PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$2,946.00
|
|
Service Code
|
HCPCS 27814
|
Min. Negotiated Rate |
$493.95 |
Max. Negotiated Rate |
$2,062.20 |
Rate for Payer: Aetna Commercial |
$1,010.25
|
Rate for Payer: Aetna Medicare |
$753.92
|
Rate for Payer: BCBS Complete |
$518.65
|
Rate for Payer: BCBS MAPPO |
$753.92
|
Rate for Payer: BCBS Trust/PPO |
$761.81
|
Rate for Payer: BCN Commercial |
$1,124.94
|
Rate for Payer: BCN Medicare Advantage |
$753.92
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cofinity Commercial |
$1,085.64
|
Rate for Payer: Cofinity Commercial |
$1,010.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.92
|
Rate for Payer: Healthscope Commercial |
$904.70
|
Rate for Payer: Healthscope Whirlpool |
$904.70
|
Rate for Payer: Meridian Medicaid |
$518.65
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$791.62
|
Rate for Payer: PACE SWMI |
$753.92
|
Rate for Payer: PHP Medicare Advantage |
$753.92
|
Rate for Payer: Priority Health Choice Medicaid |
$493.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.51
|
Rate for Payer: Priority Health Medicare |
$753.92
|
Rate for Payer: Priority Health Narrow Network |
$1,175.51
|
Rate for Payer: UHC Medicare Advantage |
$776.54
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
OP
|
$2,946.00
|
|
Service Code
|
CPT 27814
|
Hospital Charge Code |
27814
|
Min. Negotiated Rate |
$2,062.20 |
Max. Negotiated Rate |
$7,948.86 |
Rate for Payer: Aetna Commercial |
$2,651.40
|
Rate for Payer: Aetna Medicare |
$6,359.09
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
Rate for Payer: ASR ASR |
$2,857.62
|
Rate for Payer: BCBS Complete |
$3,652.66
|
Rate for Payer: BCBS MAPPO |
$6,359.09
|
Rate for Payer: BCBS Trust/PPO |
$2,284.03
|
Rate for Payer: BCN Commercial |
$2,284.03
|
Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cofinity Commercial |
$2,769.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,356.80
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
Rate for Payer: Healthscope Commercial |
$2,946.00
|
Rate for Payer: Healthscope Whirlpool |
$2,857.62
|
Rate for Payer: Humana Choice PPO Medicare |
$6,359.09
|
Rate for Payer: Mclaren Commercial |
$2,651.40
|
Rate for Payer: Mclaren Medicaid |
$3,478.42
|
Rate for Payer: Mclaren Medicare |
$6,359.09
|
Rate for Payer: Meridian Medicaid |
$3,652.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,504.10
|
Rate for Payer: PACE Medicare |
$6,041.14
|
Rate for Payer: PACE SWMI |
$6,359.09
|
Rate for Payer: PHP Commercial |
$6,995.00
|
Rate for Payer: PHP Medicaid |
$3,478.42
|
Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,680.86
|
Rate for Payer: Priority Health Medicare |
$6,359.09
|
Rate for Payer: Priority Health Narrow Network |
$2,091.66
|
Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,592.48
|
Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
Rate for Payer: VA VA |
$6,359.09
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Facility
|
IP
|
$2,946.00
|
|
Service Code
|
CPT 27814
|
Hospital Charge Code |
27814
|
Min. Negotiated Rate |
$2,062.20 |
Max. Negotiated Rate |
$2,946.00 |
Rate for Payer: Aetna Commercial |
$2,651.40
|
Rate for Payer: ASR ASR |
$2,857.62
|
Rate for Payer: BCBS Trust/PPO |
$2,284.03
|
Rate for Payer: BCN Commercial |
$2,284.03
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cofinity Commercial |
$2,769.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,356.80
|
Rate for Payer: Healthscope Commercial |
$2,946.00
|
Rate for Payer: Healthscope Whirlpool |
$2,857.62
|
Rate for Payer: Mclaren Commercial |
$2,651.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,504.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,592.48
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
Both
|
$2,946.00
|
|
Service Code
|
HCPCS 27814
|
Hospital Charge Code |
27814
|
Min. Negotiated Rate |
$493.95 |
Max. Negotiated Rate |
$2,062.20 |
Rate for Payer: Aetna Commercial |
$1,010.25
|
Rate for Payer: Aetna Medicare |
$753.92
|
Rate for Payer: BCBS Complete |
$518.65
|
Rate for Payer: BCBS MAPPO |
$753.92
|
Rate for Payer: BCBS Trust/PPO |
$761.81
|
Rate for Payer: BCN Commercial |
$1,124.94
|
Rate for Payer: BCN Medicare Advantage |
$753.92
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cash Price |
$2,356.80
|
Rate for Payer: Cofinity Commercial |
$1,085.64
|
Rate for Payer: Cofinity Commercial |
$1,010.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.92
|
Rate for Payer: Healthscope Commercial |
$904.70
|
Rate for Payer: Healthscope Whirlpool |
$904.70
|
Rate for Payer: Meridian Medicaid |
$518.65
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$791.62
|
Rate for Payer: PACE SWMI |
$753.92
|
Rate for Payer: PHP Medicare Advantage |
$753.92
|
Rate for Payer: Priority Health Choice Medicaid |
$493.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,062.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.51
|
Rate for Payer: Priority Health Medicare |
$753.92
|
Rate for Payer: Priority Health Narrow Network |
$1,175.51
|
Rate for Payer: UHC Medicare Advantage |
$776.54
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,300.00
|
|
Service Code
|
HCPCS 28415
|
Min. Negotiated Rate |
$721.43 |
Max. Negotiated Rate |
$2,310.00 |
Rate for Payer: Aetna Commercial |
$1,481.02
|
Rate for Payer: Aetna Medicare |
$1,105.24
|
Rate for Payer: BCBS Complete |
$757.50
|
Rate for Payer: BCBS MAPPO |
$1,105.24
|
Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
Rate for Payer: BCN Commercial |
$1,648.79
|
Rate for Payer: BCN Medicare Advantage |
$1,105.24
|
Rate for Payer: Cash Price |
$2,640.00
|
Rate for Payer: Cash Price |
$2,640.00
|
Rate for Payer: Cofinity Commercial |
$1,481.02
|
Rate for Payer: Cofinity Commercial |
$1,591.55
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.24
|
Rate for Payer: Healthscope Commercial |
$1,326.29
|
Rate for Payer: Healthscope Whirlpool |
$1,326.29
|
Rate for Payer: Meridian Medicaid |
$757.50
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,160.50
|
Rate for Payer: PACE SWMI |
$1,105.24
|
Rate for Payer: PHP Medicare Advantage |
$1,105.24
|
Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,310.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,722.93
|
Rate for Payer: Priority Health Medicare |
$1,105.24
|
Rate for Payer: Priority Health Narrow Network |
$1,722.93
|
Rate for Payer: UHC Medicare Advantage |
$1,138.40
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,180.00
|
|
Service Code
|
HCPCS 28420
|
Min. Negotiated Rate |
$372.45 |
Max. Negotiated Rate |
$1,990.51 |
Rate for Payer: Aetna Commercial |
$1,709.68
|
Rate for Payer: Aetna Medicare |
$1,275.88
|
Rate for Payer: BCBS Complete |
$876.71
|
Rate for Payer: BCBS MAPPO |
$1,275.88
|
Rate for Payer: BCBS Trust/PPO |
$372.45
|
Rate for Payer: BCN Commercial |
$1,904.86
|
Rate for Payer: BCN Medicare Advantage |
$1,275.88
|
Rate for Payer: Cash Price |
$1,744.00
|
Rate for Payer: Cash Price |
$1,744.00
|
Rate for Payer: Cofinity Commercial |
$1,837.27
|
Rate for Payer: Cofinity Commercial |
$1,709.68
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.88
|
Rate for Payer: Healthscope Commercial |
$1,531.06
|
Rate for Payer: Healthscope Whirlpool |
$1,531.06
|
Rate for Payer: Meridian Medicaid |
$876.71
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,339.67
|
Rate for Payer: PACE SWMI |
$1,275.88
|
Rate for Payer: PHP Medicare Advantage |
$1,275.88
|
Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,526.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,990.51
|
Rate for Payer: Priority Health Medicare |
$1,275.88
|
Rate for Payer: Priority Health Narrow Network |
$1,990.51
|
Rate for Payer: UHC Medicare Advantage |
$1,314.16
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,513.00
|
|
Service Code
|
HCPCS 27828
|
Min. Negotiated Rate |
$853.07 |
Max. Negotiated Rate |
$3,159.10 |
Rate for Payer: Aetna Commercial |
$1,750.55
|
Rate for Payer: Aetna Medicare |
$1,306.38
|
Rate for Payer: BCBS Complete |
$895.72
|
Rate for Payer: BCBS MAPPO |
$1,306.38
|
Rate for Payer: BCBS Trust/PPO |
$1,308.07
|
Rate for Payer: BCN Commercial |
$1,948.36
|
Rate for Payer: BCN Medicare Advantage |
$1,306.38
|
Rate for Payer: Cash Price |
$3,610.40
|
Rate for Payer: Cash Price |
$3,610.40
|
Rate for Payer: Cofinity Commercial |
$1,750.55
|
Rate for Payer: Cofinity Commercial |
$1,881.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.38
|
Rate for Payer: Healthscope Commercial |
$1,567.66
|
Rate for Payer: Healthscope Whirlpool |
$1,567.66
|
Rate for Payer: Meridian Medicaid |
$895.72
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.70
|
Rate for Payer: PACE SWMI |
$1,306.38
|
Rate for Payer: PHP Medicare Advantage |
$1,306.38
|
Rate for Payer: Priority Health Choice Medicaid |
$853.07
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,159.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,035.96
|
Rate for Payer: Priority Health Medicare |
$1,306.38
|
Rate for Payer: Priority Health Narrow Network |
$2,035.96
|
Rate for Payer: UHC Medicare Advantage |
$1,345.57
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,040.00
|
|
Service Code
|
HCPCS 27826
|
Min. Negotiated Rate |
$551.24 |
Max. Negotiated Rate |
$3,384.29 |
Rate for Payer: Aetna Commercial |
$1,124.72
|
Rate for Payer: Aetna Medicare |
$839.34
|
Rate for Payer: BCBS Complete |
$578.80
|
Rate for Payer: BCBS MAPPO |
$839.34
|
Rate for Payer: BCBS Trust/PPO |
$3,384.29
|
Rate for Payer: BCN Commercial |
$1,257.85
|
Rate for Payer: BCN Medicare Advantage |
$839.34
|
Rate for Payer: Cash Price |
$2,432.00
|
Rate for Payer: Cash Price |
$2,432.00
|
Rate for Payer: Cofinity Commercial |
$1,208.65
|
Rate for Payer: Cofinity Commercial |
$1,124.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$839.34
|
Rate for Payer: Healthscope Commercial |
$1,007.21
|
Rate for Payer: Healthscope Whirlpool |
$1,007.21
|
Rate for Payer: Meridian Medicaid |
$578.80
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$881.31
|
Rate for Payer: PACE SWMI |
$839.34
|
Rate for Payer: PHP Medicare Advantage |
$839.34
|
Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,128.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.42
|
Rate for Payer: Priority Health Medicare |
$839.34
|
Rate for Payer: Priority Health Narrow Network |
$1,314.42
|
Rate for Payer: UHC Medicare Advantage |
$864.52
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,276.00
|
|
Service Code
|
HCPCS 27827
|
Min. Negotiated Rate |
$721.86 |
Max. Negotiated Rate |
$3,897.80 |
Rate for Payer: Aetna Commercial |
$1,476.12
|
Rate for Payer: Aetna Medicare |
$1,101.58
|
Rate for Payer: BCBS Complete |
$757.95
|
Rate for Payer: BCBS MAPPO |
$1,101.58
|
Rate for Payer: BCBS Trust/PPO |
$3,897.80
|
Rate for Payer: BCN Commercial |
$1,647.82
|
Rate for Payer: BCN Medicare Advantage |
$1,101.58
|
Rate for Payer: Cash Price |
$3,420.80
|
Rate for Payer: Cash Price |
$3,420.80
|
Rate for Payer: Cofinity Commercial |
$1,586.28
|
Rate for Payer: Cofinity Commercial |
$1,476.12
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.58
|
Rate for Payer: Healthscope Commercial |
$1,321.90
|
Rate for Payer: Healthscope Whirlpool |
$1,321.90
|
Rate for Payer: Meridian Medicaid |
$757.95
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,156.66
|
Rate for Payer: PACE SWMI |
$1,101.58
|
Rate for Payer: PHP Medicare Advantage |
$1,101.58
|
Rate for Payer: Priority Health Choice Medicaid |
$721.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,993.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.92
|
Rate for Payer: Priority Health Medicare |
$1,101.58
|
Rate for Payer: Priority Health Narrow Network |
$1,721.92
|
Rate for Payer: UHC Medicare Advantage |
$1,134.63
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$1,976.00
|
|
Service Code
|
HCPCS 27248
|
Min. Negotiated Rate |
$480.10 |
Max. Negotiated Rate |
$2,101.58 |
Rate for Payer: Aetna Commercial |
$985.89
|
Rate for Payer: Aetna Medicare |
$735.74
|
Rate for Payer: BCBS Complete |
$504.10
|
Rate for Payer: BCBS MAPPO |
$735.74
|
Rate for Payer: BCBS Trust/PPO |
$2,101.58
|
Rate for Payer: BCN Commercial |
$1,094.15
|
Rate for Payer: BCN Medicare Advantage |
$735.74
|
Rate for Payer: Cash Price |
$1,580.80
|
Rate for Payer: Cash Price |
$1,580.80
|
Rate for Payer: Cofinity Commercial |
$985.89
|
Rate for Payer: Cofinity Commercial |
$1,059.47
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.74
|
Rate for Payer: Healthscope Commercial |
$882.89
|
Rate for Payer: Healthscope Whirlpool |
$882.89
|
Rate for Payer: Meridian Medicaid |
$504.10
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$772.53
|
Rate for Payer: PACE SWMI |
$735.74
|
Rate for Payer: PHP Medicare Advantage |
$735.74
|
Rate for Payer: Priority Health Choice Medicaid |
$480.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.34
|
Rate for Payer: Priority Health Medicare |
$735.74
|
Rate for Payer: Priority Health Narrow Network |
$1,143.34
|
Rate for Payer: UHC Medicare Advantage |
$757.81
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,802.00
|
|
Service Code
|
HCPCS 24579
|
Min. Negotiated Rate |
$378.26 |
Max. Negotiated Rate |
$1,961.40 |
Rate for Payer: Aetna Commercial |
$1,103.33
|
Rate for Payer: Aetna Medicare |
$823.38
|
Rate for Payer: BCBS Complete |
$567.40
|
Rate for Payer: BCBS MAPPO |
$823.38
|
Rate for Payer: BCBS Trust/PPO |
$378.26
|
Rate for Payer: BCN Commercial |
$1,229.02
|
Rate for Payer: BCN Medicare Advantage |
$823.38
|
Rate for Payer: Cash Price |
$2,241.60
|
Rate for Payer: Cash Price |
$2,241.60
|
Rate for Payer: Cofinity Commercial |
$1,103.33
|
Rate for Payer: Cofinity Commercial |
$1,185.67
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.38
|
Rate for Payer: Healthscope Commercial |
$988.06
|
Rate for Payer: Healthscope Whirlpool |
$988.06
|
Rate for Payer: Meridian Medicaid |
$567.40
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$864.55
|
Rate for Payer: PACE SWMI |
$823.38
|
Rate for Payer: PHP Medicare Advantage |
$823.38
|
Rate for Payer: Priority Health Choice Medicaid |
$540.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,961.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.28
|
Rate for Payer: Priority Health Medicare |
$823.38
|
Rate for Payer: Priority Health Narrow Network |
$1,284.28
|
Rate for Payer: UHC Medicare Advantage |
$848.08
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$960.00
|
|
Service Code
|
HCPCS 28675
|
Min. Negotiated Rate |
$268.17 |
Max. Negotiated Rate |
$841.50 |
Rate for Payer: Aetna Commercial |
$539.34
|
Rate for Payer: Aetna Medicare |
$402.49
|
Rate for Payer: BCBS Complete |
$281.58
|
Rate for Payer: BCBS MAPPO |
$402.49
|
Rate for Payer: BCBS Trust/PPO |
$671.47
|
Rate for Payer: BCN Commercial |
$841.50
|
Rate for Payer: BCN Medicare Advantage |
$402.49
|
Rate for Payer: Cash Price |
$768.00
|
Rate for Payer: Cash Price |
$768.00
|
Rate for Payer: Cofinity Commercial |
$579.59
|
Rate for Payer: Cofinity Commercial |
$539.34
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.49
|
Rate for Payer: Healthscope Commercial |
$482.99
|
Rate for Payer: Healthscope Whirlpool |
$482.99
|
Rate for Payer: Meridian Medicaid |
$281.58
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$422.61
|
Rate for Payer: PACE SWMI |
$402.49
|
Rate for Payer: PHP Medicare Advantage |
$402.49
|
Rate for Payer: Priority Health Choice Medicaid |
$268.17
|
Rate for Payer: Priority Health Cigna Priority Health |
$672.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.17
|
Rate for Payer: Priority Health Medicare |
$402.49
|
Rate for Payer: Priority Health Narrow Network |
$631.17
|
Rate for Payer: UHC Medicare Advantage |
$414.56
|
|
PR OPEN TREATMENT LUNATE DISLOCATION
|
Professional
|
Both
|
$1,867.00
|
|
Service Code
|
HCPCS 25695
|
Min. Negotiated Rate |
$412.58 |
Max. Negotiated Rate |
$1,306.90 |
Rate for Payer: Aetna Commercial |
$841.05
|
Rate for Payer: Aetna Medicare |
$627.65
|
Rate for Payer: BCBS Complete |
$433.21
|
Rate for Payer: BCBS MAPPO |
$627.65
|
Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
Rate for Payer: BCN Commercial |
$937.77
|
Rate for Payer: BCN Medicare Advantage |
$627.65
|
Rate for Payer: Cash Price |
$1,493.60
|
Rate for Payer: Cash Price |
$1,493.60
|
Rate for Payer: Cofinity Commercial |
$903.82
|
Rate for Payer: Cofinity Commercial |
$841.05
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.65
|
Rate for Payer: Healthscope Commercial |
$753.18
|
Rate for Payer: Healthscope Whirlpool |
$753.18
|
Rate for Payer: Meridian Medicaid |
$433.21
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$659.03
|
Rate for Payer: PACE SWMI |
$627.65
|
Rate for Payer: PHP Medicare Advantage |
$627.65
|
Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,306.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$979.94
|
Rate for Payer: Priority Health Medicare |
$627.65
|
Rate for Payer: Priority Health Narrow Network |
$979.94
|
Rate for Payer: UHC Medicare Advantage |
$646.48
|
|
PR OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE
|
Professional
|
Both
|
$1,679.00
|
|
Service Code
|
HCPCS 21465
|
Min. Negotiated Rate |
$509.71 |
Max. Negotiated Rate |
$3,350.93 |
Rate for Payer: Aetna Commercial |
$1,043.97
|
Rate for Payer: Aetna Medicare |
$779.08
|
Rate for Payer: BCBS Complete |
$535.20
|
Rate for Payer: BCBS MAPPO |
$779.08
|
Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
Rate for Payer: BCN Commercial |
$1,159.64
|
Rate for Payer: BCN Medicare Advantage |
$779.08
|
Rate for Payer: Cash Price |
$1,343.20
|
Rate for Payer: Cash Price |
$1,343.20
|
Rate for Payer: Cofinity Commercial |
$1,121.88
|
Rate for Payer: Cofinity Commercial |
$1,043.97
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.08
|
Rate for Payer: Healthscope Commercial |
$934.90
|
Rate for Payer: Healthscope Whirlpool |
$934.90
|
Rate for Payer: Meridian Medicaid |
$535.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.03
|
Rate for Payer: PACE SWMI |
$779.08
|
Rate for Payer: PHP Medicare Advantage |
$779.08
|
Rate for Payer: Priority Health Choice Medicaid |
$509.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,175.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.77
|
Rate for Payer: Priority Health Medicare |
$779.08
|
Rate for Payer: Priority Health Narrow Network |
$1,211.77
|
Rate for Payer: UHC Medicare Advantage |
$802.45
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,138.00
|
|
Service Code
|
HCPCS 27766
|
Min. Negotiated Rate |
$392.35 |
Max. Negotiated Rate |
$2,661.86 |
Rate for Payer: Aetna Commercial |
$800.82
|
Rate for Payer: Aetna Medicare |
$597.63
|
Rate for Payer: BCBS Complete |
$411.97
|
Rate for Payer: BCBS MAPPO |
$597.63
|
Rate for Payer: BCBS Trust/PPO |
$2,661.86
|
Rate for Payer: BCN Commercial |
$895.26
|
Rate for Payer: BCN Medicare Advantage |
$597.63
|
Rate for Payer: Cash Price |
$1,710.40
|
Rate for Payer: Cash Price |
$1,710.40
|
Rate for Payer: Cofinity Commercial |
$800.82
|
Rate for Payer: Cofinity Commercial |
$860.59
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.63
|
Rate for Payer: Healthscope Commercial |
$717.16
|
Rate for Payer: Healthscope Whirlpool |
$717.16
|
Rate for Payer: Meridian Medicaid |
$411.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$627.51
|
Rate for Payer: PACE SWMI |
$597.63
|
Rate for Payer: PHP Medicare Advantage |
$597.63
|
Rate for Payer: Priority Health Choice Medicaid |
$392.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,496.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.51
|
Rate for Payer: Priority Health Medicare |
$597.63
|
Rate for Payer: Priority Health Narrow Network |
$935.51
|
Rate for Payer: UHC Medicare Advantage |
$615.56
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,887.00
|
|
Service Code
|
HCPCS 26715
|
Min. Negotiated Rate |
$374.24 |
Max. Negotiated Rate |
$1,320.90 |
Rate for Payer: Aetna Commercial |
$757.19
|
Rate for Payer: Aetna Medicare |
$565.07
|
Rate for Payer: BCBS Complete |
$392.95
|
Rate for Payer: BCBS MAPPO |
$565.07
|
Rate for Payer: BCBS Trust/PPO |
$381.43
|
Rate for Payer: BCN Commercial |
$849.33
|
Rate for Payer: BCN Medicare Advantage |
$565.07
|
Rate for Payer: Cash Price |
$1,509.60
|
Rate for Payer: Cash Price |
$1,509.60
|
Rate for Payer: Cofinity Commercial |
$813.70
|
Rate for Payer: Cofinity Commercial |
$757.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.07
|
Rate for Payer: Healthscope Commercial |
$678.08
|
Rate for Payer: Healthscope Whirlpool |
$678.08
|
Rate for Payer: Meridian Medicaid |
$392.95
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$593.32
|
Rate for Payer: PACE SWMI |
$565.07
|
Rate for Payer: PHP Medicare Advantage |
$565.07
|
Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,320.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$887.51
|
Rate for Payer: Priority Health Medicare |
$565.07
|
Rate for Payer: Priority Health Narrow Network |
$887.51
|
Rate for Payer: UHC Medicare Advantage |
$582.02
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,320.00
|
|
Service Code
|
HCPCS 28485
|
Min. Negotiated Rate |
$365.08 |
Max. Negotiated Rate |
$924.00 |
Rate for Payer: Aetna Commercial |
$735.47
|
Rate for Payer: Aetna Medicare |
$548.86
|
Rate for Payer: BCBS Complete |
$383.33
|
Rate for Payer: BCBS MAPPO |
$548.86
|
Rate for Payer: BCBS Trust/PPO |
$613.88
|
Rate for Payer: BCN Commercial |
$824.89
|
Rate for Payer: BCN Medicare Advantage |
$548.86
|
Rate for Payer: Cash Price |
$1,056.00
|
Rate for Payer: Cash Price |
$1,056.00
|
Rate for Payer: Cofinity Commercial |
$790.36
|
Rate for Payer: Cofinity Commercial |
$735.47
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.86
|
Rate for Payer: Healthscope Commercial |
$658.63
|
Rate for Payer: Healthscope Whirlpool |
$658.63
|
Rate for Payer: Meridian Medicaid |
$383.33
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$576.30
|
Rate for Payer: PACE SWMI |
$548.86
|
Rate for Payer: PHP Medicare Advantage |
$548.86
|
Rate for Payer: Priority Health Choice Medicaid |
$365.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$924.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$861.98
|
Rate for Payer: Priority Health Medicare |
$548.86
|
Rate for Payer: Priority Health Narrow Network |
$861.98
|
Rate for Payer: UHC Medicare Advantage |
$565.33
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$824.00
|
|
Service Code
|
HCPCS 21325
|
Min. Negotiated Rate |
$286.49 |
Max. Negotiated Rate |
$1,404.22 |
Rate for Payer: Aetna Commercial |
$576.88
|
Rate for Payer: Aetna Medicare |
$430.51
|
Rate for Payer: BCBS Complete |
$300.81
|
Rate for Payer: BCBS MAPPO |
$430.51
|
Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
Rate for Payer: BCN Commercial |
$656.30
|
Rate for Payer: BCN Medicare Advantage |
$430.51
|
Rate for Payer: Cash Price |
$659.20
|
Rate for Payer: Cash Price |
$659.20
|
Rate for Payer: Cofinity Commercial |
$619.93
|
Rate for Payer: Cofinity Commercial |
$576.88
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.51
|
Rate for Payer: Healthscope Commercial |
$516.61
|
Rate for Payer: Healthscope Whirlpool |
$516.61
|
Rate for Payer: Meridian Medicaid |
$300.81
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$452.04
|
Rate for Payer: PACE SWMI |
$430.51
|
Rate for Payer: PHP Medicare Advantage |
$430.51
|
Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$576.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.81
|
Rate for Payer: Priority Health Medicare |
$430.51
|
Rate for Payer: Priority Health Narrow Network |
$685.81
|
Rate for Payer: UHC Medicare Advantage |
$443.43
|
|
PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE
|
Professional
|
Both
|
$1,906.00
|
|
Service Code
|
HCPCS 25545
|
Min. Negotiated Rate |
$407.26 |
Max. Negotiated Rate |
$1,334.20 |
Rate for Payer: Aetna Commercial |
$826.71
|
Rate for Payer: Aetna Medicare |
$616.95
|
Rate for Payer: BCBS Complete |
$427.62
|
Rate for Payer: BCBS MAPPO |
$616.95
|
Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
Rate for Payer: BCN Commercial |
$925.06
|
Rate for Payer: BCN Medicare Advantage |
$616.95
|
Rate for Payer: Cash Price |
$1,524.80
|
Rate for Payer: Cash Price |
$1,524.80
|
Rate for Payer: Cofinity Commercial |
$888.41
|
Rate for Payer: Cofinity Commercial |
$826.71
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.95
|
Rate for Payer: Healthscope Commercial |
$740.34
|
Rate for Payer: Healthscope Whirlpool |
$740.34
|
Rate for Payer: Meridian Medicaid |
$427.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.80
|
Rate for Payer: PACE SWMI |
$616.95
|
Rate for Payer: PHP Medicare Advantage |
$616.95
|
Rate for Payer: Priority Health Choice Medicaid |
$407.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,334.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.65
|
Rate for Payer: Priority Health Medicare |
$616.95
|
Rate for Payer: Priority Health Narrow Network |
$966.65
|
Rate for Payer: UHC Medicare Advantage |
$635.46
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,317.00
|
|
Service Code
|
HCPCS 21422
|
Min. Negotiated Rate |
$399.38 |
Max. Negotiated Rate |
$22,818.32 |
Rate for Payer: Aetna Commercial |
$823.82
|
Rate for Payer: Aetna Medicare |
$614.79
|
Rate for Payer: BCBS Complete |
$419.35
|
Rate for Payer: BCBS MAPPO |
$614.79
|
Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
Rate for Payer: BCN Commercial |
$921.16
|
Rate for Payer: BCN Medicare Advantage |
$614.79
|
Rate for Payer: Cash Price |
$1,053.60
|
Rate for Payer: Cash Price |
$1,053.60
|
Rate for Payer: Cofinity Commercial |
$823.82
|
Rate for Payer: Cofinity Commercial |
$885.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.79
|
Rate for Payer: Healthscope Commercial |
$737.75
|
Rate for Payer: Healthscope Whirlpool |
$737.75
|
Rate for Payer: Meridian Medicaid |
$419.35
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.53
|
Rate for Payer: PACE SWMI |
$614.79
|
Rate for Payer: PHP Medicare Advantage |
$614.79
|
Rate for Payer: Priority Health Choice Medicaid |
$399.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$921.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.57
|
Rate for Payer: Priority Health Medicare |
$614.79
|
Rate for Payer: Priority Health Narrow Network |
$962.57
|
Rate for Payer: UHC Medicare Advantage |
$633.23
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,272.00
|
|
Service Code
|
HCPCS 27769
|
Min. Negotiated Rate |
$469.67 |
Max. Negotiated Rate |
$2,788.67 |
Rate for Payer: Aetna Commercial |
$960.57
|
Rate for Payer: Aetna Medicare |
$716.84
|
Rate for Payer: BCBS Complete |
$493.15
|
Rate for Payer: BCBS MAPPO |
$716.84
|
Rate for Payer: BCBS Trust/PPO |
$2,788.67
|
Rate for Payer: BCN Commercial |
$1,069.23
|
Rate for Payer: BCN Medicare Advantage |
$716.84
|
Rate for Payer: Cash Price |
$1,017.60
|
Rate for Payer: Cash Price |
$1,017.60
|
Rate for Payer: Cofinity Commercial |
$960.57
|
Rate for Payer: Cofinity Commercial |
$1,032.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.84
|
Rate for Payer: Healthscope Commercial |
$860.21
|
Rate for Payer: Healthscope Whirlpool |
$860.21
|
Rate for Payer: Meridian Medicaid |
$493.15
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$752.68
|
Rate for Payer: PACE SWMI |
$716.84
|
Rate for Payer: PHP Medicare Advantage |
$716.84
|
Rate for Payer: Priority Health Choice Medicaid |
$469.67
|
Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.30
|
Rate for Payer: Priority Health Medicare |
$716.84
|
Rate for Payer: Priority Health Narrow Network |
$1,117.30
|
Rate for Payer: UHC Medicare Advantage |
$738.35
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,233.00
|
|
Service Code
|
HCPCS 27784
|
Min. Negotiated Rate |
$463.49 |
Max. Negotiated Rate |
$2,244.78 |
Rate for Payer: Aetna Commercial |
$938.70
|
Rate for Payer: Aetna Medicare |
$700.52
|
Rate for Payer: BCBS Complete |
$486.66
|
Rate for Payer: BCBS MAPPO |
$700.52
|
Rate for Payer: BCBS Trust/PPO |
$2,244.78
|
Rate for Payer: BCN Commercial |
$1,046.26
|
Rate for Payer: BCN Medicare Advantage |
$700.52
|
Rate for Payer: Cash Price |
$1,786.40
|
Rate for Payer: Cash Price |
$1,786.40
|
Rate for Payer: Cofinity Commercial |
$938.70
|
Rate for Payer: Cofinity Commercial |
$1,008.75
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.52
|
Rate for Payer: Healthscope Commercial |
$840.62
|
Rate for Payer: Healthscope Whirlpool |
$840.62
|
Rate for Payer: Meridian Medicaid |
$486.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$735.55
|
Rate for Payer: PACE SWMI |
$700.52
|
Rate for Payer: PHP Medicare Advantage |
$700.52
|
Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,563.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,093.29
|
Rate for Payer: Priority Health Medicare |
$700.52
|
Rate for Payer: Priority Health Narrow Network |
$1,093.29
|
Rate for Payer: UHC Medicare Advantage |
$721.54
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE
|
Professional
|
Both
|
$2,023.00
|
|
Service Code
|
HCPCS 25515
|
Min. Negotiated Rate |
$436.44 |
Max. Negotiated Rate |
$1,416.10 |
Rate for Payer: Aetna Commercial |
$885.91
|
Rate for Payer: Aetna Medicare |
$661.13
|
Rate for Payer: BCBS Complete |
$458.26
|
Rate for Payer: BCBS MAPPO |
$661.13
|
Rate for Payer: BCBS Trust/PPO |
$1,387.32
|
Rate for Payer: BCN Commercial |
$989.57
|
Rate for Payer: BCN Medicare Advantage |
$661.13
|
Rate for Payer: Cash Price |
$1,618.40
|
Rate for Payer: Cash Price |
$1,618.40
|
Rate for Payer: Cofinity Commercial |
$885.91
|
Rate for Payer: Cofinity Commercial |
$952.03
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.13
|
Rate for Payer: Healthscope Commercial |
$793.36
|
Rate for Payer: Healthscope Whirlpool |
$793.36
|
Rate for Payer: Meridian Medicaid |
$458.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$694.19
|
Rate for Payer: PACE SWMI |
$661.13
|
Rate for Payer: PHP Medicare Advantage |
$661.13
|
Rate for Payer: Priority Health Choice Medicaid |
$436.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,416.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.07
|
Rate for Payer: Priority Health Medicare |
$661.13
|
Rate for Payer: Priority Health Narrow Network |
$1,034.07
|
Rate for Payer: UHC Medicare Advantage |
$680.96
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,957.00
|
|
Service Code
|
HCPCS 28585
|
Min. Negotiated Rate |
$312.23 |
Max. Negotiated Rate |
$1,369.90 |
Rate for Payer: Aetna Commercial |
$917.79
|
Rate for Payer: Aetna Medicare |
$684.92
|
Rate for Payer: BCBS Complete |
$478.83
|
Rate for Payer: BCBS MAPPO |
$684.92
|
Rate for Payer: BCBS Trust/PPO |
$312.23
|
Rate for Payer: BCN Commercial |
$1,291.09
|
Rate for Payer: BCN Medicare Advantage |
$684.92
|
Rate for Payer: Cash Price |
$1,565.60
|
Rate for Payer: Cash Price |
$1,565.60
|
Rate for Payer: Cofinity Commercial |
$917.79
|
Rate for Payer: Cofinity Commercial |
$986.28
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.92
|
Rate for Payer: Healthscope Commercial |
$821.90
|
Rate for Payer: Healthscope Whirlpool |
$821.90
|
Rate for Payer: Meridian Medicaid |
$478.83
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$719.17
|
Rate for Payer: PACE SWMI |
$684.92
|
Rate for Payer: PHP Medicare Advantage |
$684.92
|
Rate for Payer: Priority Health Choice Medicaid |
$456.03
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,369.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,065.22
|
Rate for Payer: Priority Health Medicare |
$684.92
|
Rate for Payer: Priority Health Narrow Network |
$1,065.22
|
Rate for Payer: UHC Medicare Advantage |
$705.47
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,080.00
|
|
Service Code
|
HCPCS 28445
|
Min. Negotiated Rate |
$588.53 |
Max. Negotiated Rate |
$2,156.00 |
Rate for Payer: Aetna Commercial |
$1,371.17
|
Rate for Payer: Aetna Medicare |
$1,023.26
|
Rate for Payer: BCBS Complete |
$708.97
|
Rate for Payer: BCBS MAPPO |
$1,023.26
|
Rate for Payer: BCBS Trust/PPO |
$588.53
|
Rate for Payer: BCN Commercial |
$1,521.26
|
Rate for Payer: BCN Medicare Advantage |
$1,023.26
|
Rate for Payer: Cash Price |
$2,464.00
|
Rate for Payer: Cash Price |
$2,464.00
|
Rate for Payer: Cofinity Commercial |
$1,371.17
|
Rate for Payer: Cofinity Commercial |
$1,473.49
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.26
|
Rate for Payer: Healthscope Commercial |
$1,227.91
|
Rate for Payer: Healthscope Whirlpool |
$1,227.91
|
Rate for Payer: Meridian Medicaid |
$708.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,074.42
|
Rate for Payer: PACE SWMI |
$1,023.26
|
Rate for Payer: PHP Medicare Advantage |
$1,023.26
|
Rate for Payer: Priority Health Choice Medicaid |
$675.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,156.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,589.66
|
Rate for Payer: Priority Health Medicare |
$1,023.26
|
Rate for Payer: Priority Health Narrow Network |
$1,589.66
|
Rate for Payer: UHC Medicare Advantage |
$1,053.96
|
|