|
PR ORPHENADRINE INJECTION
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS J2360
|
| Min. Negotiated Rate |
$11.19 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna Commercial |
$14.99
|
| Rate for Payer: Aetna Medicare |
$11.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.99
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$11.19
|
| Rate for Payer: BCN Medicare Advantage |
$11.19
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.19
|
| Rate for Payer: Healthscope Commercial |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$20.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.50
|
| Rate for Payer: Nomi Health Commercial |
$13.43
|
| Rate for Payer: PACE SWMI |
$11.19
|
| Rate for Payer: PHP Medicare Advantage |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$11.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$11.19
|
|
|
PR ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 97760
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$80.23 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.12
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Healthscope Commercial |
$80.23
|
| Rate for Payer: Healthscope Commercial |
$69.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.80
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.37
|
| Rate for Payer: UHC Medicare Advantage |
$43.37
|
|
|
PR ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 97763
|
| Min. Negotiated Rate |
$42.40 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$63.17
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.17
|
| Rate for Payer: BCBS Complete |
$42.40
|
| Rate for Payer: BCBS MAPPO |
$47.14
|
| Rate for Payer: BCN Medicare Advantage |
$47.14
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$67.88
|
| Rate for Payer: Cofinity Commercial |
$63.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.14
|
| Rate for Payer: Healthscope Commercial |
$75.42
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.90
|
| Rate for Payer: Nomi Health Commercial |
$56.57
|
| Rate for Payer: PACE SWMI |
$47.14
|
| Rate for Payer: PHP Medicare Advantage |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.90
|
| Rate for Payer: Priority Health Medicare |
$47.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.14
|
| Rate for Payer: UHC Medicare Advantage |
$47.14
|
|
|
PR ORTHOVISC INJ PER DOSE
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS J7324
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$211.90 |
| Rate for Payer: Aetna Commercial |
$153.48
|
| Rate for Payer: Aetna Medicare |
$119.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.48
|
| Rate for Payer: BCBS Complete |
$75.60
|
| Rate for Payer: BCBS MAPPO |
$114.54
|
| Rate for Payer: BCN Medicare Advantage |
$114.54
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cofinity Commercial |
$164.94
|
| Rate for Payer: Cofinity Commercial |
$153.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.54
|
| Rate for Payer: Healthscope Commercial |
$211.90
|
| Rate for Payer: Healthscope Commercial |
$183.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.85
|
| Rate for Payer: Nomi Health Commercial |
$137.45
|
| Rate for Payer: PACE SWMI |
$114.54
|
| Rate for Payer: PHP Medicare Advantage |
$114.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.85
|
| Rate for Payer: Priority Health Medicare |
$114.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.54
|
| Rate for Payer: UHC Medicare Advantage |
$114.54
|
|
|
PR OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 28114
|
| Min. Negotiated Rate |
$775.20 |
| Max. Negotiated Rate |
$1,485.05 |
| Rate for Payer: Aetna Commercial |
$1,075.66
|
| Rate for Payer: Aetna Medicare |
$834.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.66
|
| Rate for Payer: BCBS Complete |
$775.20
|
| Rate for Payer: BCBS MAPPO |
$802.73
|
| Rate for Payer: BCN Medicare Advantage |
$802.73
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,155.93
|
| Rate for Payer: Cofinity Commercial |
$1,075.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.73
|
| Rate for Payer: Healthscope Commercial |
$1,284.37
|
| Rate for Payer: Healthscope Commercial |
$1,485.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$963.28
|
| Rate for Payer: PACE SWMI |
$802.73
|
| Rate for Payer: PHP Medicare Advantage |
$802.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health Medicare |
$802.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$802.73
|
| Rate for Payer: UHC Medicare Advantage |
$802.73
|
|
|
PR OSTC PRTL EXOSTC/CONDYLC METAR HEAD
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 28288
|
| Min. Negotiated Rate |
$395.20 |
| Max. Negotiated Rate |
$766.60 |
| Rate for Payer: Aetna Commercial |
$555.27
|
| Rate for Payer: Aetna Medicare |
$430.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$555.27
|
| Rate for Payer: BCBS Complete |
$395.20
|
| Rate for Payer: BCBS MAPPO |
$414.38
|
| Rate for Payer: BCN Medicare Advantage |
$414.38
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Commercial |
$596.71
|
| Rate for Payer: Cofinity Commercial |
$555.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.38
|
| Rate for Payer: Healthscope Commercial |
$766.60
|
| Rate for Payer: Healthscope Commercial |
$663.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$435.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.20
|
| Rate for Payer: Nomi Health Commercial |
$497.26
|
| Rate for Payer: PACE SWMI |
$414.38
|
| Rate for Payer: PHP Medicare Advantage |
$414.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health Medicare |
$414.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$414.38
|
| Rate for Payer: UHC Medicare Advantage |
$414.38
|
|
|
PR OSTECTOMY CALCANEUS
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 28118
|
| Min. Negotiated Rate |
$407.09 |
| Max. Negotiated Rate |
$753.12 |
| Rate for Payer: Aetna Commercial |
$545.50
|
| Rate for Payer: Aetna Medicare |
$423.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.50
|
| Rate for Payer: BCBS Complete |
$411.60
|
| Rate for Payer: BCBS MAPPO |
$407.09
|
| Rate for Payer: BCN Medicare Advantage |
$407.09
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$586.21
|
| Rate for Payer: Cofinity Commercial |
$545.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.09
|
| Rate for Payer: Healthscope Commercial |
$651.34
|
| Rate for Payer: Healthscope Commercial |
$753.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.85
|
| Rate for Payer: Nomi Health Commercial |
$488.51
|
| Rate for Payer: PACE SWMI |
$407.09
|
| Rate for Payer: PHP Medicare Advantage |
$407.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health Medicare |
$407.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.09
|
| Rate for Payer: UHC Medicare Advantage |
$407.09
|
|
|
PR OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS
|
Professional
|
Both
|
$1,222.00
|
|
|
Service Code
|
HCPCS 28119
|
| Min. Negotiated Rate |
$348.90 |
| Max. Negotiated Rate |
$794.30 |
| Rate for Payer: Aetna Commercial |
$467.53
|
| Rate for Payer: Aetna Medicare |
$362.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.53
|
| Rate for Payer: BCBS Complete |
$488.80
|
| Rate for Payer: BCBS MAPPO |
$348.90
|
| Rate for Payer: BCN Medicare Advantage |
$348.90
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cofinity Commercial |
$502.42
|
| Rate for Payer: Cofinity Commercial |
$467.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.90
|
| Rate for Payer: Healthscope Commercial |
$645.47
|
| Rate for Payer: Healthscope Commercial |
$558.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.30
|
| Rate for Payer: Nomi Health Commercial |
$418.68
|
| Rate for Payer: PACE SWMI |
$348.90
|
| Rate for Payer: PHP Medicare Advantage |
$348.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.30
|
| Rate for Payer: Priority Health Medicare |
$348.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.90
|
| Rate for Payer: UHC Medicare Advantage |
$348.90
|
|
|
PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 28111
|
| Min. Negotiated Rate |
$305.36 |
| Max. Negotiated Rate |
$564.92 |
| Rate for Payer: Aetna Commercial |
$409.18
|
| Rate for Payer: Aetna Medicare |
$317.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.18
|
| Rate for Payer: BCBS Complete |
$332.40
|
| Rate for Payer: BCBS MAPPO |
$305.36
|
| Rate for Payer: BCN Medicare Advantage |
$305.36
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$439.72
|
| Rate for Payer: Cofinity Commercial |
$409.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.36
|
| Rate for Payer: Healthscope Commercial |
$488.58
|
| Rate for Payer: Healthscope Commercial |
$564.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$540.15
|
| Rate for Payer: Nomi Health Commercial |
$366.43
|
| Rate for Payer: PACE SWMI |
$305.36
|
| Rate for Payer: PHP Medicare Advantage |
$305.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health Medicare |
$305.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.36
|
| Rate for Payer: UHC Medicare Advantage |
$305.36
|
|
|
PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Professional
|
Both
|
$1,034.00
|
|
|
Service Code
|
HCPCS 28113
|
| Min. Negotiated Rate |
$408.41 |
| Max. Negotiated Rate |
$755.56 |
| Rate for Payer: Aetna Commercial |
$547.27
|
| Rate for Payer: Aetna Medicare |
$424.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.27
|
| Rate for Payer: BCBS Complete |
$413.60
|
| Rate for Payer: BCBS MAPPO |
$408.41
|
| Rate for Payer: BCN Medicare Advantage |
$408.41
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cofinity Commercial |
$588.11
|
| Rate for Payer: Cofinity Commercial |
$547.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.41
|
| Rate for Payer: Healthscope Commercial |
$755.56
|
| Rate for Payer: Healthscope Commercial |
$653.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.10
|
| Rate for Payer: Nomi Health Commercial |
$490.09
|
| Rate for Payer: PACE SWMI |
$408.41
|
| Rate for Payer: PHP Medicare Advantage |
$408.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.10
|
| Rate for Payer: Priority Health Medicare |
$408.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.41
|
| Rate for Payer: UHC Medicare Advantage |
$408.41
|
|
|
PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4
|
Professional
|
Both
|
$971.00
|
|
|
Service Code
|
HCPCS 28112
|
| Min. Negotiated Rate |
$300.16 |
| Max. Negotiated Rate |
$631.15 |
| Rate for Payer: Aetna Commercial |
$402.21
|
| Rate for Payer: Aetna Medicare |
$312.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.21
|
| Rate for Payer: BCBS Complete |
$388.40
|
| Rate for Payer: BCBS MAPPO |
$300.16
|
| Rate for Payer: BCN Medicare Advantage |
$300.16
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cofinity Commercial |
$432.23
|
| Rate for Payer: Cofinity Commercial |
$402.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.16
|
| Rate for Payer: Healthscope Commercial |
$480.26
|
| Rate for Payer: Healthscope Commercial |
$555.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$631.15
|
| Rate for Payer: Nomi Health Commercial |
$360.19
|
| Rate for Payer: PACE SWMI |
$300.16
|
| Rate for Payer: PHP Medicare Advantage |
$300.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.15
|
| Rate for Payer: Priority Health Medicare |
$300.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.16
|
| Rate for Payer: UHC Medicare Advantage |
$300.16
|
|
|
PR OSTECTOMY PRTL 5TH METAR HEAD SPX
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 28110
|
| Min. Negotiated Rate |
$282.52 |
| Max. Negotiated Rate |
$594.10 |
| Rate for Payer: Aetna Commercial |
$378.58
|
| Rate for Payer: Aetna Medicare |
$293.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.58
|
| Rate for Payer: BCBS Complete |
$365.60
|
| Rate for Payer: BCBS MAPPO |
$282.52
|
| Rate for Payer: BCN Medicare Advantage |
$282.52
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$406.83
|
| Rate for Payer: Cofinity Commercial |
$378.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.52
|
| Rate for Payer: Healthscope Commercial |
$522.66
|
| Rate for Payer: Healthscope Commercial |
$452.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$594.10
|
| Rate for Payer: Nomi Health Commercial |
$339.02
|
| Rate for Payer: PACE SWMI |
$282.52
|
| Rate for Payer: PHP Medicare Advantage |
$282.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health Medicare |
$282.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.52
|
| Rate for Payer: UHC Medicare Advantage |
$282.52
|
|
|
PR OSTECTOMY STERNUM PARTIAL
|
Professional
|
Both
|
$3,953.00
|
|
|
Service Code
|
HCPCS 21620
|
| Min. Negotiated Rate |
$484.45 |
| Max. Negotiated Rate |
$2,569.45 |
| Rate for Payer: Aetna Commercial |
$649.16
|
| Rate for Payer: Aetna Medicare |
$503.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.16
|
| Rate for Payer: BCBS Complete |
$1,581.20
|
| Rate for Payer: BCBS MAPPO |
$484.45
|
| Rate for Payer: BCN Medicare Advantage |
$484.45
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cofinity Commercial |
$697.61
|
| Rate for Payer: Cofinity Commercial |
$649.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.45
|
| Rate for Payer: Healthscope Commercial |
$775.12
|
| Rate for Payer: Healthscope Commercial |
$896.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,569.45
|
| Rate for Payer: Nomi Health Commercial |
$581.34
|
| Rate for Payer: PACE SWMI |
$484.45
|
| Rate for Payer: PHP Medicare Advantage |
$484.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,569.45
|
| Rate for Payer: Priority Health Medicare |
$484.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.45
|
| Rate for Payer: UHC Medicare Advantage |
$484.45
|
|
|
PR OSTECTOMY TARSAL COALITION
|
Professional
|
Both
|
$1,439.00
|
|
|
Service Code
|
HCPCS 28116
|
| Min. Negotiated Rate |
$499.10 |
| Max. Negotiated Rate |
$935.35 |
| Rate for Payer: Aetna Commercial |
$668.79
|
| Rate for Payer: Aetna Medicare |
$519.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$668.79
|
| Rate for Payer: BCBS Complete |
$575.60
|
| Rate for Payer: BCBS MAPPO |
$499.10
|
| Rate for Payer: BCN Medicare Advantage |
$499.10
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cofinity Commercial |
$718.70
|
| Rate for Payer: Cofinity Commercial |
$668.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.10
|
| Rate for Payer: Healthscope Commercial |
$923.34
|
| Rate for Payer: Healthscope Commercial |
$798.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$935.35
|
| Rate for Payer: Nomi Health Commercial |
$598.92
|
| Rate for Payer: PACE SWMI |
$499.10
|
| Rate for Payer: PHP Medicare Advantage |
$499.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$935.35
|
| Rate for Payer: Priority Health Medicare |
$499.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$499.10
|
| Rate for Payer: UHC Medicare Advantage |
$499.10
|
|
|
PR OSTEOCHONDRAL ALLOGRAFT KNEE OPEN
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 27415
|
| Min. Negotiated Rate |
$1,322.51 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,772.16
|
| Rate for Payer: Aetna Medicare |
$1,375.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,772.16
|
| Rate for Payer: BCBS Complete |
$1,830.00
|
| Rate for Payer: BCBS MAPPO |
$1,322.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,322.51
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,904.41
|
| Rate for Payer: Cofinity Commercial |
$1,772.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,322.51
|
| Rate for Payer: Healthscope Commercial |
$2,116.02
|
| Rate for Payer: Healthscope Commercial |
$2,446.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,388.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,973.75
|
| Rate for Payer: Nomi Health Commercial |
$1,587.01
|
| Rate for Payer: PACE SWMI |
$1,322.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,322.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health Medicare |
$1,322.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,322.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,322.51
|
|
|
PR OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY
|
Professional
|
Both
|
$3,097.00
|
|
|
Service Code
|
HCPCS 27416
|
| Min. Negotiated Rate |
$946.93 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$1,268.89
|
| Rate for Payer: Aetna Medicare |
$984.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,363.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,268.89
|
| Rate for Payer: BCBS Complete |
$1,238.80
|
| Rate for Payer: BCBS MAPPO |
$946.93
|
| Rate for Payer: BCN Medicare Advantage |
$946.93
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,363.58
|
| Rate for Payer: Cofinity Commercial |
$1,268.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.93
|
| Rate for Payer: Healthscope Commercial |
$1,751.82
|
| Rate for Payer: Healthscope Commercial |
$1,515.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$994.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,013.05
|
| Rate for Payer: Nomi Health Commercial |
$1,136.32
|
| Rate for Payer: PACE SWMI |
$946.93
|
| Rate for Payer: PHP Medicare Advantage |
$946.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.05
|
| Rate for Payer: Priority Health Medicare |
$946.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$946.93
|
| Rate for Payer: UHC Medicare Advantage |
$946.93
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 98925
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial |
$28.97
|
| Rate for Payer: Aetna Medicare |
$22.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.97
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$21.62
|
| Rate for Payer: BCN Medicare Advantage |
$21.62
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$31.13
|
| Rate for Payer: Cofinity Commercial |
$28.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.62
|
| Rate for Payer: Healthscope Commercial |
$34.59
|
| Rate for Payer: Healthscope Commercial |
$40.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Nomi Health Commercial |
$25.94
|
| Rate for Payer: PACE SWMI |
$21.62
|
| Rate for Payer: PHP Medicare Advantage |
$21.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$21.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.62
|
| Rate for Payer: UHC Medicare Advantage |
$21.62
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 98926
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$60.55 |
| Rate for Payer: Aetna Commercial |
$43.86
|
| Rate for Payer: Aetna Medicare |
$34.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.86
|
| Rate for Payer: BCBS Complete |
$31.20
|
| Rate for Payer: BCBS MAPPO |
$32.73
|
| Rate for Payer: BCN Medicare Advantage |
$32.73
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$47.13
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.73
|
| Rate for Payer: Healthscope Commercial |
$60.55
|
| Rate for Payer: Healthscope Commercial |
$52.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.70
|
| Rate for Payer: Nomi Health Commercial |
$39.28
|
| Rate for Payer: PACE SWMI |
$32.73
|
| Rate for Payer: PHP Medicare Advantage |
$32.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health Medicare |
$32.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.73
|
| Rate for Payer: UHC Medicare Advantage |
$32.73
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 98927
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$80.59 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$45.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.37
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$43.56
|
| Rate for Payer: BCN Medicare Advantage |
$43.56
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$62.73
|
| Rate for Payer: Cofinity Commercial |
$58.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.56
|
| Rate for Payer: Healthscope Commercial |
$69.70
|
| Rate for Payer: Healthscope Commercial |
$80.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.30
|
| Rate for Payer: Nomi Health Commercial |
$52.27
|
| Rate for Payer: PACE SWMI |
$43.56
|
| Rate for Payer: PHP Medicare Advantage |
$43.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Medicare |
$43.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.56
|
| Rate for Payer: UHC Medicare Advantage |
$43.56
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 98928
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$101.69 |
| Rate for Payer: Aetna Commercial |
$73.66
|
| Rate for Payer: Aetna Medicare |
$57.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.66
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$54.97
|
| Rate for Payer: BCN Medicare Advantage |
$54.97
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$79.16
|
| Rate for Payer: Cofinity Commercial |
$73.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.97
|
| Rate for Payer: Healthscope Commercial |
$87.95
|
| Rate for Payer: Healthscope Commercial |
$101.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.25
|
| Rate for Payer: Nomi Health Commercial |
$65.96
|
| Rate for Payer: PACE SWMI |
$54.97
|
| Rate for Payer: PHP Medicare Advantage |
$54.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$54.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.97
|
| Rate for Payer: UHC Medicare Advantage |
$54.97
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 98929
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$121.17 |
| Rate for Payer: Aetna Commercial |
$87.77
|
| Rate for Payer: Aetna Medicare |
$68.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.77
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$65.50
|
| Rate for Payer: BCN Medicare Advantage |
$65.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$94.32
|
| Rate for Payer: Cofinity Commercial |
$87.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.50
|
| Rate for Payer: Healthscope Commercial |
$104.80
|
| Rate for Payer: Healthscope Commercial |
$121.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.50
|
| Rate for Payer: Nomi Health Commercial |
$78.60
|
| Rate for Payer: PACE SWMI |
$65.50
|
| Rate for Payer: PHP Medicare Advantage |
$65.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health Medicare |
$65.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.50
|
| Rate for Payer: UHC Medicare Advantage |
$65.50
|
|
|
PR OSTEOPLASTY CARPAL BONE SHORTENING
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 25394
|
| Min. Negotiated Rate |
$760.01 |
| Max. Negotiated Rate |
$1,406.02 |
| Rate for Payer: Aetna Commercial |
$1,018.41
|
| Rate for Payer: Aetna Medicare |
$790.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.41
|
| Rate for Payer: BCBS Complete |
$775.20
|
| Rate for Payer: BCBS MAPPO |
$760.01
|
| Rate for Payer: BCN Medicare Advantage |
$760.01
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,094.41
|
| Rate for Payer: Cofinity Commercial |
$1,018.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.01
|
| Rate for Payer: Healthscope Commercial |
$1,406.02
|
| Rate for Payer: Healthscope Commercial |
$1,216.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$912.01
|
| Rate for Payer: PACE SWMI |
$760.01
|
| Rate for Payer: PHP Medicare Advantage |
$760.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health Medicare |
$760.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.01
|
| Rate for Payer: UHC Medicare Advantage |
$760.01
|
|
|
PR OSTEOPLASTY FEMUR LENGTHENING
|
Professional
|
Both
|
$3,981.00
|
|
|
Service Code
|
HCPCS 27466
|
| Min. Negotiated Rate |
$1,141.30 |
| Max. Negotiated Rate |
$2,587.65 |
| Rate for Payer: Aetna Commercial |
$1,529.34
|
| Rate for Payer: Aetna Medicare |
$1,186.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,643.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.34
|
| Rate for Payer: BCBS Complete |
$1,592.40
|
| Rate for Payer: BCBS MAPPO |
$1,141.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.30
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,643.47
|
| Rate for Payer: Cofinity Commercial |
$1,529.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.30
|
| Rate for Payer: Healthscope Commercial |
$1,826.08
|
| Rate for Payer: Healthscope Commercial |
$2,111.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,198.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,587.65
|
| Rate for Payer: Nomi Health Commercial |
$1,369.56
|
| Rate for Payer: PACE SWMI |
$1,141.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,587.65
|
| Rate for Payer: Priority Health Medicare |
$1,141.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,141.30
|
|
|
PR OSTEOPLASTY HUMERUS
|
Professional
|
Both
|
$3,335.00
|
|
|
Service Code
|
HCPCS 24420
|
| Min. Negotiated Rate |
$1,016.53 |
| Max. Negotiated Rate |
$2,167.75 |
| Rate for Payer: Aetna Commercial |
$1,362.15
|
| Rate for Payer: Aetna Medicare |
$1,057.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.15
|
| Rate for Payer: BCBS Complete |
$1,334.00
|
| Rate for Payer: BCBS MAPPO |
$1,016.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.53
|
| Rate for Payer: Cash Price |
$2,668.00
|
| Rate for Payer: Cash Price |
$2,668.00
|
| Rate for Payer: Cofinity Commercial |
$1,463.80
|
| Rate for Payer: Cofinity Commercial |
$1,362.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.53
|
| Rate for Payer: Healthscope Commercial |
$1,880.58
|
| Rate for Payer: Healthscope Commercial |
$1,626.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,067.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.75
|
| Rate for Payer: Nomi Health Commercial |
$1,219.84
|
| Rate for Payer: PACE SWMI |
$1,016.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,167.75
|
| Rate for Payer: Priority Health Medicare |
$1,016.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,016.53
|
|
|
PR OSTEOPLASTY RADIUS/ULNA SHORTENING
|
Professional
|
Both
|
$2,689.00
|
|
|
Service Code
|
HCPCS 25390
|
| Min. Negotiated Rate |
$742.90 |
| Max. Negotiated Rate |
$1,747.85 |
| Rate for Payer: Aetna Commercial |
$995.49
|
| Rate for Payer: Aetna Medicare |
$772.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,069.78
|
| Rate for Payer: BCBS Complete |
$1,075.60
|
| Rate for Payer: BCBS MAPPO |
$742.90
|
| Rate for Payer: BCN Medicare Advantage |
$742.90
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Cofinity Commercial |
$995.49
|
| Rate for Payer: Cofinity Commercial |
$1,069.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$742.90
|
| Rate for Payer: Healthscope Commercial |
$1,188.64
|
| Rate for Payer: Healthscope Commercial |
$1,374.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$780.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.85
|
| Rate for Payer: Nomi Health Commercial |
$891.48
|
| Rate for Payer: PACE SWMI |
$742.90
|
| Rate for Payer: PHP Medicare Advantage |
$742.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.85
|
| Rate for Payer: Priority Health Medicare |
$742.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$742.90
|
| Rate for Payer: UHC Medicare Advantage |
$742.90
|
|
