Christopher Pietrzyk, D.C.
Individual · Chiropractic
Cost Score
Overview of Christopher Pietrzyk, D.C.
Specialties
Chiropractic
Education and Training
- Medical School: Other (graduated 2000)
Additional Information
- Offers telehealth: Unknown
- Accepts Medicare: Yes
- Gender: Male
- NPI: 1447393004
Office Location
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Sample Price Estimate Shown Below
This is an example estimate demonstrating how the tool works. Enter a treatment description above and click "Calculate Estimate" to see pricing specific to your needs.
Out-of-Pocket Cost Estimate
Benchmark
Cost Breakdown
Services
Sample medical procedure A (CPT 12345)
Sample medical procedure B (CPT 67890)
Total Cost
Total
What this estimate includes:
What this estimate does not include:
Cost Benchmarks
Cost Benchmarks by Billing Code (Self-Pay)
Chiropractic manipulative treatment, 3 to 4 spinal regions
Code: CPT 98941
485 patient bills
Median Price in this Area
Bill from this Provider
Price Difference
$54.92
Cost Estimate FAQs
How are the cost percentages calculated?
Each provider has a cost score, which represents how expensive the provider is compared to similar providers in the area. For example, if a hospital has a cost score of +30%, this means that, on average, procedures at this hospital are 30% more expensive than other hospitals in the area. The cost score is calculated using the following steps: First, we take each individual procedure that the provider offers (such as an office visit, X-ray, or surgery) and compare the provider's price for that procedure to the average price charged by similar providers in the surrounding area. This gives us a percentage difference for each procedure. For example, if a provider charges $150 for an office visit and the area average is $100, that procedure is +50% above average. If they charge $200 for an X-ray and the area average is $180, that's +11% above average. We then calculate a weighted average of these percentage differences across all procedures the provider offers. Procedures that are billed more frequently are weighted more heavily in the cost score calculation, so common procedures have a greater impact on the overall score than rare procedures. So a cost score of +30% means that across all the procedures this provider offers, weighted by how often each procedure is performed, they charge 30% more on average than similar providers in the area.
Will my health insurance affect these prices?
Yes, health insurance can significantly affect how much you pay for healthcare services. The prices shown represent self-pay or "sticker" prices - what you would typically pay if you don't have insurance coverage. When you have health insurance, the actual cost depends on whether the provider is in your insurance network. In-network providers have negotiated contracted rates with your insurance company, which are typically much lower than self-pay prices. These negotiated rates affect both the total amount charged for the service and your out-of-pocket costs (such as copays, coinsurance, or deductibles). Out-of-network providers don't have these contracted rates with your insurance, so you may pay significantly more - sometimes close to the full self-pay price - even with insurance coverage. Additionally, your insurance company may pay little or nothing toward out-of-network care, leaving you responsible for a much larger portion of the bill. The difference between in-network and out-of-network costs can be substantial, often varying by hundreds or thousands of dollars for the same procedure. That's why it's important to verify whether a provider is in your insurance network before receiving care.
What is the difference between in-network and out-of-network providers?
If you have health insurance, some providers (hospitals, urgent cares, doctors, etc) will be considered in-network with your insurance plan and some will be considered out-of-network. A provider that's in-network means that there is a contracted relationship between that provider and your insurance company. Usually, the provider has agreed to offer a discounted rate for their services to everyone with your insurance plan. It's important to know ahead of time whether a healthcare provider is in-network or out-of-network with your insurance plan before you go in for a patient visit. Read below for more information on how to check if a provider is in-network with your insurance plan.
How can I check if a provider is in-network?
If you have health insurance, it's important to do your due diligence and check ahead of time if a provider is in-network with your insurance plan before going in for a patient visit.
Even though the in-network providers with your insurance plan will charge different prices, it will usually save you money overall to go with a provider that offers an in-network discount versus a provider that's out-of-network.
Many insurance providers offer online tools to find providers that are in-network:
However, it's best to call and verify that a provider is in-network directly with your insurance company. Insurance networks change frequently and the provider information from the online tool may not be up to date.
Where does the pricing data come from?
Every time you visit a healthcare provider (hospital, urgent care, doctor's office, etc) a bill is sent from that provider to your insurance company - this bill is called a claim. The insurance claim contains a list of all the procedures that were administered to you during your patient visit and the amount charged for each procedure. We aggregate insurance claims data at scale - across all 50 states and from over 1 million providers to populate the Price Tool. The prices displayed in the Price Tool represent the average charges from these patient bills. These prices represent the out-of-network or 'sticker' price for each procedure. This is the amount you would pay if you did not have health insurance or went to a provider that was out-of-network. If you have health insurance and visit a provider that's in-network you will usually pay a discounted rate.
How accurate is the pricing data?
The prices displayed in the Price Tool are pulled from real patient bills, and represent the average amounts that patients were charged from each provider. Healthcare providers are allowed to update their prices as they see fit. The pricing information in the Price Tool represents the most recent data available but may not reflect the current prices that each provider is charging. These prices represent the out-of-network or 'sticker' price for each procedure. If you have health insurance and visit a provider that's in-network you will usually pay a discounted rate.
How can I contact customer support?
Self-pay pricing data as of: 2022
Source: CMS and licensed data partners
Quality Measures
The MIPS (Merit-based Incentive Payment System) score measures a provider's performance across four key areas, with scores ranging from 0-100 points:
- Quality (30%): Patient care quality based on clinical measures
- Cost (30%): Cost-effectiveness of care provided
- Promoting Interoperability (25%): Use of certified electronic health records
- Improvement Activities (15%): Care process improvements and patient engagement
Learn more about MIPS scoring from the Centers for Medicare & Medicaid Services (CMS).
Quality Measure FAQs
What is the MIPS performance grade?
This score comes from the U.S. Centers for Medicare & Medicaid Services (CMS) and is calculated on a scale of 0-100 by evaluating a provider's performance in four key areas: Quality of patient care, cost-effectiveness, use of electronic health records, and activities to improve their practice. A higher score generally indicates that the provider meets or exceeds the national benchmark for high-quality, cost-efficient care. As a general guide, a score of 75 or higher is considered good, as it meets or exceeds the national performance threshold set by CMS. An average score typically falls in the 19-74 point range, resulting in a small penalty for the provider. A lower score (18 points or less) indicates performance was significantly below the national standard and resulted in the maximum penalty. The score is part of a federal program called the Merit-based Incentive Payment System (MIPS), which adjusts Medicare payments to doctors based on the value they provide. This system is designed to give consumers insight into a provider's performance on a range of important quality and cost measures.
How do I interpret a provider's MIPS score?
MIPS scores range from 0 to 100 points. Generally, higher scores indicate better performance compared to other providers. Here's how to understand the scoring: - Below 75 points: The provider performed below the national threshold and receives a payment penalty from Medicare - 75 points: Neutral performance - meets the minimum standard - 75-85 points: Above-average performance with positive payment adjustments - 85-100 points: Exceptional performance - among the top performers nationally However, it's important to note that MIPS scores primarily measure what can be easily tracked and reported to Medicare, not necessarily the full picture of care quality. They're one data point to consider alongside other factors like patient reviews, your specific health needs, and whether the provider accepts your insurance.
Why don't all providers have MIPS scores?
Not all healthcare providers are required to participate in MIPS. To be eligible for MIPS, a provider must: - Be a physician or certain other types of Medicare-enrolled clinicians (such as physician assistants, nurse practitioners, or therapists) - Bill more than $90,000 in Medicare Part B charges annually - See more than 200 Medicare patients per year - Provide more than 200 covered services to Medicare patients Providers who don't meet these requirements are exempt from MIPS reporting. Additionally, providers who are new to Medicare (enrolled for the first time within the current year) or who participate in certain advanced alternative payment models are also exempt. This means that many providers—especially those in smaller practices, those who primarily serve non-Medicare patients, or specialists with lower Medicare patient volumes—may not have MIPS scores available. The absence of a MIPS score doesn't indicate poor quality; it simply means the provider isn't required to participate in the program.
Do MIPS scores vary by medical specialty?
Yes and no. While CMS has created specialty-specific quality measures (47 different specialty measure sets), all providers participating in MIPS are ultimately scored against the same national performance threshold of 75 points, regardless of specialty. This means that a cardiologist, family medicine doctor, and orthopedic surgeon are all evaluated against the same scoring benchmarks, even though they practice very different types of medicine. Each specialty can choose from a tailored list of quality measures most relevant to their practice, but the final score comparison is universal. This approach has limitations—what constitutes "high-quality care" can vary significantly between specialties, and comparing a primary care physician's score to a specialist's score may not always provide an apples-to-apples comparison. Use MIPS scores as one factor in your decision, but also consider specialty-specific expertise and patient reviews for your particular health needs.
What are the limitations of MIPS scores?
While MIPS scores provide useful information about provider quality, they have several important limitations to keep in mind: Not a Complete Picture: MIPS scores measure what can be easily tracked and reported to Medicare—things like whether certain preventive screenings were performed or medications were prescribed. They don't capture many important aspects of care quality, such as communication skills, compassion, cultural competency, or how well a provider coordinates your care with other specialists. May Not Reflect Care for All Patients: MIPS scores are based primarily on Medicare patients. If you're not a Medicare beneficiary, a provider's performance for your demographic may differ from their MIPS score. Complexity and Social Factors: Research has shown that providers caring for more medically complex or socially vulnerable patient populations often receive lower MIPS scores, even when delivering high-quality care. Low scores don't always mean poor care—they may reflect the challenges of treating patients with multiple chronic conditions or limited resources. Time Lag: As mentioned above, publicly available MIPS scores are typically 1-2 years old and may not reflect a provider's current performance or recent practice improvements. Best Used in Combination: MIPS scores are most helpful when used alongside other information like patient reviews, board certifications, years of experience, hospital affiliations, and whether the provider accepts your insurance and has availability that works for your schedule.
Source: Denniston Data Inc. (DDI) and CMS
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