|
PR ORTHOVISC INJ PER DOSE
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS J7324
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$134.56 |
| Rate for Payer: Aetna Commercial |
$134.56
|
| Rate for Payer: Aetna Medicare |
$94.50
|
| Rate for Payer: BCBS Complete |
$75.60
|
| Rate for Payer: BCBS Trust/PPO |
$133.10
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.80
|
| Rate for Payer: UHC Exchange |
$119.80
|
|
|
PR OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 28114
|
| Min. Negotiated Rate |
$545.28 |
| Max. Negotiated Rate |
$1,554.48 |
| Rate for Payer: Aetna Commercial |
$1,103.34
|
| Rate for Payer: Aetna Medicare |
$969.00
|
| Rate for Payer: BCBS Complete |
$572.54
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$1,554.48
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Meridian Medicaid |
$572.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$962.26
|
| Rate for Payer: UHC Exchange |
$962.26
|
| Rate for Payer: UHCCP Medicaid |
$545.28
|
|
|
PR OSTC PRTL EXOSTC/CONDYLC METAR HEAD
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 28288
|
| Min. Negotiated Rate |
$78.19 |
| Max. Negotiated Rate |
$877.67 |
| Rate for Payer: Aetna Commercial |
$571.03
|
| Rate for Payer: Aetna Medicare |
$494.00
|
| Rate for Payer: BCBS Complete |
$297.23
|
| Rate for Payer: BCBS Trust/PPO |
$78.19
|
| Rate for Payer: BCN Commercial |
$877.67
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Meridian Medicaid |
$297.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.21
|
| Rate for Payer: Priority Health Narrow Network |
$672.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$496.72
|
| Rate for Payer: UHC Exchange |
$496.72
|
| Rate for Payer: UHCCP Medicaid |
$283.08
|
|
|
PR OSTECTOMY CALCANEUS
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 28118
|
| Min. Negotiated Rate |
$276.47 |
| Max. Negotiated Rate |
$2,262.71 |
| Rate for Payer: Aetna Commercial |
$555.17
|
| Rate for Payer: Aetna Medicare |
$514.50
|
| Rate for Payer: BCBS Complete |
$290.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.71
|
| Rate for Payer: BCN Commercial |
$877.67
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Meridian Medicaid |
$290.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.37
|
| Rate for Payer: Priority Health Narrow Network |
$652.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.77
|
| Rate for Payer: UHC Exchange |
$479.77
|
| Rate for Payer: UHCCP Medicaid |
$276.47
|
|
|
PR OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS
|
Professional
|
Both
|
$1,222.00
|
|
|
Service Code
|
HCPCS 28119
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$811.47 |
| Rate for Payer: Aetna Commercial |
$477.77
|
| Rate for Payer: Aetna Medicare |
$611.00
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCBS Trust/PPO |
$811.47
|
| Rate for Payer: BCN Commercial |
$761.85
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$562.30
|
| Rate for Payer: Priority Health Narrow Network |
$562.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.78
|
| Rate for Payer: UHC Exchange |
$421.78
|
| Rate for Payer: UHCCP Medicaid |
$237.07
|
|
|
PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 28111
|
| Min. Negotiated Rate |
$206.82 |
| Max. Negotiated Rate |
$693.44 |
| Rate for Payer: Aetna Commercial |
$427.63
|
| Rate for Payer: Aetna Medicare |
$415.50
|
| Rate for Payer: BCBS Complete |
$217.16
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$693.44
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Meridian Medicaid |
$217.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.54
|
| Rate for Payer: Priority Health Narrow Network |
$490.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.54
|
| Rate for Payer: UHC Exchange |
$394.54
|
| Rate for Payer: UHCCP Medicaid |
$206.82
|
|
|
PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Professional
|
Both
|
$1,034.00
|
|
|
Service Code
|
HCPCS 28113
|
| Min. Negotiated Rate |
$278.82 |
| Max. Negotiated Rate |
$850.30 |
| Rate for Payer: Aetna Commercial |
$559.27
|
| Rate for Payer: Aetna Medicare |
$517.00
|
| Rate for Payer: BCBS Complete |
$292.76
|
| Rate for Payer: BCBS Trust/PPO |
$522.49
|
| Rate for Payer: BCN Commercial |
$850.30
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Meridian Medicaid |
$292.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$657.96
|
| Rate for Payer: Priority Health Narrow Network |
$657.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$491.60
|
| Rate for Payer: UHC Exchange |
$491.60
|
| Rate for Payer: UHCCP Medicaid |
$278.82
|
|
|
PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4
|
Professional
|
Both
|
$971.00
|
|
|
Service Code
|
HCPCS 28112
|
| Min. Negotiated Rate |
$204.27 |
| Max. Negotiated Rate |
$1,106.26 |
| Rate for Payer: Aetna Commercial |
$411.03
|
| Rate for Payer: Aetna Medicare |
$485.50
|
| Rate for Payer: BCBS Complete |
$214.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.26
|
| Rate for Payer: BCN Commercial |
$702.23
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Meridian Medicaid |
$214.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.91
|
| Rate for Payer: Priority Health Narrow Network |
$482.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$368.22
|
| Rate for Payer: UHC Exchange |
$368.22
|
| Rate for Payer: UHCCP Medicaid |
$204.27
|
|
|
PR OSTECTOMY PRTL 5TH METAR HEAD SPX
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 28110
|
| Min. Negotiated Rate |
$192.55 |
| Max. Negotiated Rate |
$667.54 |
| Rate for Payer: Aetna Commercial |
$382.12
|
| Rate for Payer: Aetna Medicare |
$457.00
|
| Rate for Payer: BCBS Complete |
$202.18
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Meridian Medicaid |
$202.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.39
|
| Rate for Payer: Priority Health Narrow Network |
$453.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.60
|
| Rate for Payer: UHC Exchange |
$335.60
|
| Rate for Payer: UHCCP Medicaid |
$192.55
|
|
|
PR OSTECTOMY STERNUM PARTIAL
|
Professional
|
Both
|
$3,953.00
|
|
|
Service Code
|
HCPCS 21620
|
| Min. Negotiated Rate |
$324.61 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$678.09
|
| Rate for Payer: Aetna Medicare |
$1,976.50
|
| Rate for Payer: BCBS Complete |
$340.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$737.90
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Meridian Medicaid |
$340.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,569.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.44
|
| Rate for Payer: Priority Health Narrow Network |
$771.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.58
|
| Rate for Payer: UHC Exchange |
$608.58
|
| Rate for Payer: UHCCP Medicaid |
$324.61
|
|
|
PR OSTECTOMY TARSAL COALITION
|
Professional
|
Both
|
$1,439.00
|
|
|
Service Code
|
HCPCS 28116
|
| Min. Negotiated Rate |
$337.39 |
| Max. Negotiated Rate |
$1,784.07 |
| Rate for Payer: Aetna Commercial |
$769.13
|
| Rate for Payer: Aetna Medicare |
$719.50
|
| Rate for Payer: BCBS Complete |
$354.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,784.07
|
| Rate for Payer: BCN Commercial |
$1,138.62
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Meridian Medicaid |
$354.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$935.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$895.59
|
| Rate for Payer: Priority Health Narrow Network |
$895.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$666.54
|
| Rate for Payer: UHC Exchange |
$666.54
|
| Rate for Payer: UHCCP Medicaid |
$337.39
|
|
|
PR OSTEOCHONDRAL ALLOGRAFT KNEE OPEN
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 27415
|
| Min. Negotiated Rate |
$709.51 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,833.39
|
| Rate for Payer: Aetna Medicare |
$2,287.50
|
| Rate for Payer: BCBS Complete |
$933.74
|
| Rate for Payer: BCBS Trust/PPO |
$709.51
|
| Rate for Payer: BCN Commercial |
$2,007.97
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Meridian Medicaid |
$933.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$889.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,106.68
|
| Rate for Payer: Priority Health Narrow Network |
$2,106.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,578.07
|
| Rate for Payer: UHC Exchange |
$1,578.07
|
| Rate for Payer: UHCCP Medicaid |
$889.28
|
|
|
PR OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY
|
Professional
|
Both
|
$3,097.00
|
|
|
Service Code
|
HCPCS 27416
|
| Min. Negotiated Rate |
$637.30 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$1,308.99
|
| Rate for Payer: Aetna Medicare |
$1,548.50
|
| Rate for Payer: BCBS Complete |
$669.16
|
| Rate for Payer: BCBS Trust/PPO |
$852.15
|
| Rate for Payer: BCN Commercial |
$1,438.67
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Meridian Medicaid |
$669.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,508.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.82
|
| Rate for Payer: UHC Exchange |
$1,116.82
|
| Rate for Payer: UHCCP Medicaid |
$637.30
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 98925
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$1,227.77 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.77
|
| Rate for Payer: BCN Commercial |
$30.34
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.76
|
| Rate for Payer: Priority Health Narrow Network |
$30.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.48
|
| Rate for Payer: UHC Exchange |
$23.48
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 98926
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$1,021.73 |
| Rate for Payer: Aetna Commercial |
$28.73
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.73
|
| Rate for Payer: BCN Commercial |
$43.39
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Narrow Network |
$46.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.83
|
| Rate for Payer: UHC Exchange |
$33.83
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 98927
|
| Min. Negotiated Rate |
$29.18 |
| Max. Negotiated Rate |
$1,177.05 |
| Rate for Payer: Aetna Commercial |
$37.99
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: BCBS Complete |
$30.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,177.05
|
| Rate for Payer: BCN Commercial |
$56.11
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Meridian Medicaid |
$30.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.96
|
| Rate for Payer: Priority Health Narrow Network |
$61.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.63
|
| Rate for Payer: UHC Exchange |
$44.63
|
| Rate for Payer: UHCCP Medicaid |
$29.18
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 98928
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$332.83 |
| Rate for Payer: Aetna Commercial |
$47.49
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS Trust/PPO |
$332.83
|
| Rate for Payer: BCN Commercial |
$69.16
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.25
|
| Rate for Payer: Priority Health Narrow Network |
$78.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.10
|
| Rate for Payer: UHC Exchange |
$53.10
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 98929
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$193.36 |
| Rate for Payer: Aetna Commercial |
$58.11
|
| Rate for Payer: Aetna Medicare |
$75.00
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$81.23
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.64
|
| Rate for Payer: Priority Health Narrow Network |
$93.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.58
|
| Rate for Payer: UHC Exchange |
$61.58
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
|
PR OSTEOPLASTY CARPAL BONE SHORTENING
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 25394
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$1,259.70 |
| Rate for Payer: Aetna Commercial |
$1,047.57
|
| Rate for Payer: Aetna Medicare |
$969.00
|
| Rate for Payer: BCBS Complete |
$538.78
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$1,154.74
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Meridian Medicaid |
$538.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,214.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,214.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$893.29
|
| Rate for Payer: UHC Exchange |
$893.29
|
| Rate for Payer: UHCCP Medicaid |
$513.12
|
|
|
PR OSTEOPLASTY FEMUR LENGTHENING
|
Professional
|
Both
|
$3,981.00
|
|
|
Service Code
|
HCPCS 27466
|
| Min. Negotiated Rate |
$767.44 |
| Max. Negotiated Rate |
$2,587.65 |
| Rate for Payer: Aetna Commercial |
$1,582.85
|
| Rate for Payer: Aetna Medicare |
$1,990.50
|
| Rate for Payer: BCBS Complete |
$805.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.94
|
| Rate for Payer: BCN Commercial |
$1,734.81
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Cash Price |
$3,184.80
|
| Rate for Payer: Meridian Medicaid |
$805.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$767.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,587.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,819.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,819.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,369.70
|
| Rate for Payer: UHC Exchange |
$1,369.70
|
| Rate for Payer: UHCCP Medicaid |
$767.44
|
|
|
PR OSTEOPLASTY HUMERUS
|
Professional
|
Both
|
$3,335.00
|
|
|
Service Code
|
HCPCS 24420
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$2,167.75 |
| Rate for Payer: Aetna Commercial |
$1,403.52
|
| Rate for Payer: Aetna Medicare |
$1,667.50
|
| Rate for Payer: BCBS Complete |
$723.51
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$1,567.68
|
| Rate for Payer: Cash Price |
$2,668.00
|
| Rate for Payer: Cash Price |
$2,668.00
|
| Rate for Payer: Meridian Medicaid |
$723.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$689.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,167.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,639.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,639.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,132.80
|
| Rate for Payer: UHC Exchange |
$1,132.80
|
| Rate for Payer: UHCCP Medicaid |
$689.06
|
|
|
PR OSTEOPLASTY RADIUS/ULNA SHORTENING
|
Professional
|
Both
|
$2,689.00
|
|
|
Service Code
|
HCPCS 25390
|
| Min. Negotiated Rate |
$502.47 |
| Max. Negotiated Rate |
$1,747.85 |
| Rate for Payer: Aetna Commercial |
$1,026.00
|
| Rate for Payer: Aetna Medicare |
$1,344.50
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCBS Trust/PPO |
$580.07
|
| Rate for Payer: BCN Commercial |
$1,133.25
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Cash Price |
$2,151.20
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,188.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,188.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$928.63
|
| Rate for Payer: UHC Exchange |
$928.63
|
| Rate for Payer: UHCCP Medicaid |
$502.47
|
|
|
PR OSTEOPLASTY TIBIA&FIBULA LENGTHENING/SHORTENING
|
Professional
|
Both
|
$4,771.00
|
|
|
Service Code
|
HCPCS 27715
|
| Min. Negotiated Rate |
$226.28 |
| Max. Negotiated Rate |
$3,101.15 |
| Rate for Payer: Aetna Commercial |
$1,433.12
|
| Rate for Payer: Aetna Medicare |
$2,385.50
|
| Rate for Payer: BCBS Complete |
$729.77
|
| Rate for Payer: BCBS Trust/PPO |
$226.28
|
| Rate for Payer: BCN Commercial |
$1,571.58
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Meridian Medicaid |
$729.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,648.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,234.69
|
| Rate for Payer: UHC Exchange |
$1,234.69
|
| Rate for Payer: UHCCP Medicaid |
$695.02
|
|
|
PR OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL
|
Professional
|
Both
|
$7,871.00
|
|
|
Service Code
|
HCPCS 27165
|
| Min. Negotiated Rate |
$885.23 |
| Max. Negotiated Rate |
$5,116.15 |
| Rate for Payer: Aetna Commercial |
$1,842.03
|
| Rate for Payer: Aetna Medicare |
$3,935.50
|
| Rate for Payer: BCBS Complete |
$929.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,570.11
|
| Rate for Payer: BCN Commercial |
$2,010.42
|
| Rate for Payer: Cash Price |
$6,296.80
|
| Rate for Payer: Cash Price |
$6,296.80
|
| Rate for Payer: Meridian Medicaid |
$929.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$885.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,116.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,102.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,102.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,588.57
|
| Rate for Payer: UHC Exchange |
$1,588.57
|
| Rate for Payer: UHCCP Medicaid |
$885.23
|
|
|
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,746.00
|
|
|
Service Code
|
HCPCS 28300
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,703.80 |
| Rate for Payer: Aetna Commercial |
$866.13
|
| Rate for Payer: Aetna Medicare |
$873.00
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.80
|
| Rate for Payer: BCN Commercial |
$953.41
|
| Rate for Payer: Cash Price |
$1,396.80
|
| Rate for Payer: Cash Price |
$1,396.80
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,002.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.72
|
| Rate for Payer: UHC Exchange |
$769.72
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
|
