|
PR OSTEOPLASTY FEMUR LENGTHENING
|
Professional
|
Both
|
$4,100.00
|
|
|
Service Code
|
HCPCS 27466
|
| Min. Negotiated Rate |
$873.30 |
| Max. Negotiated Rate |
$3,075.00 |
| Rate for Payer: Aetna Commercial |
$1,806.91
|
| Rate for Payer: Aetna Medicare |
$1,348.44
|
| Rate for Payer: BCBS Complete |
$916.97
|
| Rate for Payer: BCBS MAPPO |
$1,348.44
|
| Rate for Payer: BCN Commercial |
$1,794.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,348.44
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,941.75
|
| Rate for Payer: Cofinity Commercial |
$1,806.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,348.44
|
| Rate for Payer: Healthscope Commercial |
$1,618.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,618.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,415.86
|
| Rate for Payer: Meridian Medicaid |
$916.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,483.28
|
| Rate for Payer: Nomi Health Commercial |
$1,618.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,075.00
|
| Rate for Payer: PACE SWMI |
$1,348.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,348.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,917.97
|
| Rate for Payer: Priority Health Medicare |
$1,348.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,917.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,348.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,077.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,348.44
|
| Rate for Payer: UHC Exchange |
$2,077.13
|
| Rate for Payer: UHC Medicaid |
$873.30
|
| Rate for Payer: UHCCP DNSP |
$1,348.44
|
| Rate for Payer: UHCCP Medicaid |
$873.30
|
|
|
PR OSTEOPLASTY HUMERUS
|
Professional
|
Both
|
$3,435.00
|
|
|
Service Code
|
HCPCS 24420
|
| Min. Negotiated Rate |
$638.79 |
| Max. Negotiated Rate |
$2,576.25 |
| Rate for Payer: Aetna Commercial |
$1,305.19
|
| Rate for Payer: Aetna Medicare |
$974.02
|
| Rate for Payer: BCBS Complete |
$670.73
|
| Rate for Payer: BCBS MAPPO |
$974.02
|
| Rate for Payer: BCN Commercial |
$1,610.97
|
| Rate for Payer: BCN Medicare Advantage |
$974.02
|
| Rate for Payer: Cash Price |
$2,748.00
|
| Rate for Payer: Cash Price |
$2,748.00
|
| Rate for Payer: Cofinity Commercial |
$1,402.59
|
| Rate for Payer: Cofinity Commercial |
$1,305.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.02
|
| Rate for Payer: Healthscope Commercial |
$1,168.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.72
|
| Rate for Payer: Meridian Medicaid |
$670.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,071.42
|
| Rate for Payer: Nomi Health Commercial |
$1,168.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,576.25
|
| Rate for Payer: PACE SWMI |
$974.02
|
| Rate for Payer: PHP Medicare Advantage |
$974.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,722.08
|
| Rate for Payer: Priority Health Medicare |
$974.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,722.08
|
| Rate for Payer: Railroad Medicare Medicare |
$974.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,787.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$974.02
|
| Rate for Payer: UHC Exchange |
$1,787.24
|
| Rate for Payer: UHC Medicaid |
$638.79
|
| Rate for Payer: UHCCP DNSP |
$974.02
|
| Rate for Payer: UHCCP Medicaid |
$638.79
|
|
|
PR OSTEOPLASTY RADIUS/ULNA SHORTENING
|
Professional
|
Both
|
$2,770.00
|
|
|
Service Code
|
HCPCS 25390
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$2,077.50 |
| Rate for Payer: Aetna Commercial |
$922.16
|
| Rate for Payer: Aetna Medicare |
$688.18
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS MAPPO |
$688.18
|
| Rate for Payer: BCN Commercial |
$1,174.73
|
| Rate for Payer: BCN Medicare Advantage |
$688.18
|
| Rate for Payer: Cash Price |
$2,216.00
|
| Rate for Payer: Cash Price |
$2,216.00
|
| Rate for Payer: Cofinity Commercial |
$990.98
|
| Rate for Payer: Cofinity Commercial |
$922.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.18
|
| Rate for Payer: Healthscope Commercial |
$825.82
|
| Rate for Payer: Healthscope Whirlpool |
$825.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.59
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$757.00
|
| Rate for Payer: Nomi Health Commercial |
$825.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.50
|
| Rate for Payer: PACE SWMI |
$688.18
|
| Rate for Payer: PHP Medicare Advantage |
$688.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,255.75
|
| Rate for Payer: Priority Health Medicare |
$688.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,255.75
|
| Rate for Payer: Railroad Medicare Medicare |
$688.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,341.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.18
|
| Rate for Payer: UHC Exchange |
$1,341.56
|
| Rate for Payer: UHC Medicaid |
$449.43
|
| Rate for Payer: UHCCP DNSP |
$688.18
|
| Rate for Payer: UHCCP Medicaid |
$449.43
|
|
|
PR OSTEOPLASTY TIBIA&FIBULA LENGTHENING/SHORTENING
|
Professional
|
Both
|
$4,914.00
|
|
|
Service Code
|
HCPCS 27715
|
| Min. Negotiated Rate |
$868.61 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$1,797.09
|
| Rate for Payer: Aetna Medicare |
$1,341.11
|
| Rate for Payer: BCBS Complete |
$912.04
|
| Rate for Payer: BCBS MAPPO |
$1,341.11
|
| Rate for Payer: BCN Commercial |
$1,624.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,341.11
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cash Price |
$3,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,797.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,341.11
|
| Rate for Payer: Healthscope Commercial |
$1,609.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,609.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,408.17
|
| Rate for Payer: Meridian Medicaid |
$912.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,475.22
|
| Rate for Payer: Nomi Health Commercial |
$1,609.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,685.50
|
| Rate for Payer: PACE SWMI |
$1,341.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,341.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$868.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,736.99
|
| Rate for Payer: Priority Health Medicare |
$1,341.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,736.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,341.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,878.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,341.11
|
| Rate for Payer: UHC Exchange |
$1,878.47
|
| Rate for Payer: UHC Medicaid |
$868.61
|
| Rate for Payer: UHCCP DNSP |
$1,341.11
|
| Rate for Payer: UHCCP Medicaid |
$868.61
|
|
|
PR OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL
|
Professional
|
Both
|
$8,107.00
|
|
|
Service Code
|
HCPCS 27165
|
| Min. Negotiated Rate |
$803.22 |
| Max. Negotiated Rate |
$6,080.25 |
| Rate for Payer: Aetna Commercial |
$1,658.68
|
| Rate for Payer: Aetna Medicare |
$1,237.82
|
| Rate for Payer: BCBS Complete |
$843.38
|
| Rate for Payer: BCBS MAPPO |
$1,237.82
|
| Rate for Payer: BCN Commercial |
$2,069.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.82
|
| Rate for Payer: Cash Price |
$6,485.60
|
| Rate for Payer: Cash Price |
$6,485.60
|
| Rate for Payer: Cofinity Commercial |
$1,782.46
|
| Rate for Payer: Cofinity Commercial |
$1,658.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.82
|
| Rate for Payer: Healthscope Commercial |
$1,485.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,485.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.71
|
| Rate for Payer: Meridian Medicaid |
$843.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,361.60
|
| Rate for Payer: Nomi Health Commercial |
$1,485.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,080.25
|
| Rate for Payer: PACE SWMI |
$1,237.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,212.35
|
| Rate for Payer: Priority Health Medicare |
$1,237.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,212.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,237.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,409.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,237.82
|
| Rate for Payer: UHC Exchange |
$2,409.13
|
| Rate for Payer: UHC Medicaid |
$803.22
|
| Rate for Payer: UHCCP DNSP |
$1,237.82
|
| Rate for Payer: UHCCP Medicaid |
$803.22
|
|
|
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,798.00
|
|
|
Service Code
|
HCPCS 28300
|
| Min. Negotiated Rate |
$389.79 |
| Max. Negotiated Rate |
$1,348.50 |
| Rate for Payer: Aetna Commercial |
$800.32
|
| Rate for Payer: Aetna Medicare |
$597.25
|
| Rate for Payer: BCBS Complete |
$409.28
|
| Rate for Payer: BCBS MAPPO |
$597.25
|
| Rate for Payer: BCN Commercial |
$989.99
|
| Rate for Payer: BCN Medicare Advantage |
$597.25
|
| Rate for Payer: Cash Price |
$1,438.40
|
| Rate for Payer: Cash Price |
$1,438.40
|
| Rate for Payer: Cofinity Commercial |
$860.04
|
| Rate for Payer: Cofinity Commercial |
$800.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.25
|
| Rate for Payer: Healthscope Commercial |
$716.70
|
| Rate for Payer: Healthscope Whirlpool |
$716.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.11
|
| Rate for Payer: Meridian Medicaid |
$409.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$656.98
|
| Rate for Payer: Nomi Health Commercial |
$716.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,348.50
|
| Rate for Payer: PACE SWMI |
$597.25
|
| Rate for Payer: PHP Medicare Advantage |
$597.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,058.27
|
| Rate for Payer: Priority Health Medicare |
$597.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,058.27
|
| Rate for Payer: Railroad Medicare Medicare |
$597.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,138.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$597.25
|
| Rate for Payer: UHC Exchange |
$1,138.92
|
| Rate for Payer: UHC Medicaid |
$389.79
|
| Rate for Payer: UHCCP DNSP |
$597.25
|
| Rate for Payer: UHCCP Medicaid |
$389.79
|
|
|
PR OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,781.00
|
|
|
Service Code
|
HCPCS 23480
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$1,435.43 |
| Rate for Payer: Aetna Commercial |
$1,001.56
|
| Rate for Payer: Aetna Medicare |
$747.43
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$747.43
|
| Rate for Payer: BCN Commercial |
$1,250.43
|
| Rate for Payer: BCN Medicare Advantage |
$747.43
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,076.30
|
| Rate for Payer: Cofinity Commercial |
$1,001.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.43
|
| Rate for Payer: Healthscope Commercial |
$896.92
|
| Rate for Payer: Healthscope Whirlpool |
$896.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.80
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$822.17
|
| Rate for Payer: Nomi Health Commercial |
$896.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.75
|
| Rate for Payer: PACE SWMI |
$747.43
|
| Rate for Payer: PHP Medicare Advantage |
$747.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,336.67
|
| Rate for Payer: Priority Health Medicare |
$747.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.67
|
| Rate for Payer: Railroad Medicare Medicare |
$747.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,435.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$747.43
|
| Rate for Payer: UHC Exchange |
$1,435.43
|
| Rate for Payer: UHC Medicaid |
$487.13
|
| Rate for Payer: UHCCP DNSP |
$747.43
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 23485
|
| Min. Negotiated Rate |
$555.72 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,145.61
|
| Rate for Payer: Aetna Medicare |
$854.93
|
| Rate for Payer: BCBS Complete |
$583.51
|
| Rate for Payer: BCBS MAPPO |
$854.93
|
| Rate for Payer: BCN Commercial |
$1,446.63
|
| Rate for Payer: BCN Medicare Advantage |
$854.93
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,231.10
|
| Rate for Payer: Cofinity Commercial |
$1,145.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.93
|
| Rate for Payer: Healthscope Commercial |
$1,025.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,025.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.68
|
| Rate for Payer: Meridian Medicaid |
$583.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$940.42
|
| Rate for Payer: Nomi Health Commercial |
$1,025.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,875.00
|
| Rate for Payer: PACE SWMI |
$854.93
|
| Rate for Payer: PHP Medicare Advantage |
$854.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,546.42
|
| Rate for Payer: Priority Health Medicare |
$854.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,546.42
|
| Rate for Payer: Railroad Medicare Medicare |
$854.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,676.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$854.93
|
| Rate for Payer: UHC Exchange |
$1,676.63
|
| Rate for Payer: UHC Medicaid |
$555.72
|
| Rate for Payer: UHCCP DNSP |
$854.93
|
| Rate for Payer: UHCCP Medicaid |
$555.72
|
|
|
PR OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION
|
Professional
|
Both
|
$3,001.00
|
|
|
Service Code
|
HCPCS 27450
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$2,250.75 |
| Rate for Payer: Aetna Commercial |
$1,219.78
|
| Rate for Payer: Aetna Medicare |
$910.28
|
| Rate for Payer: BCBS Complete |
$621.75
|
| Rate for Payer: BCBS MAPPO |
$910.28
|
| Rate for Payer: BCN Commercial |
$1,527.30
|
| Rate for Payer: BCN Medicare Advantage |
$910.28
|
| Rate for Payer: Cash Price |
$2,400.80
|
| Rate for Payer: Cash Price |
$2,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,310.80
|
| Rate for Payer: Cofinity Commercial |
$1,219.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.28
|
| Rate for Payer: Healthscope Commercial |
$1,092.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,092.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.79
|
| Rate for Payer: Meridian Medicaid |
$621.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.31
|
| Rate for Payer: Nomi Health Commercial |
$1,092.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.75
|
| Rate for Payer: PACE SWMI |
$910.28
|
| Rate for Payer: PHP Medicare Advantage |
$910.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,632.65
|
| Rate for Payer: Priority Health Medicare |
$910.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.65
|
| Rate for Payer: Railroad Medicare Medicare |
$910.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,778.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$910.28
|
| Rate for Payer: UHC Exchange |
$1,778.26
|
| Rate for Payer: UHC Medicaid |
$592.14
|
| Rate for Payer: UHCCP DNSP |
$910.28
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
|
|
PR OSTEOTOMY FIBULA
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27707
|
| Min. Negotiated Rate |
$250.28 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Aetna Commercial |
$506.90
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: BCBS Complete |
$262.79
|
| Rate for Payer: BCBS MAPPO |
$378.28
|
| Rate for Payer: BCN Commercial |
$622.97
|
| Rate for Payer: BCN Medicare Advantage |
$378.28
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$544.72
|
| Rate for Payer: Cofinity Commercial |
$506.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.28
|
| Rate for Payer: Healthscope Commercial |
$453.94
|
| Rate for Payer: Healthscope Whirlpool |
$453.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.19
|
| Rate for Payer: Meridian Medicaid |
$262.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.11
|
| Rate for Payer: Nomi Health Commercial |
$453.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: PACE SWMI |
$378.28
|
| Rate for Payer: PHP Medicare Advantage |
$378.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$665.93
|
| Rate for Payer: Priority Health Medicare |
$378.28
|
| Rate for Payer: Priority Health Narrow Network |
$665.93
|
| Rate for Payer: Railroad Medicare Medicare |
$378.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$690.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.28
|
| Rate for Payer: UHC Exchange |
$690.19
|
| Rate for Payer: UHC Medicaid |
$250.28
|
| Rate for Payer: UHCCP DNSP |
$378.28
|
| Rate for Payer: UHCCP Medicaid |
$250.28
|
|
|
PR OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 24400
|
| Min. Negotiated Rate |
$494.16 |
| Max. Negotiated Rate |
$1,437.29 |
| Rate for Payer: Aetna Commercial |
$1,013.68
|
| Rate for Payer: Aetna Medicare |
$756.48
|
| Rate for Payer: BCBS Complete |
$518.87
|
| Rate for Payer: BCBS MAPPO |
$756.48
|
| Rate for Payer: BCN Commercial |
$1,262.88
|
| Rate for Payer: BCN Medicare Advantage |
$756.48
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$1,089.33
|
| Rate for Payer: Cofinity Commercial |
$1,013.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.48
|
| Rate for Payer: Healthscope Commercial |
$907.78
|
| Rate for Payer: Healthscope Whirlpool |
$907.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.30
|
| Rate for Payer: Meridian Medicaid |
$518.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$832.13
|
| Rate for Payer: Nomi Health Commercial |
$907.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,132.50
|
| Rate for Payer: PACE SWMI |
$756.48
|
| Rate for Payer: PHP Medicare Advantage |
$756.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,349.99
|
| Rate for Payer: Priority Health Medicare |
$756.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,349.99
|
| Rate for Payer: Railroad Medicare Medicare |
$756.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,437.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$756.48
|
| Rate for Payer: UHC Exchange |
$1,437.29
|
| Rate for Payer: UHC Medicaid |
$494.16
|
| Rate for Payer: UHCCP DNSP |
$756.48
|
| Rate for Payer: UHCCP Medicaid |
$494.16
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE
|
Professional
|
Both
|
$2,697.00
|
|
|
Service Code
|
HCPCS 27146
|
| Min. Negotiated Rate |
$745.50 |
| Max. Negotiated Rate |
$2,243.38 |
| Rate for Payer: Aetna Commercial |
$1,540.05
|
| Rate for Payer: Aetna Medicare |
$1,149.29
|
| Rate for Payer: BCBS Complete |
$782.77
|
| Rate for Payer: BCBS MAPPO |
$1,149.29
|
| Rate for Payer: BCN Commercial |
$1,935.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.29
|
| Rate for Payer: Cash Price |
$2,157.60
|
| Rate for Payer: Cash Price |
$2,157.60
|
| Rate for Payer: Cofinity Commercial |
$1,654.98
|
| Rate for Payer: Cofinity Commercial |
$1,540.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.29
|
| Rate for Payer: Healthscope Commercial |
$1,379.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,379.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,206.75
|
| Rate for Payer: Meridian Medicaid |
$782.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,264.22
|
| Rate for Payer: Nomi Health Commercial |
$1,379.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,022.75
|
| Rate for Payer: PACE SWMI |
$1,149.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,069.16
|
| Rate for Payer: Priority Health Medicare |
$1,149.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,069.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,243.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,149.29
|
| Rate for Payer: UHC Exchange |
$2,243.38
|
| Rate for Payer: UHC Medicaid |
$745.50
|
| Rate for Payer: UHCCP DNSP |
$1,149.29
|
| Rate for Payer: UHCCP Medicaid |
$745.50
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT
|
Professional
|
Both
|
$3,384.00
|
|
|
Service Code
|
HCPCS 27151
|
| Min. Negotiated Rate |
$911.00 |
| Max. Negotiated Rate |
$2,790.19 |
| Rate for Payer: Aetna Commercial |
$1,887.74
|
| Rate for Payer: Aetna Medicare |
$1,408.76
|
| Rate for Payer: BCBS Complete |
$956.55
|
| Rate for Payer: BCBS MAPPO |
$1,408.76
|
| Rate for Payer: BCN Commercial |
$2,619.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,408.76
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Cofinity Commercial |
$2,028.61
|
| Rate for Payer: Cofinity Commercial |
$1,887.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,408.76
|
| Rate for Payer: Healthscope Commercial |
$1,690.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,690.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,479.20
|
| Rate for Payer: Meridian Medicaid |
$956.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,549.64
|
| Rate for Payer: Nomi Health Commercial |
$1,690.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,538.00
|
| Rate for Payer: PACE SWMI |
$1,408.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,408.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$911.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,549.31
|
| Rate for Payer: Priority Health Medicare |
$1,408.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,549.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,408.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,790.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,408.76
|
| Rate for Payer: UHC Exchange |
$2,790.19
|
| Rate for Payer: UHC Medicaid |
$911.00
|
| Rate for Payer: UHCCP DNSP |
$1,408.76
|
| Rate for Payer: UHCCP Medicaid |
$911.00
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ
|
Professional
|
Both
|
$2,306.00
|
|
|
Service Code
|
HCPCS 27147
|
| Min. Negotiated Rate |
$845.61 |
| Max. Negotiated Rate |
$2,577.13 |
| Rate for Payer: Aetna Commercial |
$1,750.35
|
| Rate for Payer: Aetna Medicare |
$1,306.23
|
| Rate for Payer: BCBS Complete |
$887.89
|
| Rate for Payer: BCBS MAPPO |
$1,306.23
|
| Rate for Payer: BCN Commercial |
$2,208.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.23
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cofinity Commercial |
$1,880.97
|
| Rate for Payer: Cofinity Commercial |
$1,750.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.23
|
| Rate for Payer: Healthscope Commercial |
$1,567.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,567.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,371.54
|
| Rate for Payer: Meridian Medicaid |
$887.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,436.85
|
| Rate for Payer: Nomi Health Commercial |
$1,567.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,729.50
|
| Rate for Payer: PACE SWMI |
$1,306.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$845.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,360.33
|
| Rate for Payer: Priority Health Medicare |
$1,306.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,360.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,306.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,577.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,306.23
|
| Rate for Payer: UHC Exchange |
$2,577.13
|
| Rate for Payer: UHC Medicaid |
$845.61
|
| Rate for Payer: UHCCP DNSP |
$1,306.23
|
| Rate for Payer: UHCCP Medicaid |
$845.61
|
|
|
PR OSTEOTOMY METACARPAL EACH
|
Professional
|
Both
|
$1,839.00
|
|
|
Service Code
|
HCPCS 26565
|
| Min. Negotiated Rate |
$440.27 |
| Max. Negotiated Rate |
$1,379.25 |
| Rate for Payer: Aetna Commercial |
$883.56
|
| Rate for Payer: Aetna Medicare |
$659.37
|
| Rate for Payer: BCBS Complete |
$462.28
|
| Rate for Payer: BCBS MAPPO |
$659.37
|
| Rate for Payer: BCN Commercial |
$1,077.63
|
| Rate for Payer: BCN Medicare Advantage |
$659.37
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cofinity Commercial |
$949.49
|
| Rate for Payer: Cofinity Commercial |
$883.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.37
|
| Rate for Payer: Healthscope Commercial |
$791.24
|
| Rate for Payer: Healthscope Whirlpool |
$791.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.34
|
| Rate for Payer: Meridian Medicaid |
$462.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.31
|
| Rate for Payer: Nomi Health Commercial |
$791.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,379.25
|
| Rate for Payer: PACE SWMI |
$659.37
|
| Rate for Payer: PHP Medicare Advantage |
$659.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,151.96
|
| Rate for Payer: Priority Health Medicare |
$659.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.96
|
| Rate for Payer: Railroad Medicare Medicare |
$659.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,184.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.37
|
| Rate for Payer: UHC Exchange |
$1,184.02
|
| Rate for Payer: UHC Medicaid |
$440.27
|
| Rate for Payer: UHCCP DNSP |
$659.37
|
| Rate for Payer: UHCCP Medicaid |
$440.27
|
|
|
PR OSTEOTOMY PHALANX FINGER EACH
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 26567
|
| Min. Negotiated Rate |
$446.45 |
| Max. Negotiated Rate |
$1,225.50 |
| Rate for Payer: Aetna Commercial |
$895.91
|
| Rate for Payer: Aetna Medicare |
$668.59
|
| Rate for Payer: BCBS Complete |
$468.77
|
| Rate for Payer: BCBS MAPPO |
$668.59
|
| Rate for Payer: BCN Commercial |
$1,087.10
|
| Rate for Payer: BCN Medicare Advantage |
$668.59
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$962.77
|
| Rate for Payer: Cofinity Commercial |
$895.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.59
|
| Rate for Payer: Healthscope Commercial |
$802.31
|
| Rate for Payer: Healthscope Whirlpool |
$802.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$702.02
|
| Rate for Payer: Meridian Medicaid |
$468.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$735.45
|
| Rate for Payer: Nomi Health Commercial |
$802.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$668.59
|
| Rate for Payer: PHP Medicare Advantage |
$668.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,162.06
|
| Rate for Payer: Priority Health Medicare |
$668.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,162.06
|
| Rate for Payer: Railroad Medicare Medicare |
$668.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,191.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$668.59
|
| Rate for Payer: UHC Exchange |
$1,191.34
|
| Rate for Payer: UHC Medicaid |
$446.45
|
| Rate for Payer: UHCCP DNSP |
$668.59
|
| Rate for Payer: UHCCP Medicaid |
$446.45
|
|
|
PR OSTEOTOMY RADIUS DISTAL THIRD
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 25350
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,721.25 |
| Rate for Payer: Aetna Commercial |
$818.14
|
| Rate for Payer: Aetna Medicare |
$610.55
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS MAPPO |
$610.55
|
| Rate for Payer: BCN Commercial |
$1,033.32
|
| Rate for Payer: BCN Medicare Advantage |
$610.55
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Cofinity Commercial |
$879.19
|
| Rate for Payer: Cofinity Commercial |
$818.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.55
|
| Rate for Payer: Healthscope Commercial |
$732.66
|
| Rate for Payer: Healthscope Whirlpool |
$732.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.08
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$671.61
|
| Rate for Payer: Nomi Health Commercial |
$732.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,721.25
|
| Rate for Payer: PACE SWMI |
$610.55
|
| Rate for Payer: PHP Medicare Advantage |
$610.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,104.58
|
| Rate for Payer: Priority Health Medicare |
$610.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,104.58
|
| Rate for Payer: Railroad Medicare Medicare |
$610.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,175.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$610.55
|
| Rate for Payer: UHC Exchange |
$1,175.93
|
| Rate for Payer: UHC Medicaid |
$399.80
|
| Rate for Payer: UHCCP DNSP |
$610.55
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
|
|
PR OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD
|
Professional
|
Both
|
$1,747.00
|
|
|
Service Code
|
HCPCS 25355
|
| Min. Negotiated Rate |
$458.16 |
| Max. Negotiated Rate |
$1,335.80 |
| Rate for Payer: Aetna Commercial |
$940.13
|
| Rate for Payer: Aetna Medicare |
$701.59
|
| Rate for Payer: BCBS Complete |
$481.07
|
| Rate for Payer: BCBS MAPPO |
$701.59
|
| Rate for Payer: BCN Commercial |
$1,169.25
|
| Rate for Payer: BCN Medicare Advantage |
$701.59
|
| Rate for Payer: Cash Price |
$1,397.60
|
| Rate for Payer: Cash Price |
$1,397.60
|
| Rate for Payer: Cofinity Commercial |
$940.13
|
| Rate for Payer: Cofinity Commercial |
$1,010.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.59
|
| Rate for Payer: Healthscope Commercial |
$841.91
|
| Rate for Payer: Healthscope Whirlpool |
$841.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$736.67
|
| Rate for Payer: Meridian Medicaid |
$481.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$771.75
|
| Rate for Payer: Nomi Health Commercial |
$841.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,310.25
|
| Rate for Payer: PACE SWMI |
$701.59
|
| Rate for Payer: PHP Medicare Advantage |
$701.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,249.91
|
| Rate for Payer: Priority Health Medicare |
$701.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,249.91
|
| Rate for Payer: Railroad Medicare Medicare |
$701.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,335.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$701.59
|
| Rate for Payer: UHC Exchange |
$1,335.80
|
| Rate for Payer: UHC Medicaid |
$458.16
|
| Rate for Payer: UHCCP DNSP |
$701.59
|
| Rate for Payer: UHCCP Medicaid |
$458.16
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM
|
Professional
|
Both
|
$2,791.00
|
|
|
Service Code
|
HCPCS 22208
|
| Min. Negotiated Rate |
$336.75 |
| Max. Negotiated Rate |
$2,093.25 |
| Rate for Payer: Aetna Commercial |
$713.67
|
| Rate for Payer: Aetna Medicare |
$532.59
|
| Rate for Payer: BCBS Complete |
$353.59
|
| Rate for Payer: BCBS MAPPO |
$532.59
|
| Rate for Payer: BCN Commercial |
$883.92
|
| Rate for Payer: BCN Medicare Advantage |
$532.59
|
| Rate for Payer: Cash Price |
$2,232.80
|
| Rate for Payer: Cash Price |
$2,232.80
|
| Rate for Payer: Cofinity Commercial |
$766.93
|
| Rate for Payer: Cofinity Commercial |
$713.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.59
|
| Rate for Payer: Healthscope Commercial |
$639.11
|
| Rate for Payer: Healthscope Whirlpool |
$639.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.22
|
| Rate for Payer: Meridian Medicaid |
$353.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$585.85
|
| Rate for Payer: Nomi Health Commercial |
$639.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,093.25
|
| Rate for Payer: PACE SWMI |
$532.59
|
| Rate for Payer: PHP Medicare Advantage |
$532.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$944.88
|
| Rate for Payer: Priority Health Medicare |
$532.59
|
| Rate for Payer: Priority Health Narrow Network |
$944.88
|
| Rate for Payer: Railroad Medicare Medicare |
$532.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,050.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$532.59
|
| Rate for Payer: UHC Exchange |
$1,050.86
|
| Rate for Payer: UHC Medicaid |
$336.75
|
| Rate for Payer: UHCCP DNSP |
$532.59
|
| Rate for Payer: UHCCP Medicaid |
$336.75
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR
|
Professional
|
Both
|
$5,165.00
|
|
|
Service Code
|
HCPCS 22207
|
| Min. Negotiated Rate |
$1,412.19 |
| Max. Negotiated Rate |
$4,238.00 |
| Rate for Payer: Aetna Commercial |
$2,954.15
|
| Rate for Payer: Aetna Medicare |
$2,204.59
|
| Rate for Payer: BCBS Complete |
$1,482.80
|
| Rate for Payer: BCBS MAPPO |
$2,204.59
|
| Rate for Payer: BCN Commercial |
$3,617.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,204.59
|
| Rate for Payer: Cash Price |
$4,132.00
|
| Rate for Payer: Cash Price |
$4,132.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.61
|
| Rate for Payer: Cofinity Commercial |
$2,954.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,204.59
|
| Rate for Payer: Healthscope Commercial |
$2,645.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,645.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,314.82
|
| Rate for Payer: Meridian Medicaid |
$1,482.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,425.05
|
| Rate for Payer: Nomi Health Commercial |
$2,645.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,873.75
|
| Rate for Payer: PACE SWMI |
$2,204.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,204.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,412.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,866.83
|
| Rate for Payer: Priority Health Medicare |
$2,204.59
|
| Rate for Payer: Priority Health Narrow Network |
$3,866.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,204.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,238.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,204.59
|
| Rate for Payer: UHC Exchange |
$4,238.00
|
| Rate for Payer: UHC Medicaid |
$1,412.19
|
| Rate for Payer: UHCCP DNSP |
$2,204.59
|
| Rate for Payer: UHCCP Medicaid |
$1,412.19
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC
|
Professional
|
Both
|
$5,275.00
|
|
|
Service Code
|
HCPCS 22206
|
| Min. Negotiated Rate |
$1,457.35 |
| Max. Negotiated Rate |
$4,333.38 |
| Rate for Payer: Aetna Commercial |
$3,053.32
|
| Rate for Payer: Aetna Medicare |
$2,278.60
|
| Rate for Payer: BCBS Complete |
$1,530.22
|
| Rate for Payer: BCBS MAPPO |
$2,278.60
|
| Rate for Payer: BCN Commercial |
$3,713.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,278.60
|
| Rate for Payer: Cash Price |
$4,220.00
|
| Rate for Payer: Cash Price |
$4,220.00
|
| Rate for Payer: Cofinity Commercial |
$3,281.18
|
| Rate for Payer: Cofinity Commercial |
$3,053.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,278.60
|
| Rate for Payer: Healthscope Commercial |
$2,734.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,734.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,392.53
|
| Rate for Payer: Meridian Medicaid |
$1,530.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,506.46
|
| Rate for Payer: Nomi Health Commercial |
$2,734.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,956.25
|
| Rate for Payer: PACE SWMI |
$2,278.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,278.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,457.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,970.10
|
| Rate for Payer: Priority Health Medicare |
$2,278.60
|
| Rate for Payer: Priority Health Narrow Network |
$3,970.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,278.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,333.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,278.60
|
| Rate for Payer: UHC Exchange |
$4,333.38
|
| Rate for Payer: UHC Medicaid |
$1,457.35
|
| Rate for Payer: UHCCP DNSP |
$2,278.60
|
| Rate for Payer: UHCCP Medicaid |
$1,457.35
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,838.00
|
|
|
Service Code
|
HCPCS 22210
|
| Min. Negotiated Rate |
$1,092.69 |
| Max. Negotiated Rate |
$3,148.03 |
| Rate for Payer: Aetna Commercial |
$2,271.07
|
| Rate for Payer: Aetna Medicare |
$1,694.83
|
| Rate for Payer: BCBS Complete |
$1,147.32
|
| Rate for Payer: BCBS MAPPO |
$1,694.83
|
| Rate for Payer: BCN Commercial |
$2,980.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,694.83
|
| Rate for Payer: Cash Price |
$3,070.40
|
| Rate for Payer: Cash Price |
$3,070.40
|
| Rate for Payer: Cofinity Commercial |
$2,440.56
|
| Rate for Payer: Cofinity Commercial |
$2,271.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,694.83
|
| Rate for Payer: Healthscope Commercial |
$2,033.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,033.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,779.57
|
| Rate for Payer: Meridian Medicaid |
$1,147.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,864.31
|
| Rate for Payer: Nomi Health Commercial |
$2,033.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,878.50
|
| Rate for Payer: PACE SWMI |
$1,694.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,694.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,092.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,900.65
|
| Rate for Payer: Priority Health Medicare |
$1,694.83
|
| Rate for Payer: Priority Health Narrow Network |
$2,900.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,694.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,148.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,694.83
|
| Rate for Payer: UHC Exchange |
$3,148.03
|
| Rate for Payer: UHC Medicaid |
$1,092.69
|
| Rate for Payer: UHCCP DNSP |
$1,694.83
|
| Rate for Payer: UHCCP Medicaid |
$1,092.69
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR
|
Professional
|
Both
|
$3,193.00
|
|
|
Service Code
|
HCPCS 22214
|
| Min. Negotiated Rate |
$921.01 |
| Max. Negotiated Rate |
$2,636.83 |
| Rate for Payer: Aetna Commercial |
$1,906.36
|
| Rate for Payer: Aetna Medicare |
$1,422.66
|
| Rate for Payer: BCBS Complete |
$967.06
|
| Rate for Payer: BCBS MAPPO |
$1,422.66
|
| Rate for Payer: BCN Commercial |
$2,303.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,422.66
|
| Rate for Payer: Cash Price |
$2,554.40
|
| Rate for Payer: Cash Price |
$2,554.40
|
| Rate for Payer: Cofinity Commercial |
$2,048.63
|
| Rate for Payer: Cofinity Commercial |
$1,906.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,422.66
|
| Rate for Payer: Healthscope Commercial |
$1,707.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,707.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,493.79
|
| Rate for Payer: Meridian Medicaid |
$967.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,564.93
|
| Rate for Payer: Nomi Health Commercial |
$1,707.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,394.75
|
| Rate for Payer: PACE SWMI |
$1,422.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,422.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,462.55
|
| Rate for Payer: Priority Health Medicare |
$1,422.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,462.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,422.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,636.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,422.66
|
| Rate for Payer: UHC Exchange |
$2,636.83
|
| Rate for Payer: UHC Medicaid |
$921.01
|
| Rate for Payer: UHCCP DNSP |
$1,422.66
|
| Rate for Payer: UHCCP Medicaid |
$921.01
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC
|
Professional
|
Both
|
$3,180.00
|
|
|
Service Code
|
HCPCS 22212
|
| Min. Negotiated Rate |
$928.47 |
| Max. Negotiated Rate |
$2,626.32 |
| Rate for Payer: Aetna Commercial |
$1,922.23
|
| Rate for Payer: Aetna Medicare |
$1,434.50
|
| Rate for Payer: BCBS Complete |
$974.89
|
| Rate for Payer: BCBS MAPPO |
$1,434.50
|
| Rate for Payer: BCN Commercial |
$2,307.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,434.50
|
| Rate for Payer: Cash Price |
$2,544.00
|
| Rate for Payer: Cash Price |
$2,544.00
|
| Rate for Payer: Cofinity Commercial |
$2,065.68
|
| Rate for Payer: Cofinity Commercial |
$1,922.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,434.50
|
| Rate for Payer: Healthscope Commercial |
$1,721.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,721.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,506.22
|
| Rate for Payer: Meridian Medicaid |
$974.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,577.95
|
| Rate for Payer: Nomi Health Commercial |
$1,721.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,385.00
|
| Rate for Payer: PACE SWMI |
$1,434.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,434.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$928.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,466.27
|
| Rate for Payer: Priority Health Medicare |
$1,434.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,466.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,434.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,626.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,434.50
|
| Rate for Payer: UHC Exchange |
$2,626.32
|
| Rate for Payer: UHC Medicaid |
$928.47
|
| Rate for Payer: UHCCP DNSP |
$1,434.50
|
| Rate for Payer: UHCCP Medicaid |
$928.47
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,389.00
|
|
|
Service Code
|
HCPCS 22220
|
| Min. Negotiated Rate |
$994.07 |
| Max. Negotiated Rate |
$2,879.33 |
| Rate for Payer: Aetna Commercial |
$2,062.45
|
| Rate for Payer: Aetna Medicare |
$1,539.14
|
| Rate for Payer: BCBS Complete |
$1,043.77
|
| Rate for Payer: BCBS MAPPO |
$1,539.14
|
| Rate for Payer: BCN Commercial |
$2,718.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,539.14
|
| Rate for Payer: Cash Price |
$2,711.20
|
| Rate for Payer: Cash Price |
$2,711.20
|
| Rate for Payer: Cofinity Commercial |
$2,216.36
|
| Rate for Payer: Cofinity Commercial |
$2,062.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,539.14
|
| Rate for Payer: Healthscope Commercial |
$1,846.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,846.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,616.10
|
| Rate for Payer: Meridian Medicaid |
$1,043.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,693.05
|
| Rate for Payer: Nomi Health Commercial |
$1,846.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,541.75
|
| Rate for Payer: PACE SWMI |
$1,539.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,539.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$994.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,645.14
|
| Rate for Payer: Priority Health Medicare |
$1,539.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,645.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,539.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,879.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,539.14
|
| Rate for Payer: UHC Exchange |
$2,879.33
|
| Rate for Payer: UHC Medicaid |
$994.07
|
| Rate for Payer: UHCCP DNSP |
$1,539.14
|
| Rate for Payer: UHCCP Medicaid |
$994.07
|
|
