: Priority Health Medicare |
$1,235.66
|
| Rate for Payer: Priority Health SBD |
$2,222.47
|
| Rate for Payer: Priority Health Tiered Network |
$2,222.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,235.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,407.06
|
| Rate for Payer: UHC Core |
$2,407.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,235.66
|
| Rate for Payer: UHC Exchange |
$2,407.06
|
| Rate for Payer: UHC Medicaid |
$802.58
|
| Rate for Payer: UHCCP Medicaid |
$802.58
|
|
|
PR OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 27416
|
| Min. Negotiated Rate |
$575.53 |
| Max. Negotiated Rate |
$2,392.50 |
| Rate for Payer: Aetna Commercial |
$1,186.33
|
| Rate for Payer: Aetna Medicare |
$920.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,274.86
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCBS MAPPO |
$885.32
|
| Rate for Payer: BCN Commercial |
$1,489.96
|
| Rate for Payer: BCN Medicare Advantage |
$885.32
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,274.86
|
| Rate for Payer: Cofinity Commercial |
$1,186.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$885.32
|
| Rate for Payer: Healthscope Commercial |
$1,637.84
|
| Rate for Payer: Healthscope Commercial |
$1,416.51
|
| Rate for Payer: Mclaren Medicaid |
$575.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$929.59
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$973.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,741.59
|
| Rate for Payer: Nomi Health Commercial |
$1,062.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,392.50
|
| Rate for Payer: PACE SWMI |
$885.32
|
| Rate for Payer: PHP Medicare Advantage |
$885.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,592.73
|
| Rate for Payer: Priority Health Medicare |
$885.32
|
| Rate for Payer: Priority Health SBD |
$1,592.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.73
|
| Rate for Payer: Railroad Medicare Medicare |
$885.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,718.25
|
| Rate for Payer: UHC Core |
$1,718.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$885.32
|
| Rate for Payer: UHC Exchange |
$1,718.25
|
| Rate for Payer: UHC Medicaid |
$575.53
|
| Rate for Payer: UHCCP Medicaid |
$575.53
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 98925
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$20.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.11
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$19.52
|
| Rate for Payer: BCN Commercial |
$22.70
|
| Rate for Payer: BCN Medicare Advantage |
$19.52
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$28.11
|
| Rate for Payer: Cofinity Commercial |
$26.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.52
|
| Rate for Payer: Healthscope Commercial |
$36.11
|
| Rate for Payer: Healthscope Commercial |
$31.23
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.50
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.37
|
| Rate for Payer: Nomi Health Commercial |
$23.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$19.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.23
|
| Rate for Payer: Priority Health Medicare |
$19.52
|
| Rate for Payer: Priority Health SBD |
$31.23
|
| Rate for Payer: Priority Health Tiered Network |
$31.23
|
| Rate for Payer: Railroad Medicare Medicare |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.58
|
| Rate for Payer: UHC Core |
$38.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.52
|
| Rate for Payer: UHC Exchange |
$38.58
|
| Rate for Payer: UHC Medicaid |
$12.57
|
| Rate for Payer: UHCCP Medicaid |
$12.57
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 98926
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$39.44
|
| Rate for Payer: Aetna Medicare |
$30.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.38
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.43
|
| Rate for Payer: BCN Commercial |
$34.38
|
| Rate for Payer: BCN Medicare Advantage |
$29.43
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$42.38
|
| Rate for Payer: Cofinity Commercial |
$39.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.43
|
| Rate for Payer: Healthscope Commercial |
$54.45
|
| Rate for Payer: Healthscope Commercial |
$47.09
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.90
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.24
|
| Rate for Payer: Nomi Health Commercial |
$35.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PACE SWMI |
$29.43
|
| Rate for Payer: PHP Medicare Advantage |
$29.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.31
|
| Rate for Payer: Priority Health Medicare |
$29.43
|
| Rate for Payer: Priority Health SBD |
$47.31
|
| Rate for Payer: Priority Health Tiered Network |
$47.31
|
| Rate for Payer: Railroad Medicare Medicare |
$29.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.51
|
| Rate for Payer: UHC Core |
$58.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.43
|
| Rate for Payer: UHC Exchange |
$58.51
|
| Rate for Payer: UHC Medicaid |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 98927
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Commercial |
$53.28
|
| Rate for Payer: Aetna Medicare |
$41.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$39.76
|
| Rate for Payer: BCN Commercial |
$45.73
|
| Rate for Payer: BCN Medicare Advantage |
$39.76
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$57.25
|
| Rate for Payer: Cofinity Commercial |
$53.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.76
|
| Rate for Payer: Healthscope Commercial |
$73.56
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.75
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.20
|
| Rate for Payer: Nomi Health Commercial |
$47.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: PACE SWMI |
$39.76
|
| Rate for Payer: PHP Medicare Advantage |
$39.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.91
|
| Rate for Payer: Priority Health Medicare |
$39.76
|
| Rate for Payer: Priority Health SBD |
$62.91
|
| Rate for Payer: Priority Health Tiered Network |
$62.91
|
| Rate for Payer: Railroad Medicare Medicare |
$39.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.76
|
| Rate for Payer: UHC Core |
$76.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.76
|
| Rate for Payer: UHC Exchange |
$76.76
|
| Rate for Payer: UHC Medicaid |
$25.56
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 98928
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Aetna Commercial |
$66.57
|
| Rate for Payer: Aetna Medicare |
$51.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.54
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$49.68
|
| Rate for Payer: BCN Commercial |
$57.75
|
| Rate for Payer: BCN Medicare Advantage |
$49.68
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$71.54
|
| Rate for Payer: Cofinity Commercial |
$66.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.68
|
| Rate for Payer: Healthscope Commercial |
$91.91
|
| Rate for Payer: Healthscope Commercial |
$79.49
|
| Rate for Payer: Mclaren Medicaid |
$31.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.16
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.71
|
| Rate for Payer: Nomi Health Commercial |
$59.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$49.68
|
| Rate for Payer: PHP Medicare Advantage |
$49.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$79.45
|
| Rate for Payer: Priority Health Medicare |
$49.68
|
| Rate for Payer: Priority Health SBD |
$79.45
|
| Rate for Payer: Priority Health Tiered Network |
$79.45
|
| Rate for Payer: Railroad Medicare Medicare |
$49.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.12
|
| Rate for Payer: UHC Core |
$96.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.68
|
| Rate for Payer: UHC Exchange |
$96.12
|
| Rate for Payer: UHC Medicaid |
$31.95
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 98929
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$117.71 |
| Rate for Payer: Aetna Commercial |
$78.94
|
| Rate for Payer: Aetna Medicare |
$61.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.83
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$58.91
|
| Rate for Payer: BCN Commercial |
$68.76
|
| Rate for Payer: BCN Medicare Advantage |
$58.91
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$84.83
|
| Rate for Payer: Cofinity Commercial |
$78.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.91
|
| Rate for Payer: Healthscope Commercial |
$94.26
|
| Rate for Payer: Healthscope Commercial |
$108.98
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.86
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.68
|
| Rate for Payer: Nomi Health Commercial |
$70.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: PACE SWMI |
$58.91
|
| Rate for Payer: PHP Medicare Advantage |
$58.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.60
|
| Rate for Payer: Priority Health Medicare |
$58.91
|
| Rate for Payer: Priority Health SBD |
$94.60
|
| Rate for Payer: Priority Health Tiered Network |
$94.60
|
| Rate for Payer: Railroad Medicare Medicare |
$58.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.71
|
| Rate for Payer: UHC Core |
$117.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.91
|
| Rate for Payer: UHC Exchange |
$117.71
|
| Rate for Payer: UHC Medicaid |
$37.91
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
|
PR OSTEOPLASTY CARPAL BONE SHORTENING
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 25394
|
| Min. Negotiated Rate |
$469.03 |
| Max. Negotiated Rate |
$1,497.00 |
| Rate for Payer: Aetna Commercial |
$962.76
|
| Rate for Payer: Aetna Medicare |
$747.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.76
|
| Rate for Payer: BCBS Complete |
$492.48
|
| Rate for Payer: BCBS MAPPO |
$718.48
|
| Rate for Payer: BCN Commercial |
$1,199.63
|
| Rate for Payer: BCN Medicare Advantage |
$718.48
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$962.76
|
| Rate for Payer: Cofinity Commercial |
$1,034.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$718.48
|
| Rate for Payer: Healthscope Commercial |
$1,329.19
|
| Rate for Payer: Healthscope Commercial |
$1,149.57
|
| Rate for Payer: Mclaren Medicaid |
$469.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.40
|
| Rate for Payer: Meridian Medicaid |
$492.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$790.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.72
|
| Rate for Payer: Nomi Health Commercial |
$862.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$718.48
|
| Rate for Payer: PHP Medicare Advantage |
$718.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,282.38
|
| Rate for Payer: Priority Health Medicare |
$718.48
|
| Rate for Payer: Priority Health SBD |
$1,282.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,282.38
|
| Rate for Payer: Railroad Medicare Medicare |
$718.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,370.74
|
| Rate for Payer: UHC Core |
$1,370.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$718.48
|
| Rate for Payer: UHC Exchange |
$1,370.74
|
| Rate for Payer: UHC Medicaid |
$469.03
|
| Rate for Payer: UHCCP Medicaid |
$469.03
|
|
|
PR OSTEOPLASTY FEMUR LENGTHENING
|
Professional
|
Both
|
$4,100.00
|
|
|
Service Code
|
HCPCS 27466
|
| Min. Negotiated Rate |
$873.30 |
| Max. Negotiated Rate |
$3,075.00 |
| Rate for Payer: Aetna Commercial |
$1,806.91
|
| Rate for Payer: Aetna Medicare |
$1,402.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,806.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.75
|
| Rate for Payer: BCBS Complete |
$916.97
|
| Rate for Payer: BCBS MAPPO |
$1,348.44
|
| Rate for Payer: BCN Commercial |
$1,794.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,348.44
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,941.75
|
| Rate for Payer: Cofinity Commercial |
$1,806.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,348.44
|
| Rate for Payer: Healthscope Commercial |
$2,494.61
|
| Rate for Payer: Healthscope Commercial |
$2,157.50
|
| Rate for Payer: Mclaren Medicaid |
$873.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,415.86
|
| Rate for Payer: Meridian Medicaid |
$916.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,483.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,101.50
|
| Rate for Payer: Nomi Health Commercial |
$1,618.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,075.00
|
| Rate for Payer: PACE SWMI |
$1,348.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,348.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,917.97
|
| Rate for Payer: Priority Health Medicare |
$1,348.44
|
| Rate for Payer: Priority Health SBD |
$1,917.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,917.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,348.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,077.13
|
| Rate for Payer: UHC Core |
$2,077.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,348.44
|
| Rate for Payer: UHC Exchange |
$2,077.13
|
| Rate for Payer: UHC Medicaid |
$873.30
|
| Rate for Payer: UHCCP Medicaid |
$873.30
|
|
|
PR OSTEOPLASTY HUMERUS
|
Professional
|
Both
|
$3,435.00
|
|
|
Service Code
|
HCPCS 24420
|
| Min. Negotiated Rate |
$638.79 |
| Max. Negotiated Rate |
$2,576.25 |
| Rate for Payer: Aetna Commercial |
$1,305.19
|
| Rate for Payer: Aetna Medicare |
$1,012.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.59
|
| Rate for Payer: BCBS Complete |
$670.73
|
| Rate for Payer: BCBS MAPPO |
$974.02
|
| Rate for Payer: BCN Commercial |
$1,610.97
|
| Rate for Payer: BCN Medicare Advantage |
$974.02
|
| Rate for Payer: Cash Price |
$2,748.00
|
| Rate for Payer: Cash Price |
$2,748.00
|
| Rate for Payer: Cofinity Commercial |
$1,402.59
|
| Rate for Payer: Cofinity Commercial |
$1,305.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.02
|
| Rate for Payer: Healthscope Commercial |
$1,801.94
|
| Rate for Payer: Healthscope Commercial |
$1,558.43
|
| Rate for Payer: Mclaren Medicaid |
$638.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.72
|
| Rate for Payer: Meridian Medicaid |
$670.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,071.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,884.94
|
| Rate for Payer: Nomi Health Commercial |
$1,168.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,576.25
|
| Rate for Payer: PACE SWMI |
$974.02
|
| Rate for Payer: PHP Medicare Advantage |
$974.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,722.08
|
| Rate for Payer: Priority Health Medicare |
$974.02
|
| Rate for Payer: Priority Health SBD |
$1,722.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,722.08
|
| Rate for Payer: Railroad Medicare Medicare |
$974.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,787.24
|
| Rate for Payer: UHC Core |
$1,787.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$974.02
|
| Rate for Payer: UHC Exchange |
$1,787.24
|
| Rate for Payer: UHC Medicaid |
$638.79
|
| Rate for Payer: UHCCP Medicaid |
$638.79
|
|
|
PR OSTEOPLASTY RADIUS/ULNA SHORTENING
|
Professional
|
Both
|
$2,770.00
|
|
|
Service Code
|
HCPCS 25390
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$2,077.50 |
| Rate for Payer: Aetna Commercial |
$922.16
|
| Rate for Payer: Aetna Medicare |
$715.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.98
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS MAPPO |
$688.18
|
| Rate for Payer: BCN Commercial |
$1,174.73
|
| Rate for Payer: BCN Medicare Advantage |
$688.18
|
| Rate for Payer: Cash Price |
$2,216.00
|
| Rate for Payer: Cash Price |
$2,216.00
|
| Rate for Payer: Cofinity Commercial |
$990.98
|
| Rate for Payer: Cofinity Commercial |
$922.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.18
|
| Rate for Payer: Healthscope Commercial |
$1,273.13
|
| Rate for Payer: Healthscope Commercial |
$1,101.09
|
| Rate for Payer: Mclaren Medicaid |
$449.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.59
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$757.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,366.74
|
| Rate for Payer: Nomi Health Commercial |
$825.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.50
|
| Rate for Payer: PACE SWMI |
$688.18
|
| Rate for Payer: PHP Medicare Advantage |
$688.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,255.75
|
| Rate for Payer: Priority Health Medicare |
$688.18
|
| Rate for Payer: Priority Health SBD |
$1,255.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,255.75
|
| Rate for Payer: Railroad Medicare Medicare |
$688.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,341.56
|
| Rate for Payer: UHC Core |
$1,341.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.18
|
| Rate for Payer: UHC Exchange |
$1,341.56
|
| Rate for Payer: UHC Medicaid |
$449.43
|
| Rate for Payer: UHCCP Medicaid |
$449.43
|
|
|
PR OSTEOPLASTY TIBIA&FIBULA LENGTHENING/SHORTENING
|
Professional
|
Both
|
$4,914.00
|
|
|
Service Code
|
HCPCS 27715
|
| Min. Negotiated Rate |
$868.61 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$1,797.09
|
| Rate for Payer: Aetna Medicare |
$1,394.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,931.20
|
| Rate for Payer: BCBS Complete |
$912.04
|
| Rate for Payer: BCBS MAPPO |
$1,341.11
|
| Rate for Payer: BCN Commercial |
$1,624.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,341.11
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,797.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,341.11
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Commercial |
$2,145.78
|
| Rate for Payer: Mclaren Medicaid |
$868.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,408.17
|
| Rate for Payer: Meridian Medicaid |
$912.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,475.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,902.62
|
| Rate for Payer: Nomi Health Commercial |
$1,609.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,685.50
|
| Rate for Payer: PACE SWMI |
$1,341.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,341.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$868.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,736.99
|
| Rate for Payer: Priority Health Medicare |
$1,341.11
|
| Rate for Payer: Priority Health SBD |
$1,736.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,736.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,341.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,878.47
|
| Rate for Payer: UHC Core |
$1,878.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,341.11
|
| Rate for Payer: UHC Exchange |
$1,878.47
|
| Rate for Payer: UHC Medicaid |
$868.61
|
| Rate for Payer: UHCCP Medicaid |
$868.61
|
|
|
PR OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL
|
Professional
|
Both
|
$8,107.00
|
|
|
Service Code
|
HCPCS 27165
|
| Min. Negotiated Rate |
$803.22 |
| Max. Negotiated Rate |
$6,080.25 |
| Rate for Payer: Aetna Commercial |
$1,658.68
|
| Rate for Payer: Aetna Medicare |
$1,287.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,658.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,782.46
|
| Rate for Payer: BCBS Complete |
$843.38
|
| Rate for Payer: BCBS MAPPO |
$1,237.82
|
| Rate for Payer: BCN Commercial |
$2,069.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.82
|
| Rate for Payer: Cash Price |
$6,485.60
|
| Rate for Payer: Cash Price |
$6,485.60
|
| Rate for Payer: Cofinity Commercial |
$1,782.46
|
| Rate for Payer: Cofinity Commercial |
$1,658.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.82
|
| Rate for Payer: Healthscope Commercial |
$2,289.97
|
| Rate for Payer: Healthscope Commercial |
$1,980.51
|
| Rate for Payer: Mclaren Medicaid |
$803.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.71
|
| Rate for Payer: Meridian Medicaid |
$843.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,361.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,436.98
|
| Rate for Payer: Nomi Health Commercial |
$1,485.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,080.25
|
| Rate for Payer: PACE SWMI |
$1,237.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,212.35
|
| Rate for Payer: Priority Health Medicare |
$1,237.82
|
| Rate for Payer: Priority Health SBD |
$2,212.35
|
| Rate for Payer: Priority Health Tiered Network |
$2,212.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,237.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,409.13
|
| Rate for Payer: UHC Core |
$2,409.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,237.82
|
| Rate for Payer: UHC Exchange |
$2,409.13
|
| Rate for Payer: UHC Medicaid |
$803.22
|
| Rate for Payer: UHCCP Medicaid |
$803.22
|
|
|
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,798.00
|
|
|
Service Code
|
HCPCS 28300
|
| Min. Negotiated Rate |
$389.79 |
| Max. Negotiated Rate |
$1,348.50 |
| Rate for Payer: Aetna Commercial |
$800.32
|
| Rate for Payer: Aetna Medicare |
$621.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.04
|
| Rate for Payer: BCBS Complete |
$409.28
|
| Rate for Payer: BCBS MAPPO |
$597.25
|
| Rate for Payer: BCN Commercial |
$989.99
|
| Rate for Payer: BCN Medicare Advantage |
$597.25
|
| Rate for Payer: Cash Price |
$1,438.40
|
| Rate for Payer: Cash Price |
$1,438.40
|
| Rate for Payer: Cofinity Commercial |
$860.04
|
| Rate for Payer: Cofinity Commercial |
$800.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.25
|
| Rate for Payer: Healthscope Commercial |
$955.60
|
| Rate for Payer: Healthscope Commercial |
$1,104.91
|
| Rate for Payer: Mclaren Medicaid |
$389.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.11
|
| Rate for Payer: Meridian Medicaid |
$409.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$656.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,152.45
|
| Rate for Payer: Nomi Health Commercial |
$716.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,348.50
|
| Rate for Payer: PACE SWMI |
$597.25
|
| Rate for Payer: PHP Medicare Advantage |
$597.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,058.27
|
| Rate for Payer: Priority Health Medicare |
$597.25
|
| Rate for Payer: Priority Health SBD |
$1,058.27
|
| Rate for Payer: Priority Health Tiered Network |
$1,058.27
|
| Rate for Payer: Railroad Medicare Medicare |
$597.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,138.92
|
| Rate for Payer: UHC Core |
$1,138.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$597.25
|
| Rate for Payer: UHC Exchange |
$1,138.92
|
| Rate for Payer: UHC Medicaid |
$389.79
|
| Rate for Payer: UHCCP Medicaid |
$389.79
|
|
|
PR OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,781.00
|
|
|
Service Code
|
HCPCS 23480
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$1,458.63 |
| Rate for Payer: Aetna Commercial |
$1,001.56
|
| Rate for Payer: Aetna Medicare |
$777.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,076.30
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$747.43
|
| Rate for Payer: BCN Commercial |
$1,250.43
|
| Rate for Payer: BCN Medicare Advantage |
$747.43
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,076.30
|
| Rate for Payer: Cofinity Commercial |
$1,001.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.43
|
| Rate for Payer: Healthscope Commercial |
$1,382.75
|
| Rate for Payer: Healthscope Commercial |
$1,195.89
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.80
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$822.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,458.63
|
| Rate for Payer: Nomi Health Commercial |
$896.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.75
|
| Rate for Payer: PACE SWMI |
$747.43
|
| Rate for Payer: PHP Medicare Advantage |
$747.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,336.67
|
| Rate for Payer: Priority Health Medicare |
$747.43
|
| Rate for Payer: Priority Health SBD |
$1,336.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,336.67
|
| Rate for Payer: Railroad Medicare Medicare |
$747.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,435.43
|
| Rate for Payer: UHC Core |
$1,435.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$747.43
|
| Rate for Payer: UHC Exchange |
$1,435.43
|
| Rate for Payer: UHC Medicaid |
$487.13
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 23485
|
| Min. Negotiated Rate |
$555.72 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,145.61
|
| Rate for Payer: Aetna Medicare |
$889.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.10
|
| Rate for Payer: BCBS Complete |
$583.51
|
| Rate for Payer: BCBS MAPPO |
$854.93
|
| Rate for Payer: BCN Commercial |
$1,446.63
|
| Rate for Payer: BCN Medicare Advantage |
$854.93
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,231.10
|
| Rate for Payer: Cofinity Commercial |
$1,145.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.93
|
| Rate for Payer: Healthscope Commercial |
$1,581.62
|
| Rate for Payer: Healthscope Commercial |
$1,367.89
|
| Rate for Payer: Mclaren Medicaid |
$555.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.68
|
| Rate for Payer: Meridian Medicaid |
$583.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$940.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,694.56
|
| Rate for Payer: Nomi Health Commercial |
$1,025.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,875.00
|
| Rate for Payer: PACE SWMI |
$854.93
|
| Rate for Payer: PHP Medicare Advantage |
$854.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,546.42
|
| Rate for Payer: Priority Health Medicare |
$854.93
|
| Rate for Payer: Priority Health SBD |
$1,546.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,546.42
|
| Rate for Payer: Railroad Medicare Medicare |
$854.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,676.63
|
| Rate for Payer: UHC Core |
$1,676.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$854.93
|
| Rate for Payer: UHC Exchange |
$1,676.63
|
| Rate for Payer: UHC Medicaid |
$555.72
|
| Rate for Payer: UHCCP Medicaid |
$555.72
|
|
|
PR OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION
|
Professional
|
Both
|
$3,001.00
|
|
|
Service Code
|
HCPCS 27450
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$2,250.75 |
| Rate for Payer: Aetna Commercial |
$1,219.78
|
| Rate for Payer: Aetna Medicare |
$946.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.80
|
| Rate for Payer: BCBS Complete |
$621.75
|
| Rate for Payer: BCBS MAPPO |
$910.28
|
| Rate for Payer: BCN Commercial |
$1,527.30
|
| Rate for Payer: BCN Medicare Advantage |
$910.28
|
| Rate for Payer: Cash Price |
$2,400.80
|
| Rate for Payer: Cash Price |
$2,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,310.80
|
| Rate for Payer: Cofinity Commercial |
$1,219.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.28
|
| Rate for Payer: Healthscope Commercial |
$1,684.02
|
| Rate for Payer: Healthscope Commercial |
$1,456.45
|
| Rate for Payer: Mclaren Medicaid |
$592.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.79
|
| Rate for Payer: Meridian Medicaid |
$621.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,802.12
|
| Rate for Payer: Nomi Health Commercial |
$1,092.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.75
|
| Rate for Payer: PACE SWMI |
$910.28
|
| Rate for Payer: PHP Medicare Advantage |
$910.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,632.65
|
| Rate for Payer: Priority Health Medicare |
$910.28
|
| Rate for Payer: Priority Health SBD |
$1,632.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,632.65
|
| Rate for Payer: Railroad Medicare Medicare |
$910.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,778.26
|
| Rate for Payer: UHC Core |
$1,778.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$910.28
|
| Rate for Payer: UHC Exchange |
$1,778.26
|
| Rate for Payer: UHC Medicaid |
$592.14
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
|
|
PR OSTEOTOMY FIBULA
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27707
|
| Min. Negotiated Rate |
$250.28 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Aetna Commercial |
$506.90
|
| Rate for Payer: Aetna Medicare |
$393.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.72
|
| Rate for Payer: BCBS Complete |
$262.79
|
| Rate for Payer: BCBS MAPPO |
$378.28
|
| Rate for Payer: BCN Commercial |
$622.97
|
| Rate for Payer: BCN Medicare Advantage |
$378.28
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$544.72
|
| Rate for Payer: Cofinity Commercial |
$506.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.28
|
| Rate for Payer: Healthscope Commercial |
$699.82
|
| Rate for Payer: Healthscope Commercial |
$605.25
|
| Rate for Payer: Mclaren Medicaid |
$250.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.19
|
| Rate for Payer: Meridian Medicaid |
$262.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.21
|
| Rate for Payer: Nomi Health Commercial |
$453.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: PACE SWMI |
$378.28
|
| Rate for Payer: PHP Medicare Advantage |
$378.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$665.93
|
| Rate for Payer: Priority Health Medicare |
$378.28
|
| Rate for Payer: Priority Health SBD |
$665.93
|
| Rate for Payer: Priority Health Tiered Network |
$665.93
|
| Rate for Payer: Railroad Medicare Medicare |
$378.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$690.19
|
| Rate for Payer: UHC Core |
$690.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.28
|
| Rate for Payer: UHC Exchange |
$690.19
|
| Rate for Payer: UHC Medicaid |
$250.28
|
| Rate for Payer: UHCCP Medicaid |
$250.28
|
|
|
PR OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 24400
|
| Min. Negotiated Rate |
$494.16 |
| Max. Negotiated Rate |
$1,470.22 |
| Rate for Payer: Aetna Commercial |
$1,013.68
|
| Rate for Payer: Aetna Medicare |
$786.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,013.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.33
|
| Rate for Payer: BCBS Complete |
$518.87
|
| Rate for Payer: BCBS MAPPO |
$756.48
|
| Rate for Payer: BCN Commercial |
$1,262.88
|
| Rate for Payer: BCN Medicare Advantage |
$756.48
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$1,089.33
|
| Rate for Payer: Cofinity Commercial |
$1,013.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.48
|
| Rate for Payer: Healthscope Commercial |
$1,399.49
|
| Rate for Payer: Healthscope Commercial |
$1,210.37
|
| Rate for Payer: Mclaren Medicaid |
$494.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.30
|
| Rate for Payer: Meridian Medicaid |
$518.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$832.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,470.22
|
| Rate for Payer: Nomi Health Commercial |
$907.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,132.50
|
| Rate for Payer: PACE SWMI |
$756.48
|
| Rate for Payer: PHP Medicare Advantage |
$756.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,349.99
|
| Rate for Payer: Priority Health Medicare |
$756.48
|
| Rate for Payer: Priority Health SBD |
$1,349.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,349.99
|
| Rate for Payer: Railroad Medicare Medicare |
$756.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,437.29
|
| Rate for Payer: UHC Core |
$1,437.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$756.48
|
| Rate for Payer: UHC Exchange |
$1,437.29
|
| Rate for Payer: UHC Medicaid |
$494.16
|
| Rate for Payer: UHCCP Medicaid |
$494.16
|
|
