|
PR OPEN TREATMENT METATARSAL FRACTURE EACH
|
Professional
|
$1,033.18
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
Z12437
|
| Min. Negotiated Rate |
$509.07 |
| Max. Negotiated Rate |
$1,239.82 |
| Rate for Payer: Aetna Medicare |
$529.51
|
| Rate for Payer: Anthem Exchange |
$509.07
|
| Rate for Payer: Anthem Medicare |
$529.51
|
| Rate for Payer: Anthem PPO |
$509.07
|
| Rate for Payer: Anthem Traditional |
$509.07
|
| Rate for Payer: Caresource Just 4 Me |
$608.94
|
| Rate for Payer: Caresource Medicare |
$582.46
|
| Rate for Payer: Centivo/Paragon All Products |
$820.74
|
| Rate for Payer: Coventry/First Health All Products |
$1,239.82
|
| Rate for Payer: Frontpath All Products |
$720.82
|
| Rate for Payer: Humana ChoiceCare |
$1,033.18
|
| Rate for Payer: Humana Medicare |
$529.51
|
| Rate for Payer: Lucent/Coldwater Veneers |
$900.17
|
| Rate for Payer: Lutheran Preferred All Products |
$847.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$774.88
|
| Rate for Payer: PHP All Products |
$898.87
|
| Rate for Payer: Plain Church Group Ministry All Products |
$529.51
|
| Rate for Payer: Signature Care EPO |
$653.65
|
| Rate for Payer: Signature Care PPO |
$653.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$794.00
|
| Rate for Payer: United Healthcare Commercial |
$578.66
|
| Rate for Payer: United Healthcare Medicare |
$516.59
|
|
|
PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE
|
Professional
|
$1,142.60
|
|
|
Service Code
|
CPT 25545
|
| Hospital Charge Code |
Z12238
|
| Min. Negotiated Rate |
$571.30 |
| Max. Negotiated Rate |
$1,371.12 |
| Rate for Payer: Aetna Medicare |
$585.59
|
| Rate for Payer: Anthem Exchange |
$856.40
|
| Rate for Payer: Anthem Medicare |
$585.59
|
| Rate for Payer: Anthem PPO |
$856.40
|
| Rate for Payer: Anthem Traditional |
$856.40
|
| Rate for Payer: Caresource Just 4 Me |
$673.43
|
| Rate for Payer: Caresource Medicare |
$644.15
|
| Rate for Payer: Centivo/Paragon All Products |
$907.66
|
| Rate for Payer: Coventry/First Health All Products |
$1,371.12
|
| Rate for Payer: Frontpath All Products |
$808.50
|
| Rate for Payer: Humana ChoiceCare |
$1,142.60
|
| Rate for Payer: Humana Medicare |
$585.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$995.50
|
| Rate for Payer: Lutheran Preferred All Products |
$937.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$856.95
|
| Rate for Payer: PHP All Products |
$994.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$585.59
|
| Rate for Payer: Signature Care EPO |
$965.60
|
| Rate for Payer: Signature Care PPO |
$965.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$878.00
|
| Rate for Payer: United Healthcare Commercial |
$669.76
|
| Rate for Payer: United Healthcare Medicare |
$571.30
|
|
|
PR OPEN TREATMENT PROX HUMERAL FRACTURE
|
Professional
|
$1,603.10
|
|
|
Service Code
|
CPT 23615
|
| Hospital Charge Code |
Z12177
|
| Min. Negotiated Rate |
$801.55 |
| Max. Negotiated Rate |
$1,923.72 |
| Rate for Payer: Aetna Medicare |
$821.59
|
| Rate for Payer: Anthem Exchange |
$959.10
|
| Rate for Payer: Anthem Medicare |
$821.59
|
| Rate for Payer: Anthem PPO |
$959.10
|
| Rate for Payer: Anthem Traditional |
$959.10
|
| Rate for Payer: Caresource Just 4 Me |
$944.83
|
| Rate for Payer: Caresource Medicare |
$903.75
|
| Rate for Payer: Centivo/Paragon All Products |
$1,273.46
|
| Rate for Payer: Coventry/First Health All Products |
$1,923.72
|
| Rate for Payer: Frontpath All Products |
$1,147.03
|
| Rate for Payer: Humana ChoiceCare |
$1,603.10
|
| Rate for Payer: Humana Medicare |
$821.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,396.70
|
| Rate for Payer: Lutheran Preferred All Products |
$1,315.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,202.32
|
| Rate for Payer: PHP All Products |
$1,394.70
|
| Rate for Payer: Plain Church Group Ministry All Products |
$821.59
|
| Rate for Payer: Signature Care EPO |
$1,049.75
|
| Rate for Payer: Signature Care PPO |
$1,049.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,232.00
|
| Rate for Payer: United Healthcare Commercial |
$940.70
|
| Rate for Payer: United Healthcare Medicare |
$801.55
|
|
|
PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
|
Professional
|
$1,292.94
|
|
|
Service Code
|
CPT 27784
|
| Hospital Charge Code |
Z12396
|
| Min. Negotiated Rate |
$646.47 |
| Max. Negotiated Rate |
$1,551.53 |
| Rate for Payer: Humana Medicare |
$662.64
|
| Rate for Payer: Aetna Medicare |
$662.64
|
| Rate for Payer: Anthem Exchange |
$685.20
|
| Rate for Payer: Anthem Medicare |
$662.64
|
| Rate for Payer: Anthem PPO |
$685.20
|
| Rate for Payer: Anthem Traditional |
$685.20
|
| Rate for Payer: Caresource Just 4 Me |
$762.04
|
| Rate for Payer: Caresource Medicare |
$728.90
|
| Rate for Payer: Centivo/Paragon All Products |
$1,027.09
|
| Rate for Payer: Coventry/First Health All Products |
$1,551.53
|
| Rate for Payer: Frontpath All Products |
$917.44
|
| Rate for Payer: Humana ChoiceCare |
$1,292.94
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,126.49
|
| Rate for Payer: Lutheran Preferred All Products |
$1,060.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$969.71
|
| Rate for Payer: PHP All Products |
$1,124.87
|
| Rate for Payer: Plain Church Group Ministry All Products |
$662.64
|
| Rate for Payer: Signature Care EPO |
$788.80
|
| Rate for Payer: Signature Care PPO |
$788.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$994.00
|
| Rate for Payer: United Healthcare Commercial |
$747.11
|
| Rate for Payer: United Healthcare Medicare |
$646.47
|
|
|
PR OPEN TREATMENT RADIAL SHAFT FRACTURE
|
Professional
|
$1,222.86
|
|
|
Service Code
|
CPT 25515
|
| Hospital Charge Code |
Z12234
|
| Min. Negotiated Rate |
$611.43 |
| Max. Negotiated Rate |
$1,467.43 |
| Rate for Payer: Aetna Medicare |
$626.71
|
| Rate for Payer: Anthem Medicare |
$626.71
|
| Rate for Payer: Caresource Just 4 Me |
$720.72
|
| Rate for Payer: Caresource Medicare |
$689.38
|
| Rate for Payer: Centivo/Paragon All Products |
$971.40
|
| Rate for Payer: Coventry/First Health All Products |
$1,467.43
|
| Rate for Payer: Frontpath All Products |
$867.88
|
| Rate for Payer: Humana ChoiceCare |
$1,222.86
|
| Rate for Payer: Humana Medicare |
$626.71
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,065.41
|
| Rate for Payer: PHCS/Multiplan All Products |
$917.14
|
| Rate for Payer: PHP All Products |
$1,063.89
|
| Rate for Payer: Plain Church Group Ministry All Products |
$626.71
|
| Rate for Payer: Signature Care EPO |
$971.55
|
| Rate for Payer: Signature Care PPO |
$971.55
|
| Rate for Payer: United Healthcare Commercial |
$716.79
|
| Rate for Payer: United Healthcare Medicare |
$611.43
|
|
|
PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA
|
Professional
|
$1,355.40
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
Z12295
|
| Min. Negotiated Rate |
$584.40 |
| Max. Negotiated Rate |
$1,626.48 |
| Rate for Payer: Aetna Medicare |
$694.64
|
| Rate for Payer: Anthem Exchange |
$584.40
|
| Rate for Payer: Anthem Medicare |
$694.64
|
| Rate for Payer: Anthem PPO |
$584.40
|
| Rate for Payer: Anthem Traditional |
$584.40
|
| Rate for Payer: Caresource Just 4 Me |
$798.84
|
| Rate for Payer: Caresource Medicare |
$764.10
|
| Rate for Payer: Centivo/Paragon All Products |
$1,076.69
|
| Rate for Payer: Coventry/First Health All Products |
$1,626.48
|
| Rate for Payer: Frontpath All Products |
$960.51
|
| Rate for Payer: Humana ChoiceCare |
$1,355.40
|
| Rate for Payer: Humana Medicare |
$694.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,180.89
|
| Rate for Payer: Lutheran Preferred All Products |
$1,111.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,016.55
|
| Rate for Payer: PHP All Products |
$1,179.19
|
| Rate for Payer: Plain Church Group Ministry All Products |
$694.64
|
| Rate for Payer: Signature Care EPO |
$677.45
|
| Rate for Payer: Signature Care PPO |
$677.45
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,042.00
|
| Rate for Payer: United Healthcare Commercial |
$743.73
|
| Rate for Payer: United Healthcare Medicare |
$677.70
|
|
|
PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE
|
Professional
|
$1,313.92
|
|
|
Service Code
|
CPT 25628
|
| Hospital Charge Code |
Z12250
|
| Min. Negotiated Rate |
$656.96 |
| Max. Negotiated Rate |
$1,576.70 |
| Rate for Payer: Aetna Medicare |
$673.39
|
| Rate for Payer: Anthem Exchange |
$815.60
|
| Rate for Payer: Anthem Medicare |
$673.39
|
| Rate for Payer: Anthem PPO |
$815.60
|
| Rate for Payer: Anthem Traditional |
$815.60
|
| Rate for Payer: Caresource Just 4 Me |
$774.40
|
| Rate for Payer: Caresource Medicare |
$740.73
|
| Rate for Payer: Centivo/Paragon All Products |
$1,043.75
|
| Rate for Payer: Coventry/First Health All Products |
$1,576.70
|
| Rate for Payer: Frontpath All Products |
$932.80
|
| Rate for Payer: Humana ChoiceCare |
$1,313.92
|
| Rate for Payer: Humana Medicare |
$673.39
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,144.76
|
| Rate for Payer: Lutheran Preferred All Products |
$1,077.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$985.44
|
| Rate for Payer: PHP All Products |
$1,143.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$673.39
|
| Rate for Payer: Signature Care EPO |
$943.50
|
| Rate for Payer: Signature Care PPO |
$943.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,010.00
|
| Rate for Payer: United Healthcare Commercial |
$767.04
|
| Rate for Payer: United Healthcare Medicare |
$656.96
|
|
|
PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB
|
Professional
|
$1,053.76
|
|
|
Service Code
|
CPT 26685
|
| Hospital Charge Code |
Z12287
|
| Min. Negotiated Rate |
$526.88 |
| Max. Negotiated Rate |
$1,264.51 |
| Rate for Payer: Aetna Medicare |
$540.05
|
| Rate for Payer: Anthem Exchange |
$681.50
|
| Rate for Payer: Anthem Medicare |
$540.05
|
| Rate for Payer: Anthem PPO |
$681.50
|
| Rate for Payer: Anthem Traditional |
$681.50
|
| Rate for Payer: Caresource Just 4 Me |
$621.06
|
| Rate for Payer: Caresource Medicare |
$594.05
|
| Rate for Payer: Centivo/Paragon All Products |
$837.08
|
| Rate for Payer: Coventry/First Health All Products |
$1,264.51
|
| Rate for Payer: Frontpath All Products |
$744.24
|
| Rate for Payer: Humana ChoiceCare |
$1,053.76
|
| Rate for Payer: Humana Medicare |
$540.05
|
| Rate for Payer: Lucent/Coldwater Veneers |
$918.08
|
| Rate for Payer: Lutheran Preferred All Products |
$864.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$790.32
|
| Rate for Payer: PHP All Products |
$916.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$540.05
|
| Rate for Payer: Signature Care EPO |
$770.95
|
| Rate for Payer: Signature Care PPO |
$770.95
|
| Rate for Payer: Three Rivers Preferred All Products |
$810.00
|
| Rate for Payer: United Healthcare Commercial |
$594.66
|
| Rate for Payer: United Healthcare Medicare |
$526.88
|
|
|
PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB
|
Professional
|
$1,150.76
|
|
|
Service Code
|
CPT 26665
|
| Hospital Charge Code |
Z12284
|
| Min. Negotiated Rate |
$575.38 |
| Max. Negotiated Rate |
$1,380.91 |
| Rate for Payer: Aetna Medicare |
$589.76
|
| Rate for Payer: Anthem Exchange |
$738.20
|
| Rate for Payer: Anthem Medicare |
$589.76
|
| Rate for Payer: Anthem PPO |
$738.20
|
| Rate for Payer: Anthem Traditional |
$738.20
|
| Rate for Payer: Caresource Just 4 Me |
$678.22
|
| Rate for Payer: Caresource Medicare |
$648.74
|
| Rate for Payer: Centivo/Paragon All Products |
$914.13
|
| Rate for Payer: Coventry/First Health All Products |
$1,380.91
|
| Rate for Payer: Frontpath All Products |
$804.74
|
| Rate for Payer: Humana ChoiceCare |
$1,150.76
|
| Rate for Payer: Humana Medicare |
$589.76
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,002.59
|
| Rate for Payer: Lutheran Preferred All Products |
$944.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$863.07
|
| Rate for Payer: PHP All Products |
$1,001.16
|
| Rate for Payer: Plain Church Group Ministry All Products |
$589.76
|
| Rate for Payer: Signature Care EPO |
$836.40
|
| Rate for Payer: Signature Care PPO |
$836.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$885.00
|
| Rate for Payer: United Healthcare Commercial |
$644.48
|
| Rate for Payer: United Healthcare Medicare |
$575.38
|
|
|
PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS
|
Professional
|
$1,176.96
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
Z12399
|
| Min. Negotiated Rate |
$588.48 |
| Max. Negotiated Rate |
$1,412.35 |
| Rate for Payer: Aetna Medicare |
$603.20
|
| Rate for Payer: Anthem Exchange |
$752.70
|
| Rate for Payer: Anthem Medicare |
$603.20
|
| Rate for Payer: Anthem PPO |
$752.70
|
| Rate for Payer: Anthem Traditional |
$752.70
|
| Rate for Payer: Caresource Just 4 Me |
$693.68
|
| Rate for Payer: Caresource Medicare |
$663.52
|
| Rate for Payer: Centivo/Paragon All Products |
$934.96
|
| Rate for Payer: Coventry/First Health All Products |
$1,412.35
|
| Rate for Payer: Frontpath All Products |
$836.55
|
| Rate for Payer: Humana ChoiceCare |
$1,176.96
|
| Rate for Payer: Humana Medicare |
$603.20
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,025.44
|
| Rate for Payer: Lutheran Preferred All Products |
$965.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$882.72
|
| Rate for Payer: PHP All Products |
$1,023.96
|
| Rate for Payer: Plain Church Group Ministry All Products |
$603.20
|
| Rate for Payer: Signature Care EPO |
$848.30
|
| Rate for Payer: Signature Care PPO |
$848.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$905.00
|
| Rate for Payer: United Healthcare Commercial |
$755.06
|
| Rate for Payer: United Healthcare Medicare |
$588.48
|
|
|
PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH
|
Professional
|
$923.18
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
Z12298
|
| Min. Negotiated Rate |
$461.59 |
| Max. Negotiated Rate |
$1,107.82 |
| Rate for Payer: Aetna Medicare |
$473.13
|
| Rate for Payer: Anthem Exchange |
$472.80
|
| Rate for Payer: Anthem Medicare |
$473.13
|
| Rate for Payer: Anthem PPO |
$472.80
|
| Rate for Payer: Anthem Traditional |
$472.80
|
| Rate for Payer: Caresource Just 4 Me |
$544.10
|
| Rate for Payer: Caresource Medicare |
$520.44
|
| Rate for Payer: Centivo/Paragon All Products |
$733.35
|
| Rate for Payer: Coventry/First Health All Products |
$1,107.82
|
| Rate for Payer: Frontpath All Products |
$647.10
|
| Rate for Payer: Humana ChoiceCare |
$923.18
|
| Rate for Payer: Humana Medicare |
$473.13
|
| Rate for Payer: Lucent/Coldwater Veneers |
$804.32
|
| Rate for Payer: Lutheran Preferred All Products |
$757.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$692.38
|
| Rate for Payer: PHP All Products |
$803.17
|
| Rate for Payer: Plain Church Group Ministry All Products |
$473.13
|
| Rate for Payer: Signature Care EPO |
$514.25
|
| Rate for Payer: Signature Care PPO |
$514.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$710.00
|
| Rate for Payer: United Healthcare Commercial |
$491.66
|
| Rate for Payer: United Healthcare Medicare |
$461.59
|
|
|
PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION
|
Professional
|
$1,291.72
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
Z12411
|
| Min. Negotiated Rate |
$645.86 |
| Max. Negotiated Rate |
$1,550.06 |
| Rate for Payer: Aetna Medicare |
$661.69
|
| Rate for Payer: Anthem Exchange |
$1,027.60
|
| Rate for Payer: Anthem Medicare |
$661.69
|
| Rate for Payer: Anthem PPO |
$1,027.60
|
| Rate for Payer: Anthem Traditional |
$1,027.60
|
| Rate for Payer: Caresource Just 4 Me |
$760.94
|
| Rate for Payer: Caresource Medicare |
$727.86
|
| Rate for Payer: Centivo/Paragon All Products |
$1,025.62
|
| Rate for Payer: Coventry/First Health All Products |
$1,550.06
|
| Rate for Payer: Frontpath All Products |
$917.01
|
| Rate for Payer: Humana ChoiceCare |
$1,291.72
|
| Rate for Payer: Humana Medicare |
$661.69
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,124.87
|
| Rate for Payer: Lutheran Preferred All Products |
$1,059.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$968.79
|
| Rate for Payer: PHP All Products |
$1,123.79
|
| Rate for Payer: Plain Church Group Ministry All Products |
$661.69
|
| Rate for Payer: Signature Care EPO |
$705.50
|
| Rate for Payer: Signature Care PPO |
$705.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$993.00
|
| Rate for Payer: United Healthcare Commercial |
$706.54
|
| Rate for Payer: United Healthcare Medicare |
$645.86
|
|
|
PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE
|
Professional
|
$1,744.04
|
|
|
Service Code
|
CPT 27514
|
| Hospital Charge Code |
Z12362
|
| Min. Negotiated Rate |
$872.02 |
| Max. Negotiated Rate |
$2,092.85 |
| Rate for Payer: Aetna Medicare |
$893.82
|
| Rate for Payer: Anthem Exchange |
$1,607.30
|
| Rate for Payer: Anthem Medicare |
$893.82
|
| Rate for Payer: Anthem PPO |
$1,607.30
|
| Rate for Payer: Anthem Traditional |
$1,607.30
|
| Rate for Payer: Caresource Just 4 Me |
$1,027.89
|
| Rate for Payer: Caresource Medicare |
$983.20
|
| Rate for Payer: Centivo/Paragon All Products |
$1,385.42
|
| Rate for Payer: Coventry/First Health All Products |
$2,092.85
|
| Rate for Payer: Frontpath All Products |
$1,259.34
|
| Rate for Payer: Humana ChoiceCare |
$1,744.04
|
| Rate for Payer: Humana Medicare |
$893.82
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,519.49
|
| Rate for Payer: Lutheran Preferred All Products |
$1,430.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,308.03
|
| Rate for Payer: PHP All Products |
$1,517.32
|
| Rate for Payer: Plain Church Group Ministry All Products |
$893.82
|
| Rate for Payer: Signature Care EPO |
$1,528.42
|
| Rate for Payer: Signature Care PPO |
$1,528.42
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,341.00
|
| Rate for Payer: United Healthcare Commercial |
$1,128.43
|
| Rate for Payer: United Healthcare Medicare |
$872.02
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W EXTENSION
|
Professional
|
$2,226.22
|
|
|
Service Code
|
CPT 27513
|
| Hospital Charge Code |
Z12361
|
| Min. Negotiated Rate |
$1,113.11 |
| Max. Negotiated Rate |
$2,671.46 |
| Rate for Payer: Aetna Medicare |
$1,141.26
|
| Rate for Payer: Anthem Exchange |
$1,665.40
|
| Rate for Payer: Anthem Medicare |
$1,141.26
|
| Rate for Payer: Anthem PPO |
$1,665.40
|
| Rate for Payer: Anthem Traditional |
$1,665.40
|
| Rate for Payer: Caresource Just 4 Me |
$1,312.45
|
| Rate for Payer: Caresource Medicare |
$1,255.39
|
| Rate for Payer: Centivo/Paragon All Products |
$1,768.95
|
| Rate for Payer: Coventry/First Health All Products |
$2,671.46
|
| Rate for Payer: Frontpath All Products |
$1,612.79
|
| Rate for Payer: Humana ChoiceCare |
$2,226.22
|
| Rate for Payer: Humana Medicare |
$1,141.26
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,940.14
|
| Rate for Payer: Lutheran Preferred All Products |
$1,826.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,669.66
|
| Rate for Payer: PHP All Products |
$1,936.82
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,141.26
|
| Rate for Payer: Signature Care EPO |
$1,860.65
|
| Rate for Payer: Signature Care PPO |
$1,860.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,712.00
|
| Rate for Payer: United Healthcare Commercial |
$1,408.76
|
| Rate for Payer: United Healthcare Medicare |
$1,113.11
|
|
|
PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O EXTENSION
|
Professional
|
$1,798.12
|
|
|
Service Code
|
CPT 27511
|
| Hospital Charge Code |
Z12360
|
| Min. Negotiated Rate |
$899.06 |
| Max. Negotiated Rate |
$2,157.74 |
| Rate for Payer: Aetna Medicare |
$921.53
|
| Rate for Payer: Anthem Exchange |
$1,365.70
|
| Rate for Payer: Anthem Medicare |
$921.53
|
| Rate for Payer: Anthem PPO |
$1,365.70
|
| Rate for Payer: Anthem Traditional |
$1,365.70
|
| Rate for Payer: Caresource Just 4 Me |
$1,059.76
|
| Rate for Payer: Caresource Medicare |
$1,013.68
|
| Rate for Payer: Centivo/Paragon All Products |
$1,428.37
|
| Rate for Payer: Coventry/First Health All Products |
$2,157.74
|
| Rate for Payer: Frontpath All Products |
$1,297.39
|
| Rate for Payer: Humana ChoiceCare |
$1,798.12
|
| Rate for Payer: Humana Medicare |
$921.53
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,566.60
|
| Rate for Payer: Lutheran Preferred All Products |
$1,474.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,348.59
|
| Rate for Payer: PHP All Products |
$1,564.36
|
| Rate for Payer: Plain Church Group Ministry All Products |
$921.53
|
| Rate for Payer: Signature Care EPO |
$1,451.80
|
| Rate for Payer: Signature Care PPO |
$1,451.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,382.00
|
| Rate for Payer: United Healthcare Commercial |
$1,119.10
|
| Rate for Payer: United Healthcare Medicare |
$899.06
|
|
|
PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES
|
Professional
|
$1,190.64
|
|
|
Service Code
|
CPT 28505
|
| Hospital Charge Code |
Z12439
|
| Min. Negotiated Rate |
$466.34 |
| Max. Negotiated Rate |
$1,428.77 |
| Rate for Payer: Aetna Medicare |
$466.34
|
| Rate for Payer: Anthem Exchange |
$517.72
|
| Rate for Payer: Anthem Medicare |
$466.34
|
| Rate for Payer: Anthem PPO |
$517.72
|
| Rate for Payer: Anthem Traditional |
$517.72
|
| Rate for Payer: Caresource Just 4 Me |
$536.29
|
| Rate for Payer: Caresource Medicare |
$512.97
|
| Rate for Payer: Centivo/Paragon All Products |
$722.83
|
| Rate for Payer: Coventry/First Health All Products |
$1,428.77
|
| Rate for Payer: Frontpath All Products |
$641.38
|
| Rate for Payer: Humana ChoiceCare |
$1,190.64
|
| Rate for Payer: Humana Medicare |
$466.34
|
| Rate for Payer: Lucent/Coldwater Veneers |
$792.78
|
| Rate for Payer: Lutheran Preferred All Products |
$746.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$892.98
|
| Rate for Payer: PHP All Products |
$791.65
|
| Rate for Payer: Plain Church Group Ministry All Products |
$466.34
|
| Rate for Payer: Signature Care EPO |
$756.50
|
| Rate for Payer: Signature Care PPO |
$756.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$700.00
|
| Rate for Payer: United Healthcare Commercial |
$533.71
|
| Rate for Payer: United Healthcare Medicare |
$595.32
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN
|
Professional
|
$1,682.08
|
|
|
Service Code
|
CPT 24545
|
| Hospital Charge Code |
Z12205
|
| Min. Negotiated Rate |
$841.04 |
| Max. Negotiated Rate |
$2,018.50 |
| Rate for Payer: Aetna Medicare |
$861.91
|
| Rate for Payer: Anthem Medicare |
$861.91
|
| Rate for Payer: Caresource Just 4 Me |
$991.20
|
| Rate for Payer: Caresource Medicare |
$948.10
|
| Rate for Payer: Centivo/Paragon All Products |
$1,335.96
|
| Rate for Payer: Coventry/First Health All Products |
$2,018.50
|
| Rate for Payer: Frontpath All Products |
$1,205.96
|
| Rate for Payer: Humana ChoiceCare |
$1,682.08
|
| Rate for Payer: Humana Medicare |
$861.91
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,465.25
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,261.56
|
| Rate for Payer: PHP All Products |
$1,463.42
|
| Rate for Payer: Plain Church Group Ministry All Products |
$861.91
|
| Rate for Payer: Signature Care EPO |
$1,104.15
|
| Rate for Payer: Signature Care PPO |
$1,104.15
|
| Rate for Payer: United Healthcare Commercial |
$989.31
|
| Rate for Payer: United Healthcare Medicare |
$841.04
|
|
|
PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W XTN
|
Professional
|
$1,878.12
|
|
|
Service Code
|
CPT 24546
|
| Hospital Charge Code |
Z12206
|
| Min. Negotiated Rate |
$939.06 |
| Max. Negotiated Rate |
$2,253.74 |
| Rate for Payer: Aetna Medicare |
$962.54
|
| Rate for Payer: Anthem Exchange |
$1,356.80
|
| Rate for Payer: Anthem Medicare |
$962.54
|
| Rate for Payer: Anthem PPO |
$1,356.80
|
| Rate for Payer: Anthem Traditional |
$1,356.80
|
| Rate for Payer: Caresource Just 4 Me |
$1,106.92
|
| Rate for Payer: Caresource Medicare |
$1,058.79
|
| Rate for Payer: Centivo/Paragon All Products |
$1,491.94
|
| Rate for Payer: Coventry/First Health All Products |
$2,253.74
|
| Rate for Payer: Frontpath All Products |
$1,346.63
|
| Rate for Payer: Humana ChoiceCare |
$1,878.12
|
| Rate for Payer: Humana Medicare |
$962.54
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,636.32
|
| Rate for Payer: Lutheran Preferred All Products |
$1,540.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,408.59
|
| Rate for Payer: PHP All Products |
$1,633.97
|
| Rate for Payer: Plain Church Group Ministry All Products |
$962.54
|
| Rate for Payer: Signature Care EPO |
$1,586.10
|
| Rate for Payer: Signature Care PPO |
$1,586.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,444.00
|
| Rate for Payer: United Healthcare Commercial |
$1,148.63
|
| Rate for Payer: United Healthcare Medicare |
$939.06
|
|
|
PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE
|
Professional
|
$1,479.26
|
|
|
Service Code
|
CPT 27540
|
| Hospital Charge Code |
Z12370
|
| Min. Negotiated Rate |
$739.63 |
| Max. Negotiated Rate |
$1,775.11 |
| Rate for Payer: Aetna Medicare |
$758.12
|
| Rate for Payer: Anthem Exchange |
$1,178.60
|
| Rate for Payer: Anthem Medicare |
$758.12
|
| Rate for Payer: Anthem PPO |
$1,178.60
|
| Rate for Payer: Anthem Traditional |
$1,178.60
|
| Rate for Payer: Caresource Just 4 Me |
$871.84
|
| Rate for Payer: Caresource Medicare |
$833.93
|
| Rate for Payer: Centivo/Paragon All Products |
$1,175.09
|
| Rate for Payer: Coventry/First Health All Products |
$1,775.11
|
| Rate for Payer: Frontpath All Products |
$1,057.45
|
| Rate for Payer: Humana ChoiceCare |
$1,479.26
|
| Rate for Payer: Humana Medicare |
$758.12
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,288.80
|
| Rate for Payer: Lutheran Preferred All Products |
$1,213.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,109.44
|
| Rate for Payer: PHP All Products |
$1,286.96
|
| Rate for Payer: Plain Church Group Ministry All Products |
$758.12
|
| Rate for Payer: Signature Care EPO |
$1,289.23
|
| Rate for Payer: Signature Care PPO |
$1,289.23
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,137.00
|
| Rate for Payer: United Healthcare Commercial |
$902.41
|
| Rate for Payer: United Healthcare Medicare |
$739.63
|
|
|
PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION 1
|
Professional
|
$1,005.12
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
Z12300
|
| Min. Negotiated Rate |
$435.20 |
| Max. Negotiated Rate |
$1,206.14 |
| Rate for Payer: Aetna Medicare |
$514.97
|
| Rate for Payer: Anthem Exchange |
$435.20
|
| Rate for Payer: Anthem Medicare |
$514.97
|
| Rate for Payer: Anthem PPO |
$435.20
|
| Rate for Payer: Anthem Traditional |
$435.20
|
| Rate for Payer: Caresource Just 4 Me |
$592.22
|
| Rate for Payer: Caresource Medicare |
$566.47
|
| Rate for Payer: Centivo/Paragon All Products |
$798.20
|
| Rate for Payer: Coventry/First Health All Products |
$1,206.14
|
| Rate for Payer: Frontpath All Products |
$705.03
|
| Rate for Payer: Humana ChoiceCare |
$1,005.12
|
| Rate for Payer: Humana Medicare |
$514.97
|
| Rate for Payer: Lucent/Coldwater Veneers |
$875.45
|
| Rate for Payer: Lutheran Preferred All Products |
$824.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$753.84
|
| Rate for Payer: PHP All Products |
$874.45
|
| Rate for Payer: Plain Church Group Ministry All Products |
$514.97
|
| Rate for Payer: Signature Care EPO |
$518.50
|
| Rate for Payer: Signature Care PPO |
$518.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$772.00
|
| Rate for Payer: United Healthcare Commercial |
$537.15
|
| Rate for Payer: United Healthcare Medicare |
$502.56
|
|
|
PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE
|
Professional
|
$1,054.08
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
Z12282
|
| Min. Negotiated Rate |
$527.04 |
| Max. Negotiated Rate |
$1,264.90 |
| Rate for Payer: Aetna Medicare |
$539.91
|
| Rate for Payer: Anthem Exchange |
$554.80
|
| Rate for Payer: Anthem Medicare |
$539.91
|
| Rate for Payer: Anthem PPO |
$554.80
|
| Rate for Payer: Anthem Traditional |
$554.80
|
| Rate for Payer: Caresource Just 4 Me |
$620.90
|
| Rate for Payer: Caresource Medicare |
$593.90
|
| Rate for Payer: Centivo/Paragon All Products |
$836.86
|
| Rate for Payer: Coventry/First Health All Products |
$1,264.90
|
| Rate for Payer: Frontpath All Products |
$742.92
|
| Rate for Payer: Humana ChoiceCare |
$1,054.08
|
| Rate for Payer: Humana Medicare |
$539.91
|
| Rate for Payer: Lucent/Coldwater Veneers |
$917.85
|
| Rate for Payer: Lutheran Preferred All Products |
$864.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$790.56
|
| Rate for Payer: PHP All Products |
$917.05
|
| Rate for Payer: Plain Church Group Ministry All Products |
$539.91
|
| Rate for Payer: Signature Care EPO |
$627.30
|
| Rate for Payer: Signature Care PPO |
$627.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$810.00
|
| Rate for Payer: United Healthcare Commercial |
$580.18
|
| Rate for Payer: United Healthcare Medicare |
$527.04
|
|
|
PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW
|
Professional
|
$1,233.44
|
|
|
Service Code
|
CPT 24635
|
| Hospital Charge Code |
Z12210
|
| Min. Negotiated Rate |
$616.72 |
| Max. Negotiated Rate |
$1,480.13 |
| Rate for Payer: Aetna Medicare |
$632.14
|
| Rate for Payer: Anthem Exchange |
$1,416.40
|
| Rate for Payer: Anthem Medicare |
$632.14
|
| Rate for Payer: Anthem PPO |
$1,416.40
|
| Rate for Payer: Anthem Traditional |
$1,416.40
|
| Rate for Payer: Caresource Just 4 Me |
$726.96
|
| Rate for Payer: Caresource Medicare |
$695.35
|
| Rate for Payer: Centivo/Paragon All Products |
$979.82
|
| Rate for Payer: Coventry/First Health All Products |
$1,480.13
|
| Rate for Payer: Frontpath All Products |
$874.12
|
| Rate for Payer: Humana ChoiceCare |
$1,233.44
|
| Rate for Payer: Humana Medicare |
$632.14
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,074.64
|
| Rate for Payer: Lutheran Preferred All Products |
$1,011.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$925.08
|
| Rate for Payer: PHP All Products |
$1,073.09
|
| Rate for Payer: Plain Church Group Ministry All Products |
$632.14
|
| Rate for Payer: Signature Care EPO |
$1,071.75
|
| Rate for Payer: Signature Care PPO |
$1,071.75
|
| Rate for Payer: Three Rivers Preferred All Products |
$948.00
|
| Rate for Payer: United Healthcare Commercial |
$806.45
|
| Rate for Payer: United Healthcare Medicare |
$616.72
|
|
|
PR OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA
|
Professional
|
$1,088.74
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
Z12292
|
| Min. Negotiated Rate |
$544.37 |
| Max. Negotiated Rate |
$1,306.49 |
| Rate for Payer: Aetna Medicare |
$557.98
|
| Rate for Payer: Anthem Exchange |
$575.62
|
| Rate for Payer: Anthem Medicare |
$557.98
|
| Rate for Payer: Anthem PPO |
$575.62
|
| Rate for Payer: Anthem Traditional |
$575.62
|
| Rate for Payer: Caresource Just 4 Me |
$641.68
|
| Rate for Payer: Caresource Medicare |
$613.78
|
| Rate for Payer: Centivo/Paragon All Products |
$864.87
|
| Rate for Payer: Coventry/First Health All Products |
$1,306.49
|
| Rate for Payer: Frontpath All Products |
$768.27
|
| Rate for Payer: Humana ChoiceCare |
$1,088.74
|
| Rate for Payer: Humana Medicare |
$557.98
|
| Rate for Payer: Lucent/Coldwater Veneers |
$948.57
|
| Rate for Payer: Lutheran Preferred All Products |
$893.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$816.56
|
| Rate for Payer: PHP All Products |
$947.21
|
| Rate for Payer: Plain Church Group Ministry All Products |
$557.98
|
| Rate for Payer: Signature Care EPO |
$685.10
|
| Rate for Payer: Signature Care PPO |
$685.10
|
| Rate for Payer: Three Rivers Preferred All Products |
$837.00
|
| Rate for Payer: United Healthcare Commercial |
$605.41
|
| Rate for Payer: United Healthcare Medicare |
$544.37
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE
|
Professional
|
$1,199.98
|
|
|
Service Code
|
CPT 24665
|
| Hospital Charge Code |
Z12214
|
| Min. Negotiated Rate |
$599.99 |
| Max. Negotiated Rate |
$1,439.98 |
| Rate for Payer: Aetna Medicare |
$614.99
|
| Rate for Payer: Anthem Exchange |
$798.70
|
| Rate for Payer: Anthem Medicare |
$614.99
|
| Rate for Payer: Anthem PPO |
$798.70
|
| Rate for Payer: Anthem Traditional |
$798.70
|
| Rate for Payer: Caresource Just 4 Me |
$707.24
|
| Rate for Payer: Caresource Medicare |
$676.49
|
| Rate for Payer: Centivo/Paragon All Products |
$953.23
|
| Rate for Payer: Coventry/First Health All Products |
$1,439.98
|
| Rate for Payer: Frontpath All Products |
$851.54
|
| Rate for Payer: Humana ChoiceCare |
$1,199.98
|
| Rate for Payer: Humana Medicare |
$614.99
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,045.48
|
| Rate for Payer: Lutheran Preferred All Products |
$984.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$899.99
|
| Rate for Payer: PHP All Products |
$1,043.98
|
| Rate for Payer: Plain Church Group Ministry All Products |
$614.99
|
| Rate for Payer: Signature Care EPO |
$908.65
|
| Rate for Payer: Signature Care PPO |
$908.65
|
| Rate for Payer: Three Rivers Preferred All Products |
$922.00
|
| Rate for Payer: United Healthcare Commercial |
$693.40
|
| Rate for Payer: United Healthcare Medicare |
$599.99
|
|
|
PR OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC
|
Professional
|
$1,334.50
|
|
|
Service Code
|
CPT 24666
|
| Hospital Charge Code |
Z12215
|
| Min. Negotiated Rate |
$667.25 |
| Max. Negotiated Rate |
$1,601.40 |
| Rate for Payer: Aetna Medicare |
$683.93
|
| Rate for Payer: Anthem Exchange |
$964.30
|
| Rate for Payer: Anthem Medicare |
$683.93
|
| Rate for Payer: Anthem PPO |
$964.30
|
| Rate for Payer: Anthem Traditional |
$964.30
|
| Rate for Payer: Caresource Just 4 Me |
$786.52
|
| Rate for Payer: Caresource Medicare |
$752.32
|
| Rate for Payer: Centivo/Paragon All Products |
$1,060.09
|
| Rate for Payer: Coventry/First Health All Products |
$1,601.40
|
| Rate for Payer: Frontpath All Products |
$949.39
|
| Rate for Payer: Humana ChoiceCare |
$1,334.50
|
| Rate for Payer: Humana Medicare |
$683.93
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,162.68
|
| Rate for Payer: Lutheran Preferred All Products |
$1,094.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,000.88
|
| Rate for Payer: PHP All Products |
$1,161.02
|
| Rate for Payer: Plain Church Group Ministry All Products |
$683.93
|
| Rate for Payer: Signature Care EPO |
$1,024.25
|
| Rate for Payer: Signature Care PPO |
$1,024.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,026.00
|
| Rate for Payer: United Healthcare Commercial |
$789.11
|
| Rate for Payer: United Healthcare Medicare |
$667.25
|
|
