|
PR CAST SUP LNG ARM SPLINT FBRG
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4018
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$34.19 |
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna Medicare |
$19.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.76
|
| Rate for Payer: BCBS MAPPO |
$18.48
|
| Rate for Payer: BCN Commercial |
$17.70
|
| Rate for Payer: BCN Medicare Advantage |
$18.48
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$26.61
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.48
|
| Rate for Payer: Healthscope Commercial |
$29.57
|
| Rate for Payer: Healthscope Commercial |
$34.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.25
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$18.48
|
| Rate for Payer: PHP Medicare Advantage |
$18.48
|
| Rate for Payer: Priority Health Medicare |
$18.48
|
| Rate for Payer: Railroad Medicare Medicare |
$18.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.03
|
| Rate for Payer: UHC Core |
$6.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.48
|
| Rate for Payer: UHC Exchange |
$6.03
|
|
|
PR CAST SUP LNG ARM SPLINT PLST
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS Q4017
|
| Min. Negotiated Rate |
$3.78 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$15.54
|
| Rate for Payer: Aetna Medicare |
$12.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.70
|
| Rate for Payer: BCBS MAPPO |
$11.60
|
| Rate for Payer: BCN Commercial |
$11.10
|
| Rate for Payer: BCN Medicare Advantage |
$11.60
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$16.70
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.60
|
| Rate for Payer: Healthscope Commercial |
$18.56
|
| Rate for Payer: Healthscope Commercial |
$21.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$13.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$11.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.60
|
| Rate for Payer: Priority Health Medicare |
$11.60
|
| Rate for Payer: Railroad Medicare Medicare |
$11.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.78
|
| Rate for Payer: UHC Core |
$3.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.60
|
| Rate for Payer: UHC Exchange |
$3.78
|
|
|
PR CAST SUP LNG ARM SPLNT PED F
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS Q4020
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$12.44
|
| Rate for Payer: Aetna Medicare |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.44
|
| Rate for Payer: BCBS MAPPO |
$9.28
|
| Rate for Payer: BCN Commercial |
$8.89
|
| Rate for Payer: BCN Medicare Advantage |
$9.28
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$12.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.28
|
| Rate for Payer: Healthscope Commercial |
$14.85
|
| Rate for Payer: Healthscope Commercial |
$17.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.66
|
| Rate for Payer: Nomi Health Commercial |
$11.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE SWMI |
$9.28
|
| Rate for Payer: PHP Medicare Advantage |
$9.28
|
| Rate for Payer: Priority Health Medicare |
$9.28
|
| Rate for Payer: Railroad Medicare Medicare |
$9.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.02
|
| Rate for Payer: UHC Core |
$3.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.28
|
| Rate for Payer: UHC Exchange |
$3.02
|
|
|
PR CAST SUP LNG LEG CYLINDER FB
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS Q4034
|
| Min. Negotiated Rate |
$27.84 |
| Max. Negotiated Rate |
$157.97 |
| Rate for Payer: Aetna Commercial |
$114.42
|
| Rate for Payer: Aetna Medicare |
$88.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.96
|
| Rate for Payer: BCBS MAPPO |
$85.39
|
| Rate for Payer: BCN Commercial |
$81.76
|
| Rate for Payer: BCN Medicare Advantage |
$85.39
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$122.96
|
| Rate for Payer: Cofinity Commercial |
$114.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.39
|
| Rate for Payer: Healthscope Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$157.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Nomi Health Commercial |
$102.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PACE SWMI |
$85.39
|
| Rate for Payer: PHP Medicare Advantage |
$85.39
|
| Rate for Payer: Priority Health Medicare |
$85.39
|
| Rate for Payer: Railroad Medicare Medicare |
$85.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.84
|
| Rate for Payer: UHC Core |
$27.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.39
|
| Rate for Payer: UHC Exchange |
$27.84
|
|
|
PR CAST SUP LNGLEG CYLNDR PED F
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS Q4036
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$79.05 |
| Rate for Payer: Aetna Commercial |
$57.26
|
| Rate for Payer: Aetna Medicare |
$44.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.26
|
| Rate for Payer: BCBS MAPPO |
$42.73
|
| Rate for Payer: BCN Commercial |
$40.91
|
| Rate for Payer: BCN Medicare Advantage |
$42.73
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$57.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.73
|
| Rate for Payer: Healthscope Commercial |
$68.37
|
| Rate for Payer: Healthscope Commercial |
$79.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.87
|
| Rate for Payer: Nomi Health Commercial |
$51.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$42.73
|
| Rate for Payer: PHP Medicare Advantage |
$42.73
|
| Rate for Payer: Priority Health Medicare |
$42.73
|
| Rate for Payer: Railroad Medicare Medicare |
$42.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.93
|
| Rate for Payer: UHC Core |
$13.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.73
|
| Rate for Payer: UHC Exchange |
$13.93
|
|
|
PR CAST SUP LNG LEG PED FBRGLS
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS Q4032
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$89.65 |
| Rate for Payer: Aetna Commercial |
$64.94
|
| Rate for Payer: Aetna Medicare |
$50.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.78
|
| Rate for Payer: BCBS MAPPO |
$48.46
|
| Rate for Payer: BCN Commercial |
$46.40
|
| Rate for Payer: BCN Medicare Advantage |
$48.46
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$69.78
|
| Rate for Payer: Cofinity Commercial |
$64.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$77.54
|
| Rate for Payer: Healthscope Commercial |
$89.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.22
|
| Rate for Payer: Nomi Health Commercial |
$58.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$48.46
|
| Rate for Payer: PHP Medicare Advantage |
$48.46
|
| Rate for Payer: Priority Health Medicare |
$48.46
|
| Rate for Payer: Railroad Medicare Medicare |
$48.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.80
|
| Rate for Payer: UHC Core |
$15.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.46
|
| Rate for Payer: UHC Exchange |
$15.80
|
|
|
PR CAST SUP LNG LEG SPLNT FBRGL
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS Q4042
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$80.46 |
| Rate for Payer: Aetna Commercial |
$58.28
|
| Rate for Payer: Aetna Medicare |
$45.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.28
|
| Rate for Payer: BCBS MAPPO |
$43.49
|
| Rate for Payer: BCN Commercial |
$41.64
|
| Rate for Payer: BCN Medicare Advantage |
$43.49
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$58.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.49
|
| Rate for Payer: Healthscope Commercial |
$69.58
|
| Rate for Payer: Healthscope Commercial |
$80.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.58
|
| Rate for Payer: Nomi Health Commercial |
$52.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
| Rate for Payer: PACE SWMI |
$43.49
|
| Rate for Payer: PHP Medicare Advantage |
$43.49
|
| Rate for Payer: Priority Health Medicare |
$43.49
|
| Rate for Payer: Railroad Medicare Medicare |
$43.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Core |
$14.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.49
|
| Rate for Payer: UHC Exchange |
$14.18
|
|
|
PR CAST SUP LNG LEG SPLNT PED F
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS Q4044
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$40.29 |
| Rate for Payer: Aetna Commercial |
$29.19
|
| Rate for Payer: Aetna Medicare |
$22.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.36
|
| Rate for Payer: BCBS MAPPO |
$21.78
|
| Rate for Payer: BCN Commercial |
$20.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.78
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$31.36
|
| Rate for Payer: Cofinity Commercial |
$29.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.78
|
| Rate for Payer: Healthscope Commercial |
$34.85
|
| Rate for Payer: Healthscope Commercial |
$40.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.32
|
| Rate for Payer: Nomi Health Commercial |
$26.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$21.78
|
| Rate for Payer: PHP Medicare Advantage |
$21.78
|
| Rate for Payer: Priority Health Medicare |
$21.78
|
| Rate for Payer: Railroad Medicare Medicare |
$21.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.10
|
| Rate for Payer: UHC Core |
$7.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.78
|
| Rate for Payer: UHC Exchange |
$7.10
|
|
|
PR CAST SUP LONG ARM ADULT FBRG
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS Q4006
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$68.82 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.85
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCN Commercial |
$35.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Healthscope Commercial |
$59.52
|
| Rate for Payer: Healthscope Commercial |
$68.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.72
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: Priority Health Medicare |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.13
|
| Rate for Payer: UHC Core |
$12.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.20
|
| Rate for Payer: UHC Exchange |
$12.13
|
|
|
PR CAST SUP LONG ARM PED FBRGLS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4008
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$34.39 |
| Rate for Payer: Aetna Commercial |
$24.91
|
| Rate for Payer: Aetna Medicare |
$19.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.77
|
| Rate for Payer: BCBS MAPPO |
$18.59
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$18.59
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$26.77
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.59
|
| Rate for Payer: Healthscope Commercial |
$29.74
|
| Rate for Payer: Healthscope Commercial |
$34.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.35
|
| Rate for Payer: Nomi Health Commercial |
$22.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$18.59
|
| Rate for Payer: PHP Medicare Advantage |
$18.59
|
| Rate for Payer: Priority Health Medicare |
$18.59
|
| Rate for Payer: Railroad Medicare Medicare |
$18.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.06
|
| Rate for Payer: UHC Core |
$6.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.59
|
| Rate for Payer: UHC Exchange |
$6.06
|
|
|
PR CAST SUP LONG LEG FIBERGLASS
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS Q4030
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$179.30 |
| Rate for Payer: Aetna Commercial |
$129.87
|
| Rate for Payer: Aetna Medicare |
$100.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.87
|
| Rate for Payer: BCBS MAPPO |
$96.92
|
| Rate for Payer: BCN Commercial |
$92.79
|
| Rate for Payer: BCN Medicare Advantage |
$96.92
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$139.56
|
| Rate for Payer: Cofinity Commercial |
$129.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.92
|
| Rate for Payer: Healthscope Commercial |
$155.07
|
| Rate for Payer: Healthscope Commercial |
$179.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.44
|
| Rate for Payer: Nomi Health Commercial |
$116.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$96.92
|
| Rate for Payer: PHP Medicare Advantage |
$96.92
|
| Rate for Payer: Priority Health Medicare |
$96.92
|
| Rate for Payer: Railroad Medicare Medicare |
$96.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.60
|
| Rate for Payer: UHC Core |
$31.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.92
|
| Rate for Payer: UHC Exchange |
$31.60
|
|
|
PR CAST SUPPLIES UNLISTED
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS Q4050
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
|
|
PR CAST SUP SHOULDER CAST FBRGL
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS Q4004
|
| Min. Negotiated Rate |
$50.55 |
| Max. Negotiated Rate |
$286.81 |
| Rate for Payer: Aetna Commercial |
$207.74
|
| Rate for Payer: Aetna Medicare |
$161.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.74
|
| Rate for Payer: BCBS MAPPO |
$155.03
|
| Rate for Payer: BCN Commercial |
$148.43
|
| Rate for Payer: BCN Medicare Advantage |
$155.03
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$223.24
|
| Rate for Payer: Cofinity Commercial |
$207.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.03
|
| Rate for Payer: Healthscope Commercial |
$248.05
|
| Rate for Payer: Healthscope Commercial |
$286.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.67
|
| Rate for Payer: Nomi Health Commercial |
$186.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
| Rate for Payer: PACE SWMI |
$155.03
|
| Rate for Payer: PHP Medicare Advantage |
$155.03
|
| Rate for Payer: Priority Health Medicare |
$155.03
|
| Rate for Payer: Railroad Medicare Medicare |
$155.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.55
|
| Rate for Payer: UHC Core |
$50.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.03
|
| Rate for Payer: UHC Exchange |
$50.55
|
|
|
PR CAST SUP SHRT LEG FIBERGLASS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS Q4038
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$97.09 |
| Rate for Payer: Aetna Commercial |
$70.32
|
| Rate for Payer: Aetna Medicare |
$54.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.57
|
| Rate for Payer: BCBS MAPPO |
$52.48
|
| Rate for Payer: BCN Commercial |
$50.24
|
| Rate for Payer: BCN Medicare Advantage |
$52.48
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$75.57
|
| Rate for Payer: Cofinity Commercial |
$70.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.48
|
| Rate for Payer: Healthscope Commercial |
$83.97
|
| Rate for Payer: Healthscope Commercial |
$97.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.97
|
| Rate for Payer: Nomi Health Commercial |
$62.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: PACE SWMI |
$52.48
|
| Rate for Payer: PHP Medicare Advantage |
$52.48
|
| Rate for Payer: Priority Health Medicare |
$52.48
|
| Rate for Payer: Railroad Medicare Medicare |
$52.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.11
|
| Rate for Payer: UHC Core |
$17.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.48
|
| Rate for Payer: UHC Exchange |
$17.11
|
|
|
PR CAST SUP SHRT LEG PED FBRGLS
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS Q4040
|
| Min. Negotiated Rate |
$8.56 |
| Max. Negotiated Rate |
$48.53 |
| Rate for Payer: Aetna Commercial |
$35.15
|
| Rate for Payer: Aetna Medicare |
$27.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.15
|
| Rate for Payer: BCBS MAPPO |
$26.23
|
| Rate for Payer: BCN Commercial |
$25.12
|
| Rate for Payer: BCN Medicare Advantage |
$26.23
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$37.77
|
| Rate for Payer: Cofinity Commercial |
$35.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.23
|
| Rate for Payer: Healthscope Commercial |
$41.97
|
| Rate for Payer: Healthscope Commercial |
$48.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.48
|
| Rate for Payer: Nomi Health Commercial |
$31.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.50
|
| Rate for Payer: PACE SWMI |
$26.23
|
| Rate for Payer: PHP Medicare Advantage |
$26.23
|
| Rate for Payer: Priority Health Medicare |
$26.23
|
| Rate for Payer: Railroad Medicare Medicare |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.56
|
| Rate for Payer: UHC Core |
$8.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.23
|
| Rate for Payer: UHC Exchange |
$8.56
|
|
|
PR CAST SUP SHT ARM ADULT FBRGL
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS Q4010
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$33.23
|
| Rate for Payer: Aetna Medicare |
$25.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: BCBS MAPPO |
$24.80
|
| Rate for Payer: BCN Commercial |
$23.74
|
| Rate for Payer: BCN Medicare Advantage |
$24.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$35.71
|
| Rate for Payer: Cofinity Commercial |
$33.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$39.68
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.14
|
| Rate for Payer: Nomi Health Commercial |
$29.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$24.80
|
| Rate for Payer: PHP Medicare Advantage |
$24.80
|
| Rate for Payer: Priority Health Medicare |
$24.80
|
| Rate for Payer: Railroad Medicare Medicare |
$24.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.09
|
| Rate for Payer: UHC Core |
$8.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.80
|
| Rate for Payer: UHC Exchange |
$8.09
|
|
|
PR CAST SUP SHT ARM ADULT PLSTR
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS Q4009
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$20.41 |
| Rate for Payer: Aetna Commercial |
$14.78
|
| Rate for Payer: Aetna Medicare |
$11.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.78
|
| Rate for Payer: BCBS MAPPO |
$11.03
|
| Rate for Payer: BCN Commercial |
$10.56
|
| Rate for Payer: BCN Medicare Advantage |
$11.03
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$14.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.03
|
| Rate for Payer: Healthscope Commercial |
$17.65
|
| Rate for Payer: Healthscope Commercial |
$20.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.29
|
| Rate for Payer: Nomi Health Commercial |
$13.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PACE SWMI |
$11.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.03
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.60
|
| Rate for Payer: UHC Core |
$3.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.03
|
| Rate for Payer: UHC Exchange |
$3.60
|
|
|
PR CAST SUP SHT ARM PED FBRGLAS
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS Q4012
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Aetna Commercial |
$16.66
|
| Rate for Payer: Aetna Medicare |
$12.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.90
|
| Rate for Payer: BCBS MAPPO |
$12.43
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$12.43
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$16.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.43
|
| Rate for Payer: Healthscope Commercial |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$23.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.60
|
| Rate for Payer: Nomi Health Commercial |
$14.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$12.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.43
|
| Rate for Payer: Priority Health Medicare |
$12.43
|
| Rate for Payer: Railroad Medicare Medicare |
$12.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.05
|
| Rate for Payer: UHC Core |
$4.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.43
|
| Rate for Payer: UHC Exchange |
$4.05
|
|
|
PR CAST SUP SHT ARM SPLINT FBRG
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4022
|
| Min. Negotiated Rate |
$5.05 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.77
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$14.84
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$22.32
|
| Rate for Payer: Cofinity Commercial |
$20.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.46
|
| Rate for Payer: Nomi Health Commercial |
$18.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.05
|
| Rate for Payer: UHC Core |
$5.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.50
|
| Rate for Payer: UHC Exchange |
$5.05
|
|
|
PR CAST SUP SHT ARM SPLINT PLST
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS Q4021
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: PACE SWMI |
$8.59
|
| Rate for Payer: Aetna Commercial |
$11.51
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.37
|
| Rate for Payer: BCBS MAPPO |
$8.59
|
| Rate for Payer: BCN Commercial |
$8.22
|
| Rate for Payer: BCN Medicare Advantage |
$8.59
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$12.37
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.59
|
| Rate for Payer: Healthscope Commercial |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$15.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.01
|
| Rate for Payer: Nomi Health Commercial |
$10.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$8.59
|
| Rate for Payer: Priority Health Medicare |
$8.59
|
| Rate for Payer: Railroad Medicare Medicare |
$8.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.80
|
| Rate for Payer: UHC Core |
$2.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.59
|
| Rate for Payer: UHC Exchange |
$2.80
|
|
|
PR CAST SUP SHT ARM SPLNT PED F
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS Q4024
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$8.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$7.76
|
| Rate for Payer: BCN Commercial |
$7.43
|
| Rate for Payer: BCN Medicare Advantage |
$7.76
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$10.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.76
|
| Rate for Payer: Healthscope Commercial |
$12.42
|
| Rate for Payer: Healthscope Commercial |
$14.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.24
|
| Rate for Payer: Nomi Health Commercial |
$9.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: PACE SWMI |
$7.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.76
|
| Rate for Payer: Priority Health Medicare |
$7.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.53
|
| Rate for Payer: UHC Core |
$2.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.76
|
| Rate for Payer: UHC Exchange |
$2.53
|
|
|
PR CAST SUP SHT ARM SPLNT PED P
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS Q4023
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Aetna Commercial |
$5.78
|
| Rate for Payer: Aetna Medicare |
$4.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: BCBS MAPPO |
$4.31
|
| Rate for Payer: BCN Commercial |
$4.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.31
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$6.21
|
| Rate for Payer: Cofinity Commercial |
$5.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.31
|
| Rate for Payer: Healthscope Commercial |
$6.90
|
| Rate for Payer: Healthscope Commercial |
$7.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.03
|
| Rate for Payer: Nomi Health Commercial |
$5.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: PACE SWMI |
$4.31
|
| Rate for Payer: PHP Medicare Advantage |
$4.31
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Railroad Medicare Medicare |
$4.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.41
|
| Rate for Payer: UHC Core |
$1.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.31
|
| Rate for Payer: UHC Exchange |
$1.41
|
|
|
PR CAST SUP SHT LEG SPLNT FBRGL
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS Q4046
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$31.88
|
| Rate for Payer: Aetna Medicare |
$24.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.88
|
| Rate for Payer: BCBS MAPPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$22.77
|
| Rate for Payer: BCN Medicare Advantage |
$23.79
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Cofinity Commercial |
$31.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.79
|
| Rate for Payer: Healthscope Commercial |
$38.06
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.19
|
| Rate for Payer: Nomi Health Commercial |
$28.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$23.79
|
| Rate for Payer: PHP Medicare Advantage |
$23.79
|
| Rate for Payer: Priority Health Medicare |
$23.79
|
| Rate for Payer: Railroad Medicare Medicare |
$23.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.75
|
| Rate for Payer: UHC Core |
$7.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.79
|
| Rate for Payer: UHC Exchange |
$7.75
|
|
|
PR CAST SUP SHT LEG SPLNT PED F
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4048
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$22.02 |
| Rate for Payer: Aetna Commercial |
$15.95
|
| Rate for Payer: Aetna Medicare |
$12.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.14
|
| Rate for Payer: BCBS MAPPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.90
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$15.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.90
|
| Rate for Payer: Healthscope Commercial |
$19.04
|
| Rate for Payer: Healthscope Commercial |
$22.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.11
|
| Rate for Payer: Nomi Health Commercial |
$14.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$11.90
|
| Rate for Payer: PHP Medicare Advantage |
$11.90
|
| Rate for Payer: Priority Health Medicare |
$11.90
|
| Rate for Payer: Railroad Medicare Medicare |
$11.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.88
|
| Rate for Payer: UHC Core |
$3.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.90
|
| Rate for Payer: UHC Exchange |
$3.88
|
|
|
PR CAST SUP SHT LEG SPLNT PED P
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS Q4047
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Medicare |
$7.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.60
|
| Rate for Payer: BCBS MAPPO |
$7.36
|
| Rate for Payer: BCN Commercial |
$7.05
|
| Rate for Payer: BCN Medicare Advantage |
$7.36
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.36
|
| Rate for Payer: Healthscope Commercial |
$13.62
|
| Rate for Payer: Healthscope Commercial |
$11.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.87
|
| Rate for Payer: Nomi Health Commercial |
$8.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$7.36
|
| Rate for Payer: Priority Health Medicare |
$7.36
|
| Rate for Payer: Railroad Medicare Medicare |
$7.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.40
|
| Rate for Payer: UHC Core |
$2.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.36
|
| Rate for Payer: UHC Exchange |
$2.40
|
|
