|
PR OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 23480
|
| Min. Negotiated Rate |
$134.57 |
| Max. Negotiated Rate |
$1,266.56 |
| Rate for Payer: Aetna Commercial |
$1,096.36
|
| Rate for Payer: Aetna Medicare |
$864.50
|
| Rate for Payer: BCBS Complete |
$561.58
|
| Rate for Payer: BCBS Trust/PPO |
$134.57
|
| Rate for Payer: BCN Commercial |
$1,207.03
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Meridian Medicaid |
$561.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,266.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,266.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$939.64
|
| Rate for Payer: UHC Exchange |
$939.64
|
| Rate for Payer: UHCCP Medicaid |
$534.84
|
|
|
PR OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL
|
Professional
|
Both
|
$2,427.00
|
|
|
Service Code
|
HCPCS 23485
|
| Min. Negotiated Rate |
$168.53 |
| Max. Negotiated Rate |
$1,577.55 |
| Rate for Payer: Aetna Commercial |
$1,269.43
|
| Rate for Payer: Aetna Medicare |
$1,213.50
|
| Rate for Payer: BCBS Complete |
$649.71
|
| Rate for Payer: BCBS Trust/PPO |
$168.53
|
| Rate for Payer: BCN Commercial |
$1,399.57
|
| Rate for Payer: Cash Price |
$1,941.60
|
| Rate for Payer: Cash Price |
$1,941.60
|
| Rate for Payer: Meridian Medicaid |
$649.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,577.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,468.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,468.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,109.32
|
| Rate for Payer: UHC Exchange |
$1,109.32
|
| Rate for Payer: UHCCP Medicaid |
$618.77
|
|
|
PR OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION
|
Professional
|
Both
|
$2,914.00
|
|
|
Service Code
|
HCPCS 27450
|
| Min. Negotiated Rate |
$653.27 |
| Max. Negotiated Rate |
$1,894.10 |
| Rate for Payer: Aetna Commercial |
$1,357.97
|
| Rate for Payer: Aetna Medicare |
$1,457.00
|
| Rate for Payer: BCBS Complete |
$685.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.69
|
| Rate for Payer: BCN Commercial |
$1,489.49
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Meridian Medicaid |
$685.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,552.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,552.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.19
|
| Rate for Payer: UHC Exchange |
$1,174.19
|
| Rate for Payer: UHCCP Medicaid |
$653.27
|
|
|
PR OSTEOTOMY FIBULA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27707
|
| Min. Negotiated Rate |
$266.46 |
| Max. Negotiated Rate |
$2,447.61 |
| Rate for Payer: Aetna Commercial |
$528.68
|
| Rate for Payer: Aetna Medicare |
$650.50
|
| Rate for Payer: BCBS Complete |
$279.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,447.61
|
| Rate for Payer: BCN Commercial |
$598.63
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Meridian Medicaid |
$279.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$630.99
|
| Rate for Payer: Priority Health Narrow Network |
$630.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$450.00
|
| Rate for Payer: UHC Exchange |
$450.00
|
| Rate for Payer: UHCCP Medicaid |
$266.46
|
|
|
PR OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$1,466.00
|
|
|
Service Code
|
HCPCS 24400
|
| Min. Negotiated Rate |
$227.70 |
| Max. Negotiated Rate |
$1,278.76 |
| Rate for Payer: Aetna Commercial |
$1,101.27
|
| Rate for Payer: Aetna Medicare |
$733.00
|
| Rate for Payer: BCBS Complete |
$567.18
|
| Rate for Payer: BCBS Trust/PPO |
$227.70
|
| Rate for Payer: BCN Commercial |
$1,218.76
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Meridian Medicaid |
$567.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,278.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,278.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$938.58
|
| Rate for Payer: UHC Exchange |
$938.58
|
| Rate for Payer: UHCCP Medicaid |
$540.17
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE
|
Professional
|
Both
|
$2,618.00
|
|
|
Service Code
|
HCPCS 27146
|
| Min. Negotiated Rate |
$827.93 |
| Max. Negotiated Rate |
$1,961.65 |
| Rate for Payer: Aetna Commercial |
$1,710.09
|
| Rate for Payer: Aetna Medicare |
$1,309.00
|
| Rate for Payer: BCBS Complete |
$869.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,896.07
|
| Rate for Payer: BCN Commercial |
$1,855.51
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Meridian Medicaid |
$869.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$827.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,961.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,961.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,472.50
|
| Rate for Payer: UHC Exchange |
$1,472.50
|
| Rate for Payer: UHCCP Medicaid |
$827.93
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT
|
Professional
|
Both
|
$3,285.00
|
|
|
Service Code
|
HCPCS 27151
|
| Min. Negotiated Rate |
$1,020.06 |
| Max. Negotiated Rate |
$2,541.32 |
| Rate for Payer: Aetna Commercial |
$2,117.11
|
| Rate for Payer: Aetna Medicare |
$1,642.50
|
| Rate for Payer: BCBS Complete |
$1,071.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,915.09
|
| Rate for Payer: BCN Commercial |
$2,541.32
|
| Rate for Payer: Cash Price |
$2,628.00
|
| Rate for Payer: Cash Price |
$2,628.00
|
| Rate for Payer: Meridian Medicaid |
$1,071.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,417.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,417.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,797.70
|
| Rate for Payer: UHC Exchange |
$1,797.70
|
| Rate for Payer: UHCCP Medicaid |
$1,020.06
|
|
|
PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ
|
Professional
|
Both
|
$2,239.00
|
|
|
Service Code
|
HCPCS 27147
|
| Min. Negotiated Rate |
$944.44 |
| Max. Negotiated Rate |
$2,238.99 |
| Rate for Payer: Aetna Commercial |
$1,956.61
|
| Rate for Payer: Aetna Medicare |
$1,119.50
|
| Rate for Payer: BCBS Complete |
$991.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,559.54
|
| Rate for Payer: BCN Commercial |
$2,135.03
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Meridian Medicaid |
$991.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,238.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,238.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,704.90
|
| Rate for Payer: UHC Exchange |
$1,704.90
|
| Rate for Payer: UHCCP Medicaid |
$944.44
|
|
|
PR OSTEOTOMY METACARPAL EACH
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 26565
|
| Min. Negotiated Rate |
$460.93 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Aetna Commercial |
$969.85
|
| Rate for Payer: Aetna Medicare |
$892.50
|
| Rate for Payer: BCBS Complete |
$483.98
|
| Rate for Payer: BCBS Trust/PPO |
$668.83
|
| Rate for Payer: BCN Commercial |
$1,062.38
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Meridian Medicaid |
$483.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,100.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$752.09
|
| Rate for Payer: UHC Exchange |
$752.09
|
| Rate for Payer: UHCCP Medicaid |
$460.93
|
|
|
PR OSTEOTOMY PHALANX FINGER EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26567
|
| Min. Negotiated Rate |
$140.53 |
| Max. Negotiated Rate |
$1,113.39 |
| Rate for Payer: Aetna Commercial |
$952.97
|
| Rate for Payer: Aetna Medicare |
$793.00
|
| Rate for Payer: BCBS Complete |
$488.23
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$1,070.70
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Meridian Medicaid |
$488.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$753.44
|
| Rate for Payer: UHC Exchange |
$753.44
|
| Rate for Payer: UHCCP Medicaid |
$464.98
|
|
|
PR OSTEOTOMY RADIUS DISTAL THIRD
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25350
|
| Min. Negotiated Rate |
$441.98 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$899.05
|
| Rate for Payer: Aetna Medicare |
$1,114.00
|
| Rate for Payer: BCBS Complete |
$464.08
|
| Rate for Payer: BCBS Trust/PPO |
$604.38
|
| Rate for Payer: BCN Commercial |
$996.90
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Meridian Medicaid |
$464.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$816.73
|
| Rate for Payer: UHC Exchange |
$816.73
|
| Rate for Payer: UHCCP Medicaid |
$441.98
|
|
|
PR OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD
|
Professional
|
Both
|
$1,696.00
|
|
|
Service Code
|
HCPCS 25355
|
| Min. Negotiated Rate |
$500.12 |
| Max. Negotiated Rate |
$1,184.62 |
| Rate for Payer: Aetna Commercial |
$1,022.43
|
| Rate for Payer: Aetna Medicare |
$848.00
|
| Rate for Payer: BCBS Complete |
$525.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.28
|
| Rate for Payer: BCN Commercial |
$1,126.89
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Meridian Medicaid |
$525.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,102.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,184.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$925.69
|
| Rate for Payer: UHC Exchange |
$925.69
|
| Rate for Payer: UHCCP Medicaid |
$500.12
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM
|
Professional
|
Both
|
$2,710.00
|
|
|
Service Code
|
HCPCS 22208
|
| Min. Negotiated Rate |
$378.08 |
| Max. Negotiated Rate |
$13,048.08 |
| Rate for Payer: Aetna Commercial |
$790.71
|
| Rate for Payer: Aetna Medicare |
$1,355.00
|
| Rate for Payer: BCBS Complete |
$396.98
|
| Rate for Payer: BCBS Trust/PPO |
$13,048.08
|
| Rate for Payer: BCN Commercial |
$854.70
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Meridian Medicaid |
$396.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,761.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.12
|
| Rate for Payer: Priority Health Narrow Network |
$897.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$698.53
|
| Rate for Payer: UHC Exchange |
$698.53
|
| Rate for Payer: UHCCP Medicaid |
$378.08
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR
|
Professional
|
Both
|
$5,015.00
|
|
|
Service Code
|
HCPCS 22207
|
| Min. Negotiated Rate |
$950.50 |
| Max. Negotiated Rate |
$3,686.70 |
| Rate for Payer: Aetna Commercial |
$3,215.31
|
| Rate for Payer: Aetna Medicare |
$2,507.50
|
| Rate for Payer: BCBS Complete |
$1,624.59
|
| Rate for Payer: BCBS Trust/PPO |
$950.50
|
| Rate for Payer: BCN Commercial |
$3,510.17
|
| Rate for Payer: Cash Price |
$4,012.00
|
| Rate for Payer: Cash Price |
$4,012.00
|
| Rate for Payer: Meridian Medicaid |
$1,624.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,547.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,259.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,686.70
|
| Rate for Payer: Priority Health Narrow Network |
$3,686.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,782.08
|
| Rate for Payer: UHC Exchange |
$2,782.08
|
| Rate for Payer: UHCCP Medicaid |
$1,547.23
|
|
|
PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC
|
Professional
|
Both
|
$5,121.00
|
|
|
Service Code
|
HCPCS 22206
|
| Min. Negotiated Rate |
$1,588.55 |
| Max. Negotiated Rate |
$17,177.60 |
| Rate for Payer: Aetna Commercial |
$3,283.38
|
| Rate for Payer: Aetna Medicare |
$2,560.50
|
| Rate for Payer: BCBS Complete |
$1,667.98
|
| Rate for Payer: BCBS Trust/PPO |
$17,177.60
|
| Rate for Payer: BCN Commercial |
$3,582.01
|
| Rate for Payer: Cash Price |
$4,096.80
|
| Rate for Payer: Cash Price |
$4,096.80
|
| Rate for Payer: Meridian Medicaid |
$1,667.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,588.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,328.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,768.62
|
| Rate for Payer: Priority Health Narrow Network |
$3,768.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,744.04
|
| Rate for Payer: UHC Exchange |
$2,744.04
|
| Rate for Payer: UHCCP Medicaid |
$1,588.55
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,726.00
|
|
|
Service Code
|
HCPCS 22210
|
| Min. Negotiated Rate |
$1,160.64 |
| Max. Negotiated Rate |
$13,048.08 |
| Rate for Payer: Aetna Commercial |
$2,400.84
|
| Rate for Payer: Aetna Medicare |
$1,863.00
|
| Rate for Payer: BCBS Complete |
$1,218.67
|
| Rate for Payer: BCBS Trust/PPO |
$13,048.08
|
| Rate for Payer: BCN Commercial |
$2,885.69
|
| Rate for Payer: Cash Price |
$2,980.80
|
| Rate for Payer: Cash Price |
$2,980.80
|
| Rate for Payer: Meridian Medicaid |
$1,218.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,160.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,421.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,760.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,760.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,040.04
|
| Rate for Payer: UHC Exchange |
$2,040.04
|
| Rate for Payer: UHCCP Medicaid |
$1,160.64
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 22214
|
| Min. Negotiated Rate |
$985.34 |
| Max. Negotiated Rate |
$17,177.60 |
| Rate for Payer: Aetna Commercial |
$2,016.15
|
| Rate for Payer: Aetna Medicare |
$1,550.00
|
| Rate for Payer: BCBS Complete |
$1,034.61
|
| Rate for Payer: BCBS Trust/PPO |
$17,177.60
|
| Rate for Payer: BCN Commercial |
$2,222.51
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Meridian Medicaid |
$1,034.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$985.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,336.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,336.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,703.21
|
| Rate for Payer: UHC Exchange |
$1,703.21
|
| Rate for Payer: UHCCP Medicaid |
$985.34
|
|
|
PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 22212
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$2,336.18 |
| Rate for Payer: Aetna Commercial |
$2,011.70
|
| Rate for Payer: Aetna Medicare |
$1,543.50
|
| Rate for Payer: BCBS Complete |
$1,036.17
|
| Rate for Payer: BCBS Trust/PPO |
$24.96
|
| Rate for Payer: BCN Commercial |
$2,222.02
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Meridian Medicaid |
$1,036.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$986.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,006.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,336.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,336.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,689.37
|
| Rate for Payer: UHC Exchange |
$1,689.37
|
| Rate for Payer: UHCCP Medicaid |
$986.83
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV
|
Professional
|
Both
|
$3,290.00
|
|
|
Service Code
|
HCPCS 22220
|
| Min. Negotiated Rate |
$180.34 |
| Max. Negotiated Rate |
$2,617.72 |
| Rate for Payer: Aetna Commercial |
$2,167.65
|
| Rate for Payer: Aetna Medicare |
$1,645.00
|
| Rate for Payer: BCBS Complete |
$1,111.32
|
| Rate for Payer: BCBS Trust/PPO |
$180.34
|
| Rate for Payer: BCN Commercial |
$2,617.72
|
| Rate for Payer: Cash Price |
$2,632.00
|
| Rate for Payer: Cash Price |
$2,632.00
|
| Rate for Payer: Meridian Medicaid |
$1,111.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,058.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,138.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,496.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,496.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,852.90
|
| Rate for Payer: UHC Exchange |
$1,852.90
|
| Rate for Payer: UHCCP Medicaid |
$1,058.40
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 22226
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$573.58 |
| Rate for Payer: Aetna Commercial |
$486.64
|
| Rate for Payer: Aetna Medicare |
$334.50
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$573.58
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.49
|
| Rate for Payer: Priority Health Narrow Network |
$544.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$438.60
|
| Rate for Payer: UHC Exchange |
$438.60
|
| Rate for Payer: UHCCP Medicaid |
$230.25
|
|
|
PR OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR
|
Professional
|
Both
|
$3,280.00
|
|
|
Service Code
|
HCPCS 22224
|
| Min. Negotiated Rate |
$180.34 |
| Max. Negotiated Rate |
$2,434.38 |
| Rate for Payer: Aetna Commercial |
$2,126.35
|
| Rate for Payer: Aetna Medicare |
$1,640.00
|
| Rate for Payer: BCBS Complete |
$1,080.01
|
| Rate for Payer: BCBS Trust/PPO |
$180.34
|
| Rate for Payer: BCN Commercial |
$2,319.26
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Meridian Medicaid |
$1,080.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,028.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,132.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,434.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,434.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,819.22
|
| Rate for Payer: UHC Exchange |
$1,819.22
|
| Rate for Payer: UHCCP Medicaid |
$1,028.58
|
|
|
PR OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 28304
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,211.44 |
| Rate for Payer: Aetna Commercial |
$807.84
|
| Rate for Payer: Aetna Medicare |
$758.00
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.98
|
| Rate for Payer: BCN Commercial |
$1,211.44
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$945.46
|
| Rate for Payer: Priority Health Narrow Network |
$945.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$695.26
|
| Rate for Payer: UHC Exchange |
$695.26
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
|
|
PR OSTEOTOMY TIBIA
|
Professional
|
Both
|
$3,036.00
|
|
|
Service Code
|
HCPCS 27705
|
| Min. Negotiated Rate |
$483.30 |
| Max. Negotiated Rate |
$2,650.81 |
| Rate for Payer: Aetna Commercial |
$1,009.73
|
| Rate for Payer: Aetna Medicare |
$1,518.00
|
| Rate for Payer: BCBS Complete |
$507.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,650.81
|
| Rate for Payer: BCN Commercial |
$1,107.35
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Cash Price |
$2,428.80
|
| Rate for Payer: Meridian Medicaid |
$507.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,973.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$880.06
|
| Rate for Payer: UHC Exchange |
$880.06
|
| Rate for Payer: UHCCP Medicaid |
$483.30
|
|
|
PR OSTEOTOMY TIBIA & FIBULA
|
Professional
|
Both
|
$3,469.00
|
|
|
Service Code
|
HCPCS 27709
|
| Min. Negotiated Rate |
$490.37 |
| Max. Negotiated Rate |
$2,254.85 |
| Rate for Payer: Aetna Commercial |
$1,543.67
|
| Rate for Payer: Aetna Medicare |
$1,734.50
|
| Rate for Payer: BCBS Complete |
$774.72
|
| Rate for Payer: BCBS Trust/PPO |
$490.37
|
| Rate for Payer: BCN Commercial |
$1,659.06
|
| Rate for Payer: Cash Price |
$2,775.20
|
| Rate for Payer: Cash Price |
$2,775.20
|
| Rate for Payer: Meridian Medicaid |
$774.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$737.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,757.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,336.25
|
| Rate for Payer: UHC Exchange |
$1,336.25
|
| Rate for Payer: UHCCP Medicaid |
$737.83
|
|
|
PR OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX
|
Professional
|
Both
|
$3,164.00
|
|
|
Service Code
|
HCPCS 27140
|
| Min. Negotiated Rate |
$583.62 |
| Max. Negotiated Rate |
$2,056.60 |
| Rate for Payer: Aetna Commercial |
$1,192.72
|
| Rate for Payer: Aetna Medicare |
$1,582.00
|
| Rate for Payer: BCBS Complete |
$612.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.54
|
| Rate for Payer: BCN Commercial |
$1,316.01
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Cash Price |
$2,531.20
|
| Rate for Payer: Meridian Medicaid |
$612.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,382.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,382.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,032.97
|
| Rate for Payer: UHC Exchange |
$1,032.97
|
| Rate for Payer: UHCCP Medicaid |
$583.62
|
|
