|
PR OPEN TREATMENT ULNAR FRACTURE PROXIMAL END
|
Facility
|
OP
|
$2,343.00
|
|
|
Service Code
|
CPT 24685
|
| Hospital Charge Code |
24685
|
| Min. Negotiated Rate |
$1,522.95 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$2,108.70
|
| Rate for Payer: Aetna Medicare |
$6,999.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: ASR ASR |
$2,272.71
|
| Rate for Payer: ASR Commercial |
$2,272.71
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.68
|
| Rate for Payer: BCN Commercial |
$1,816.53
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,874.40
|
| 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: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,343.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,272.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$2,108.70
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.55
|
| Rate for Payer: Nomi Health Commercial |
$1,921.26
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$7,699.21
|
| Rate for Payer: PHP Medicaid |
$3,751.61
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.94
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,642.44
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,061.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$10,848.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP DNSP |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR OPEN TREATMENT ULNAR SHAFT FRACTURE W/INT FIXJ
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25545
|
| Min. Negotiated Rate |
$411.52 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$829.87
|
| Rate for Payer: Aetna Medicare |
$972.00
|
| Rate for Payer: BCBS Complete |
$432.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
| Rate for Payer: BCN Commercial |
$925.06
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Meridian Medicaid |
$432.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$972.95
|
| Rate for Payer: Priority Health Narrow Network |
$972.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$702.90
|
| Rate for Payer: UHC Exchange |
$702.90
|
| Rate for Payer: UHCCP Medicaid |
$411.52
|
|
|
PR OPEN TREATMENT ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$1,667.00
|
|
|
Service Code
|
HCPCS 25652
|
| Min. Negotiated Rate |
$410.88 |
| Max. Negotiated Rate |
$1,501.43 |
| Rate for Payer: Aetna Commercial |
$828.66
|
| Rate for Payer: Aetna Medicare |
$833.50
|
| Rate for Payer: BCBS Complete |
$431.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.43
|
| Rate for Payer: BCN Commercial |
$922.13
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Meridian Medicaid |
$431.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$969.89
|
| Rate for Payer: Priority Health Narrow Network |
$969.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$699.54
|
| Rate for Payer: UHC Exchange |
$699.54
|
| Rate for Payer: UHCCP Medicaid |
$410.88
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 1-2 RIBS
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 0245T
|
| Min. Negotiated Rate |
$1,339.20 |
| Max. Negotiated Rate |
$2,176.20 |
| Rate for Payer: Aetna Medicare |
$1,674.00
|
| Rate for Payer: BCBS Complete |
$1,339.20
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 3-4 RIBS
|
Professional
|
Both
|
$3,689.00
|
|
|
Service Code
|
HCPCS 0246T
|
| Min. Negotiated Rate |
$1,475.60 |
| Max. Negotiated Rate |
$2,397.85 |
| Rate for Payer: Aetna Medicare |
$1,844.50
|
| Rate for Payer: BCBS Complete |
$1,475.60
|
| Rate for Payer: Cash Price |
$2,951.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.85
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 5-6 RIBS
|
Professional
|
Both
|
$4,080.00
|
|
|
Service Code
|
HCPCS 0247T
|
| Min. Negotiated Rate |
$1,632.00 |
| Max. Negotiated Rate |
$2,652.00 |
| Rate for Payer: Aetna Medicare |
$2,040.00
|
| Rate for Payer: BCBS Complete |
$1,632.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
|
|
PR OPEN TREAT RIB FRACTURE W/INT FIXATION, UNILATERAL, 7+ RIBS
|
Professional
|
Both
|
$4,709.00
|
|
|
Service Code
|
HCPCS 0248T
|
| Min. Negotiated Rate |
$1,883.60 |
| Max. Negotiated Rate |
$3,060.85 |
| Rate for Payer: Aetna Medicare |
$2,354.50
|
| Rate for Payer: BCBS Complete |
$1,883.60
|
| Rate for Payer: Cash Price |
$3,767.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,060.85
|
|
|
PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,743.00
|
|
|
Service Code
|
HCPCS 23550
|
| Min. Negotiated Rate |
$374.67 |
| Max. Negotiated Rate |
$1,782.95 |
| Rate for Payer: Aetna Commercial |
$763.42
|
| Rate for Payer: Aetna Medicare |
$1,371.50
|
| Rate for Payer: BCBS Complete |
$393.40
|
| Rate for Payer: BCBS Trust/PPO |
$528.83
|
| Rate for Payer: BCN Commercial |
$846.39
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Cash Price |
$2,194.40
|
| Rate for Payer: Meridian Medicaid |
$393.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,782.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$888.98
|
| Rate for Payer: Priority Health Narrow Network |
$888.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.95
|
| Rate for Payer: UHC Exchange |
$648.95
|
| Rate for Payer: UHCCP Medicaid |
$374.67
|
|
|
PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 24615
|
| Min. Negotiated Rate |
$466.47 |
| Max. Negotiated Rate |
$1,675.05 |
| Rate for Payer: Aetna Commercial |
$952.27
|
| Rate for Payer: Aetna Medicare |
$1,288.50
|
| Rate for Payer: BCBS Complete |
$489.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: BCN Commercial |
$1,053.10
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Meridian Medicaid |
$489.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,104.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,104.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.36
|
| Rate for Payer: UHC Exchange |
$813.36
|
| Rate for Payer: UHCCP Medicaid |
$466.47
|
|
|
PR OPEN TX ACUTE SHOULDER DISLOCATION
|
Professional
|
Both
|
$2,720.00
|
|
|
Service Code
|
HCPCS 23660
|
| Min. Negotiated Rate |
$367.62 |
| Max. Negotiated Rate |
$1,768.00 |
| Rate for Payer: Aetna Commercial |
$780.08
|
| Rate for Payer: Aetna Medicare |
$1,360.00
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS Trust/PPO |
$367.62
|
| Rate for Payer: BCN Commercial |
$867.89
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Cash Price |
$2,176.00
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.84
|
| Rate for Payer: Priority Health Narrow Network |
$909.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$658.97
|
| Rate for Payer: UHC Exchange |
$658.97
|
| Rate for Payer: UHCCP Medicaid |
$384.04
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 26746
|
| Min. Negotiated Rate |
$486.28 |
| Max. Negotiated Rate |
$1,644.50 |
| Rate for Payer: Aetna Commercial |
$988.24
|
| Rate for Payer: Aetna Medicare |
$1,265.00
|
| Rate for Payer: BCBS Complete |
$510.59
|
| Rate for Payer: BCBS Trust/PPO |
$663.54
|
| Rate for Payer: BCN Commercial |
$1,095.13
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Meridian Medicaid |
$510.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,149.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.22
|
| Rate for Payer: UHC Exchange |
$815.22
|
| Rate for Payer: UHCCP Medicaid |
$486.28
|
|
|
PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 25645
|
| Min. Negotiated Rate |
$375.95 |
| Max. Negotiated Rate |
$1,263.69 |
| Rate for Payer: Aetna Commercial |
$762.34
|
| Rate for Payer: Aetna Medicare |
$754.00
|
| Rate for Payer: BCBS Complete |
$394.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.69
|
| Rate for Payer: BCN Commercial |
$846.87
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Meridian Medicaid |
$394.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$890.00
|
| Rate for Payer: Priority Health Narrow Network |
$890.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$641.42
|
| Rate for Payer: UHC Exchange |
$641.42
|
| Rate for Payer: UHCCP Medicaid |
$375.95
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
HCPCS 25628
|
| Min. Negotiated Rate |
$471.80 |
| Max. Negotiated Rate |
$1,315.60 |
| Rate for Payer: Aetna Commercial |
$959.80
|
| Rate for Payer: Aetna Medicare |
$1,012.00
|
| Rate for Payer: BCBS Complete |
$495.39
|
| Rate for Payer: BCBS Trust/PPO |
$548.81
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Meridian Medicaid |
$495.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,114.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$814.84
|
| Rate for Payer: UHC Exchange |
$814.84
|
| Rate for Payer: UHCCP Medicaid |
$471.80
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$2,255.00
|
|
|
Service Code
|
HCPCS 26685
|
| Min. Negotiated Rate |
$56.88 |
| Max. Negotiated Rate |
$1,465.75 |
| Rate for Payer: Aetna Commercial |
$764.98
|
| Rate for Payer: Aetna Medicare |
$1,127.50
|
| Rate for Payer: BCBS Complete |
$399.88
|
| Rate for Payer: BCBS Trust/PPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$851.77
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Meridian Medicaid |
$399.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.13
|
| Rate for Payer: Priority Health Narrow Network |
$898.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.96
|
| Rate for Payer: UHC Exchange |
$637.96
|
| Rate for Payer: UHCCP Medicaid |
$380.84
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$2,888.00
|
|
|
Service Code
|
HCPCS 26665
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$1,877.20 |
| Rate for Payer: Aetna Commercial |
$832.65
|
| Rate for Payer: Aetna Medicare |
$1,444.00
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: BCN Commercial |
$926.54
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,877.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.98
|
| Rate for Payer: Priority Health Narrow Network |
$974.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$696.78
|
| Rate for Payer: UHC Exchange |
$696.78
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
|
|
PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION
|
Professional
|
Both
|
$2,455.00
|
|
|
Service Code
|
HCPCS 23515
|
| Min. Negotiated Rate |
$285.26 |
| Max. Negotiated Rate |
$1,595.75 |
| Rate for Payer: Aetna Commercial |
$959.84
|
| Rate for Payer: Aetna Medicare |
$1,227.50
|
| Rate for Payer: BCBS Complete |
$494.49
|
| Rate for Payer: BCBS Trust/PPO |
$285.26
|
| Rate for Payer: BCN Commercial |
$1,062.87
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Cash Price |
$1,964.00
|
| Rate for Payer: Meridian Medicaid |
$494.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,595.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.46
|
| Rate for Payer: UHC Exchange |
$815.46
|
| Rate for Payer: UHCCP Medicaid |
$470.94
|
|
|
PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 21365
|
| Min. Negotiated Rate |
$180.58 |
| Max. Negotiated Rate |
$1,648.72 |
| Rate for Payer: Aetna Commercial |
$1,448.48
|
| Rate for Payer: Aetna Medicare |
$1,009.00
|
| Rate for Payer: BCBS Complete |
$733.35
|
| Rate for Payer: BCBS Trust/PPO |
$180.58
|
| Rate for Payer: BCN Commercial |
$1,582.82
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Meridian Medicaid |
$733.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,648.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,289.82
|
| Rate for Payer: UHC Exchange |
$1,289.82
|
| Rate for Payer: UHCCP Medicaid |
$698.43
|
|
|
PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$3,475.00
|
|
|
Service Code
|
HCPCS 21344
|
| Min. Negotiated Rate |
$118.87 |
| Max. Negotiated Rate |
$2,258.75 |
| Rate for Payer: Aetna Commercial |
$1,845.66
|
| Rate for Payer: Aetna Medicare |
$1,737.50
|
| Rate for Payer: BCBS Complete |
$937.77
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$2,044.63
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Cash Price |
$2,780.00
|
| Rate for Payer: Meridian Medicaid |
$937.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,258.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,129.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,891.54
|
| Rate for Payer: UHC Exchange |
$1,891.54
|
| Rate for Payer: UHCCP Medicaid |
$893.11
|
|
|
PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR
|
Professional
|
Both
|
$3,013.00
|
|
|
Service Code
|
HCPCS 21433
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,638.95 |
| Rate for Payer: Aetna Commercial |
$2,312.83
|
| Rate for Payer: Aetna Medicare |
$1,506.50
|
| Rate for Payer: BCBS Complete |
$1,170.36
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,530.37
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Cash Price |
$2,410.40
|
| Rate for Payer: Meridian Medicaid |
$1,170.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,114.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,958.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,638.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,638.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,984.33
|
| Rate for Payer: UHC Exchange |
$1,984.33
|
| Rate for Payer: UHCCP Medicaid |
$1,114.63
|
|
|
PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE
|
Professional
|
Both
|
$2,453.00
|
|
|
Service Code
|
HCPCS 21343
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$1,667.03 |
| Rate for Payer: Aetna Commercial |
$1,431.81
|
| Rate for Payer: Aetna Medicare |
$1,226.50
|
| Rate for Payer: BCBS Complete |
$733.79
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Cash Price |
$1,962.40
|
| Rate for Payer: Meridian Medicaid |
$733.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,667.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,667.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,347.10
|
| Rate for Payer: UHC Exchange |
$1,347.10
|
| Rate for Payer: UHCCP Medicaid |
$698.85
|
|
|
PR OPEN TX DEPRESSED MALAR FRACTURE
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 21360
|
| Min. Negotiated Rate |
$340.16 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$680.88
|
| Rate for Payer: Aetna Medicare |
$518.50
|
| Rate for Payer: BCBS Complete |
$357.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$771.14
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Meridian Medicaid |
$357.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$810.62
|
| Rate for Payer: Priority Health Narrow Network |
$810.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$603.94
|
| Rate for Payer: UHC Exchange |
$603.94
|
| Rate for Payer: UHCCP Medicaid |
$340.16
|
|
|
PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
HCPCS 21356
|
| Min. Negotiated Rate |
$261.56 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$497.11
|
| Rate for Payer: Aetna Medicare |
$412.00
|
| Rate for Payer: BCBS Complete |
$274.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$801.92
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Meridian Medicaid |
$274.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$535.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.81
|
| Rate for Payer: Priority Health Narrow Network |
$620.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$428.05
|
| Rate for Payer: UHC Exchange |
$428.05
|
| Rate for Payer: UHCCP Medicaid |
$261.56
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Facility
|
OP
|
$2,471.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$1,606.15 |
| Max. Negotiated Rate |
$10,848.88 |
| Rate for Payer: Aetna Commercial |
$2,223.90
|
| Rate for Payer: Aetna Medicare |
$6,999.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: ASR ASR |
$2,396.87
|
| Rate for Payer: ASR Commercial |
$2,396.87
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.50
|
| Rate for Payer: BCN Commercial |
$1,915.77
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cofinity Commercial |
$2,322.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$2,471.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,396.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,999.28
|
| Rate for Payer: Mclaren Commercial |
$2,223.90
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,100.35
|
| Rate for Payer: Nomi Health Commercial |
$2,026.22
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$7,699.21
|
| Rate for Payer: PHP Medicaid |
$3,751.61
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,165.09
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,732.17
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,174.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$10,848.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP DNSP |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
27792
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$2,729.34 |
| Rate for Payer: Aetna Commercial |
$860.56
|
| Rate for Payer: Aetna Medicare |
$1,235.50
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,729.34
|
| Rate for Payer: BCN Commercial |
$1,046.55
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.38
|
| Rate for Payer: Priority Health Narrow Network |
$998.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.48
|
| Rate for Payer: UHC Exchange |
$808.48
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$2,471.00
|
|
|
Service Code
|
HCPCS 27792
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$2,729.34 |
| Rate for Payer: Aetna Commercial |
$860.56
|
| Rate for Payer: Aetna Medicare |
$1,235.50
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,729.34
|
| Rate for Payer: BCN Commercial |
$1,046.55
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Cash Price |
$1,976.80
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.38
|
| Rate for Payer: Priority Health Narrow Network |
$998.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.48
|
| Rate for Payer: UHC Exchange |
$808.48
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
