|
PR CLTX PROX FIBULA/SHFT FX W/MANJ
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 27781
|
| Min. Negotiated Rate |
$267.10 |
| Max. Negotiated Rate |
$2,284.34 |
| Rate for Payer: Aetna Commercial |
$536.25
|
| Rate for Payer: Aetna Medicare |
$400.19
|
| Rate for Payer: BCBS Complete |
$280.46
|
| Rate for Payer: BCBS MAPPO |
$400.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,284.34
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$400.19
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$576.27
|
| Rate for Payer: Cofinity Commercial |
$536.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.19
|
| Rate for Payer: Healthscope Commercial |
$480.23
|
| Rate for Payer: Healthscope Whirlpool |
$480.23
|
| Rate for Payer: Meridian Medicaid |
$280.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$420.20
|
| Rate for Payer: PACE SWMI |
$400.19
|
| Rate for Payer: PHP Medicare Advantage |
$400.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$630.66
|
| Rate for Payer: Priority Health Medicare |
$400.19
|
| Rate for Payer: Priority Health Narrow Network |
$630.66
|
| Rate for Payer: UHC Medicare Advantage |
$412.20
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/O MANJ
|
Professional
|
Both
|
$653.00
|
|
|
Service Code
|
HCPCS 27780
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$2,660.11 |
| Rate for Payer: Aetna Commercial |
$378.28
|
| Rate for Payer: Aetna Medicare |
$282.30
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$282.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,660.11
|
| Rate for Payer: BCN Commercial |
$465.71
|
| Rate for Payer: BCN Medicare Advantage |
$282.30
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cofinity Commercial |
$406.51
|
| Rate for Payer: Cofinity Commercial |
$378.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.30
|
| Rate for Payer: Healthscope Commercial |
$338.76
|
| Rate for Payer: Healthscope Whirlpool |
$338.76
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$296.42
|
| Rate for Payer: PACE SWMI |
$282.30
|
| Rate for Payer: PHP Medicare Advantage |
$282.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.84
|
| Rate for Payer: Priority Health Medicare |
$282.30
|
| Rate for Payer: Priority Health Narrow Network |
$447.84
|
| Rate for Payer: UHC Medicare Advantage |
$290.77
|
|
|
PR CLTX PROX HUMRL FX W/MNPJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 23605
|
| Min. Negotiated Rate |
$282.44 |
| Max. Negotiated Rate |
$977.20 |
| Rate for Payer: Aetna Commercial |
$568.70
|
| Rate for Payer: Aetna Medicare |
$424.40
|
| Rate for Payer: BCBS Complete |
$296.56
|
| Rate for Payer: BCBS MAPPO |
$424.40
|
| Rate for Payer: BCBS Trust/PPO |
$303.24
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$424.40
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$611.14
|
| Rate for Payer: Cofinity Commercial |
$568.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.40
|
| Rate for Payer: Healthscope Commercial |
$509.28
|
| Rate for Payer: Healthscope Whirlpool |
$509.28
|
| Rate for Payer: Meridian Medicaid |
$296.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$445.62
|
| Rate for Payer: PACE SWMI |
$424.40
|
| Rate for Payer: PHP Medicare Advantage |
$424.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$977.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$667.43
|
| Rate for Payer: Priority Health Medicare |
$424.40
|
| Rate for Payer: Priority Health Narrow Network |
$667.43
|
| Rate for Payer: UHC Medicare Advantage |
$437.13
|
|
|
PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$770.00
|
|
|
Service Code
|
HCPCS 23600
|
| Min. Negotiated Rate |
$203.34 |
| Max. Negotiated Rate |
$539.00 |
| Rate for Payer: Aetna Commercial |
$418.98
|
| Rate for Payer: Aetna Medicare |
$312.67
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS MAPPO |
$312.67
|
| Rate for Payer: BCBS Trust/PPO |
$203.34
|
| Rate for Payer: BCN Commercial |
$403.26
|
| Rate for Payer: BCN Medicare Advantage |
$312.67
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cofinity Commercial |
$418.98
|
| Rate for Payer: Cofinity Commercial |
$450.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.67
|
| Rate for Payer: Healthscope Commercial |
$375.20
|
| Rate for Payer: Healthscope Whirlpool |
$375.20
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.30
|
| Rate for Payer: PACE SWMI |
$312.67
|
| Rate for Payer: PHP Medicare Advantage |
$312.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.86
|
| Rate for Payer: Priority Health Medicare |
$312.67
|
| Rate for Payer: Priority Health Narrow Network |
$496.86
|
| Rate for Payer: UHC Medicare Advantage |
$322.05
|
|
|
PR CLTX PROX TIBFIB JT DISLC REQ ANES
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 27831
|
| Min. Negotiated Rate |
$133.15 |
| Max. Negotiated Rate |
$636.78 |
| Rate for Payer: Aetna Commercial |
$542.08
|
| Rate for Payer: Aetna Medicare |
$404.54
|
| Rate for Payer: BCBS Complete |
$282.92
|
| Rate for Payer: BCBS MAPPO |
$404.54
|
| Rate for Payer: BCBS Trust/PPO |
$133.15
|
| Rate for Payer: BCN Commercial |
$609.38
|
| Rate for Payer: BCN Medicare Advantage |
$404.54
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$582.54
|
| Rate for Payer: Cofinity Commercial |
$542.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.54
|
| Rate for Payer: Healthscope Commercial |
$485.45
|
| Rate for Payer: Healthscope Whirlpool |
$485.45
|
| Rate for Payer: Meridian Medicaid |
$282.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$424.77
|
| Rate for Payer: PACE SWMI |
$404.54
|
| Rate for Payer: PHP Medicare Advantage |
$404.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$636.78
|
| Rate for Payer: Priority Health Medicare |
$404.54
|
| Rate for Payer: Priority Health Narrow Network |
$636.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.68
|
|
|
PR CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ
|
Professional
|
Both
|
$704.00
|
|
|
Service Code
|
HCPCS 25660
|
| Min. Negotiated Rate |
$296.71 |
| Max. Negotiated Rate |
$1,828.45 |
| Rate for Payer: Aetna Commercial |
$595.17
|
| Rate for Payer: Aetna Medicare |
$444.16
|
| Rate for Payer: BCBS Complete |
$311.55
|
| Rate for Payer: BCBS MAPPO |
$444.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,828.45
|
| Rate for Payer: BCN Commercial |
$670.47
|
| Rate for Payer: BCN Medicare Advantage |
$444.16
|
| Rate for Payer: Cash Price |
$563.20
|
| Rate for Payer: Cash Price |
$563.20
|
| Rate for Payer: Cofinity Commercial |
$639.59
|
| Rate for Payer: Cofinity Commercial |
$595.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.16
|
| Rate for Payer: Healthscope Commercial |
$532.99
|
| Rate for Payer: Healthscope Whirlpool |
$532.99
|
| Rate for Payer: Meridian Medicaid |
$311.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$466.37
|
| Rate for Payer: PACE SWMI |
$444.16
|
| Rate for Payer: PHP Medicare Advantage |
$444.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.61
|
| Rate for Payer: Priority Health Medicare |
$444.16
|
| Rate for Payer: Priority Health Narrow Network |
$700.61
|
| Rate for Payer: UHC Medicare Advantage |
$457.48
|
|
|
PR CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 24640
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$890.19 |
| Rate for Payer: Aetna Commercial |
$104.67
|
| Rate for Payer: Aetna Medicare |
$78.11
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$78.11
|
| Rate for Payer: BCBS Trust/PPO |
$890.19
|
| Rate for Payer: BCN Commercial |
$152.96
|
| Rate for Payer: BCN Medicare Advantage |
$78.11
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$112.48
|
| Rate for Payer: Cofinity Commercial |
$104.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.11
|
| Rate for Payer: Healthscope Commercial |
$93.73
|
| Rate for Payer: Healthscope Whirlpool |
$93.73
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.02
|
| Rate for Payer: PACE SWMI |
$78.11
|
| Rate for Payer: PHP Medicare Advantage |
$78.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.04
|
| Rate for Payer: Priority Health Medicare |
$78.11
|
| Rate for Payer: Priority Health Narrow Network |
$122.04
|
| Rate for Payer: UHC Medicare Advantage |
$80.45
|
|
|
PR CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT
|
Professional
|
Both
|
$1,474.00
|
|
|
Service Code
|
HCPCS 25520
|
| Min. Negotiated Rate |
$358.69 |
| Max. Negotiated Rate |
$1,412.15 |
| Rate for Payer: Aetna Commercial |
$723.12
|
| Rate for Payer: Aetna Medicare |
$539.64
|
| Rate for Payer: BCBS Complete |
$376.62
|
| Rate for Payer: BCBS MAPPO |
$539.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,412.15
|
| Rate for Payer: BCN Commercial |
$862.03
|
| Rate for Payer: BCN Medicare Advantage |
$539.64
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$777.08
|
| Rate for Payer: Cofinity Commercial |
$723.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.64
|
| Rate for Payer: Healthscope Commercial |
$647.57
|
| Rate for Payer: Healthscope Whirlpool |
$647.57
|
| Rate for Payer: Meridian Medicaid |
$376.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$566.62
|
| Rate for Payer: PACE SWMI |
$539.64
|
| Rate for Payer: PHP Medicare Advantage |
$539.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$848.20
|
| Rate for Payer: Priority Health Medicare |
$539.64
|
| Rate for Payer: Priority Health Narrow Network |
$848.20
|
| Rate for Payer: UHC Medicare Advantage |
$555.83
|
|
|
PR CLTX SCAPULAR FX W/MNPJ W/WO SKELETAL TRACTION
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 23575
|
| Min. Negotiated Rate |
$192.30 |
| Max. Negotiated Rate |
$707.70 |
| Rate for Payer: Aetna Commercial |
$504.08
|
| Rate for Payer: Aetna Medicare |
$376.18
|
| Rate for Payer: BCBS Complete |
$264.36
|
| Rate for Payer: BCBS MAPPO |
$376.18
|
| Rate for Payer: BCBS Trust/PPO |
$192.30
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: BCN Medicare Advantage |
$376.18
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cofinity Commercial |
$504.08
|
| Rate for Payer: Cofinity Commercial |
$541.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.18
|
| Rate for Payer: Healthscope Commercial |
$451.42
|
| Rate for Payer: Healthscope Whirlpool |
$451.42
|
| Rate for Payer: Meridian Medicaid |
$264.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$394.99
|
| Rate for Payer: PACE SWMI |
$376.18
|
| Rate for Payer: PHP Medicare Advantage |
$376.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$593.38
|
| Rate for Payer: Priority Health Medicare |
$376.18
|
| Rate for Payer: Priority Health Narrow Network |
$593.38
|
| Rate for Payer: UHC Medicare Advantage |
$387.47
|
|
|
PR CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 23665
|
| Min. Negotiated Rate |
$159.61 |
| Max. Negotiated Rate |
$942.20 |
| Rate for Payer: Aetna Commercial |
$531.16
|
| Rate for Payer: Aetna Medicare |
$396.39
|
| Rate for Payer: BCBS Complete |
$278.67
|
| Rate for Payer: BCBS MAPPO |
$396.39
|
| Rate for Payer: BCBS Trust/PPO |
$159.61
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: BCN Medicare Advantage |
$396.39
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$570.80
|
| Rate for Payer: Cofinity Commercial |
$531.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.39
|
| Rate for Payer: Healthscope Commercial |
$475.67
|
| Rate for Payer: Healthscope Whirlpool |
$475.67
|
| Rate for Payer: Meridian Medicaid |
$278.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.21
|
| Rate for Payer: PACE SWMI |
$396.39
|
| Rate for Payer: PHP Medicare Advantage |
$396.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.01
|
| Rate for Payer: Priority Health Medicare |
$396.39
|
| Rate for Payer: Priority Health Narrow Network |
$624.01
|
| Rate for Payer: UHC Medicare Advantage |
$408.28
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 24535
|
| Min. Negotiated Rate |
$376.58 |
| Max. Negotiated Rate |
$1,125.60 |
| Rate for Payer: Aetna Commercial |
$757.70
|
| Rate for Payer: Aetna Medicare |
$565.45
|
| Rate for Payer: BCBS Complete |
$395.41
|
| Rate for Payer: BCBS MAPPO |
$565.45
|
| Rate for Payer: BCBS Trust/PPO |
$605.96
|
| Rate for Payer: BCN Commercial |
$925.06
|
| Rate for Payer: BCN Medicare Advantage |
$565.45
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$814.25
|
| Rate for Payer: Cofinity Commercial |
$757.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.45
|
| Rate for Payer: Healthscope Commercial |
$678.54
|
| Rate for Payer: Healthscope Whirlpool |
$678.54
|
| Rate for Payer: Meridian Medicaid |
$395.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$593.72
|
| Rate for Payer: PACE SWMI |
$565.45
|
| Rate for Payer: PHP Medicare Advantage |
$565.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$887.00
|
| Rate for Payer: Priority Health Medicare |
$565.45
|
| Rate for Payer: Priority Health Narrow Network |
$887.00
|
| Rate for Payer: UHC Medicare Advantage |
$582.41
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 24530
|
| Min. Negotiated Rate |
$234.09 |
| Max. Negotiated Rate |
$578.90 |
| Rate for Payer: Aetna Commercial |
$467.49
|
| Rate for Payer: Aetna Medicare |
$348.87
|
| Rate for Payer: BCBS Complete |
$245.79
|
| Rate for Payer: BCBS MAPPO |
$348.87
|
| Rate for Payer: BCBS Trust/PPO |
$472.30
|
| Rate for Payer: BCN Commercial |
$576.64
|
| Rate for Payer: BCN Medicare Advantage |
$348.87
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$502.37
|
| Rate for Payer: Cofinity Commercial |
$467.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.87
|
| Rate for Payer: Healthscope Commercial |
$418.64
|
| Rate for Payer: Healthscope Whirlpool |
$418.64
|
| Rate for Payer: Meridian Medicaid |
$245.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$366.31
|
| Rate for Payer: PACE SWMI |
$348.87
|
| Rate for Payer: PHP Medicare Advantage |
$348.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$552.01
|
| Rate for Payer: Priority Health Medicare |
$348.87
|
| Rate for Payer: Priority Health Narrow Network |
$552.01
|
| Rate for Payer: UHC Medicare Advantage |
$359.34
|
|
|
PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ
|
Professional
|
Both
|
$2,156.00
|
|
|
Service Code
|
HCPCS 27503
|
| Min. Negotiated Rate |
$516.95 |
| Max. Negotiated Rate |
$1,509.20 |
| Rate for Payer: Aetna Commercial |
$1,061.66
|
| Rate for Payer: Aetna Medicare |
$792.28
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$792.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$1,180.15
|
| Rate for Payer: BCN Medicare Advantage |
$792.28
|
| Rate for Payer: Cash Price |
$1,724.80
|
| Rate for Payer: Cash Price |
$1,724.80
|
| Rate for Payer: Cofinity Commercial |
$1,061.66
|
| Rate for Payer: Cofinity Commercial |
$1,140.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.28
|
| Rate for Payer: Healthscope Commercial |
$950.74
|
| Rate for Payer: Healthscope Whirlpool |
$950.74
|
| Rate for Payer: Meridian Medicaid |
$542.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$831.89
|
| Rate for Payer: PACE SWMI |
$792.28
|
| Rate for Payer: PHP Medicare Advantage |
$792.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.23
|
| Rate for Payer: Priority Health Medicare |
$792.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.23
|
| Rate for Payer: UHC Medicare Advantage |
$816.05
|
|
|
PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ
|
Professional
|
Both
|
$1,545.00
|
|
|
Service Code
|
HCPCS 27501
|
| Min. Negotiated Rate |
$324.83 |
| Max. Negotiated Rate |
$3,213.12 |
| Rate for Payer: Aetna Commercial |
$660.31
|
| Rate for Payer: Aetna Medicare |
$492.77
|
| Rate for Payer: BCBS Complete |
$341.07
|
| Rate for Payer: BCBS MAPPO |
$492.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,213.12
|
| Rate for Payer: BCN Commercial |
$750.61
|
| Rate for Payer: BCN Medicare Advantage |
$492.77
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cofinity Commercial |
$709.59
|
| Rate for Payer: Cofinity Commercial |
$660.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.77
|
| Rate for Payer: Healthscope Commercial |
$591.32
|
| Rate for Payer: Healthscope Whirlpool |
$591.32
|
| Rate for Payer: Meridian Medicaid |
$341.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$517.41
|
| Rate for Payer: PACE SWMI |
$492.77
|
| Rate for Payer: PHP Medicare Advantage |
$492.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.09
|
| Rate for Payer: Priority Health Medicare |
$492.77
|
| Rate for Payer: Priority Health Narrow Network |
$771.09
|
| Rate for Payer: UHC Medicare Advantage |
$507.55
|
|
|
PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES
|
Professional
|
Both
|
$696.00
|
|
|
Service Code
|
HCPCS 28545
|
| Min. Negotiated Rate |
$179.77 |
| Max. Negotiated Rate |
$656.68 |
| Rate for Payer: Aetna Commercial |
$357.42
|
| Rate for Payer: Aetna Medicare |
$266.73
|
| Rate for Payer: BCBS Complete |
$188.76
|
| Rate for Payer: BCBS MAPPO |
$266.73
|
| Rate for Payer: BCBS Trust/PPO |
$656.68
|
| Rate for Payer: BCN Commercial |
$462.78
|
| Rate for Payer: BCN Medicare Advantage |
$266.73
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cofinity Commercial |
$384.09
|
| Rate for Payer: Cofinity Commercial |
$357.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.73
|
| Rate for Payer: Healthscope Commercial |
$320.08
|
| Rate for Payer: Healthscope Whirlpool |
$320.08
|
| Rate for Payer: Meridian Medicaid |
$188.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$280.07
|
| Rate for Payer: PACE SWMI |
$266.73
|
| Rate for Payer: PHP Medicare Advantage |
$266.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.32
|
| Rate for Payer: Priority Health Medicare |
$266.73
|
| Rate for Payer: Priority Health Narrow Network |
$423.32
|
| Rate for Payer: UHC Medicare Advantage |
$274.73
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 27530
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$1,234.64 |
| Rate for Payer: Aetna Commercial |
$382.70
|
| Rate for Payer: Aetna Medicare |
$285.60
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS MAPPO |
$285.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.64
|
| Rate for Payer: BCN Commercial |
$463.27
|
| Rate for Payer: BCN Medicare Advantage |
$285.60
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$411.26
|
| Rate for Payer: Cofinity Commercial |
$382.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$342.72
|
| Rate for Payer: Healthscope Whirlpool |
$342.72
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.88
|
| Rate for Payer: PACE SWMI |
$285.60
|
| Rate for Payer: PHP Medicare Advantage |
$285.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.48
|
| Rate for Payer: Priority Health Medicare |
$285.60
|
| Rate for Payer: Priority Health Narrow Network |
$454.48
|
| Rate for Payer: UHC Medicare Advantage |
$294.17
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27532
|
| Min. Negotiated Rate |
$378.71 |
| Max. Negotiated Rate |
$936.15 |
| Rate for Payer: Aetna Commercial |
$767.82
|
| Rate for Payer: Aetna Medicare |
$573.00
|
| Rate for Payer: BCBS Complete |
$397.65
|
| Rate for Payer: BCBS MAPPO |
$573.00
|
| Rate for Payer: BCBS Trust/PPO |
$936.15
|
| Rate for Payer: BCN Commercial |
$920.67
|
| Rate for Payer: BCN Medicare Advantage |
$573.00
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$825.12
|
| Rate for Payer: Cofinity Commercial |
$767.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.00
|
| Rate for Payer: Healthscope Commercial |
$687.60
|
| Rate for Payer: Healthscope Whirlpool |
$687.60
|
| Rate for Payer: Meridian Medicaid |
$397.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$601.65
|
| Rate for Payer: PACE SWMI |
$573.00
|
| Rate for Payer: PHP Medicare Advantage |
$573.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.19
|
| Rate for Payer: Priority Health Medicare |
$573.00
|
| Rate for Payer: Priority Health Narrow Network |
$896.19
|
| Rate for Payer: UHC Medicare Advantage |
$590.19
|
|
|
PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,758.00
|
|
|
Service Code
|
HCPCS 27752
|
| Min. Negotiated Rate |
$321.63 |
| Max. Negotiated Rate |
$3,450.64 |
| Rate for Payer: Aetna Commercial |
$653.22
|
| Rate for Payer: Aetna Medicare |
$487.48
|
| Rate for Payer: BCBS Complete |
$337.71
|
| Rate for Payer: BCBS MAPPO |
$487.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,450.64
|
| Rate for Payer: BCN Commercial |
$799.48
|
| Rate for Payer: BCN Medicare Advantage |
$487.48
|
| Rate for Payer: Cash Price |
$1,406.40
|
| Rate for Payer: Cash Price |
$1,406.40
|
| Rate for Payer: Cofinity Commercial |
$653.22
|
| Rate for Payer: Cofinity Commercial |
$701.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.48
|
| Rate for Payer: Healthscope Commercial |
$584.98
|
| Rate for Payer: Healthscope Whirlpool |
$584.98
|
| Rate for Payer: Meridian Medicaid |
$337.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$511.85
|
| Rate for Payer: PACE SWMI |
$487.48
|
| Rate for Payer: PHP Medicare Advantage |
$487.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.42
|
| Rate for Payer: Priority Health Medicare |
$487.48
|
| Rate for Payer: Priority Health Narrow Network |
$763.42
|
| Rate for Payer: UHC Medicare Advantage |
$502.10
|
|
|
PR CLTX TIBIAL SHAFT FX W/O MANIPULATION
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 27750
|
| Min. Negotiated Rate |
$215.13 |
| Max. Negotiated Rate |
$632.10 |
| Rate for Payer: Aetna Commercial |
$428.85
|
| Rate for Payer: Aetna Medicare |
$320.04
|
| Rate for Payer: BCBS Complete |
$225.89
|
| Rate for Payer: BCBS MAPPO |
$320.04
|
| Rate for Payer: BCBS Trust/PPO |
$565.81
|
| Rate for Payer: BCN Commercial |
$522.39
|
| Rate for Payer: BCN Medicare Advantage |
$320.04
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$460.86
|
| Rate for Payer: Cofinity Commercial |
$428.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.04
|
| Rate for Payer: Healthscope Commercial |
$384.05
|
| Rate for Payer: Healthscope Whirlpool |
$384.05
|
| Rate for Payer: Meridian Medicaid |
$225.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$336.04
|
| Rate for Payer: PACE SWMI |
$320.04
|
| Rate for Payer: PHP Medicare Advantage |
$320.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.56
|
| Rate for Payer: Priority Health Medicare |
$320.04
|
| Rate for Payer: Priority Health Narrow Network |
$506.56
|
| Rate for Payer: UHC Medicare Advantage |
$329.64
|
|
|
PR CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ
|
Professional
|
Both
|
$876.00
|
|
|
Service Code
|
HCPCS 25680
|
| Min. Negotiated Rate |
$348.68 |
| Max. Negotiated Rate |
$1,480.30 |
| Rate for Payer: Aetna Commercial |
$703.11
|
| Rate for Payer: Aetna Medicare |
$524.71
|
| Rate for Payer: BCBS Complete |
$366.11
|
| Rate for Payer: BCBS MAPPO |
$524.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
| Rate for Payer: BCN Commercial |
$789.70
|
| Rate for Payer: BCN Medicare Advantage |
$524.71
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cofinity Commercial |
$755.58
|
| Rate for Payer: Cofinity Commercial |
$703.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.71
|
| Rate for Payer: Healthscope Commercial |
$629.65
|
| Rate for Payer: Healthscope Whirlpool |
$629.65
|
| Rate for Payer: Meridian Medicaid |
$366.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$550.95
|
| Rate for Payer: PACE SWMI |
$524.71
|
| Rate for Payer: PHP Medicare Advantage |
$524.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.21
|
| Rate for Payer: Priority Health Medicare |
$524.71
|
| Rate for Payer: Priority Health Narrow Network |
$825.21
|
| Rate for Payer: UHC Medicare Advantage |
$540.45
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION
|
Professional
|
Both
|
$1,663.00
|
|
|
Service Code
|
HCPCS 27818
|
| Min. Negotiated Rate |
$290.32 |
| Max. Negotiated Rate |
$3,352.06 |
| Rate for Payer: Aetna Commercial |
$587.03
|
| Rate for Payer: Aetna Medicare |
$438.08
|
| Rate for Payer: BCBS Complete |
$304.84
|
| Rate for Payer: BCBS MAPPO |
$438.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,352.06
|
| Rate for Payer: BCN Commercial |
$736.44
|
| Rate for Payer: BCN Medicare Advantage |
$438.08
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cofinity Commercial |
$587.03
|
| Rate for Payer: Cofinity Commercial |
$630.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.08
|
| Rate for Payer: Healthscope Commercial |
$525.70
|
| Rate for Payer: Healthscope Whirlpool |
$525.70
|
| Rate for Payer: Meridian Medicaid |
$304.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$459.98
|
| Rate for Payer: PACE SWMI |
$438.08
|
| Rate for Payer: PHP Medicare Advantage |
$438.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.81
|
| Rate for Payer: Priority Health Medicare |
$438.08
|
| Rate for Payer: Priority Health Narrow Network |
$685.81
|
| Rate for Payer: UHC Medicare Advantage |
$451.22
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 27816
|
| Min. Negotiated Rate |
$196.17 |
| Max. Negotiated Rate |
$2,170.78 |
| Rate for Payer: Aetna Commercial |
$389.89
|
| Rate for Payer: Aetna Medicare |
$290.96
|
| Rate for Payer: BCBS Complete |
$205.98
|
| Rate for Payer: BCBS MAPPO |
$290.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.78
|
| Rate for Payer: BCN Commercial |
$496.49
|
| Rate for Payer: BCN Medicare Advantage |
$290.96
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$389.89
|
| Rate for Payer: Cofinity Commercial |
$418.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.96
|
| Rate for Payer: Healthscope Commercial |
$349.15
|
| Rate for Payer: Healthscope Whirlpool |
$349.15
|
| Rate for Payer: Meridian Medicaid |
$205.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$305.51
|
| Rate for Payer: PACE SWMI |
$290.96
|
| Rate for Payer: PHP Medicare Advantage |
$290.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.60
|
| Rate for Payer: Priority Health Medicare |
$290.96
|
| Rate for Payer: Priority Health Narrow Network |
$460.60
|
| Rate for Payer: UHC Medicare Advantage |
$299.69
|
|
|
PR CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 22310
|
| Min. Negotiated Rate |
$193.83 |
| Max. Negotiated Rate |
$613.90 |
| Rate for Payer: Aetna Commercial |
$391.45
|
| Rate for Payer: Aetna Medicare |
$292.13
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$292.13
|
| Rate for Payer: BCBS Trust/PPO |
$368.43
|
| Rate for Payer: BCN Commercial |
$459.85
|
| Rate for Payer: BCN Medicare Advantage |
$292.13
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$391.45
|
| Rate for Payer: Cofinity Commercial |
$420.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.13
|
| Rate for Payer: Healthscope Commercial |
$350.56
|
| Rate for Payer: Healthscope Whirlpool |
$350.56
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$306.74
|
| Rate for Payer: PACE SWMI |
$292.13
|
| Rate for Payer: PHP Medicare Advantage |
$292.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$459.08
|
| Rate for Payer: Priority Health Medicare |
$292.13
|
| Rate for Payer: Priority Health Narrow Network |
$459.08
|
| Rate for Payer: UHC Medicare Advantage |
$300.89
|
|
|
PR CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ
|
Professional
|
Both
|
$1,276.00
|
|
|
Service Code
|
HCPCS 22315
|
| Min. Negotiated Rate |
$368.43 |
| Max. Negotiated Rate |
$1,305.75 |
| Rate for Payer: Aetna Commercial |
$1,020.74
|
| Rate for Payer: Aetna Medicare |
$761.75
|
| Rate for Payer: BCBS Complete |
$530.05
|
| Rate for Payer: BCBS MAPPO |
$761.75
|
| Rate for Payer: BCBS Trust/PPO |
$368.43
|
| Rate for Payer: BCN Commercial |
$1,305.75
|
| Rate for Payer: BCN Medicare Advantage |
$761.75
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cofinity Commercial |
$1,096.92
|
| Rate for Payer: Cofinity Commercial |
$1,020.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.75
|
| Rate for Payer: Healthscope Commercial |
$914.10
|
| Rate for Payer: Healthscope Whirlpool |
$914.10
|
| Rate for Payer: Meridian Medicaid |
$530.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$799.84
|
| Rate for Payer: PACE SWMI |
$761.75
|
| Rate for Payer: PHP Medicare Advantage |
$761.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$893.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,187.78
|
| Rate for Payer: Priority Health Medicare |
$761.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,187.78
|
| Rate for Payer: UHC Medicare Advantage |
$784.60
|
|
|
PR CMBND ANTERPOST COLPORRAPHY W/CYSTO
|
Professional
|
Both
|
$1,989.00
|
|
|
Service Code
|
HCPCS 57260
|
| Min. Negotiated Rate |
$499.91 |
| Max. Negotiated Rate |
$1,612.37 |
| Rate for Payer: Aetna Commercial |
$1,035.55
|
| Rate for Payer: Aetna Medicare |
$772.80
|
| Rate for Payer: BCBS Complete |
$524.91
|
| Rate for Payer: BCBS MAPPO |
$772.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$1,141.55
|
| Rate for Payer: BCN Medicare Advantage |
$772.80
|
| Rate for Payer: Cash Price |
$1,591.20
|
| Rate for Payer: Cash Price |
$1,591.20
|
| Rate for Payer: Cofinity Commercial |
$1,035.55
|
| Rate for Payer: Cofinity Commercial |
$1,112.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.80
|
| Rate for Payer: Healthscope Commercial |
$927.36
|
| Rate for Payer: Healthscope Whirlpool |
$927.36
|
| Rate for Payer: Meridian Medicaid |
$524.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$811.44
|
| Rate for Payer: PACE SWMI |
$772.80
|
| Rate for Payer: PHP Medicare Advantage |
$772.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,105.91
|
| Rate for Payer: Priority Health Medicare |
$772.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,105.91
|
| Rate for Payer: UHC Medicare Advantage |
$795.98
|
|
