|
PR CLOSED RX RADIAL SHAFT FX
|
Professional
|
Both
|
$548.94
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
z25500
|
| Min. Negotiated Rate |
$137.90 |
| Max. Negotiated Rate |
$36,900.00 |
| Rate for Payer: Aetna Commercial |
$242.54
|
| Rate for Payer: Aetna Commercial |
$242.54
|
| Rate for Payer: Aetna Medicare |
$242.54
|
| Rate for Payer: Aetna Medicare |
$242.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$344.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$344.58
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$137.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$137.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$269.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$269.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$278.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$278.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.79
|
| Rate for Payer: Cash Price |
$318.04
|
| Rate for Payer: Cash Price |
$329.36
|
| Rate for Payer: Centivo All Commercial |
$375.94
|
| Rate for Payer: Centivo All Commercial |
$375.94
|
| Rate for Payer: Cigna All Commercial |
$242.54
|
| Rate for Payer: Cigna All Commercial |
$242.54
|
| Rate for Payer: CORVEL All Commercial |
$242.54
|
| Rate for Payer: CORVEL All Commercial |
$242.54
|
| Rate for Payer: Coventry All Commercial |
$291.05
|
| Rate for Payer: Coventry All Commercial |
$291.05
|
| Rate for Payer: Encore All Commercial |
$242.54
|
| Rate for Payer: Encore All Commercial |
$242.54
|
| Rate for Payer: Frontpath All Commercial |
$332.16
|
| Rate for Payer: Frontpath All Commercial |
$332.16
|
| Rate for Payer: Humana ChoiceCare |
$221.21
|
| Rate for Payer: Humana ChoiceCare |
$221.21
|
| Rate for Payer: Humana Medicare |
$242.54
|
| Rate for Payer: Humana Medicare |
$242.54
|
| Rate for Payer: Lucent All Commercial |
$339.56
|
| Rate for Payer: Lucent All Commercial |
$339.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$393.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$393.00
|
| Rate for Payer: Managed Health Services Medicaid |
$269.99
|
| Rate for Payer: Managed Health Services Medicaid |
$269.99
|
| Rate for Payer: MDWise Medicaid |
$269.99
|
| Rate for Payer: MDWise Medicaid |
$269.99
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$137.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$137.90
|
| Rate for Payer: PHCS All Commercial |
$242.54
|
| Rate for Payer: PHCS All Commercial |
$242.54
|
| Rate for Payer: PHP All Commercial |
$417.12
|
| Rate for Payer: PHP All Commercial |
$417.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.54
|
| Rate for Payer: Sagamore Health Network All Products |
$242.54
|
| Rate for Payer: Sagamore Health Network All Products |
$242.54
|
| Rate for Payer: Signature Care EPO |
$364.65
|
| Rate for Payer: Signature Care EPO |
$364.65
|
| Rate for Payer: Signature Care PPO |
$364.65
|
| Rate for Payer: Signature Care PPO |
$364.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,900.00
|
| Rate for Payer: United Healthcare Commercial |
$239.74
|
| Rate for Payer: United Healthcare Commercial |
$239.74
|
| Rate for Payer: United Healthcare Medicare |
$265.03
|
| Rate for Payer: United Healthcare Medicare |
$265.03
|
|
|
PR CLOSED RX RADIAL SHAFT FX,MANIPULATN
|
Professional
|
Both
|
$967.72
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
z25505
|
| Min. Negotiated Rate |
$255.50 |
| Max. Negotiated Rate |
$65,500.00 |
| Rate for Payer: Aetna Commercial |
$431.33
|
| Rate for Payer: Aetna Commercial |
$431.33
|
| Rate for Payer: Aetna Medicare |
$431.33
|
| Rate for Payer: Aetna Medicare |
$431.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$570.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$570.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$255.50
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$255.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$475.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$496.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$496.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$474.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$474.46
|
| Rate for Payer: Cash Price |
$563.65
|
| Rate for Payer: Cash Price |
$580.63
|
| Rate for Payer: Centivo All Commercial |
$668.56
|
| Rate for Payer: Centivo All Commercial |
$668.56
|
| Rate for Payer: Cigna All Commercial |
$431.33
|
| Rate for Payer: Cigna All Commercial |
$431.33
|
| Rate for Payer: CORVEL All Commercial |
$431.33
|
| Rate for Payer: CORVEL All Commercial |
$431.33
|
| Rate for Payer: Coventry All Commercial |
$517.60
|
| Rate for Payer: Coventry All Commercial |
$517.60
|
| Rate for Payer: Encore All Commercial |
$431.33
|
| Rate for Payer: Encore All Commercial |
$431.33
|
| Rate for Payer: Frontpath All Commercial |
$595.80
|
| Rate for Payer: Frontpath All Commercial |
$595.80
|
| Rate for Payer: Humana ChoiceCare |
$459.33
|
| Rate for Payer: Humana ChoiceCare |
$459.33
|
| Rate for Payer: Humana Medicare |
$431.33
|
| Rate for Payer: Humana Medicare |
$431.33
|
| Rate for Payer: Lucent All Commercial |
$603.86
|
| Rate for Payer: Lucent All Commercial |
$603.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$698.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$698.00
|
| Rate for Payer: Managed Health Services Medicaid |
$475.96
|
| Rate for Payer: Managed Health Services Medicaid |
$475.96
|
| Rate for Payer: MDWise Medicaid |
$475.96
|
| Rate for Payer: MDWise Medicaid |
$475.96
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$255.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$255.50
|
| Rate for Payer: PHCS All Commercial |
$431.33
|
| Rate for Payer: PHCS All Commercial |
$431.33
|
| Rate for Payer: PHP All Commercial |
$741.31
|
| Rate for Payer: PHP All Commercial |
$741.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$431.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$431.33
|
| Rate for Payer: Sagamore Health Network All Products |
$431.33
|
| Rate for Payer: Sagamore Health Network All Products |
$431.33
|
| Rate for Payer: Signature Care EPO |
$710.60
|
| Rate for Payer: Signature Care EPO |
$710.60
|
| Rate for Payer: Signature Care PPO |
$710.60
|
| Rate for Payer: Signature Care PPO |
$710.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$65,500.00
|
| Rate for Payer: United Healthcare Commercial |
$475.98
|
| Rate for Payer: United Healthcare Commercial |
$475.98
|
| Rate for Payer: United Healthcare Medicare |
$469.71
|
| Rate for Payer: United Healthcare Medicare |
$469.71
|
|
|
PR CLOSED RX RADIAL SHAFT FX W/DISLOCATION
|
Professional
|
Both
|
$1,091.66
|
|
|
Service Code
|
CPT 25520
|
| Hospital Charge Code |
z25520
|
| Min. Negotiated Rate |
$353.92 |
| Max. Negotiated Rate |
$77,000.00 |
| Rate for Payer: Aetna Commercial |
$511.08
|
| Rate for Payer: Aetna Commercial |
$511.08
|
| Rate for Payer: Aetna Medicare |
$511.08
|
| Rate for Payer: Aetna Medicare |
$511.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$686.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$686.60
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$353.92
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$353.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$536.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$536.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$587.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$587.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.19
|
| Rate for Payer: Cash Price |
$638.00
|
| Rate for Payer: Cash Price |
$655.00
|
| Rate for Payer: Centivo All Commercial |
$792.17
|
| Rate for Payer: Centivo All Commercial |
$792.17
|
| Rate for Payer: Cigna All Commercial |
$511.08
|
| Rate for Payer: Cigna All Commercial |
$511.08
|
| Rate for Payer: CORVEL All Commercial |
$511.08
|
| Rate for Payer: CORVEL All Commercial |
$511.08
|
| Rate for Payer: Coventry All Commercial |
$613.30
|
| Rate for Payer: Coventry All Commercial |
$613.30
|
| Rate for Payer: Encore All Commercial |
$511.08
|
| Rate for Payer: Encore All Commercial |
$511.08
|
| Rate for Payer: Frontpath All Commercial |
$707.01
|
| Rate for Payer: Frontpath All Commercial |
$707.01
|
| Rate for Payer: Humana ChoiceCare |
$533.91
|
| Rate for Payer: Humana ChoiceCare |
$533.91
|
| Rate for Payer: Humana Medicare |
$511.08
|
| Rate for Payer: Humana Medicare |
$511.08
|
| Rate for Payer: Lucent All Commercial |
$715.51
|
| Rate for Payer: Lucent All Commercial |
$715.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$821.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$821.00
|
| Rate for Payer: Managed Health Services Medicaid |
$536.92
|
| Rate for Payer: Managed Health Services Medicaid |
$536.92
|
| Rate for Payer: MDWise Medicaid |
$536.92
|
| Rate for Payer: MDWise Medicaid |
$536.92
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$353.92
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$353.92
|
| Rate for Payer: PHCS All Commercial |
$511.08
|
| Rate for Payer: PHCS All Commercial |
$511.08
|
| Rate for Payer: PHP All Commercial |
$871.13
|
| Rate for Payer: PHP All Commercial |
$871.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$511.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$511.08
|
| Rate for Payer: Sagamore Health Network All Products |
$511.08
|
| Rate for Payer: Sagamore Health Network All Products |
$511.08
|
| Rate for Payer: Signature Care EPO |
$788.80
|
| Rate for Payer: Signature Care EPO |
$788.80
|
| Rate for Payer: Signature Care PPO |
$788.80
|
| Rate for Payer: Signature Care PPO |
$788.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$77,000.00
|
| Rate for Payer: United Healthcare Commercial |
$542.65
|
| Rate for Payer: United Healthcare Commercial |
$542.65
|
| Rate for Payer: United Healthcare Medicare |
$531.67
|
| Rate for Payer: United Healthcare Medicare |
$531.67
|
|
|
PR CLOSED RX RAD/ULNA SHAFT FX
|
Professional
|
Both
|
$559.04
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
z25560
|
| Min. Negotiated Rate |
$136.84 |
| Max. Negotiated Rate |
$37,100.00 |
| Rate for Payer: Aetna Commercial |
$243.91
|
| Rate for Payer: Aetna Commercial |
$243.91
|
| Rate for Payer: Aetna Medicare |
$243.91
|
| Rate for Payer: Aetna Medicare |
$243.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$322.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$322.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$136.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$136.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$274.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$274.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$280.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$280.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$268.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$268.30
|
| Rate for Payer: Cash Price |
$324.32
|
| Rate for Payer: Cash Price |
$335.42
|
| Rate for Payer: Centivo All Commercial |
$378.06
|
| Rate for Payer: Centivo All Commercial |
$378.06
|
| Rate for Payer: Cigna All Commercial |
$243.91
|
| Rate for Payer: Cigna All Commercial |
$243.91
|
| Rate for Payer: CORVEL All Commercial |
$243.91
|
| Rate for Payer: CORVEL All Commercial |
$243.91
|
| Rate for Payer: Coventry All Commercial |
$292.69
|
| Rate for Payer: Coventry All Commercial |
$292.69
|
| Rate for Payer: Encore All Commercial |
$243.91
|
| Rate for Payer: Encore All Commercial |
$243.91
|
| Rate for Payer: Frontpath All Commercial |
$334.26
|
| Rate for Payer: Frontpath All Commercial |
$334.26
|
| Rate for Payer: Humana ChoiceCare |
$216.43
|
| Rate for Payer: Humana ChoiceCare |
$216.43
|
| Rate for Payer: Humana Medicare |
$243.91
|
| Rate for Payer: Humana Medicare |
$243.91
|
| Rate for Payer: Lucent All Commercial |
$341.47
|
| Rate for Payer: Lucent All Commercial |
$341.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$395.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$274.95
|
| Rate for Payer: Managed Health Services Medicaid |
$274.95
|
| Rate for Payer: MDWise Medicaid |
$274.95
|
| Rate for Payer: MDWise Medicaid |
$274.95
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$136.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$136.84
|
| Rate for Payer: PHCS All Commercial |
$243.91
|
| Rate for Payer: PHCS All Commercial |
$243.91
|
| Rate for Payer: PHP All Commercial |
$419.44
|
| Rate for Payer: PHP All Commercial |
$419.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$243.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$243.91
|
| Rate for Payer: Sagamore Health Network All Products |
$243.91
|
| Rate for Payer: Sagamore Health Network All Products |
$243.91
|
| Rate for Payer: Signature Care EPO |
$367.20
|
| Rate for Payer: Signature Care EPO |
$367.20
|
| Rate for Payer: Signature Care PPO |
$367.20
|
| Rate for Payer: Signature Care PPO |
$367.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37,100.00
|
| Rate for Payer: United Healthcare Commercial |
$238.45
|
| Rate for Payer: United Healthcare Commercial |
$238.45
|
| Rate for Payer: United Healthcare Medicare |
$270.27
|
| Rate for Payer: United Healthcare Medicare |
$270.27
|
|
|
PR CLOSED RX RAD/ULNA SHAFT FX,MANIP
|
Professional
|
Both
|
$985.88
|
|
|
Service Code
|
CPT 25565
|
| Hospital Charge Code |
z25565
|
| Min. Negotiated Rate |
$287.20 |
| Max. Negotiated Rate |
$66,100.00 |
| Rate for Payer: Aetna Commercial |
$437.91
|
| Rate for Payer: Aetna Commercial |
$437.91
|
| Rate for Payer: Aetna Medicare |
$437.91
|
| Rate for Payer: Aetna Medicare |
$437.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$628.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$628.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$287.20
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$287.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$484.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$484.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$503.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$503.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$481.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$481.70
|
| Rate for Payer: Cash Price |
$577.43
|
| Rate for Payer: Cash Price |
$591.53
|
| Rate for Payer: Centivo All Commercial |
$678.76
|
| Rate for Payer: Centivo All Commercial |
$678.76
|
| Rate for Payer: Cigna All Commercial |
$437.91
|
| Rate for Payer: Cigna All Commercial |
$437.91
|
| Rate for Payer: CORVEL All Commercial |
$437.91
|
| Rate for Payer: CORVEL All Commercial |
$437.91
|
| Rate for Payer: Coventry All Commercial |
$525.49
|
| Rate for Payer: Coventry All Commercial |
$525.49
|
| Rate for Payer: Encore All Commercial |
$437.91
|
| Rate for Payer: Encore All Commercial |
$437.91
|
| Rate for Payer: Frontpath All Commercial |
$607.29
|
| Rate for Payer: Frontpath All Commercial |
$607.29
|
| Rate for Payer: Humana ChoiceCare |
$478.23
|
| Rate for Payer: Humana ChoiceCare |
$478.23
|
| Rate for Payer: Humana Medicare |
$437.91
|
| Rate for Payer: Humana Medicare |
$437.91
|
| Rate for Payer: Lucent All Commercial |
$613.07
|
| Rate for Payer: Lucent All Commercial |
$613.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$705.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$705.00
|
| Rate for Payer: Managed Health Services Medicaid |
$484.90
|
| Rate for Payer: Managed Health Services Medicaid |
$484.90
|
| Rate for Payer: MDWise Medicaid |
$484.90
|
| Rate for Payer: MDWise Medicaid |
$484.90
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$287.20
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$287.20
|
| Rate for Payer: PHCS All Commercial |
$437.91
|
| Rate for Payer: PHCS All Commercial |
$437.91
|
| Rate for Payer: PHP All Commercial |
$748.19
|
| Rate for Payer: PHP All Commercial |
$748.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$437.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$437.91
|
| Rate for Payer: Sagamore Health Network All Products |
$437.91
|
| Rate for Payer: Sagamore Health Network All Products |
$437.91
|
| Rate for Payer: Signature Care EPO |
$744.60
|
| Rate for Payer: Signature Care EPO |
$744.60
|
| Rate for Payer: Signature Care PPO |
$744.60
|
| Rate for Payer: Signature Care PPO |
$744.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66,100.00
|
| Rate for Payer: United Healthcare Commercial |
$494.85
|
| Rate for Payer: United Healthcare Commercial |
$494.85
|
| Rate for Payer: United Healthcare Medicare |
$481.19
|
| Rate for Payer: United Healthcare Medicare |
$481.19
|
|
|
PR CLOSED RX SCAPULA FX
|
Professional
|
Both
|
$450.96
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
z23570
|
| Min. Negotiated Rate |
$122.34 |
| Max. Negotiated Rate |
$34,600.00 |
| Rate for Payer: Aetna Commercial |
$228.13
|
| Rate for Payer: Aetna Commercial |
$228.13
|
| Rate for Payer: Aetna Medicare |
$228.13
|
| Rate for Payer: Aetna Medicare |
$228.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$233.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$233.10
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$122.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$122.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$221.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$221.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$262.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$262.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$250.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$250.94
|
| Rate for Payer: Cash Price |
$262.03
|
| Rate for Payer: Cash Price |
$270.58
|
| Rate for Payer: Centivo All Commercial |
$353.60
|
| Rate for Payer: Centivo All Commercial |
$353.60
|
| Rate for Payer: Cigna All Commercial |
$228.13
|
| Rate for Payer: Cigna All Commercial |
$228.13
|
| Rate for Payer: CORVEL All Commercial |
$228.13
|
| Rate for Payer: CORVEL All Commercial |
$228.13
|
| Rate for Payer: Coventry All Commercial |
$273.76
|
| Rate for Payer: Coventry All Commercial |
$273.76
|
| Rate for Payer: Encore All Commercial |
$228.13
|
| Rate for Payer: Encore All Commercial |
$228.13
|
| Rate for Payer: Frontpath All Commercial |
$311.92
|
| Rate for Payer: Frontpath All Commercial |
$311.92
|
| Rate for Payer: Humana ChoiceCare |
$218.91
|
| Rate for Payer: Humana ChoiceCare |
$218.91
|
| Rate for Payer: Humana Medicare |
$228.13
|
| Rate for Payer: Humana Medicare |
$228.13
|
| Rate for Payer: Lucent All Commercial |
$319.38
|
| Rate for Payer: Lucent All Commercial |
$319.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$369.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$369.00
|
| Rate for Payer: Managed Health Services Medicaid |
$221.80
|
| Rate for Payer: Managed Health Services Medicaid |
$221.80
|
| Rate for Payer: MDWise Medicaid |
$221.80
|
| Rate for Payer: MDWise Medicaid |
$221.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$122.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$122.34
|
| Rate for Payer: PHCS All Commercial |
$228.13
|
| Rate for Payer: PHCS All Commercial |
$228.13
|
| Rate for Payer: PHP All Commercial |
$391.99
|
| Rate for Payer: PHP All Commercial |
$391.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$228.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$228.13
|
| Rate for Payer: Sagamore Health Network All Products |
$228.13
|
| Rate for Payer: Sagamore Health Network All Products |
$228.13
|
| Rate for Payer: Signature Care EPO |
$335.75
|
| Rate for Payer: Signature Care EPO |
$335.75
|
| Rate for Payer: Signature Care PPO |
$335.75
|
| Rate for Payer: Signature Care PPO |
$335.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34,600.00
|
| Rate for Payer: United Healthcare Commercial |
$233.36
|
| Rate for Payer: United Healthcare Commercial |
$233.36
|
| Rate for Payer: United Healthcare Medicare |
$218.36
|
| Rate for Payer: United Healthcare Medicare |
$218.36
|
|
|
PR CLOSED RX SESAMOID BONE FX
|
Professional
|
Both
|
$214.18
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
z28530
|
| Min. Negotiated Rate |
$56.07 |
| Max. Negotiated Rate |
$144.10 |
| Rate for Payer: Aetna Commercial |
$92.97
|
| Rate for Payer: Aetna Commercial |
$92.97
|
| Rate for Payer: Aetna Medicare |
$92.97
|
| Rate for Payer: Aetna Medicare |
$92.97
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.07
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$110.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$110.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.27
|
| Rate for Payer: Cash Price |
$134.69
|
| Rate for Payer: Cash Price |
$128.51
|
| Rate for Payer: Centivo All Commercial |
$144.10
|
| Rate for Payer: Centivo All Commercial |
$144.10
|
| Rate for Payer: Cigna All Commercial |
$92.97
|
| Rate for Payer: Cigna All Commercial |
$92.97
|
| Rate for Payer: CORVEL All Commercial |
$92.97
|
| Rate for Payer: CORVEL All Commercial |
$92.97
|
| Rate for Payer: Coventry All Commercial |
$111.56
|
| Rate for Payer: Coventry All Commercial |
$111.56
|
| Rate for Payer: Encore All Commercial |
$92.97
|
| Rate for Payer: Encore All Commercial |
$92.97
|
| Rate for Payer: Frontpath All Commercial |
$124.68
|
| Rate for Payer: Frontpath All Commercial |
$124.68
|
| Rate for Payer: Humana ChoiceCare |
$105.90
|
| Rate for Payer: Humana ChoiceCare |
$105.90
|
| Rate for Payer: Humana Medicare |
$92.97
|
| Rate for Payer: Humana Medicare |
$92.97
|
| Rate for Payer: Lucent All Commercial |
$130.16
|
| Rate for Payer: Lucent All Commercial |
$130.16
|
| Rate for Payer: Managed Health Services Medicaid |
$110.41
|
| Rate for Payer: Managed Health Services Medicaid |
$110.41
|
| Rate for Payer: MDWise Medicaid |
$110.41
|
| Rate for Payer: MDWise Medicaid |
$110.41
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$56.07
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$56.07
|
| Rate for Payer: PHCS All Commercial |
$92.97
|
| Rate for Payer: PHCS All Commercial |
$92.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$92.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$92.97
|
| Rate for Payer: Sagamore Health Network All Products |
$92.97
|
| Rate for Payer: Sagamore Health Network All Products |
$92.97
|
| Rate for Payer: United Healthcare Commercial |
$108.34
|
| Rate for Payer: United Healthcare Commercial |
$108.34
|
| Rate for Payer: United Healthcare Medicare |
$107.09
|
| Rate for Payer: United Healthcare Medicare |
$107.09
|
|
|
PR CLOSED RX SHLDR DISLOC,ANESTHESIA
|
Professional
|
Both
|
$769.92
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
z23655
|
| Min. Negotiated Rate |
$375.11 |
| Max. Negotiated Rate |
$57,700.00 |
| Rate for Payer: Aetna Commercial |
$384.33
|
| Rate for Payer: Aetna Commercial |
$384.33
|
| Rate for Payer: Aetna Medicare |
$384.33
|
| Rate for Payer: Aetna Medicare |
$384.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$398.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$398.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$378.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$378.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$441.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$441.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$422.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$422.76
|
| Rate for Payer: Cash Price |
$461.95
|
| Rate for Payer: Cash Price |
$450.13
|
| Rate for Payer: Centivo All Commercial |
$595.71
|
| Rate for Payer: Centivo All Commercial |
$595.71
|
| Rate for Payer: Cigna All Commercial |
$384.33
|
| Rate for Payer: Cigna All Commercial |
$384.33
|
| Rate for Payer: CORVEL All Commercial |
$384.33
|
| Rate for Payer: CORVEL All Commercial |
$384.33
|
| Rate for Payer: Coventry All Commercial |
$461.20
|
| Rate for Payer: Coventry All Commercial |
$461.20
|
| Rate for Payer: Encore All Commercial |
$384.33
|
| Rate for Payer: Encore All Commercial |
$384.33
|
| Rate for Payer: Frontpath All Commercial |
$530.35
|
| Rate for Payer: Frontpath All Commercial |
$530.35
|
| Rate for Payer: Humana ChoiceCare |
$377.54
|
| Rate for Payer: Humana ChoiceCare |
$377.54
|
| Rate for Payer: Humana Medicare |
$384.33
|
| Rate for Payer: Humana Medicare |
$384.33
|
| Rate for Payer: Lucent All Commercial |
$538.06
|
| Rate for Payer: Lucent All Commercial |
$538.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$615.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$615.00
|
| Rate for Payer: Managed Health Services Medicaid |
$378.67
|
| Rate for Payer: Managed Health Services Medicaid |
$378.67
|
| Rate for Payer: MDWise Medicaid |
$378.67
|
| Rate for Payer: MDWise Medicaid |
$378.67
|
| Rate for Payer: PHCS All Commercial |
$384.33
|
| Rate for Payer: PHCS All Commercial |
$384.33
|
| Rate for Payer: PHP All Commercial |
$652.70
|
| Rate for Payer: PHP All Commercial |
$652.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$384.33
|
| Rate for Payer: Sagamore Health Network All Products |
$384.33
|
| Rate for Payer: Sagamore Health Network All Products |
$384.33
|
| Rate for Payer: Signature Care EPO |
$504.05
|
| Rate for Payer: Signature Care EPO |
$504.05
|
| Rate for Payer: Signature Care PPO |
$504.05
|
| Rate for Payer: Signature Care PPO |
$504.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$57,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$57,700.00
|
| Rate for Payer: United Healthcare Commercial |
$401.64
|
| Rate for Payer: United Healthcare Commercial |
$401.64
|
| Rate for Payer: United Healthcare Medicare |
$375.11
|
| Rate for Payer: United Healthcare Medicare |
$375.11
|
|
|
PR CLOSED RX SHLDR DISLOCATION
|
Professional
|
Both
|
$636.70
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
z23650
|
| Min. Negotiated Rate |
$157.80 |
| Max. Negotiated Rate |
$42,600.00 |
| Rate for Payer: Aetna Commercial |
$278.11
|
| Rate for Payer: Aetna Commercial |
$278.11
|
| Rate for Payer: Aetna Medicare |
$278.11
|
| Rate for Payer: Aetna Medicare |
$278.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$333.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$333.90
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$313.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$313.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$319.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$319.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$305.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$305.92
|
| Rate for Payer: Cash Price |
$369.02
|
| Rate for Payer: Cash Price |
$382.02
|
| Rate for Payer: Centivo All Commercial |
$431.07
|
| Rate for Payer: Centivo All Commercial |
$431.07
|
| Rate for Payer: Cigna All Commercial |
$278.11
|
| Rate for Payer: Cigna All Commercial |
$278.11
|
| Rate for Payer: CORVEL All Commercial |
$278.11
|
| Rate for Payer: CORVEL All Commercial |
$278.11
|
| Rate for Payer: Coventry All Commercial |
$333.73
|
| Rate for Payer: Coventry All Commercial |
$333.73
|
| Rate for Payer: Encore All Commercial |
$278.11
|
| Rate for Payer: Encore All Commercial |
$278.11
|
| Rate for Payer: Frontpath All Commercial |
$384.90
|
| Rate for Payer: Frontpath All Commercial |
$384.90
|
| Rate for Payer: Humana ChoiceCare |
$262.84
|
| Rate for Payer: Humana ChoiceCare |
$262.84
|
| Rate for Payer: Humana Medicare |
$278.11
|
| Rate for Payer: Humana Medicare |
$278.11
|
| Rate for Payer: Lucent All Commercial |
$389.35
|
| Rate for Payer: Lucent All Commercial |
$389.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$455.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$455.00
|
| Rate for Payer: Managed Health Services Medicaid |
$313.15
|
| Rate for Payer: Managed Health Services Medicaid |
$313.15
|
| Rate for Payer: MDWise Medicaid |
$313.15
|
| Rate for Payer: MDWise Medicaid |
$313.15
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$157.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$157.80
|
| Rate for Payer: PHCS All Commercial |
$278.11
|
| Rate for Payer: PHCS All Commercial |
$278.11
|
| Rate for Payer: PHP All Commercial |
$482.67
|
| Rate for Payer: PHP All Commercial |
$482.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$278.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$278.11
|
| Rate for Payer: Sagamore Health Network All Products |
$278.11
|
| Rate for Payer: Sagamore Health Network All Products |
$278.11
|
| Rate for Payer: Signature Care EPO |
$457.30
|
| Rate for Payer: Signature Care EPO |
$457.30
|
| Rate for Payer: Signature Care PPO |
$457.30
|
| Rate for Payer: Signature Care PPO |
$457.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,600.00
|
| Rate for Payer: United Healthcare Commercial |
$277.41
|
| Rate for Payer: United Healthcare Commercial |
$277.41
|
| Rate for Payer: United Healthcare Medicare |
$307.52
|
| Rate for Payer: United Healthcare Medicare |
$307.52
|
|
|
PR CLOSED RX SHLDR DISLOC,GR TUB FX
|
Professional
|
Both
|
$828.94
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
z23665
|
| Min. Negotiated Rate |
$227.75 |
| Max. Negotiated Rate |
$641.43 |
| Rate for Payer: Aetna Commercial |
$375.88
|
| Rate for Payer: Aetna Commercial |
$375.88
|
| Rate for Payer: Aetna Medicare |
$375.88
|
| Rate for Payer: Aetna Medicare |
$375.88
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$227.75
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$227.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$407.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$407.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.47
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cash Price |
$497.36
|
| Rate for Payer: Centivo All Commercial |
$582.61
|
| Rate for Payer: Centivo All Commercial |
$582.61
|
| Rate for Payer: Cigna All Commercial |
$375.88
|
| Rate for Payer: Cigna All Commercial |
$375.88
|
| Rate for Payer: CORVEL All Commercial |
$375.88
|
| Rate for Payer: CORVEL All Commercial |
$375.88
|
| Rate for Payer: Coventry All Commercial |
$451.06
|
| Rate for Payer: Coventry All Commercial |
$451.06
|
| Rate for Payer: Encore All Commercial |
$375.88
|
| Rate for Payer: Encore All Commercial |
$375.88
|
| Rate for Payer: Frontpath All Commercial |
$519.27
|
| Rate for Payer: Frontpath All Commercial |
$519.27
|
| Rate for Payer: Humana ChoiceCare |
$395.32
|
| Rate for Payer: Humana ChoiceCare |
$395.32
|
| Rate for Payer: Humana Medicare |
$375.88
|
| Rate for Payer: Humana Medicare |
$375.88
|
| Rate for Payer: Lucent All Commercial |
$526.23
|
| Rate for Payer: Lucent All Commercial |
$526.23
|
| Rate for Payer: Managed Health Services Medicaid |
$407.70
|
| Rate for Payer: Managed Health Services Medicaid |
$407.70
|
| Rate for Payer: MDWise Medicaid |
$407.70
|
| Rate for Payer: MDWise Medicaid |
$407.70
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$227.75
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$227.75
|
| Rate for Payer: PHCS All Commercial |
$375.88
|
| Rate for Payer: PHCS All Commercial |
$375.88
|
| Rate for Payer: PHP All Commercial |
$641.43
|
| Rate for Payer: PHP All Commercial |
$641.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.88
|
| Rate for Payer: Sagamore Health Network All Products |
$375.88
|
| Rate for Payer: Sagamore Health Network All Products |
$375.88
|
| Rate for Payer: Signature Care EPO |
$630.70
|
| Rate for Payer: Signature Care EPO |
$630.70
|
| Rate for Payer: Signature Care PPO |
$630.70
|
| Rate for Payer: Signature Care PPO |
$630.70
|
| Rate for Payer: United Healthcare Commercial |
$406.78
|
| Rate for Payer: United Healthcare Commercial |
$406.78
|
| Rate for Payer: United Healthcare Medicare |
$401.47
|
| Rate for Payer: United Healthcare Medicare |
$401.47
|
|
|
PR CLOSED RX TALOTARSAL DISLOC
|
Professional
|
Both
|
$450.14
|
|
|
Service Code
|
CPT 28570
|
| Hospital Charge Code |
z28570
|
| Min. Negotiated Rate |
$101.40 |
| Max. Negotiated Rate |
$315.72 |
| Rate for Payer: Aetna Commercial |
$183.33
|
| Rate for Payer: Aetna Commercial |
$183.33
|
| Rate for Payer: Aetna Medicare |
$183.33
|
| Rate for Payer: Aetna Medicare |
$183.33
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$101.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$101.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$221.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$221.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$210.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$210.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$201.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$201.66
|
| Rate for Payer: Cash Price |
$260.39
|
| Rate for Payer: Cash Price |
$270.08
|
| Rate for Payer: Centivo All Commercial |
$284.16
|
| Rate for Payer: Centivo All Commercial |
$284.16
|
| Rate for Payer: Cigna All Commercial |
$183.33
|
| Rate for Payer: Cigna All Commercial |
$183.33
|
| Rate for Payer: CORVEL All Commercial |
$183.33
|
| Rate for Payer: CORVEL All Commercial |
$183.33
|
| Rate for Payer: Coventry All Commercial |
$220.00
|
| Rate for Payer: Coventry All Commercial |
$220.00
|
| Rate for Payer: Encore All Commercial |
$183.33
|
| Rate for Payer: Encore All Commercial |
$183.33
|
| Rate for Payer: Frontpath All Commercial |
$250.43
|
| Rate for Payer: Frontpath All Commercial |
$250.43
|
| Rate for Payer: Humana ChoiceCare |
$169.40
|
| Rate for Payer: Humana ChoiceCare |
$169.40
|
| Rate for Payer: Humana Medicare |
$183.33
|
| Rate for Payer: Humana Medicare |
$183.33
|
| Rate for Payer: Lucent All Commercial |
$256.66
|
| Rate for Payer: Lucent All Commercial |
$256.66
|
| Rate for Payer: Managed Health Services Medicaid |
$221.40
|
| Rate for Payer: Managed Health Services Medicaid |
$221.40
|
| Rate for Payer: MDWise Medicaid |
$221.40
|
| Rate for Payer: MDWise Medicaid |
$221.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$101.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$101.40
|
| Rate for Payer: PHCS All Commercial |
$183.33
|
| Rate for Payer: PHCS All Commercial |
$183.33
|
| Rate for Payer: PHP All Commercial |
$315.72
|
| Rate for Payer: PHP All Commercial |
$315.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$183.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$183.33
|
| Rate for Payer: Sagamore Health Network All Products |
$183.33
|
| Rate for Payer: Sagamore Health Network All Products |
$183.33
|
| Rate for Payer: Signature Care EPO |
$258.40
|
| Rate for Payer: Signature Care EPO |
$258.40
|
| Rate for Payer: Signature Care PPO |
$258.40
|
| Rate for Payer: Signature Care PPO |
$258.40
|
| Rate for Payer: United Healthcare Commercial |
$161.90
|
| Rate for Payer: United Healthcare Commercial |
$161.90
|
| Rate for Payer: United Healthcare Medicare |
$216.99
|
| Rate for Payer: United Healthcare Medicare |
$216.99
|
|
|
PR CLOSED RX TALOTARSAL DISLOC,ANESTH
|
Professional
|
Both
|
$719.02
|
|
|
Service Code
|
CPT 28575
|
| Hospital Charge Code |
z28575
|
| Min. Negotiated Rate |
$175.63 |
| Max. Negotiated Rate |
$543.51 |
| Rate for Payer: Aetna Commercial |
$317.22
|
| Rate for Payer: Aetna Commercial |
$317.22
|
| Rate for Payer: Aetna Medicare |
$317.22
|
| Rate for Payer: Aetna Medicare |
$317.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$175.63
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$175.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$353.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$353.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$364.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$348.94
|
| Rate for Payer: Cash Price |
$418.20
|
| Rate for Payer: Cash Price |
$431.41
|
| Rate for Payer: Centivo All Commercial |
$491.69
|
| Rate for Payer: Centivo All Commercial |
$491.69
|
| Rate for Payer: Cigna All Commercial |
$317.22
|
| Rate for Payer: Cigna All Commercial |
$317.22
|
| Rate for Payer: CORVEL All Commercial |
$317.22
|
| Rate for Payer: CORVEL All Commercial |
$317.22
|
| Rate for Payer: Coventry All Commercial |
$380.66
|
| Rate for Payer: Coventry All Commercial |
$380.66
|
| Rate for Payer: Encore All Commercial |
$317.22
|
| Rate for Payer: Encore All Commercial |
$317.22
|
| Rate for Payer: Frontpath All Commercial |
$436.50
|
| Rate for Payer: Frontpath All Commercial |
$436.50
|
| Rate for Payer: Humana ChoiceCare |
$302.70
|
| Rate for Payer: Humana ChoiceCare |
$302.70
|
| Rate for Payer: Humana Medicare |
$317.22
|
| Rate for Payer: Humana Medicare |
$317.22
|
| Rate for Payer: Lucent All Commercial |
$444.11
|
| Rate for Payer: Lucent All Commercial |
$444.11
|
| Rate for Payer: Managed Health Services Medicaid |
$353.65
|
| Rate for Payer: Managed Health Services Medicaid |
$353.65
|
| Rate for Payer: MDWise Medicaid |
$353.65
|
| Rate for Payer: MDWise Medicaid |
$353.65
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$175.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$175.63
|
| Rate for Payer: PHCS All Commercial |
$317.22
|
| Rate for Payer: PHCS All Commercial |
$317.22
|
| Rate for Payer: PHP All Commercial |
$543.51
|
| Rate for Payer: PHP All Commercial |
$543.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$317.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$317.22
|
| Rate for Payer: Sagamore Health Network All Products |
$317.22
|
| Rate for Payer: Sagamore Health Network All Products |
$317.22
|
| Rate for Payer: Signature Care EPO |
$440.30
|
| Rate for Payer: Signature Care EPO |
$440.30
|
| Rate for Payer: Signature Care PPO |
$440.30
|
| Rate for Payer: Signature Care PPO |
$440.30
|
| Rate for Payer: United Healthcare Commercial |
$321.88
|
| Rate for Payer: United Healthcare Commercial |
$321.88
|
| Rate for Payer: United Healthcare Medicare |
$348.50
|
| Rate for Payer: United Healthcare Medicare |
$348.50
|
|
|
PR CLOSED RX TALUS FX
|
Professional
|
Both
|
$458.96
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
z28430
|
| Min. Negotiated Rate |
$131.80 |
| Max. Negotiated Rate |
$30,000.00 |
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna Medicare |
$198.63
|
| Rate for Payer: Aetna Medicare |
$198.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$240.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$240.49
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$131.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$225.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$225.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$228.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$218.49
|
| Rate for Payer: Cash Price |
$266.70
|
| Rate for Payer: Cash Price |
$275.38
|
| Rate for Payer: Centivo All Commercial |
$307.88
|
| Rate for Payer: Centivo All Commercial |
$307.88
|
| Rate for Payer: Cigna All Commercial |
$198.63
|
| Rate for Payer: Cigna All Commercial |
$198.63
|
| Rate for Payer: CORVEL All Commercial |
$198.63
|
| Rate for Payer: CORVEL All Commercial |
$198.63
|
| Rate for Payer: Coventry All Commercial |
$238.36
|
| Rate for Payer: Coventry All Commercial |
$238.36
|
| Rate for Payer: Encore All Commercial |
$198.63
|
| Rate for Payer: Encore All Commercial |
$198.63
|
| Rate for Payer: Frontpath All Commercial |
$270.31
|
| Rate for Payer: Frontpath All Commercial |
$270.31
|
| Rate for Payer: Humana ChoiceCare |
$198.80
|
| Rate for Payer: Humana ChoiceCare |
$198.80
|
| Rate for Payer: Humana Medicare |
$198.63
|
| Rate for Payer: Humana Medicare |
$198.63
|
| Rate for Payer: Lucent All Commercial |
$278.08
|
| Rate for Payer: Lucent All Commercial |
$278.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$320.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$320.00
|
| Rate for Payer: Managed Health Services Medicaid |
$225.74
|
| Rate for Payer: Managed Health Services Medicaid |
$225.74
|
| Rate for Payer: MDWise Medicaid |
$225.74
|
| Rate for Payer: MDWise Medicaid |
$225.74
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$131.80
|
| Rate for Payer: PHCS All Commercial |
$198.63
|
| Rate for Payer: PHCS All Commercial |
$198.63
|
| Rate for Payer: PHP All Commercial |
$339.56
|
| Rate for Payer: PHP All Commercial |
$339.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.63
|
| Rate for Payer: Sagamore Health Network All Products |
$198.63
|
| Rate for Payer: Sagamore Health Network All Products |
$198.63
|
| Rate for Payer: Signature Care EPO |
$348.50
|
| Rate for Payer: Signature Care EPO |
$348.50
|
| Rate for Payer: Signature Care PPO |
$348.50
|
| Rate for Payer: Signature Care PPO |
$348.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30,000.00
|
| Rate for Payer: United Healthcare Commercial |
$209.56
|
| Rate for Payer: United Healthcare Commercial |
$209.56
|
| Rate for Payer: United Healthcare Medicare |
$222.25
|
| Rate for Payer: United Healthcare Medicare |
$222.25
|
|
|
PR CLOSED RX TARSAL FX,EACH
|
Professional
|
Both
|
$405.36
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
z28450
|
| Min. Negotiated Rate |
$104.73 |
| Max. Negotiated Rate |
$27,200.00 |
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$220.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$220.64
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$104.73
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$104.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$199.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$199.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$207.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$198.37
|
| Rate for Payer: Cash Price |
$234.17
|
| Rate for Payer: Cash Price |
$243.22
|
| Rate for Payer: Centivo All Commercial |
$279.53
|
| Rate for Payer: Centivo All Commercial |
$279.53
|
| Rate for Payer: Cigna All Commercial |
$180.34
|
| Rate for Payer: Cigna All Commercial |
$180.34
|
| Rate for Payer: CORVEL All Commercial |
$180.34
|
| Rate for Payer: CORVEL All Commercial |
$180.34
|
| Rate for Payer: Coventry All Commercial |
$216.41
|
| Rate for Payer: Coventry All Commercial |
$216.41
|
| Rate for Payer: Encore All Commercial |
$180.34
|
| Rate for Payer: Encore All Commercial |
$180.34
|
| Rate for Payer: Frontpath All Commercial |
$244.35
|
| Rate for Payer: Frontpath All Commercial |
$244.35
|
| Rate for Payer: Humana ChoiceCare |
$186.37
|
| Rate for Payer: Humana ChoiceCare |
$186.37
|
| Rate for Payer: Humana Medicare |
$180.34
|
| Rate for Payer: Humana Medicare |
$180.34
|
| Rate for Payer: Lucent All Commercial |
$252.48
|
| Rate for Payer: Lucent All Commercial |
$252.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$290.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$290.00
|
| Rate for Payer: Managed Health Services Medicaid |
$199.37
|
| Rate for Payer: Managed Health Services Medicaid |
$199.37
|
| Rate for Payer: MDWise Medicaid |
$199.37
|
| Rate for Payer: MDWise Medicaid |
$199.37
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$104.73
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$104.73
|
| Rate for Payer: PHCS All Commercial |
$180.34
|
| Rate for Payer: PHCS All Commercial |
$180.34
|
| Rate for Payer: PHP All Commercial |
$307.58
|
| Rate for Payer: PHP All Commercial |
$307.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.34
|
| Rate for Payer: Sagamore Health Network All Products |
$180.34
|
| Rate for Payer: Sagamore Health Network All Products |
$180.34
|
| Rate for Payer: Signature Care EPO |
$336.60
|
| Rate for Payer: Signature Care EPO |
$336.60
|
| Rate for Payer: Signature Care PPO |
$336.60
|
| Rate for Payer: Signature Care PPO |
$336.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$27,200.00
|
| Rate for Payer: United Healthcare Commercial |
$194.80
|
| Rate for Payer: United Healthcare Commercial |
$194.80
|
| Rate for Payer: United Healthcare Medicare |
$195.14
|
| Rate for Payer: United Healthcare Medicare |
$195.14
|
|
|
PR CLOSED RX TIBIAL PLATEAU FX
|
Professional
|
Both
|
$590.98
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
z27530
|
| Min. Negotiated Rate |
$205.18 |
| Max. Negotiated Rate |
$41,300.00 |
| Rate for Payer: Aetna Commercial |
$272.63
|
| Rate for Payer: Aetna Commercial |
$272.63
|
| Rate for Payer: Aetna Medicare |
$272.63
|
| Rate for Payer: Aetna Medicare |
$272.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$521.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$521.96
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$205.18
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$205.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$290.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$290.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.89
|
| Rate for Payer: Cash Price |
$343.16
|
| Rate for Payer: Cash Price |
$354.59
|
| Rate for Payer: Centivo All Commercial |
$422.58
|
| Rate for Payer: Centivo All Commercial |
$422.58
|
| Rate for Payer: Cigna All Commercial |
$272.63
|
| Rate for Payer: Cigna All Commercial |
$272.63
|
| Rate for Payer: CORVEL All Commercial |
$272.63
|
| Rate for Payer: CORVEL All Commercial |
$272.63
|
| Rate for Payer: Coventry All Commercial |
$327.16
|
| Rate for Payer: Coventry All Commercial |
$327.16
|
| Rate for Payer: Encore All Commercial |
$272.63
|
| Rate for Payer: Encore All Commercial |
$272.63
|
| Rate for Payer: Frontpath All Commercial |
$372.93
|
| Rate for Payer: Frontpath All Commercial |
$372.93
|
| Rate for Payer: Humana ChoiceCare |
$352.19
|
| Rate for Payer: Humana ChoiceCare |
$352.19
|
| Rate for Payer: Humana Medicare |
$272.63
|
| Rate for Payer: Humana Medicare |
$272.63
|
| Rate for Payer: Lucent All Commercial |
$381.68
|
| Rate for Payer: Lucent All Commercial |
$381.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$440.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$440.00
|
| Rate for Payer: Managed Health Services Medicaid |
$290.66
|
| Rate for Payer: Managed Health Services Medicaid |
$290.66
|
| Rate for Payer: MDWise Medicaid |
$290.66
|
| Rate for Payer: MDWise Medicaid |
$290.66
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$205.18
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$205.18
|
| Rate for Payer: PHCS All Commercial |
$272.63
|
| Rate for Payer: PHCS All Commercial |
$272.63
|
| Rate for Payer: PHP All Commercial |
$467.19
|
| Rate for Payer: PHP All Commercial |
$467.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.63
|
| Rate for Payer: Sagamore Health Network All Products |
$272.63
|
| Rate for Payer: Sagamore Health Network All Products |
$272.63
|
| Rate for Payer: Signature Care EPO |
$485.86
|
| Rate for Payer: Signature Care EPO |
$485.86
|
| Rate for Payer: Signature Care PPO |
$485.86
|
| Rate for Payer: Signature Care PPO |
$485.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,300.00
|
| Rate for Payer: United Healthcare Commercial |
$375.33
|
| Rate for Payer: United Healthcare Commercial |
$375.33
|
| Rate for Payer: United Healthcare Medicare |
$285.97
|
| Rate for Payer: United Healthcare Medicare |
$285.97
|
|
|
PR CLOSED RX TIBIA SHAFT FX
|
Professional
|
Both
|
$665.84
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
z27750
|
| Min. Negotiated Rate |
$186.41 |
| Max. Negotiated Rate |
$46,000.00 |
| Rate for Payer: Aetna Commercial |
$303.84
|
| Rate for Payer: Aetna Commercial |
$303.84
|
| Rate for Payer: Aetna Medicare |
$303.84
|
| Rate for Payer: Aetna Medicare |
$303.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$461.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$461.48
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$186.41
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$186.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$327.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$327.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$334.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$334.22
|
| Rate for Payer: Cash Price |
$387.01
|
| Rate for Payer: Cash Price |
$399.50
|
| Rate for Payer: Centivo All Commercial |
$470.95
|
| Rate for Payer: Centivo All Commercial |
$470.95
|
| Rate for Payer: Cigna All Commercial |
$303.84
|
| Rate for Payer: Cigna All Commercial |
$303.84
|
| Rate for Payer: CORVEL All Commercial |
$303.84
|
| Rate for Payer: CORVEL All Commercial |
$303.84
|
| Rate for Payer: Coventry All Commercial |
$364.61
|
| Rate for Payer: Coventry All Commercial |
$364.61
|
| Rate for Payer: Encore All Commercial |
$303.84
|
| Rate for Payer: Encore All Commercial |
$303.84
|
| Rate for Payer: Frontpath All Commercial |
$416.99
|
| Rate for Payer: Frontpath All Commercial |
$416.99
|
| Rate for Payer: Humana ChoiceCare |
$302.41
|
| Rate for Payer: Humana ChoiceCare |
$302.41
|
| Rate for Payer: Humana Medicare |
$303.84
|
| Rate for Payer: Humana Medicare |
$303.84
|
| Rate for Payer: Lucent All Commercial |
$425.38
|
| Rate for Payer: Lucent All Commercial |
$425.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$491.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$491.00
|
| Rate for Payer: Managed Health Services Medicaid |
$327.49
|
| Rate for Payer: Managed Health Services Medicaid |
$327.49
|
| Rate for Payer: MDWise Medicaid |
$327.49
|
| Rate for Payer: MDWise Medicaid |
$327.49
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$186.41
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$186.41
|
| Rate for Payer: PHCS All Commercial |
$303.84
|
| Rate for Payer: PHCS All Commercial |
$303.84
|
| Rate for Payer: PHP All Commercial |
$520.82
|
| Rate for Payer: PHP All Commercial |
$520.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$303.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$303.84
|
| Rate for Payer: Sagamore Health Network All Products |
$303.84
|
| Rate for Payer: Sagamore Health Network All Products |
$303.84
|
| Rate for Payer: Signature Care EPO |
$487.05
|
| Rate for Payer: Signature Care EPO |
$487.05
|
| Rate for Payer: Signature Care PPO |
$487.05
|
| Rate for Payer: Signature Care PPO |
$487.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$46,000.00
|
| Rate for Payer: United Healthcare Commercial |
$317.85
|
| Rate for Payer: United Healthcare Commercial |
$317.85
|
| Rate for Payer: United Healthcare Medicare |
$322.51
|
| Rate for Payer: United Healthcare Medicare |
$322.51
|
|
|
PR CLOSED RX TIBIA SHAFT FX,MANIPULATN
|
Professional
|
Both
|
$986.04
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
z27752
|
| Min. Negotiated Rate |
$260.34 |
| Max. Negotiated Rate |
$69,300.00 |
| Rate for Payer: Aetna Commercial |
$460.27
|
| Rate for Payer: Aetna Commercial |
$460.27
|
| Rate for Payer: Aetna Medicare |
$460.27
|
| Rate for Payer: Aetna Medicare |
$460.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$654.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$260.34
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$260.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$497.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$497.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$529.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$529.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$506.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$506.30
|
| Rate for Payer: Cash Price |
$606.54
|
| Rate for Payer: Cash Price |
$591.62
|
| Rate for Payer: Centivo All Commercial |
$713.42
|
| Rate for Payer: Centivo All Commercial |
$713.42
|
| Rate for Payer: Cigna All Commercial |
$460.27
|
| Rate for Payer: Cigna All Commercial |
$460.27
|
| Rate for Payer: CORVEL All Commercial |
$460.27
|
| Rate for Payer: CORVEL All Commercial |
$460.27
|
| Rate for Payer: Coventry All Commercial |
$552.32
|
| Rate for Payer: Coventry All Commercial |
$552.32
|
| Rate for Payer: Encore All Commercial |
$460.27
|
| Rate for Payer: Encore All Commercial |
$460.27
|
| Rate for Payer: Frontpath All Commercial |
$638.76
|
| Rate for Payer: Frontpath All Commercial |
$638.76
|
| Rate for Payer: Humana ChoiceCare |
$498.82
|
| Rate for Payer: Humana ChoiceCare |
$498.82
|
| Rate for Payer: Humana Medicare |
$460.27
|
| Rate for Payer: Humana Medicare |
$460.27
|
| Rate for Payer: Lucent All Commercial |
$644.38
|
| Rate for Payer: Lucent All Commercial |
$644.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$739.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$739.00
|
| Rate for Payer: Managed Health Services Medicaid |
$497.20
|
| Rate for Payer: Managed Health Services Medicaid |
$497.20
|
| Rate for Payer: MDWise Medicaid |
$497.20
|
| Rate for Payer: MDWise Medicaid |
$497.20
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$260.34
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$260.34
|
| Rate for Payer: PHCS All Commercial |
$460.27
|
| Rate for Payer: PHCS All Commercial |
$460.27
|
| Rate for Payer: PHP All Commercial |
$783.97
|
| Rate for Payer: PHP All Commercial |
$783.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$460.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$460.27
|
| Rate for Payer: Sagamore Health Network All Products |
$460.27
|
| Rate for Payer: Sagamore Health Network All Products |
$460.27
|
| Rate for Payer: Signature Care EPO |
$759.90
|
| Rate for Payer: Signature Care EPO |
$759.90
|
| Rate for Payer: Signature Care PPO |
$759.90
|
| Rate for Payer: Signature Care PPO |
$759.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$69,300.00
|
| Rate for Payer: United Healthcare Commercial |
$524.30
|
| Rate for Payer: United Healthcare Commercial |
$524.30
|
| Rate for Payer: United Healthcare Medicare |
$493.02
|
| Rate for Payer: United Healthcare Medicare |
$493.02
|
|
|
PR CLOSED RX TIB TUBER FX
|
Professional
|
Both
|
$916.30
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
z27538
|
| Min. Negotiated Rate |
$245.99 |
| Max. Negotiated Rate |
$63,800.00 |
| Rate for Payer: Aetna Commercial |
$424.92
|
| Rate for Payer: Aetna Commercial |
$424.92
|
| Rate for Payer: Aetna Medicare |
$424.92
|
| Rate for Payer: Aetna Medicare |
$424.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$647.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$647.49
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$245.99
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$245.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$450.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$450.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$488.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$488.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$467.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$467.41
|
| Rate for Payer: Cash Price |
$535.57
|
| Rate for Payer: Cash Price |
$549.78
|
| Rate for Payer: Centivo All Commercial |
$658.63
|
| Rate for Payer: Centivo All Commercial |
$658.63
|
| Rate for Payer: Cigna All Commercial |
$424.92
|
| Rate for Payer: Cigna All Commercial |
$424.92
|
| Rate for Payer: CORVEL All Commercial |
$424.92
|
| Rate for Payer: CORVEL All Commercial |
$424.92
|
| Rate for Payer: Coventry All Commercial |
$509.90
|
| Rate for Payer: Coventry All Commercial |
$509.90
|
| Rate for Payer: Encore All Commercial |
$424.92
|
| Rate for Payer: Encore All Commercial |
$424.92
|
| Rate for Payer: Frontpath All Commercial |
$586.18
|
| Rate for Payer: Frontpath All Commercial |
$586.18
|
| Rate for Payer: Humana ChoiceCare |
$434.25
|
| Rate for Payer: Humana ChoiceCare |
$434.25
|
| Rate for Payer: Humana Medicare |
$424.92
|
| Rate for Payer: Humana Medicare |
$424.92
|
| Rate for Payer: Lucent All Commercial |
$594.89
|
| Rate for Payer: Lucent All Commercial |
$594.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$680.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$680.00
|
| Rate for Payer: Managed Health Services Medicaid |
$450.67
|
| Rate for Payer: Managed Health Services Medicaid |
$450.67
|
| Rate for Payer: MDWise Medicaid |
$450.67
|
| Rate for Payer: MDWise Medicaid |
$450.67
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$245.99
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$245.99
|
| Rate for Payer: PHCS All Commercial |
$424.92
|
| Rate for Payer: PHCS All Commercial |
$424.92
|
| Rate for Payer: PHP All Commercial |
$721.56
|
| Rate for Payer: PHP All Commercial |
$721.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$424.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$424.92
|
| Rate for Payer: Sagamore Health Network All Products |
$424.92
|
| Rate for Payer: Sagamore Health Network All Products |
$424.92
|
| Rate for Payer: Signature Care EPO |
$682.55
|
| Rate for Payer: Signature Care EPO |
$682.55
|
| Rate for Payer: Signature Care PPO |
$682.55
|
| Rate for Payer: Signature Care PPO |
$682.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63,800.00
|
| Rate for Payer: United Healthcare Commercial |
$453.19
|
| Rate for Payer: United Healthcare Commercial |
$453.19
|
| Rate for Payer: United Healthcare Medicare |
$446.31
|
| Rate for Payer: United Healthcare Medicare |
$446.31
|
|
|
PR CLOSED RX TOE FX
|
Professional
|
Both
|
$232.80
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
z28510
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$17,100.00 |
| Rate for Payer: Aetna Commercial |
$111.87
|
| Rate for Payer: Aetna Commercial |
$111.87
|
| Rate for Payer: Aetna Medicare |
$111.87
|
| Rate for Payer: Aetna Medicare |
$111.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$118.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$118.22
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.91
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$60.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$128.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$128.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.06
|
| Rate for Payer: Cash Price |
$134.35
|
| Rate for Payer: Cash Price |
$139.68
|
| Rate for Payer: Centivo All Commercial |
$173.40
|
| Rate for Payer: Centivo All Commercial |
$173.40
|
| Rate for Payer: Cigna All Commercial |
$111.87
|
| Rate for Payer: Cigna All Commercial |
$111.87
|
| Rate for Payer: CORVEL All Commercial |
$111.87
|
| Rate for Payer: CORVEL All Commercial |
$111.87
|
| Rate for Payer: Coventry All Commercial |
$134.24
|
| Rate for Payer: Coventry All Commercial |
$134.24
|
| Rate for Payer: Encore All Commercial |
$111.87
|
| Rate for Payer: Encore All Commercial |
$111.87
|
| Rate for Payer: Frontpath All Commercial |
$150.14
|
| Rate for Payer: Frontpath All Commercial |
$150.14
|
| Rate for Payer: Humana ChoiceCare |
$110.76
|
| Rate for Payer: Humana ChoiceCare |
$110.76
|
| Rate for Payer: Humana Medicare |
$111.87
|
| Rate for Payer: Humana Medicare |
$111.87
|
| Rate for Payer: Lucent All Commercial |
$156.62
|
| Rate for Payer: Lucent All Commercial |
$156.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$183.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$183.00
|
| Rate for Payer: Managed Health Services Medicaid |
$114.50
|
| Rate for Payer: Managed Health Services Medicaid |
$114.50
|
| Rate for Payer: MDWise Medicaid |
$114.50
|
| Rate for Payer: MDWise Medicaid |
$114.50
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$60.91
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$60.91
|
| Rate for Payer: PHCS All Commercial |
$111.87
|
| Rate for Payer: PHCS All Commercial |
$111.87
|
| Rate for Payer: PHP All Commercial |
$193.76
|
| Rate for Payer: PHP All Commercial |
$193.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$111.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$111.87
|
| Rate for Payer: Sagamore Health Network All Products |
$111.87
|
| Rate for Payer: Sagamore Health Network All Products |
$111.87
|
| Rate for Payer: Signature Care EPO |
$173.40
|
| Rate for Payer: Signature Care EPO |
$173.40
|
| Rate for Payer: Signature Care PPO |
$173.40
|
| Rate for Payer: Signature Care PPO |
$173.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17,100.00
|
| Rate for Payer: United Healthcare Commercial |
$118.84
|
| Rate for Payer: United Healthcare Commercial |
$118.84
|
| Rate for Payer: United Healthcare Medicare |
$111.96
|
| Rate for Payer: United Healthcare Medicare |
$111.96
|
|
|
PR CLOSED RX TOE FX,MANIPULATN
|
Professional
|
Both
|
$316.20
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
z28515
|
| Min. Negotiated Rate |
$73.02 |
| Max. Negotiated Rate |
$207.89 |
| Rate for Payer: Aetna Commercial |
$134.12
|
| Rate for Payer: Aetna Commercial |
$134.12
|
| Rate for Payer: Aetna Medicare |
$134.12
|
| Rate for Payer: Aetna Medicare |
$134.12
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$73.02
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$73.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$155.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$155.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$147.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$147.53
|
| Rate for Payer: Cash Price |
$182.02
|
| Rate for Payer: Cash Price |
$189.72
|
| Rate for Payer: Centivo All Commercial |
$207.89
|
| Rate for Payer: Centivo All Commercial |
$207.89
|
| Rate for Payer: Cigna All Commercial |
$134.12
|
| Rate for Payer: Cigna All Commercial |
$134.12
|
| Rate for Payer: CORVEL All Commercial |
$134.12
|
| Rate for Payer: CORVEL All Commercial |
$134.12
|
| Rate for Payer: Coventry All Commercial |
$160.94
|
| Rate for Payer: Coventry All Commercial |
$160.94
|
| Rate for Payer: Encore All Commercial |
$134.12
|
| Rate for Payer: Encore All Commercial |
$134.12
|
| Rate for Payer: Frontpath All Commercial |
$180.91
|
| Rate for Payer: Frontpath All Commercial |
$180.91
|
| Rate for Payer: Humana ChoiceCare |
$142.32
|
| Rate for Payer: Humana ChoiceCare |
$142.32
|
| Rate for Payer: Humana Medicare |
$134.12
|
| Rate for Payer: Humana Medicare |
$134.12
|
| Rate for Payer: Lucent All Commercial |
$187.77
|
| Rate for Payer: Lucent All Commercial |
$187.77
|
| Rate for Payer: Managed Health Services Medicaid |
$155.52
|
| Rate for Payer: Managed Health Services Medicaid |
$155.52
|
| Rate for Payer: MDWise Medicaid |
$155.52
|
| Rate for Payer: MDWise Medicaid |
$155.52
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$73.02
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$73.02
|
| Rate for Payer: PHCS All Commercial |
$134.12
|
| Rate for Payer: PHCS All Commercial |
$134.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$134.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$134.12
|
| Rate for Payer: Sagamore Health Network All Products |
$134.12
|
| Rate for Payer: Sagamore Health Network All Products |
$134.12
|
| Rate for Payer: United Healthcare Commercial |
$147.40
|
| Rate for Payer: United Healthcare Commercial |
$147.40
|
| Rate for Payer: United Healthcare Medicare |
$151.68
|
| Rate for Payer: United Healthcare Medicare |
$151.68
|
|
|
PR CLOSED RX TRIMALLEOLAR FX
|
Professional
|
Both
|
$635.92
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
z27816
|
| Min. Negotiated Rate |
$191.26 |
| Max. Negotiated Rate |
$41,900.00 |
| Rate for Payer: Aetna Commercial |
$277.23
|
| Rate for Payer: Aetna Commercial |
$277.23
|
| Rate for Payer: Aetna Medicare |
$277.23
|
| Rate for Payer: Aetna Medicare |
$277.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$191.26
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$191.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$312.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$318.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$318.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$304.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$304.95
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$381.55
|
| Rate for Payer: Centivo All Commercial |
$429.71
|
| Rate for Payer: Centivo All Commercial |
$429.71
|
| Rate for Payer: Cigna All Commercial |
$277.23
|
| Rate for Payer: Cigna All Commercial |
$277.23
|
| Rate for Payer: CORVEL All Commercial |
$277.23
|
| Rate for Payer: CORVEL All Commercial |
$277.23
|
| Rate for Payer: Coventry All Commercial |
$332.68
|
| Rate for Payer: Coventry All Commercial |
$332.68
|
| Rate for Payer: Encore All Commercial |
$277.23
|
| Rate for Payer: Encore All Commercial |
$277.23
|
| Rate for Payer: Frontpath All Commercial |
$380.41
|
| Rate for Payer: Frontpath All Commercial |
$380.41
|
| Rate for Payer: Humana ChoiceCare |
$269.63
|
| Rate for Payer: Humana ChoiceCare |
$269.63
|
| Rate for Payer: Humana Medicare |
$277.23
|
| Rate for Payer: Humana Medicare |
$277.23
|
| Rate for Payer: Lucent All Commercial |
$388.12
|
| Rate for Payer: Lucent All Commercial |
$388.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$447.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$447.00
|
| Rate for Payer: Managed Health Services Medicaid |
$312.77
|
| Rate for Payer: Managed Health Services Medicaid |
$312.77
|
| Rate for Payer: MDWise Medicaid |
$312.77
|
| Rate for Payer: MDWise Medicaid |
$312.77
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$191.26
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$191.26
|
| Rate for Payer: PHCS All Commercial |
$277.23
|
| Rate for Payer: PHCS All Commercial |
$277.23
|
| Rate for Payer: PHP All Commercial |
$473.87
|
| Rate for Payer: PHP All Commercial |
$473.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$277.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$277.23
|
| Rate for Payer: Sagamore Health Network All Products |
$277.23
|
| Rate for Payer: Sagamore Health Network All Products |
$277.23
|
| Rate for Payer: Signature Care EPO |
$447.10
|
| Rate for Payer: Signature Care EPO |
$447.10
|
| Rate for Payer: Signature Care PPO |
$447.10
|
| Rate for Payer: Signature Care PPO |
$447.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$41,900.00
|
| Rate for Payer: United Healthcare Commercial |
$282.46
|
| Rate for Payer: United Healthcare Commercial |
$282.46
|
| Rate for Payer: United Healthcare Medicare |
$306.67
|
| Rate for Payer: United Healthcare Medicare |
$306.67
|
|
|
PR CLOSED RX TRIMALLEOLAR FX,MANIP
|
Professional
|
Both
|
$935.26
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
z27818
|
| Min. Negotiated Rate |
$320.89 |
| Max. Negotiated Rate |
$62,300.00 |
| Rate for Payer: Aetna Commercial |
$411.15
|
| Rate for Payer: Aetna Commercial |
$411.15
|
| Rate for Payer: Aetna Medicare |
$411.15
|
| Rate for Payer: Aetna Medicare |
$411.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$653.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$653.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$320.89
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$320.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$460.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$460.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$472.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$472.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$452.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$452.26
|
| Rate for Payer: Cash Price |
$545.21
|
| Rate for Payer: Cash Price |
$561.16
|
| Rate for Payer: Centivo All Commercial |
$637.28
|
| Rate for Payer: Centivo All Commercial |
$637.28
|
| Rate for Payer: Cigna All Commercial |
$411.15
|
| Rate for Payer: Cigna All Commercial |
$411.15
|
| Rate for Payer: CORVEL All Commercial |
$411.15
|
| Rate for Payer: CORVEL All Commercial |
$411.15
|
| Rate for Payer: Coventry All Commercial |
$493.38
|
| Rate for Payer: Coventry All Commercial |
$493.38
|
| Rate for Payer: Encore All Commercial |
$411.15
|
| Rate for Payer: Encore All Commercial |
$411.15
|
| Rate for Payer: Frontpath All Commercial |
$569.87
|
| Rate for Payer: Frontpath All Commercial |
$569.87
|
| Rate for Payer: Humana ChoiceCare |
$460.18
|
| Rate for Payer: Humana ChoiceCare |
$460.18
|
| Rate for Payer: Humana Medicare |
$411.15
|
| Rate for Payer: Humana Medicare |
$411.15
|
| Rate for Payer: Lucent All Commercial |
$575.61
|
| Rate for Payer: Lucent All Commercial |
$575.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$664.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$664.00
|
| Rate for Payer: Managed Health Services Medicaid |
$460.00
|
| Rate for Payer: Managed Health Services Medicaid |
$460.00
|
| Rate for Payer: MDWise Medicaid |
$460.00
|
| Rate for Payer: MDWise Medicaid |
$460.00
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$320.89
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$320.89
|
| Rate for Payer: PHCS All Commercial |
$411.15
|
| Rate for Payer: PHCS All Commercial |
$411.15
|
| Rate for Payer: PHP All Commercial |
$704.60
|
| Rate for Payer: PHP All Commercial |
$704.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$411.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$411.15
|
| Rate for Payer: Sagamore Health Network All Products |
$411.15
|
| Rate for Payer: Sagamore Health Network All Products |
$411.15
|
| Rate for Payer: Signature Care EPO |
$720.80
|
| Rate for Payer: Signature Care EPO |
$720.80
|
| Rate for Payer: Signature Care PPO |
$720.80
|
| Rate for Payer: Signature Care PPO |
$720.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62,300.00
|
| Rate for Payer: United Healthcare Commercial |
$463.64
|
| Rate for Payer: United Healthcare Commercial |
$463.64
|
| Rate for Payer: United Healthcare Medicare |
$454.34
|
| Rate for Payer: United Healthcare Medicare |
$454.34
|
|
|
PR CLOSED RX ULNA SHAFT FX
|
Professional
|
Both
|
$511.04
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
z25530
|
| Min. Negotiated Rate |
$130.84 |
| Max. Negotiated Rate |
$34,700.00 |
| Rate for Payer: Aetna Commercial |
$228.17
|
| Rate for Payer: Aetna Commercial |
$228.17
|
| Rate for Payer: Aetna Medicare |
$228.17
|
| Rate for Payer: Aetna Medicare |
$228.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$333.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$333.40
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$130.84
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$130.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$251.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$251.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$262.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$262.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$250.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$250.99
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cash Price |
$306.62
|
| Rate for Payer: Centivo All Commercial |
$353.66
|
| Rate for Payer: Centivo All Commercial |
$353.66
|
| Rate for Payer: Cigna All Commercial |
$228.17
|
| Rate for Payer: Cigna All Commercial |
$228.17
|
| Rate for Payer: CORVEL All Commercial |
$228.17
|
| Rate for Payer: CORVEL All Commercial |
$228.17
|
| Rate for Payer: Coventry All Commercial |
$273.80
|
| Rate for Payer: Coventry All Commercial |
$273.80
|
| Rate for Payer: Encore All Commercial |
$228.17
|
| Rate for Payer: Encore All Commercial |
$228.17
|
| Rate for Payer: Frontpath All Commercial |
$311.21
|
| Rate for Payer: Frontpath All Commercial |
$311.21
|
| Rate for Payer: Humana ChoiceCare |
$211.24
|
| Rate for Payer: Humana ChoiceCare |
$211.24
|
| Rate for Payer: Humana Medicare |
$228.17
|
| Rate for Payer: Humana Medicare |
$228.17
|
| Rate for Payer: Lucent All Commercial |
$319.44
|
| Rate for Payer: Lucent All Commercial |
$319.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$371.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$371.00
|
| Rate for Payer: Managed Health Services Medicaid |
$251.35
|
| Rate for Payer: Managed Health Services Medicaid |
$251.35
|
| Rate for Payer: MDWise Medicaid |
$251.35
|
| Rate for Payer: MDWise Medicaid |
$251.35
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$130.84
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$130.84
|
| Rate for Payer: PHCS All Commercial |
$228.17
|
| Rate for Payer: PHCS All Commercial |
$228.17
|
| Rate for Payer: PHP All Commercial |
$393.20
|
| Rate for Payer: PHP All Commercial |
$393.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$228.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$228.17
|
| Rate for Payer: Sagamore Health Network All Products |
$228.17
|
| Rate for Payer: Sagamore Health Network All Products |
$228.17
|
| Rate for Payer: Signature Care EPO |
$351.90
|
| Rate for Payer: Signature Care EPO |
$351.90
|
| Rate for Payer: Signature Care PPO |
$351.90
|
| Rate for Payer: Signature Care PPO |
$351.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34,700.00
|
| Rate for Payer: United Healthcare Commercial |
$228.20
|
| Rate for Payer: United Healthcare Commercial |
$228.20
|
| Rate for Payer: United Healthcare Medicare |
$246.16
|
| Rate for Payer: United Healthcare Medicare |
$246.16
|
|
|
PR CLOSED RX ULNA SHAFT FX,MANIPULATN
|
Professional
|
Both
|
$941.98
|
|
|
Service Code
|
CPT 25535
|
| Hospital Charge Code |
z25535
|
| Min. Negotiated Rate |
$251.28 |
| Max. Negotiated Rate |
$64,900.00 |
| Rate for Payer: Aetna Commercial |
$430.52
|
| Rate for Payer: Aetna Commercial |
$430.52
|
| Rate for Payer: Aetna Medicare |
$430.52
|
| Rate for Payer: Aetna Medicare |
$430.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$562.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$562.30
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$251.28
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$251.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$463.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$463.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$495.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$473.57
|
| Rate for Payer: Cash Price |
$549.91
|
| Rate for Payer: Cash Price |
$565.19
|
| Rate for Payer: Centivo All Commercial |
$667.31
|
| Rate for Payer: Centivo All Commercial |
$667.31
|
| Rate for Payer: Cigna All Commercial |
$430.52
|
| Rate for Payer: Cigna All Commercial |
$430.52
|
| Rate for Payer: CORVEL All Commercial |
$430.52
|
| Rate for Payer: CORVEL All Commercial |
$430.52
|
| Rate for Payer: Coventry All Commercial |
$516.62
|
| Rate for Payer: Coventry All Commercial |
$516.62
|
| Rate for Payer: Encore All Commercial |
$430.52
|
| Rate for Payer: Encore All Commercial |
$430.52
|
| Rate for Payer: Frontpath All Commercial |
$593.40
|
| Rate for Payer: Frontpath All Commercial |
$593.40
|
| Rate for Payer: Humana ChoiceCare |
$450.94
|
| Rate for Payer: Humana ChoiceCare |
$450.94
|
| Rate for Payer: Humana Medicare |
$430.52
|
| Rate for Payer: Humana Medicare |
$430.52
|
| Rate for Payer: Lucent All Commercial |
$602.73
|
| Rate for Payer: Lucent All Commercial |
$602.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$693.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$693.00
|
| Rate for Payer: Managed Health Services Medicaid |
$463.31
|
| Rate for Payer: Managed Health Services Medicaid |
$463.31
|
| Rate for Payer: MDWise Medicaid |
$463.31
|
| Rate for Payer: MDWise Medicaid |
$463.31
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$251.28
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$251.28
|
| Rate for Payer: PHCS All Commercial |
$430.52
|
| Rate for Payer: PHCS All Commercial |
$430.52
|
| Rate for Payer: PHP All Commercial |
$735.02
|
| Rate for Payer: PHP All Commercial |
$735.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$430.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$430.52
|
| Rate for Payer: Sagamore Health Network All Products |
$430.52
|
| Rate for Payer: Sagamore Health Network All Products |
$430.52
|
| Rate for Payer: Signature Care EPO |
$686.80
|
| Rate for Payer: Signature Care EPO |
$686.80
|
| Rate for Payer: Signature Care PPO |
$686.80
|
| Rate for Payer: Signature Care PPO |
$686.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$64,900.00
|
| Rate for Payer: United Healthcare Commercial |
$467.96
|
| Rate for Payer: United Healthcare Commercial |
$467.96
|
| Rate for Payer: United Healthcare Medicare |
$458.26
|
| Rate for Payer: United Healthcare Medicare |
$458.26
|
|
|
PR CLOSED RX ULNA STYLOID FX
|
Professional
|
Both
|
$633.14
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
z25650
|
| Min. Negotiated Rate |
$172.80 |
| Max. Negotiated Rate |
$43,800.00 |
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: Aetna Medicare |
$288.53
|
| Rate for Payer: Aetna Medicare |
$288.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$423.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$423.36
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$172.80
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$172.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$311.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$311.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$317.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$317.38
|
| Rate for Payer: Cash Price |
$369.71
|
| Rate for Payer: Cash Price |
$379.88
|
| Rate for Payer: Centivo All Commercial |
$447.22
|
| Rate for Payer: Centivo All Commercial |
$447.22
|
| Rate for Payer: Cigna All Commercial |
$288.53
|
| Rate for Payer: Cigna All Commercial |
$288.53
|
| Rate for Payer: CORVEL All Commercial |
$288.53
|
| Rate for Payer: CORVEL All Commercial |
$288.53
|
| Rate for Payer: Coventry All Commercial |
$346.24
|
| Rate for Payer: Coventry All Commercial |
$346.24
|
| Rate for Payer: Encore All Commercial |
$288.53
|
| Rate for Payer: Encore All Commercial |
$288.53
|
| Rate for Payer: Frontpath All Commercial |
$395.49
|
| Rate for Payer: Frontpath All Commercial |
$395.49
|
| Rate for Payer: Humana ChoiceCare |
$267.51
|
| Rate for Payer: Humana ChoiceCare |
$267.51
|
| Rate for Payer: Humana Medicare |
$288.53
|
| Rate for Payer: Humana Medicare |
$288.53
|
| Rate for Payer: Lucent All Commercial |
$403.94
|
| Rate for Payer: Lucent All Commercial |
$403.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$468.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$468.00
|
| Rate for Payer: Managed Health Services Medicaid |
$311.40
|
| Rate for Payer: Managed Health Services Medicaid |
$311.40
|
| Rate for Payer: MDWise Medicaid |
$311.40
|
| Rate for Payer: MDWise Medicaid |
$311.40
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$172.80
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$172.80
|
| Rate for Payer: PHCS All Commercial |
$288.53
|
| Rate for Payer: PHCS All Commercial |
$288.53
|
| Rate for Payer: PHP All Commercial |
$496.24
|
| Rate for Payer: PHP All Commercial |
$496.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$288.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$288.53
|
| Rate for Payer: Sagamore Health Network All Products |
$288.53
|
| Rate for Payer: Sagamore Health Network All Products |
$288.53
|
| Rate for Payer: Signature Care EPO |
$447.95
|
| Rate for Payer: Signature Care EPO |
$447.95
|
| Rate for Payer: Signature Care PPO |
$447.95
|
| Rate for Payer: Signature Care PPO |
$447.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$43,800.00
|
| Rate for Payer: United Healthcare Commercial |
$293.11
|
| Rate for Payer: United Healthcare Commercial |
$293.11
|
| Rate for Payer: United Healthcare Medicare |
$308.09
|
| Rate for Payer: United Healthcare Medicare |
$308.09
|
|
