PR OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS
|
Professional
|
Both
|
$53.00
|
|
Service Code
|
HCPCS 98925
|
Min. Negotiated Rate |
$14.48 |
Max. Negotiated Rate |
$1,227.77 |
Rate for Payer: Aetna Commercial |
$30.70
|
Rate for Payer: Aetna Medicare |
$22.91
|
Rate for Payer: BCBS Complete |
$15.20
|
Rate for Payer: BCBS MAPPO |
$22.91
|
Rate for Payer: BCBS Trust/PPO |
$1,227.77
|
Rate for Payer: BCN Commercial |
$30.34
|
Rate for Payer: BCN Medicare Advantage |
$22.91
|
Rate for Payer: Cash Price |
$42.40
|
Rate for Payer: Cash Price |
$42.40
|
Rate for Payer: Cofinity Commercial |
$32.99
|
Rate for Payer: Cofinity Commercial |
$30.70
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.91
|
Rate for Payer: Healthscope Commercial |
$27.49
|
Rate for Payer: Healthscope Whirlpool |
$27.49
|
Rate for Payer: Meridian Medicaid |
$15.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.06
|
Rate for Payer: PACE SWMI |
$22.91
|
Rate for Payer: PHP Medicare Advantage |
$22.91
|
Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.99
|
Rate for Payer: Priority Health Medicare |
$22.91
|
Rate for Payer: Priority Health Narrow Network |
$30.99
|
Rate for Payer: UHC Medicare Advantage |
$23.60
|
|
PR OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS
|
Professional
|
Both
|
$76.00
|
|
Service Code
|
HCPCS 98926
|
Min. Negotiated Rate |
$21.94 |
Max. Negotiated Rate |
$1,021.73 |
Rate for Payer: Aetna Commercial |
$45.77
|
Rate for Payer: Aetna Medicare |
$34.16
|
Rate for Payer: BCBS Complete |
$23.04
|
Rate for Payer: BCBS MAPPO |
$34.16
|
Rate for Payer: BCBS Trust/PPO |
$1,021.73
|
Rate for Payer: BCN Commercial |
$43.39
|
Rate for Payer: BCN Medicare Advantage |
$34.16
|
Rate for Payer: Cash Price |
$60.80
|
Rate for Payer: Cash Price |
$60.80
|
Rate for Payer: Cofinity Commercial |
$49.19
|
Rate for Payer: Cofinity Commercial |
$45.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.16
|
Rate for Payer: Healthscope Commercial |
$40.99
|
Rate for Payer: Healthscope Whirlpool |
$40.99
|
Rate for Payer: Meridian Medicaid |
$23.04
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.87
|
Rate for Payer: PACE SWMI |
$34.16
|
Rate for Payer: PHP Medicare Advantage |
$34.16
|
Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.26
|
Rate for Payer: Priority Health Medicare |
$34.16
|
Rate for Payer: Priority Health Narrow Network |
$46.26
|
Rate for Payer: UHC Medicare Advantage |
$35.18
|
|
PR OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS
|
Professional
|
Both
|
$100.00
|
|
Service Code
|
HCPCS 98927
|
Min. Negotiated Rate |
$29.18 |
Max. Negotiated Rate |
$1,177.05 |
Rate for Payer: Aetna Commercial |
$60.03
|
Rate for Payer: Aetna Medicare |
$44.80
|
Rate for Payer: BCBS Complete |
$30.64
|
Rate for Payer: BCBS MAPPO |
$44.80
|
Rate for Payer: BCBS Trust/PPO |
$1,177.05
|
Rate for Payer: BCN Commercial |
$56.11
|
Rate for Payer: BCN Medicare Advantage |
$44.80
|
Rate for Payer: Cash Price |
$80.00
|
Rate for Payer: Cash Price |
$80.00
|
Rate for Payer: Cofinity Commercial |
$64.51
|
Rate for Payer: Cofinity Commercial |
$60.03
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.80
|
Rate for Payer: Healthscope Commercial |
$53.76
|
Rate for Payer: Healthscope Whirlpool |
$53.76
|
Rate for Payer: Meridian Medicaid |
$30.64
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.04
|
Rate for Payer: PACE SWMI |
$44.80
|
Rate for Payer: PHP Medicare Advantage |
$44.80
|
Rate for Payer: Priority Health Choice Medicaid |
$29.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.64
|
Rate for Payer: Priority Health Medicare |
$44.80
|
Rate for Payer: Priority Health Narrow Network |
$60.64
|
Rate for Payer: UHC Medicare Advantage |
$46.14
|
|
PR OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS
|
Professional
|
Both
|
$123.00
|
|
Service Code
|
HCPCS 98928
|
Min. Negotiated Rate |
$36.85 |
Max. Negotiated Rate |
$332.83 |
Rate for Payer: Aetna Commercial |
$76.57
|
Rate for Payer: Aetna Medicare |
$57.14
|
Rate for Payer: BCBS Complete |
$38.69
|
Rate for Payer: BCBS MAPPO |
$57.14
|
Rate for Payer: BCBS Trust/PPO |
$332.83
|
Rate for Payer: BCN Commercial |
$69.16
|
Rate for Payer: BCN Medicare Advantage |
$57.14
|
Rate for Payer: Cash Price |
$98.40
|
Rate for Payer: Cash Price |
$98.40
|
Rate for Payer: Cofinity Commercial |
$82.28
|
Rate for Payer: Cofinity Commercial |
$76.57
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.14
|
Rate for Payer: Healthscope Commercial |
$68.57
|
Rate for Payer: Healthscope Whirlpool |
$68.57
|
Rate for Payer: Meridian Medicaid |
$38.69
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.00
|
Rate for Payer: PACE SWMI |
$57.14
|
Rate for Payer: PHP Medicare Advantage |
$57.14
|
Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.26
|
Rate for Payer: Priority Health Medicare |
$57.14
|
Rate for Payer: Priority Health Narrow Network |
$77.26
|
Rate for Payer: UHC Medicare Advantage |
$58.85
|
|
PR OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS
|
Professional
|
Both
|
$147.00
|
|
Service Code
|
HCPCS 98929
|
Min. Negotiated Rate |
$44.09 |
Max. Negotiated Rate |
$193.36 |
Rate for Payer: Aetna Commercial |
$91.72
|
Rate for Payer: Aetna Medicare |
$68.45
|
Rate for Payer: BCBS Complete |
$46.29
|
Rate for Payer: BCBS MAPPO |
$68.45
|
Rate for Payer: BCBS Trust/PPO |
$193.36
|
Rate for Payer: BCN Commercial |
$81.23
|
Rate for Payer: BCN Medicare Advantage |
$68.45
|
Rate for Payer: Cash Price |
$117.60
|
Rate for Payer: Cash Price |
$117.60
|
Rate for Payer: Cofinity Commercial |
$98.57
|
Rate for Payer: Cofinity Commercial |
$91.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.45
|
Rate for Payer: Healthscope Commercial |
$82.14
|
Rate for Payer: Healthscope Whirlpool |
$82.14
|
Rate for Payer: Meridian Medicaid |
$46.29
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.87
|
Rate for Payer: PACE SWMI |
$68.45
|
Rate for Payer: PHP Medicare Advantage |
$68.45
|
Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.53
|
Rate for Payer: Priority Health Medicare |
$68.45
|
Rate for Payer: Priority Health Narrow Network |
$92.53
|
Rate for Payer: UHC Medicare Advantage |
$70.50
|
|
PR OSTEOPLASTY CARPAL BONE SHORTENING
|
Professional
|
Both
|
$1,900.00
|
|
Service Code
|
HCPCS 25394
|
Min. Negotiated Rate |
$508.22 |
Max. Negotiated Rate |
$1,330.00 |
Rate for Payer: Aetna Commercial |
$1,037.55
|
Rate for Payer: Aetna Medicare |
$774.29
|
Rate for Payer: BCBS Complete |
$533.63
|
Rate for Payer: BCBS MAPPO |
$774.29
|
Rate for Payer: BCBS Trust/PPO |
$556.83
|
Rate for Payer: BCN Commercial |
$1,154.74
|
Rate for Payer: BCN Medicare Advantage |
$774.29
|
Rate for Payer: Cash Price |
$1,520.00
|
Rate for Payer: Cash Price |
$1,520.00
|
Rate for Payer: Cofinity Commercial |
$1,114.98
|
Rate for Payer: Cofinity Commercial |
$1,037.55
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.29
|
Rate for Payer: Healthscope Commercial |
$929.15
|
Rate for Payer: Healthscope Whirlpool |
$929.15
|
Rate for Payer: Meridian Medicaid |
$533.63
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$813.00
|
Rate for Payer: PACE SWMI |
$774.29
|
Rate for Payer: PHP Medicare Advantage |
$774.29
|
Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.66
|
Rate for Payer: Priority Health Medicare |
$774.29
|
Rate for Payer: Priority Health Narrow Network |
$1,206.66
|
Rate for Payer: UHC Medicare Advantage |
$797.52
|
|
PR OSTEOPLASTY FEMUR LENGTHENING
|
Professional
|
Both
|
$3,903.00
|
|
Service Code
|
HCPCS 27466
|
Min. Negotiated Rate |
$761.69 |
Max. Negotiated Rate |
$2,732.10 |
Rate for Payer: Aetna Commercial |
$1,564.45
|
Rate for Payer: Aetna Medicare |
$1,167.50
|
Rate for Payer: BCBS Complete |
$799.77
|
Rate for Payer: BCBS MAPPO |
$1,167.50
|
Rate for Payer: BCBS Trust/PPO |
$1,594.94
|
Rate for Payer: BCN Commercial |
$1,734.81
|
Rate for Payer: BCN Medicare Advantage |
$1,167.50
|
Rate for Payer: Cash Price |
$3,122.40
|
Rate for Payer: Cash Price |
$3,122.40
|
Rate for Payer: Cofinity Commercial |
$1,681.20
|
Rate for Payer: Cofinity Commercial |
$1,564.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,167.50
|
Rate for Payer: Healthscope Commercial |
$1,401.00
|
Rate for Payer: Healthscope Whirlpool |
$1,401.00
|
Rate for Payer: Meridian Medicaid |
$799.77
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,225.88
|
Rate for Payer: PACE SWMI |
$1,167.50
|
Rate for Payer: PHP Medicare Advantage |
$1,167.50
|
Rate for Payer: Priority Health Choice Medicaid |
$761.69
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,732.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,812.81
|
Rate for Payer: Priority Health Medicare |
$1,167.50
|
Rate for Payer: Priority Health Narrow Network |
$1,812.81
|
Rate for Payer: UHC Medicare Advantage |
$1,202.52
|
|
PR OSTEOPLASTY HUMERUS
|
Professional
|
Both
|
$3,270.00
|
|
Service Code
|
HCPCS 24420
|
Min. Negotiated Rate |
$306.41 |
Max. Negotiated Rate |
$2,289.00 |
Rate for Payer: Aetna Commercial |
$1,403.23
|
Rate for Payer: Aetna Medicare |
$1,047.19
|
Rate for Payer: BCBS Complete |
$720.37
|
Rate for Payer: BCBS MAPPO |
$1,047.19
|
Rate for Payer: BCBS Trust/PPO |
$306.41
|
Rate for Payer: BCN Commercial |
$1,567.68
|
Rate for Payer: BCN Medicare Advantage |
$1,047.19
|
Rate for Payer: Cash Price |
$2,616.00
|
Rate for Payer: Cash Price |
$2,616.00
|
Rate for Payer: Cofinity Commercial |
$1,507.95
|
Rate for Payer: Cofinity Commercial |
$1,403.23
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.19
|
Rate for Payer: Healthscope Commercial |
$1,256.63
|
Rate for Payer: Healthscope Whirlpool |
$1,256.63
|
Rate for Payer: Meridian Medicaid |
$720.37
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,099.55
|
Rate for Payer: PACE SWMI |
$1,047.19
|
Rate for Payer: PHP Medicare Advantage |
$1,047.19
|
Rate for Payer: Priority Health Choice Medicaid |
$686.07
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,289.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,638.16
|
Rate for Payer: Priority Health Medicare |
$1,047.19
|
Rate for Payer: Priority Health Narrow Network |
$1,638.16
|
Rate for Payer: UHC Medicare Advantage |
$1,078.61
|
|
PR OSTEOPLASTY RADIUS/ULNA SHORTENING
|
Professional
|
Both
|
$2,636.00
|
|
Service Code
|
HCPCS 25390
|
Min. Negotiated Rate |
$497.57 |
Max. Negotiated Rate |
$1,845.20 |
Rate for Payer: Aetna Commercial |
$1,017.46
|
Rate for Payer: Aetna Medicare |
$759.30
|
Rate for Payer: BCBS Complete |
$522.45
|
Rate for Payer: BCBS MAPPO |
$759.30
|
Rate for Payer: BCBS Trust/PPO |
$580.07
|
Rate for Payer: BCN Commercial |
$1,133.25
|
Rate for Payer: BCN Medicare Advantage |
$759.30
|
Rate for Payer: Cash Price |
$2,108.80
|
Rate for Payer: Cash Price |
$2,108.80
|
Rate for Payer: Cofinity Commercial |
$1,017.46
|
Rate for Payer: Cofinity Commercial |
$1,093.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.30
|
Rate for Payer: Healthscope Commercial |
$911.16
|
Rate for Payer: Healthscope Whirlpool |
$911.16
|
Rate for Payer: Meridian Medicaid |
$522.45
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$797.26
|
Rate for Payer: PACE SWMI |
$759.30
|
Rate for Payer: PHP Medicare Advantage |
$759.30
|
Rate for Payer: Priority Health Choice Medicaid |
$497.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,845.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,184.19
|
Rate for Payer: Priority Health Medicare |
$759.30
|
Rate for Payer: Priority Health Narrow Network |
$1,184.19
|
Rate for Payer: UHC Medicare Advantage |
$782.08
|
|
PR OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN
|
Professional
|
Both
|
$4,677.00
|
|
Service Code
|
HCPCS 27715
|
Min. Negotiated Rate |
$226.28 |
Max. Negotiated Rate |
$3,273.90 |
Rate for Payer: Aetna Commercial |
$1,416.39
|
Rate for Payer: Aetna Medicare |
$1,057.01
|
Rate for Payer: BCBS Complete |
$724.63
|
Rate for Payer: BCBS MAPPO |
$1,057.01
|
Rate for Payer: BCBS Trust/PPO |
$226.28
|
Rate for Payer: BCN Commercial |
$1,571.58
|
Rate for Payer: BCN Medicare Advantage |
$1,057.01
|
Rate for Payer: Cash Price |
$3,741.60
|
Rate for Payer: Cash Price |
$3,741.60
|
Rate for Payer: Cofinity Commercial |
$1,522.09
|
Rate for Payer: Cofinity Commercial |
$1,416.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,057.01
|
Rate for Payer: Healthscope Commercial |
$1,268.41
|
Rate for Payer: Healthscope Whirlpool |
$1,268.41
|
Rate for Payer: Meridian Medicaid |
$724.63
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,109.86
|
Rate for Payer: PACE SWMI |
$1,057.01
|
Rate for Payer: PHP Medicare Advantage |
$1,057.01
|
Rate for Payer: Priority Health Choice Medicaid |
$690.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,273.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,642.25
|
Rate for Payer: Priority Health Medicare |
$1,057.01
|
Rate for Payer: Priority Health Narrow Network |
$1,642.25
|
Rate for Payer: UHC Medicare Advantage |
$1,088.72
|
|
PR OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL
|
Professional
|
Both
|
$7,717.00
|
|
Service Code
|
HCPCS 27165
|
Min. Negotiated Rate |
$880.12 |
Max. Negotiated Rate |
$5,401.90 |
Rate for Payer: Aetna Commercial |
$1,814.20
|
Rate for Payer: Aetna Medicare |
$1,353.88
|
Rate for Payer: BCBS Complete |
$924.13
|
Rate for Payer: BCBS MAPPO |
$1,353.88
|
Rate for Payer: BCBS Trust/PPO |
$1,570.11
|
Rate for Payer: BCN Commercial |
$2,010.42
|
Rate for Payer: BCN Medicare Advantage |
$1,353.88
|
Rate for Payer: Cash Price |
$6,173.60
|
Rate for Payer: Cash Price |
$6,173.60
|
Rate for Payer: Cofinity Commercial |
$1,949.59
|
Rate for Payer: Cofinity Commercial |
$1,814.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.88
|
Rate for Payer: Healthscope Commercial |
$1,624.66
|
Rate for Payer: Healthscope Whirlpool |
$1,624.66
|
Rate for Payer: Meridian Medicaid |
$924.13
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,421.57
|
Rate for Payer: PACE SWMI |
$1,353.88
|
Rate for Payer: PHP Medicare Advantage |
$1,353.88
|
Rate for Payer: Priority Health Choice Medicaid |
$880.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,401.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.81
|
Rate for Payer: Priority Health Medicare |
$1,353.88
|
Rate for Payer: Priority Health Narrow Network |
$2,100.81
|
Rate for Payer: UHC Medicare Advantage |
$1,394.50
|
|
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,712.00
|
|
Service Code
|
HCPCS 28300
|
Min. Negotiated Rate |
$419.61 |
Max. Negotiated Rate |
$1,703.80 |
Rate for Payer: Aetna Commercial |
$857.94
|
Rate for Payer: Aetna Medicare |
$640.25
|
Rate for Payer: BCBS Complete |
$440.59
|
Rate for Payer: BCBS MAPPO |
$640.25
|
Rate for Payer: BCBS Trust/PPO |
$1,703.80
|
Rate for Payer: BCN Commercial |
$953.41
|
Rate for Payer: BCN Medicare Advantage |
$640.25
|
Rate for Payer: Cash Price |
$1,369.60
|
Rate for Payer: Cash Price |
$1,369.60
|
Rate for Payer: Cofinity Commercial |
$921.96
|
Rate for Payer: Cofinity Commercial |
$857.94
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.25
|
Rate for Payer: Healthscope Commercial |
$768.30
|
Rate for Payer: Healthscope Whirlpool |
$768.30
|
Rate for Payer: Meridian Medicaid |
$440.59
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$672.26
|
Rate for Payer: PACE SWMI |
$640.25
|
Rate for Payer: PHP Medicare Advantage |
$640.25
|
Rate for Payer: Priority Health Choice Medicaid |
$419.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,198.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$996.28
|
Rate for Payer: Priority Health Medicare |
$640.25
|
Rate for Payer: Priority Health Narrow Network |
$996.28
|
Rate for Payer: UHC Medicare Advantage |
$659.46
|
|
PR OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,695.00
|
|
Service Code
|
HCPCS 23480
|
Min. Negotiated Rate |
$134.57 |
Max. Negotiated Rate |
$1,261.30 |
Rate for Payer: Aetna Commercial |
$1,085.87
|
Rate for Payer: Aetna Medicare |
$810.35
|
Rate for Payer: BCBS Complete |
$556.67
|
Rate for Payer: BCBS MAPPO |
$810.35
|
Rate for Payer: BCBS Trust/PPO |
$134.57
|
Rate for Payer: BCN Commercial |
$1,207.03
|
Rate for Payer: BCN Medicare Advantage |
$810.35
|
Rate for Payer: Cash Price |
$1,356.00
|
Rate for Payer: Cash Price |
$1,356.00
|
Rate for Payer: Cofinity Commercial |
$1,085.87
|
Rate for Payer: Cofinity Commercial |
$1,166.90
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.35
|
Rate for Payer: Healthscope Commercial |
$972.42
|
Rate for Payer: Healthscope Whirlpool |
$972.42
|
Rate for Payer: Meridian Medicaid |
$556.67
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.87
|
Rate for Payer: PACE SWMI |
$810.35
|
Rate for Payer: PHP Medicare Advantage |
$810.35
|
Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,186.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.30
|
Rate for Payer: Priority Health Medicare |
$810.35
|
Rate for Payer: Priority Health Narrow Network |
$1,261.30
|
Rate for Payer: UHC Medicare Advantage |
$834.66
|
|
PR OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL
|
Professional
|
Both
|
$2,379.00
|
|
Service Code
|
HCPCS 23485
|
Min. Negotiated Rate |
$168.53 |
Max. Negotiated Rate |
$1,665.30 |
Rate for Payer: Aetna Commercial |
$1,261.50
|
Rate for Payer: Aetna Medicare |
$941.42
|
Rate for Payer: BCBS Complete |
$645.24
|
Rate for Payer: BCBS MAPPO |
$941.42
|
Rate for Payer: BCBS Trust/PPO |
$168.53
|
Rate for Payer: BCN Commercial |
$1,399.57
|
Rate for Payer: BCN Medicare Advantage |
$941.42
|
Rate for Payer: Cash Price |
$1,903.20
|
Rate for Payer: Cash Price |
$1,903.20
|
Rate for Payer: Cofinity Commercial |
$1,261.50
|
Rate for Payer: Cofinity Commercial |
$1,355.64
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$941.42
|
Rate for Payer: Healthscope Commercial |
$1,129.70
|
Rate for Payer: Healthscope Whirlpool |
$1,129.70
|
Rate for Payer: Meridian Medicaid |
$645.24
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$988.49
|
Rate for Payer: PACE SWMI |
$941.42
|
Rate for Payer: PHP Medicare Advantage |
$941.42
|
Rate for Payer: Priority Health Choice Medicaid |
$614.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,665.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,462.50
|
Rate for Payer: Priority Health Medicare |
$941.42
|
Rate for Payer: Priority Health Narrow Network |
$1,462.50
|
Rate for Payer: UHC Medicare Advantage |
$969.66
|
|
PR OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION
|
Professional
|
Both
|
$2,857.00
|
|
Service Code
|
HCPCS 27450
|
Min. Negotiated Rate |
$649.86 |
Max. Negotiated Rate |
$1,999.90 |
Rate for Payer: Aetna Commercial |
$1,341.58
|
Rate for Payer: Aetna Medicare |
$1,001.18
|
Rate for Payer: BCBS Complete |
$682.35
|
Rate for Payer: BCBS MAPPO |
$1,001.18
|
Rate for Payer: BCBS Trust/PPO |
$1,095.69
|
Rate for Payer: BCN Commercial |
$1,489.49
|
Rate for Payer: BCN Medicare Advantage |
$1,001.18
|
Rate for Payer: Cash Price |
$2,285.60
|
Rate for Payer: Cash Price |
$2,285.60
|
Rate for Payer: Cofinity Commercial |
$1,441.70
|
Rate for Payer: Cofinity Commercial |
$1,341.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.18
|
Rate for Payer: Healthscope Commercial |
$1,201.42
|
Rate for Payer: Healthscope Whirlpool |
$1,201.42
|
Rate for Payer: Meridian Medicaid |
$682.35
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,051.24
|
Rate for Payer: PACE SWMI |
$1,001.18
|
Rate for Payer: PHP Medicare Advantage |
$1,001.18
|
Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,999.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,556.46
|
Rate for Payer: Priority Health Medicare |
$1,001.18
|
Rate for Payer: Priority Health Narrow Network |
$1,556.46
|
Rate for Payer: UHC Medicare Advantage |
$1,031.22
|
|
PR OSTEOTOMY FIBULA
|
Professional
|
Both
|
$1,275.00
|
|
Service Code
|
HCPCS 27707
|
Min. Negotiated Rate |
$264.12 |
Max. Negotiated Rate |
$2,447.61 |
Rate for Payer: Aetna Commercial |
$532.44
|
Rate for Payer: Aetna Medicare |
$397.34
|
Rate for Payer: BCBS Complete |
$277.33
|
Rate for Payer: BCBS MAPPO |
$397.34
|
Rate for Payer: BCBS Trust/PPO |
$2,447.61
|
Rate for Payer: BCN Commercial |
$598.63
|
Rate for Payer: BCN Medicare Advantage |
$397.34
|
Rate for Payer: Cash Price |
$1,020.00
|
Rate for Payer: Cash Price |
$1,020.00
|
Rate for Payer: Cofinity Commercial |
$532.44
|
Rate for Payer: Cofinity Commercial |
$572.17
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.34
|
Rate for Payer: Healthscope Commercial |
$476.81
|
Rate for Payer: Healthscope Whirlpool |
$476.81
|
Rate for Payer: Meridian Medicaid |
$277.33
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$417.21
|
Rate for Payer: PACE SWMI |
$397.34
|
Rate for Payer: PHP Medicare Advantage |
$397.34
|
Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$625.55
|
Rate for Payer: Priority Health Medicare |
$397.34
|
Rate for Payer: Priority Health Narrow Network |
$625.55
|
Rate for Payer: UHC Medicare Advantage |
$409.26
|
|
PR OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,437.00
|
|
Service Code
|
HCPCS 24400
|
Min. Negotiated Rate |
$227.70 |
Max. Negotiated Rate |
$1,273.57 |
Rate for Payer: Aetna Commercial |
$1,094.50
|
Rate for Payer: Aetna Medicare |
$816.79
|
Rate for Payer: BCBS Complete |
$562.03
|
Rate for Payer: BCBS MAPPO |
$816.79
|
Rate for Payer: BCBS Trust/PPO |
$227.70
|
Rate for Payer: BCN Commercial |
$1,218.76
|
Rate for Payer: BCN Medicare Advantage |
$816.79
|
Rate for Payer: Cash Price |
$1,149.60
|
Rate for Payer: Cash Price |
$1,149.60
|
Rate for Payer: Cofinity Commercial |
$1,094.50
|
Rate for Payer: Cofinity Commercial |
$1,176.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.79
|
Rate for Payer: Healthscope Commercial |
$980.15
|
Rate for Payer: Healthscope Whirlpool |
$980.15
|
Rate for Payer: Meridian Medicaid |
$562.03
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$857.63
|
Rate for Payer: PACE SWMI |
$816.79
|
Rate for Payer: PHP Medicare Advantage |
$816.79
|
Rate for Payer: Priority Health Choice Medicaid |
$535.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,005.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.57
|
Rate for Payer: Priority Health Medicare |
$816.79
|
Rate for Payer: Priority Health Narrow Network |
$1,273.57
|
Rate for Payer: UHC Medicare Advantage |
$841.29
|
|
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 |
$1,676.41
|
Rate for Payer: Aetna Medicare |
$1,251.05
|
Rate for Payer: BCBS Complete |
$862.18
|
Rate for Payer: BCBS MAPPO |
$1,251.05
|
Rate for Payer: BCBS Trust/PPO |
$1,896.07
|
Rate for Payer: BCN Commercial |
$1,855.51
|
Rate for Payer: BCN Medicare Advantage |
$1,251.05
|
Rate for Payer: Cash Price |
$2,053.60
|
Rate for Payer: Cash Price |
$2,053.60
|
Rate for Payer: Cofinity Commercial |
$1,801.51
|
Rate for Payer: Cofinity Commercial |
$1,676.41
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,251.05
|
Rate for Payer: Healthscope Commercial |
$1,501.26
|
Rate for Payer: Healthscope Whirlpool |
$1,501.26
|
Rate for Payer: Meridian Medicaid |
$862.18
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,313.60
|
Rate for Payer: PACE SWMI |
$1,251.05
|
Rate for Payer: PHP Medicare Advantage |
$1,251.05
|
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 Medicare |
$1,251.05
|
Rate for Payer: Priority Health Narrow Network |
$1,938.94
|
Rate for Payer: UHC Medicare Advantage |
$1,288.58
|
|
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 |
$2,541.32 |
Rate for Payer: Aetna Commercial |
$2,087.68
|
Rate for Payer: Aetna Medicare |
$1,557.97
|
Rate for Payer: BCBS Complete |
$1,062.56
|
Rate for Payer: BCBS MAPPO |
$1,557.97
|
Rate for Payer: BCBS Trust/PPO |
$1,915.09
|
Rate for Payer: BCN Commercial |
$2,541.32
|
Rate for Payer: BCN Medicare Advantage |
$1,557.97
|
Rate for Payer: Cash Price |
$2,576.80
|
Rate for Payer: Cash Price |
$2,576.80
|
Rate for Payer: Cofinity Commercial |
$2,243.48
|
Rate for Payer: Cofinity Commercial |
$2,087.68
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,557.97
|
Rate for Payer: Healthscope Commercial |
$1,869.56
|
Rate for Payer: Healthscope Whirlpool |
$1,869.56
|
Rate for Payer: Meridian Medicaid |
$1,062.56
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,635.87
|
Rate for Payer: PACE SWMI |
$1,557.97
|
Rate for Payer: PHP Medicare Advantage |
$1,557.97
|
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 Medicare |
$1,557.97
|
Rate for Payer: Priority Health Narrow Network |
$2,411.80
|
Rate for Payer: UHC Medicare Advantage |
$1,604.71
|
|
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 |
$1,929.73
|
Rate for Payer: Aetna Medicare |
$1,440.10
|
Rate for Payer: BCBS Complete |
$984.06
|
Rate for Payer: BCBS MAPPO |
$1,440.10
|
Rate for Payer: BCBS Trust/PPO |
$1,559.54
|
Rate for Payer: BCN Commercial |
$2,135.03
|
Rate for Payer: BCN Medicare Advantage |
$1,440.10
|
Rate for Payer: Cash Price |
$1,756.00
|
Rate for Payer: Cash Price |
$1,756.00
|
Rate for Payer: Cofinity Commercial |
$2,073.74
|
Rate for Payer: Cofinity Commercial |
$1,929.73
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,440.10
|
Rate for Payer: Healthscope Commercial |
$1,728.12
|
Rate for Payer: Healthscope Whirlpool |
$1,728.12
|
Rate for Payer: Meridian Medicaid |
$984.06
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,512.10
|
Rate for Payer: PACE SWMI |
$1,440.10
|
Rate for Payer: PHP Medicare Advantage |
$1,440.10
|
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 Medicare |
$1,440.10
|
Rate for Payer: Priority Health Narrow Network |
$2,231.03
|
Rate for Payer: UHC Medicare Advantage |
$1,483.30
|
|
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 |
$936.91
|
Rate for Payer: Aetna Medicare |
$699.19
|
Rate for Payer: BCBS Complete |
$483.54
|
Rate for Payer: BCBS MAPPO |
$699.19
|
Rate for Payer: BCBS Trust/PPO |
$668.83
|
Rate for Payer: BCN Commercial |
$1,062.38
|
Rate for Payer: BCN Medicare Advantage |
$699.19
|
Rate for Payer: Cash Price |
$1,400.00
|
Rate for Payer: Cash Price |
$1,400.00
|
Rate for Payer: Cofinity Commercial |
$1,006.83
|
Rate for Payer: Cofinity Commercial |
$936.91
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.19
|
Rate for Payer: Healthscope Commercial |
$839.03
|
Rate for Payer: Healthscope Whirlpool |
$839.03
|
Rate for Payer: Meridian Medicaid |
$483.54
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$734.15
|
Rate for Payer: PACE SWMI |
$699.19
|
Rate for Payer: PHP Medicare Advantage |
$699.19
|
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 Medicare |
$699.19
|
Rate for Payer: Priority Health Narrow Network |
$1,110.16
|
Rate for Payer: UHC Medicare Advantage |
$720.17
|
|
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 |
$944.27
|
Rate for Payer: Aetna Medicare |
$704.68
|
Rate for Payer: BCBS Complete |
$489.34
|
Rate for Payer: BCBS MAPPO |
$704.68
|
Rate for Payer: BCBS Trust/PPO |
$140.53
|
Rate for Payer: BCN Commercial |
$1,070.70
|
Rate for Payer: BCN Medicare Advantage |
$704.68
|
Rate for Payer: Cash Price |
$1,244.00
|
Rate for Payer: Cash Price |
$1,244.00
|
Rate for Payer: Cofinity Commercial |
$944.27
|
Rate for Payer: Cofinity Commercial |
$1,014.74
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.68
|
Rate for Payer: Healthscope Commercial |
$845.62
|
Rate for Payer: Healthscope Whirlpool |
$845.62
|
Rate for Payer: Meridian Medicaid |
$489.34
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$739.91
|
Rate for Payer: PACE SWMI |
$704.68
|
Rate for Payer: PHP Medicare Advantage |
$704.68
|
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 Medicare |
$704.68
|
Rate for Payer: Priority Health Narrow Network |
$1,118.84
|
Rate for Payer: UHC Medicare Advantage |
$725.82
|
|
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 |
$893.30
|
Rate for Payer: Aetna Medicare |
$666.64
|
Rate for Payer: BCBS Complete |
$459.83
|
Rate for Payer: BCBS MAPPO |
$666.64
|
Rate for Payer: BCBS Trust/PPO |
$604.38
|
Rate for Payer: BCN Commercial |
$996.90
|
Rate for Payer: BCN Medicare Advantage |
$666.64
|
Rate for Payer: Cash Price |
$1,747.20
|
Rate for Payer: Cash Price |
$1,747.20
|
Rate for Payer: Cofinity Commercial |
$959.96
|
Rate for Payer: Cofinity Commercial |
$893.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.64
|
Rate for Payer: Healthscope Commercial |
$799.97
|
Rate for Payer: Healthscope Whirlpool |
$799.97
|
Rate for Payer: Meridian Medicaid |
$459.83
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$699.97
|
Rate for Payer: PACE SWMI |
$666.64
|
Rate for Payer: PHP Medicare Advantage |
$666.64
|
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 Medicare |
$666.64
|
Rate for Payer: Priority Health Narrow Network |
$1,041.73
|
Rate for Payer: UHC Medicare Advantage |
$686.64
|
|
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 |
$1,012.22
|
Rate for Payer: Aetna Medicare |
$755.39
|
Rate for Payer: BCBS Complete |
$520.65
|
Rate for Payer: BCBS MAPPO |
$755.39
|
Rate for Payer: BCBS Trust/PPO |
$1,041.28
|
Rate for Payer: BCN Commercial |
$1,126.89
|
Rate for Payer: BCN Medicare Advantage |
$755.39
|
Rate for Payer: Cash Price |
$1,330.40
|
Rate for Payer: Cash Price |
$1,330.40
|
Rate for Payer: Cofinity Commercial |
$1,012.22
|
Rate for Payer: Cofinity Commercial |
$1,087.76
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.39
|
Rate for Payer: Healthscope Commercial |
$906.47
|
Rate for Payer: Healthscope Whirlpool |
$906.47
|
Rate for Payer: Meridian Medicaid |
$520.65
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$793.16
|
Rate for Payer: PACE SWMI |
$755.39
|
Rate for Payer: PHP Medicare Advantage |
$755.39
|
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 Medicare |
$755.39
|
Rate for Payer: Priority Health Narrow Network |
$1,177.56
|
Rate for Payer: UHC Medicare Advantage |
$778.05
|
|
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 |
$785.41
|
Rate for Payer: Aetna Medicare |
$586.13
|
Rate for Payer: BCBS Complete |
$394.30
|
Rate for Payer: BCBS MAPPO |
$586.13
|
Rate for Payer: BCBS Trust/PPO |
$13,048.08
|
Rate for Payer: BCN Commercial |
$854.70
|
Rate for Payer: BCN Medicare Advantage |
$586.13
|
Rate for Payer: Cash Price |
$2,125.60
|
Rate for Payer: Cash Price |
$2,125.60
|
Rate for Payer: Cofinity Commercial |
$785.41
|
Rate for Payer: Cofinity Commercial |
$844.03
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.13
|
Rate for Payer: Healthscope Commercial |
$703.36
|
Rate for Payer: Healthscope Whirlpool |
$703.36
|
Rate for Payer: Meridian Medicaid |
$394.30
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$615.44
|
Rate for Payer: PACE SWMI |
$586.13
|
Rate for Payer: PHP Medicare Advantage |
$586.13
|
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 Medicare |
$586.13
|
Rate for Payer: Priority Health Narrow Network |
$893.13
|
Rate for Payer: UHC Medicare Advantage |
$603.71
|
|