|
PR OMENTAL FLAP,INTRA-ABDOMINAL
|
Professional
|
$625.30
|
|
|
Service Code
|
CPT 49905
|
| Hospital Charge Code |
Z12675
|
| Min. Negotiated Rate |
$312.65 |
| Max. Negotiated Rate |
$750.36 |
| Rate for Payer: Aetna Medicare |
$320.46
|
| Rate for Payer: Anthem Exchange |
$484.00
|
| Rate for Payer: Anthem Medicare |
$320.46
|
| Rate for Payer: Anthem PPO |
$484.00
|
| Rate for Payer: Anthem Traditional |
$484.00
|
| Rate for Payer: Caresource Just 4 Me |
$368.53
|
| Rate for Payer: Caresource Medicare |
$352.51
|
| Rate for Payer: Centivo/Paragon All Products |
$496.71
|
| Rate for Payer: Coventry/First Health All Products |
$750.36
|
| Rate for Payer: Frontpath All Products |
$465.56
|
| Rate for Payer: Humana ChoiceCare |
$625.30
|
| Rate for Payer: Humana Medicare |
$320.46
|
| Rate for Payer: Lucent/Coldwater Veneers |
$544.78
|
| Rate for Payer: Lutheran Preferred All Products |
$481.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$468.97
|
| Rate for Payer: PHP All Products |
$547.13
|
| Rate for Payer: Plain Church Group Ministry All Products |
$320.46
|
| Rate for Payer: Signature Care EPO |
$514.25
|
| Rate for Payer: Signature Care PPO |
$514.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$449.00
|
| Rate for Payer: United Healthcare Commercial |
$395.39
|
| Rate for Payer: United Healthcare Medicare |
$312.65
|
|
|
PR OPEN FIXATN MID HUMERUS FRACTURE
|
Professional
|
$1,599.60
|
|
|
Service Code
|
CPT 24515
|
| Hospital Charge Code |
Z12200
|
| Min. Negotiated Rate |
$799.80 |
| Max. Negotiated Rate |
$1,919.52 |
| Rate for Payer: Aetna Medicare |
$819.80
|
| Rate for Payer: Anthem Exchange |
$1,085.30
|
| Rate for Payer: Anthem Medicare |
$819.80
|
| Rate for Payer: Anthem PPO |
$1,085.30
|
| Rate for Payer: Anthem Traditional |
$1,085.30
|
| Rate for Payer: Caresource Just 4 Me |
$942.77
|
| Rate for Payer: Caresource Medicare |
$901.78
|
| Rate for Payer: Centivo/Paragon All Products |
$1,270.69
|
| Rate for Payer: Coventry/First Health All Products |
$1,919.52
|
| Rate for Payer: Frontpath All Products |
$1,143.94
|
| Rate for Payer: Humana ChoiceCare |
$1,599.60
|
| Rate for Payer: Humana Medicare |
$819.80
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,393.66
|
| Rate for Payer: Lutheran Preferred All Products |
$1,312.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,199.70
|
| Rate for Payer: PHP All Products |
$1,391.66
|
| Rate for Payer: Plain Church Group Ministry All Products |
$819.80
|
| Rate for Payer: Signature Care EPO |
$1,228.25
|
| Rate for Payer: Signature Care PPO |
$1,228.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,230.00
|
| Rate for Payer: United Healthcare Commercial |
$949.15
|
| Rate for Payer: United Healthcare Medicare |
$799.80
|
|
|
PR OPEN FIX INTER/SUBTROCH FX,IMPLNT
|
Professional
|
$2,213.28
|
|
|
Service Code
|
CPT 27245
|
| Hospital Charge Code |
Z12323
|
| Min. Negotiated Rate |
$1,106.64 |
| Max. Negotiated Rate |
$2,655.94 |
| Rate for Payer: Aetna Medicare |
$1,134.31
|
| Rate for Payer: Anthem Exchange |
$1,802.80
|
| Rate for Payer: Anthem Medicare |
$1,134.31
|
| Rate for Payer: Anthem PPO |
$1,802.80
|
| Rate for Payer: Anthem Traditional |
$1,802.80
|
| Rate for Payer: Caresource Just 4 Me |
$1,304.46
|
| Rate for Payer: Caresource Medicare |
$1,247.74
|
| Rate for Payer: Centivo/Paragon All Products |
$1,758.18
|
| Rate for Payer: Coventry/First Health All Products |
$2,655.94
|
| Rate for Payer: Frontpath All Products |
$1,594.41
|
| Rate for Payer: Humana ChoiceCare |
$2,213.28
|
| Rate for Payer: Humana Medicare |
$1,134.31
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,928.33
|
| Rate for Payer: Lutheran Preferred All Products |
$1,815.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,659.96
|
| Rate for Payer: PHP All Products |
$1,925.56
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,134.31
|
| Rate for Payer: Signature Care EPO |
$1,936.66
|
| Rate for Payer: Signature Care PPO |
$1,936.66
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,701.00
|
| Rate for Payer: United Healthcare Commercial |
$1,386.08
|
| Rate for Payer: United Healthcare Medicare |
$1,106.64
|
|
|
PR OPEN PROX HUMERAL FRACTURE PROSHETIC REPLACEMENT
|
Professional
|
$2,232.84
|
|
|
Service Code
|
CPT 23616
|
| Hospital Charge Code |
Z12178
|
| Min. Negotiated Rate |
$1,116.42 |
| Max. Negotiated Rate |
$2,679.41 |
| Rate for Payer: Aetna Medicare |
$1,144.33
|
| Rate for Payer: Anthem Exchange |
$2,019.50
|
| Rate for Payer: Anthem Medicare |
$1,144.33
|
| Rate for Payer: Anthem PPO |
$2,019.50
|
| Rate for Payer: Anthem Traditional |
$2,019.50
|
| Rate for Payer: Caresource Just 4 Me |
$1,315.98
|
| Rate for Payer: Caresource Medicare |
$1,258.76
|
| Rate for Payer: Centivo/Paragon All Products |
$1,773.71
|
| Rate for Payer: Coventry/First Health All Products |
$2,679.41
|
| Rate for Payer: Frontpath All Products |
$1,605.34
|
| Rate for Payer: Humana ChoiceCare |
$2,232.84
|
| Rate for Payer: Humana Medicare |
$1,144.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,945.36
|
| Rate for Payer: Lutheran Preferred All Products |
$1,831.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,674.63
|
| Rate for Payer: PHP All Products |
$1,942.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,144.33
|
| Rate for Payer: Signature Care EPO |
$1,951.26
|
| Rate for Payer: Signature Care PPO |
$1,951.26
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,716.00
|
| Rate for Payer: United Healthcare Commercial |
$1,405.03
|
| Rate for Payer: United Healthcare Medicare |
$1,116.42
|
|
|
PR OPEN ROD FIXATN HUMERAL SHAFT FX
|
Professional
|
$1,559.08
|
|
|
Service Code
|
CPT 24516
|
| Hospital Charge Code |
Z12201
|
| Min. Negotiated Rate |
$779.54 |
| Max. Negotiated Rate |
$1,870.90 |
| Rate for Payer: Aetna Medicare |
$799.03
|
| Rate for Payer: Anthem Exchange |
$1,097.00
|
| Rate for Payer: Anthem Medicare |
$799.03
|
| Rate for Payer: Anthem PPO |
$1,097.00
|
| Rate for Payer: Anthem Traditional |
$1,097.00
|
| Rate for Payer: Caresource Just 4 Me |
$918.88
|
| Rate for Payer: Caresource Medicare |
$878.93
|
| Rate for Payer: Centivo/Paragon All Products |
$1,238.50
|
| Rate for Payer: Coventry/First Health All Products |
$1,870.90
|
| Rate for Payer: Frontpath All Products |
$1,117.35
|
| Rate for Payer: Humana ChoiceCare |
$1,559.08
|
| Rate for Payer: Humana Medicare |
$799.03
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,358.35
|
| Rate for Payer: Lutheran Preferred All Products |
$1,278.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,169.31
|
| Rate for Payer: PHP All Products |
$1,356.40
|
| Rate for Payer: Plain Church Group Ministry All Products |
$799.03
|
| Rate for Payer: Signature Care EPO |
$1,215.50
|
| Rate for Payer: Signature Care PPO |
$1,215.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,199.00
|
| Rate for Payer: United Healthcare Commercial |
$939.59
|
| Rate for Payer: United Healthcare Medicare |
$779.54
|
|
|
PR OPEN RX A-C JT DISLOC
|
Professional
|
$1,046.16
|
|
|
Service Code
|
CPT 23550
|
| Hospital Charge Code |
Z12172
|
| Min. Negotiated Rate |
$523.08 |
| Max. Negotiated Rate |
$1,255.39 |
| Rate for Payer: Caresource Medicare |
$589.78
|
| Rate for Payer: Aetna Medicare |
$536.16
|
| Rate for Payer: Anthem Exchange |
$747.10
|
| Rate for Payer: Anthem Medicare |
$536.16
|
| Rate for Payer: Anthem PPO |
$747.10
|
| Rate for Payer: Anthem Traditional |
$747.10
|
| Rate for Payer: Caresource Just 4 Me |
$616.58
|
| Rate for Payer: Centivo/Paragon All Products |
$831.05
|
| Rate for Payer: Coventry/First Health All Products |
$1,255.39
|
| Rate for Payer: Frontpath All Products |
$742.81
|
| Rate for Payer: Humana ChoiceCare |
$1,046.16
|
| Rate for Payer: Humana Medicare |
$536.16
|
| Rate for Payer: Lucent/Coldwater Veneers |
$911.47
|
| Rate for Payer: Lutheran Preferred All Products |
$858.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$784.62
|
| Rate for Payer: PHP All Products |
$910.16
|
| Rate for Payer: Plain Church Group Ministry All Products |
$536.16
|
| Rate for Payer: Signature Care EPO |
$791.35
|
| Rate for Payer: Signature Care PPO |
$791.35
|
| Rate for Payer: Three Rivers Preferred All Products |
$804.00
|
| Rate for Payer: United Healthcare Commercial |
$613.91
|
| Rate for Payer: United Healthcare Medicare |
$523.08
|
|
|
PR OPEN RX A-C JT DISLOC,FASCIAL GRFT
|
Professional
|
$1,182.58
|
|
|
Service Code
|
CPT 23552
|
| Hospital Charge Code |
Z12173
|
| Min. Negotiated Rate |
$591.29 |
| Max. Negotiated Rate |
$1,419.10 |
| Rate for Payer: Aetna Medicare |
$606.08
|
| Rate for Payer: Anthem Exchange |
$802.90
|
| Rate for Payer: Anthem Medicare |
$606.08
|
| Rate for Payer: Anthem PPO |
$802.90
|
| Rate for Payer: Anthem Traditional |
$802.90
|
| Rate for Payer: Caresource Just 4 Me |
$696.99
|
| Rate for Payer: Caresource Medicare |
$666.69
|
| Rate for Payer: Centivo/Paragon All Products |
$939.42
|
| Rate for Payer: Coventry/First Health All Products |
$1,419.10
|
| Rate for Payer: Frontpath All Products |
$849.55
|
| Rate for Payer: Humana ChoiceCare |
$1,182.58
|
| Rate for Payer: Humana Medicare |
$606.08
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,030.34
|
| Rate for Payer: Lutheran Preferred All Products |
$970.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$886.93
|
| Rate for Payer: PHP All Products |
$1,028.85
|
| Rate for Payer: Plain Church Group Ministry All Products |
$606.08
|
| Rate for Payer: Signature Care EPO |
$917.15
|
| Rate for Payer: Signature Care PPO |
$917.15
|
| Rate for Payer: Three Rivers Preferred All Products |
$909.00
|
| Rate for Payer: United Healthcare Commercial |
$707.29
|
| Rate for Payer: United Healthcare Medicare |
$591.29
|
|
|
PR OPEN RX BILAT TIB PLAT FX
|
Professional
|
$2,143.10
|
|
|
Service Code
|
CPT 27536
|
| Hospital Charge Code |
Z12368
|
| Min. Negotiated Rate |
$1,071.55 |
| Max. Negotiated Rate |
$2,571.72 |
| Rate for Payer: Aetna Medicare |
$1,098.50
|
| Rate for Payer: Anthem Exchange |
$1,366.20
|
| Rate for Payer: Anthem Medicare |
$1,098.50
|
| Rate for Payer: Anthem PPO |
$1,366.20
|
| Rate for Payer: Anthem Traditional |
$1,366.20
|
| Rate for Payer: Caresource Just 4 Me |
$1,263.27
|
| Rate for Payer: Caresource Medicare |
$1,208.35
|
| Rate for Payer: Centivo/Paragon All Products |
$1,702.67
|
| Rate for Payer: Coventry/First Health All Products |
$2,571.72
|
| Rate for Payer: Frontpath All Products |
$1,542.03
|
| Rate for Payer: Humana ChoiceCare |
$2,143.10
|
| Rate for Payer: Humana Medicare |
$1,098.50
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,867.45
|
| Rate for Payer: Lutheran Preferred All Products |
$1,758.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,607.32
|
| Rate for Payer: PHP All Products |
$1,864.50
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,098.50
|
| Rate for Payer: Signature Care EPO |
$1,592.90
|
| Rate for Payer: Signature Care PPO |
$1,592.90
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,648.00
|
| Rate for Payer: United Healthcare Commercial |
$1,298.85
|
| Rate for Payer: United Healthcare Medicare |
$1,071.55
|
|
|
PR OPEN RX C-MC DISLOC,COMPLEX
|
Professional
|
$1,135.98
|
|
|
Service Code
|
CPT 26686
|
| Hospital Charge Code |
Z12288
|
| Min. Negotiated Rate |
$567.99 |
| Max. Negotiated Rate |
$1,363.18 |
| Rate for Payer: Aetna Medicare |
$582.18
|
| Rate for Payer: Anthem Exchange |
$756.50
|
| Rate for Payer: Anthem Medicare |
$582.18
|
| Rate for Payer: Anthem PPO |
$756.50
|
| Rate for Payer: Anthem Traditional |
$756.50
|
| Rate for Payer: Caresource Just 4 Me |
$669.51
|
| Rate for Payer: Caresource Medicare |
$640.40
|
| Rate for Payer: Centivo/Paragon All Products |
$902.38
|
| Rate for Payer: Coventry/First Health All Products |
$1,363.18
|
| Rate for Payer: Frontpath All Products |
$810.46
|
| Rate for Payer: Humana ChoiceCare |
$1,135.98
|
| Rate for Payer: Humana Medicare |
$582.18
|
| Rate for Payer: Lucent/Coldwater Veneers |
$989.71
|
| Rate for Payer: Lutheran Preferred All Products |
$931.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$851.99
|
| Rate for Payer: PHP All Products |
$988.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$582.18
|
| Rate for Payer: Signature Care EPO |
$871.25
|
| Rate for Payer: Signature Care PPO |
$871.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$873.00
|
| Rate for Payer: United Healthcare Commercial |
$660.49
|
| Rate for Payer: United Healthcare Medicare |
$567.99
|
|
|
PR OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR
|
Professional
|
$1,350.42
|
|
|
Service Code
|
CPT 25607
|
| Hospital Charge Code |
Z12246
|
| Min. Negotiated Rate |
$675.21 |
| Max. Negotiated Rate |
$1,620.50 |
| Rate for Payer: Aetna Medicare |
$692.09
|
| Rate for Payer: Anthem Exchange |
$819.30
|
| Rate for Payer: Anthem Medicare |
$692.09
|
| Rate for Payer: Anthem PPO |
$819.30
|
| Rate for Payer: Anthem Traditional |
$819.30
|
| Rate for Payer: Caresource Just 4 Me |
$795.90
|
| Rate for Payer: Caresource Medicare |
$761.30
|
| Rate for Payer: Centivo/Paragon All Products |
$1,072.74
|
| Rate for Payer: Coventry/First Health All Products |
$1,620.50
|
| Rate for Payer: Frontpath All Products |
$955.29
|
| Rate for Payer: Humana ChoiceCare |
$1,350.42
|
| Rate for Payer: Humana Medicare |
$692.09
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,176.55
|
| Rate for Payer: Lutheran Preferred All Products |
$1,107.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,012.82
|
| Rate for Payer: PHP All Products |
$1,174.86
|
| Rate for Payer: Plain Church Group Ministry All Products |
$692.09
|
| Rate for Payer: Signature Care EPO |
$923.95
|
| Rate for Payer: Signature Care PPO |
$923.95
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,038.00
|
| Rate for Payer: United Healthcare Commercial |
$763.28
|
| Rate for Payer: United Healthcare Medicare |
$675.21
|
|
|
PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG
|
Professional
|
$1,507.84
|
|
|
Service Code
|
CPT 25608
|
| Hospital Charge Code |
Z12247
|
| Min. Negotiated Rate |
$753.92 |
| Max. Negotiated Rate |
$1,809.41 |
| Rate for Payer: Humana Medicare |
$772.77
|
| Rate for Payer: Aetna Medicare |
$772.77
|
| Rate for Payer: Anthem Exchange |
$980.14
|
| Rate for Payer: Anthem Medicare |
$772.77
|
| Rate for Payer: Anthem PPO |
$980.14
|
| Rate for Payer: Anthem Traditional |
$980.14
|
| Rate for Payer: Caresource Just 4 Me |
$888.69
|
| Rate for Payer: Caresource Medicare |
$850.05
|
| Rate for Payer: Centivo/Paragon All Products |
$1,197.79
|
| Rate for Payer: Coventry/First Health All Products |
$1,809.41
|
| Rate for Payer: Frontpath All Products |
$1,071.42
|
| Rate for Payer: Humana ChoiceCare |
$1,507.84
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,313.71
|
| Rate for Payer: Lutheran Preferred All Products |
$1,236.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,130.88
|
| Rate for Payer: PHP All Products |
$1,311.83
|
| Rate for Payer: Plain Church Group Ministry All Products |
$772.77
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,159.00
|
| Rate for Payer: United Healthcare Commercial |
$871.21
|
| Rate for Payer: United Healthcare Medicare |
$753.92
|
|
|
PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG
|
Professional
|
$1,913.02
|
|
|
Service Code
|
CPT 25609
|
| Hospital Charge Code |
Z12248
|
| Min. Negotiated Rate |
$956.51 |
| Max. Negotiated Rate |
$2,295.62 |
| Rate for Payer: Aetna Medicare |
$980.42
|
| Rate for Payer: Anthem Exchange |
$1,250.03
|
| Rate for Payer: Anthem Medicare |
$980.42
|
| Rate for Payer: Anthem PPO |
$1,250.03
|
| Rate for Payer: Anthem Traditional |
$1,250.03
|
| Rate for Payer: Caresource Just 4 Me |
$1,127.48
|
| Rate for Payer: Caresource Medicare |
$1,078.46
|
| Rate for Payer: Centivo/Paragon All Products |
$1,519.65
|
| Rate for Payer: Coventry/First Health All Products |
$2,295.62
|
| Rate for Payer: Frontpath All Products |
$1,361.26
|
| Rate for Payer: Humana ChoiceCare |
$1,913.02
|
| Rate for Payer: Humana Medicare |
$980.42
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,666.71
|
| Rate for Payer: Lutheran Preferred All Products |
$1,569.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,434.76
|
| Rate for Payer: PHP All Products |
$1,664.32
|
| Rate for Payer: Plain Church Group Ministry All Products |
$980.42
|
| Rate for Payer: Signature Care EPO |
$1,338.75
|
| Rate for Payer: Signature Care PPO |
$1,338.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,471.00
|
| Rate for Payer: United Healthcare Commercial |
$1,113.05
|
| Rate for Payer: United Healthcare Medicare |
$956.51
|
|
|
PR OPEN RX FEMUR FX+INTRAMED ROD
|
Professional
|
$2,414.82
|
|
|
Service Code
|
CPT 27506
|
| Hospital Charge Code |
Z12357
|
| Min. Negotiated Rate |
$1,207.41 |
| Max. Negotiated Rate |
$2,897.78 |
| Rate for Payer: Aetna Medicare |
$1,237.59
|
| Rate for Payer: Anthem Exchange |
$1,621.80
|
| Rate for Payer: Anthem Medicare |
$1,237.59
|
| Rate for Payer: Anthem PPO |
$1,621.80
|
| Rate for Payer: Anthem Traditional |
$1,621.80
|
| Rate for Payer: Caresource Just 4 Me |
$1,423.23
|
| Rate for Payer: Caresource Medicare |
$1,361.35
|
| Rate for Payer: Centivo/Paragon All Products |
$1,918.26
|
| Rate for Payer: Coventry/First Health All Products |
$2,897.78
|
| Rate for Payer: Frontpath All Products |
$1,736.84
|
| Rate for Payer: Humana ChoiceCare |
$2,414.82
|
| Rate for Payer: Humana Medicare |
$1,237.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,103.90
|
| Rate for Payer: Lutheran Preferred All Products |
$1,980.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,811.12
|
| Rate for Payer: PHP All Products |
$2,100.89
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,237.59
|
| Rate for Payer: Signature Care EPO |
$1,766.30
|
| Rate for Payer: Signature Care PPO |
$1,766.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,856.00
|
| Rate for Payer: United Healthcare Commercial |
$1,457.98
|
| Rate for Payer: United Healthcare Medicare |
$1,207.41
|
|
|
PR OPEN RX GR TUBEROSITY FX
|
Professional
|
$1,419.90
|
|
|
Service Code
|
CPT 23630
|
| Hospital Charge Code |
Z12180
|
| Min. Negotiated Rate |
$709.95 |
| Max. Negotiated Rate |
$1,703.88 |
| Rate for Payer: Aetna Medicare |
$727.70
|
| Rate for Payer: Anthem Exchange |
$758.80
|
| Rate for Payer: Anthem Medicare |
$727.70
|
| Rate for Payer: Anthem PPO |
$758.80
|
| Rate for Payer: Anthem Traditional |
$758.80
|
| Rate for Payer: Caresource Just 4 Me |
$836.86
|
| Rate for Payer: Caresource Medicare |
$800.47
|
| Rate for Payer: Centivo/Paragon All Products |
$1,127.94
|
| Rate for Payer: Coventry/First Health All Products |
$1,703.88
|
| Rate for Payer: Frontpath All Products |
$1,009.67
|
| Rate for Payer: Humana ChoiceCare |
$1,419.90
|
| Rate for Payer: Humana Medicare |
$727.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,237.09
|
| Rate for Payer: Lutheran Preferred All Products |
$1,164.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,064.93
|
| Rate for Payer: PHP All Products |
$1,235.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$727.70
|
| Rate for Payer: Signature Care EPO |
$812.60
|
| Rate for Payer: Signature Care PPO |
$812.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,092.00
|
| Rate for Payer: United Healthcare Commercial |
$807.73
|
| Rate for Payer: United Healthcare Medicare |
$709.95
|
|
|
PR OPEN RX PATELLA FX
|
Professional
|
$1,369.30
|
|
|
Service Code
|
CPT 27524
|
| Hospital Charge Code |
Z12365
|
| Min. Negotiated Rate |
$684.65 |
| Max. Negotiated Rate |
$1,643.16 |
| Rate for Payer: Aetna Medicare |
$701.76
|
| Rate for Payer: Anthem Exchange |
$969.90
|
| Rate for Payer: Anthem Medicare |
$701.76
|
| Rate for Payer: Anthem PPO |
$969.90
|
| Rate for Payer: Anthem Traditional |
$969.90
|
| Rate for Payer: Caresource Just 4 Me |
$807.02
|
| Rate for Payer: Caresource Medicare |
$771.94
|
| Rate for Payer: Centivo/Paragon All Products |
$1,087.73
|
| Rate for Payer: Coventry/First Health All Products |
$1,643.16
|
| Rate for Payer: Frontpath All Products |
$979.06
|
| Rate for Payer: Humana ChoiceCare |
$1,369.30
|
| Rate for Payer: Humana Medicare |
$701.76
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,192.99
|
| Rate for Payer: Lutheran Preferred All Products |
$1,123.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,026.97
|
| Rate for Payer: PHP All Products |
$1,191.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$701.76
|
| Rate for Payer: Signature Care EPO |
$1,060.80
|
| Rate for Payer: Signature Care PPO |
$1,060.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,053.00
|
| Rate for Payer: United Healthcare Commercial |
$816.86
|
| Rate for Payer: United Healthcare Medicare |
$684.65
|
|
|
PR OPEN RX TIBIA SHAFT FX,SCREWS
|
Professional
|
$1,624.76
|
|
|
Service Code
|
CPT 27758
|
| Hospital Charge Code |
Z12389
|
| Min. Negotiated Rate |
$812.38 |
| Max. Negotiated Rate |
$1,949.71 |
| Rate for Payer: Aetna Medicare |
$832.85
|
| Rate for Payer: Anthem Exchange |
$1,188.40
|
| Rate for Payer: Anthem Medicare |
$832.85
|
| Rate for Payer: Anthem PPO |
$1,188.40
|
| Rate for Payer: Anthem Traditional |
$1,188.40
|
| Rate for Payer: Caresource Just 4 Me |
$957.78
|
| Rate for Payer: Caresource Medicare |
$916.14
|
| Rate for Payer: Centivo/Paragon All Products |
$1,290.92
|
| Rate for Payer: Coventry/First Health All Products |
$1,949.71
|
| Rate for Payer: Frontpath All Products |
$1,164.48
|
| Rate for Payer: Humana ChoiceCare |
$1,624.76
|
| Rate for Payer: Humana Medicare |
$832.85
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,415.85
|
| Rate for Payer: Lutheran Preferred All Products |
$1,333.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,218.57
|
| Rate for Payer: PHP All Products |
$1,413.54
|
| Rate for Payer: Plain Church Group Ministry All Products |
$832.85
|
| Rate for Payer: Signature Care EPO |
$1,217.20
|
| Rate for Payer: Signature Care PPO |
$1,217.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,249.00
|
| Rate for Payer: United Healthcare Commercial |
$966.74
|
| Rate for Payer: United Healthcare Medicare |
$812.38
|
|
|
PR OPEN RX ULNAR STYLOID FX
|
Professional
|
$1,139.42
|
|
|
Service Code
|
CPT 25652
|
| Hospital Charge Code |
Z12253
|
| Min. Negotiated Rate |
$569.71 |
| Max. Negotiated Rate |
$1,367.30 |
| Rate for Payer: Aetna Medicare |
$583.95
|
| Rate for Payer: Anthem Exchange |
$725.50
|
| Rate for Payer: Anthem Medicare |
$583.95
|
| Rate for Payer: Anthem PPO |
$725.50
|
| Rate for Payer: Anthem Traditional |
$725.50
|
| Rate for Payer: Caresource Just 4 Me |
$671.54
|
| Rate for Payer: Caresource Medicare |
$642.35
|
| Rate for Payer: Centivo/Paragon All Products |
$905.12
|
| Rate for Payer: Coventry/First Health All Products |
$1,367.30
|
| Rate for Payer: Frontpath All Products |
$806.91
|
| Rate for Payer: Humana ChoiceCare |
$1,139.42
|
| Rate for Payer: Humana Medicare |
$583.95
|
| Rate for Payer: Lucent/Coldwater Veneers |
$992.72
|
| Rate for Payer: Lutheran Preferred All Products |
$934.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$854.57
|
| Rate for Payer: PHP All Products |
$991.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$583.95
|
| Rate for Payer: Signature Care EPO |
$840.65
|
| Rate for Payer: Signature Care PPO |
$840.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$876.00
|
| Rate for Payer: United Healthcare Commercial |
$658.75
|
| Rate for Payer: United Healthcare Medicare |
$569.71
|
|
|
PR OPEN STOMACH,REULCER,SUTURE
|
Professional
|
$2,395.10
|
|
|
Service Code
|
CPT 43501
|
| Hospital Charge Code |
Z12595
|
| Min. Negotiated Rate |
$1,178.10 |
| Max. Negotiated Rate |
$2,874.12 |
| Rate for Payer: Aetna Medicare |
$1,227.33
|
| Rate for Payer: Anthem Exchange |
$1,178.10
|
| Rate for Payer: Anthem Medicare |
$1,227.33
|
| Rate for Payer: Anthem PPO |
$1,178.10
|
| Rate for Payer: Anthem Traditional |
$1,178.10
|
| Rate for Payer: Caresource Just 4 Me |
$1,411.43
|
| Rate for Payer: Caresource Medicare |
$1,350.06
|
| Rate for Payer: Centivo/Paragon All Products |
$1,902.36
|
| Rate for Payer: Coventry/First Health All Products |
$2,874.12
|
| Rate for Payer: Frontpath All Products |
$1,789.10
|
| Rate for Payer: Humana ChoiceCare |
$2,395.10
|
| Rate for Payer: Humana Medicare |
$1,227.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,086.46
|
| Rate for Payer: Lutheran Preferred All Products |
$1,841.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,796.32
|
| Rate for Payer: PHP All Products |
$2,095.72
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,227.33
|
| Rate for Payer: Signature Care EPO |
$1,632.85
|
| Rate for Payer: Signature Care PPO |
$1,632.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,718.00
|
| Rate for Payer: United Healthcare Commercial |
$1,433.06
|
| Rate for Payer: United Healthcare Medicare |
$1,197.55
|
|
|
PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE
|
Professional
|
$1,391.20
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
Z12402
|
| Min. Negotiated Rate |
$695.60 |
| Max. Negotiated Rate |
$1,669.44 |
| Rate for Payer: Aetna Medicare |
$712.99
|
| Rate for Payer: Anthem Exchange |
$1,035.60
|
| Rate for Payer: Anthem Medicare |
$712.99
|
| Rate for Payer: Anthem PPO |
$1,035.60
|
| Rate for Payer: Anthem Traditional |
$1,035.60
|
| Rate for Payer: Caresource Just 4 Me |
$819.94
|
| Rate for Payer: Caresource Medicare |
$784.29
|
| Rate for Payer: Centivo/Paragon All Products |
$1,105.13
|
| Rate for Payer: Coventry/First Health All Products |
$1,669.44
|
| Rate for Payer: Frontpath All Products |
$992.29
|
| Rate for Payer: Humana ChoiceCare |
$1,391.20
|
| Rate for Payer: Humana Medicare |
$712.99
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,212.08
|
| Rate for Payer: Lutheran Preferred All Products |
$1,141.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,043.40
|
| Rate for Payer: PHP All Products |
$1,210.34
|
| Rate for Payer: Plain Church Group Ministry All Products |
$712.99
|
| Rate for Payer: Signature Care EPO |
$1,125.40
|
| Rate for Payer: Signature Care PPO |
$1,125.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,069.00
|
| Rate for Payer: United Healthcare Commercial |
$842.13
|
| Rate for Payer: United Healthcare Medicare |
$695.60
|
|
|
PR OPEN TREATMENT CLAVICULAR FRACTURE INTERNAL FX
|
Professional
|
$1,312.10
|
|
|
Service Code
|
CPT 23515
|
| Hospital Charge Code |
Z12170
|
| Min. Negotiated Rate |
$656.05 |
| Max. Negotiated Rate |
$1,574.52 |
| Rate for Payer: Aetna Medicare |
$672.45
|
| Rate for Payer: Anthem Exchange |
$733.00
|
| Rate for Payer: Anthem Medicare |
$672.45
|
| Rate for Payer: Anthem PPO |
$733.00
|
| Rate for Payer: Anthem Traditional |
$733.00
|
| Rate for Payer: Caresource Just 4 Me |
$773.32
|
| Rate for Payer: Caresource Medicare |
$739.70
|
| Rate for Payer: Centivo/Paragon All Products |
$1,042.30
|
| Rate for Payer: Coventry/First Health All Products |
$1,574.52
|
| Rate for Payer: Frontpath All Products |
$933.95
|
| Rate for Payer: Humana ChoiceCare |
$1,312.10
|
| Rate for Payer: Humana Medicare |
$672.45
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,143.16
|
| Rate for Payer: Lutheran Preferred All Products |
$1,076.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$984.07
|
| Rate for Payer: PHP All Products |
$1,141.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$672.45
|
| Rate for Payer: Signature Care EPO |
$811.75
|
| Rate for Payer: Signature Care PPO |
$811.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,009.00
|
| Rate for Payer: United Healthcare Commercial |
$756.40
|
| Rate for Payer: United Healthcare Medicare |
$656.05
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA
|
Professional
|
$2,407.18
|
|
|
Service Code
|
CPT 27828
|
| Hospital Charge Code |
Z12410
|
| Min. Negotiated Rate |
$1,203.59 |
| Max. Negotiated Rate |
$2,888.62 |
| Rate for Payer: Aetna Medicare |
$1,233.67
|
| Rate for Payer: Anthem Medicare |
$1,233.67
|
| Rate for Payer: Caresource Just 4 Me |
$1,418.72
|
| Rate for Payer: Caresource Medicare |
$1,357.04
|
| Rate for Payer: Centivo/Paragon All Products |
$1,912.19
|
| Rate for Payer: Coventry/First Health All Products |
$2,888.62
|
| Rate for Payer: Frontpath All Products |
$1,728.96
|
| Rate for Payer: Humana ChoiceCare |
$2,407.18
|
| Rate for Payer: Humana Medicare |
$1,233.67
|
| Rate for Payer: Lucent/Coldwater Veneers |
$2,097.24
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,805.38
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,233.67
|
| Rate for Payer: United Healthcare Commercial |
$1,413.59
|
| Rate for Payer: United Healthcare Medicare |
$1,203.59
|
|
|
PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY
|
Professional
|
$2,035.14
|
|
|
Service Code
|
CPT 27827
|
| Hospital Charge Code |
Z12409
|
| Min. Negotiated Rate |
$1,017.57 |
| Max. Negotiated Rate |
$2,442.17 |
| Rate for Payer: Aetna Medicare |
$1,043.33
|
| Rate for Payer: Anthem Exchange |
$1,887.30
|
| Rate for Payer: Anthem Medicare |
$1,043.33
|
| Rate for Payer: Anthem PPO |
$1,887.30
|
| Rate for Payer: Anthem Traditional |
$1,887.30
|
| Rate for Payer: Caresource Just 4 Me |
$1,199.83
|
| Rate for Payer: Caresource Medicare |
$1,147.66
|
| Rate for Payer: Centivo/Paragon All Products |
$1,617.16
|
| Rate for Payer: Coventry/First Health All Products |
$2,442.17
|
| Rate for Payer: Frontpath All Products |
$1,454.04
|
| Rate for Payer: Humana ChoiceCare |
$2,035.14
|
| Rate for Payer: Humana Medicare |
$1,043.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,773.66
|
| Rate for Payer: Lutheran Preferred All Products |
$1,669.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,526.36
|
| Rate for Payer: PHP All Products |
$1,770.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,043.33
|
| Rate for Payer: Signature Care EPO |
$1,558.90
|
| Rate for Payer: Signature Care PPO |
$1,558.90
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,565.00
|
| Rate for Payer: United Healthcare Commercial |
$1,179.63
|
| Rate for Payer: United Healthcare Medicare |
$1,017.57
|
|
|
PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE
|
Professional
|
$1,350.16
|
|
|
Service Code
|
CPT 27248
|
| Hospital Charge Code |
Z12325
|
| Min. Negotiated Rate |
$675.08 |
| Max. Negotiated Rate |
$1,620.19 |
| Rate for Payer: Aetna Medicare |
$691.95
|
| Rate for Payer: Anthem Exchange |
$1,044.90
|
| Rate for Payer: Anthem Medicare |
$691.95
|
| Rate for Payer: Anthem PPO |
$1,044.90
|
| Rate for Payer: Anthem Traditional |
$1,044.90
|
| Rate for Payer: Caresource Just 4 Me |
$795.74
|
| Rate for Payer: Caresource Medicare |
$761.15
|
| Rate for Payer: Centivo/Paragon All Products |
$1,072.52
|
| Rate for Payer: Coventry/First Health All Products |
$1,620.19
|
| Rate for Payer: Frontpath All Products |
$971.96
|
| Rate for Payer: Humana ChoiceCare |
$1,350.16
|
| Rate for Payer: Humana Medicare |
$691.95
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,176.32
|
| Rate for Payer: Lutheran Preferred All Products |
$1,107.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,012.62
|
| Rate for Payer: PHP All Products |
$1,174.63
|
| Rate for Payer: Plain Church Group Ministry All Products |
$691.95
|
| Rate for Payer: Signature Care EPO |
$1,090.55
|
| Rate for Payer: Signature Care PPO |
$1,090.55
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,038.00
|
| Rate for Payer: United Healthcare Commercial |
$820.61
|
| Rate for Payer: United Healthcare Medicare |
$675.08
|
|
|
PR OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION
|
Professional
|
$1,049.88
|
|
|
Service Code
|
CPT 28675
|
| Hospital Charge Code |
Z12445
|
| Min. Negotiated Rate |
$388.03 |
| Max. Negotiated Rate |
$1,259.86 |
| Rate for Payer: Aetna Medicare |
$388.03
|
| Rate for Payer: Anthem Exchange |
$438.01
|
| Rate for Payer: Anthem Medicare |
$388.03
|
| Rate for Payer: Anthem PPO |
$438.01
|
| Rate for Payer: Anthem Traditional |
$438.01
|
| Rate for Payer: Caresource Just 4 Me |
$446.23
|
| Rate for Payer: Caresource Medicare |
$426.83
|
| Rate for Payer: Centivo/Paragon All Products |
$601.45
|
| Rate for Payer: Coventry/First Health All Products |
$1,259.86
|
| Rate for Payer: Frontpath All Products |
$526.58
|
| Rate for Payer: Humana ChoiceCare |
$1,049.88
|
| Rate for Payer: Humana Medicare |
$388.03
|
| Rate for Payer: Lucent/Coldwater Veneers |
$659.65
|
| Rate for Payer: Lutheran Preferred All Products |
$621.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$787.41
|
| Rate for Payer: PHP All Products |
$658.70
|
| Rate for Payer: Plain Church Group Ministry All Products |
$388.03
|
| Rate for Payer: Signature Care EPO |
$654.50
|
| Rate for Payer: Signature Care PPO |
$654.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$582.00
|
| Rate for Payer: United Healthcare Commercial |
$433.38
|
| Rate for Payer: United Healthcare Medicare |
$524.94
|
|
|
PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE
|
Professional
|
$1,107.90
|
|
|
Service Code
|
CPT 27766
|
| Hospital Charge Code |
Z12392
|
| Min. Negotiated Rate |
$553.95 |
| Max. Negotiated Rate |
$1,329.48 |
| Rate for Payer: Aetna Medicare |
$567.49
|
| Rate for Payer: Anthem Exchange |
$809.00
|
| Rate for Payer: Anthem Medicare |
$567.49
|
| Rate for Payer: Anthem PPO |
$809.00
|
| Rate for Payer: Anthem Traditional |
$809.00
|
| Rate for Payer: Caresource Just 4 Me |
$652.61
|
| Rate for Payer: Caresource Medicare |
$624.24
|
| Rate for Payer: Centivo/Paragon All Products |
$879.61
|
| Rate for Payer: Coventry/First Health All Products |
$1,329.48
|
| Rate for Payer: Frontpath All Products |
$782.76
|
| Rate for Payer: Humana ChoiceCare |
$1,107.90
|
| Rate for Payer: Humana Medicare |
$567.49
|
| Rate for Payer: Lucent/Coldwater Veneers |
$964.73
|
| Rate for Payer: Lutheran Preferred All Products |
$908.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$830.93
|
| Rate for Payer: PHP All Products |
$963.87
|
| Rate for Payer: Plain Church Group Ministry All Products |
$567.49
|
| Rate for Payer: Signature Care EPO |
$906.10
|
| Rate for Payer: Signature Care PPO |
$906.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$851.00
|
| Rate for Payer: United Healthcare Commercial |
$655.98
|
| Rate for Payer: United Healthcare Medicare |
$553.95
|
|
