|
PR APPLICATION CAST HAND & LOWER FOREARM GAUNTLET
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 29085
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Aetna Commercial |
$82.49
|
| Rate for Payer: Aetna Medicare |
$61.56
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$61.56
|
| Rate for Payer: BCN Commercial |
$81.29
|
| Rate for Payer: BCN Medicare Advantage |
$61.56
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$88.65
|
| Rate for Payer: Cofinity Commercial |
$82.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.56
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Healthscope Whirlpool |
$73.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.64
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.72
|
| Rate for Payer: Nomi Health Commercial |
$73.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.25
|
| Rate for Payer: PACE SWMI |
$61.56
|
| Rate for Payer: PHP Medicare Advantage |
$61.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$110.20
|
| Rate for Payer: Priority Health Medicare |
$61.56
|
| Rate for Payer: Priority Health Narrow Network |
$110.20
|
| Rate for Payer: Railroad Medicare Medicare |
$61.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.56
|
| Rate for Payer: UHC Exchange |
$115.76
|
| Rate for Payer: UHC Medicaid |
$40.47
|
| Rate for Payer: UHCCP DNSP |
$61.56
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
|
|
PR APPLICATION CAST SHOULDER TO HAND LONG ARM
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 29065
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$200.25 |
| Rate for Payer: Aetna Commercial |
$83.82
|
| Rate for Payer: Aetna Medicare |
$62.55
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$62.55
|
| Rate for Payer: BCN Commercial |
$81.68
|
| Rate for Payer: BCN Medicare Advantage |
$62.55
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$90.07
|
| Rate for Payer: Cofinity Commercial |
$83.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.55
|
| Rate for Payer: Healthscope Commercial |
$75.06
|
| Rate for Payer: Healthscope Whirlpool |
$75.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.68
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.81
|
| Rate for Payer: Nomi Health Commercial |
$75.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.25
|
| Rate for Payer: PACE SWMI |
$62.55
|
| Rate for Payer: PHP Medicare Advantage |
$62.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$110.72
|
| Rate for Payer: Priority Health Medicare |
$62.55
|
| Rate for Payer: Priority Health Narrow Network |
$110.72
|
| Rate for Payer: Railroad Medicare Medicare |
$62.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.55
|
| Rate for Payer: UHC Exchange |
$117.54
|
| Rate for Payer: UHC Medicaid |
$41.11
|
| Rate for Payer: UHCCP DNSP |
$62.55
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR APPLICATION CYLINDER CAST THIGH TO ANKLE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 29365
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$107.23
|
| Rate for Payer: Aetna Medicare |
$80.02
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$80.02
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$80.02
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$115.23
|
| Rate for Payer: Cofinity Commercial |
$107.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.02
|
| Rate for Payer: Healthscope Commercial |
$96.02
|
| Rate for Payer: Healthscope Whirlpool |
$96.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.02
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.02
|
| Rate for Payer: Nomi Health Commercial |
$96.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$80.02
|
| Rate for Payer: PHP Medicare Advantage |
$80.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$141.60
|
| Rate for Payer: Priority Health Medicare |
$80.02
|
| Rate for Payer: Priority Health Narrow Network |
$141.60
|
| Rate for Payer: Railroad Medicare Medicare |
$80.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.02
|
| Rate for Payer: UHC Exchange |
$151.15
|
| Rate for Payer: UHC Medicaid |
$52.40
|
| Rate for Payer: UHCCP DNSP |
$80.02
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
PR APPLICATION FINGER SPLINT DYNAMIC
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 29131
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$40.88
|
| Rate for Payer: Aetna Medicare |
$30.51
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$30.51
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$30.51
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$43.93
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.51
|
| Rate for Payer: Healthscope Commercial |
$36.61
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.04
|
| Rate for Payer: Meridian Medicaid |
$20.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.56
|
| Rate for Payer: Nomi Health Commercial |
$36.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: PACE SWMI |
$30.51
|
| Rate for Payer: PHP Medicare Advantage |
$30.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.89
|
| Rate for Payer: Priority Health Medicare |
$30.51
|
| Rate for Payer: Priority Health Narrow Network |
$55.89
|
| Rate for Payer: Railroad Medicare Medicare |
$30.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.51
|
| Rate for Payer: UHC Exchange |
$59.72
|
| Rate for Payer: UHC Medicaid |
$19.81
|
| Rate for Payer: UHCCP DNSP |
$30.51
|
| Rate for Payer: UHCCP Medicaid |
$19.81
|
|
|
PR APPLICATION FINGER SPLINT STATIC
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 29130
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$34.14
|
| Rate for Payer: Aetna Medicare |
$25.48
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.48
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Cofinity Commercial |
$34.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.48
|
| Rate for Payer: Healthscope Commercial |
$30.58
|
| Rate for Payer: Healthscope Whirlpool |
$30.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.75
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.03
|
| Rate for Payer: Nomi Health Commercial |
$30.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: PACE SWMI |
$25.48
|
| Rate for Payer: PHP Medicare Advantage |
$25.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.31
|
| Rate for Payer: Priority Health Medicare |
$25.48
|
| Rate for Payer: Priority Health Narrow Network |
$46.31
|
| Rate for Payer: Railroad Medicare Medicare |
$25.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.48
|
| Rate for Payer: UHC Exchange |
$51.99
|
| Rate for Payer: UHC Medicaid |
$16.40
|
| Rate for Payer: UHCCP DNSP |
$25.48
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
|
|
PR APPLICATION HALO CRANIAL INCLUDING REMOVAL
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 20661
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$870.93 |
| Rate for Payer: Aetna Commercial |
$714.10
|
| Rate for Payer: Aetna Medicare |
$532.91
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$532.91
|
| Rate for Payer: BCN Commercial |
$870.93
|
| Rate for Payer: BCN Medicare Advantage |
$532.91
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$767.39
|
| Rate for Payer: Cofinity Commercial |
$714.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.91
|
| Rate for Payer: Healthscope Commercial |
$639.49
|
| Rate for Payer: Healthscope Whirlpool |
$639.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.56
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$586.20
|
| Rate for Payer: Nomi Health Commercial |
$639.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$849.00
|
| Rate for Payer: PACE SWMI |
$532.91
|
| Rate for Payer: PHP Medicare Advantage |
$532.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$847.47
|
| Rate for Payer: Priority Health Medicare |
$532.91
|
| Rate for Payer: Priority Health Narrow Network |
$847.47
|
| Rate for Payer: Railroad Medicare Medicare |
$532.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$532.91
|
| Rate for Payer: UHC Exchange |
$865.89
|
| Rate for Payer: UHC Medicaid |
$352.94
|
| Rate for Payer: UHCCP DNSP |
$532.91
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
|
|
PR APPLICATION HIP SPICA CAST 1 LEG
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 29305
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Aetna Commercial |
$197.29
|
| Rate for Payer: Aetna Medicare |
$147.23
|
| Rate for Payer: BCBS Complete |
$101.53
|
| Rate for Payer: BCBS MAPPO |
$147.23
|
| Rate for Payer: BCN Commercial |
$242.02
|
| Rate for Payer: BCN Medicare Advantage |
$147.23
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cofinity Commercial |
$197.29
|
| Rate for Payer: Cofinity Commercial |
$212.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.23
|
| Rate for Payer: Healthscope Commercial |
$176.68
|
| Rate for Payer: Healthscope Whirlpool |
$176.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.59
|
| Rate for Payer: Meridian Medicaid |
$101.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.95
|
| Rate for Payer: Nomi Health Commercial |
$176.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
| Rate for Payer: PACE SWMI |
$147.23
|
| Rate for Payer: PHP Medicare Advantage |
$147.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$258.70
|
| Rate for Payer: Priority Health Medicare |
$147.23
|
| Rate for Payer: Priority Health Narrow Network |
$258.70
|
| Rate for Payer: Railroad Medicare Medicare |
$147.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.23
|
| Rate for Payer: UHC Exchange |
$273.28
|
| Rate for Payer: UHC Medicaid |
$96.70
|
| Rate for Payer: UHCCP DNSP |
$147.23
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
|
|
PR APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 22851
|
| Min. Negotiated Rate |
$858.00 |
| Max. Negotiated Rate |
$1,608.75 |
| Rate for Payer: BCBS Complete |
$858.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,608.75
|
|
|
PR APPLICATION LONG ARM SPLINT SHOULDER TO HAND
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 29105
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna Medicare |
$37.95
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$37.95
|
| Rate for Payer: BCN Commercial |
$62.25
|
| Rate for Payer: BCN Medicare Advantage |
$37.95
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.95
|
| Rate for Payer: Healthscope Commercial |
$45.54
|
| Rate for Payer: Healthscope Whirlpool |
$45.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.85
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.74
|
| Rate for Payer: Nomi Health Commercial |
$45.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.50
|
| Rate for Payer: PACE SWMI |
$37.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.54
|
| Rate for Payer: Priority Health Medicare |
$37.95
|
| Rate for Payer: Priority Health Narrow Network |
$66.54
|
| Rate for Payer: Railroad Medicare Medicare |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.95
|
| Rate for Payer: UHC Exchange |
$74.47
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP DNSP |
$37.95
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
PR APPLICATION LONG LEG CAST BRACE
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 29358
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$213.75 |
| Rate for Payer: Aetna Commercial |
$125.49
|
| Rate for Payer: Aetna Medicare |
$93.65
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$93.65
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: BCN Medicare Advantage |
$93.65
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$134.86
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.65
|
| Rate for Payer: Healthscope Commercial |
$112.38
|
| Rate for Payer: Healthscope Whirlpool |
$112.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.33
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.02
|
| Rate for Payer: Nomi Health Commercial |
$112.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PACE SWMI |
$93.65
|
| Rate for Payer: PHP Medicare Advantage |
$93.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$167.15
|
| Rate for Payer: Priority Health Medicare |
$93.65
|
| Rate for Payer: Priority Health Narrow Network |
$167.15
|
| Rate for Payer: Railroad Medicare Medicare |
$93.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.65
|
| Rate for Payer: UHC Exchange |
$179.19
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP DNSP |
$93.65
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR APPLICATION LONG LEG CAST THIGH-TOE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 29345
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$217.50 |
| Rate for Payer: Aetna Commercial |
$119.81
|
| Rate for Payer: Aetna Medicare |
$89.41
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$89.41
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$128.75
|
| Rate for Payer: Cofinity Commercial |
$119.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.41
|
| Rate for Payer: Healthscope Commercial |
$107.29
|
| Rate for Payer: Healthscope Whirlpool |
$107.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.88
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.35
|
| Rate for Payer: Nomi Health Commercial |
$107.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.50
|
| Rate for Payer: PACE SWMI |
$89.41
|
| Rate for Payer: PHP Medicare Advantage |
$89.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$160.77
|
| Rate for Payer: Priority Health Medicare |
$89.41
|
| Rate for Payer: Priority Health Narrow Network |
$160.77
|
| Rate for Payer: Railroad Medicare Medicare |
$89.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.41
|
| Rate for Payer: UHC Exchange |
$173.81
|
| Rate for Payer: UHC Medicaid |
$58.36
|
| Rate for Payer: UHCCP DNSP |
$89.41
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 29355
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$127.02
|
| Rate for Payer: Aetna Medicare |
$94.79
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$94.79
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$94.79
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$136.50
|
| Rate for Payer: Cofinity Commercial |
$127.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.79
|
| Rate for Payer: Healthscope Commercial |
$113.75
|
| Rate for Payer: Healthscope Whirlpool |
$113.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.53
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.27
|
| Rate for Payer: Nomi Health Commercial |
$113.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$94.79
|
| Rate for Payer: PHP Medicare Advantage |
$94.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$170.87
|
| Rate for Payer: Priority Health Medicare |
$94.79
|
| Rate for Payer: Priority Health Narrow Network |
$170.87
|
| Rate for Payer: Railroad Medicare Medicare |
$94.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.79
|
| Rate for Payer: UHC Exchange |
$186.04
|
| Rate for Payer: UHC Medicaid |
$61.77
|
| Rate for Payer: UHCCP DNSP |
$94.79
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR APPLICATION LONG LEG SPLINT THIGH TO ANKLE/TOES
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 29505
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$105.75 |
| Rate for Payer: Aetna Commercial |
$70.89
|
| Rate for Payer: Aetna Medicare |
$52.90
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCBS MAPPO |
$52.90
|
| Rate for Payer: BCN Commercial |
$80.18
|
| Rate for Payer: BCN Medicare Advantage |
$52.90
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$76.18
|
| Rate for Payer: Cofinity Commercial |
$70.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.90
|
| Rate for Payer: Healthscope Commercial |
$63.48
|
| Rate for Payer: Healthscope Whirlpool |
$63.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.55
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.19
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$52.90
|
| Rate for Payer: PHP Medicare Advantage |
$52.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.71
|
| Rate for Payer: Priority Health Medicare |
$52.90
|
| Rate for Payer: Priority Health Narrow Network |
$85.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.90
|
| Rate for Payer: UHC Exchange |
$87.57
|
| Rate for Payer: UHC Medicaid |
$34.93
|
| Rate for Payer: UHCCP DNSP |
$52.90
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
|
|
PR APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 97010
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$4.45
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCN Commercial |
$6.68
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.54
|
| Rate for Payer: UHC Exchange |
$5.54
|
|
|
PR APPLICATION MODALITY 1/> AREAS WHIRLPOOL
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 97022
|
| Min. Negotiated Rate |
$14.90 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Medicare |
$14.90
|
| Rate for Payer: BCBS MAPPO |
$14.90
|
| Rate for Payer: BCN Commercial |
$16.03
|
| Rate for Payer: BCN Medicare Advantage |
$14.90
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$19.97
|
| Rate for Payer: Cofinity Commercial |
$21.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$17.88
|
| Rate for Payer: Healthscope Whirlpool |
$17.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.39
|
| Rate for Payer: Nomi Health Commercial |
$17.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.25
|
| Rate for Payer: PACE SWMI |
$14.90
|
| Rate for Payer: PHP Medicare Advantage |
$14.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$14.90
|
| Rate for Payer: Priority Health Narrow Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$14.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.90
|
| Rate for Payer: UHC Exchange |
$15.65
|
| Rate for Payer: UHCCP DNSP |
$14.90
|
|
|
PR APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 20692
|
| Min. Negotiated Rate |
$667.76 |
| Max. Negotiated Rate |
$1,956.37 |
| Rate for Payer: Aetna Commercial |
$1,371.14
|
| Rate for Payer: Aetna Medicare |
$1,023.24
|
| Rate for Payer: BCBS Complete |
$701.15
|
| Rate for Payer: BCBS MAPPO |
$1,023.24
|
| Rate for Payer: BCN Commercial |
$1,715.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.24
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$1,473.47
|
| Rate for Payer: Cofinity Commercial |
$1,371.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.24
|
| Rate for Payer: Healthscope Commercial |
$1,227.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,227.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.40
|
| Rate for Payer: Meridian Medicaid |
$701.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.56
|
| Rate for Payer: Nomi Health Commercial |
$1,227.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,487.25
|
| Rate for Payer: PACE SWMI |
$1,023.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,833.87
|
| Rate for Payer: Priority Health Medicare |
$1,023.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,833.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,023.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,956.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,023.24
|
| Rate for Payer: UHC Exchange |
$1,956.37
|
| Rate for Payer: UHC Medicaid |
$667.76
|
| Rate for Payer: UHCCP DNSP |
$1,023.24
|
| Rate for Payer: UHCCP Medicaid |
$667.76
|
|
|
PR APPLICATION OF SURFACE NEUROSTIMULATOR
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 64550
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
|
|
PR APPLICATION PATELLAR TENDON BEARING CAST
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 29435
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$269.25 |
| Rate for Payer: Aetna Commercial |
$106.10
|
| Rate for Payer: Aetna Medicare |
$79.18
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$79.18
|
| Rate for Payer: BCN Commercial |
$131.47
|
| Rate for Payer: BCN Medicare Advantage |
$79.18
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$106.10
|
| Rate for Payer: Cofinity Commercial |
$114.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.18
|
| Rate for Payer: Healthscope Commercial |
$95.02
|
| Rate for Payer: Healthscope Whirlpool |
$95.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.14
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.10
|
| Rate for Payer: Nomi Health Commercial |
$95.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$79.18
|
| Rate for Payer: PHP Medicare Advantage |
$79.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$140.53
|
| Rate for Payer: Priority Health Medicare |
$79.18
|
| Rate for Payer: Priority Health Narrow Network |
$140.53
|
| Rate for Payer: Railroad Medicare Medicare |
$79.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.18
|
| Rate for Payer: UHC Exchange |
$142.44
|
| Rate for Payer: UHC Medicaid |
$51.76
|
| Rate for Payer: UHCCP DNSP |
$79.18
|
| Rate for Payer: UHCCP Medicaid |
$51.76
|
|
|
PR APPLICATION RIGHT & LEFT PULMONARY ARTERY BAND
|
Professional
|
Both
|
$3,462.00
|
|
|
Service Code
|
HCPCS 33620
|
| Min. Negotiated Rate |
$980.44 |
| Max. Negotiated Rate |
$2,940.98 |
| Rate for Payer: Aetna Commercial |
$2,066.19
|
| Rate for Payer: Aetna Medicare |
$1,541.93
|
| Rate for Payer: BCBS Complete |
$1,029.46
|
| Rate for Payer: BCBS MAPPO |
$1,541.93
|
| Rate for Payer: BCN Commercial |
$2,423.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,541.93
|
| Rate for Payer: Cash Price |
$2,769.60
|
| Rate for Payer: Cash Price |
$2,769.60
|
| Rate for Payer: Cofinity Commercial |
$2,220.38
|
| Rate for Payer: Cofinity Commercial |
$2,066.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,541.93
|
| Rate for Payer: Healthscope Commercial |
$1,850.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,850.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,619.03
|
| Rate for Payer: Meridian Medicaid |
$1,029.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,696.12
|
| Rate for Payer: Nomi Health Commercial |
$1,850.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,596.50
|
| Rate for Payer: PACE SWMI |
$1,541.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,541.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$980.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,606.35
|
| Rate for Payer: Priority Health Medicare |
$1,541.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,606.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,541.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,940.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,541.93
|
| Rate for Payer: UHC Exchange |
$2,940.98
|
| Rate for Payer: UHC Medicaid |
$980.44
|
| Rate for Payer: UHCCP DNSP |
$1,541.93
|
| Rate for Payer: UHCCP Medicaid |
$980.44
|
|
|
PR APPLICATION RIGID TOTAL CONTACT LEG CAST
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 29445
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$119.45
|
| Rate for Payer: Aetna Medicare |
$89.14
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$89.14
|
| Rate for Payer: BCN Commercial |
$115.85
|
| Rate for Payer: BCN Medicare Advantage |
$89.14
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$128.36
|
| Rate for Payer: Cofinity Commercial |
$119.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$106.97
|
| Rate for Payer: Healthscope Whirlpool |
$106.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.05
|
| Rate for Payer: Nomi Health Commercial |
$106.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: PACE SWMI |
$89.14
|
| Rate for Payer: PHP Medicare Advantage |
$89.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.03
|
| Rate for Payer: Priority Health Medicare |
$89.14
|
| Rate for Payer: Priority Health Narrow Network |
$157.03
|
| Rate for Payer: Railroad Medicare Medicare |
$89.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.14
|
| Rate for Payer: UHC Exchange |
$179.59
|
| Rate for Payer: UHC Medicaid |
$57.72
|
| Rate for Payer: UHCCP DNSP |
$89.14
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
|
|
PR APPLICATION SHORT ARM SPLINT DYNAMIC
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 29126
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$59.01
|
| Rate for Payer: Aetna Medicare |
$44.04
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$44.04
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.04
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$63.42
|
| Rate for Payer: Cofinity Commercial |
$59.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.04
|
| Rate for Payer: Healthscope Commercial |
$52.85
|
| Rate for Payer: Healthscope Whirlpool |
$52.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.24
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.44
|
| Rate for Payer: Nomi Health Commercial |
$52.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.50
|
| Rate for Payer: PACE SWMI |
$44.04
|
| Rate for Payer: PHP Medicare Advantage |
$44.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$80.38
|
| Rate for Payer: Priority Health Medicare |
$44.04
|
| Rate for Payer: Priority Health Narrow Network |
$80.38
|
| Rate for Payer: Railroad Medicare Medicare |
$44.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.04
|
| Rate for Payer: UHC Exchange |
$84.55
|
| Rate for Payer: UHC Medicaid |
$28.97
|
| Rate for Payer: UHCCP DNSP |
$44.04
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 29125
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Aetna Commercial |
$53.04
|
| Rate for Payer: Aetna Medicare |
$39.58
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$39.58
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$39.58
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$57.00
|
| Rate for Payer: Cofinity Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.58
|
| Rate for Payer: Healthscope Commercial |
$47.50
|
| Rate for Payer: Healthscope Whirlpool |
$47.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.56
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.54
|
| Rate for Payer: Nomi Health Commercial |
$47.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.50
|
| Rate for Payer: PACE SWMI |
$39.58
|
| Rate for Payer: PHP Medicare Advantage |
$39.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.48
|
| Rate for Payer: Priority Health Medicare |
$39.58
|
| Rate for Payer: Priority Health Narrow Network |
$65.48
|
| Rate for Payer: Railroad Medicare Medicare |
$39.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.58
|
| Rate for Payer: UHC Exchange |
$68.07
|
| Rate for Payer: UHC Medicaid |
$26.20
|
| Rate for Payer: UHCCP DNSP |
$39.58
|
| Rate for Payer: UHCCP Medicaid |
$26.20
|
|
|
PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 29405
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$72.53
|
| Rate for Payer: Aetna Medicare |
$54.13
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$54.13
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$54.13
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$77.95
|
| Rate for Payer: Cofinity Commercial |
$72.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.13
|
| Rate for Payer: Healthscope Commercial |
$64.96
|
| Rate for Payer: Healthscope Whirlpool |
$64.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.84
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.54
|
| Rate for Payer: Nomi Health Commercial |
$64.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.00
|
| Rate for Payer: PACE SWMI |
$54.13
|
| Rate for Payer: PHP Medicare Advantage |
$54.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.29
|
| Rate for Payer: Priority Health Medicare |
$54.13
|
| Rate for Payer: Priority Health Narrow Network |
$95.29
|
| Rate for Payer: Railroad Medicare Medicare |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.13
|
| Rate for Payer: UHC Exchange |
$102.02
|
| Rate for Payer: UHC Medicaid |
$35.57
|
| Rate for Payer: UHCCP DNSP |
$54.13
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
|
|
PR APPLICATION SHORT LEG CAST WALKING/AMBULATORY
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 29425
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$209.25 |
| Rate for Payer: Aetna Commercial |
$66.42
|
| Rate for Payer: Aetna Medicare |
$49.57
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$49.57
|
| Rate for Payer: BCN Commercial |
$64.80
|
| Rate for Payer: BCN Medicare Advantage |
$49.57
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Cofinity Commercial |
$66.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.57
|
| Rate for Payer: Healthscope Commercial |
$59.48
|
| Rate for Payer: Healthscope Whirlpool |
$59.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.05
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.53
|
| Rate for Payer: Nomi Health Commercial |
$59.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.25
|
| Rate for Payer: PACE SWMI |
$49.57
|
| Rate for Payer: PHP Medicare Advantage |
$49.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.83
|
| Rate for Payer: Priority Health Medicare |
$49.57
|
| Rate for Payer: Priority Health Narrow Network |
$87.83
|
| Rate for Payer: Railroad Medicare Medicare |
$49.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.57
|
| Rate for Payer: UHC Exchange |
$96.20
|
| Rate for Payer: UHC Medicaid |
$32.59
|
| Rate for Payer: UHCCP DNSP |
$49.57
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
PR APPLICATION SHORT LEG SPLINT CALF TO FOOT
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 29515
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Commercial |
$64.82
|
| Rate for Payer: Aetna Medicare |
$48.37
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$48.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$48.37
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$69.65
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.37
|
| Rate for Payer: Healthscope Commercial |
$58.04
|
| Rate for Payer: Healthscope Whirlpool |
$58.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.79
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.21
|
| Rate for Payer: Nomi Health Commercial |
$58.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$48.37
|
| Rate for Payer: PHP Medicare Advantage |
$48.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$80.92
|
| Rate for Payer: Priority Health Medicare |
$48.37
|
| Rate for Payer: Priority Health Narrow Network |
$80.92
|
| Rate for Payer: Railroad Medicare Medicare |
$48.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.37
|
| Rate for Payer: UHC Exchange |
$86.06
|
| Rate for Payer: UHC Medicaid |
$31.74
|
| Rate for Payer: UHCCP DNSP |
$48.37
|
| Rate for Payer: UHCCP Medicaid |
$31.74
|
|
