|
PR OPEN TREATMENT CALCANEAL FRACTURE
|
Professional
|
Both
|
$3,366.00
|
|
|
Service Code
|
HCPCS 28415
|
| Min. Negotiated Rate |
$725.27 |
| Max. Negotiated Rate |
$2,187.90 |
| Rate for Payer: Aetna Commercial |
$1,498.02
|
| Rate for Payer: Aetna Medicare |
$1,683.00
|
| Rate for Payer: BCBS Complete |
$761.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: BCN Commercial |
$1,648.79
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Meridian Medicaid |
$761.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,187.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,305.55
|
| Rate for Payer: UHC Exchange |
$1,305.55
|
| Rate for Payer: UHCCP Medicaid |
$725.27
|
|
|
PR OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT
|
Professional
|
Both
|
$2,224.00
|
|
|
Service Code
|
HCPCS 28420
|
| Min. Negotiated Rate |
$372.45 |
| Max. Negotiated Rate |
$1,994.73 |
| Rate for Payer: Aetna Commercial |
$1,729.13
|
| Rate for Payer: Aetna Medicare |
$1,112.00
|
| Rate for Payer: BCBS Complete |
$881.63
|
| Rate for Payer: BCBS Trust/PPO |
$372.45
|
| Rate for Payer: BCN Commercial |
$1,904.86
|
| Rate for Payer: Cash Price |
$1,779.20
|
| Rate for Payer: Cash Price |
$1,779.20
|
| Rate for Payer: Meridian Medicaid |
$881.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,445.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,994.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,994.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.30
|
| Rate for Payer: UHC Exchange |
$1,407.30
|
| Rate for Payer: UHCCP Medicaid |
$839.65
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$4,603.00
|
|
|
Service Code
|
HCPCS 27828
|
| Min. Negotiated Rate |
$855.62 |
| Max. Negotiated Rate |
$2,991.95 |
| Rate for Payer: Aetna Commercial |
$1,772.06
|
| Rate for Payer: Aetna Medicare |
$2,301.50
|
| Rate for Payer: BCBS Complete |
$898.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.07
|
| Rate for Payer: BCN Commercial |
$1,948.36
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Cash Price |
$3,682.40
|
| Rate for Payer: Meridian Medicaid |
$898.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,991.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,037.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,037.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,498.75
|
| Rate for Payer: UHC Exchange |
$1,498.75
|
| Rate for Payer: UHCCP Medicaid |
$855.62
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 27826
|
| Min. Negotiated Rate |
$552.52 |
| Max. Negotiated Rate |
$3,384.29 |
| Rate for Payer: Aetna Commercial |
$1,135.98
|
| Rate for Payer: Aetna Medicare |
$1,550.50
|
| Rate for Payer: BCBS Complete |
$580.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,384.29
|
| Rate for Payer: BCN Commercial |
$1,257.85
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Meridian Medicaid |
$580.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,316.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$947.77
|
| Rate for Payer: UHC Exchange |
$947.77
|
| Rate for Payer: UHCCP Medicaid |
$552.52
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$4,362.00
|
|
|
Service Code
|
HCPCS 27827
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$3,897.80 |
| Rate for Payer: Aetna Commercial |
$1,490.61
|
| Rate for Payer: Aetna Medicare |
$2,181.00
|
| Rate for Payer: BCBS Complete |
$761.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.80
|
| Rate for Payer: BCN Commercial |
$1,647.82
|
| Rate for Payer: Cash Price |
$3,489.60
|
| Rate for Payer: Cash Price |
$3,489.60
|
| Rate for Payer: Meridian Medicaid |
$761.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,835.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,724.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,724.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,246.85
|
| Rate for Payer: UHC Exchange |
$1,246.85
|
| Rate for Payer: UHCCP Medicaid |
$725.69
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$2,016.00
|
|
|
Service Code
|
HCPCS 27248
|
| Min. Negotiated Rate |
$483.94 |
| Max. Negotiated Rate |
$2,101.58 |
| Rate for Payer: Aetna Commercial |
$996.94
|
| Rate for Payer: Aetna Medicare |
$1,008.00
|
| Rate for Payer: BCBS Complete |
$508.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.58
|
| Rate for Payer: BCN Commercial |
$1,094.15
|
| Rate for Payer: Cash Price |
$1,612.80
|
| Rate for Payer: Cash Price |
$1,612.80
|
| Rate for Payer: Meridian Medicaid |
$508.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,310.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$864.60
|
| Rate for Payer: UHC Exchange |
$864.60
|
| Rate for Payer: UHCCP Medicaid |
$483.94
|
|
|
PR OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 24579
|
| Min. Negotiated Rate |
$378.26 |
| Max. Negotiated Rate |
$1,857.70 |
| Rate for Payer: Aetna Commercial |
$1,111.10
|
| Rate for Payer: Aetna Medicare |
$1,429.00
|
| Rate for Payer: BCBS Complete |
$573.22
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$1,229.02
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Meridian Medicaid |
$573.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,290.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,290.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$951.17
|
| Rate for Payer: UHC Exchange |
$951.17
|
| Rate for Payer: UHCCP Medicaid |
$545.92
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$979.00
|
|
|
Service Code
|
HCPCS 28675
|
| Min. Negotiated Rate |
$269.66 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$534.76
|
| Rate for Payer: Aetna Medicare |
$489.50
|
| Rate for Payer: BCBS Complete |
$283.14
|
| Rate for Payer: BCBS Trust/PPO |
$671.47
|
| Rate for Payer: BCN Commercial |
$841.50
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Meridian Medicaid |
$283.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.66
|
| Rate for Payer: Priority Health Narrow Network |
$640.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$466.15
|
| Rate for Payer: UHC Exchange |
$466.15
|
| Rate for Payer: UHCCP Medicaid |
$269.66
|
|
|
PR OPEN TREATMENT LUNATE DISLOCATION
|
Professional
|
Both
|
$1,904.00
|
|
|
Service Code
|
HCPCS 25695
|
| Min. Negotiated Rate |
$416.20 |
| Max. Negotiated Rate |
$1,237.60 |
| Rate for Payer: Aetna Commercial |
$848.78
|
| Rate for Payer: Aetna Medicare |
$952.00
|
| Rate for Payer: BCBS Complete |
$437.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$937.77
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Cash Price |
$1,523.20
|
| Rate for Payer: Meridian Medicaid |
$437.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$985.66
|
| Rate for Payer: Priority Health Narrow Network |
$985.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.92
|
| Rate for Payer: UHC Exchange |
$718.92
|
| Rate for Payer: UHCCP Medicaid |
$416.20
|
|
|
PR OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE
|
Professional
|
Both
|
$1,713.00
|
|
|
Service Code
|
HCPCS 21465
|
| Min. Negotiated Rate |
$520.79 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$1,066.23
|
| Rate for Payer: Aetna Medicare |
$856.50
|
| Rate for Payer: BCBS Complete |
$546.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$1,159.64
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Meridian Medicaid |
$546.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,217.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,217.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,073.82
|
| Rate for Payer: UHC Exchange |
$1,073.82
|
| Rate for Payer: UHCCP Medicaid |
$520.79
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 27766
|
| Min. Negotiated Rate |
$396.18 |
| Max. Negotiated Rate |
$2,661.86 |
| Rate for Payer: Aetna Commercial |
$805.90
|
| Rate for Payer: Aetna Medicare |
$1,090.50
|
| Rate for Payer: BCBS Complete |
$415.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,661.86
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Meridian Medicaid |
$415.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$937.33
|
| Rate for Payer: Priority Health Narrow Network |
$937.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.33
|
| Rate for Payer: UHC Exchange |
$691.33
|
| Rate for Payer: UHCCP Medicaid |
$396.18
|
|
|
PR OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 26715
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$1,251.25 |
| Rate for Payer: Aetna Commercial |
$760.98
|
| Rate for Payer: Aetna Medicare |
$962.50
|
| Rate for Payer: BCBS Complete |
$397.20
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$849.33
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Meridian Medicaid |
$397.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.07
|
| Rate for Payer: Priority Health Narrow Network |
$894.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$626.93
|
| Rate for Payer: UHC Exchange |
$626.93
|
| Rate for Payer: UHCCP Medicaid |
$378.29
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 28485
|
| Min. Negotiated Rate |
$366.15 |
| Max. Negotiated Rate |
$874.90 |
| Rate for Payer: Aetna Commercial |
$740.09
|
| Rate for Payer: Aetna Medicare |
$673.00
|
| Rate for Payer: BCBS Complete |
$384.46
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$824.89
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Meridian Medicaid |
$384.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.19
|
| Rate for Payer: Priority Health Narrow Network |
$872.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.35
|
| Rate for Payer: UHC Exchange |
$608.35
|
| Rate for Payer: UHCCP Medicaid |
$366.15
|
|
|
PR OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 21325
|
| Min. Negotiated Rate |
$285.85 |
| Max. Negotiated Rate |
$1,404.22 |
| Rate for Payer: Aetna Commercial |
$583.69
|
| Rate for Payer: Aetna Medicare |
$420.00
|
| Rate for Payer: BCBS Complete |
$300.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
| Rate for Payer: BCN Commercial |
$656.30
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Meridian Medicaid |
$300.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.42
|
| Rate for Payer: Priority Health Narrow Network |
$684.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$527.68
|
| Rate for Payer: UHC Exchange |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$285.85
|
|
|
PR OPEN TREATMENT PALATAL/MAXILLARY FRACTURE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 21422
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$849.13
|
| Rate for Payer: Aetna Medicare |
$671.50
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$921.16
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.11
|
| Rate for Payer: Priority Health Narrow Network |
$954.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$756.37
|
| Rate for Payer: UHC Exchange |
$756.37
|
| Rate for Payer: UHCCP Medicaid |
$408.32
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 27769
|
| Min. Negotiated Rate |
$473.50 |
| Max. Negotiated Rate |
$2,788.67 |
| Rate for Payer: Aetna Commercial |
$976.15
|
| Rate for Payer: Aetna Medicare |
$648.50
|
| Rate for Payer: BCBS Complete |
$497.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,788.67
|
| Rate for Payer: BCN Commercial |
$1,069.23
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Meridian Medicaid |
$497.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,122.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$812.34
|
| Rate for Payer: UHC Exchange |
$812.34
|
| Rate for Payer: UHCCP Medicaid |
$473.50
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 27784
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$2,244.78 |
| Rate for Payer: Aetna Commercial |
$940.92
|
| Rate for Payer: Aetna Medicare |
$1,139.00
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.78
|
| Rate for Payer: BCN Commercial |
$1,046.26
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,107.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$806.02
|
| Rate for Payer: UHC Exchange |
$806.02
|
| Rate for Payer: UHCCP Medicaid |
$463.49
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 25515
|
| Min. Negotiated Rate |
$440.27 |
| Max. Negotiated Rate |
$1,387.32 |
| Rate for Payer: Aetna Commercial |
$891.56
|
| Rate for Payer: Aetna Medicare |
$1,031.50
|
| Rate for Payer: BCBS Complete |
$462.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,387.32
|
| Rate for Payer: BCN Commercial |
$989.57
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Meridian Medicaid |
$462.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.65
|
| Rate for Payer: UHC Exchange |
$755.65
|
| Rate for Payer: UHCCP Medicaid |
$440.27
|
|
|
PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 28585
|
| Min. Negotiated Rate |
$312.23 |
| Max. Negotiated Rate |
$1,297.40 |
| Rate for Payer: Aetna Commercial |
$912.33
|
| Rate for Payer: Aetna Medicare |
$998.00
|
| Rate for Payer: BCBS Complete |
$486.88
|
| Rate for Payer: BCBS Trust/PPO |
$312.23
|
| Rate for Payer: BCN Commercial |
$1,291.09
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Meridian Medicaid |
$486.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,089.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,089.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.23
|
| Rate for Payer: UHC Exchange |
$855.23
|
| Rate for Payer: UHCCP Medicaid |
$463.70
|
|
|
PR OPEN TREATMENT TALUS FRACTURE
|
Professional
|
Both
|
$3,142.00
|
|
|
Service Code
|
HCPCS 28445
|
| Min. Negotiated Rate |
$588.53 |
| Max. Negotiated Rate |
$2,042.30 |
| Rate for Payer: Aetna Commercial |
$1,370.13
|
| Rate for Payer: Aetna Medicare |
$1,571.00
|
| Rate for Payer: BCBS Complete |
$711.43
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Cash Price |
$2,513.60
|
| Rate for Payer: Meridian Medicaid |
$711.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,042.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,613.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,613.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,238.21
|
| Rate for Payer: UHC Exchange |
$1,238.21
|
| Rate for Payer: UHCCP Medicaid |
$677.55
|
|
|
PR OPEN TREATMENT TARSAL BONE DISLOCATION
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 28555
|
| Min. Negotiated Rate |
$422.59 |
| Max. Negotiated Rate |
$1,269.58 |
| Rate for Payer: Aetna Commercial |
$870.72
|
| Rate for Payer: Aetna Medicare |
$864.00
|
| Rate for Payer: BCBS Complete |
$443.72
|
| Rate for Payer: BCBS Trust/PPO |
$645.58
|
| Rate for Payer: BCN Commercial |
$1,269.58
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Meridian Medicaid |
$443.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,022.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,022.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.60
|
| Rate for Payer: UHC Exchange |
$766.60
|
| Rate for Payer: UHCCP Medicaid |
$422.59
|
|
|
PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 28615
|
| Min. Negotiated Rate |
$538.04 |
| Max. Negotiated Rate |
$1,778.26 |
| Rate for Payer: Aetna Commercial |
$1,091.05
|
| Rate for Payer: Aetna Medicare |
$897.50
|
| Rate for Payer: BCBS Complete |
$564.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.26
|
| Rate for Payer: BCN Commercial |
$1,214.37
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Meridian Medicaid |
$564.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,279.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,279.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$897.55
|
| Rate for Payer: UHC Exchange |
$897.55
|
| Rate for Payer: UHCCP Medicaid |
$538.04
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,522.95 |
| Rate for Payer: Aetna Commercial |
$871.05
|
| Rate for Payer: Aetna Medicare |
$1,171.50
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$735.13
|
| Rate for Payer: UHC Exchange |
$735.13
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,522.95 |
| Rate for Payer: Aetna Commercial |
$871.05
|
| Rate for Payer: Aetna Medicare |
$1,171.50
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$735.13
|
| Rate for Payer: UHC Exchange |
$735.13
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
|
|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
IP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,522.95 |
| Max. Negotiated Rate |
$2,343.00 |
| Rate for Payer: Aetna Commercial |
$2,108.70
|
| Rate for Payer: ASR ASR |
$2,272.71
|
| Rate for Payer: ASR Commercial |
$2,272.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,909.31
|
| Rate for Payer: BCN Commercial |
$1,816.53
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,202.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.40
|
| Rate for Payer: Healthscope Commercial |
$2,343.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,272.71
|
| Rate for Payer: Mclaren Commercial |
$2,108.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: Nomi Health Commercial |
$1,921.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,061.84
|
|
