|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 26615
|
| Min. Negotiated Rate |
$53.49 |
| Max. Negotiated Rate |
$1,251.25 |
| Rate for Payer: Aetna Commercial |
$765.08
|
| Rate for Payer: Aetna Medicare |
$962.50
|
| Rate for Payer: BCBS Complete |
$398.77
|
| Rate for Payer: BCBS Trust/PPO |
$53.49
|
| Rate for Payer: BCN Commercial |
$851.77
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Meridian Medicaid |
$398.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.12
|
| Rate for Payer: Priority Health Narrow Network |
$897.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.22
|
| Rate for Payer: UHC Exchange |
$628.22
|
| Rate for Payer: UHCCP Medicaid |
$379.78
|
|
|
PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 28645
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$945.59 |
| Rate for Payer: Aetna Commercial |
$643.68
|
| Rate for Payer: Aetna Medicare |
$518.50
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS Trust/PPO |
$821.51
|
| Rate for Payer: BCN Commercial |
$945.59
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.59
|
| Rate for Payer: Priority Health Narrow Network |
$751.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$550.30
|
| Rate for Payer: UHC Exchange |
$550.30
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
Both
|
$3,444.00
|
|
|
Service Code
|
HCPCS 24635
|
| Min. Negotiated Rate |
$444.96 |
| Max. Negotiated Rate |
$2,238.60 |
| Rate for Payer: Aetna Commercial |
$899.81
|
| Rate for Payer: Aetna Medicare |
$1,722.00
|
| Rate for Payer: BCBS Complete |
$467.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$998.86
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Meridian Medicaid |
$467.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,238.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,048.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.84
|
| Rate for Payer: UHC Exchange |
$811.84
|
| Rate for Payer: UHCCP Medicaid |
$444.96
|
|
|
PR OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 21330
|
| Min. Negotiated Rate |
$343.57 |
| Max. Negotiated Rate |
$1,404.22 |
| Rate for Payer: Aetna Commercial |
$702.66
|
| Rate for Payer: Aetna Medicare |
$827.50
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.22
|
| Rate for Payer: BCN Commercial |
$788.24
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$822.33
|
| Rate for Payer: Priority Health Narrow Network |
$822.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.35
|
| Rate for Payer: UHC Exchange |
$638.35
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION
|
Professional
|
Both
|
$1,476.00
|
|
|
Service Code
|
HCPCS 21336
|
| Min. Negotiated Rate |
$409.39 |
| Max. Negotiated Rate |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$851.72
|
| Rate for Payer: Aetna Medicare |
$738.00
|
| Rate for Payer: BCBS Complete |
$429.86
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$936.30
|
| Rate for Payer: Cash Price |
$1,180.80
|
| Rate for Payer: Cash Price |
$1,180.80
|
| Rate for Payer: Meridian Medicaid |
$429.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$959.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$978.54
|
| Rate for Payer: Priority Health Narrow Network |
$978.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$725.40
|
| Rate for Payer: UHC Exchange |
$725.40
|
| Rate for Payer: UHCCP Medicaid |
$409.39
|
|
|
PR OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 21338
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,218.10 |
| Rate for Payer: Aetna Commercial |
$881.10
|
| Rate for Payer: Aetna Medicare |
$937.00
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$989.57
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,029.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$830.34
|
| Rate for Payer: UHC Exchange |
$830.34
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL
|
Professional
|
Both
|
$1,196.00
|
|
|
Service Code
|
HCPCS 21386
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$917.96
|
| Rate for Payer: Aetna Medicare |
$598.00
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$1,013.51
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$773.50
|
| Rate for Payer: UHC Exchange |
$773.50
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
|
|
PR OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL
|
Professional
|
Both
|
$1,545.00
|
|
|
Service Code
|
HCPCS 21385
|
| Min. Negotiated Rate |
$473.29 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$985.76
|
| Rate for Payer: Aetna Medicare |
$772.50
|
| Rate for Payer: BCBS Complete |
$496.95
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$1,075.09
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Meridian Medicaid |
$496.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,122.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$804.97
|
| Rate for Payer: UHC Exchange |
$804.97
|
| Rate for Payer: UHCCP Medicaid |
$473.29
|
|
|
PR OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR
|
Professional
|
Both
|
$1,579.00
|
|
|
Service Code
|
HCPCS 21423
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$1,218.73 |
| Rate for Payer: Aetna Commercial |
$1,075.12
|
| Rate for Payer: Aetna Medicare |
$789.50
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS Trust/PPO |
$24.96
|
| Rate for Payer: BCN Commercial |
$1,169.40
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,218.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$921.82
|
| Rate for Payer: UHC Exchange |
$921.82
|
| Rate for Payer: UHCCP Medicaid |
$512.90
|
|
|
PR OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA
|
Professional
|
Both
|
$1,815.00
|
|
|
Service Code
|
HCPCS 26735
|
| Min. Negotiated Rate |
$391.92 |
| Max. Negotiated Rate |
$1,561.28 |
| Rate for Payer: Aetna Commercial |
$790.77
|
| Rate for Payer: Aetna Medicare |
$907.50
|
| Rate for Payer: BCBS Complete |
$411.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.28
|
| Rate for Payer: BCN Commercial |
$880.11
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Meridian Medicaid |
$411.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.15
|
| Rate for Payer: Priority Health Narrow Network |
$927.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$654.25
|
| Rate for Payer: UHC Exchange |
$654.25
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
|
|
PR OPEN TX POST PELVIC FXCTURE
|
Professional
|
Both
|
$2,367.00
|
|
|
Service Code
|
HCPCS G0415
|
| Min. Negotiated Rate |
$446.41 |
| Max. Negotiated Rate |
$2,095.49 |
| Rate for Payer: Aetna Commercial |
$1,373.54
|
| Rate for Payer: Aetna Medicare |
$1,183.50
|
| Rate for Payer: BCBS Complete |
$931.51
|
| Rate for Payer: BCBS Trust/PPO |
$446.41
|
| Rate for Payer: BCN Commercial |
$2,004.07
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Meridian Medicaid |
$931.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$887.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,095.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,095.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,599.43
|
| Rate for Payer: UHC Exchange |
$1,599.43
|
| Rate for Payer: UHCCP Medicaid |
$887.15
|
|
|
PR OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 27832
|
| Min. Negotiated Rate |
$496.50 |
| Max. Negotiated Rate |
$1,321.62 |
| Rate for Payer: Aetna Commercial |
$1,009.97
|
| Rate for Payer: Aetna Medicare |
$921.50
|
| Rate for Payer: BCBS Complete |
$521.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.62
|
| Rate for Payer: BCN Commercial |
$1,116.14
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Meridian Medicaid |
$521.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,174.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,174.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$834.95
|
| Rate for Payer: UHC Exchange |
$834.95
|
| Rate for Payer: UHCCP Medicaid |
$496.50
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
Both
|
$2,365.00
|
|
|
Service Code
|
HCPCS 24665
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$1,537.25 |
| Rate for Payer: Aetna Commercial |
$875.66
|
| Rate for Payer: Aetna Medicare |
$1,182.50
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.54
|
| Rate for Payer: BCN Commercial |
$971.00
|
| Rate for Payer: Cash Price |
$1,892.00
|
| Rate for Payer: Cash Price |
$1,892.00
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$733.31
|
| Rate for Payer: UHC Exchange |
$733.31
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC
|
Professional
|
Both
|
$2,905.00
|
|
|
Service Code
|
HCPCS 24666
|
| Min. Negotiated Rate |
$479.25 |
| Max. Negotiated Rate |
$1,888.25 |
| Rate for Payer: Aetna Commercial |
$977.72
|
| Rate for Payer: Aetna Medicare |
$1,452.50
|
| Rate for Payer: BCBS Complete |
$503.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,044.45
|
| Rate for Payer: BCN Commercial |
$1,080.46
|
| Rate for Payer: Cash Price |
$2,324.00
|
| Rate for Payer: Cash Price |
$2,324.00
|
| Rate for Payer: Meridian Medicaid |
$503.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,888.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$832.67
|
| Rate for Payer: UHC Exchange |
$832.67
|
| Rate for Payer: UHCCP Medicaid |
$479.25
|
|
|
PR OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES
|
Professional
|
Both
|
$1,984.00
|
|
|
Service Code
|
HCPCS 25670
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$1,426.94 |
| Rate for Payer: Aetna Commercial |
$813.10
|
| Rate for Payer: Aetna Medicare |
$992.00
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.94
|
| Rate for Payer: BCN Commercial |
$899.66
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,289.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$944.45
|
| Rate for Payer: Priority Health Narrow Network |
$944.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$688.63
|
| Rate for Payer: UHC Exchange |
$688.63
|
| Rate for Payer: UHCCP Medicaid |
$397.88
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 21811
|
| Min. Negotiated Rate |
$377.01 |
| Max. Negotiated Rate |
$6,603.85 |
| Rate for Payer: Aetna Commercial |
$802.06
|
| Rate for Payer: Aetna Medicare |
$631.50
|
| Rate for Payer: BCBS Complete |
$395.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,603.85
|
| Rate for Payer: BCN Commercial |
$859.09
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Meridian Medicaid |
$395.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.65
|
| Rate for Payer: Priority Health Narrow Network |
$898.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$775.09
|
| Rate for Payer: UHC Exchange |
$775.09
|
| Rate for Payer: UHCCP Medicaid |
$377.01
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS
|
Professional
|
Both
|
$1,763.00
|
|
|
Service Code
|
HCPCS 21812
|
| Min. Negotiated Rate |
$456.46 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$970.72
|
| Rate for Payer: Aetna Medicare |
$881.50
|
| Rate for Payer: BCBS Complete |
$479.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$1,041.37
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Meridian Medicaid |
$479.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,145.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$929.51
|
| Rate for Payer: UHC Exchange |
$929.51
|
| Rate for Payer: UHCCP Medicaid |
$456.46
|
|
|
PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 21813
|
| Min. Negotiated Rate |
$99.81 |
| Max. Negotiated Rate |
$1,485.88 |
| Rate for Payer: Aetna Commercial |
$1,332.58
|
| Rate for Payer: Aetna Medicare |
$992.50
|
| Rate for Payer: BCBS Complete |
$656.64
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$1,423.52
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Meridian Medicaid |
$656.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$625.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,485.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,485.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.79
|
| Rate for Payer: UHC Exchange |
$1,264.79
|
| Rate for Payer: UHCCP Medicaid |
$625.37
|
|
|
PR OPEN TX SCAPULAR FX W/INT FIXATION WHEN PFRMD
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 23585
|
| Min. Negotiated Rate |
$187.20 |
| Max. Negotiated Rate |
$2,074.80 |
| Rate for Payer: Aetna Commercial |
$1,304.27
|
| Rate for Payer: Aetna Medicare |
$1,596.00
|
| Rate for Payer: BCBS Complete |
$664.91
|
| Rate for Payer: BCBS Trust/PPO |
$187.20
|
| Rate for Payer: BCN Commercial |
$1,432.81
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Meridian Medicaid |
$664.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,501.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.83
|
| Rate for Payer: UHC Exchange |
$1,116.83
|
| Rate for Payer: UHCCP Medicaid |
$633.25
|
|
|
PR OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 28531
|
| Min. Negotiated Rate |
$118.85 |
| Max. Negotiated Rate |
$486.56 |
| Rate for Payer: Aetna Commercial |
$237.60
|
| Rate for Payer: Aetna Medicare |
$335.00
|
| Rate for Payer: BCBS Complete |
$124.79
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$478.42
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Meridian Medicaid |
$124.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.90
|
| Rate for Payer: Priority Health Narrow Network |
$280.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.01
|
| Rate for Payer: UHC Exchange |
$237.01
|
| Rate for Payer: UHCCP Medicaid |
$118.85
|
|
|
PR OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,451.00
|
|
|
Service Code
|
HCPCS 23530
|
| Min. Negotiated Rate |
$378.50 |
| Max. Negotiated Rate |
$1,593.15 |
| Rate for Payer: Aetna Commercial |
$767.80
|
| Rate for Payer: Aetna Medicare |
$1,225.50
|
| Rate for Payer: BCBS Complete |
$397.42
|
| Rate for Payer: BCBS Trust/PPO |
$414.72
|
| Rate for Payer: BCN Commercial |
$852.74
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Meridian Medicaid |
$397.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,593.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$895.59
|
| Rate for Payer: Priority Health Narrow Network |
$895.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$623.28
|
| Rate for Payer: UHC Exchange |
$623.28
|
| Rate for Payer: UHCCP Medicaid |
$378.50
|
|
|
PR OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION
|
Professional
|
Both
|
$1,004.00
|
|
|
Service Code
|
HCPCS 21825
|
| Min. Negotiated Rate |
$358.05 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$728.58
|
| Rate for Payer: Aetna Medicare |
$502.00
|
| Rate for Payer: BCBS Complete |
$375.95
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$804.85
|
| Rate for Payer: Cash Price |
$803.20
|
| Rate for Payer: Cash Price |
$803.20
|
| Rate for Payer: Meridian Medicaid |
$375.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$652.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$848.79
|
| Rate for Payer: Priority Health Narrow Network |
$848.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$662.12
|
| Rate for Payer: UHC Exchange |
$662.12
|
| Rate for Payer: UHCCP Medicaid |
$358.05
|
|
|
PR OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 28465
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,021.15 |
| Rate for Payer: Aetna Commercial |
$835.92
|
| Rate for Payer: Aetna Medicare |
$785.50
|
| Rate for Payer: BCBS Complete |
$440.14
|
| Rate for Payer: BCBS Trust/PPO |
$524.60
|
| Rate for Payer: BCN Commercial |
$931.42
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Meridian Medicaid |
$440.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$991.26
|
| Rate for Payer: Priority Health Narrow Network |
$991.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.24
|
| Rate for Payer: UHC Exchange |
$704.24
|
| Rate for Payer: UHCCP Medicaid |
$419.18
|
|
|
PR OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,786.00
|
|
|
Service Code
|
HCPCS 27535
|
| Min. Negotiated Rate |
$533.05 |
| Max. Negotiated Rate |
$1,810.90 |
| Rate for Payer: Aetna Commercial |
$1,202.31
|
| Rate for Payer: Aetna Medicare |
$1,393.00
|
| Rate for Payer: BCBS Complete |
$609.22
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$1,313.07
|
| Rate for Payer: Cash Price |
$2,228.80
|
| Rate for Payer: Cash Price |
$2,228.80
|
| Rate for Payer: Meridian Medicaid |
$609.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,810.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,375.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,375.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,054.90
|
| Rate for Payer: UHC Exchange |
$1,054.90
|
| Rate for Payer: UHCCP Medicaid |
$580.21
|
|
|
PR OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC
|
Professional
|
Both
|
$2,108.00
|
|
|
Service Code
|
HCPCS 25685
|
| Min. Negotiated Rate |
$481.17 |
| Max. Negotiated Rate |
$1,614.48 |
| Rate for Payer: Aetna Commercial |
$981.61
|
| Rate for Payer: Aetna Medicare |
$1,054.00
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.48
|
| Rate for Payer: BCN Commercial |
$1,084.38
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,139.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,139.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$834.76
|
| Rate for Payer: UHC Exchange |
$834.76
|
| Rate for Payer: UHCCP Medicaid |
$481.17
|
|
