|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE
|
Professional
|
Both
|
$2,567.00
|
|
|
Service Code
|
HCPCS 27146
|
| Min. Negotiated Rate |
$821.12 |
| Max. Negotiated Rate |
$1,938.94 |
| Rate for Payer: Aetna Commercial |
$1,710.09
|
| Rate for Payer: BCBS Complete |
$862.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,896.07
|
| Rate for Payer: Cash Price |
$2,053.60
|
| Rate for Payer: Cash Price |
$2,053.60
|
| Rate for Payer: Meridian Medicaid |
$862.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,938.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,938.94
|
| Rate for Payer: Priority Health SBD |
$1,938.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,180.82
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT
|
Professional
|
Both
|
$3,221.00
|
|
|
Service Code
|
HCPCS 27151
|
| Min. Negotiated Rate |
$1,011.96 |
| Max. Negotiated Rate |
$2,411.80 |
| Rate for Payer: Aetna Commercial |
$2,117.11
|
| Rate for Payer: BCBS Complete |
$1,062.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,915.09
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Meridian Medicaid |
$1,062.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,011.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,411.80
|
| Rate for Payer: Priority Health Narrow Network |
$2,411.80
|
| Rate for Payer: Priority Health SBD |
$2,411.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,481.66
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ
|
Professional
|
Both
|
$2,195.00
|
|
|
Service Code
|
HCPCS 27147
|
| Min. Negotiated Rate |
$937.20 |
| Max. Negotiated Rate |
$2,231.03 |
| Rate for Payer: Aetna Commercial |
$1,956.61
|
| Rate for Payer: BCBS Complete |
$984.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,559.54
|
| Rate for Payer: Cash Price |
$1,756.00
|
| Rate for Payer: Cash Price |
$1,756.00
|
| Rate for Payer: Meridian Medicaid |
$984.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$937.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,536.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,231.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,231.03
|
| Rate for Payer: Priority Health SBD |
$2,231.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,009.70
|
|
|
PR OSTEOTOMY METACARPAL EACH
|
Professional
|
Both
|
$1,750.00
|
|
|
Service Code
|
HCPCS 26565
|
| Min. Negotiated Rate |
$460.51 |
| Max. Negotiated Rate |
$1,225.00 |
| Rate for Payer: Aetna Commercial |
$969.85
|
| Rate for Payer: BCBS Complete |
$483.54
|
| Rate for Payer: BCBS Trust/PPO |
$668.83
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Meridian Medicaid |
$483.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,110.16
|
| Rate for Payer: Priority Health SBD |
$1,110.16
|
| Rate for Payer: UMR Bronson Commercial |
$805.00
|
|
|
PR OSTEOTOMY PHALANX FINGER EACH
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26567
|
| Min. Negotiated Rate |
$140.53 |
| Max. Negotiated Rate |
$1,118.84 |
| Rate for Payer: Aetna Commercial |
$952.97
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Meridian Medicaid |
$489.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,118.84
|
| Rate for Payer: Priority Health SBD |
$1,118.84
|
| Rate for Payer: UMR Bronson Commercial |
$715.30
|
|
|
PR OSTEOTOMY RADIUS DISTAL THIRD
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 25350
|
| Min. Negotiated Rate |
$437.93 |
| Max. Negotiated Rate |
$1,528.80 |
| Rate for Payer: Aetna Commercial |
$899.05
|
| Rate for Payer: BCBS Complete |
$459.83
|
| Rate for Payer: BCBS Trust/PPO |
$604.38
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Meridian Medicaid |
$459.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,041.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,041.73
|
| Rate for Payer: Priority Health SBD |
$1,041.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,004.64
|
|
|
PR OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD
|
Professional
|
Both
|
$1,663.00
|
|
|
Service Code
|
HCPCS 25355
|
| Min. Negotiated Rate |
$495.86 |
| Max. Negotiated Rate |
$1,177.56 |
| Rate for Payer: Aetna Commercial |
$1,022.43
|
| Rate for Payer: BCBS Complete |
$520.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.28
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Meridian Medicaid |
$520.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,177.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,177.56
|
| Rate for Payer: Priority Health SBD |
$1,177.56
|
| Rate for Payer: UMR Bronson Commercial |
$764.98
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 22208
|
| Min. Negotiated Rate |
$375.52 |
| Max. Negotiated Rate |
$13,048.08 |
| Rate for Payer: Aetna Commercial |
$790.71
|
| Rate for Payer: BCBS Complete |
$394.30
|
| Rate for Payer: BCBS Trust/PPO |
$13,048.08
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Meridian Medicaid |
$394.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$893.13
|
| Rate for Payer: Priority Health Narrow Network |
$893.13
|
| Rate for Payer: Priority Health SBD |
$893.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,222.22
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR
|
Professional
|
Both
|
$4,916.86
|
|
|
Service Code
|
HCPCS 22207
|
| Min. Negotiated Rate |
$950.50 |
| Max. Negotiated Rate |
$3,668.00 |
| Rate for Payer: Aetna Commercial |
$3,215.31
|
| Rate for Payer: BCBS Complete |
$1,620.35
|
| Rate for Payer: BCBS Trust/PPO |
$950.50
|
| Rate for Payer: Cash Price |
$3,933.49
|
| Rate for Payer: Cash Price |
$3,933.49
|
| Rate for Payer: Meridian Medicaid |
$1,620.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,543.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,441.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,668.00
|
| Rate for Payer: Priority Health Narrow Network |
$3,668.00
|
| Rate for Payer: Priority Health SBD |
$3,668.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,261.76
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC
|
Professional
|
Both
|
$5,020.60
|
|
|
Service Code
|
HCPCS 22206
|
| Min. Negotiated Rate |
$1,577.48 |
| Max. Negotiated Rate |
$17,177.60 |
| Rate for Payer: Aetna Commercial |
$3,283.38
|
| Rate for Payer: BCBS Complete |
$1,656.35
|
| Rate for Payer: BCBS Trust/PPO |
$17,177.60
|
| Rate for Payer: Cash Price |
$4,016.48
|
| Rate for Payer: Cash Price |
$4,016.48
|
| Rate for Payer: Meridian Medicaid |
$1,656.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,577.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,514.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,743.06
|
| Rate for Payer: Priority Health Narrow Network |
$3,743.06
|
| Rate for Payer: Priority Health SBD |
$3,743.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,309.48
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,652.78
|
|
|
Service Code
|
HCPCS 22210
|
| Min. Negotiated Rate |
$1,155.53 |
| Max. Negotiated Rate |
$13,048.08 |
| Rate for Payer: Aetna Commercial |
$2,400.84
|
| Rate for Payer: BCBS Complete |
$1,213.31
|
| Rate for Payer: BCBS Trust/PPO |
$13,048.08
|
| Rate for Payer: Cash Price |
$2,922.22
|
| Rate for Payer: Cash Price |
$2,922.22
|
| Rate for Payer: Meridian Medicaid |
$1,213.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,155.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,556.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,738.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,738.62
|
| Rate for Payer: Priority Health SBD |
$2,738.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,680.28
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR
|
Professional
|
Both
|
$3,038.92
|
|
|
Service Code
|
HCPCS 22214
|
| Min. Negotiated Rate |
$978.10 |
| Max. Negotiated Rate |
$17,177.60 |
| Rate for Payer: Aetna Commercial |
$2,016.15
|
| Rate for Payer: BCBS Complete |
$1,027.00
|
| Rate for Payer: BCBS Trust/PPO |
$17,177.60
|
| Rate for Payer: Cash Price |
$2,431.14
|
| Rate for Payer: Cash Price |
$2,431.14
|
| Rate for Payer: Meridian Medicaid |
$1,027.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$978.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,127.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,322.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,322.44
|
| Rate for Payer: Priority Health SBD |
$2,322.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,397.90
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC
|
Professional
|
Both
|
$3,026.04
|
|
|
Service Code
|
HCPCS 22212
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$2,321.92 |
| Rate for Payer: Aetna Commercial |
$2,011.70
|
| Rate for Payer: BCBS Complete |
$1,026.77
|
| Rate for Payer: BCBS Trust/PPO |
$24.96
|
| Rate for Payer: Cash Price |
$2,420.83
|
| Rate for Payer: Cash Price |
$2,420.83
|
| Rate for Payer: Meridian Medicaid |
$1,026.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,321.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,321.92
|
| Rate for Payer: Priority Health SBD |
$2,321.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,391.98
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,225.00
|
|
|
Service Code
|
HCPCS 22220
|
| Min. Negotiated Rate |
$180.34 |
| Max. Negotiated Rate |
$2,484.31 |
| Rate for Payer: Aetna Commercial |
$2,167.65
|
| Rate for Payer: BCBS Complete |
$1,097.45
|
| Rate for Payer: BCBS Trust/PPO |
$180.34
|
| Rate for Payer: Cash Price |
$2,580.00
|
| Rate for Payer: Cash Price |
$2,580.00
|
| Rate for Payer: Meridian Medicaid |
$1,097.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,045.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,257.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,484.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,484.31
|
| Rate for Payer: Priority Health SBD |
$2,484.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,483.50
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL
|
Professional
|
Both
|
$656.00
|
|
|
Service Code
|
HCPCS 22226
|
| Min. Negotiated Rate |
$227.91 |
| Max. Negotiated Rate |
$544.36 |
| Rate for Payer: Aetna Commercial |
$486.64
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: Cash Price |
$524.80
|
| Rate for Payer: Cash Price |
$524.80
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.36
|
| Rate for Payer: Priority Health Narrow Network |
$544.36
|
| Rate for Payer: Priority Health SBD |
$544.36
|
| Rate for Payer: UMR Bronson Commercial |
$301.76
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR
|
Professional
|
Both
|
$3,215.24
|
|
|
Service Code
|
HCPCS 22224
|
| Min. Negotiated Rate |
$180.34 |
| Max. Negotiated Rate |
$2,423.55 |
| Rate for Payer: Aetna Commercial |
$2,126.35
|
| Rate for Payer: BCBS Complete |
$1,069.94
|
| Rate for Payer: BCBS Trust/PPO |
$180.34
|
| Rate for Payer: Cash Price |
$2,572.19
|
| Rate for Payer: Cash Price |
$2,572.19
|
| Rate for Payer: Meridian Medicaid |
$1,069.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,018.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,250.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,423.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.55
|
| Rate for Payer: Priority Health SBD |
$2,423.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,479.01
|
|
|
PR OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS
|
Professional
|
Both
|
$1,486.00
|
|
|
Service Code
|
HCPCS 28304
|
| Min. Negotiated Rate |
$395.75 |
| Max. Negotiated Rate |
$1,184.98 |
| Rate for Payer: Aetna Commercial |
$807.84
|
| Rate for Payer: BCBS Complete |
$415.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.98
|
| Rate for Payer: Cash Price |
$1,188.80
|
| Rate for Payer: Cash Price |
$1,188.80
|
| Rate for Payer: Meridian Medicaid |
$415.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,040.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.09
|
| Rate for Payer: Priority Health Narrow Network |
$939.09
|
| Rate for Payer: Priority Health SBD |
$939.09
|
| Rate for Payer: UMR Bronson Commercial |
$683.56
|
|
|
PR OSTEOTOMY TIBIA
|
Professional
|
Both
|
$2,976.00
|
|
|
Service Code
|
HCPCS 27705
|
| Min. Negotiated Rate |
$483.51 |
| Max. Negotiated Rate |
$2,650.81 |
| Rate for Payer: Aetna Commercial |
$1,009.73
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,650.81
|
| Rate for Payer: Cash Price |
$2,380.80
|
| Rate for Payer: Cash Price |
$2,380.80
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,083.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,157.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.13
|
| Rate for Payer: Priority Health SBD |
$1,157.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,368.96
|
|
|
PR OSTEOTOMY TIBIA & FIBULA
|
Professional
|
Both
|
$3,401.00
|
|
|
Service Code
|
HCPCS 27709
|
| Min. Negotiated Rate |
$490.37 |
| Max. Negotiated Rate |
$2,380.70 |
| Rate for Payer: Aetna Commercial |
$1,543.67
|
| Rate for Payer: BCBS Complete |
$772.26
|
| Rate for Payer: BCBS Trust/PPO |
$490.37
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Meridian Medicaid |
$772.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,380.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,733.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.66
|
| Rate for Payer: Priority Health SBD |
$1,733.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,564.46
|
|
|
PR OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX
|
Professional
|
Both
|
$3,102.00
|
|
|
Service Code
|
HCPCS 27140
|
| Min. Negotiated Rate |
$578.51 |
| Max. Negotiated Rate |
$2,171.40 |
| Rate for Payer: Aetna Commercial |
$1,192.72
|
| Rate for Payer: BCBS Complete |
$607.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.54
|
| Rate for Payer: Cash Price |
$2,481.60
|
| Rate for Payer: Cash Price |
$2,481.60
|
| Rate for Payer: Meridian Medicaid |
$607.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,375.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,375.18
|
| Rate for Payer: Priority Health SBD |
$1,375.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.92
|
|
|
PR OSTEOTOMY ULNA
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 25360
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,528.80 |
| Rate for Payer: Aetna Commercial |
$871.38
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS Trust/PPO |
$677.28
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,012.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.61
|
| Rate for Payer: Priority Health SBD |
$1,012.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,004.64
|
|
|
PR OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL
|
Professional
|
Both
|
$2,670.00
|
|
|
Service Code
|
HCPCS 27457
|
| Min. Negotiated Rate |
$607.69 |
| Max. Negotiated Rate |
$1,869.00 |
| Rate for Payer: Aetna Commercial |
$1,285.67
|
| Rate for Payer: BCBS Complete |
$638.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.50
|
| Rate for Payer: Cash Price |
$2,136.00
|
| Rate for Payer: Cash Price |
$2,136.00
|
| Rate for Payer: Meridian Medicaid |
$638.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$607.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,472.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,472.21
|
| Rate for Payer: Priority Health SBD |
$1,472.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,228.20
|
|
|
PR OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL
|
Professional
|
Both
|
$1,993.00
|
|
|
Service Code
|
HCPCS 27455
|
| Min. Negotiated Rate |
$619.40 |
| Max. Negotiated Rate |
$1,475.78 |
| Rate for Payer: Aetna Commercial |
$1,279.84
|
| Rate for Payer: BCBS Complete |
$650.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.98
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Meridian Medicaid |
$650.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,475.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,475.78
|
| Rate for Payer: Priority Health SBD |
$1,475.78
|
| Rate for Payer: UMR Bronson Commercial |
$916.78
|
|
|
PR OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE
|
Professional
|
Both
|
$795.00
|
|
|
Service Code
|
HCPCS 28312
|
| Min. Negotiated Rate |
$223.22 |
| Max. Negotiated Rate |
$1,771.92 |
| Rate for Payer: Aetna Commercial |
$424.19
|
| Rate for Payer: BCBS Complete |
$234.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,771.92
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Meridian Medicaid |
$234.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$516.27
|
| Rate for Payer: Priority Health Narrow Network |
$516.27
|
| Rate for Payer: Priority Health SBD |
$516.27
|
| Rate for Payer: UMR Bronson Commercial |
$365.70
|
|
|
PR OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 28310
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$1,691.62 |
| Rate for Payer: Aetna Commercial |
$478.50
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.62
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$655.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.47
|
| Rate for Payer: Priority Health Narrow Network |
$550.47
|
| Rate for Payer: Priority Health SBD |
$550.47
|
| Rate for Payer: UMR Bronson Commercial |
$431.02
|
|
