|
PR OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 98925
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$28.97
|
| Rate for Payer: Aetna Medicare |
$22.48
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.70
|
| 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 |
$21.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.62
|
| Rate for Payer: UHC Exchange |
$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 |
$50.70 |
| Rate for Payer: Aetna Commercial |
$43.86
|
| Rate for Payer: Aetna Medicare |
$34.04
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.37
|
| 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 |
$33.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.73
|
| Rate for Payer: UHC Exchange |
$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 |
$66.30 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$45.30
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.74
|
| 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 |
$44.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.56
|
| Rate for Payer: UHC Exchange |
$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 |
$81.25 |
| Rate for Payer: Aetna Commercial |
$73.66
|
| Rate for Payer: Aetna Medicare |
$57.17
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.72
|
| 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 |
$55.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.97
|
| Rate for Payer: UHC Exchange |
$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 |
$97.50 |
| Rate for Payer: Aetna Commercial |
$87.77
|
| Rate for Payer: Aetna Medicare |
$68.12
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.78
|
| 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 |
$66.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.50
|
| Rate for Payer: UHC Exchange |
$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 |
$1,259.70 |
| Rate for Payer: Aetna Commercial |
$1,018.41
|
| Rate for Payer: Aetna Medicare |
$790.41
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.01
|
| 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 |
$767.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.01
|
| Rate for Payer: UHC Exchange |
$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: 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,198.37
|
| 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 |
$1,152.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,141.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.30
|
| Rate for Payer: UHC Exchange |
$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: 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,067.36
|
| 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 |
$1,026.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,016.53
|
| Rate for Payer: UHC Exchange |
$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: 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$780.04
|
| 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 |
$750.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$742.90
|
| Rate for Payer: UHC Exchange |
$742.90
|
| Rate for Payer: UHC Medicare Advantage |
$742.90
|
|
|
PR OSTEOPLASTY TIBIA&FIBULA LENGTHENING/SHORTENING
|
Professional
|
Both
|
$4,771.00
|
|
|
Service Code
|
HCPCS 27715
|
| Min. Negotiated Rate |
$1,032.85 |
| Max. Negotiated Rate |
$3,101.15 |
| Rate for Payer: Aetna Commercial |
$1,384.02
|
| Rate for Payer: Aetna Medicare |
$1,074.16
|
| Rate for Payer: BCBS Complete |
$1,908.40
|
| Rate for Payer: BCBS MAPPO |
$1,032.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,032.85
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cofinity Commercial |
$1,487.30
|
| Rate for Payer: Cofinity Commercial |
$1,384.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,032.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,084.49
|
| Rate for Payer: Nomi Health Commercial |
$1,239.42
|
| Rate for Payer: PACE SWMI |
$1,032.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,032.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.15
|
| Rate for Payer: Priority Health Medicare |
$1,043.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,032.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,032.85
|
| Rate for Payer: UHC Exchange |
$1,032.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,032.85
|
|
|
PR OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL
|
Professional
|
Both
|
$7,871.00
|
|
|
Service Code
|
HCPCS 27165
|
| Min. Negotiated Rate |
$1,317.75 |
| Max. Negotiated Rate |
$5,116.15 |
| Rate for Payer: Aetna Commercial |
$1,765.79
|
| Rate for Payer: Aetna Medicare |
$1,370.46
|
| Rate for Payer: BCBS Complete |
$3,148.40
|
| Rate for Payer: BCBS MAPPO |
$1,317.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.75
|
| Rate for Payer: Cash Price |
$6,296.80
|
| Rate for Payer: Cash Price |
$6,296.80
|
| Rate for Payer: Cofinity Commercial |
$1,897.56
|
| Rate for Payer: Cofinity Commercial |
$1,765.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,383.64
|
| Rate for Payer: Nomi Health Commercial |
$1,581.30
|
| Rate for Payer: PACE SWMI |
$1,317.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,116.15
|
| Rate for Payer: Priority Health Medicare |
$1,330.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,317.75
|
| Rate for Payer: UHC Exchange |
$1,317.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,317.75
|
|
|
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,746.00
|
|
|
Service Code
|
HCPCS 28300
|
| Min. Negotiated Rate |
$627.05 |
| Max. Negotiated Rate |
$1,134.90 |
| Rate for Payer: Aetna Commercial |
$840.25
|
| Rate for Payer: Aetna Medicare |
$652.13
|
| Rate for Payer: BCBS Complete |
$698.40
|
| Rate for Payer: BCBS MAPPO |
$627.05
|
| Rate for Payer: BCN Medicare Advantage |
$627.05
|
| Rate for Payer: Cash Price |
$1,396.80
|
| Rate for Payer: Cash Price |
$1,396.80
|
| Rate for Payer: Cofinity Commercial |
$902.95
|
| Rate for Payer: Cofinity Commercial |
$840.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.40
|
| Rate for Payer: Nomi Health Commercial |
$752.46
|
| Rate for Payer: PACE SWMI |
$627.05
|
| Rate for Payer: PHP Medicare Advantage |
$627.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.90
|
| Rate for Payer: Priority Health Medicare |
$633.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.05
|
| Rate for Payer: UHC Exchange |
$627.05
|
| Rate for Payer: UHC Medicare Advantage |
$627.05
|
|
|
PR OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 23480
|
| Min. Negotiated Rate |
$691.60 |
| Max. Negotiated Rate |
$1,142.15 |
| Rate for Payer: Aetna Commercial |
$1,062.83
|
| Rate for Payer: Aetna Medicare |
$824.89
|
| Rate for Payer: BCBS Complete |
$691.60
|
| Rate for Payer: BCBS MAPPO |
$793.16
|
| Rate for Payer: BCN Medicare Advantage |
$793.16
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,142.15
|
| Rate for Payer: Cofinity Commercial |
$1,062.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.82
|
| Rate for Payer: Nomi Health Commercial |
$951.79
|
| Rate for Payer: PACE SWMI |
$793.16
|
| Rate for Payer: PHP Medicare Advantage |
$793.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health Medicare |
$801.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.16
|
| Rate for Payer: UHC Exchange |
$793.16
|
| Rate for Payer: UHC Medicare Advantage |
$793.16
|
|
|
PR OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL
|
Professional
|
Both
|
$2,427.00
|
|
|
Service Code
|
HCPCS 23485
|
| Min. Negotiated Rate |
$919.64 |
| Max. Negotiated Rate |
$1,577.55 |
| Rate for Payer: Aetna Commercial |
$1,232.32
|
| Rate for Payer: Aetna Medicare |
$956.43
|
| Rate for Payer: BCBS Complete |
$970.80
|
| Rate for Payer: BCBS MAPPO |
$919.64
|
| Rate for Payer: BCN Medicare Advantage |
$919.64
|
| Rate for Payer: Cash Price |
$1,941.60
|
| Rate for Payer: Cash Price |
$1,941.60
|
| Rate for Payer: Cofinity Commercial |
$1,324.28
|
| Rate for Payer: Cofinity Commercial |
$1,232.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$919.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$965.62
|
| Rate for Payer: Nomi Health Commercial |
$1,103.57
|
| Rate for Payer: PACE SWMI |
$919.64
|
| Rate for Payer: PHP Medicare Advantage |
$919.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,577.55
|
| Rate for Payer: Priority Health Medicare |
$928.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$919.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$919.64
|
| Rate for Payer: UHC Exchange |
$919.64
|
| Rate for Payer: UHC Medicare Advantage |
$919.64
|
|
|
PR OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION
|
Professional
|
Both
|
$2,914.00
|
|
|
Service Code
|
HCPCS 27450
|
| Min. Negotiated Rate |
$970.58 |
| Max. Negotiated Rate |
$1,894.10 |
| Rate for Payer: Aetna Commercial |
$1,300.58
|
| Rate for Payer: Aetna Medicare |
$1,009.40
|
| Rate for Payer: BCBS Complete |
$1,165.60
|
| Rate for Payer: BCBS MAPPO |
$970.58
|
| Rate for Payer: BCN Medicare Advantage |
$970.58
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,397.64
|
| Rate for Payer: Cofinity Commercial |
$1,300.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,019.11
|
| Rate for Payer: Nomi Health Commercial |
$1,164.70
|
| Rate for Payer: PACE SWMI |
$970.58
|
| Rate for Payer: PHP Medicare Advantage |
$970.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.10
|
| Rate for Payer: Priority Health Medicare |
$980.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$970.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$970.58
|
| Rate for Payer: UHC Exchange |
$970.58
|
| Rate for Payer: UHC Medicare Advantage |
$970.58
|
|
|
PR OSTEOTOMY FIBULA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27707
|
| Min. Negotiated Rate |
$389.77 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$522.29
|
| Rate for Payer: Aetna Medicare |
$405.36
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$389.77
|
| Rate for Payer: BCN Medicare Advantage |
$389.77
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$561.27
|
| Rate for Payer: Cofinity Commercial |
$522.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.26
|
| Rate for Payer: Nomi Health Commercial |
$467.72
|
| Rate for Payer: PACE SWMI |
$389.77
|
| Rate for Payer: PHP Medicare Advantage |
$389.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$393.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.77
|
| Rate for Payer: UHC Exchange |
$389.77
|
| Rate for Payer: UHC Medicare Advantage |
$389.77
|
|
|
PR OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,466.00
|
|
|
Service Code
|
HCPCS 24400
|
| Min. Negotiated Rate |
$586.40 |
| Max. Negotiated Rate |
$1,151.27 |
| Rate for Payer: Aetna Commercial |
$1,071.32
|
| Rate for Payer: Aetna Medicare |
$831.47
|
| Rate for Payer: BCBS Complete |
$586.40
|
| Rate for Payer: BCBS MAPPO |
$799.49
|
| Rate for Payer: BCN Medicare Advantage |
$799.49
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cofinity Commercial |
$1,151.27
|
| Rate for Payer: Cofinity Commercial |
$1,071.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$799.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.46
|
| Rate for Payer: Nomi Health Commercial |
$959.39
|
| Rate for Payer: PACE SWMI |
$799.49
|
| Rate for Payer: PHP Medicare Advantage |
$799.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.90
|
| Rate for Payer: Priority Health Medicare |
$807.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$799.49
|
| Rate for Payer: UHC Exchange |
$799.49
|
| Rate for Payer: UHC Medicare Advantage |
$799.49
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE
|
Professional
|
Both
|
$2,618.00
|
|
|
Service Code
|
HCPCS 27146
|
| Min. Negotiated Rate |
$1,047.20 |
| Max. Negotiated Rate |
$1,774.93 |
| Rate for Payer: Aetna Commercial |
$1,651.67
|
| Rate for Payer: Aetna Medicare |
$1,281.89
|
| Rate for Payer: BCBS Complete |
$1,047.20
|
| Rate for Payer: BCBS MAPPO |
$1,232.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,232.59
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cofinity Commercial |
$1,774.93
|
| Rate for Payer: Cofinity Commercial |
$1,651.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,232.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,294.22
|
| Rate for Payer: Nomi Health Commercial |
$1,479.11
|
| Rate for Payer: PACE SWMI |
$1,232.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,232.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.70
|
| Rate for Payer: Priority Health Medicare |
$1,244.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,232.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,232.59
|
| Rate for Payer: UHC Exchange |
$1,232.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,232.59
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT
|
Professional
|
Both
|
$3,285.00
|
|
|
Service Code
|
HCPCS 27151
|
| Min. Negotiated Rate |
$1,314.00 |
| Max. Negotiated Rate |
$2,192.28 |
| Rate for Payer: Aetna Commercial |
$2,040.04
|
| Rate for Payer: Aetna Medicare |
$1,583.32
|
| Rate for Payer: BCBS Complete |
$1,314.00
|
| Rate for Payer: BCBS MAPPO |
$1,522.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.42
|
| Rate for Payer: Cash Price |
$2,628.00
|
| Rate for Payer: Cash Price |
$2,628.00
|
| Rate for Payer: Cofinity Commercial |
$2,192.28
|
| Rate for Payer: Cofinity Commercial |
$2,040.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.54
|
| Rate for Payer: Nomi Health Commercial |
$1,826.90
|
| Rate for Payer: PACE SWMI |
$1,522.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.25
|
| Rate for Payer: Priority Health Medicare |
$1,537.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,522.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.42
|
| Rate for Payer: UHC Exchange |
$1,522.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.42
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ
|
Professional
|
Both
|
$2,239.00
|
|
|
Service Code
|
HCPCS 27147
|
| Min. Negotiated Rate |
$895.60 |
| Max. Negotiated Rate |
$2,028.02 |
| Rate for Payer: Aetna Commercial |
$1,887.19
|
| Rate for Payer: Aetna Medicare |
$1,464.68
|
| Rate for Payer: BCBS Complete |
$895.60
|
| Rate for Payer: BCBS MAPPO |
$1,408.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,408.35
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cofinity Commercial |
$2,028.02
|
| Rate for Payer: Cofinity Commercial |
$1,887.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,408.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,478.77
|
| Rate for Payer: Nomi Health Commercial |
$1,690.02
|
| Rate for Payer: PACE SWMI |
$1,408.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,408.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.35
|
| Rate for Payer: Priority Health Medicare |
$1,422.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,408.35
|
| Rate for Payer: UHC Exchange |
$1,408.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,408.35
|
|
|
PR OSTEOTOMY METACARPAL EACH
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 26565
|
| Min. Negotiated Rate |
$668.42 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Aetna Commercial |
$895.68
|
| Rate for Payer: Aetna Medicare |
$695.16
|
| Rate for Payer: BCBS Complete |
$714.00
|
| Rate for Payer: BCBS MAPPO |
$668.42
|
| Rate for Payer: BCN Medicare Advantage |
$668.42
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$962.52
|
| Rate for Payer: Cofinity Commercial |
$895.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.84
|
| Rate for Payer: Nomi Health Commercial |
$802.10
|
| Rate for Payer: PACE SWMI |
$668.42
|
| Rate for Payer: PHP Medicare Advantage |
$668.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health Medicare |
$675.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$668.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.42
|
| Rate for Payer: UHC Exchange |
$668.42
|
| Rate for Payer: UHC Medicare Advantage |
$668.42
|
|
|
PR OSTEOTOMY PHALANX FINGER EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26567
|
| Min. Negotiated Rate |
$634.40 |
| Max. Negotiated Rate |
$1,030.90 |
| Rate for Payer: Aetna Commercial |
$903.83
|
| Rate for Payer: Aetna Medicare |
$701.48
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$674.50
|
| Rate for Payer: BCN Medicare Advantage |
$674.50
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$971.28
|
| Rate for Payer: Cofinity Commercial |
$903.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.23
|
| Rate for Payer: Nomi Health Commercial |
$809.40
|
| Rate for Payer: PACE SWMI |
$674.50
|
| Rate for Payer: PHP Medicare Advantage |
$674.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$681.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.50
|
| Rate for Payer: UHC Exchange |
$674.50
|
| Rate for Payer: UHC Medicare Advantage |
$674.50
|
|
|
PR OSTEOTOMY RADIUS DISTAL THIRD
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25350
|
| Min. Negotiated Rate |
$651.95 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$873.61
|
| Rate for Payer: Aetna Medicare |
$678.03
|
| Rate for Payer: BCBS Complete |
$891.20
|
| Rate for Payer: BCBS MAPPO |
$651.95
|
| Rate for Payer: BCN Medicare Advantage |
$651.95
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$938.81
|
| Rate for Payer: Cofinity Commercial |
$873.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.55
|
| Rate for Payer: Nomi Health Commercial |
$782.34
|
| Rate for Payer: PACE SWMI |
$651.95
|
| Rate for Payer: PHP Medicare Advantage |
$651.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$658.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$651.95
|
| Rate for Payer: UHC Exchange |
$651.95
|
| Rate for Payer: UHC Medicare Advantage |
$651.95
|
|
|
PR OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD
|
Professional
|
Both
|
$1,696.00
|
|
|
Service Code
|
HCPCS 25355
|
| Min. Negotiated Rate |
$678.40 |
| Max. Negotiated Rate |
$1,102.40 |
| Rate for Payer: Aetna Commercial |
$992.07
|
| Rate for Payer: Aetna Medicare |
$769.96
|
| Rate for Payer: BCBS Complete |
$678.40
|
| Rate for Payer: BCBS MAPPO |
$740.35
|
| Rate for Payer: BCN Medicare Advantage |
$740.35
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cofinity Commercial |
$992.07
|
| Rate for Payer: Cofinity Commercial |
$1,066.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.37
|
| Rate for Payer: Nomi Health Commercial |
$888.42
|
| Rate for Payer: PACE SWMI |
$740.35
|
| Rate for Payer: PHP Medicare Advantage |
$740.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,102.40
|
| Rate for Payer: Priority Health Medicare |
$747.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.35
|
| Rate for Payer: UHC Exchange |
$740.35
|
| Rate for Payer: UHC Medicare Advantage |
$740.35
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM
|
Professional
|
Both
|
$2,710.00
|
|
|
Service Code
|
HCPCS 22208
|
| Min. Negotiated Rate |
$578.06 |
| Max. Negotiated Rate |
$1,761.50 |
| Rate for Payer: Aetna Commercial |
$774.60
|
| Rate for Payer: Aetna Medicare |
$601.18
|
| Rate for Payer: BCBS Complete |
$1,084.00
|
| Rate for Payer: BCBS MAPPO |
$578.06
|
| Rate for Payer: BCN Medicare Advantage |
$578.06
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cofinity Commercial |
$832.41
|
| Rate for Payer: Cofinity Commercial |
$774.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.96
|
| Rate for Payer: Nomi Health Commercial |
$693.67
|
| Rate for Payer: PACE SWMI |
$578.06
|
| Rate for Payer: PHP Medicare Advantage |
$578.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,761.50
|
| Rate for Payer: Priority Health Medicare |
$583.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.06
|
| Rate for Payer: UHC Exchange |
$578.06
|
| Rate for Payer: UHC Medicare Advantage |
$578.06
|
|
