|
PR OPEN TREATMENT CLAVICULAR FRACTURE INTERNAL FX
|
Professional
|
Both
|
$1,340.28
|
|
|
Service Code
|
CPT 23515
|
| Hospital Charge Code |
z23515
|
| Min. Negotiated Rate |
$607.30 |
| Max. Negotiated Rate |
$100,900.00 |
| Rate for Payer: Aetna Commercial |
$671.78
|
| Rate for Payer: Aetna Commercial |
$671.78
|
| Rate for Payer: Aetna Medicare |
$671.78
|
| Rate for Payer: Aetna Medicare |
$671.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$733.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$733.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$659.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$659.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$772.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$772.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$738.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$738.96
|
| Rate for Payer: Cash Price |
$804.17
|
| Rate for Payer: Cash Price |
$787.26
|
| Rate for Payer: Centivo All Commercial |
$1,041.26
|
| Rate for Payer: Centivo All Commercial |
$1,041.26
|
| Rate for Payer: Cigna All Commercial |
$671.78
|
| Rate for Payer: Cigna All Commercial |
$671.78
|
| Rate for Payer: CORVEL All Commercial |
$671.78
|
| Rate for Payer: CORVEL All Commercial |
$671.78
|
| Rate for Payer: Coventry All Commercial |
$806.14
|
| Rate for Payer: Coventry All Commercial |
$806.14
|
| Rate for Payer: Encore All Commercial |
$671.78
|
| Rate for Payer: Encore All Commercial |
$671.78
|
| Rate for Payer: Frontpath All Commercial |
$933.95
|
| Rate for Payer: Frontpath All Commercial |
$933.95
|
| Rate for Payer: Humana ChoiceCare |
$607.30
|
| Rate for Payer: Humana ChoiceCare |
$607.30
|
| Rate for Payer: Humana Medicare |
$671.78
|
| Rate for Payer: Humana Medicare |
$671.78
|
| Rate for Payer: Lucent All Commercial |
$940.49
|
| Rate for Payer: Lucent All Commercial |
$940.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,076.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,076.00
|
| Rate for Payer: Managed Health Services Medicaid |
$659.20
|
| Rate for Payer: Managed Health Services Medicaid |
$659.20
|
| Rate for Payer: MDWise Medicaid |
$659.20
|
| Rate for Payer: MDWise Medicaid |
$659.20
|
| Rate for Payer: PHCS All Commercial |
$671.78
|
| Rate for Payer: PHCS All Commercial |
$671.78
|
| Rate for Payer: PHP All Commercial |
$1,141.53
|
| Rate for Payer: PHP All Commercial |
$1,141.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$671.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$671.78
|
| Rate for Payer: Sagamore Health Network All Products |
$671.78
|
| Rate for Payer: Sagamore Health Network All Products |
$671.78
|
| Rate for Payer: Signature Care EPO |
$811.75
|
| Rate for Payer: Signature Care EPO |
$811.75
|
| Rate for Payer: Signature Care PPO |
$811.75
|
| Rate for Payer: Signature Care PPO |
$811.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$100,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$100,900.00
|
| Rate for Payer: United Healthcare Commercial |
$756.40
|
| Rate for Payer: United Healthcare Commercial |
$756.40
|
| Rate for Payer: United Healthcare Medicare |
$656.05
|
| Rate for Payer: United Healthcare Medicare |
$656.05
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
Both
|
$2,448.74
|
|
|
Service Code
|
CPT 27828
|
| Hospital Charge Code |
z27828
|
| Min. Negotiated Rate |
$1,203.59 |
| Max. Negotiated Rate |
$1,925.43 |
| Rate for Payer: Aetna Commercial |
$1,242.21
|
| Rate for Payer: Aetna Commercial |
$1,242.21
|
| Rate for Payer: Aetna Medicare |
$1,242.21
|
| Rate for Payer: Aetna Medicare |
$1,242.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,204.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,204.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,428.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,428.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,366.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,366.43
|
| Rate for Payer: Cash Price |
$1,444.31
|
| Rate for Payer: Cash Price |
$1,469.24
|
| Rate for Payer: Centivo All Commercial |
$1,925.43
|
| Rate for Payer: Centivo All Commercial |
$1,925.43
|
| Rate for Payer: Cigna All Commercial |
$1,242.21
|
| Rate for Payer: Cigna All Commercial |
$1,242.21
|
| Rate for Payer: CORVEL All Commercial |
$1,242.21
|
| Rate for Payer: CORVEL All Commercial |
$1,242.21
|
| Rate for Payer: Coventry All Commercial |
$1,490.65
|
| Rate for Payer: Coventry All Commercial |
$1,490.65
|
| Rate for Payer: Encore All Commercial |
$1,242.21
|
| Rate for Payer: Encore All Commercial |
$1,242.21
|
| Rate for Payer: Frontpath All Commercial |
$1,728.96
|
| Rate for Payer: Frontpath All Commercial |
$1,728.96
|
| Rate for Payer: Humana ChoiceCare |
$1,313.75
|
| Rate for Payer: Humana ChoiceCare |
$1,313.75
|
| Rate for Payer: Humana Medicare |
$1,242.21
|
| Rate for Payer: Humana Medicare |
$1,242.21
|
| Rate for Payer: Lucent All Commercial |
$1,739.09
|
| Rate for Payer: Lucent All Commercial |
$1,739.09
|
| Rate for Payer: Managed Health Services Medicaid |
$1,204.39
|
| Rate for Payer: Managed Health Services Medicaid |
$1,204.39
|
| Rate for Payer: MDWise Medicaid |
$1,204.39
|
| Rate for Payer: MDWise Medicaid |
$1,204.39
|
| Rate for Payer: PHCS All Commercial |
$1,242.21
|
| Rate for Payer: PHCS All Commercial |
$1,242.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,242.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,242.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,242.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,242.21
|
| Rate for Payer: United Healthcare Commercial |
$1,413.59
|
| Rate for Payer: United Healthcare Commercial |
$1,413.59
|
| Rate for Payer: United Healthcare Medicare |
$1,203.59
|
| Rate for Payer: United Healthcare Medicare |
$1,203.59
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
Both
|
$2,072.68
|
|
|
Service Code
|
CPT 27827
|
| Hospital Charge Code |
z27827
|
| Min. Negotiated Rate |
$1,017.57 |
| Max. Negotiated Rate |
$156,500.00 |
| Rate for Payer: Aetna Commercial |
$1,047.65
|
| Rate for Payer: Aetna Commercial |
$1,047.65
|
| Rate for Payer: Aetna Medicare |
$1,047.65
|
| Rate for Payer: Aetna Medicare |
$1,047.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,887.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,887.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,019.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,019.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,204.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,204.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,152.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,152.41
|
| Rate for Payer: Cash Price |
$1,243.61
|
| Rate for Payer: Cash Price |
$1,221.08
|
| Rate for Payer: Centivo All Commercial |
$1,623.86
|
| Rate for Payer: Centivo All Commercial |
$1,623.86
|
| Rate for Payer: Cigna All Commercial |
$1,047.65
|
| Rate for Payer: Cigna All Commercial |
$1,047.65
|
| Rate for Payer: CORVEL All Commercial |
$1,047.65
|
| Rate for Payer: CORVEL All Commercial |
$1,047.65
|
| Rate for Payer: Coventry All Commercial |
$1,257.18
|
| Rate for Payer: Coventry All Commercial |
$1,257.18
|
| Rate for Payer: Encore All Commercial |
$1,047.65
|
| Rate for Payer: Encore All Commercial |
$1,047.65
|
| Rate for Payer: Frontpath All Commercial |
$1,454.04
|
| Rate for Payer: Frontpath All Commercial |
$1,454.04
|
| Rate for Payer: Humana ChoiceCare |
$1,165.50
|
| Rate for Payer: Humana ChoiceCare |
$1,165.50
|
| Rate for Payer: Humana Medicare |
$1,047.65
|
| Rate for Payer: Humana Medicare |
$1,047.65
|
| Rate for Payer: Lucent All Commercial |
$1,466.71
|
| Rate for Payer: Lucent All Commercial |
$1,466.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,669.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,669.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,019.42
|
| Rate for Payer: Managed Health Services Medicaid |
$1,019.42
|
| Rate for Payer: MDWise Medicaid |
$1,019.42
|
| Rate for Payer: MDWise Medicaid |
$1,019.42
|
| Rate for Payer: PHCS All Commercial |
$1,047.65
|
| Rate for Payer: PHCS All Commercial |
$1,047.65
|
| Rate for Payer: PHP All Commercial |
$1,770.57
|
| Rate for Payer: PHP All Commercial |
$1,770.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,047.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,047.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,047.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,047.65
|
| Rate for Payer: Signature Care EPO |
$1,558.90
|
| Rate for Payer: Signature Care EPO |
$1,558.90
|
| Rate for Payer: Signature Care PPO |
$1,558.90
|
| Rate for Payer: Signature Care PPO |
$1,558.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156,500.00
|
| Rate for Payer: United Healthcare Commercial |
$1,179.63
|
| Rate for Payer: United Healthcare Commercial |
$1,179.63
|
| Rate for Payer: United Healthcare Medicare |
$1,017.57
|
| Rate for Payer: United Healthcare Medicare |
$1,017.57
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
Both
|
$1,375.24
|
|
|
Service Code
|
CPT 27248
|
| Hospital Charge Code |
z27248
|
| Min. Negotiated Rate |
$675.08 |
| Max. Negotiated Rate |
$103,800.00 |
| Rate for Payer: Aetna Commercial |
$695.62
|
| Rate for Payer: Aetna Commercial |
$695.62
|
| Rate for Payer: Aetna Medicare |
$695.62
|
| Rate for Payer: Aetna Medicare |
$695.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,044.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,044.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$676.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$676.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$799.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$799.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$765.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$765.18
|
| Rate for Payer: Cash Price |
$825.14
|
| Rate for Payer: Cash Price |
$810.10
|
| Rate for Payer: Centivo All Commercial |
$1,078.21
|
| Rate for Payer: Centivo All Commercial |
$1,078.21
|
| Rate for Payer: Cigna All Commercial |
$695.62
|
| Rate for Payer: Cigna All Commercial |
$695.62
|
| Rate for Payer: CORVEL All Commercial |
$695.62
|
| Rate for Payer: CORVEL All Commercial |
$695.62
|
| Rate for Payer: Coventry All Commercial |
$834.74
|
| Rate for Payer: Coventry All Commercial |
$834.74
|
| Rate for Payer: Encore All Commercial |
$695.62
|
| Rate for Payer: Encore All Commercial |
$695.62
|
| Rate for Payer: Frontpath All Commercial |
$971.96
|
| Rate for Payer: Frontpath All Commercial |
$971.96
|
| Rate for Payer: Humana ChoiceCare |
$815.34
|
| Rate for Payer: Humana ChoiceCare |
$815.34
|
| Rate for Payer: Humana Medicare |
$695.62
|
| Rate for Payer: Humana Medicare |
$695.62
|
| Rate for Payer: Lucent All Commercial |
$973.87
|
| Rate for Payer: Lucent All Commercial |
$973.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,107.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,107.00
|
| Rate for Payer: Managed Health Services Medicaid |
$676.40
|
| Rate for Payer: Managed Health Services Medicaid |
$676.40
|
| Rate for Payer: MDWise Medicaid |
$676.40
|
| Rate for Payer: MDWise Medicaid |
$676.40
|
| Rate for Payer: PHCS All Commercial |
$695.62
|
| Rate for Payer: PHCS All Commercial |
$695.62
|
| Rate for Payer: PHP All Commercial |
$1,174.63
|
| Rate for Payer: PHP All Commercial |
$1,174.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$695.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$695.62
|
| Rate for Payer: Sagamore Health Network All Products |
$695.62
|
| Rate for Payer: Sagamore Health Network All Products |
$695.62
|
| Rate for Payer: Signature Care EPO |
$1,090.55
|
| Rate for Payer: Signature Care EPO |
$1,090.55
|
| Rate for Payer: Signature Care PPO |
$1,090.55
|
| Rate for Payer: Signature Care PPO |
$1,090.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$103,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$103,800.00
|
| Rate for Payer: United Healthcare Commercial |
$820.61
|
| Rate for Payer: United Healthcare Commercial |
$820.61
|
| Rate for Payer: United Healthcare Medicare |
$675.08
|
| Rate for Payer: United Healthcare Medicare |
$675.08
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
Both
|
$1,074.80
|
|
|
Service Code
|
CPT 28675
|
| Hospital Charge Code |
z28675
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$58,200.00 |
| Rate for Payer: Aetna Commercial |
$386.57
|
| Rate for Payer: Aetna Commercial |
$386.57
|
| Rate for Payer: Aetna Medicare |
$386.57
|
| Rate for Payer: Aetna Medicare |
$386.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$438.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$438.01
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$210.06
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$210.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$528.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$528.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$444.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$444.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$425.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$425.23
|
| Rate for Payer: Cash Price |
$629.93
|
| Rate for Payer: Cash Price |
$644.88
|
| Rate for Payer: Centivo All Commercial |
$599.18
|
| Rate for Payer: Centivo All Commercial |
$599.18
|
| Rate for Payer: Cigna All Commercial |
$386.57
|
| Rate for Payer: Cigna All Commercial |
$386.57
|
| Rate for Payer: CORVEL All Commercial |
$386.57
|
| Rate for Payer: CORVEL All Commercial |
$386.57
|
| Rate for Payer: Coventry All Commercial |
$463.88
|
| Rate for Payer: Coventry All Commercial |
$463.88
|
| Rate for Payer: Encore All Commercial |
$386.57
|
| Rate for Payer: Encore All Commercial |
$386.57
|
| Rate for Payer: Frontpath All Commercial |
$526.58
|
| Rate for Payer: Frontpath All Commercial |
$526.58
|
| Rate for Payer: Humana ChoiceCare |
$268.95
|
| Rate for Payer: Humana ChoiceCare |
$268.95
|
| Rate for Payer: Humana Medicare |
$386.57
|
| Rate for Payer: Humana Medicare |
$386.57
|
| Rate for Payer: Lucent All Commercial |
$541.20
|
| Rate for Payer: Lucent All Commercial |
$541.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$621.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$621.00
|
| Rate for Payer: Managed Health Services Medicaid |
$528.63
|
| Rate for Payer: Managed Health Services Medicaid |
$528.63
|
| Rate for Payer: MDWise Medicaid |
$528.63
|
| Rate for Payer: MDWise Medicaid |
$528.63
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$210.06
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$210.06
|
| Rate for Payer: PHCS All Commercial |
$386.57
|
| Rate for Payer: PHCS All Commercial |
$386.57
|
| Rate for Payer: PHP All Commercial |
$658.70
|
| Rate for Payer: PHP All Commercial |
$658.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.57
|
| Rate for Payer: Sagamore Health Network All Products |
$386.57
|
| Rate for Payer: Sagamore Health Network All Products |
$386.57
|
| Rate for Payer: Signature Care EPO |
$654.50
|
| Rate for Payer: Signature Care EPO |
$654.50
|
| Rate for Payer: Signature Care PPO |
$654.50
|
| Rate for Payer: Signature Care PPO |
$654.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$58,200.00
|
| Rate for Payer: United Healthcare Commercial |
$433.38
|
| Rate for Payer: United Healthcare Commercial |
$433.38
|
| Rate for Payer: United Healthcare Medicare |
$524.94
|
| Rate for Payer: United Healthcare Medicare |
$524.94
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,128.28
|
|
|
Service Code
|
CPT 27766
|
| Hospital Charge Code |
z27766
|
| Min. Negotiated Rate |
$553.95 |
| Max. Negotiated Rate |
$85,100.00 |
| Rate for Payer: Aetna Commercial |
$565.81
|
| Rate for Payer: Aetna Commercial |
$565.81
|
| Rate for Payer: Aetna Medicare |
$565.81
|
| Rate for Payer: Aetna Medicare |
$565.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$554.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$554.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$650.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$650.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$622.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$622.39
|
| Rate for Payer: Cash Price |
$676.97
|
| Rate for Payer: Cash Price |
$664.74
|
| Rate for Payer: Centivo All Commercial |
$877.01
|
| Rate for Payer: Centivo All Commercial |
$877.01
|
| Rate for Payer: Cigna All Commercial |
$565.81
|
| Rate for Payer: Cigna All Commercial |
$565.81
|
| Rate for Payer: CORVEL All Commercial |
$565.81
|
| Rate for Payer: CORVEL All Commercial |
$565.81
|
| Rate for Payer: Coventry All Commercial |
$678.97
|
| Rate for Payer: Coventry All Commercial |
$678.97
|
| Rate for Payer: Encore All Commercial |
$565.81
|
| Rate for Payer: Encore All Commercial |
$565.81
|
| Rate for Payer: Frontpath All Commercial |
$782.76
|
| Rate for Payer: Frontpath All Commercial |
$782.76
|
| Rate for Payer: Humana ChoiceCare |
$678.32
|
| Rate for Payer: Humana ChoiceCare |
$678.32
|
| Rate for Payer: Humana Medicare |
$565.81
|
| Rate for Payer: Humana Medicare |
$565.81
|
| Rate for Payer: Lucent All Commercial |
$792.13
|
| Rate for Payer: Lucent All Commercial |
$792.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$908.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$908.00
|
| Rate for Payer: Managed Health Services Medicaid |
$554.93
|
| Rate for Payer: Managed Health Services Medicaid |
$554.93
|
| Rate for Payer: MDWise Medicaid |
$554.93
|
| Rate for Payer: MDWise Medicaid |
$554.93
|
| Rate for Payer: PHCS All Commercial |
$565.81
|
| Rate for Payer: PHCS All Commercial |
$565.81
|
| Rate for Payer: PHP All Commercial |
$963.87
|
| Rate for Payer: PHP All Commercial |
$963.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$565.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$565.81
|
| Rate for Payer: Sagamore Health Network All Products |
$565.81
|
| Rate for Payer: Sagamore Health Network All Products |
$565.81
|
| Rate for Payer: Signature Care EPO |
$906.10
|
| Rate for Payer: Signature Care EPO |
$906.10
|
| Rate for Payer: Signature Care PPO |
$906.10
|
| Rate for Payer: Signature Care PPO |
$906.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85,100.00
|
| Rate for Payer: United Healthcare Commercial |
$655.98
|
| Rate for Payer: United Healthcare Commercial |
$655.98
|
| Rate for Payer: United Healthcare Medicare |
$553.95
|
| Rate for Payer: United Healthcare Medicare |
$553.95
|
|
|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
Both
|
$1,062.22
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
z28485
|
| Min. Negotiated Rate |
$480.61 |
| Max. Negotiated Rate |
$79,400.00 |
| Rate for Payer: Aetna Commercial |
$529.87
|
| Rate for Payer: Aetna Commercial |
$529.87
|
| Rate for Payer: Aetna Medicare |
$529.87
|
| Rate for Payer: Aetna Medicare |
$529.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$509.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$509.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$522.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$522.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$609.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$609.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$582.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$582.86
|
| Rate for Payer: Cash Price |
$637.33
|
| Rate for Payer: Cash Price |
$619.91
|
| Rate for Payer: Centivo All Commercial |
$821.30
|
| Rate for Payer: Centivo All Commercial |
$821.30
|
| Rate for Payer: Cigna All Commercial |
$529.87
|
| Rate for Payer: Cigna All Commercial |
$529.87
|
| Rate for Payer: CORVEL All Commercial |
$529.87
|
| Rate for Payer: CORVEL All Commercial |
$529.87
|
| Rate for Payer: Coventry All Commercial |
$635.84
|
| Rate for Payer: Coventry All Commercial |
$635.84
|
| Rate for Payer: Encore All Commercial |
$529.87
|
| Rate for Payer: Encore All Commercial |
$529.87
|
| Rate for Payer: Frontpath All Commercial |
$720.82
|
| Rate for Payer: Frontpath All Commercial |
$720.82
|
| Rate for Payer: Humana ChoiceCare |
$480.61
|
| Rate for Payer: Humana ChoiceCare |
$480.61
|
| Rate for Payer: Humana Medicare |
$529.87
|
| Rate for Payer: Humana Medicare |
$529.87
|
| Rate for Payer: Lucent All Commercial |
$741.82
|
| Rate for Payer: Lucent All Commercial |
$741.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$847.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$847.00
|
| Rate for Payer: Managed Health Services Medicaid |
$522.44
|
| Rate for Payer: Managed Health Services Medicaid |
$522.44
|
| Rate for Payer: MDWise Medicaid |
$522.44
|
| Rate for Payer: MDWise Medicaid |
$522.44
|
| Rate for Payer: PHCS All Commercial |
$529.87
|
| Rate for Payer: PHCS All Commercial |
$529.87
|
| Rate for Payer: PHP All Commercial |
$898.87
|
| Rate for Payer: PHP All Commercial |
$898.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$529.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$529.87
|
| Rate for Payer: Sagamore Health Network All Products |
$529.87
|
| Rate for Payer: Sagamore Health Network All Products |
$529.87
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$79,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$79,400.00
|
| Rate for Payer: United Healthcare Commercial |
$578.66
|
| Rate for Payer: United Healthcare Commercial |
$578.66
|
| Rate for Payer: United Healthcare Medicare |
$516.59
|
| Rate for Payer: United Healthcare Medicare |
$516.59
|
|
|
PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE
|
Professional
|
Both
|
$1,169.48
|
|
|
Service Code
|
CPT 25545
|
| Hospital Charge Code |
z25545
|
| Min. Negotiated Rate |
$571.30 |
| Max. Negotiated Rate |
$87,800.00 |
| Rate for Payer: Aetna Commercial |
$584.07
|
| Rate for Payer: Aetna Commercial |
$584.07
|
| Rate for Payer: Aetna Medicare |
$584.07
|
| Rate for Payer: Aetna Medicare |
$584.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$856.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$856.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$575.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$575.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$671.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$671.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$642.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$642.48
|
| Rate for Payer: Cash Price |
$701.69
|
| Rate for Payer: Cash Price |
$685.56
|
| Rate for Payer: Centivo All Commercial |
$905.31
|
| Rate for Payer: Centivo All Commercial |
$905.31
|
| Rate for Payer: Cigna All Commercial |
$584.07
|
| Rate for Payer: Cigna All Commercial |
$584.07
|
| Rate for Payer: CORVEL All Commercial |
$584.07
|
| Rate for Payer: CORVEL All Commercial |
$584.07
|
| Rate for Payer: Coventry All Commercial |
$700.88
|
| Rate for Payer: Coventry All Commercial |
$700.88
|
| Rate for Payer: Encore All Commercial |
$584.07
|
| Rate for Payer: Encore All Commercial |
$584.07
|
| Rate for Payer: Frontpath All Commercial |
$808.50
|
| Rate for Payer: Frontpath All Commercial |
$808.50
|
| Rate for Payer: Humana ChoiceCare |
$721.01
|
| Rate for Payer: Humana ChoiceCare |
$721.01
|
| Rate for Payer: Humana Medicare |
$584.07
|
| Rate for Payer: Humana Medicare |
$584.07
|
| Rate for Payer: Lucent All Commercial |
$817.70
|
| Rate for Payer: Lucent All Commercial |
$817.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$937.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$937.00
|
| Rate for Payer: Managed Health Services Medicaid |
$575.19
|
| Rate for Payer: Managed Health Services Medicaid |
$575.19
|
| Rate for Payer: MDWise Medicaid |
$575.19
|
| Rate for Payer: MDWise Medicaid |
$575.19
|
| Rate for Payer: PHCS All Commercial |
$584.07
|
| Rate for Payer: PHCS All Commercial |
$584.07
|
| Rate for Payer: PHP All Commercial |
$994.07
|
| Rate for Payer: PHP All Commercial |
$994.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$584.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$584.07
|
| Rate for Payer: Sagamore Health Network All Products |
$584.07
|
| Rate for Payer: Sagamore Health Network All Products |
$584.07
|
| Rate for Payer: Signature Care EPO |
$965.60
|
| Rate for Payer: Signature Care EPO |
$965.60
|
| Rate for Payer: Signature Care PPO |
$965.60
|
| Rate for Payer: Signature Care PPO |
$965.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87,800.00
|
| Rate for Payer: United Healthcare Commercial |
$669.76
|
| Rate for Payer: United Healthcare Commercial |
$669.76
|
| Rate for Payer: United Healthcare Medicare |
$571.30
|
| Rate for Payer: United Healthcare Medicare |
$571.30
|
|
|
PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE
|
Professional
|
Both
|
$1,348.52
|
|
|
Service Code
|
CPT 27769
|
| Hospital Charge Code |
z27769
|
| Min. Negotiated Rate |
$661.00 |
| Max. Negotiated Rate |
$1,054.57 |
| Rate for Payer: Aetna Commercial |
$680.37
|
| Rate for Payer: Aetna Commercial |
$680.37
|
| Rate for Payer: Aetna Medicare |
$680.37
|
| Rate for Payer: Aetna Medicare |
$680.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$663.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$663.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.41
|
| Rate for Payer: Cash Price |
$793.20
|
| Rate for Payer: Cash Price |
$809.11
|
| Rate for Payer: Centivo All Commercial |
$1,054.57
|
| Rate for Payer: Centivo All Commercial |
$1,054.57
|
| Rate for Payer: Cigna All Commercial |
$680.37
|
| Rate for Payer: Cigna All Commercial |
$680.37
|
| Rate for Payer: CORVEL All Commercial |
$680.37
|
| Rate for Payer: CORVEL All Commercial |
$680.37
|
| Rate for Payer: Coventry All Commercial |
$816.44
|
| Rate for Payer: Coventry All Commercial |
$816.44
|
| Rate for Payer: Encore All Commercial |
$680.37
|
| Rate for Payer: Encore All Commercial |
$680.37
|
| Rate for Payer: Frontpath All Commercial |
$946.37
|
| Rate for Payer: Frontpath All Commercial |
$946.37
|
| Rate for Payer: Humana ChoiceCare |
$662.54
|
| Rate for Payer: Humana ChoiceCare |
$662.54
|
| Rate for Payer: Humana Medicare |
$680.37
|
| Rate for Payer: Humana Medicare |
$680.37
|
| Rate for Payer: Lucent All Commercial |
$952.52
|
| Rate for Payer: Lucent All Commercial |
$952.52
|
| Rate for Payer: Managed Health Services Medicaid |
$663.26
|
| Rate for Payer: Managed Health Services Medicaid |
$663.26
|
| Rate for Payer: MDWise Medicaid |
$663.26
|
| Rate for Payer: MDWise Medicaid |
$663.26
|
| Rate for Payer: PHCS All Commercial |
$680.37
|
| Rate for Payer: PHCS All Commercial |
$680.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$680.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$680.37
|
| Rate for Payer: Sagamore Health Network All Products |
$680.37
|
| Rate for Payer: Sagamore Health Network All Products |
$680.37
|
| Rate for Payer: United Healthcare Commercial |
$752.38
|
| Rate for Payer: United Healthcare Commercial |
$752.38
|
| Rate for Payer: United Healthcare Medicare |
$661.00
|
| Rate for Payer: United Healthcare Medicare |
$661.00
|
|
|
PR OPEN TREATMENT PROX HUMERAL FRACTURE
|
Professional
|
Both
|
$1,636.44
|
|
|
Service Code
|
CPT 23615
|
| Hospital Charge Code |
z23615
|
| Min. Negotiated Rate |
$789.05 |
| Max. Negotiated Rate |
$123,200.00 |
| Rate for Payer: Aetna Commercial |
$822.96
|
| Rate for Payer: Aetna Commercial |
$822.96
|
| Rate for Payer: Aetna Medicare |
$822.96
|
| Rate for Payer: Aetna Medicare |
$822.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$959.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$959.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$804.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$804.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$946.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$946.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$905.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$905.26
|
| Rate for Payer: Cash Price |
$981.86
|
| Rate for Payer: Cash Price |
$961.86
|
| Rate for Payer: Centivo All Commercial |
$1,275.59
|
| Rate for Payer: Centivo All Commercial |
$1,275.59
|
| Rate for Payer: Cigna All Commercial |
$822.96
|
| Rate for Payer: Cigna All Commercial |
$822.96
|
| Rate for Payer: CORVEL All Commercial |
$822.96
|
| Rate for Payer: CORVEL All Commercial |
$822.96
|
| Rate for Payer: Coventry All Commercial |
$987.55
|
| Rate for Payer: Coventry All Commercial |
$987.55
|
| Rate for Payer: Encore All Commercial |
$822.96
|
| Rate for Payer: Encore All Commercial |
$822.96
|
| Rate for Payer: Frontpath All Commercial |
$1,147.03
|
| Rate for Payer: Frontpath All Commercial |
$1,147.03
|
| Rate for Payer: Humana ChoiceCare |
$789.05
|
| Rate for Payer: Humana ChoiceCare |
$789.05
|
| Rate for Payer: Humana Medicare |
$822.96
|
| Rate for Payer: Humana Medicare |
$822.96
|
| Rate for Payer: Lucent All Commercial |
$1,152.14
|
| Rate for Payer: Lucent All Commercial |
$1,152.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,315.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,315.00
|
| Rate for Payer: Managed Health Services Medicaid |
$804.87
|
| Rate for Payer: Managed Health Services Medicaid |
$804.87
|
| Rate for Payer: MDWise Medicaid |
$804.87
|
| Rate for Payer: MDWise Medicaid |
$804.87
|
| Rate for Payer: PHCS All Commercial |
$822.96
|
| Rate for Payer: PHCS All Commercial |
$822.96
|
| Rate for Payer: PHP All Commercial |
$1,394.70
|
| Rate for Payer: PHP All Commercial |
$1,394.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$822.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$822.96
|
| Rate for Payer: Sagamore Health Network All Products |
$822.96
|
| Rate for Payer: Sagamore Health Network All Products |
$822.96
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$123,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$123,200.00
|
| Rate for Payer: United Healthcare Commercial |
$940.70
|
| Rate for Payer: United Healthcare Commercial |
$940.70
|
| Rate for Payer: United Healthcare Medicare |
$801.55
|
| Rate for Payer: United Healthcare Medicare |
$801.55
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
Both
|
$1,330.90
|
|
|
Service Code
|
CPT 27784
|
| Hospital Charge Code |
z27784
|
| Min. Negotiated Rate |
$590.09 |
| Max. Negotiated Rate |
$99,400.00 |
| Rate for Payer: Aetna Commercial |
$661.38
|
| Rate for Payer: Aetna Commercial |
$661.38
|
| Rate for Payer: Aetna Medicare |
$661.38
|
| Rate for Payer: Aetna Medicare |
$661.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$685.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$685.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$654.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$654.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$760.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$760.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$727.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$727.52
|
| Rate for Payer: Cash Price |
$798.54
|
| Rate for Payer: Cash Price |
$775.76
|
| Rate for Payer: Centivo All Commercial |
$1,025.14
|
| Rate for Payer: Centivo All Commercial |
$1,025.14
|
| Rate for Payer: Cigna All Commercial |
$661.38
|
| Rate for Payer: Cigna All Commercial |
$661.38
|
| Rate for Payer: CORVEL All Commercial |
$661.38
|
| Rate for Payer: CORVEL All Commercial |
$661.38
|
| Rate for Payer: Coventry All Commercial |
$793.66
|
| Rate for Payer: Coventry All Commercial |
$793.66
|
| Rate for Payer: Encore All Commercial |
$661.38
|
| Rate for Payer: Encore All Commercial |
$661.38
|
| Rate for Payer: Frontpath All Commercial |
$917.44
|
| Rate for Payer: Frontpath All Commercial |
$917.44
|
| Rate for Payer: Humana ChoiceCare |
$590.09
|
| Rate for Payer: Humana ChoiceCare |
$590.09
|
| Rate for Payer: Humana Medicare |
$661.38
|
| Rate for Payer: Humana Medicare |
$661.38
|
| Rate for Payer: Lucent All Commercial |
$925.93
|
| Rate for Payer: Lucent All Commercial |
$925.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,060.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,060.00
|
| Rate for Payer: Managed Health Services Medicaid |
$654.59
|
| Rate for Payer: Managed Health Services Medicaid |
$654.59
|
| Rate for Payer: MDWise Medicaid |
$654.59
|
| Rate for Payer: MDWise Medicaid |
$654.59
|
| Rate for Payer: PHCS All Commercial |
$661.38
|
| Rate for Payer: PHCS All Commercial |
$661.38
|
| Rate for Payer: PHP All Commercial |
$1,124.87
|
| Rate for Payer: PHP All Commercial |
$1,124.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$661.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$661.38
|
| Rate for Payer: Sagamore Health Network All Products |
$661.38
|
| Rate for Payer: Sagamore Health Network All Products |
$661.38
|
| 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 |
$99,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$99,400.00
|
| Rate for Payer: United Healthcare Commercial |
$747.11
|
| Rate for Payer: United Healthcare Commercial |
$747.11
|
| Rate for Payer: United Healthcare Medicare |
$646.47
|
| Rate for Payer: United Healthcare Medicare |
$646.47
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE
|
Professional
|
Both
|
$1,252.80
|
|
|
Service Code
|
CPT 25515
|
| Hospital Charge Code |
z25515
|
| Min. Negotiated Rate |
$611.43 |
| Max. Negotiated Rate |
$1,063.89 |
| Rate for Payer: Aetna Commercial |
$625.92
|
| Rate for Payer: Aetna Commercial |
$625.92
|
| Rate for Payer: Aetna Medicare |
$625.92
|
| Rate for Payer: Aetna Medicare |
$625.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$616.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$616.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$719.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$719.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$688.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$688.51
|
| Rate for Payer: Cash Price |
$751.68
|
| Rate for Payer: Cash Price |
$733.72
|
| Rate for Payer: Centivo All Commercial |
$970.18
|
| Rate for Payer: Centivo All Commercial |
$970.18
|
| Rate for Payer: Cigna All Commercial |
$625.92
|
| Rate for Payer: Cigna All Commercial |
$625.92
|
| Rate for Payer: CORVEL All Commercial |
$625.92
|
| Rate for Payer: CORVEL All Commercial |
$625.92
|
| Rate for Payer: Coventry All Commercial |
$751.10
|
| Rate for Payer: Coventry All Commercial |
$751.10
|
| Rate for Payer: Encore All Commercial |
$625.92
|
| Rate for Payer: Encore All Commercial |
$625.92
|
| Rate for Payer: Frontpath All Commercial |
$867.88
|
| Rate for Payer: Frontpath All Commercial |
$867.88
|
| Rate for Payer: Humana ChoiceCare |
$726.47
|
| Rate for Payer: Humana ChoiceCare |
$726.47
|
| Rate for Payer: Humana Medicare |
$625.92
|
| Rate for Payer: Humana Medicare |
$625.92
|
| Rate for Payer: Lucent All Commercial |
$876.29
|
| Rate for Payer: Lucent All Commercial |
$876.29
|
| Rate for Payer: Managed Health Services Medicaid |
$616.17
|
| Rate for Payer: Managed Health Services Medicaid |
$616.17
|
| Rate for Payer: MDWise Medicaid |
$616.17
|
| Rate for Payer: MDWise Medicaid |
$616.17
|
| Rate for Payer: PHCS All Commercial |
$625.92
|
| Rate for Payer: PHCS All Commercial |
$625.92
|
| Rate for Payer: PHP All Commercial |
$1,063.89
|
| Rate for Payer: PHP All Commercial |
$1,063.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$625.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$625.92
|
| Rate for Payer: Sagamore Health Network All Products |
$625.92
|
| Rate for Payer: Sagamore Health Network All Products |
$625.92
|
| Rate for Payer: Signature Care EPO |
$971.55
|
| Rate for Payer: Signature Care EPO |
$971.55
|
| Rate for Payer: Signature Care PPO |
$971.55
|
| Rate for Payer: Signature Care PPO |
$971.55
|
| Rate for Payer: United Healthcare Commercial |
$716.79
|
| Rate for Payer: United Healthcare Commercial |
$716.79
|
| Rate for Payer: United Healthcare Medicare |
$611.43
|
| Rate for Payer: United Healthcare Medicare |
$611.43
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
Both
|
$1,383.98
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
z26746
|
| Min. Negotiated Rate |
$491.25 |
| Max. Negotiated Rate |
$104,200.00 |
| Rate for Payer: Aetna Commercial |
$694.52
|
| Rate for Payer: Aetna Commercial |
$694.52
|
| Rate for Payer: Aetna Medicare |
$694.52
|
| Rate for Payer: Aetna Medicare |
$694.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$584.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$584.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$680.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$680.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$798.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$798.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$763.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$763.97
|
| Rate for Payer: Cash Price |
$830.39
|
| Rate for Payer: Cash Price |
$813.24
|
| Rate for Payer: Centivo All Commercial |
$1,076.51
|
| Rate for Payer: Centivo All Commercial |
$1,076.51
|
| Rate for Payer: Cigna All Commercial |
$694.52
|
| Rate for Payer: Cigna All Commercial |
$694.52
|
| Rate for Payer: CORVEL All Commercial |
$694.52
|
| Rate for Payer: CORVEL All Commercial |
$694.52
|
| Rate for Payer: Coventry All Commercial |
$833.42
|
| Rate for Payer: Coventry All Commercial |
$833.42
|
| Rate for Payer: Encore All Commercial |
$694.52
|
| Rate for Payer: Encore All Commercial |
$694.52
|
| Rate for Payer: Frontpath All Commercial |
$960.51
|
| Rate for Payer: Frontpath All Commercial |
$960.51
|
| Rate for Payer: Humana ChoiceCare |
$491.25
|
| Rate for Payer: Humana ChoiceCare |
$491.25
|
| Rate for Payer: Humana Medicare |
$694.52
|
| Rate for Payer: Humana Medicare |
$694.52
|
| Rate for Payer: Lucent All Commercial |
$972.33
|
| Rate for Payer: Lucent All Commercial |
$972.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,111.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,111.00
|
| Rate for Payer: Managed Health Services Medicaid |
$680.70
|
| Rate for Payer: Managed Health Services Medicaid |
$680.70
|
| Rate for Payer: MDWise Medicaid |
$680.70
|
| Rate for Payer: MDWise Medicaid |
$680.70
|
| Rate for Payer: PHCS All Commercial |
$694.52
|
| Rate for Payer: PHCS All Commercial |
$694.52
|
| Rate for Payer: PHP All Commercial |
$1,179.19
|
| Rate for Payer: PHP All Commercial |
$1,179.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$694.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$694.52
|
| Rate for Payer: Sagamore Health Network All Products |
$694.52
|
| Rate for Payer: Sagamore Health Network All Products |
$694.52
|
| Rate for Payer: Signature Care EPO |
$677.45
|
| Rate for Payer: Signature Care EPO |
$677.45
|
| Rate for Payer: Signature Care PPO |
$677.45
|
| Rate for Payer: Signature Care PPO |
$677.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104,200.00
|
| Rate for Payer: United Healthcare Commercial |
$743.73
|
| Rate for Payer: United Healthcare Commercial |
$743.73
|
| Rate for Payer: United Healthcare Medicare |
$677.70
|
| Rate for Payer: United Healthcare Medicare |
$677.70
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE
|
Professional
|
Both
|
$1,342.44
|
|
|
Service Code
|
CPT 25628
|
| Hospital Charge Code |
z25628
|
| Min. Negotiated Rate |
$656.96 |
| Max. Negotiated Rate |
$101,000.00 |
| Rate for Payer: Aetna Commercial |
$673.67
|
| Rate for Payer: Aetna Commercial |
$673.67
|
| Rate for Payer: Aetna Medicare |
$673.67
|
| Rate for Payer: Aetna Medicare |
$673.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$815.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$660.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$660.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$774.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$774.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$741.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$741.04
|
| Rate for Payer: Cash Price |
$805.46
|
| Rate for Payer: Cash Price |
$788.35
|
| Rate for Payer: Centivo All Commercial |
$1,044.19
|
| Rate for Payer: Centivo All Commercial |
$1,044.19
|
| Rate for Payer: Cigna All Commercial |
$673.67
|
| Rate for Payer: Cigna All Commercial |
$673.67
|
| Rate for Payer: CORVEL All Commercial |
$673.67
|
| Rate for Payer: CORVEL All Commercial |
$673.67
|
| Rate for Payer: Coventry All Commercial |
$808.40
|
| Rate for Payer: Coventry All Commercial |
$808.40
|
| Rate for Payer: Encore All Commercial |
$673.67
|
| Rate for Payer: Encore All Commercial |
$673.67
|
| Rate for Payer: Frontpath All Commercial |
$932.80
|
| Rate for Payer: Frontpath All Commercial |
$932.80
|
| Rate for Payer: Humana ChoiceCare |
$703.78
|
| Rate for Payer: Humana ChoiceCare |
$703.78
|
| Rate for Payer: Humana Medicare |
$673.67
|
| Rate for Payer: Humana Medicare |
$673.67
|
| Rate for Payer: Lucent All Commercial |
$943.14
|
| Rate for Payer: Lucent All Commercial |
$943.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,077.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,077.00
|
| Rate for Payer: Managed Health Services Medicaid |
$660.26
|
| Rate for Payer: Managed Health Services Medicaid |
$660.26
|
| Rate for Payer: MDWise Medicaid |
$660.26
|
| Rate for Payer: MDWise Medicaid |
$660.26
|
| Rate for Payer: PHCS All Commercial |
$673.67
|
| Rate for Payer: PHCS All Commercial |
$673.67
|
| Rate for Payer: PHP All Commercial |
$1,143.12
|
| Rate for Payer: PHP All Commercial |
$1,143.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$673.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$673.67
|
| Rate for Payer: Sagamore Health Network All Products |
$673.67
|
| Rate for Payer: Sagamore Health Network All Products |
$673.67
|
| Rate for Payer: Signature Care EPO |
$943.50
|
| Rate for Payer: Signature Care EPO |
$943.50
|
| Rate for Payer: Signature Care PPO |
$943.50
|
| Rate for Payer: Signature Care PPO |
$943.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$101,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$101,000.00
|
| Rate for Payer: United Healthcare Commercial |
$767.04
|
| Rate for Payer: United Healthcare Commercial |
$767.04
|
| Rate for Payer: United Healthcare Medicare |
$656.96
|
| Rate for Payer: United Healthcare Medicare |
$656.96
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
Both
|
$1,084.62
|
|
|
Service Code
|
CPT 26685
|
| Hospital Charge Code |
z26685
|
| Min. Negotiated Rate |
$526.88 |
| Max. Negotiated Rate |
$81,000.00 |
| Rate for Payer: Aetna Commercial |
$539.38
|
| Rate for Payer: Aetna Commercial |
$539.38
|
| Rate for Payer: Aetna Medicare |
$539.38
|
| Rate for Payer: Aetna Medicare |
$539.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$681.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$681.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$533.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$533.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$620.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$620.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$593.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$593.32
|
| Rate for Payer: Cash Price |
$650.77
|
| Rate for Payer: Cash Price |
$632.26
|
| Rate for Payer: Centivo All Commercial |
$836.04
|
| Rate for Payer: Centivo All Commercial |
$836.04
|
| Rate for Payer: Cigna All Commercial |
$539.38
|
| Rate for Payer: Cigna All Commercial |
$539.38
|
| Rate for Payer: CORVEL All Commercial |
$539.38
|
| Rate for Payer: CORVEL All Commercial |
$539.38
|
| Rate for Payer: Coventry All Commercial |
$647.26
|
| Rate for Payer: Coventry All Commercial |
$647.26
|
| Rate for Payer: Encore All Commercial |
$539.38
|
| Rate for Payer: Encore All Commercial |
$539.38
|
| Rate for Payer: Frontpath All Commercial |
$744.24
|
| Rate for Payer: Frontpath All Commercial |
$744.24
|
| Rate for Payer: Humana ChoiceCare |
$568.70
|
| Rate for Payer: Humana ChoiceCare |
$568.70
|
| Rate for Payer: Humana Medicare |
$539.38
|
| Rate for Payer: Humana Medicare |
$539.38
|
| Rate for Payer: Lucent All Commercial |
$755.13
|
| Rate for Payer: Lucent All Commercial |
$755.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$864.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$864.00
|
| Rate for Payer: Managed Health Services Medicaid |
$533.46
|
| Rate for Payer: Managed Health Services Medicaid |
$533.46
|
| Rate for Payer: MDWise Medicaid |
$533.46
|
| Rate for Payer: MDWise Medicaid |
$533.46
|
| Rate for Payer: PHCS All Commercial |
$539.38
|
| Rate for Payer: PHCS All Commercial |
$539.38
|
| Rate for Payer: PHP All Commercial |
$916.77
|
| Rate for Payer: PHP All Commercial |
$916.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$539.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$539.38
|
| Rate for Payer: Sagamore Health Network All Products |
$539.38
|
| Rate for Payer: Sagamore Health Network All Products |
$539.38
|
| Rate for Payer: Signature Care EPO |
$770.95
|
| Rate for Payer: Signature Care EPO |
$770.95
|
| Rate for Payer: Signature Care PPO |
$770.95
|
| Rate for Payer: Signature Care PPO |
$770.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$81,000.00
|
| Rate for Payer: United Healthcare Commercial |
$594.66
|
| Rate for Payer: United Healthcare Commercial |
$594.66
|
| Rate for Payer: United Healthcare Medicare |
$526.88
|
| Rate for Payer: United Healthcare Medicare |
$526.88
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
Both
|
$1,177.74
|
|
|
Service Code
|
CPT 26665
|
| Hospital Charge Code |
z26665
|
| Min. Negotiated Rate |
$575.38 |
| Max. Negotiated Rate |
$88,500.00 |
| Rate for Payer: Aetna Commercial |
$586.74
|
| Rate for Payer: Aetna Commercial |
$586.74
|
| Rate for Payer: Aetna Medicare |
$586.74
|
| Rate for Payer: Aetna Medicare |
$586.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$738.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$738.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$579.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$579.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$674.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$674.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$645.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$645.41
|
| Rate for Payer: Cash Price |
$706.64
|
| Rate for Payer: Cash Price |
$690.46
|
| Rate for Payer: Centivo All Commercial |
$909.45
|
| Rate for Payer: Centivo All Commercial |
$909.45
|
| Rate for Payer: Cigna All Commercial |
$586.74
|
| Rate for Payer: Cigna All Commercial |
$586.74
|
| Rate for Payer: CORVEL All Commercial |
$586.74
|
| Rate for Payer: CORVEL All Commercial |
$586.74
|
| Rate for Payer: Coventry All Commercial |
$704.09
|
| Rate for Payer: Coventry All Commercial |
$704.09
|
| Rate for Payer: Encore All Commercial |
$586.74
|
| Rate for Payer: Encore All Commercial |
$586.74
|
| Rate for Payer: Frontpath All Commercial |
$804.74
|
| Rate for Payer: Frontpath All Commercial |
$804.74
|
| Rate for Payer: Humana ChoiceCare |
$610.73
|
| Rate for Payer: Humana ChoiceCare |
$610.73
|
| Rate for Payer: Humana Medicare |
$586.74
|
| Rate for Payer: Humana Medicare |
$586.74
|
| Rate for Payer: Lucent All Commercial |
$821.44
|
| Rate for Payer: Lucent All Commercial |
$821.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$944.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$944.00
|
| Rate for Payer: Managed Health Services Medicaid |
$579.26
|
| Rate for Payer: Managed Health Services Medicaid |
$579.26
|
| Rate for Payer: MDWise Medicaid |
$579.26
|
| Rate for Payer: MDWise Medicaid |
$579.26
|
| Rate for Payer: PHCS All Commercial |
$586.74
|
| Rate for Payer: PHCS All Commercial |
$586.74
|
| Rate for Payer: PHP All Commercial |
$1,001.16
|
| Rate for Payer: PHP All Commercial |
$1,001.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$586.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$586.74
|
| Rate for Payer: Sagamore Health Network All Products |
$586.74
|
| Rate for Payer: Sagamore Health Network All Products |
$586.74
|
| Rate for Payer: Signature Care EPO |
$836.40
|
| Rate for Payer: Signature Care EPO |
$836.40
|
| Rate for Payer: Signature Care PPO |
$836.40
|
| Rate for Payer: Signature Care PPO |
$836.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88,500.00
|
| Rate for Payer: United Healthcare Commercial |
$644.48
|
| Rate for Payer: United Healthcare Commercial |
$644.48
|
| Rate for Payer: United Healthcare Medicare |
$575.38
|
| Rate for Payer: United Healthcare Medicare |
$575.38
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
Both
|
$1,202.62
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
z27792
|
| Min. Negotiated Rate |
$588.48 |
| Max. Negotiated Rate |
$90,500.00 |
| Rate for Payer: Aetna Commercial |
$604.05
|
| Rate for Payer: Aetna Commercial |
$604.05
|
| Rate for Payer: Aetna Medicare |
$604.05
|
| Rate for Payer: Aetna Medicare |
$604.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$752.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$752.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$591.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$591.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$694.66
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$694.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$664.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$664.46
|
| Rate for Payer: Cash Price |
$721.57
|
| Rate for Payer: Cash Price |
$706.18
|
| Rate for Payer: Centivo All Commercial |
$936.28
|
| Rate for Payer: Centivo All Commercial |
$936.28
|
| Rate for Payer: Cigna All Commercial |
$604.05
|
| Rate for Payer: Cigna All Commercial |
$604.05
|
| Rate for Payer: CORVEL All Commercial |
$604.05
|
| Rate for Payer: CORVEL All Commercial |
$604.05
|
| Rate for Payer: Coventry All Commercial |
$724.86
|
| Rate for Payer: Coventry All Commercial |
$724.86
|
| Rate for Payer: Encore All Commercial |
$604.05
|
| Rate for Payer: Encore All Commercial |
$604.05
|
| Rate for Payer: Frontpath All Commercial |
$836.55
|
| Rate for Payer: Frontpath All Commercial |
$836.55
|
| Rate for Payer: Humana ChoiceCare |
$635.20
|
| Rate for Payer: Humana ChoiceCare |
$635.20
|
| Rate for Payer: Humana Medicare |
$604.05
|
| Rate for Payer: Humana Medicare |
$604.05
|
| Rate for Payer: Lucent All Commercial |
$845.67
|
| Rate for Payer: Lucent All Commercial |
$845.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.00
|
| Rate for Payer: Managed Health Services Medicaid |
$591.50
|
| Rate for Payer: Managed Health Services Medicaid |
$591.50
|
| Rate for Payer: MDWise Medicaid |
$591.50
|
| Rate for Payer: MDWise Medicaid |
$591.50
|
| Rate for Payer: PHCS All Commercial |
$604.05
|
| Rate for Payer: PHCS All Commercial |
$604.05
|
| Rate for Payer: PHP All Commercial |
$1,023.96
|
| Rate for Payer: PHP All Commercial |
$1,023.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.05
|
| Rate for Payer: Sagamore Health Network All Products |
$604.05
|
| Rate for Payer: Sagamore Health Network All Products |
$604.05
|
| Rate for Payer: Signature Care EPO |
$848.30
|
| Rate for Payer: Signature Care EPO |
$848.30
|
| Rate for Payer: Signature Care PPO |
$848.30
|
| Rate for Payer: Signature Care PPO |
$848.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90,500.00
|
| Rate for Payer: United Healthcare Commercial |
$755.06
|
| Rate for Payer: United Healthcare Commercial |
$755.06
|
| Rate for Payer: United Healthcare Medicare |
$588.48
|
| Rate for Payer: United Healthcare Medicare |
$588.48
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
Both
|
$947.76
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
z26765
|
| Min. Negotiated Rate |
$368.21 |
| Max. Negotiated Rate |
$71,000.00 |
| Rate for Payer: Aetna Commercial |
$470.43
|
| Rate for Payer: Aetna Commercial |
$470.43
|
| Rate for Payer: Aetna Medicare |
$470.43
|
| Rate for Payer: Aetna Medicare |
$470.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$472.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$472.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$466.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$466.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$540.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$540.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$517.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$517.47
|
| Rate for Payer: Cash Price |
$568.66
|
| Rate for Payer: Cash Price |
$553.91
|
| Rate for Payer: Centivo All Commercial |
$729.17
|
| Rate for Payer: Centivo All Commercial |
$729.17
|
| Rate for Payer: Cigna All Commercial |
$470.43
|
| Rate for Payer: Cigna All Commercial |
$470.43
|
| Rate for Payer: CORVEL All Commercial |
$470.43
|
| Rate for Payer: CORVEL All Commercial |
$470.43
|
| Rate for Payer: Coventry All Commercial |
$564.52
|
| Rate for Payer: Coventry All Commercial |
$564.52
|
| Rate for Payer: Encore All Commercial |
$470.43
|
| Rate for Payer: Encore All Commercial |
$470.43
|
| Rate for Payer: Frontpath All Commercial |
$647.10
|
| Rate for Payer: Frontpath All Commercial |
$647.10
|
| Rate for Payer: Humana ChoiceCare |
$368.21
|
| Rate for Payer: Humana ChoiceCare |
$368.21
|
| Rate for Payer: Humana Medicare |
$470.43
|
| Rate for Payer: Humana Medicare |
$470.43
|
| Rate for Payer: Lucent All Commercial |
$658.60
|
| Rate for Payer: Lucent All Commercial |
$658.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$757.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$757.00
|
| Rate for Payer: Managed Health Services Medicaid |
$466.14
|
| Rate for Payer: Managed Health Services Medicaid |
$466.14
|
| Rate for Payer: MDWise Medicaid |
$466.14
|
| Rate for Payer: MDWise Medicaid |
$466.14
|
| Rate for Payer: PHCS All Commercial |
$470.43
|
| Rate for Payer: PHCS All Commercial |
$470.43
|
| Rate for Payer: PHP All Commercial |
$803.17
|
| Rate for Payer: PHP All Commercial |
$803.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$470.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$470.43
|
| Rate for Payer: Sagamore Health Network All Products |
$470.43
|
| Rate for Payer: Sagamore Health Network All Products |
$470.43
|
| Rate for Payer: Signature Care EPO |
$514.25
|
| Rate for Payer: Signature Care EPO |
$514.25
|
| Rate for Payer: Signature Care PPO |
$514.25
|
| Rate for Payer: Signature Care PPO |
$514.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71,000.00
|
| Rate for Payer: United Healthcare Commercial |
$491.66
|
| Rate for Payer: United Healthcare Commercial |
$491.66
|
| Rate for Payer: United Healthcare Medicare |
$461.59
|
| Rate for Payer: United Healthcare Medicare |
$461.59
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
Both
|
$1,316.48
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
z27829
|
| Min. Negotiated Rate |
$526.29 |
| Max. Negotiated Rate |
$99,300.00 |
| Rate for Payer: Aetna Commercial |
$664.66
|
| Rate for Payer: Aetna Commercial |
$664.66
|
| Rate for Payer: Aetna Medicare |
$664.66
|
| Rate for Payer: Aetna Medicare |
$664.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,027.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,027.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$647.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$647.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$764.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$764.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$731.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$731.13
|
| Rate for Payer: Cash Price |
$789.89
|
| Rate for Payer: Cash Price |
$775.03
|
| Rate for Payer: Centivo All Commercial |
$1,030.22
|
| Rate for Payer: Centivo All Commercial |
$1,030.22
|
| Rate for Payer: Cigna All Commercial |
$664.66
|
| Rate for Payer: Cigna All Commercial |
$664.66
|
| Rate for Payer: CORVEL All Commercial |
$664.66
|
| Rate for Payer: CORVEL All Commercial |
$664.66
|
| Rate for Payer: Coventry All Commercial |
$797.59
|
| Rate for Payer: Coventry All Commercial |
$797.59
|
| Rate for Payer: Encore All Commercial |
$664.66
|
| Rate for Payer: Encore All Commercial |
$664.66
|
| Rate for Payer: Frontpath All Commercial |
$917.01
|
| Rate for Payer: Frontpath All Commercial |
$917.01
|
| Rate for Payer: Humana ChoiceCare |
$526.29
|
| Rate for Payer: Humana ChoiceCare |
$526.29
|
| Rate for Payer: Humana Medicare |
$664.66
|
| Rate for Payer: Humana Medicare |
$664.66
|
| Rate for Payer: Lucent All Commercial |
$930.52
|
| Rate for Payer: Lucent All Commercial |
$930.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,059.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,059.00
|
| Rate for Payer: Managed Health Services Medicaid |
$647.49
|
| Rate for Payer: Managed Health Services Medicaid |
$647.49
|
| Rate for Payer: MDWise Medicaid |
$647.49
|
| Rate for Payer: MDWise Medicaid |
$647.49
|
| Rate for Payer: PHCS All Commercial |
$664.66
|
| Rate for Payer: PHCS All Commercial |
$664.66
|
| Rate for Payer: PHP All Commercial |
$1,123.79
|
| Rate for Payer: PHP All Commercial |
$1,123.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$664.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$664.66
|
| Rate for Payer: Sagamore Health Network All Products |
$664.66
|
| Rate for Payer: Sagamore Health Network All Products |
$664.66
|
| Rate for Payer: Signature Care EPO |
$705.50
|
| Rate for Payer: Signature Care EPO |
$705.50
|
| Rate for Payer: Signature Care PPO |
$705.50
|
| Rate for Payer: Signature Care PPO |
$705.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$99,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$99,300.00
|
| Rate for Payer: United Healthcare Commercial |
$706.54
|
| Rate for Payer: United Healthcare Commercial |
$706.54
|
| Rate for Payer: United Healthcare Medicare |
$645.86
|
| Rate for Payer: United Healthcare Medicare |
$645.86
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
Both
|
$1,774.40
|
|
|
Service Code
|
CPT 27514
|
| Hospital Charge Code |
z27514
|
| Min. Negotiated Rate |
$872.02 |
| Max. Negotiated Rate |
$134,100.00 |
| Rate for Payer: Aetna Commercial |
$899.07
|
| Rate for Payer: Aetna Commercial |
$899.07
|
| Rate for Payer: Aetna Medicare |
$899.07
|
| Rate for Payer: Aetna Medicare |
$899.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,607.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,607.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$872.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$872.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,033.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,033.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$988.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$988.98
|
| Rate for Payer: Cash Price |
$1,064.64
|
| Rate for Payer: Cash Price |
$1,046.42
|
| Rate for Payer: Centivo All Commercial |
$1,393.56
|
| Rate for Payer: Centivo All Commercial |
$1,393.56
|
| Rate for Payer: Cigna All Commercial |
$899.07
|
| Rate for Payer: Cigna All Commercial |
$899.07
|
| Rate for Payer: CORVEL All Commercial |
$899.07
|
| Rate for Payer: CORVEL All Commercial |
$899.07
|
| Rate for Payer: Coventry All Commercial |
$1,078.88
|
| Rate for Payer: Coventry All Commercial |
$1,078.88
|
| Rate for Payer: Encore All Commercial |
$899.07
|
| Rate for Payer: Encore All Commercial |
$899.07
|
| Rate for Payer: Frontpath All Commercial |
$1,259.34
|
| Rate for Payer: Frontpath All Commercial |
$1,259.34
|
| Rate for Payer: Humana ChoiceCare |
$1,340.71
|
| Rate for Payer: Humana ChoiceCare |
$1,340.71
|
| Rate for Payer: Humana Medicare |
$899.07
|
| Rate for Payer: Humana Medicare |
$899.07
|
| Rate for Payer: Lucent All Commercial |
$1,258.70
|
| Rate for Payer: Lucent All Commercial |
$1,258.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,430.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,430.00
|
| Rate for Payer: Managed Health Services Medicaid |
$872.72
|
| Rate for Payer: Managed Health Services Medicaid |
$872.72
|
| Rate for Payer: MDWise Medicaid |
$872.72
|
| Rate for Payer: MDWise Medicaid |
$872.72
|
| Rate for Payer: PHCS All Commercial |
$899.07
|
| Rate for Payer: PHCS All Commercial |
$899.07
|
| Rate for Payer: PHP All Commercial |
$1,517.32
|
| Rate for Payer: PHP All Commercial |
$1,517.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$899.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$899.07
|
| Rate for Payer: Sagamore Health Network All Products |
$899.07
|
| Rate for Payer: Sagamore Health Network All Products |
$899.07
|
| Rate for Payer: Signature Care EPO |
$1,528.42
|
| Rate for Payer: Signature Care EPO |
$1,528.42
|
| Rate for Payer: Signature Care PPO |
$1,528.42
|
| Rate for Payer: Signature Care PPO |
$1,528.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$134,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$134,100.00
|
| Rate for Payer: United Healthcare Commercial |
$1,128.43
|
| Rate for Payer: United Healthcare Commercial |
$1,128.43
|
| Rate for Payer: United Healthcare Medicare |
$872.02
|
| Rate for Payer: United Healthcare Medicare |
$872.02
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W EXTENSION
|
Professional
|
Both
|
$2,262.00
|
|
|
Service Code
|
CPT 27513
|
| Hospital Charge Code |
z27513
|
| Min. Negotiated Rate |
$1,112.54 |
| Max. Negotiated Rate |
$171,200.00 |
| Rate for Payer: Aetna Commercial |
$1,148.79
|
| Rate for Payer: Aetna Commercial |
$1,148.79
|
| Rate for Payer: Aetna Medicare |
$1,148.79
|
| Rate for Payer: Aetna Medicare |
$1,148.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,665.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,112.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$1,112.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,321.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,321.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,263.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,263.67
|
| Rate for Payer: Cash Price |
$1,357.20
|
| Rate for Payer: Cash Price |
$1,335.73
|
| Rate for Payer: Centivo All Commercial |
$1,780.62
|
| Rate for Payer: Centivo All Commercial |
$1,780.62
|
| Rate for Payer: Cigna All Commercial |
$1,148.79
|
| Rate for Payer: Cigna All Commercial |
$1,148.79
|
| Rate for Payer: CORVEL All Commercial |
$1,148.79
|
| Rate for Payer: CORVEL All Commercial |
$1,148.79
|
| Rate for Payer: Coventry All Commercial |
$1,378.55
|
| Rate for Payer: Coventry All Commercial |
$1,378.55
|
| Rate for Payer: Encore All Commercial |
$1,148.79
|
| Rate for Payer: Encore All Commercial |
$1,148.79
|
| Rate for Payer: Frontpath All Commercial |
$1,612.79
|
| Rate for Payer: Frontpath All Commercial |
$1,612.79
|
| Rate for Payer: Humana ChoiceCare |
$1,391.02
|
| Rate for Payer: Humana ChoiceCare |
$1,391.02
|
| Rate for Payer: Humana Medicare |
$1,148.79
|
| Rate for Payer: Humana Medicare |
$1,148.79
|
| Rate for Payer: Lucent All Commercial |
$1,608.31
|
| Rate for Payer: Lucent All Commercial |
$1,608.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,826.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,826.00
|
| Rate for Payer: Managed Health Services Medicaid |
$1,112.54
|
| Rate for Payer: Managed Health Services Medicaid |
$1,112.54
|
| Rate for Payer: MDWise Medicaid |
$1,112.54
|
| Rate for Payer: MDWise Medicaid |
$1,112.54
|
| Rate for Payer: PHCS All Commercial |
$1,148.79
|
| Rate for Payer: PHCS All Commercial |
$1,148.79
|
| Rate for Payer: PHP All Commercial |
$1,936.82
|
| Rate for Payer: PHP All Commercial |
$1,936.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,148.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,148.79
|
| Rate for Payer: Sagamore Health Network All Products |
$1,148.79
|
| Rate for Payer: Sagamore Health Network All Products |
$1,148.79
|
| Rate for Payer: Signature Care EPO |
$1,860.65
|
| Rate for Payer: Signature Care EPO |
$1,860.65
|
| Rate for Payer: Signature Care PPO |
$1,860.65
|
| Rate for Payer: Signature Care PPO |
$1,860.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$171,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,408.76
|
| Rate for Payer: United Healthcare Commercial |
$1,408.76
|
| Rate for Payer: United Healthcare Medicare |
$1,113.11
|
| Rate for Payer: United Healthcare Medicare |
$1,113.11
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O EXTENSION
|
Professional
|
Both
|
$1,829.12
|
|
|
Service Code
|
CPT 27511
|
| Hospital Charge Code |
z27511
|
| Min. Negotiated Rate |
$899.06 |
| Max. Negotiated Rate |
$138,200.00 |
| Rate for Payer: Aetna Commercial |
$926.27
|
| Rate for Payer: Aetna Commercial |
$926.27
|
| Rate for Payer: Aetna Medicare |
$926.27
|
| Rate for Payer: Aetna Medicare |
$926.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,365.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,365.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$899.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$899.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,065.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,065.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,018.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,018.90
|
| Rate for Payer: Cash Price |
$1,097.47
|
| Rate for Payer: Cash Price |
$1,078.87
|
| Rate for Payer: Centivo All Commercial |
$1,435.72
|
| Rate for Payer: Centivo All Commercial |
$1,435.72
|
| Rate for Payer: Cigna All Commercial |
$926.27
|
| Rate for Payer: Cigna All Commercial |
$926.27
|
| Rate for Payer: CORVEL All Commercial |
$926.27
|
| Rate for Payer: CORVEL All Commercial |
$926.27
|
| Rate for Payer: Coventry All Commercial |
$1,111.52
|
| Rate for Payer: Coventry All Commercial |
$1,111.52
|
| Rate for Payer: Encore All Commercial |
$926.27
|
| Rate for Payer: Encore All Commercial |
$926.27
|
| Rate for Payer: Frontpath All Commercial |
$1,297.39
|
| Rate for Payer: Frontpath All Commercial |
$1,297.39
|
| Rate for Payer: Humana ChoiceCare |
$1,083.93
|
| Rate for Payer: Humana ChoiceCare |
$1,083.93
|
| Rate for Payer: Humana Medicare |
$926.27
|
| Rate for Payer: Humana Medicare |
$926.27
|
| Rate for Payer: Lucent All Commercial |
$1,296.78
|
| Rate for Payer: Lucent All Commercial |
$1,296.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,474.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,474.00
|
| Rate for Payer: Managed Health Services Medicaid |
$899.64
|
| Rate for Payer: Managed Health Services Medicaid |
$899.64
|
| Rate for Payer: MDWise Medicaid |
$899.64
|
| Rate for Payer: MDWise Medicaid |
$899.64
|
| Rate for Payer: PHCS All Commercial |
$926.27
|
| Rate for Payer: PHCS All Commercial |
$926.27
|
| Rate for Payer: PHP All Commercial |
$1,564.36
|
| Rate for Payer: PHP All Commercial |
$1,564.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$926.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$926.27
|
| Rate for Payer: Sagamore Health Network All Products |
$926.27
|
| Rate for Payer: Sagamore Health Network All Products |
$926.27
|
| Rate for Payer: Signature Care EPO |
$1,451.80
|
| Rate for Payer: Signature Care EPO |
$1,451.80
|
| Rate for Payer: Signature Care PPO |
$1,451.80
|
| Rate for Payer: Signature Care PPO |
$1,451.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,119.10
|
| Rate for Payer: United Healthcare Commercial |
$1,119.10
|
| Rate for Payer: United Healthcare Medicare |
$899.06
|
| Rate for Payer: United Healthcare Medicare |
$899.06
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
Both
|
$1,216.80
|
|
|
Service Code
|
CPT 28505
|
| Hospital Charge Code |
z28505
|
| Min. Negotiated Rate |
$254.70 |
| Max. Negotiated Rate |
$70,000.00 |
| Rate for Payer: Aetna Commercial |
$470.06
|
| Rate for Payer: Aetna Commercial |
$470.06
|
| Rate for Payer: Aetna Medicare |
$470.06
|
| Rate for Payer: Aetna Medicare |
$470.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$517.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$517.72
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$254.70
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$254.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$598.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$598.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$540.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$540.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$517.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$517.07
|
| Rate for Payer: Cash Price |
$714.38
|
| Rate for Payer: Cash Price |
$730.08
|
| Rate for Payer: Centivo All Commercial |
$728.59
|
| Rate for Payer: Centivo All Commercial |
$728.59
|
| Rate for Payer: Cigna All Commercial |
$470.06
|
| Rate for Payer: Cigna All Commercial |
$470.06
|
| Rate for Payer: CORVEL All Commercial |
$470.06
|
| Rate for Payer: CORVEL All Commercial |
$470.06
|
| Rate for Payer: Coventry All Commercial |
$564.07
|
| Rate for Payer: Coventry All Commercial |
$564.07
|
| Rate for Payer: Encore All Commercial |
$470.06
|
| Rate for Payer: Encore All Commercial |
$470.06
|
| Rate for Payer: Frontpath All Commercial |
$641.38
|
| Rate for Payer: Frontpath All Commercial |
$641.38
|
| Rate for Payer: Humana ChoiceCare |
$331.21
|
| Rate for Payer: Humana ChoiceCare |
$331.21
|
| Rate for Payer: Humana Medicare |
$470.06
|
| Rate for Payer: Humana Medicare |
$470.06
|
| Rate for Payer: Lucent All Commercial |
$658.08
|
| Rate for Payer: Lucent All Commercial |
$658.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.00
|
| Rate for Payer: Managed Health Services Medicaid |
$598.47
|
| Rate for Payer: Managed Health Services Medicaid |
$598.47
|
| Rate for Payer: MDWise Medicaid |
$598.47
|
| Rate for Payer: MDWise Medicaid |
$598.47
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$254.70
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$254.70
|
| Rate for Payer: PHCS All Commercial |
$470.06
|
| Rate for Payer: PHCS All Commercial |
$470.06
|
| Rate for Payer: PHP All Commercial |
$791.65
|
| Rate for Payer: PHP All Commercial |
$791.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$470.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$470.06
|
| Rate for Payer: Sagamore Health Network All Products |
$470.06
|
| Rate for Payer: Sagamore Health Network All Products |
$470.06
|
| Rate for Payer: Signature Care EPO |
$756.50
|
| Rate for Payer: Signature Care EPO |
$756.50
|
| Rate for Payer: Signature Care PPO |
$756.50
|
| Rate for Payer: Signature Care PPO |
$756.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$70,000.00
|
| Rate for Payer: United Healthcare Commercial |
$533.71
|
| Rate for Payer: United Healthcare Commercial |
$533.71
|
| Rate for Payer: United Healthcare Medicare |
$595.32
|
| Rate for Payer: United Healthcare Medicare |
$595.32
|
|
|
PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE
|
Professional
|
Both
|
$1,063.04
|
|
|
Service Code
|
CPT 28525
|
| Hospital Charge Code |
z28525
|
| Min. Negotiated Rate |
$206.95 |
| Max. Negotiated Rate |
$591.19 |
| Rate for Payer: Aetna Commercial |
$381.41
|
| Rate for Payer: Aetna Medicare |
$381.41
|
| Rate for Payer: Buckeye Health Medicaid OOS |
$206.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$522.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$438.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$419.55
|
| Rate for Payer: Cash Price |
$637.82
|
| Rate for Payer: Centivo All Commercial |
$591.19
|
| Rate for Payer: Cigna All Commercial |
$381.41
|
| Rate for Payer: CORVEL All Commercial |
$381.41
|
| Rate for Payer: Coventry All Commercial |
$457.69
|
| Rate for Payer: Encore All Commercial |
$381.41
|
| Rate for Payer: Frontpath All Commercial |
$518.95
|
| Rate for Payer: Humana ChoiceCare |
$290.34
|
| Rate for Payer: Humana Medicare |
$381.41
|
| Rate for Payer: Lucent All Commercial |
$533.97
|
| Rate for Payer: Managed Health Services Medicaid |
$522.85
|
| Rate for Payer: MDWise Medicaid |
$522.85
|
| Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare |
$206.95
|
| Rate for Payer: PHCS All Commercial |
$381.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$381.41
|
| Rate for Payer: Sagamore Health Network All Products |
$381.41
|
| Rate for Payer: United Healthcare Commercial |
$423.28
|
| Rate for Payer: United Healthcare Medicare |
$517.38
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
Both
|
$1,718.48
|
|
|
Service Code
|
CPT 24545
|
| Hospital Charge Code |
z24545
|
| Min. Negotiated Rate |
$825.45 |
| Max. Negotiated Rate |
$1,463.42 |
| Rate for Payer: Aetna Commercial |
$864.46
|
| Rate for Payer: Aetna Commercial |
$864.46
|
| Rate for Payer: Aetna Medicare |
$864.46
|
| Rate for Payer: Aetna Medicare |
$864.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$845.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$845.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$994.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$994.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$950.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$950.91
|
| Rate for Payer: Cash Price |
$1,031.09
|
| Rate for Payer: Cash Price |
$1,009.25
|
| Rate for Payer: Centivo All Commercial |
$1,339.91
|
| Rate for Payer: Centivo All Commercial |
$1,339.91
|
| Rate for Payer: Cigna All Commercial |
$864.46
|
| Rate for Payer: Cigna All Commercial |
$864.46
|
| Rate for Payer: CORVEL All Commercial |
$864.46
|
| Rate for Payer: CORVEL All Commercial |
$864.46
|
| Rate for Payer: Coventry All Commercial |
$1,037.35
|
| Rate for Payer: Coventry All Commercial |
$1,037.35
|
| Rate for Payer: Encore All Commercial |
$864.46
|
| Rate for Payer: Encore All Commercial |
$864.46
|
| Rate for Payer: Frontpath All Commercial |
$1,205.96
|
| Rate for Payer: Frontpath All Commercial |
$1,205.96
|
| Rate for Payer: Humana ChoiceCare |
$825.45
|
| Rate for Payer: Humana ChoiceCare |
$825.45
|
| Rate for Payer: Humana Medicare |
$864.46
|
| Rate for Payer: Humana Medicare |
$864.46
|
| Rate for Payer: Lucent All Commercial |
$1,210.24
|
| Rate for Payer: Lucent All Commercial |
$1,210.24
|
| Rate for Payer: Managed Health Services Medicaid |
$845.22
|
| Rate for Payer: Managed Health Services Medicaid |
$845.22
|
| Rate for Payer: MDWise Medicaid |
$845.22
|
| Rate for Payer: MDWise Medicaid |
$845.22
|
| Rate for Payer: PHCS All Commercial |
$864.46
|
| Rate for Payer: PHCS All Commercial |
$864.46
|
| Rate for Payer: PHP All Commercial |
$1,463.42
|
| Rate for Payer: PHP All Commercial |
$1,463.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$864.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$864.46
|
| Rate for Payer: Sagamore Health Network All Products |
$864.46
|
| Rate for Payer: Sagamore Health Network All Products |
$864.46
|
| Rate for Payer: Signature Care EPO |
$1,104.15
|
| Rate for Payer: Signature Care EPO |
$1,104.15
|
| Rate for Payer: Signature Care PPO |
$1,104.15
|
| Rate for Payer: Signature Care PPO |
$1,104.15
|
| Rate for Payer: United Healthcare Commercial |
$989.31
|
| Rate for Payer: United Healthcare Commercial |
$989.31
|
| Rate for Payer: United Healthcare Medicare |
$841.04
|
| Rate for Payer: United Healthcare Medicare |
$841.04
|
|
