|
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: Aetna New Business (MI Preferred) |
$1,397.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.58
|
| 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 Commercial |
$1,358.81
|
| 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 |
$970.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$970.58
|
| Rate for Payer: UHC Medicare Advantage |
$970.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,340.44
|
|
|
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: Aetna New Business (MI Preferred) |
$561.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| 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 Commercial |
$545.68
|
| Rate for Payer: PHP Medicare Advantage |
$389.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$389.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.77
|
| Rate for Payer: UHC Medicare Advantage |
$389.77
|
| Rate for Payer: UMR Bronson Commercial |
$598.46
|
|
|
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: Aetna New Business (MI Preferred) |
$1,151.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,071.32
|
| 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 Commercial |
$1,119.29
|
| Rate for Payer: PHP Medicare Advantage |
$799.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.90
|
| Rate for Payer: Priority Health Medicare |
$799.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$799.49
|
| Rate for Payer: UHC Medicare Advantage |
$799.49
|
| Rate for Payer: UMR Bronson Commercial |
$674.36
|
|
|
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: Aetna New Business (MI Preferred) |
$1,774.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,651.67
|
| 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 Commercial |
$1,725.63
|
| 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 |
$1,232.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,232.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,232.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,204.28
|
|
|
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: Aetna New Business (MI Preferred) |
$2,192.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,040.04
|
| 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 Commercial |
$2,131.39
|
| 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 |
$1,522.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,511.10
|
|
|
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: Aetna New Business (MI Preferred) |
$2,028.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.19
|
| 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 Commercial |
$1,971.69
|
| 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 |
$1,408.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,408.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,408.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,029.94
|
|
|
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: Aetna New Business (MI Preferred) |
$962.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.68
|
| 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 Commercial |
$935.79
|
| 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 |
$668.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.42
|
| Rate for Payer: UHC Medicare Advantage |
$668.42
|
| Rate for Payer: UMR Bronson Commercial |
$821.10
|
|
|
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: Aetna New Business (MI Preferred) |
$971.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$903.83
|
| 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 Commercial |
$944.30
|
| 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 |
$674.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.50
|
| Rate for Payer: UHC Medicare Advantage |
$674.50
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
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: Aetna New Business (MI Preferred) |
$938.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.61
|
| 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 Commercial |
$912.73
|
| 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 |
$651.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$651.95
|
| Rate for Payer: UHC Medicare Advantage |
$651.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.88
|
|
|
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: Aetna New Business (MI Preferred) |
$992.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.10
|
| 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 Commercial |
$1,036.49
|
| 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 |
$740.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.35
|
| Rate for Payer: UHC Medicare Advantage |
$740.35
|
| Rate for Payer: UMR Bronson Commercial |
$780.16
|
|
|
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: Aetna New Business (MI Preferred) |
$832.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.60
|
| 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 Commercial |
$809.28
|
| 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 |
$578.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.06
|
| Rate for Payer: UHC Medicare Advantage |
$578.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.60
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR
|
Professional
|
Both
|
$5,015.00
|
|
|
Service Code
|
HCPCS 22207
|
| Min. Negotiated Rate |
$2,006.00 |
| Max. Negotiated Rate |
$3,363.42 |
| Rate for Payer: Aetna Commercial |
$3,129.85
|
| Rate for Payer: Aetna Medicare |
$2,429.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,363.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,129.85
|
| Rate for Payer: BCBS Complete |
$2,006.00
|
| Rate for Payer: BCBS MAPPO |
$2,335.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,335.71
|
| Rate for Payer: Cash Price |
$4,012.00
|
| Rate for Payer: Cash Price |
$4,012.00
|
| Rate for Payer: Cofinity Commercial |
$3,363.42
|
| Rate for Payer: Cofinity Commercial |
$3,129.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,335.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,452.50
|
| Rate for Payer: Nomi Health Commercial |
$2,802.85
|
| Rate for Payer: PACE SWMI |
$2,335.71
|
| Rate for Payer: PHP Commercial |
$3,269.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,335.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,259.75
|
| Rate for Payer: Priority Health Medicare |
$2,335.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,335.71
|
| Rate for Payer: UHC Medicare Advantage |
$2,335.71
|
| Rate for Payer: UMR Bronson Commercial |
$2,306.90
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC
|
Professional
|
Both
|
$5,121.00
|
|
|
Service Code
|
HCPCS 22206
|
| Min. Negotiated Rate |
$2,048.40 |
| Max. Negotiated Rate |
$3,462.83 |
| Rate for Payer: Aetna Commercial |
$3,222.35
|
| Rate for Payer: Aetna Medicare |
$2,500.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,462.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,222.35
|
| Rate for Payer: BCBS Complete |
$2,048.40
|
| Rate for Payer: BCBS MAPPO |
$2,404.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,404.74
|
| Rate for Payer: Cash Price |
$4,096.80
|
| Rate for Payer: Cash Price |
$4,096.80
|
| Rate for Payer: Cofinity Commercial |
$3,462.83
|
| Rate for Payer: Cofinity Commercial |
$3,222.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,404.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,524.98
|
| Rate for Payer: Nomi Health Commercial |
$2,885.69
|
| Rate for Payer: PACE SWMI |
$2,404.74
|
| Rate for Payer: PHP Commercial |
$3,366.64
|
| Rate for Payer: PHP Medicare Advantage |
$2,404.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,328.65
|
| Rate for Payer: Priority Health Medicare |
$2,404.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,404.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,404.74
|
| Rate for Payer: UMR Bronson Commercial |
$2,355.66
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,726.00
|
|
|
Service Code
|
HCPCS 22210
|
| Min. Negotiated Rate |
$1,490.40 |
| Max. Negotiated Rate |
$2,512.60 |
| Rate for Payer: Aetna Commercial |
$2,338.11
|
| Rate for Payer: Aetna Medicare |
$1,814.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,512.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,338.11
|
| Rate for Payer: BCBS Complete |
$1,490.40
|
| Rate for Payer: BCBS MAPPO |
$1,744.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,744.86
|
| Rate for Payer: Cash Price |
$2,980.80
|
| Rate for Payer: Cash Price |
$2,980.80
|
| Rate for Payer: Cofinity Commercial |
$2,512.60
|
| Rate for Payer: Cofinity Commercial |
$2,338.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,744.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,832.10
|
| Rate for Payer: Nomi Health Commercial |
$2,093.83
|
| Rate for Payer: PACE SWMI |
$1,744.86
|
| Rate for Payer: PHP Commercial |
$2,442.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,744.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,421.90
|
| Rate for Payer: Priority Health Medicare |
$1,744.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,744.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,744.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,713.96
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 22214
|
| Min. Negotiated Rate |
$1,240.00 |
| Max. Negotiated Rate |
$2,125.41 |
| Rate for Payer: Aetna Commercial |
$1,977.81
|
| Rate for Payer: Aetna Medicare |
$1,535.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,125.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,977.81
|
| Rate for Payer: BCBS Complete |
$1,240.00
|
| Rate for Payer: BCBS MAPPO |
$1,475.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,475.98
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cofinity Commercial |
$2,125.41
|
| Rate for Payer: Cofinity Commercial |
$1,977.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,475.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,549.78
|
| Rate for Payer: Nomi Health Commercial |
$1,771.18
|
| Rate for Payer: PACE SWMI |
$1,475.98
|
| Rate for Payer: PHP Commercial |
$2,066.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,475.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.00
|
| Rate for Payer: Priority Health Medicare |
$1,475.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,475.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,475.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.00
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 22212
|
| Min. Negotiated Rate |
$1,234.80 |
| Max. Negotiated Rate |
$2,128.98 |
| Rate for Payer: Aetna Commercial |
$1,981.14
|
| Rate for Payer: Aetna Medicare |
$1,537.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,128.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,981.14
|
| Rate for Payer: BCBS Complete |
$1,234.80
|
| Rate for Payer: BCBS MAPPO |
$1,478.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,478.46
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cofinity Commercial |
$2,128.98
|
| Rate for Payer: Cofinity Commercial |
$1,981.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,478.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,552.38
|
| Rate for Payer: Nomi Health Commercial |
$1,774.15
|
| Rate for Payer: PACE SWMI |
$1,478.46
|
| Rate for Payer: PHP Commercial |
$2,069.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,478.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,006.55
|
| Rate for Payer: Priority Health Medicare |
$1,478.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,478.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,478.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,420.02
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,290.00
|
|
|
Service Code
|
HCPCS 22220
|
| Min. Negotiated Rate |
$1,316.00 |
| Max. Negotiated Rate |
$2,289.04 |
| Rate for Payer: Aetna Commercial |
$2,130.08
|
| Rate for Payer: Aetna Medicare |
$1,653.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,289.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,130.08
|
| Rate for Payer: BCBS Complete |
$1,316.00
|
| Rate for Payer: BCBS MAPPO |
$1,589.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,589.61
|
| Rate for Payer: Cash Price |
$2,632.00
|
| Rate for Payer: Cash Price |
$2,632.00
|
| Rate for Payer: Cofinity Commercial |
$2,289.04
|
| Rate for Payer: Cofinity Commercial |
$2,130.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,589.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,669.09
|
| Rate for Payer: Nomi Health Commercial |
$1,907.53
|
| Rate for Payer: PACE SWMI |
$1,589.61
|
| Rate for Payer: PHP Commercial |
$2,225.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,589.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,138.50
|
| Rate for Payer: Priority Health Medicare |
$1,589.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,589.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,589.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,513.40
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 22226
|
| Min. Negotiated Rate |
$267.60 |
| Max. Negotiated Rate |
$504.69 |
| Rate for Payer: Aetna Commercial |
$469.64
|
| Rate for Payer: Aetna Medicare |
$364.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.64
|
| Rate for Payer: BCBS Complete |
$267.60
|
| Rate for Payer: BCBS MAPPO |
$350.48
|
| Rate for Payer: BCN Medicare Advantage |
$350.48
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$504.69
|
| Rate for Payer: Cofinity Commercial |
$469.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.00
|
| Rate for Payer: Nomi Health Commercial |
$420.58
|
| Rate for Payer: PACE SWMI |
$350.48
|
| Rate for Payer: PHP Commercial |
$490.67
|
| Rate for Payer: PHP Medicare Advantage |
$350.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health Medicare |
$350.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.48
|
| Rate for Payer: UHC Medicare Advantage |
$350.48
|
| Rate for Payer: UMR Bronson Commercial |
$307.74
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR
|
Professional
|
Both
|
$3,280.00
|
|
|
Service Code
|
HCPCS 22224
|
| Min. Negotiated Rate |
$1,312.00 |
| Max. Negotiated Rate |
$2,216.35 |
| Rate for Payer: Aetna Commercial |
$2,062.43
|
| Rate for Payer: Aetna Medicare |
$1,600.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,216.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,062.43
|
| Rate for Payer: BCBS Complete |
$1,312.00
|
| Rate for Payer: BCBS MAPPO |
$1,539.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,539.13
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cofinity Commercial |
$2,216.35
|
| Rate for Payer: Cofinity Commercial |
$2,062.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,539.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,616.09
|
| Rate for Payer: Nomi Health Commercial |
$1,846.96
|
| Rate for Payer: PACE SWMI |
$1,539.13
|
| Rate for Payer: PHP Commercial |
$2,154.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,539.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,132.00
|
| Rate for Payer: Priority Health Medicare |
$1,539.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,539.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,539.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,508.80
|
|
|
PR OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 28304
|
| Min. Negotiated Rate |
$591.72 |
| Max. Negotiated Rate |
$985.40 |
| Rate for Payer: Aetna Commercial |
$792.90
|
| Rate for Payer: Aetna Medicare |
$615.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.90
|
| Rate for Payer: BCBS Complete |
$606.40
|
| Rate for Payer: BCBS MAPPO |
$591.72
|
| Rate for Payer: BCN Medicare Advantage |
$591.72
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$852.08
|
| Rate for Payer: Cofinity Commercial |
$792.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.31
|
| Rate for Payer: Nomi Health Commercial |
$710.06
|
| Rate for Payer: PACE SWMI |
$591.72
|
| Rate for Payer: PHP Commercial |
$828.41
|
| Rate for Payer: PHP Medicare Advantage |
$591.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health Medicare |
$591.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.72
|
| Rate for Payer: UHC Medicare Advantage |
$591.72
|
| Rate for Payer: UMR Bronson Commercial |
$697.36
|
|
|
PR OSTEOTOMY TIBIA
|
Professional
|
Both
|
$3,036.00
|
|
|
Service Code
|
HCPCS 27705
|
| Min. Negotiated Rate |
$716.16 |
| Max. Negotiated Rate |
$1,973.40 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna Medicare |
$744.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.27
|
| Rate for Payer: BCBS Complete |
$1,214.40
|
| Rate for Payer: BCBS MAPPO |
$716.16
|
| Rate for Payer: BCN Medicare Advantage |
$716.16
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cofinity Commercial |
$959.65
|
| Rate for Payer: Cofinity Commercial |
$1,031.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.97
|
| Rate for Payer: Nomi Health Commercial |
$859.39
|
| Rate for Payer: PACE SWMI |
$716.16
|
| Rate for Payer: PHP Commercial |
$1,002.62
|
| Rate for Payer: PHP Medicare Advantage |
$716.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,973.40
|
| Rate for Payer: Priority Health Medicare |
$716.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.16
|
| Rate for Payer: UHC Medicare Advantage |
$716.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.56
|
|
|
PR OSTEOTOMY TIBIA & FIBULA
|
Professional
|
Both
|
$3,469.00
|
|
|
Service Code
|
HCPCS 27709
|
| Min. Negotiated Rate |
$1,098.03 |
| Max. Negotiated Rate |
$2,254.85 |
| Rate for Payer: Aetna Commercial |
$1,471.36
|
| Rate for Payer: Aetna Medicare |
$1,141.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,581.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,471.36
|
| Rate for Payer: BCBS Complete |
$1,387.60
|
| Rate for Payer: BCBS MAPPO |
$1,098.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,098.03
|
| Rate for Payer: Cash Price |
$2,775.20
|
| Rate for Payer: Cash Price |
$2,775.20
|
| Rate for Payer: Cofinity Commercial |
$1,581.16
|
| Rate for Payer: Cofinity Commercial |
$1,471.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,098.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.93
|
| Rate for Payer: Nomi Health Commercial |
$1,317.64
|
| Rate for Payer: PACE SWMI |
$1,098.03
|
| Rate for Payer: PHP Commercial |
$1,537.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,098.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.85
|
| Rate for Payer: Priority Health Medicare |
$1,098.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,098.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,098.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,595.74
|
|
|
PR OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX
|
Professional
|
Both
|
$3,164.00
|
|
|
Service Code
|
HCPCS 27140
|
| Min. Negotiated Rate |
$866.41 |
| Max. Negotiated Rate |
$2,056.60 |
| Rate for Payer: Aetna Commercial |
$1,160.99
|
| Rate for Payer: Aetna Medicare |
$901.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.99
|
| Rate for Payer: BCBS Complete |
$1,265.60
|
| Rate for Payer: BCBS MAPPO |
$866.41
|
| Rate for Payer: BCN Medicare Advantage |
$866.41
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Cofinity Commercial |
$1,247.63
|
| Rate for Payer: Cofinity Commercial |
$1,160.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.73
|
| Rate for Payer: Nomi Health Commercial |
$1,039.69
|
| Rate for Payer: PACE SWMI |
$866.41
|
| Rate for Payer: PHP Commercial |
$1,212.97
|
| Rate for Payer: PHP Medicare Advantage |
$866.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.60
|
| Rate for Payer: Priority Health Medicare |
$866.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$866.41
|
| Rate for Payer: UHC Medicare Advantage |
$866.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,455.44
|
|
|
PR OSTEOTOMY ULNA
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25360
|
| Min. Negotiated Rate |
$635.11 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$851.05
|
| Rate for Payer: Aetna Medicare |
$660.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$914.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.05
|
| Rate for Payer: BCBS Complete |
$891.20
|
| Rate for Payer: BCBS MAPPO |
$635.11
|
| Rate for Payer: BCN Medicare Advantage |
$635.11
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$914.56
|
| Rate for Payer: Cofinity Commercial |
$851.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$635.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$666.87
|
| Rate for Payer: Nomi Health Commercial |
$762.13
|
| Rate for Payer: PACE SWMI |
$635.11
|
| Rate for Payer: PHP Commercial |
$889.15
|
| Rate for Payer: PHP Medicare Advantage |
$635.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$635.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$635.11
|
| Rate for Payer: UHC Medicare Advantage |
$635.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.88
|
|
|
PR OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL
|
Professional
|
Both
|
$2,723.00
|
|
|
Service Code
|
HCPCS 27457
|
| Min. Negotiated Rate |
$921.97 |
| Max. Negotiated Rate |
$1,769.95 |
| Rate for Payer: Aetna Commercial |
$1,235.44
|
| Rate for Payer: Aetna Medicare |
$958.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,327.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.44
|
| Rate for Payer: BCBS Complete |
$1,089.20
|
| Rate for Payer: BCBS MAPPO |
$921.97
|
| Rate for Payer: BCN Medicare Advantage |
$921.97
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cofinity Commercial |
$1,327.64
|
| Rate for Payer: Cofinity Commercial |
$1,235.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$968.07
|
| Rate for Payer: Nomi Health Commercial |
$1,106.36
|
| Rate for Payer: PACE SWMI |
$921.97
|
| Rate for Payer: PHP Commercial |
$1,290.76
|
| Rate for Payer: PHP Medicare Advantage |
$921.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,769.95
|
| Rate for Payer: Priority Health Medicare |
$921.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.97
|
| Rate for Payer: UHC Medicare Advantage |
$921.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,252.58
|
|
