|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
$1,107.90
|
|
|
Service Code
|
CPT 27766
|
| Hospital Charge Code |
z27766
|
| Min. Negotiated Rate |
$567.49 |
| Max. Negotiated Rate |
$964.73 |
| Rate for Payer: Aetna Medicare |
$567.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$652.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$624.24
|
| Rate for Payer: Cash Price |
$686.90
|
| Rate for Payer: Cash Price |
$686.90
|
| Rate for Payer: Coventry All Commercial |
$680.99
|
| Rate for Payer: Frontpath All Commercial |
$782.76
|
| Rate for Payer: Humana ChoiceCare |
$678.32
|
| Rate for Payer: Humana Medicare |
$567.49
|
| Rate for Payer: Lucent All Commercial |
$964.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$908.00
|
| Rate for Payer: PHCS All Commercial |
$830.92
|
| Rate for Payer: PHP All Commercial |
$963.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$567.49
|
| Rate for Payer: Signature Care EPO |
$906.10
|
| Rate for Payer: Signature Care PPO |
$906.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$851.00
|
| Rate for Payer: United Healthcare Commercial |
$655.98
|
| Rate for Payer: United Healthcare Medicare |
$567.49
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
$1,033.18
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
z28485
|
| Min. Negotiated Rate |
$480.61 |
| Max. Negotiated Rate |
$900.17 |
| Rate for Payer: Aetna Medicare |
$529.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$509.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$608.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$582.46
|
| Rate for Payer: Cash Price |
$640.57
|
| Rate for Payer: Cash Price |
$640.57
|
| Rate for Payer: Coventry All Commercial |
$635.41
|
| Rate for Payer: Frontpath All Commercial |
$720.82
|
| Rate for Payer: Humana ChoiceCare |
$480.61
|
| Rate for Payer: Humana Medicare |
$529.51
|
| Rate for Payer: Lucent All Commercial |
$900.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$847.00
|
| Rate for Payer: PHCS All Commercial |
$774.88
|
| Rate for Payer: PHP All Commercial |
$898.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$529.51
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$794.00
|
| Rate for Payer: United Healthcare Commercial |
$578.66
|
| Rate for Payer: United Healthcare Medicare |
$529.51
|
|
|
PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE
|
Professional
|
$1,142.60
|
|
|
Service Code
|
CPT 25545
|
| Hospital Charge Code |
z25545
|
| Min. Negotiated Rate |
$585.59 |
| Max. Negotiated Rate |
$995.50 |
| Rate for Payer: Aetna Medicare |
$585.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$856.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$673.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$644.15
|
| Rate for Payer: Cash Price |
$708.41
|
| Rate for Payer: Cash Price |
$708.41
|
| Rate for Payer: Coventry All Commercial |
$702.71
|
| Rate for Payer: Frontpath All Commercial |
$808.50
|
| Rate for Payer: Humana ChoiceCare |
$721.01
|
| Rate for Payer: Humana Medicare |
$585.59
|
| Rate for Payer: Lucent All Commercial |
$995.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$937.00
|
| Rate for Payer: PHCS All Commercial |
$856.95
|
| Rate for Payer: PHP All Commercial |
$994.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$585.59
|
| Rate for Payer: Signature Care EPO |
$965.60
|
| Rate for Payer: Signature Care PPO |
$965.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$878.00
|
| Rate for Payer: United Healthcare Commercial |
$669.76
|
| Rate for Payer: United Healthcare Medicare |
$585.59
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
$1,322.00
|
|
|
Service Code
|
CPT 27769
|
| Hospital Charge Code |
z27769
|
| Min. Negotiated Rate |
$662.54 |
| Max. Negotiated Rate |
$1,151.80 |
| Rate for Payer: Aetna Medicare |
$677.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$779.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$745.28
|
| Rate for Payer: Cash Price |
$819.64
|
| Rate for Payer: Cash Price |
$819.64
|
| Rate for Payer: Coventry All Commercial |
$813.04
|
| Rate for Payer: Frontpath All Commercial |
$946.37
|
| Rate for Payer: Humana ChoiceCare |
$662.54
|
| Rate for Payer: Humana Medicare |
$677.53
|
| Rate for Payer: Lucent All Commercial |
$1,151.80
|
| Rate for Payer: PHCS All Commercial |
$991.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$677.53
|
| Rate for Payer: United Healthcare Commercial |
$752.38
|
| Rate for Payer: United Healthcare Medicare |
$677.53
|
|
|
PR OPEN TREATMENT PROX HUMERAL FRACTURE
|
Professional
|
$1,603.10
|
|
|
Service Code
|
CPT 23615
|
| Hospital Charge Code |
z23615
|
| Min. Negotiated Rate |
$789.05 |
| Max. Negotiated Rate |
$1,396.70 |
| Rate for Payer: Aetna Medicare |
$821.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$959.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$944.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$903.75
|
| Rate for Payer: Cash Price |
$993.92
|
| Rate for Payer: Cash Price |
$993.92
|
| Rate for Payer: Coventry All Commercial |
$985.91
|
| Rate for Payer: Frontpath All Commercial |
$1,147.03
|
| Rate for Payer: Humana ChoiceCare |
$789.05
|
| Rate for Payer: Humana Medicare |
$821.59
|
| Rate for Payer: Lucent All Commercial |
$1,396.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,315.00
|
| Rate for Payer: PHCS All Commercial |
$1,202.32
|
| Rate for Payer: PHP All Commercial |
$1,394.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$821.59
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,232.00
|
| Rate for Payer: United Healthcare Commercial |
$940.70
|
| Rate for Payer: United Healthcare Medicare |
$821.59
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
$1,292.94
|
|
|
Service Code
|
CPT 27784
|
| Hospital Charge Code |
z27784
|
| Min. Negotiated Rate |
$590.09 |
| Max. Negotiated Rate |
$1,126.49 |
| Rate for Payer: Aetna Medicare |
$662.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$685.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$762.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$728.90
|
| Rate for Payer: Cash Price |
$801.62
|
| Rate for Payer: Cash Price |
$801.62
|
| Rate for Payer: Coventry All Commercial |
$795.17
|
| Rate for Payer: Frontpath All Commercial |
$917.44
|
| Rate for Payer: Humana ChoiceCare |
$590.09
|
| Rate for Payer: Humana Medicare |
$662.64
|
| Rate for Payer: Lucent All Commercial |
$1,126.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,060.00
|
| Rate for Payer: PHCS All Commercial |
$969.70
|
| Rate for Payer: PHP All Commercial |
$1,124.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$662.64
|
| Rate for Payer: Signature Care EPO |
$788.80
|
| Rate for Payer: Signature Care PPO |
$788.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$994.00
|
| Rate for Payer: United Healthcare Commercial |
$747.11
|
| Rate for Payer: United Healthcare Medicare |
$662.64
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE
|
Professional
|
$1,222.86
|
|
|
Service Code
|
CPT 25515
|
| Hospital Charge Code |
z25515
|
| Min. Negotiated Rate |
$626.71 |
| Max. Negotiated Rate |
$1,065.41 |
| Rate for Payer: Aetna Medicare |
$626.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$720.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$689.38
|
| Rate for Payer: Cash Price |
$758.17
|
| Rate for Payer: Cash Price |
$758.17
|
| Rate for Payer: Coventry All Commercial |
$752.05
|
| Rate for Payer: Frontpath All Commercial |
$867.88
|
| Rate for Payer: Humana ChoiceCare |
$726.47
|
| Rate for Payer: Humana Medicare |
$626.71
|
| Rate for Payer: Lucent All Commercial |
$1,065.41
|
| Rate for Payer: PHCS All Commercial |
$917.14
|
| Rate for Payer: PHP All Commercial |
$1,063.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$626.71
|
| Rate for Payer: Signature Care EPO |
$971.55
|
| Rate for Payer: Signature Care PPO |
$971.55
|
| Rate for Payer: United Healthcare Commercial |
$716.79
|
| Rate for Payer: United Healthcare Medicare |
$626.71
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
$1,355.40
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
z26746
|
| Min. Negotiated Rate |
$491.25 |
| Max. Negotiated Rate |
$1,180.89 |
| Rate for Payer: Aetna Medicare |
$694.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$584.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$798.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$764.10
|
| Rate for Payer: Cash Price |
$840.35
|
| Rate for Payer: Cash Price |
$840.35
|
| Rate for Payer: Coventry All Commercial |
$833.57
|
| Rate for Payer: Frontpath All Commercial |
$960.51
|
| Rate for Payer: Humana ChoiceCare |
$491.25
|
| Rate for Payer: Humana Medicare |
$694.64
|
| Rate for Payer: Lucent All Commercial |
$1,180.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,111.00
|
| Rate for Payer: PHCS All Commercial |
$1,016.55
|
| Rate for Payer: PHP All Commercial |
$1,179.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$694.64
|
| Rate for Payer: Signature Care EPO |
$677.45
|
| Rate for Payer: Signature Care PPO |
$677.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,042.00
|
| Rate for Payer: United Healthcare Commercial |
$743.73
|
| Rate for Payer: United Healthcare Medicare |
$694.64
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE
|
Professional
|
$1,313.92
|
|
|
Service Code
|
CPT 25628
|
| Hospital Charge Code |
z25628
|
| Min. Negotiated Rate |
$673.39 |
| Max. Negotiated Rate |
$1,144.76 |
| Rate for Payer: Aetna Medicare |
$673.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$774.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$740.73
|
| Rate for Payer: Cash Price |
$814.63
|
| Rate for Payer: Cash Price |
$814.63
|
| Rate for Payer: Coventry All Commercial |
$808.07
|
| Rate for Payer: Frontpath All Commercial |
$932.80
|
| Rate for Payer: Humana ChoiceCare |
$703.78
|
| Rate for Payer: Humana Medicare |
$673.39
|
| Rate for Payer: Lucent All Commercial |
$1,144.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,077.00
|
| Rate for Payer: PHCS All Commercial |
$985.44
|
| Rate for Payer: PHP All Commercial |
$1,143.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$673.39
|
| Rate for Payer: Signature Care EPO |
$943.50
|
| Rate for Payer: Signature Care PPO |
$943.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,010.00
|
| Rate for Payer: United Healthcare Commercial |
$767.04
|
| Rate for Payer: United Healthcare Medicare |
$673.39
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
$1,053.76
|
|
|
Service Code
|
CPT 26685
|
| Hospital Charge Code |
z26685
|
| Min. Negotiated Rate |
$540.05 |
| Max. Negotiated Rate |
$918.08 |
| Rate for Payer: Aetna Medicare |
$540.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$681.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$621.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$594.06
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Coventry All Commercial |
$648.06
|
| Rate for Payer: Frontpath All Commercial |
$744.24
|
| Rate for Payer: Humana ChoiceCare |
$568.70
|
| Rate for Payer: Humana Medicare |
$540.05
|
| Rate for Payer: Lucent All Commercial |
$918.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$864.00
|
| Rate for Payer: PHCS All Commercial |
$790.32
|
| Rate for Payer: PHP All Commercial |
$916.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$540.05
|
| Rate for Payer: Signature Care EPO |
$770.95
|
| Rate for Payer: Signature Care PPO |
$770.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$810.00
|
| Rate for Payer: United Healthcare Commercial |
$594.66
|
| Rate for Payer: United Healthcare Medicare |
$540.05
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
$1,150.76
|
|
|
Service Code
|
CPT 26665
|
| Hospital Charge Code |
z26665
|
| Min. Negotiated Rate |
$589.76 |
| Max. Negotiated Rate |
$1,002.59 |
| Rate for Payer: Aetna Medicare |
$589.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$738.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$678.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$648.74
|
| Rate for Payer: Cash Price |
$713.47
|
| Rate for Payer: Cash Price |
$713.47
|
| Rate for Payer: Coventry All Commercial |
$707.71
|
| Rate for Payer: Frontpath All Commercial |
$804.74
|
| Rate for Payer: Humana ChoiceCare |
$610.73
|
| Rate for Payer: Humana Medicare |
$589.76
|
| Rate for Payer: Lucent All Commercial |
$1,002.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$944.00
|
| Rate for Payer: PHCS All Commercial |
$863.07
|
| Rate for Payer: PHP All Commercial |
$1,001.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$589.76
|
| Rate for Payer: Signature Care EPO |
$836.40
|
| Rate for Payer: Signature Care PPO |
$836.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$885.00
|
| Rate for Payer: United Healthcare Commercial |
$644.48
|
| Rate for Payer: United Healthcare Medicare |
$589.76
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
$1,176.96
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
z27792
|
| Min. Negotiated Rate |
$603.20 |
| Max. Negotiated Rate |
$1,025.44 |
| Rate for Payer: Aetna Medicare |
$603.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$752.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$693.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$663.52
|
| Rate for Payer: Cash Price |
$729.72
|
| Rate for Payer: Cash Price |
$729.72
|
| Rate for Payer: Coventry All Commercial |
$723.84
|
| Rate for Payer: Frontpath All Commercial |
$836.55
|
| Rate for Payer: Humana ChoiceCare |
$635.20
|
| Rate for Payer: Humana Medicare |
$603.20
|
| Rate for Payer: Lucent All Commercial |
$1,025.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.00
|
| Rate for Payer: PHCS All Commercial |
$882.72
|
| Rate for Payer: PHP All Commercial |
$1,023.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$603.20
|
| Rate for Payer: Signature Care EPO |
$848.30
|
| Rate for Payer: Signature Care PPO |
$848.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$905.00
|
| Rate for Payer: United Healthcare Commercial |
$755.06
|
| Rate for Payer: United Healthcare Medicare |
$603.20
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
$923.18
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
z26765
|
| Min. Negotiated Rate |
$368.21 |
| Max. Negotiated Rate |
$804.32 |
| Rate for Payer: Aetna Medicare |
$473.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$472.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$544.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$520.44
|
| Rate for Payer: Cash Price |
$572.37
|
| Rate for Payer: Cash Price |
$572.37
|
| Rate for Payer: Coventry All Commercial |
$567.76
|
| Rate for Payer: Frontpath All Commercial |
$647.10
|
| Rate for Payer: Humana ChoiceCare |
$368.21
|
| Rate for Payer: Humana Medicare |
$473.13
|
| Rate for Payer: Lucent All Commercial |
$804.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$757.00
|
| Rate for Payer: PHCS All Commercial |
$692.38
|
| Rate for Payer: PHP All Commercial |
$803.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$473.13
|
| Rate for Payer: Signature Care EPO |
$514.25
|
| Rate for Payer: Signature Care PPO |
$514.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$710.00
|
| Rate for Payer: United Healthcare Commercial |
$491.66
|
| Rate for Payer: United Healthcare Medicare |
$473.13
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
$1,291.72
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
z27829
|
| Min. Negotiated Rate |
$526.29 |
| Max. Negotiated Rate |
$1,124.87 |
| Rate for Payer: Aetna Medicare |
$661.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,027.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$760.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$727.86
|
| Rate for Payer: Cash Price |
$800.87
|
| Rate for Payer: Cash Price |
$800.87
|
| Rate for Payer: Coventry All Commercial |
$794.03
|
| Rate for Payer: Frontpath All Commercial |
$917.01
|
| Rate for Payer: Humana ChoiceCare |
$526.29
|
| Rate for Payer: Humana Medicare |
$661.69
|
| Rate for Payer: Lucent All Commercial |
$1,124.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,059.00
|
| Rate for Payer: PHCS All Commercial |
$968.79
|
| Rate for Payer: PHP All Commercial |
$1,123.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$661.69
|
| Rate for Payer: Signature Care EPO |
$705.50
|
| Rate for Payer: Signature Care PPO |
$705.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$993.00
|
| Rate for Payer: United Healthcare Commercial |
$706.54
|
| Rate for Payer: United Healthcare Medicare |
$661.69
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
$1,744.04
|
|
|
Service Code
|
CPT 27514
|
| Hospital Charge Code |
z27514
|
| Min. Negotiated Rate |
$893.82 |
| Max. Negotiated Rate |
$1,607.30 |
| Rate for Payer: Aetna Medicare |
$893.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,607.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,027.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$983.20
|
| Rate for Payer: Cash Price |
$1,081.30
|
| Rate for Payer: Cash Price |
$1,081.30
|
| Rate for Payer: Coventry All Commercial |
$1,072.58
|
| Rate for Payer: Frontpath All Commercial |
$1,259.34
|
| Rate for Payer: Humana ChoiceCare |
$1,340.71
|
| Rate for Payer: Humana Medicare |
$893.82
|
| Rate for Payer: Lucent All Commercial |
$1,519.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,430.00
|
| Rate for Payer: PHCS All Commercial |
$1,308.03
|
| Rate for Payer: PHP All Commercial |
$1,517.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$893.82
|
| Rate for Payer: Signature Care EPO |
$1,528.42
|
| Rate for Payer: Signature Care PPO |
$1,528.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,341.00
|
| Rate for Payer: United Healthcare Commercial |
$1,128.43
|
| Rate for Payer: United Healthcare Medicare |
$893.82
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W EXTENSION
|
Professional
|
$2,226.22
|
|
|
Service Code
|
CPT 27513
|
| Hospital Charge Code |
z27513
|
| Min. Negotiated Rate |
$1,141.26 |
| Max. Negotiated Rate |
$1,940.14 |
| Rate for Payer: Aetna Medicare |
$1,141.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,312.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,255.39
|
| Rate for Payer: Cash Price |
$1,380.26
|
| Rate for Payer: Cash Price |
$1,380.26
|
| Rate for Payer: Coventry All Commercial |
$1,369.51
|
| Rate for Payer: Frontpath All Commercial |
$1,612.79
|
| Rate for Payer: Humana ChoiceCare |
$1,391.02
|
| Rate for Payer: Humana Medicare |
$1,141.26
|
| Rate for Payer: Lucent All Commercial |
$1,940.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,826.00
|
| Rate for Payer: PHCS All Commercial |
$1,669.66
|
| Rate for Payer: PHP All Commercial |
$1,936.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,141.26
|
| Rate for Payer: Signature Care EPO |
$1,860.65
|
| Rate for Payer: Signature Care PPO |
$1,860.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,712.00
|
| Rate for Payer: United Healthcare Commercial |
$1,408.76
|
| Rate for Payer: United Healthcare Medicare |
$1,141.26
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O EXTENSION
|
Professional
|
$1,798.12
|
|
|
Service Code
|
CPT 27511
|
| Hospital Charge Code |
z27511
|
| Min. Negotiated Rate |
$921.53 |
| Max. Negotiated Rate |
$1,566.60 |
| Rate for Payer: Aetna Medicare |
$921.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,365.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,059.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,013.68
|
| Rate for Payer: Cash Price |
$1,114.83
|
| Rate for Payer: Cash Price |
$1,114.83
|
| Rate for Payer: Coventry All Commercial |
$1,105.84
|
| Rate for Payer: Frontpath All Commercial |
$1,297.39
|
| Rate for Payer: Humana ChoiceCare |
$1,083.93
|
| Rate for Payer: Humana Medicare |
$921.53
|
| Rate for Payer: Lucent All Commercial |
$1,566.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,474.00
|
| Rate for Payer: PHCS All Commercial |
$1,348.59
|
| Rate for Payer: PHP All Commercial |
$1,564.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$921.53
|
| Rate for Payer: Signature Care EPO |
$1,451.80
|
| Rate for Payer: Signature Care PPO |
$1,451.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,382.00
|
| Rate for Payer: United Healthcare Commercial |
$1,119.10
|
| Rate for Payer: United Healthcare Medicare |
$921.53
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
$1,190.64
|
|
|
Service Code
|
CPT 28505
|
| Hospital Charge Code |
z28505
|
| Min. Negotiated Rate |
$331.21 |
| Max. Negotiated Rate |
$892.98 |
| Rate for Payer: Aetna Medicare |
$466.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$517.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$536.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$512.97
|
| Rate for Payer: Cash Price |
$738.20
|
| Rate for Payer: Cash Price |
$738.20
|
| Rate for Payer: Coventry All Commercial |
$559.61
|
| Rate for Payer: Frontpath All Commercial |
$641.38
|
| Rate for Payer: Humana ChoiceCare |
$331.21
|
| Rate for Payer: Humana Medicare |
$466.34
|
| Rate for Payer: Lucent All Commercial |
$792.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.00
|
| Rate for Payer: PHCS All Commercial |
$892.98
|
| Rate for Payer: PHP All Commercial |
$791.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$466.34
|
| Rate for Payer: Signature Care EPO |
$756.50
|
| Rate for Payer: Signature Care PPO |
$756.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$700.00
|
| Rate for Payer: United Healthcare Commercial |
$533.71
|
| Rate for Payer: United Healthcare Medicare |
$466.34
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
$1,063.04
|
|
|
Service Code
|
CPT 28525
|
| Hospital Charge Code |
z28525
|
| Min. Negotiated Rate |
$290.34 |
| Max. Negotiated Rate |
$797.28 |
| Rate for Payer: Aetna Medicare |
$381.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$439.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$420.01
|
| Rate for Payer: Cash Price |
$659.08
|
| Rate for Payer: Cash Price |
$659.08
|
| Rate for Payer: Coventry All Commercial |
$458.20
|
| Rate for Payer: Frontpath All Commercial |
$518.95
|
| Rate for Payer: Humana ChoiceCare |
$290.34
|
| Rate for Payer: Humana Medicare |
$381.83
|
| Rate for Payer: Lucent All Commercial |
$649.11
|
| Rate for Payer: PHCS All Commercial |
$797.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$381.83
|
| Rate for Payer: United Healthcare Commercial |
$423.28
|
| Rate for Payer: United Healthcare Medicare |
$381.83
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
$1,682.08
|
|
|
Service Code
|
CPT 24545
|
| Hospital Charge Code |
z24545
|
| Min. Negotiated Rate |
$825.45 |
| Max. Negotiated Rate |
$1,465.25 |
| Rate for Payer: Aetna Medicare |
$861.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$991.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$948.10
|
| Rate for Payer: Cash Price |
$1,042.89
|
| Rate for Payer: Cash Price |
$1,042.89
|
| Rate for Payer: Coventry All Commercial |
$1,034.29
|
| Rate for Payer: Frontpath All Commercial |
$1,205.96
|
| Rate for Payer: Humana ChoiceCare |
$825.45
|
| Rate for Payer: Humana Medicare |
$861.91
|
| Rate for Payer: Lucent All Commercial |
$1,465.25
|
| Rate for Payer: PHCS All Commercial |
$1,261.56
|
| Rate for Payer: PHP All Commercial |
$1,463.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$861.91
|
| Rate for Payer: Signature Care EPO |
$1,104.15
|
| Rate for Payer: Signature Care PPO |
$1,104.15
|
| Rate for Payer: United Healthcare Commercial |
$989.31
|
| Rate for Payer: United Healthcare Medicare |
$861.91
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W XTN
|
Professional
|
$1,878.12
|
|
|
Service Code
|
CPT 24546
|
| Hospital Charge Code |
z24546
|
| Min. Negotiated Rate |
$962.54 |
| Max. Negotiated Rate |
$1,636.32 |
| Rate for Payer: Aetna Medicare |
$962.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,356.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,356.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,106.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,058.79
|
| Rate for Payer: Cash Price |
$1,164.43
|
| Rate for Payer: Cash Price |
$1,164.43
|
| Rate for Payer: Coventry All Commercial |
$1,155.05
|
| Rate for Payer: Frontpath All Commercial |
$1,346.63
|
| Rate for Payer: Humana ChoiceCare |
$1,185.03
|
| Rate for Payer: Humana Medicare |
$962.54
|
| Rate for Payer: Lucent All Commercial |
$1,636.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,540.00
|
| Rate for Payer: PHCS All Commercial |
$1,408.59
|
| Rate for Payer: PHP All Commercial |
$1,633.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$962.54
|
| Rate for Payer: Signature Care EPO |
$1,586.10
|
| Rate for Payer: Signature Care PPO |
$1,586.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,444.00
|
| Rate for Payer: United Healthcare Commercial |
$1,148.63
|
| Rate for Payer: United Healthcare Medicare |
$962.54
|
|
|
PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE
|
Professional
|
$1,479.26
|
|
|
Service Code
|
CPT 27540
|
| Hospital Charge Code |
z27540
|
| Min. Negotiated Rate |
$758.12 |
| Max. Negotiated Rate |
$1,289.23 |
| Rate for Payer: Aetna Medicare |
$758.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,178.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,178.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$871.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$833.93
|
| Rate for Payer: Cash Price |
$917.14
|
| Rate for Payer: Cash Price |
$917.14
|
| Rate for Payer: Coventry All Commercial |
$909.74
|
| Rate for Payer: Frontpath All Commercial |
$1,057.45
|
| Rate for Payer: Humana ChoiceCare |
$991.60
|
| Rate for Payer: Humana Medicare |
$758.12
|
| Rate for Payer: Lucent All Commercial |
$1,288.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,213.00
|
| Rate for Payer: PHCS All Commercial |
$1,109.44
|
| Rate for Payer: PHP All Commercial |
$1,286.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$758.12
|
| Rate for Payer: Signature Care EPO |
$1,289.23
|
| Rate for Payer: Signature Care PPO |
$1,289.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,137.00
|
| Rate for Payer: United Healthcare Commercial |
$902.41
|
| Rate for Payer: United Healthcare Medicare |
$758.12
|
|
|
PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION 1
|
Professional
|
$1,005.12
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
z26785
|
| Min. Negotiated Rate |
$375.89 |
| Max. Negotiated Rate |
$875.45 |
| Rate for Payer: Aetna Medicare |
$514.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$435.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$435.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$592.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$566.47
|
| Rate for Payer: Cash Price |
$623.17
|
| Rate for Payer: Cash Price |
$623.17
|
| Rate for Payer: Coventry All Commercial |
$617.96
|
| Rate for Payer: Frontpath All Commercial |
$705.03
|
| Rate for Payer: Humana ChoiceCare |
$375.89
|
| Rate for Payer: Humana Medicare |
$514.97
|
| Rate for Payer: Lucent All Commercial |
$875.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.00
|
| Rate for Payer: PHCS All Commercial |
$753.84
|
| Rate for Payer: PHP All Commercial |
$874.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$514.97
|
| Rate for Payer: Signature Care EPO |
$518.50
|
| Rate for Payer: Signature Care PPO |
$518.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$772.00
|
| Rate for Payer: United Healthcare Commercial |
$537.15
|
| Rate for Payer: United Healthcare Medicare |
$514.97
|
|
|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
$1,054.08
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
z26615
|
| Min. Negotiated Rate |
$459.06 |
| Max. Negotiated Rate |
$917.85 |
| Rate for Payer: Aetna Medicare |
$539.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$554.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$620.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$593.90
|
| Rate for Payer: Cash Price |
$653.53
|
| Rate for Payer: Cash Price |
$653.53
|
| Rate for Payer: Coventry All Commercial |
$647.89
|
| Rate for Payer: Frontpath All Commercial |
$742.92
|
| Rate for Payer: Humana ChoiceCare |
$459.06
|
| Rate for Payer: Humana Medicare |
$539.91
|
| Rate for Payer: Lucent All Commercial |
$917.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$864.00
|
| Rate for Payer: PHCS All Commercial |
$790.56
|
| Rate for Payer: PHP All Commercial |
$917.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$539.91
|
| Rate for Payer: Signature Care EPO |
$627.30
|
| Rate for Payer: Signature Care PPO |
$627.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$810.00
|
| Rate for Payer: United Healthcare Commercial |
$580.18
|
| Rate for Payer: United Healthcare Medicare |
$539.91
|
|
|
PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION
|
Professional
|
$1,185.44
|
|
|
Service Code
|
CPT 28645
|
| Hospital Charge Code |
z28645
|
| Min. Negotiated Rate |
$324.39 |
| Max. Negotiated Rate |
$889.08 |
| Rate for Payer: Aetna Medicare |
$456.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$525.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$502.57
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Coventry All Commercial |
$548.26
|
| Rate for Payer: Frontpath All Commercial |
$623.16
|
| Rate for Payer: Humana ChoiceCare |
$324.39
|
| Rate for Payer: Humana Medicare |
$456.88
|
| Rate for Payer: Lucent All Commercial |
$776.70
|
| Rate for Payer: PHCS All Commercial |
$889.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$456.88
|
| Rate for Payer: United Healthcare Commercial |
$521.56
|
| Rate for Payer: United Healthcare Medicare |
$456.88
|
|
