hospital_name last_updated_on version hospital_location hospital_address license_number|NV "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." general_contract_provisions Boulder City Hospital 11/12/2024 2.0.0 Boulder City Hospital "999 Adams Blvd, Boulder City, NV 89005" 880065829 TRUE De-Identified Minimum Reimbursement. Items and services that do not easily translate to an individual line are not included. description code|1 code|1|type code|2 code|2|type code|3 code|3|type modifiers setting drug_unit_of_measurement drug_type_of_measurement standard_charge|gross standard_charge|discounted_cash payer_name plan_name standard_charge|negotiated_dollar standard_charge|negotiated_percentage standard_charge|negotiated_algorithm estimated_amount standard_charge|methodology standard_charge|min standard_charge|max additional_generic_notes .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Aetna PPO 38 38% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Aetna Medicare HMO 26 26% of all negotiated rates 20 percent of total billed charges 20 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Alignment Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 47 percent of total billed charges 47 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 39 percent of total billed charges 39 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Cigna PPO 68 68% of all negotiated rates 53 percent of total billed charges 53 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Coalition PPO 49 49% of all negotiated rates 38 percent of total billed charges 38 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Coventry PPO 75 75% of all negotiated rates 59 percent of total billed charges 59 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 62 percent of total billed charges 62 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Humana-Commerical PPO 70 70% of all negotiated rates 55 percent of total billed charges 55 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Multiplan PPO 80 80% of all negotiated rates 62 percent of total billed charges 62 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 One Health PPO 55 55% of all negotiated rates 38 percent of total billed charges 38 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Optum Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 P3 HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 55 percent of total billed charges 55 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Select Health HMO 41 41% of all negotiated rates 32 percent of total billed charges 32 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 26 percent of total billed charges 26 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Sierra/HPN HMO 60 60% of all negotiated rates 47 percent of total billed charges 47 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Silversummit Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 27 percent of total billed charges 27 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 Teachers Trust PPO 65 65% of all negotiated rates 51 percent of total billed charges 51 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 TriWest PPO 30 30% of all negotiated rates 23 percent of total billed charges 23 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 UHN-Universal Health Network PPO 70 70% of all negotiated rates 55 percent of total billed charges 55 78 .Gestational GTT 1-Hr 82947 CPT 4009473 LOCAL 301 RC outpatient 78 66 United Healthcare PPO 60 60% of all negotiated rates 47 percent of total billed charges 47 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Aetna PPO 38 38% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Aetna Medicare HMO 26 26% of all negotiated rates 20 percent of total billed charges 20 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Alignment Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 47 percent of total billed charges 47 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 39 percent of total billed charges 39 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Cigna PPO 68 68% of all negotiated rates 53 percent of total billed charges 53 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Coalition PPO 49 49% of all negotiated rates 38 percent of total billed charges 38 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Coventry PPO 75 75% of all negotiated rates 59 percent of total billed charges 59 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 62 percent of total billed charges 62 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Humana-Commerical PPO 70 70% of all negotiated rates 55 percent of total billed charges 55 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Multiplan PPO 80 80% of all negotiated rates 62 percent of total billed charges 62 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 One Health PPO 55 55% of all negotiated rates 38 percent of total billed charges 38 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Optum Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 P3 HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 55 percent of total billed charges 55 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Select Health HMO 41 41% of all negotiated rates 32 percent of total billed charges 32 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 26 percent of total billed charges 26 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Sierra/HPN HMO 60 60% of all negotiated rates 47 percent of total billed charges 47 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Silversummit Medicare HMO 39 39% of all negotiated rates 30 percent of total billed charges 30 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 27 percent of total billed charges 27 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 Teachers Trust PPO 65 65% of all negotiated rates 51 percent of total billed charges 51 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 TriWest PPO 30 30% of all negotiated rates 23 percent of total billed charges 23 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 UHN-Universal Health Network PPO 70 70% of all negotiated rates 55 percent of total billed charges 55 78 .Glucose Fasting 82947 CPT 4010275 LOCAL 301 RC outpatient 78 66 United Healthcare PPO 60 60% of all negotiated rates 47 percent of total billed charges 47 78 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Aetna PPO 38 38% of all negotiated rates 35 percent of total billed charges 35 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Aetna Medicare HMO 26 26% of all negotiated rates 24 percent of total billed charges 24 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Alignment Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 56 percent of total billed charges 56 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 47 percent of total billed charges 47 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Cigna PPO 68 68% of all negotiated rates 63 percent of total billed charges 63 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Coalition PPO 49 49% of all negotiated rates 46 percent of total billed charges 46 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Coventry PPO 75 75% of all negotiated rates 70 percent of total billed charges 70 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 74 percent of total billed charges 74 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Humana-Commerical PPO 70 70% of all negotiated rates 65 percent of total billed charges 65 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Multiplan PPO 80 80% of all negotiated rates 74 percent of total billed charges 74 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 One Health PPO 55 55% of all negotiated rates 46 percent of total billed charges 46 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Optum Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 P3 HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 65 percent of total billed charges 65 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Select Health HMO 41 41% of all negotiated rates 38 percent of total billed charges 38 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 31 percent of total billed charges 31 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Sierra/HPN HMO 60 60% of all negotiated rates 56 percent of total billed charges 56 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Silversummit Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 33 percent of total billed charges 33 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 Teachers Trust PPO 65 65% of all negotiated rates 60 percent of total billed charges 60 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 TriWest PPO 30 30% of all negotiated rates 28 percent of total billed charges 28 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 UHN-Universal Health Network PPO 70 70% of all negotiated rates 65 percent of total billed charges 65 93 .GTT-1 Hr 82950 CPT 4010277 LOCAL 301 RC outpatient 93 79 United Healthcare PPO 60 60% of all negotiated rates 56 percent of total billed charges 56 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Aetna PPO 38 38% of all negotiated rates 35 percent of total billed charges 35 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Aetna Medicare HMO 26 26% of all negotiated rates 24 percent of total billed charges 24 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Alignment Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 56 percent of total billed charges 56 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 47 percent of total billed charges 47 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Cigna PPO 68 68% of all negotiated rates 63 percent of total billed charges 63 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Coalition PPO 49 49% of all negotiated rates 46 percent of total billed charges 46 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Coventry PPO 75 75% of all negotiated rates 70 percent of total billed charges 70 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 74 percent of total billed charges 74 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Humana-Commerical PPO 70 70% of all negotiated rates 65 percent of total billed charges 65 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 3 fee schedule 3 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Multiplan PPO 80 80% of all negotiated rates 74 percent of total billed charges 74 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 One Health PPO 55 55% of all negotiated rates 46 percent of total billed charges 46 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Optum Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 P3 HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 65 percent of total billed charges 65 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Select Health HMO 41 41% of all negotiated rates 38 percent of total billed charges 38 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 31 percent of total billed charges 31 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Sierra/HPN HMO 60 60% of all negotiated rates 56 percent of total billed charges 56 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Silversummit Medicare HMO 39 39% of all negotiated rates 36 percent of total billed charges 36 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 33 percent of total billed charges 33 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 Teachers Trust PPO 65 65% of all negotiated rates 60 percent of total billed charges 60 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 TriWest PPO 30 30% of all negotiated rates 28 percent of total billed charges 28 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 UHN-Universal Health Network PPO 70 70% of all negotiated rates 65 percent of total billed charges 65 93 .GTT-2 Hr 82950 CPT 4010279 LOCAL 301 RC outpatient 93 79 United Healthcare PPO 60 60% of all negotiated rates 56 percent of total billed charges 56 93 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Aetna PPO 38 38% of all negotiated rates 93 percent of total billed charges 93 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Aetna Medicare HMO 26 26% of all negotiated rates 64 percent of total billed charges 64 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Alignment Medicare HMO 39 39% of all negotiated rates 96 percent of total billed charges 96 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 148 percent of total billed charges 148 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 123 percent of total billed charges 123 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 7 fee schedule 7 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 96 percent of total billed charges 96 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Cigna PPO 68 68% of all negotiated rates 167 percent of total billed charges 167 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Coalition PPO 49 49% of all negotiated rates 121 percent of total billed charges 121 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Coventry PPO 75 75% of all negotiated rates 185 percent of total billed charges 185 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 197 percent of total billed charges 197 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 7 fee schedule 7 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Humana-Commerical PPO 70 70% of all negotiated rates 172 percent of total billed charges 172 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 96 percent of total billed charges 96 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 7 fee schedule 7 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Multiplan PPO 80 80% of all negotiated rates 197 percent of total billed charges 197 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 One Health PPO 55 55% of all negotiated rates 121 percent of total billed charges 121 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Optum Medicare HMO 39 39% of all negotiated rates 96 percent of total billed charges 96 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 P3 HMO 39 39% of all negotiated rates 96 percent of total billed charges 96 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 172 percent of total billed charges 172 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Select Health HMO 41 41% of all negotiated rates 101 percent of total billed charges 101 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 82 percent of total billed charges 82 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Sierra/HPN HMO 60 60% of all negotiated rates 148 percent of total billed charges 148 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Silversummit Medicare HMO 39 39% of all negotiated rates 96 percent of total billed charges 96 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 86 percent of total billed charges 86 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 Teachers Trust PPO 65 65% of all negotiated rates 160 percent of total billed charges 160 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 TriWest PPO 30 30% of all negotiated rates 74 percent of total billed charges 74 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 UHN-Universal Health Network PPO 70 70% of all negotiated rates 172 percent of total billed charges 172 246 .GTT-3 Hr 82951 CPT 4010281 LOCAL 301 RC outpatient 246 209 United Healthcare PPO 60 60% of all negotiated rates 148 percent of total billed charges 148 246 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Aetna Medicare HMO 26 26% of all negotiated rates 202 percent of total billed charges 202 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Alignment Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 466 percent of total billed charges 466 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 389 percent of total billed charges 389 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 91 fee schedule 91 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Cigna PPO 68 68% of all negotiated rates 528 percent of total billed charges 528 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Coalition PPO 59 59% of all negotiated rates 458 percent of total billed charges 458 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Coventry PPO 75 75% of all negotiated rates 583 percent of total billed charges 583 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 622 percent of total billed charges 622 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 91 fee schedule 91 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Humana-Commerical PPO 70 70% of all negotiated rates 544 percent of total billed charges 544 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 91 fee schedule 91 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Multiplan PPO 80 80% of all negotiated rates 622 percent of total billed charges 622 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 One Health PPO 55 55% of all negotiated rates 458 percent of total billed charges 458 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Optum Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 P3 HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 544 percent of total billed charges 544 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Select Health HMO 41 41% of all negotiated rates 319 percent of total billed charges 319 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 260 percent of total billed charges 260 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Sierra/HPN HMO 60 60% of all negotiated rates 466 percent of total billed charges 466 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Silversummit Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 272 percent of total billed charges 272 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 Teachers Trust PPO 68 68% of all negotiated rates 528 percent of total billed charges 528 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 TriWest PPO 30 30% of all negotiated rates 233 percent of total billed charges 233 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 UHN-Universal Health Network PPO 70 70% of all negotiated rates 544 percent of total billed charges 544 777 10060 ED ID ABSCESS SIMPLE/SINGLE CHARGE 10060 CPT 3230606 LOCAL 450 RC outpatient 777 660 United Healthcare PPO 60 60% of all negotiated rates 466 percent of total billed charges 466 777 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Aetna Medicare HMO 26 26% of all negotiated rates 167 percent of total billed charges 167 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Alignment Medicare HMO 39 39% of all negotiated rates 251 percent of total billed charges 251 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 386 percent of total billed charges 386 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 322 percent of total billed charges 322 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 169 fee schedule 169 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 251 percent of total billed charges 251 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Cigna PPO 68 68% of all negotiated rates 437 percent of total billed charges 437 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Coalition PPO 59 59% of all negotiated rates 379 percent of total billed charges 379 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Coventry PPO 75 75% of all negotiated rates 482 percent of total billed charges 482 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 514 percent of total billed charges 514 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 169 fee schedule 169 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Humana-Commerical PPO 70 70% of all negotiated rates 450 percent of total billed charges 450 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 251 percent of total billed charges 251 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 169 fee schedule 169 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Multiplan PPO 80 80% of all negotiated rates 514 percent of total billed charges 514 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 One Health PPO 55 55% of all negotiated rates 379 percent of total billed charges 379 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Optum Medicare HMO 39 39% of all negotiated rates 251 percent of total billed charges 251 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 P3 HMO 39 39% of all negotiated rates 251 percent of total billed charges 251 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 450 percent of total billed charges 450 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Select Health HMO 41 41% of all negotiated rates 264 percent of total billed charges 264 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 215 percent of total billed charges 215 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Sierra/HPN HMO 60 60% of all negotiated rates 386 percent of total billed charges 386 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Silversummit Medicare HMO 39 39% of all negotiated rates 251 percent of total billed charges 251 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 225 percent of total billed charges 225 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 Teachers Trust PPO 68 68% of all negotiated rates 437 percent of total billed charges 437 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 TriWest PPO 30 30% of all negotiated rates 193 percent of total billed charges 193 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 UHN-Universal Health Network PPO 70 70% of all negotiated rates 450 percent of total billed charges 450 643 "10061 ED I D ABSCESS, COMPL CHARGE" 10061 CPT 3230005 LOCAL 450 RC outpatient 643 547 United Healthcare PPO 60 60% of all negotiated rates 386 percent of total billed charges 386 643 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Aetna Medicare HMO 26 26% of all negotiated rates 211 percent of total billed charges 211 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Alignment Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 487 percent of total billed charges 487 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 406 percent of total billed charges 406 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 98 fee schedule 98 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Cigna PPO 68 68% of all negotiated rates 551 percent of total billed charges 551 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Coalition PPO 59 59% of all negotiated rates 478 percent of total billed charges 478 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Coventry PPO 75 75% of all negotiated rates 608 percent of total billed charges 608 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 649 percent of total billed charges 649 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 98 fee schedule 98 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Humana-Commerical PPO 70 70% of all negotiated rates 568 percent of total billed charges 568 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 98 fee schedule 98 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Multiplan PPO 80 80% of all negotiated rates 649 percent of total billed charges 649 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 One Health PPO 55 55% of all negotiated rates 478 percent of total billed charges 478 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Optum Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 P3 HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 568 percent of total billed charges 568 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Select Health HMO 41 41% of all negotiated rates 333 percent of total billed charges 333 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 272 percent of total billed charges 272 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Sierra/HPN HMO 60 60% of all negotiated rates 487 percent of total billed charges 487 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Silversummit Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 284 percent of total billed charges 284 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 Teachers Trust PPO 68 68% of all negotiated rates 551 percent of total billed charges 551 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 TriWest PPO 30 30% of all negotiated rates 243 percent of total billed charges 243 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 UHN-Universal Health Network PPO 70 70% of all negotiated rates 568 percent of total billed charges 568 811 10080 ED ID PILONIDAL CYST SIMPLE CHARGE 10080 CPT 3238001 LOCAL 450 RC outpatient 811 689 United Healthcare PPO 60 60% of all negotiated rates 487 percent of total billed charges 487 811 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Aetna Medicare HMO 26 26% of all negotiated rates 297 percent of total billed charges 297 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Alignment Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 686 percent of total billed charges 686 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 572 percent of total billed charges 572 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 98 fee schedule 98 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Cigna PPO 68 68% of all negotiated rates 777 percent of total billed charges 777 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Coalition PPO 59 59% of all negotiated rates 674 percent of total billed charges 674 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Coventry PPO 75 75% of all negotiated rates 857 percent of total billed charges 857 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 914 percent of total billed charges 914 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 98 fee schedule 98 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Humana-Commerical PPO 70 70% of all negotiated rates 800 percent of total billed charges 800 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 98 fee schedule 98 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Multiplan PPO 80 80% of all negotiated rates 914 percent of total billed charges 914 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 One Health PPO 55 55% of all negotiated rates 674 percent of total billed charges 674 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Optum Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 P3 HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 800 percent of total billed charges 800 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Select Health HMO 41 41% of all negotiated rates 469 percent of total billed charges 469 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 383 percent of total billed charges 383 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Sierra/HPN HMO 60 60% of all negotiated rates 686 percent of total billed charges 686 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Silversummit Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 400 percent of total billed charges 400 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 Teachers Trust PPO 68 68% of all negotiated rates 777 percent of total billed charges 777 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 TriWest PPO 30 30% of all negotiated rates 343 percent of total billed charges 343 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 UHN-Universal Health Network PPO 70 70% of all negotiated rates 800 percent of total billed charges 800 1143 "10120 ED FOREIGN BODY REMOVAL, SMPL CHARGE" 10120 CPT 3231204 LOCAL 450 RC outpatient 1143 972 United Healthcare PPO 60 60% of all negotiated rates 686 percent of total billed charges 686 1143 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Aetna Medicare HMO 26 26% of all negotiated rates 1551 percent of total billed charges 1551 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Alignment Medicare HMO 39 39% of all negotiated rates 2327 percent of total billed charges 2327 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3580 percent of total billed charges 3580 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 2983 percent of total billed charges 2983 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 112 fee schedule 112 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2327 percent of total billed charges 2327 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Cigna PPO 68 68% of all negotiated rates 4057 percent of total billed charges 4057 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Coalition PPO 59 59% of all negotiated rates 3520 percent of total billed charges 3520 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Coventry PPO 75 75% of all negotiated rates 4475 percent of total billed charges 4475 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 4773 percent of total billed charges 4773 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 112 fee schedule 112 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Humana-Commerical PPO 70 70% of all negotiated rates 4176 percent of total billed charges 4176 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2327 percent of total billed charges 2327 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 112 fee schedule 112 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Multiplan PPO 80 80% of all negotiated rates 4773 percent of total billed charges 4773 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 One Health PPO 55 55% of all negotiated rates 3520 percent of total billed charges 3520 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Optum Medicare HMO 39 39% of all negotiated rates 2327 percent of total billed charges 2327 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 P3 HMO 39 39% of all negotiated rates 2327 percent of total billed charges 2327 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 4176 percent of total billed charges 4176 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Select Health HMO 41 41% of all negotiated rates 2446 percent of total billed charges 2446 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1999 percent of total billed charges 1999 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Sierra/HPN HMO 60 60% of all negotiated rates 3580 percent of total billed charges 3580 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Silversummit Medicare HMO 39 39% of all negotiated rates 2327 percent of total billed charges 2327 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 2088 percent of total billed charges 2088 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 Teachers Trust PPO 68 68% of all negotiated rates 4057 percent of total billed charges 4057 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 TriWest PPO 30 30% of all negotiated rates 1790 percent of total billed charges 1790 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 UHN-Universal Health Network PPO 70 70% of all negotiated rates 4176 percent of total billed charges 4176 5966 10140 ED DRAINAGE OF HEMATOMA CHARGE 10140 CPT 3237410 LOCAL 450 RC outpatient 5966 5071 United Healthcare PPO 60 60% of all negotiated rates 3580 percent of total billed charges 3580 5966 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Aetna Medicare HMO 26 26% of all negotiated rates 205 percent of total billed charges 205 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Alignment Medicare HMO 39 39% of all negotiated rates 307 percent of total billed charges 307 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 473 percent of total billed charges 473 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 394 percent of total billed charges 394 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 91 fee schedule 91 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 307 percent of total billed charges 307 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Cigna PPO 68 68% of all negotiated rates 536 percent of total billed charges 536 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Coalition PPO 59 59% of all negotiated rates 465 percent of total billed charges 465 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Coventry PPO 75 75% of all negotiated rates 591 percent of total billed charges 591 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 630 percent of total billed charges 630 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 91 fee schedule 91 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Humana-Commerical PPO 70 70% of all negotiated rates 552 percent of total billed charges 552 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 307 percent of total billed charges 307 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 91 fee schedule 91 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Multiplan PPO 80 80% of all negotiated rates 630 percent of total billed charges 630 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 One Health PPO 55 55% of all negotiated rates 465 percent of total billed charges 465 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Optum Medicare HMO 39 39% of all negotiated rates 307 percent of total billed charges 307 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 P3 HMO 39 39% of all negotiated rates 307 percent of total billed charges 307 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 552 percent of total billed charges 552 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Select Health HMO 41 41% of all negotiated rates 323 percent of total billed charges 323 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 264 percent of total billed charges 264 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Sierra/HPN HMO 60 60% of all negotiated rates 473 percent of total billed charges 473 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Silversummit Medicare HMO 39 39% of all negotiated rates 307 percent of total billed charges 307 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 276 percent of total billed charges 276 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 Teachers Trust PPO 68 68% of all negotiated rates 536 percent of total billed charges 536 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 TriWest PPO 30 30% of all negotiated rates 236 percent of total billed charges 236 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 UHN-Universal Health Network PPO 70 70% of all negotiated rates 552 percent of total billed charges 552 788 10160 ED PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS) CHARGE 10160 CPT 3230412 LOCAL 450 RC outpatient 788 670 United Healthcare PPO 60 60% of all negotiated rates 473 percent of total billed charges 473 788 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Aetna Medicare HMO 26 26% of all negotiated rates 421 percent of total billed charges 421 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Alignment Medicare HMO 39 39% of all negotiated rates 631 percent of total billed charges 631 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 971 percent of total billed charges 971 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 810 percent of total billed charges 810 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 27 fee schedule 27 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 631 percent of total billed charges 631 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Cigna PPO 68 68% of all negotiated rates 1101 percent of total billed charges 1101 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Coalition PPO 59 59% of all negotiated rates 955 percent of total billed charges 955 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Coventry PPO 75 75% of all negotiated rates 1214 percent of total billed charges 1214 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1295 percent of total billed charges 1295 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 27 fee schedule 27 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Humana-Commerical PPO 70 70% of all negotiated rates 1133 percent of total billed charges 1133 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 631 percent of total billed charges 631 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 27 fee schedule 27 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Multiplan PPO 80 80% of all negotiated rates 1295 percent of total billed charges 1295 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 One Health PPO 55 55% of all negotiated rates 955 percent of total billed charges 955 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Optum Medicare HMO 39 39% of all negotiated rates 631 percent of total billed charges 631 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 P3 HMO 39 39% of all negotiated rates 631 percent of total billed charges 631 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1133 percent of total billed charges 1133 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Select Health HMO 41 41% of all negotiated rates 664 percent of total billed charges 664 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 542 percent of total billed charges 542 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Sierra/HPN HMO 60 60% of all negotiated rates 971 percent of total billed charges 971 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Silversummit Medicare HMO 39 39% of all negotiated rates 631 percent of total billed charges 631 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 567 percent of total billed charges 567 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 Teachers Trust PPO 68 68% of all negotiated rates 1101 percent of total billed charges 1101 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 TriWest PPO 30 30% of all negotiated rates 486 percent of total billed charges 486 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1133 percent of total billed charges 1133 1619 11000 DEBRIDE INFECTED SKIN 11000 CPT 3230007 LOCAL 450 RC outpatient 1619 1376 United Healthcare PPO 60 60% of all negotiated rates 971 percent of total billed charges 971 1619 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Aetna Medicare HMO 26 26% of all negotiated rates 256 percent of total billed charges 256 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Alignment Medicare HMO 39 39% of all negotiated rates 383 percent of total billed charges 383 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 590 percent of total billed charges 590 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 492 percent of total billed charges 492 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 264 fee schedule 264 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 383 percent of total billed charges 383 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Cigna PPO 68 68% of all negotiated rates 668 percent of total billed charges 668 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Coalition PPO 59 59% of all negotiated rates 580 percent of total billed charges 580 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Coventry PPO 75 75% of all negotiated rates 737 percent of total billed charges 737 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 786 percent of total billed charges 786 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 264 fee schedule 264 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Humana-Commerical PPO 70 70% of all negotiated rates 688 percent of total billed charges 688 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 383 percent of total billed charges 383 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 264 fee schedule 264 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Multiplan PPO 80 80% of all negotiated rates 786 percent of total billed charges 786 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 One Health PPO 55 55% of all negotiated rates 580 percent of total billed charges 580 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Optum Medicare HMO 39 39% of all negotiated rates 383 percent of total billed charges 383 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 P3 HMO 39 39% of all negotiated rates 383 percent of total billed charges 383 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 688 percent of total billed charges 688 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Select Health HMO 41 41% of all negotiated rates 403 percent of total billed charges 403 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 329 percent of total billed charges 329 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Sierra/HPN HMO 60 60% of all negotiated rates 590 percent of total billed charges 590 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Silversummit Medicare HMO 39 39% of all negotiated rates 383 percent of total billed charges 383 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 344 percent of total billed charges 344 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 Teachers Trust PPO 68 68% of all negotiated rates 668 percent of total billed charges 668 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 TriWest PPO 30 30% of all negotiated rates 295 percent of total billed charges 295 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 UHN-Universal Health Network PPO 70 70% of all negotiated rates 688 percent of total billed charges 688 983 11010 ED DEBRIDE RMV FB W/FX SKIN CHARGE 11010 CPT 3230405 LOCAL 450 RC outpatient 983 836 United Healthcare PPO 60 60% of all negotiated rates 590 percent of total billed charges 590 983 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Aetna Medicare HMO 26 26% of all negotiated rates 582 percent of total billed charges 582 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Alignment Medicare HMO 39 39% of all negotiated rates 872 percent of total billed charges 872 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1342 percent of total billed charges 1342 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1119 percent of total billed charges 1119 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 101 fee schedule 101 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 872 percent of total billed charges 872 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Cigna PPO 68 68% of all negotiated rates 1521 percent of total billed charges 1521 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Coalition PPO 59 59% of all negotiated rates 1320 percent of total billed charges 1320 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Coventry PPO 75 75% of all negotiated rates 1678 percent of total billed charges 1678 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1790 percent of total billed charges 1790 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 101 fee schedule 101 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Humana-Commerical PPO 70 70% of all negotiated rates 1566 percent of total billed charges 1566 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 872 percent of total billed charges 872 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 101 fee schedule 101 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Multiplan PPO 80 80% of all negotiated rates 1790 percent of total billed charges 1790 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 One Health PPO 55 55% of all negotiated rates 1320 percent of total billed charges 1320 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Optum Medicare HMO 39 39% of all negotiated rates 872 percent of total billed charges 872 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 P3 HMO 39 39% of all negotiated rates 872 percent of total billed charges 872 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1566 percent of total billed charges 1566 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Select Health HMO 41 41% of all negotiated rates 917 percent of total billed charges 917 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 749 percent of total billed charges 749 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Sierra/HPN HMO 60 60% of all negotiated rates 1342 percent of total billed charges 1342 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Silversummit Medicare HMO 39 39% of all negotiated rates 872 percent of total billed charges 872 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 783 percent of total billed charges 783 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 Teachers Trust PPO 68 68% of all negotiated rates 1521 percent of total billed charges 1521 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 TriWest PPO 30 30% of all negotiated rates 671 percent of total billed charges 671 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1566 percent of total billed charges 1566 2237 11011 DEBRIDE SKIN/MUS FX O/DIS 11011 CPT 3232129 LOCAL 450 RC outpatient 2237 1901 United Healthcare PPO 60 60% of all negotiated rates 1342 percent of total billed charges 1342 2237 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Aetna Medicare HMO 26 26% of all negotiated rates 340 percent of total billed charges 340 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Alignment Medicare HMO 39 39% of all negotiated rates 510 percent of total billed charges 510 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 784 percent of total billed charges 784 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 654 percent of total billed charges 654 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 404 fee schedule 404 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 510 percent of total billed charges 510 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Cigna PPO 68 68% of all negotiated rates 889 percent of total billed charges 889 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Coalition PPO 59 59% of all negotiated rates 771 percent of total billed charges 771 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Coventry PPO 75 75% of all negotiated rates 980 percent of total billed charges 980 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1046 percent of total billed charges 1046 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 404 fee schedule 404 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Humana-Commerical PPO 70 70% of all negotiated rates 915 percent of total billed charges 915 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 510 percent of total billed charges 510 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 404 fee schedule 404 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Multiplan PPO 80 80% of all negotiated rates 1046 percent of total billed charges 1046 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 One Health PPO 55 55% of all negotiated rates 771 percent of total billed charges 771 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Optum Medicare HMO 39 39% of all negotiated rates 510 percent of total billed charges 510 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 P3 HMO 39 39% of all negotiated rates 510 percent of total billed charges 510 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 915 percent of total billed charges 915 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Select Health HMO 41 41% of all negotiated rates 536 percent of total billed charges 536 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 438 percent of total billed charges 438 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Sierra/HPN HMO 60 60% of all negotiated rates 784 percent of total billed charges 784 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Silversummit Medicare HMO 39 39% of all negotiated rates 510 percent of total billed charges 510 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 457 percent of total billed charges 457 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 Teachers Trust PPO 68 68% of all negotiated rates 889 percent of total billed charges 889 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 TriWest PPO 30 30% of all negotiated rates 392 percent of total billed charges 392 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 UHN-Universal Health Network PPO 70 70% of all negotiated rates 915 percent of total billed charges 915 1307 11012 DEB REMOV F MAT SKIN/TISS/BONE ED CHARGE 11012 CPT 3235203 LOCAL 450 RC outpatient 1307 1111 United Healthcare PPO 60 60% of all negotiated rates 784 percent of total billed charges 784 1307 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Aetna Medicare HMO 26 26% of all negotiated rates 269 percent of total billed charges 269 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Alignment Medicare HMO 39 39% of all negotiated rates 404 percent of total billed charges 404 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 622 percent of total billed charges 622 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 518 percent of total billed charges 518 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 58 fee schedule 58 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 404 percent of total billed charges 404 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Cigna PPO 68 68% of all negotiated rates 704 percent of total billed charges 704 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Coalition PPO 59 59% of all negotiated rates 611 percent of total billed charges 611 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Coventry PPO 75 75% of all negotiated rates 777 percent of total billed charges 777 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 829 percent of total billed charges 829 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 58 fee schedule 58 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Humana-Commerical PPO 70 70% of all negotiated rates 725 percent of total billed charges 725 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 404 percent of total billed charges 404 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 58 fee schedule 58 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Multiplan PPO 80 80% of all negotiated rates 829 percent of total billed charges 829 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 One Health PPO 55 55% of all negotiated rates 611 percent of total billed charges 611 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Optum Medicare HMO 39 39% of all negotiated rates 404 percent of total billed charges 404 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 P3 HMO 39 39% of all negotiated rates 404 percent of total billed charges 404 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 725 percent of total billed charges 725 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Select Health HMO 41 41% of all negotiated rates 425 percent of total billed charges 425 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 347 percent of total billed charges 347 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Sierra/HPN HMO 60 60% of all negotiated rates 622 percent of total billed charges 622 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Silversummit Medicare HMO 39 39% of all negotiated rates 404 percent of total billed charges 404 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 363 percent of total billed charges 363 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 Teachers Trust PPO 68 68% of all negotiated rates 704 percent of total billed charges 704 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 TriWest PPO 30 30% of all negotiated rates 311 percent of total billed charges 311 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 UHN-Universal Health Network PPO 70 70% of all negotiated rates 725 percent of total billed charges 725 1036 11042 DEBRIDE SUBQ TISSUE 1ST 20SQCM ED CHARGE 11042 CPT 3230410 LOCAL 450 RC outpatient 1036 881 United Healthcare PPO 60 60% of all negotiated rates 622 percent of total billed charges 622 1036 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Aetna Medicare HMO 26 26% of all negotiated rates 232 percent of total billed charges 232 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Alignment Medicare HMO 39 39% of all negotiated rates 349 percent of total billed charges 349 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 536 percent of total billed charges 536 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 447 percent of total billed charges 447 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 349 percent of total billed charges 349 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Cigna PPO 68 68% of all negotiated rates 608 percent of total billed charges 608 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Coalition PPO 59 59% of all negotiated rates 527 percent of total billed charges 527 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Coventry PPO 75 75% of all negotiated rates 671 percent of total billed charges 671 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 715 percent of total billed charges 715 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Humana-Commerical PPO 70 70% of all negotiated rates 626 percent of total billed charges 626 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 349 percent of total billed charges 349 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Multiplan PPO 80 80% of all negotiated rates 715 percent of total billed charges 715 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 One Health PPO 55 55% of all negotiated rates 527 percent of total billed charges 527 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Optum Medicare HMO 39 39% of all negotiated rates 349 percent of total billed charges 349 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 P3 HMO 39 39% of all negotiated rates 349 percent of total billed charges 349 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 626 percent of total billed charges 626 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Select Health HMO 41 41% of all negotiated rates 367 percent of total billed charges 367 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 299 percent of total billed charges 299 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Sierra/HPN HMO 60 60% of all negotiated rates 536 percent of total billed charges 536 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Silversummit Medicare HMO 39 39% of all negotiated rates 349 percent of total billed charges 349 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 313 percent of total billed charges 313 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 Teachers Trust PPO 68 68% of all negotiated rates 608 percent of total billed charges 608 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 TriWest PPO 30 30% of all negotiated rates 268 percent of total billed charges 268 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 UHN-Universal Health Network PPO 70 70% of all negotiated rates 626 percent of total billed charges 626 894 11730 AVULSION OF NAIL PLATE ED CHARGE 11730 CPT 3237309 LOCAL 450 RC outpatient 894 760 United Healthcare PPO 60 60% of all negotiated rates 536 percent of total billed charges 536 894 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Aetna Medicare HMO 26 26% of all negotiated rates 81 percent of total billed charges 81 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Alignment Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 187 percent of total billed charges 187 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 156 percent of total billed charges 156 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 19 fee schedule 19 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Cigna PPO 68 68% of all negotiated rates 212 percent of total billed charges 212 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Coalition PPO 59 59% of all negotiated rates 184 percent of total billed charges 184 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Coventry PPO 75 75% of all negotiated rates 234 percent of total billed charges 234 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 250 percent of total billed charges 250 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 19 fee schedule 19 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Humana-Commerical PPO 70 70% of all negotiated rates 218 percent of total billed charges 218 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 19 fee schedule 19 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Multiplan PPO 80 80% of all negotiated rates 250 percent of total billed charges 250 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 One Health PPO 55 55% of all negotiated rates 184 percent of total billed charges 184 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Optum Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 P3 HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 218 percent of total billed charges 218 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Select Health HMO 41 41% of all negotiated rates 128 percent of total billed charges 128 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 105 percent of total billed charges 105 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Sierra/HPN HMO 60 60% of all negotiated rates 187 percent of total billed charges 187 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Silversummit Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 109 percent of total billed charges 109 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Teachers Trust PPO 68 68% of all negotiated rates 212 percent of total billed charges 212 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 TriWest PPO 30 30% of all negotiated rates 94 percent of total billed charges 94 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 UHN-Universal Health Network PPO 70 70% of all negotiated rates 218 percent of total billed charges 218 312 11732 EA. ADDL NAIL AVULSION CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 United Healthcare PPO 60 60% of all negotiated rates 187 percent of total billed charges 187 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Aetna Medicare HMO 26 26% of all negotiated rates 81 percent of total billed charges 81 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Alignment Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 187 percent of total billed charges 187 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 156 percent of total billed charges 156 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 19 fee schedule 19 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Cigna PPO 68 68% of all negotiated rates 212 percent of total billed charges 212 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Coalition PPO 59 59% of all negotiated rates 184 percent of total billed charges 184 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Coventry PPO 75 75% of all negotiated rates 234 percent of total billed charges 234 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 250 percent of total billed charges 250 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 19 fee schedule 19 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Humana-Commerical PPO 70 70% of all negotiated rates 218 percent of total billed charges 218 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 19 fee schedule 19 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Multiplan PPO 80 80% of all negotiated rates 250 percent of total billed charges 250 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 One Health PPO 55 55% of all negotiated rates 184 percent of total billed charges 184 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Optum Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 P3 HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 218 percent of total billed charges 218 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Select Health HMO 41 41% of all negotiated rates 128 percent of total billed charges 128 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 105 percent of total billed charges 105 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Sierra/HPN HMO 60 60% of all negotiated rates 187 percent of total billed charges 187 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Silversummit Medicare HMO 39 39% of all negotiated rates 122 percent of total billed charges 122 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 109 percent of total billed charges 109 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 Teachers Trust PPO 68 68% of all negotiated rates 212 percent of total billed charges 212 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 TriWest PPO 30 30% of all negotiated rates 94 percent of total billed charges 94 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 UHN-Universal Health Network PPO 70 70% of all negotiated rates 218 percent of total billed charges 218 312 11732 ED AVULSION OF NAIL PLATE PARTIAL/COMPLETE EACH ADD CHARGE 11732 CPT 3416115 LOCAL 450 RC outpatient 312 265 United Healthcare PPO 60 60% of all negotiated rates 187 percent of total billed charges 187 312 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Aetna Medicare HMO 26 26% of all negotiated rates 105 percent of total billed charges 105 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Alignment Medicare HMO 39 39% of all negotiated rates 157 percent of total billed charges 157 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 242 percent of total billed charges 242 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 202 percent of total billed charges 202 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 31 fee schedule 31 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 157 percent of total billed charges 157 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Cigna PPO 68 68% of all negotiated rates 274 percent of total billed charges 274 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Coalition PPO 59 59% of all negotiated rates 238 percent of total billed charges 238 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Coventry PPO 75 75% of all negotiated rates 302 percent of total billed charges 302 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 322 percent of total billed charges 322 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 31 fee schedule 31 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Humana-Commerical PPO 70 70% of all negotiated rates 282 percent of total billed charges 282 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 157 percent of total billed charges 157 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 31 fee schedule 31 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Multiplan PPO 80 80% of all negotiated rates 322 percent of total billed charges 322 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 One Health PPO 55 55% of all negotiated rates 238 percent of total billed charges 238 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Optum Medicare HMO 39 39% of all negotiated rates 157 percent of total billed charges 157 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 P3 HMO 39 39% of all negotiated rates 157 percent of total billed charges 157 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 282 percent of total billed charges 282 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Select Health HMO 41 41% of all negotiated rates 165 percent of total billed charges 165 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 135 percent of total billed charges 135 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Sierra/HPN HMO 60 60% of all negotiated rates 242 percent of total billed charges 242 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Silversummit Medicare HMO 39 39% of all negotiated rates 157 percent of total billed charges 157 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 141 percent of total billed charges 141 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 Teachers Trust PPO 68 68% of all negotiated rates 274 percent of total billed charges 274 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 TriWest PPO 30 30% of all negotiated rates 121 percent of total billed charges 121 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 UHN-Universal Health Network PPO 70 70% of all negotiated rates 282 percent of total billed charges 282 403 11740 ED EVACUATION OF SUBUNGUAL HEMATOMA CHARGE 11740 CPT 3237408 LOCAL 450 RC outpatient 403 343 United Healthcare PPO 60 60% of all negotiated rates 242 percent of total billed charges 242 403 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Aetna Medicare HMO 26 26% of all negotiated rates 481 percent of total billed charges 481 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Alignment Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1110 percent of total billed charges 1110 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 925 percent of total billed charges 925 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 164 fee schedule 164 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Cigna PPO 68 68% of all negotiated rates 1258 percent of total billed charges 1258 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Coalition PPO 59 59% of all negotiated rates 1092 percent of total billed charges 1092 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Coventry PPO 75 75% of all negotiated rates 1388 percent of total billed charges 1388 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1480 percent of total billed charges 1480 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 164 fee schedule 164 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Humana-Commerical PPO 70 70% of all negotiated rates 1295 percent of total billed charges 1295 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 164 fee schedule 164 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Multiplan PPO 80 80% of all negotiated rates 1480 percent of total billed charges 1480 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 One Health PPO 55 55% of all negotiated rates 1092 percent of total billed charges 1092 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Optum Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 P3 HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1295 percent of total billed charges 1295 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Select Health HMO 41 41% of all negotiated rates 759 percent of total billed charges 759 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 620 percent of total billed charges 620 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Sierra/HPN HMO 60 60% of all negotiated rates 1110 percent of total billed charges 1110 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Silversummit Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 648 percent of total billed charges 648 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 Teachers Trust PPO 68 68% of all negotiated rates 1258 percent of total billed charges 1258 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 TriWest PPO 30 30% of all negotiated rates 555 percent of total billed charges 555 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1295 percent of total billed charges 1295 1850 11750 ED EXC NAIL/MATRIX CHARGE 11750 CPT 3237507 LOCAL 450 RC outpatient 1850 1573 United Healthcare PPO 60 60% of all negotiated rates 1110 percent of total billed charges 1110 1850 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Aetna Medicare HMO 26 26% of all negotiated rates 154 percent of total billed charges 154 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Alignment Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 355 percent of total billed charges 355 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 296 percent of total billed charges 296 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 127 fee schedule 127 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Cigna PPO 68 68% of all negotiated rates 402 percent of total billed charges 402 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Coalition PPO 59 59% of all negotiated rates 349 percent of total billed charges 349 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Coventry PPO 75 75% of all negotiated rates 443 percent of total billed charges 443 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 473 percent of total billed charges 473 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 127 fee schedule 127 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Humana-Commerical PPO 70 70% of all negotiated rates 414 percent of total billed charges 414 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 127 fee schedule 127 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Multiplan PPO 80 80% of all negotiated rates 473 percent of total billed charges 473 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 One Health PPO 55 55% of all negotiated rates 349 percent of total billed charges 349 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Optum Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 P3 HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 414 percent of total billed charges 414 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Select Health HMO 41 41% of all negotiated rates 242 percent of total billed charges 242 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 198 percent of total billed charges 198 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Sierra/HPN HMO 60 60% of all negotiated rates 355 percent of total billed charges 355 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Silversummit Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 207 percent of total billed charges 207 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 Teachers Trust PPO 68 68% of all negotiated rates 402 percent of total billed charges 402 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 TriWest PPO 30 30% of all negotiated rates 177 percent of total billed charges 177 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 UHN-Universal Health Network PPO 70 70% of all negotiated rates 414 percent of total billed charges 414 591 11760 ED REPAIR OF NAIL BED CHARGE 11760 CPT 3230112 LOCAL 450 RC outpatient 591 502 United Healthcare PPO 60 60% of all negotiated rates 355 percent of total billed charges 355 591 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Aetna Medicare HMO 26 26% of all negotiated rates 411 percent of total billed charges 411 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Alignment Medicare HMO 39 39% of all negotiated rates 617 percent of total billed charges 617 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 949 percent of total billed charges 949 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 791 percent of total billed charges 791 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 617 percent of total billed charges 617 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Cigna PPO 68 68% of all negotiated rates 1075 percent of total billed charges 1075 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Coalition PPO 59 59% of all negotiated rates 933 percent of total billed charges 933 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Coventry PPO 75 75% of all negotiated rates 1186 percent of total billed charges 1186 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1265 percent of total billed charges 1265 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Humana-Commerical PPO 70 70% of all negotiated rates 1107 percent of total billed charges 1107 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 617 percent of total billed charges 617 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Multiplan PPO 80 80% of all negotiated rates 1265 percent of total billed charges 1265 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 One Health PPO 55 55% of all negotiated rates 933 percent of total billed charges 933 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Optum Medicare HMO 39 39% of all negotiated rates 617 percent of total billed charges 617 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 P3 HMO 39 39% of all negotiated rates 617 percent of total billed charges 617 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1107 percent of total billed charges 1107 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Select Health HMO 41 41% of all negotiated rates 648 percent of total billed charges 648 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 530 percent of total billed charges 530 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Sierra/HPN HMO 60 60% of all negotiated rates 949 percent of total billed charges 949 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Silversummit Medicare HMO 39 39% of all negotiated rates 617 percent of total billed charges 617 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 553 percent of total billed charges 553 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 Teachers Trust PPO 68 68% of all negotiated rates 1075 percent of total billed charges 1075 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 TriWest PPO 30 30% of all negotiated rates 474 percent of total billed charges 474 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1107 percent of total billed charges 1107 1581 11765 ED WEDGE EXCISION SKIN OF NAIL FOLD CHARGE 11765 CPT 3237510 LOCAL 450 RC outpatient 1581 1344 United Healthcare PPO 60 60% of all negotiated rates 949 percent of total billed charges 949 1581 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 43 fee schedule 43 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 43 fee schedule 43 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 43 fee schedule 43 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12001 SIMP REPR <2.5CM ED Charge 12001 CPT 3230014 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 56 fee schedule 56 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 56 fee schedule 56 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 56 fee schedule 56 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12002 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 2.6 TO 7.5CM CHARGE 12002 CPT 3230022 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 70 fee schedule 70 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 70 fee schedule 70 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 70 fee schedule 70 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12004 SIMP RPR 7.6-12.5CM ED Charge 12004 CPT 3230048 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 95 fee schedule 95 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 95 fee schedule 95 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 95 fee schedule 95 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12005 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 12.6 TO 20.0CM CHARGE 12005 CPT 3230055 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12006 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT 20.1 TO 30.0CM CHARGE 12006 CPT 3230059 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Cigna PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Coalition PPO 59 59% of all negotiated rates 346 percent of total billed charges 346 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Coventry PPO 75 75% of all negotiated rates 440 percent of total billed charges 440 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Humana-Commerical PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 One Health PPO 55 55% of all negotiated rates 346 percent of total billed charges 346 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Sierra/HPN HMO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 205 percent of total billed charges 205 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 Teachers Trust PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 UHN-Universal Health Network PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12007 ED REPAIR SMPL WOUNDS SP-NK-TR-EXT OVER 30.0CM CHARGE 12007 CPT 3230062 LOCAL 450 RC outpatient 587 499 United Healthcare PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 53 fee schedule 53 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 53 fee schedule 53 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 53 fee schedule 53 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12011 ED REPAIR SMPL WOUNDS FACE-MM <2.5CM CHARGE 12011 CPT 3230113 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 59 fee schedule 59 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 59 fee schedule 59 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 59 fee schedule 59 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12013 ED REPAIR SMPL WOUNDS FACE-MM 2.6 TO 5.0CM CHARGE 12013 CPT 3230139 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 76 fee schedule 76 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 76 fee schedule 76 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 76 fee schedule 76 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12014 ED REPAIR SMPL WOUNDS FACE-MM 5.1 TO 7.5CM CHARGE 12014 CPT 3230147 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 94 fee schedule 94 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 94 fee schedule 94 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 94 fee schedule 94 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12015 ED REPAIR SMPL WOUNDS FACE-MM 7.6 TO 12.5CM CHARGE 12015 CPT 3230063 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Cigna PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Coalition PPO 59 59% of all negotiated rates 346 percent of total billed charges 346 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Coventry PPO 75 75% of all negotiated rates 440 percent of total billed charges 440 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Humana-Commerical PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 One Health PPO 55 55% of all negotiated rates 346 percent of total billed charges 346 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Sierra/HPN HMO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 205 percent of total billed charges 205 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 Teachers Trust PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 UHN-Universal Health Network PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12017 ED REPAIR SMPL WOUNDS FACE-MM 20.1 TO 30.0CM CHARGE 12017 CPT 3230065 LOCAL 450 RC outpatient 587 499 United Healthcare PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Cigna PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Coalition PPO 59 59% of all negotiated rates 346 percent of total billed charges 346 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Coventry PPO 75 75% of all negotiated rates 440 percent of total billed charges 440 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Humana-Commerical PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 One Health PPO 55 55% of all negotiated rates 346 percent of total billed charges 346 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Sierra/HPN HMO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 205 percent of total billed charges 205 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 Teachers Trust PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 UHN-Universal Health Network PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12018 S LAC OVER 30.1 cm 12018 CPT 3230066 LOCAL 450 RC outpatient 587 499 United Healthcare PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Aetna Medicare HMO 26 26% of all negotiated rates 714 percent of total billed charges 714 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Alignment Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1374 percent of total billed charges 1374 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 181 fee schedule 181 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Cigna PPO 68 68% of all negotiated rates 1868 percent of total billed charges 1868 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Coalition PPO 59 59% of all negotiated rates 1621 percent of total billed charges 1621 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Coventry PPO 75 75% of all negotiated rates 2060 percent of total billed charges 2060 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2198 percent of total billed charges 2198 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 181 fee schedule 181 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Humana-Commerical PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 181 fee schedule 181 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Multiplan PPO 80 80% of all negotiated rates 2198 percent of total billed charges 2198 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 One Health PPO 55 55% of all negotiated rates 1621 percent of total billed charges 1621 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Optum Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 P3 HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Select Health HMO 41 41% of all negotiated rates 1126 percent of total billed charges 1126 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 920 percent of total billed charges 920 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Sierra/HPN HMO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Silversummit Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 961 percent of total billed charges 961 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 Teachers Trust PPO 68 68% of all negotiated rates 1868 percent of total billed charges 1868 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 TriWest PPO 30 30% of all negotiated rates 824 percent of total billed charges 824 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 12020 CLOSURE OF SPLIT WOUND ED CHARGE 12020 CPT 3230086 LOCAL 450 RC outpatient 2747 2335 United Healthcare PPO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 134 fee schedule 134 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 820 percent of total billed charges 820 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 134 fee schedule 134 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 134 fee schedule 134 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 820 percent of total billed charges 820 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12021 ED WOUND DEHISCENCE/PACKING CHARGE 12021 CPT 3230071 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 145 fee schedule 145 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Cigna PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Coalition PPO 59 59% of all negotiated rates 346 percent of total billed charges 346 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Coventry PPO 75 75% of all negotiated rates 440 percent of total billed charges 440 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 145 fee schedule 145 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Humana-Commerical PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 145 fee schedule 145 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 One Health PPO 55 55% of all negotiated rates 346 percent of total billed charges 346 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Sierra/HPN HMO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 205 percent of total billed charges 205 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 Teachers Trust PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 UHN-Universal Health Network PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12031 ED INTERMEDIATE CLOSURE WOUNDS <2.5CM CHARGE 12031 CPT 3230015 LOCAL 450 RC outpatient 587 499 United Healthcare PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Aetna Medicare HMO 26 26% of all negotiated rates 344 percent of total billed charges 344 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Alignment Medicare HMO 39 39% of all negotiated rates 516 percent of total billed charges 516 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 794 percent of total billed charges 794 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 662 percent of total billed charges 662 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 184 fee schedule 184 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 516 percent of total billed charges 516 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Cigna PPO 68 68% of all negotiated rates 900 percent of total billed charges 900 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Coalition PPO 59 59% of all negotiated rates 781 percent of total billed charges 781 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Coventry PPO 75 75% of all negotiated rates 992 percent of total billed charges 992 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1058 percent of total billed charges 1058 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 184 fee schedule 184 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Humana-Commerical PPO 70 70% of all negotiated rates 926 percent of total billed charges 926 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 516 percent of total billed charges 516 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 184 fee schedule 184 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Multiplan PPO 80 80% of all negotiated rates 1058 percent of total billed charges 1058 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 One Health PPO 55 55% of all negotiated rates 781 percent of total billed charges 781 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Optum Medicare HMO 39 39% of all negotiated rates 516 percent of total billed charges 516 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 P3 HMO 39 39% of all negotiated rates 516 percent of total billed charges 516 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 926 percent of total billed charges 926 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Select Health HMO 41 41% of all negotiated rates 542 percent of total billed charges 542 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 443 percent of total billed charges 443 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Sierra/HPN HMO 60 60% of all negotiated rates 794 percent of total billed charges 794 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Silversummit Medicare HMO 39 39% of all negotiated rates 516 percent of total billed charges 516 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 463 percent of total billed charges 463 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 Teachers Trust PPO 68 68% of all negotiated rates 900 percent of total billed charges 900 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 TriWest PPO 30 30% of all negotiated rates 397 percent of total billed charges 397 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 UHN-Universal Health Network PPO 70 70% of all negotiated rates 926 percent of total billed charges 926 1323 12032 I LAC 2.6 cm TO 7.5 12032 CPT 3230016 LOCAL 450 RC outpatient 1323 1125 United Healthcare PPO 60 60% of all negotiated rates 794 percent of total billed charges 794 1323 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 196 fee schedule 196 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 196 fee schedule 196 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 196 fee schedule 196 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12034 ED INTERMEDIATE CLOSURE WOUNDS 7.6 TO 12.5CM CHARGE 12034 CPT 3230017 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 230 fee schedule 230 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 230 fee schedule 230 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 230 fee schedule 230 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12035 ED INTERMEDIATE CLOSURE WOUNDS 12.6 TO 20.0CM CHARGE 12035 CPT 3230067 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 267 fee schedule 267 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 820 percent of total billed charges 820 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 267 fee schedule 267 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 267 fee schedule 267 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 820 percent of total billed charges 820 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12036 ED INTERMEDIATE CLOSURE WOUNDS 20.1 TO 30.0CM CHARGE 12036 CPT 3230073 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 312 fee schedule 312 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 820 percent of total billed charges 820 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 312 fee schedule 312 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 312 fee schedule 312 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 820 percent of total billed charges 820 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12037 ED INTERMEDIATE CLOSURE WOUNDS OVER 30.0CM CHARGE 12037 CPT 3230072 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 148 fee schedule 148 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 148 fee schedule 148 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 148 fee schedule 148 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12041 ED LAYERED CLOSURE OF WOUNDS <2.5CM CHARGE 12041 CPT 3230018 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Aetna Medicare HMO 26 26% of all negotiated rates 210 percent of total billed charges 210 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Alignment Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 485 percent of total billed charges 485 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 405 percent of total billed charges 405 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 189 fee schedule 189 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Cigna PPO 68 68% of all negotiated rates 550 percent of total billed charges 550 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Coalition PPO 59 59% of all negotiated rates 477 percent of total billed charges 477 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Coventry PPO 75 75% of all negotiated rates 607 percent of total billed charges 607 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 647 percent of total billed charges 647 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 189 fee schedule 189 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Humana-Commerical PPO 70 70% of all negotiated rates 566 percent of total billed charges 566 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 189 fee schedule 189 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Multiplan PPO 80 80% of all negotiated rates 647 percent of total billed charges 647 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 One Health PPO 55 55% of all negotiated rates 477 percent of total billed charges 477 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Optum Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 P3 HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 566 percent of total billed charges 566 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Select Health HMO 41 41% of all negotiated rates 332 percent of total billed charges 332 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 271 percent of total billed charges 271 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Sierra/HPN HMO 60 60% of all negotiated rates 485 percent of total billed charges 485 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Silversummit Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 283 percent of total billed charges 283 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 Teachers Trust PPO 68 68% of all negotiated rates 550 percent of total billed charges 550 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 TriWest PPO 30 30% of all negotiated rates 243 percent of total billed charges 243 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 UHN-Universal Health Network PPO 70 70% of all negotiated rates 566 percent of total billed charges 566 809 12042 ED LAYERED CLOSURE OF WOUNDS 2.6 TO 7.5CM CHARGE 12042 CPT 3230019 LOCAL 450 RC outpatient 809 688 United Healthcare PPO 60 60% of all negotiated rates 485 percent of total billed charges 485 809 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 204 fee schedule 204 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Cigna PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Coalition PPO 59 59% of all negotiated rates 346 percent of total billed charges 346 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Coventry PPO 75 75% of all negotiated rates 440 percent of total billed charges 440 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 204 fee schedule 204 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Humana-Commerical PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 204 fee schedule 204 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 One Health PPO 55 55% of all negotiated rates 346 percent of total billed charges 346 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Sierra/HPN HMO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 205 percent of total billed charges 205 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 Teachers Trust PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 UHN-Universal Health Network PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 12044 ED LAYERED CLOSURE OF WOUNDS 7.6 TO 12.5CM CHARGE 12044 CPT 3230023 LOCAL 450 RC outpatient 587 499 United Healthcare PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 256 fee schedule 256 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 820 percent of total billed charges 820 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 256 fee schedule 256 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 256 fee schedule 256 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 820 percent of total billed charges 820 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12045 ED LAYERED CLOSURE OF WOUNDS 12.6 TO 20.0CM CHARGE 12045 CPT 3230074 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 291 fee schedule 291 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 820 percent of total billed charges 820 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 291 fee schedule 291 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 291 fee schedule 291 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 820 percent of total billed charges 820 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12046 I LAC 20.1 cm TO 30.0 12046 CPT 3230075 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 324 fee schedule 324 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 820 percent of total billed charges 820 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 324 fee schedule 324 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 324 fee schedule 324 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 820 percent of total billed charges 820 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12047 I LAC OVER 30.0 cm 12047 CPT 3230076 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Aetna Medicare HMO 26 26% of all negotiated rates 380 percent of total billed charges 380 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Alignment Medicare HMO 39 39% of all negotiated rates 569 percent of total billed charges 569 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 876 percent of total billed charges 876 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 730 percent of total billed charges 730 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 162 fee schedule 162 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 569 percent of total billed charges 569 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Cigna PPO 68 68% of all negotiated rates 993 percent of total billed charges 993 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Coalition PPO 59 59% of all negotiated rates 861 percent of total billed charges 861 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Coventry PPO 75 75% of all negotiated rates 1095 percent of total billed charges 1095 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1168 percent of total billed charges 1168 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 162 fee schedule 162 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Humana-Commerical PPO 70 70% of all negotiated rates 1022 percent of total billed charges 1022 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 569 percent of total billed charges 569 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 162 fee schedule 162 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Multiplan PPO 80 80% of all negotiated rates 1168 percent of total billed charges 1168 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 One Health PPO 55 55% of all negotiated rates 861 percent of total billed charges 861 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Optum Medicare HMO 39 39% of all negotiated rates 569 percent of total billed charges 569 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 P3 HMO 39 39% of all negotiated rates 569 percent of total billed charges 569 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1022 percent of total billed charges 1022 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Select Health HMO 41 41% of all negotiated rates 599 percent of total billed charges 599 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 489 percent of total billed charges 489 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Sierra/HPN HMO 60 60% of all negotiated rates 876 percent of total billed charges 876 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Silversummit Medicare HMO 39 39% of all negotiated rates 569 percent of total billed charges 569 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 511 percent of total billed charges 511 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 Teachers Trust PPO 68 68% of all negotiated rates 993 percent of total billed charges 993 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 TriWest PPO 30 30% of all negotiated rates 438 percent of total billed charges 438 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1022 percent of total billed charges 1022 1460 12051 ED LAYERED CLOSURE OF WOUNDS OF FACE <2.5CM CHARGE 12051 CPT 3230024 LOCAL 450 RC outpatient 1460 1241 United Healthcare PPO 60 60% of all negotiated rates 876 percent of total billed charges 876 1460 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 192 fee schedule 192 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 192 fee schedule 192 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 192 fee schedule 192 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12052 ED LAYERED CLOSURE OF WOUNDS OF FACE 2.6 TO 5.0CM CHARGE 12052 CPT 3230025 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 206 fee schedule 206 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 330 percent of total billed charges 330 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 206 fee schedule 206 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 206 fee schedule 206 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 330 percent of total billed charges 330 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12053 ED LAYERED CLOSURE OF WOUNDS OF FACE 5.1 TO 7.5CM CHARGE 12053 CPT 3230026 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Aetna Medicare HMO 26 26% of all negotiated rates 146 percent of total billed charges 146 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Alignment Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 280 percent of total billed charges 280 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 217 fee schedule 217 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Cigna PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Coalition PPO 59 59% of all negotiated rates 381 percent of total billed charges 381 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Coventry PPO 75 75% of all negotiated rates 420 percent of total billed charges 420 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 217 fee schedule 217 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Humana-Commerical PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 217 fee schedule 217 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Multiplan PPO 80 80% of all negotiated rates 448 percent of total billed charges 448 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 One Health PPO 55 55% of all negotiated rates 381 percent of total billed charges 381 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Optum Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 P3 HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Select Health HMO 41 41% of all negotiated rates 230 percent of total billed charges 230 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 188 percent of total billed charges 188 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Sierra/HPN HMO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Silversummit Medicare HMO 39 39% of all negotiated rates 218 percent of total billed charges 218 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 196 percent of total billed charges 196 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 Teachers Trust PPO 68 68% of all negotiated rates 381 percent of total billed charges 381 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 TriWest PPO 30 30% of all negotiated rates 168 percent of total billed charges 168 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 UHN-Universal Health Network PPO 70 70% of all negotiated rates 392 percent of total billed charges 392 560 12054 ED LAYERED CLOSURE OF WOUNDS OF FACE 7.6 TO 12.5CM CHARGE 12054 CPT 3230068 LOCAL 450 RC outpatient 560 476 United Healthcare PPO 60 60% of all negotiated rates 336 percent of total billed charges 336 560 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Aetna Medicare HMO 26 26% of all negotiated rates 439 percent of total billed charges 439 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Alignment Medicare HMO 39 39% of all negotiated rates 658 percent of total billed charges 658 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1013 percent of total billed charges 1013 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 844 percent of total billed charges 844 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 658 percent of total billed charges 658 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Cigna PPO 68 68% of all negotiated rates 1148 percent of total billed charges 1148 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Coalition PPO 59 59% of all negotiated rates 1148 percent of total billed charges 1148 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Coventry PPO 75 75% of all negotiated rates 1266 percent of total billed charges 1266 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1350 percent of total billed charges 1350 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Humana-Commerical PPO 70 70% of all negotiated rates 1182 percent of total billed charges 1182 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 658 percent of total billed charges 658 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Multiplan PPO 80 80% of all negotiated rates 1350 percent of total billed charges 1350 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 One Health PPO 55 55% of all negotiated rates 1148 percent of total billed charges 1148 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Optum Medicare HMO 39 39% of all negotiated rates 658 percent of total billed charges 658 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 P3 HMO 39 39% of all negotiated rates 658 percent of total billed charges 658 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1182 percent of total billed charges 1182 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Select Health HMO 41 41% of all negotiated rates 692 percent of total billed charges 692 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 565 percent of total billed charges 565 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Sierra/HPN HMO 60 60% of all negotiated rates 1013 percent of total billed charges 1013 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Silversummit Medicare HMO 39 39% of all negotiated rates 658 percent of total billed charges 658 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 591 percent of total billed charges 591 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 Teachers Trust PPO 68 68% of all negotiated rates 1148 percent of total billed charges 1148 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 TriWest PPO 30 30% of all negotiated rates 506 percent of total billed charges 506 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1182 percent of total billed charges 1182 1688 12055 I LAC 12.6 cm TO 20.0 12055 CPT 3230077 LOCAL 450 RC outpatient 1688 1435 United Healthcare PPO 60 60% of all negotiated rates 1013 percent of total billed charges 1013 1688 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 358 fee schedule 358 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 945 percent of total billed charges 945 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 358 fee schedule 358 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 358 fee schedule 358 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 945 percent of total billed charges 945 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12056 I LAC 20.1 cm TO 30.0 12056 CPT 3230078 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 360 fee schedule 360 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 945 percent of total billed charges 945 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 360 fee schedule 360 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 360 fee schedule 360 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 945 percent of total billed charges 945 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 12057 INTERM OVER 30.0 CM ED Charge 12057 CPT 3230079 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Aetna Medicare HMO 26 26% of all negotiated rates 714 percent of total billed charges 714 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Alignment Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1374 percent of total billed charges 1374 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 195 fee schedule 195 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Cigna PPO 68 68% of all negotiated rates 1868 percent of total billed charges 1868 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Coalition PPO 59 59% of all negotiated rates 1868 percent of total billed charges 1868 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Coventry PPO 75 75% of all negotiated rates 2060 percent of total billed charges 2060 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2198 percent of total billed charges 2198 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 195 fee schedule 195 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Humana-Commerical PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 195 fee schedule 195 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Multiplan PPO 80 80% of all negotiated rates 2198 percent of total billed charges 2198 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 One Health PPO 55 55% of all negotiated rates 1868 percent of total billed charges 1868 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Optum Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 P3 HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Select Health HMO 41 41% of all negotiated rates 1126 percent of total billed charges 1126 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 920 percent of total billed charges 920 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Sierra/HPN HMO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Silversummit Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 961 percent of total billed charges 961 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 Teachers Trust PPO 68 68% of all negotiated rates 1868 percent of total billed charges 1868 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 TriWest PPO 30 30% of all negotiated rates 824 percent of total billed charges 824 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 13100 ED CMPLX REPAIR 1.1-2.5 CM CHARGE 13100 CPT 3230087 LOCAL 450 RC outpatient 2747 2335 United Healthcare PPO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Aetna Medicare HMO 26 26% of all negotiated rates 714 percent of total billed charges 714 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Alignment Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1374 percent of total billed charges 1374 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 240 fee schedule 240 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Cigna PPO 68 68% of all negotiated rates 1868 percent of total billed charges 1868 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Coalition PPO 59 59% of all negotiated rates 1868 percent of total billed charges 1868 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Coventry PPO 75 75% of all negotiated rates 2060 percent of total billed charges 2060 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2198 percent of total billed charges 2198 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 240 fee schedule 240 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Humana-Commerical PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 240 fee schedule 240 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Multiplan PPO 80 80% of all negotiated rates 2198 percent of total billed charges 2198 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 One Health PPO 55 55% of all negotiated rates 1868 percent of total billed charges 1868 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Optum Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 P3 HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Select Health HMO 41 41% of all negotiated rates 1126 percent of total billed charges 1126 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 920 percent of total billed charges 920 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Sierra/HPN HMO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Silversummit Medicare HMO 39 39% of all negotiated rates 1071 percent of total billed charges 1071 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 961 percent of total billed charges 961 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 Teachers Trust PPO 68 68% of all negotiated rates 1868 percent of total billed charges 1868 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 TriWest PPO 30 30% of all negotiated rates 824 percent of total billed charges 824 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1923 percent of total billed charges 1923 2747 "13101 ED REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM CHARGE" 13101 CPT 3230088 LOCAL 450 RC outpatient 2747 2335 United Healthcare PPO 60 60% of all negotiated rates 1648 percent of total billed charges 1648 2747 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Aetna Medicare HMO 26 26% of all negotiated rates 530 percent of total billed charges 530 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Alignment Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1019 percent of total billed charges 1019 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 71 fee schedule 71 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Cigna PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Coalition PPO 59 59% of all negotiated rates 1385 percent of total billed charges 1385 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Coventry PPO 75 75% of all negotiated rates 1528 percent of total billed charges 1528 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 71 fee schedule 71 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Humana-Commerical PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 71 fee schedule 71 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Multiplan PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 One Health PPO 55 55% of all negotiated rates 1385 percent of total billed charges 1385 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Optum Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 P3 HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Select Health HMO 41 41% of all negotiated rates 835 percent of total billed charges 835 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 682 percent of total billed charges 682 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Sierra/HPN HMO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Silversummit Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 713 percent of total billed charges 713 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 Teachers Trust PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 TriWest PPO 30 30% of all negotiated rates 611 percent of total billed charges 611 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13102 ED CMPLX REPAIR EA ADD 5 CM CHARGE 13102 CPT 3230089 LOCAL 450 RC outpatient 2037 1731 United Healthcare PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Aetna Medicare HMO 26 26% of all negotiated rates 487 percent of total billed charges 487 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Alignment Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1123 percent of total billed charges 1123 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 936 percent of total billed charges 936 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 224 fee schedule 224 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Cigna PPO 68 68% of all negotiated rates 1273 percent of total billed charges 1273 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Coalition PPO 59 59% of all negotiated rates 1273 percent of total billed charges 1273 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Coventry PPO 75 75% of all negotiated rates 1404 percent of total billed charges 1404 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1498 percent of total billed charges 1498 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 224 fee schedule 224 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Humana-Commerical PPO 70 70% of all negotiated rates 1310 percent of total billed charges 1310 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 224 fee schedule 224 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Multiplan PPO 80 80% of all negotiated rates 1498 percent of total billed charges 1498 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 One Health PPO 55 55% of all negotiated rates 1273 percent of total billed charges 1273 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Optum Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 P3 HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1310 percent of total billed charges 1310 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Select Health HMO 41 41% of all negotiated rates 768 percent of total billed charges 768 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 627 percent of total billed charges 627 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Sierra/HPN HMO 60 60% of all negotiated rates 1123 percent of total billed charges 1123 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Silversummit Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 655 percent of total billed charges 655 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 Teachers Trust PPO 68 68% of all negotiated rates 1273 percent of total billed charges 1273 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 TriWest PPO 30 30% of all negotiated rates 562 percent of total billed charges 562 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1310 percent of total billed charges 1310 1872 13120 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 1.1 TO 2.5CM CHARGE 13120 CPT 3230081 LOCAL 450 RC outpatient 1872 1591 United Healthcare PPO 60 60% of all negotiated rates 1123 percent of total billed charges 1123 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Aetna Medicare HMO 26 26% of all negotiated rates 487 percent of total billed charges 487 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Alignment Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1123 percent of total billed charges 1123 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 936 percent of total billed charges 936 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 253 fee schedule 253 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Cigna PPO 68 68% of all negotiated rates 1273 percent of total billed charges 1273 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Coalition PPO 59 59% of all negotiated rates 1273 percent of total billed charges 1273 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Coventry PPO 75 75% of all negotiated rates 1404 percent of total billed charges 1404 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1498 percent of total billed charges 1498 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 253 fee schedule 253 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Humana-Commerical PPO 70 70% of all negotiated rates 1310 percent of total billed charges 1310 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 253 fee schedule 253 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Multiplan PPO 80 80% of all negotiated rates 1498 percent of total billed charges 1498 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 One Health PPO 55 55% of all negotiated rates 1273 percent of total billed charges 1273 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Optum Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 P3 HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1310 percent of total billed charges 1310 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Select Health HMO 41 41% of all negotiated rates 768 percent of total billed charges 768 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 627 percent of total billed charges 627 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Sierra/HPN HMO 60 60% of all negotiated rates 1123 percent of total billed charges 1123 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Silversummit Medicare HMO 39 39% of all negotiated rates 730 percent of total billed charges 730 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 655 percent of total billed charges 655 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 Teachers Trust PPO 68 68% of all negotiated rates 1273 percent of total billed charges 1273 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 TriWest PPO 30 30% of all negotiated rates 562 percent of total billed charges 562 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1310 percent of total billed charges 1310 1872 13121 ED COMPLEX REPAIR WOUNDS SCLP/ARMS/LEGS 2.6 TO 7.5CM CHARGE 13121 CPT 3230082 LOCAL 450 RC outpatient 1872 1591 United Healthcare PPO 60 60% of all negotiated rates 1123 percent of total billed charges 1123 1872 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 82 fee schedule 82 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Cigna PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Coalition PPO 59 59% of all negotiated rates 399 percent of total billed charges 399 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Coventry PPO 75 75% of all negotiated rates 440 percent of total billed charges 440 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 82 fee schedule 82 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Humana-Commerical PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 82 fee schedule 82 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 One Health PPO 55 55% of all negotiated rates 399 percent of total billed charges 399 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Sierra/HPN HMO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 205 percent of total billed charges 205 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 Teachers Trust PPO 68 68% of all negotiated rates 399 percent of total billed charges 399 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 UHN-Universal Health Network PPO 70 70% of all negotiated rates 411 percent of total billed charges 411 587 13122 ED REPAIR COMPLEX WOUND EA ADD'L 5 CM CHARGE 13122 CPT 3230069 LOCAL 450 RC outpatient 587 499 United Healthcare PPO 60 60% of all negotiated rates 352 percent of total billed charges 352 587 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 237 fee schedule 237 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 945 percent of total billed charges 945 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 237 fee schedule 237 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 237 fee schedule 237 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 945 percent of total billed charges 945 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 13131 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 1.1 TO 2.5CM CHARGE 13131 CPT 3230083 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Aetna Medicare HMO 26 26% of all negotiated rates 735 percent of total billed charges 735 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Alignment Medicare HMO 39 39% of all negotiated rates 1103 percent of total billed charges 1103 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1697 percent of total billed charges 1697 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1414 percent of total billed charges 1414 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 298 fee schedule 298 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1103 percent of total billed charges 1103 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Cigna PPO 68 68% of all negotiated rates 1923 percent of total billed charges 1923 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Coalition PPO 59 59% of all negotiated rates 1923 percent of total billed charges 1923 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Coventry PPO 75 75% of all negotiated rates 2121 percent of total billed charges 2121 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2262 percent of total billed charges 2262 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 298 fee schedule 298 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Humana-Commerical PPO 70 70% of all negotiated rates 1980 percent of total billed charges 1980 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1103 percent of total billed charges 1103 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 298 fee schedule 298 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Multiplan PPO 80 80% of all negotiated rates 2262 percent of total billed charges 2262 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 One Health PPO 55 55% of all negotiated rates 1923 percent of total billed charges 1923 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Optum Medicare HMO 39 39% of all negotiated rates 1103 percent of total billed charges 1103 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 P3 HMO 39 39% of all negotiated rates 1103 percent of total billed charges 1103 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1980 percent of total billed charges 1980 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Select Health HMO 41 41% of all negotiated rates 1159 percent of total billed charges 1159 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 947 percent of total billed charges 947 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Sierra/HPN HMO 60 60% of all negotiated rates 1697 percent of total billed charges 1697 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Silversummit Medicare HMO 39 39% of all negotiated rates 1103 percent of total billed charges 1103 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 990 percent of total billed charges 990 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 Teachers Trust PPO 68 68% of all negotiated rates 1923 percent of total billed charges 1923 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 TriWest PPO 30 30% of all negotiated rates 848 percent of total billed charges 848 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1980 percent of total billed charges 1980 2828 13132 ED COMPLEX REPAIR WOUNDS FACE/NECK/HANDS/FEET 2.6 TO 7.5CM CHARGE 13132 CPT 3230027 LOCAL 450 RC outpatient 2828 2404 United Healthcare PPO 60 60% of all negotiated rates 1697 percent of total billed charges 1697 2828 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 125 fee schedule 125 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 945 percent of total billed charges 945 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 125 fee schedule 125 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 125 fee schedule 125 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 945 percent of total billed charges 945 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 "13133 ED REPAIR COMPLEX FOREHEAD/CHEEK/MOUTH/NECK,AXILLAE,GENITALIA,HANDS AND/OR" 13133 CPT 3230084 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Aetna Medicare HMO 26 26% of all negotiated rates 530 percent of total billed charges 530 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Alignment Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1019 percent of total billed charges 1019 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Cigna PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Coalition PPO 59 59% of all negotiated rates 1385 percent of total billed charges 1385 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Coventry PPO 75 75% of all negotiated rates 1528 percent of total billed charges 1528 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Humana-Commerical PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Multiplan PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 One Health PPO 55 55% of all negotiated rates 1385 percent of total billed charges 1385 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Optum Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 P3 HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Select Health HMO 41 41% of all negotiated rates 835 percent of total billed charges 835 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 682 percent of total billed charges 682 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Sierra/HPN HMO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Silversummit Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 713 percent of total billed charges 713 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 Teachers Trust PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 TriWest PPO 30 30% of all negotiated rates 611 percent of total billed charges 611 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13150 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP <1.0CM CHARGE 13150 CPT 3230090 LOCAL 450 RC outpatient 2037 1731 United Healthcare PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Aetna Medicare HMO 26 26% of all negotiated rates 530 percent of total billed charges 530 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Alignment Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1019 percent of total billed charges 1019 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Cigna PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Coalition PPO 59 59% of all negotiated rates 1385 percent of total billed charges 1385 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Coventry PPO 75 75% of all negotiated rates 1528 percent of total billed charges 1528 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Humana-Commerical PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Multiplan PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 One Health PPO 55 55% of all negotiated rates 1385 percent of total billed charges 1385 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Optum Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 P3 HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Select Health HMO 41 41% of all negotiated rates 835 percent of total billed charges 835 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 682 percent of total billed charges 682 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Sierra/HPN HMO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Silversummit Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 713 percent of total billed charges 713 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 Teachers Trust PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 TriWest PPO 30 30% of all negotiated rates 611 percent of total billed charges 611 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13151 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 1.1 TO 2.5CM CHARGE 13151 CPT 3230091 LOCAL 450 RC outpatient 2037 1731 United Healthcare PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Aetna Medicare HMO 26 26% of all negotiated rates 530 percent of total billed charges 530 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Alignment Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1019 percent of total billed charges 1019 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 330 fee schedule 330 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Cigna PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Coalition PPO 59 59% of all negotiated rates 1385 percent of total billed charges 1385 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Coventry PPO 75 75% of all negotiated rates 1528 percent of total billed charges 1528 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 330 fee schedule 330 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Humana-Commerical PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 330 fee schedule 330 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Multiplan PPO 80 80% of all negotiated rates 1630 percent of total billed charges 1630 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 One Health PPO 55 55% of all negotiated rates 1385 percent of total billed charges 1385 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Optum Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 P3 HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Select Health HMO 41 41% of all negotiated rates 835 percent of total billed charges 835 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 682 percent of total billed charges 682 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Sierra/HPN HMO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Silversummit Medicare HMO 39 39% of all negotiated rates 794 percent of total billed charges 794 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 713 percent of total billed charges 713 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 Teachers Trust PPO 68 68% of all negotiated rates 1385 percent of total billed charges 1385 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 TriWest PPO 30 30% of all negotiated rates 611 percent of total billed charges 611 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1426 percent of total billed charges 1426 2037 13152 ED COMPLEX REPAIR WOUNDS EYELID/NOSE/EAR/LIP 2.6 TO 7.5CM CHARGE 13152 CPT 3230092 LOCAL 450 RC outpatient 2037 1731 United Healthcare PPO 60 60% of all negotiated rates 1222 percent of total billed charges 1222 2037 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Aetna Medicare HMO 26 26% of all negotiated rates 361 percent of total billed charges 361 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Alignment Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 695 percent of total billed charges 695 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 135 fee schedule 135 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Cigna PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Coalition PPO 59 59% of all negotiated rates 945 percent of total billed charges 945 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Coventry PPO 75 75% of all negotiated rates 1042 percent of total billed charges 1042 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 135 fee schedule 135 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Humana-Commerical PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 135 fee schedule 135 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Multiplan PPO 80 80% of all negotiated rates 1111 percent of total billed charges 1111 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 One Health PPO 55 55% of all negotiated rates 945 percent of total billed charges 945 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Optum Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 P3 HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Select Health HMO 41 41% of all negotiated rates 569 percent of total billed charges 569 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 465 percent of total billed charges 465 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Sierra/HPN HMO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Silversummit Medicare HMO 39 39% of all negotiated rates 542 percent of total billed charges 542 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 486 percent of total billed charges 486 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 Teachers Trust PPO 68 68% of all negotiated rates 945 percent of total billed charges 945 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 TriWest PPO 30 30% of all negotiated rates 417 percent of total billed charges 417 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 UHN-Universal Health Network PPO 70 70% of all negotiated rates 972 percent of total billed charges 972 1389 "13153 ED REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM" 13153 CPT 3230085 LOCAL 450 RC outpatient 1389 1181 United Healthcare PPO 60 60% of all negotiated rates 833 percent of total billed charges 833 1389 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Aetna Medicare HMO 26 26% of all negotiated rates 107 percent of total billed charges 107 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Alignment Medicare HMO 39 39% of all negotiated rates 160 percent of total billed charges 160 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 246 percent of total billed charges 246 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 205 percent of total billed charges 205 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 44 fee schedule 44 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 160 percent of total billed charges 160 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Cigna PPO 68 68% of all negotiated rates 279 percent of total billed charges 279 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Coalition PPO 59 59% of all negotiated rates 279 percent of total billed charges 279 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Coventry PPO 75 75% of all negotiated rates 308 percent of total billed charges 308 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 328 percent of total billed charges 328 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 44 fee schedule 44 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Humana-Commerical PPO 70 70% of all negotiated rates 287 percent of total billed charges 287 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 160 percent of total billed charges 160 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 44 fee schedule 44 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Multiplan PPO 80 80% of all negotiated rates 328 percent of total billed charges 328 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 One Health PPO 55 55% of all negotiated rates 279 percent of total billed charges 279 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Optum Medicare HMO 39 39% of all negotiated rates 160 percent of total billed charges 160 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 P3 HMO 39 39% of all negotiated rates 160 percent of total billed charges 160 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 287 percent of total billed charges 287 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Select Health HMO 41 41% of all negotiated rates 168 percent of total billed charges 168 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 137 percent of total billed charges 137 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Sierra/HPN HMO 60 60% of all negotiated rates 246 percent of total billed charges 246 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Silversummit Medicare HMO 39 39% of all negotiated rates 160 percent of total billed charges 160 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 144 percent of total billed charges 144 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 Teachers Trust PPO 68 68% of all negotiated rates 279 percent of total billed charges 279 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 TriWest PPO 30 30% of all negotiated rates 123 percent of total billed charges 123 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 UHN-Universal Health Network PPO 70 70% of all negotiated rates 287 percent of total billed charges 287 410 16000 ED INITIAL TREATMENT BURN 1ST DEG CHARGE 16000 CPT 3230009 LOCAL 450 RC outpatient 410 349 United Healthcare PPO 60 60% of all negotiated rates 246 percent of total billed charges 246 410 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Aetna Medicare HMO 26 26% of all negotiated rates 225 percent of total billed charges 225 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Alignment Medicare HMO 39 39% of all negotiated rates 338 percent of total billed charges 338 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 520 percent of total billed charges 520 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 434 percent of total billed charges 434 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 338 percent of total billed charges 338 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Cigna PPO 68 68% of all negotiated rates 590 percent of total billed charges 590 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Coalition PPO 59 59% of all negotiated rates 590 percent of total billed charges 590 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Coventry PPO 75 75% of all negotiated rates 650 percent of total billed charges 650 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 694 percent of total billed charges 694 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Humana-Commerical PPO 70 70% of all negotiated rates 607 percent of total billed charges 607 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 338 percent of total billed charges 338 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 52 fee schedule 52 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Multiplan PPO 80 80% of all negotiated rates 694 percent of total billed charges 694 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 One Health PPO 55 55% of all negotiated rates 590 percent of total billed charges 590 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Optum Medicare HMO 39 39% of all negotiated rates 338 percent of total billed charges 338 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 P3 HMO 39 39% of all negotiated rates 338 percent of total billed charges 338 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 607 percent of total billed charges 607 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Select Health HMO 41 41% of all negotiated rates 355 percent of total billed charges 355 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 290 percent of total billed charges 290 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Sierra/HPN HMO 60 60% of all negotiated rates 520 percent of total billed charges 520 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Silversummit Medicare HMO 39 39% of all negotiated rates 338 percent of total billed charges 338 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 303 percent of total billed charges 303 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 Teachers Trust PPO 68 68% of all negotiated rates 590 percent of total billed charges 590 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 TriWest PPO 30 30% of all negotiated rates 260 percent of total billed charges 260 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 UHN-Universal Health Network PPO 70 70% of all negotiated rates 607 percent of total billed charges 607 867 16020 BURN SMALL 1-2 DEGREE ED CHARGE 16020 CPT 3230028 LOCAL 450 RC outpatient 867 737 United Healthcare PPO 60 60% of all negotiated rates 520 percent of total billed charges 520 867 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Aetna Medicare HMO 26 26% of all negotiated rates 226 percent of total billed charges 226 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Alignment Medicare HMO 39 39% of all negotiated rates 339 percent of total billed charges 339 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 521 percent of total billed charges 521 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 434 percent of total billed charges 434 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 107 fee schedule 107 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 339 percent of total billed charges 339 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Cigna PPO 68 68% of all negotiated rates 590 percent of total billed charges 590 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Coalition PPO 59 59% of all negotiated rates 590 percent of total billed charges 590 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Coventry PPO 75 75% of all negotiated rates 651 percent of total billed charges 651 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 694 percent of total billed charges 694 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 107 fee schedule 107 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Humana-Commerical PPO 70 70% of all negotiated rates 608 percent of total billed charges 608 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 339 percent of total billed charges 339 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 107 fee schedule 107 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Multiplan PPO 80 80% of all negotiated rates 694 percent of total billed charges 694 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 One Health PPO 55 55% of all negotiated rates 590 percent of total billed charges 590 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Optum Medicare HMO 39 39% of all negotiated rates 339 percent of total billed charges 339 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 P3 HMO 39 39% of all negotiated rates 339 percent of total billed charges 339 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 608 percent of total billed charges 608 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Select Health HMO 41 41% of all negotiated rates 356 percent of total billed charges 356 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 291 percent of total billed charges 291 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Sierra/HPN HMO 60 60% of all negotiated rates 521 percent of total billed charges 521 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Silversummit Medicare HMO 39 39% of all negotiated rates 339 percent of total billed charges 339 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 304 percent of total billed charges 304 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 Teachers Trust PPO 68 68% of all negotiated rates 590 percent of total billed charges 590 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 TriWest PPO 30 30% of all negotiated rates 260 percent of total billed charges 260 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 UHN-Universal Health Network PPO 70 70% of all negotiated rates 608 percent of total billed charges 608 868 16025 BURN MEDIUM 1-2 DEGREE ED CHARGE 16025 CPT 3230029 LOCAL 450 RC outpatient 868 738 United Healthcare PPO 60 60% of all negotiated rates 521 percent of total billed charges 521 868 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Aetna Medicare HMO 26 26% of all negotiated rates 172 percent of total billed charges 172 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Alignment Medicare HMO 39 39% of all negotiated rates 257 percent of total billed charges 257 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 396 percent of total billed charges 396 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 330 percent of total billed charges 330 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 129 fee schedule 129 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 257 percent of total billed charges 257 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Cigna PPO 68 68% of all negotiated rates 449 percent of total billed charges 449 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Coalition PPO 59 59% of all negotiated rates 449 percent of total billed charges 449 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Coventry PPO 75 75% of all negotiated rates 495 percent of total billed charges 495 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 528 percent of total billed charges 528 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 129 fee schedule 129 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Humana-Commerical PPO 70 70% of all negotiated rates 462 percent of total billed charges 462 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 257 percent of total billed charges 257 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 129 fee schedule 129 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Multiplan PPO 80 80% of all negotiated rates 528 percent of total billed charges 528 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 One Health PPO 55 55% of all negotiated rates 449 percent of total billed charges 449 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Optum Medicare HMO 39 39% of all negotiated rates 257 percent of total billed charges 257 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 P3 HMO 39 39% of all negotiated rates 257 percent of total billed charges 257 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 462 percent of total billed charges 462 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Select Health HMO 41 41% of all negotiated rates 271 percent of total billed charges 271 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 221 percent of total billed charges 221 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Sierra/HPN HMO 60 60% of all negotiated rates 396 percent of total billed charges 396 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Silversummit Medicare HMO 39 39% of all negotiated rates 257 percent of total billed charges 257 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 231 percent of total billed charges 231 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 Teachers Trust PPO 68 68% of all negotiated rates 449 percent of total billed charges 449 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 TriWest PPO 30 30% of all negotiated rates 198 percent of total billed charges 198 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 UHN-Universal Health Network PPO 70 70% of all negotiated rates 462 percent of total billed charges 462 660 16030 BURN LARGE ED CHARGE 16030 CPT 3230031 LOCAL 450 RC outpatient 660 561 United Healthcare PPO 60 60% of all negotiated rates 396 percent of total billed charges 396 660 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Aetna Medicare HMO 26 26% of all negotiated rates 175 percent of total billed charges 175 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Alignment Medicare HMO 39 39% of all negotiated rates 262 percent of total billed charges 262 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 403 percent of total billed charges 403 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 336 percent of total billed charges 336 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 262 percent of total billed charges 262 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Cigna PPO 68 68% of all negotiated rates 457 percent of total billed charges 457 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Coalition PPO 59 59% of all negotiated rates 457 percent of total billed charges 457 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Coventry PPO 75 75% of all negotiated rates 504 percent of total billed charges 504 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 538 percent of total billed charges 538 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Humana-Commerical PPO 70 70% of all negotiated rates 470 percent of total billed charges 470 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 262 percent of total billed charges 262 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Multiplan PPO 80 80% of all negotiated rates 538 percent of total billed charges 538 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 One Health PPO 55 55% of all negotiated rates 457 percent of total billed charges 457 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Optum Medicare HMO 39 39% of all negotiated rates 262 percent of total billed charges 262 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 P3 HMO 39 39% of all negotiated rates 262 percent of total billed charges 262 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 470 percent of total billed charges 470 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Select Health HMO 41 41% of all negotiated rates 276 percent of total billed charges 276 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 225 percent of total billed charges 225 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Sierra/HPN HMO 60 60% of all negotiated rates 403 percent of total billed charges 403 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Silversummit Medicare HMO 39 39% of all negotiated rates 262 percent of total billed charges 262 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 235 percent of total billed charges 235 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 Teachers Trust PPO 68 68% of all negotiated rates 457 percent of total billed charges 457 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 TriWest PPO 30 30% of all negotiated rates 202 percent of total billed charges 202 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 UHN-Universal Health Network PPO 70 70% of all negotiated rates 470 percent of total billed charges 470 672 17250 CHEM CAUTERIZATION/GRAN TISSUE ED CHARGE 17250 CPT 3230492 LOCAL 450 RC outpatient 672 571 United Healthcare PPO 60 60% of all negotiated rates 403 percent of total billed charges 403 672 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Aetna Medicare HMO 26 26% of all negotiated rates 467 percent of total billed charges 467 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Alignment Medicare HMO 39 39% of all negotiated rates 701 percent of total billed charges 701 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1079 percent of total billed charges 1079 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 899 percent of total billed charges 899 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 42 fee schedule 42 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 701 percent of total billed charges 701 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Cigna PPO 68 68% of all negotiated rates 1223 percent of total billed charges 1223 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Coalition PPO 59 59% of all negotiated rates 1223 percent of total billed charges 1223 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Coventry PPO 75 75% of all negotiated rates 1349 percent of total billed charges 1349 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1438 percent of total billed charges 1438 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 42 fee schedule 42 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Humana-Commerical PPO 70 70% of all negotiated rates 1259 percent of total billed charges 1259 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 701 percent of total billed charges 701 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 42 fee schedule 42 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Multiplan PPO 80 80% of all negotiated rates 1438 percent of total billed charges 1438 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 One Health PPO 55 55% of all negotiated rates 1223 percent of total billed charges 1223 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Optum Medicare HMO 39 39% of all negotiated rates 701 percent of total billed charges 701 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 P3 HMO 39 39% of all negotiated rates 701 percent of total billed charges 701 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1259 percent of total billed charges 1259 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Select Health HMO 41 41% of all negotiated rates 737 percent of total billed charges 737 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 602 percent of total billed charges 602 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Sierra/HPN HMO 60 60% of all negotiated rates 1079 percent of total billed charges 1079 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Silversummit Medicare HMO 39 39% of all negotiated rates 701 percent of total billed charges 701 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 629 percent of total billed charges 629 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 Teachers Trust PPO 68 68% of all negotiated rates 1223 percent of total billed charges 1223 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 TriWest PPO 30 30% of all negotiated rates 539 percent of total billed charges 539 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1259 percent of total billed charges 1259 1798 19000 ED BREAST ASPIRATION PUNCTURE CHARGE 19000 CPT 3236025 LOCAL 450 RC outpatient 1798 1528 United Healthcare PPO 60 60% of all negotiated rates 1079 percent of total billed charges 1079 1798 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Aetna Medicare HMO 26 26% of all negotiated rates 892 percent of total billed charges 892 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Alignment Medicare HMO 39 39% of all negotiated rates 1338 percent of total billed charges 1338 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 2059 percent of total billed charges 2059 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1716 percent of total billed charges 1716 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1338 percent of total billed charges 1338 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Cigna PPO 68 68% of all negotiated rates 2333 percent of total billed charges 2333 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Coalition PPO 59 59% of all negotiated rates 2333 percent of total billed charges 2333 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Coventry PPO 75 75% of all negotiated rates 2573 percent of total billed charges 2573 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2745 percent of total billed charges 2745 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Humana-Commerical PPO 70 70% of all negotiated rates 2402 percent of total billed charges 2402 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1338 percent of total billed charges 1338 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Multiplan PPO 80 80% of all negotiated rates 2745 percent of total billed charges 2745 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 One Health PPO 55 55% of all negotiated rates 2333 percent of total billed charges 2333 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Optum Medicare HMO 39 39% of all negotiated rates 1338 percent of total billed charges 1338 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 P3 HMO 39 39% of all negotiated rates 1338 percent of total billed charges 1338 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2402 percent of total billed charges 2402 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Select Health HMO 41 41% of all negotiated rates 1407 percent of total billed charges 1407 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1149 percent of total billed charges 1149 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Sierra/HPN HMO 60 60% of all negotiated rates 2059 percent of total billed charges 2059 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Silversummit Medicare HMO 39 39% of all negotiated rates 1338 percent of total billed charges 1338 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1201 percent of total billed charges 1201 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 Teachers Trust PPO 68 68% of all negotiated rates 2333 percent of total billed charges 2333 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 TriWest PPO 30 30% of all negotiated rates 1029 percent of total billed charges 1029 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2402 percent of total billed charges 2402 3431 "19020 INCISION OF BREAST LESION, DEEP" 19020 CPT 45019020 LOCAL 450 RC outpatient 3431 2916 United Healthcare PPO 60 60% of all negotiated rates 2059 percent of total billed charges 2059 3431 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Aetna Medicare HMO 26 26% of all negotiated rates 312 percent of total billed charges 312 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Alignment Medicare HMO 39 39% of all negotiated rates 468 percent of total billed charges 468 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 719 percent of total billed charges 719 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 600 percent of total billed charges 600 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 36 fee schedule 36 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 468 percent of total billed charges 468 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Cigna PPO 68 68% of all negotiated rates 815 percent of total billed charges 815 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Coalition PPO 59 59% of all negotiated rates 815 percent of total billed charges 815 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Coventry PPO 75 75% of all negotiated rates 899 percent of total billed charges 899 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 959 percent of total billed charges 959 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 36 fee schedule 36 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Humana-Commerical PPO 70 70% of all negotiated rates 839 percent of total billed charges 839 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 468 percent of total billed charges 468 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 36 fee schedule 36 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Multiplan PPO 80 80% of all negotiated rates 959 percent of total billed charges 959 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 One Health PPO 55 55% of all negotiated rates 815 percent of total billed charges 815 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Optum Medicare HMO 39 39% of all negotiated rates 468 percent of total billed charges 468 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 P3 HMO 39 39% of all negotiated rates 468 percent of total billed charges 468 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 839 percent of total billed charges 839 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Select Health HMO 41 41% of all negotiated rates 492 percent of total billed charges 492 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 402 percent of total billed charges 402 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Sierra/HPN HMO 60 60% of all negotiated rates 719 percent of total billed charges 719 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Silversummit Medicare HMO 39 39% of all negotiated rates 468 percent of total billed charges 468 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 420 percent of total billed charges 420 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 Teachers Trust PPO 68 68% of all negotiated rates 815 percent of total billed charges 815 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 TriWest PPO 30 30% of all negotiated rates 360 percent of total billed charges 360 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 UHN-Universal Health Network PPO 70 70% of all negotiated rates 839 percent of total billed charges 839 1199 20552 INJ SINGLE/MULT TRIGGER PTS ED CHARGE 20552 CPT 3232945 LOCAL 450 RC outpatient 1199 1019 United Healthcare PPO 60 60% of all negotiated rates 719 percent of total billed charges 719 1199 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Aetna Medicare HMO 26 26% of all negotiated rates 342 percent of total billed charges 342 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Alignment Medicare HMO 39 39% of all negotiated rates 512 percent of total billed charges 512 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 788 percent of total billed charges 788 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 657 percent of total billed charges 657 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 34 fee schedule 34 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 512 percent of total billed charges 512 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Cigna PPO 68 68% of all negotiated rates 894 percent of total billed charges 894 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Coalition PPO 59 59% of all negotiated rates 894 percent of total billed charges 894 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Coventry PPO 75 75% of all negotiated rates 986 percent of total billed charges 986 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1051 percent of total billed charges 1051 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 34 fee schedule 34 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Humana-Commerical PPO 70 70% of all negotiated rates 920 percent of total billed charges 920 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 512 percent of total billed charges 512 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 34 fee schedule 34 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Multiplan PPO 80 80% of all negotiated rates 1051 percent of total billed charges 1051 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 One Health PPO 55 55% of all negotiated rates 894 percent of total billed charges 894 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Optum Medicare HMO 39 39% of all negotiated rates 512 percent of total billed charges 512 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 P3 HMO 39 39% of all negotiated rates 512 percent of total billed charges 512 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 920 percent of total billed charges 920 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Select Health HMO 41 41% of all negotiated rates 539 percent of total billed charges 539 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 440 percent of total billed charges 440 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Sierra/HPN HMO 60 60% of all negotiated rates 788 percent of total billed charges 788 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Silversummit Medicare HMO 39 39% of all negotiated rates 512 percent of total billed charges 512 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 460 percent of total billed charges 460 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 Teachers Trust PPO 68 68% of all negotiated rates 894 percent of total billed charges 894 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 TriWest PPO 30 30% of all negotiated rates 394 percent of total billed charges 394 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 UHN-Universal Health Network PPO 70 70% of all negotiated rates 920 percent of total billed charges 920 1314 20600 ARTHROCENTESIS ASP/INJ JOINT ED CHARGE 20600 CPT 3233410 LOCAL 450 RC outpatient 1314 1117 United Healthcare PPO 60 60% of all negotiated rates 788 percent of total billed charges 788 1314 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Aetna Medicare HMO 26 26% of all negotiated rates 671 percent of total billed charges 671 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Alignment Medicare HMO 39 39% of all negotiated rates 1007 percent of total billed charges 1007 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1549 percent of total billed charges 1549 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1291 percent of total billed charges 1291 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1007 percent of total billed charges 1007 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Cigna PPO 68 68% of all negotiated rates 1756 percent of total billed charges 1756 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Coalition PPO 59 59% of all negotiated rates 1756 percent of total billed charges 1756 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Coventry PPO 75 75% of all negotiated rates 1937 percent of total billed charges 1937 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2066 percent of total billed charges 2066 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Humana-Commerical PPO 70 70% of all negotiated rates 1807 percent of total billed charges 1807 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1007 percent of total billed charges 1007 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Multiplan PPO 80 80% of all negotiated rates 2066 percent of total billed charges 2066 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 One Health PPO 55 55% of all negotiated rates 1756 percent of total billed charges 1756 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Optum Medicare HMO 39 39% of all negotiated rates 1007 percent of total billed charges 1007 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 P3 HMO 39 39% of all negotiated rates 1007 percent of total billed charges 1007 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1807 percent of total billed charges 1807 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Select Health HMO 41 41% of all negotiated rates 1059 percent of total billed charges 1059 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 865 percent of total billed charges 865 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Sierra/HPN HMO 60 60% of all negotiated rates 1549 percent of total billed charges 1549 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Silversummit Medicare HMO 39 39% of all negotiated rates 1007 percent of total billed charges 1007 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 904 percent of total billed charges 904 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 Teachers Trust PPO 68 68% of all negotiated rates 1756 percent of total billed charges 1756 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 TriWest PPO 30 30% of all negotiated rates 775 percent of total billed charges 775 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1807 percent of total billed charges 1807 2582 20605 ARTHROCENTESIS ASP/INJ INT JNT ED CHARGE 20605 CPT 3230411 LOCAL 450 RC outpatient 2582 2195 United Healthcare PPO 60 60% of all negotiated rates 1549 percent of total billed charges 1549 2582 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Aetna Medicare HMO 26 26% of all negotiated rates 290 percent of total billed charges 290 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Alignment Medicare HMO 39 39% of all negotiated rates 435 percent of total billed charges 435 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 670 percent of total billed charges 670 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 558 percent of total billed charges 558 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 44 fee schedule 44 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 435 percent of total billed charges 435 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Cigna PPO 68 68% of all negotiated rates 759 percent of total billed charges 759 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Coalition PPO 59 59% of all negotiated rates 759 percent of total billed charges 759 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Coventry PPO 75 75% of all negotiated rates 837 percent of total billed charges 837 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 893 percent of total billed charges 893 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 44 fee schedule 44 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Humana-Commerical PPO 70 70% of all negotiated rates 781 percent of total billed charges 781 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 435 percent of total billed charges 435 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 44 fee schedule 44 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Multiplan PPO 80 80% of all negotiated rates 893 percent of total billed charges 893 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 One Health PPO 55 55% of all negotiated rates 759 percent of total billed charges 759 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Optum Medicare HMO 39 39% of all negotiated rates 435 percent of total billed charges 435 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 P3 HMO 39 39% of all negotiated rates 435 percent of total billed charges 435 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 781 percent of total billed charges 781 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Select Health HMO 41 41% of all negotiated rates 458 percent of total billed charges 458 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 374 percent of total billed charges 374 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Sierra/HPN HMO 60 60% of all negotiated rates 670 percent of total billed charges 670 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Silversummit Medicare HMO 39 39% of all negotiated rates 435 percent of total billed charges 435 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 391 percent of total billed charges 391 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 Teachers Trust PPO 68 68% of all negotiated rates 759 percent of total billed charges 759 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 TriWest PPO 30 30% of all negotiated rates 335 percent of total billed charges 335 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 UHN-Universal Health Network PPO 70 70% of all negotiated rates 781 percent of total billed charges 781 1116 20610 ARTHROCENTESIS MAJOR JOINT ED CHARGE 20610 CPT 3233402 LOCAL 450 RC outpatient 1116 949 United Healthcare PPO 60 60% of all negotiated rates 670 percent of total billed charges 670 1116 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Aetna Medicare HMO 26 26% of all negotiated rates 129 percent of total billed charges 129 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Alignment Medicare HMO 39 39% of all negotiated rates 193 percent of total billed charges 193 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 248 percent of total billed charges 248 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 193 percent of total billed charges 193 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Cigna PPO 68 68% of all negotiated rates 337 percent of total billed charges 337 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Coalition PPO 59 59% of all negotiated rates 337 percent of total billed charges 337 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Coventry PPO 75 75% of all negotiated rates 372 percent of total billed charges 372 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 397 percent of total billed charges 397 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Humana-Commerical PPO 70 70% of all negotiated rates 347 percent of total billed charges 347 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 193 percent of total billed charges 193 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Multiplan PPO 80 80% of all negotiated rates 397 percent of total billed charges 397 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 One Health PPO 55 55% of all negotiated rates 337 percent of total billed charges 337 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Optum Medicare HMO 39 39% of all negotiated rates 193 percent of total billed charges 193 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 P3 HMO 39 39% of all negotiated rates 193 percent of total billed charges 193 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 347 percent of total billed charges 347 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Select Health HMO 41 41% of all negotiated rates 203 percent of total billed charges 203 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 166 percent of total billed charges 166 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Sierra/HPN HMO 60 60% of all negotiated rates 298 percent of total billed charges 298 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Silversummit Medicare HMO 39 39% of all negotiated rates 193 percent of total billed charges 193 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 174 percent of total billed charges 174 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 Teachers Trust PPO 68 68% of all negotiated rates 337 percent of total billed charges 337 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 TriWest PPO 30 30% of all negotiated rates 149 percent of total billed charges 149 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 UHN-Universal Health Network PPO 70 70% of all negotiated rates 347 percent of total billed charges 347 496 21315 CLSD TMT NASL BONE FX W/O STAB ED CHARGE 21310 CPT 3230520 LOCAL 450 RC outpatient 496 422 United Healthcare PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 496 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Aetna Medicare HMO 26 26% of all negotiated rates 867 percent of total billed charges 867 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Alignment Medicare HMO 39 39% of all negotiated rates 1300 percent of total billed charges 1300 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 2000 percent of total billed charges 2000 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1667 percent of total billed charges 1667 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 473 fee schedule 473 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1300 percent of total billed charges 1300 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Cigna PPO 68 68% of all negotiated rates 2267 percent of total billed charges 2267 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Coalition PPO 59 59% of all negotiated rates 2267 percent of total billed charges 2267 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Coventry PPO 75 75% of all negotiated rates 2501 percent of total billed charges 2501 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2667 percent of total billed charges 2667 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 473 fee schedule 473 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Humana-Commerical PPO 70 70% of all negotiated rates 2334 percent of total billed charges 2334 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1300 percent of total billed charges 1300 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 473 fee schedule 473 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Multiplan PPO 80 80% of all negotiated rates 2667 percent of total billed charges 2667 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 One Health PPO 55 55% of all negotiated rates 2267 percent of total billed charges 2267 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Optum Medicare HMO 39 39% of all negotiated rates 1300 percent of total billed charges 1300 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 P3 HMO 39 39% of all negotiated rates 1300 percent of total billed charges 1300 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2334 percent of total billed charges 2334 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Select Health HMO 41 41% of all negotiated rates 1367 percent of total billed charges 1367 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1117 percent of total billed charges 1117 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Sierra/HPN HMO 60 60% of all negotiated rates 2000 percent of total billed charges 2000 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Silversummit Medicare HMO 39 39% of all negotiated rates 1300 percent of total billed charges 1300 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1167 percent of total billed charges 1167 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 Teachers Trust PPO 68 68% of all negotiated rates 2267 percent of total billed charges 2267 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 TriWest PPO 30 30% of all negotiated rates 1000 percent of total billed charges 1000 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2334 percent of total billed charges 2334 3334 21450 RED DISL MANDIB WO MANIP ED Charge 21450 CPT 3230595 LOCAL 450 RC outpatient 3334 2834 United Healthcare PPO 60 60% of all negotiated rates 2000 percent of total billed charges 2000 3334 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Aetna Medicare HMO 26 26% of all negotiated rates 132 percent of total billed charges 132 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Alignment Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 304 percent of total billed charges 304 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 254 percent of total billed charges 254 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 30 fee schedule 30 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Cigna PPO 68 68% of all negotiated rates 345 percent of total billed charges 345 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Coalition PPO 59 59% of all negotiated rates 345 percent of total billed charges 345 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Coventry PPO 75 75% of all negotiated rates 380 percent of total billed charges 380 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 406 percent of total billed charges 406 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 30 fee schedule 30 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Humana-Commerical PPO 70 70% of all negotiated rates 355 percent of total billed charges 355 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 30 fee schedule 30 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Multiplan PPO 80 80% of all negotiated rates 406 percent of total billed charges 406 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 One Health PPO 55 55% of all negotiated rates 345 percent of total billed charges 345 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Optum Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 P3 HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 355 percent of total billed charges 355 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Select Health HMO 41 41% of all negotiated rates 208 percent of total billed charges 208 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 170 percent of total billed charges 170 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Sierra/HPN HMO 60 60% of all negotiated rates 304 percent of total billed charges 304 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Silversummit Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 177 percent of total billed charges 177 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 Teachers Trust PPO 68 68% of all negotiated rates 345 percent of total billed charges 345 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 TriWest PPO 30 30% of all negotiated rates 152 percent of total billed charges 152 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 UHN-Universal Health Network PPO 70 70% of all negotiated rates 355 percent of total billed charges 355 507 21480 TEMPORAMANDIBULAR DISLOCATION ED CHARGE 21480 CPT 3234809 LOCAL 450 RC outpatient 507 431 United Healthcare PPO 60 60% of all negotiated rates 304 percent of total billed charges 304 507 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 211 fee schedule 211 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 211 fee schedule 211 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 211 fee schedule 211 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 23500 CLO TX CLAV FX WO MANIP 23500 CPT 3230505 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Aetna Medicare HMO 26 26% of all negotiated rates 157 percent of total billed charges 157 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Alignment Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 361 percent of total billed charges 361 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 301 percent of total billed charges 301 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 216 fee schedule 216 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Cigna PPO 68 68% of all negotiated rates 409 percent of total billed charges 409 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Coalition PPO 59 59% of all negotiated rates 409 percent of total billed charges 409 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Coventry PPO 75 75% of all negotiated rates 452 percent of total billed charges 452 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 482 percent of total billed charges 482 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 216 fee schedule 216 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Humana-Commerical PPO 70 70% of all negotiated rates 421 percent of total billed charges 421 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 216 fee schedule 216 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Multiplan PPO 80 80% of all negotiated rates 482 percent of total billed charges 482 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 One Health PPO 55 55% of all negotiated rates 409 percent of total billed charges 409 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Optum Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 P3 HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 421 percent of total billed charges 421 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Select Health HMO 41 41% of all negotiated rates 247 percent of total billed charges 247 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 202 percent of total billed charges 202 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Sierra/HPN HMO 60 60% of all negotiated rates 361 percent of total billed charges 361 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Silversummit Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 211 percent of total billed charges 211 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 Teachers Trust PPO 68 68% of all negotiated rates 409 percent of total billed charges 409 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 TriWest PPO 30 30% of all negotiated rates 181 percent of total billed charges 181 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 UHN-Universal Health Network PPO 70 70% of all negotiated rates 421 percent of total billed charges 421 602 23540 ED CLSD TRT AC DISLOCATION CHARGE 23540 CPT 3230500 LOCAL 450 RC outpatient 602 512 United Healthcare PPO 60 60% of all negotiated rates 361 percent of total billed charges 361 602 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Aetna Medicare HMO 26 26% of all negotiated rates 583 percent of total billed charges 583 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Alignment Medicare HMO 39 39% of all negotiated rates 875 percent of total billed charges 875 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1346 percent of total billed charges 1346 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1122 percent of total billed charges 1122 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 226 fee schedule 226 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 875 percent of total billed charges 875 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Cigna PPO 68 68% of all negotiated rates 1526 percent of total billed charges 1526 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Coalition PPO 59 59% of all negotiated rates 1526 percent of total billed charges 1526 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Coventry PPO 75 75% of all negotiated rates 1683 percent of total billed charges 1683 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1795 percent of total billed charges 1795 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 226 fee schedule 226 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Humana-Commerical PPO 70 70% of all negotiated rates 1571 percent of total billed charges 1571 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 875 percent of total billed charges 875 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 226 fee schedule 226 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Multiplan PPO 80 80% of all negotiated rates 1795 percent of total billed charges 1795 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 One Health PPO 55 55% of all negotiated rates 1526 percent of total billed charges 1526 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Optum Medicare HMO 39 39% of all negotiated rates 875 percent of total billed charges 875 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 P3 HMO 39 39% of all negotiated rates 875 percent of total billed charges 875 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1571 percent of total billed charges 1571 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Select Health HMO 41 41% of all negotiated rates 920 percent of total billed charges 920 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 752 percent of total billed charges 752 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Sierra/HPN HMO 60 60% of all negotiated rates 1346 percent of total billed charges 1346 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Silversummit Medicare HMO 39 39% of all negotiated rates 875 percent of total billed charges 875 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 785 percent of total billed charges 785 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 Teachers Trust PPO 68 68% of all negotiated rates 1526 percent of total billed charges 1526 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 TriWest PPO 30 30% of all negotiated rates 673 percent of total billed charges 673 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1571 percent of total billed charges 1571 2244 23570 CLSD TX SCAPULAR FX W/O M 23570 CPT 3231510 LOCAL 450 RC outpatient 2244 1907 United Healthcare PPO 60 60% of all negotiated rates 1346 percent of total billed charges 1346 2244 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 292 fee schedule 292 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 292 fee schedule 292 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 292 fee schedule 292 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 23600 CLSD TX PROX HUMER FX W/O 23600 CPT 3230531 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Aetna Medicare HMO 26 26% of all negotiated rates 424 percent of total billed charges 424 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Alignment Medicare HMO 39 39% of all negotiated rates 636 percent of total billed charges 636 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 978 percent of total billed charges 978 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 815 percent of total billed charges 815 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 243 fee schedule 243 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 636 percent of total billed charges 636 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Cigna PPO 68 68% of all negotiated rates 1108 percent of total billed charges 1108 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Coalition PPO 59 59% of all negotiated rates 1108 percent of total billed charges 1108 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Coventry PPO 75 75% of all negotiated rates 1223 percent of total billed charges 1223 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1304 percent of total billed charges 1304 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 243 fee schedule 243 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Humana-Commerical PPO 70 70% of all negotiated rates 1141 percent of total billed charges 1141 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 636 percent of total billed charges 636 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 243 fee schedule 243 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Multiplan PPO 80 80% of all negotiated rates 1304 percent of total billed charges 1304 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 One Health PPO 55 55% of all negotiated rates 1108 percent of total billed charges 1108 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Optum Medicare HMO 39 39% of all negotiated rates 636 percent of total billed charges 636 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 P3 HMO 39 39% of all negotiated rates 636 percent of total billed charges 636 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1141 percent of total billed charges 1141 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Select Health HMO 41 41% of all negotiated rates 668 percent of total billed charges 668 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 546 percent of total billed charges 546 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Sierra/HPN HMO 60 60% of all negotiated rates 978 percent of total billed charges 978 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Silversummit Medicare HMO 39 39% of all negotiated rates 636 percent of total billed charges 636 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 571 percent of total billed charges 571 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 Teachers Trust PPO 68 68% of all negotiated rates 1108 percent of total billed charges 1108 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 TriWest PPO 30 30% of all negotiated rates 489 percent of total billed charges 489 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1141 percent of total billed charges 1141 1630 23620 CLSD TX GREATER HUMERAL TUBEROSITY FX W/O MANIP 23620 CPT 3230543 LOCAL 450 RC outpatient 1630 1386 United Healthcare PPO 60 60% of all negotiated rates 978 percent of total billed charges 978 1630 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Aetna Medicare HMO 26 26% of all negotiated rates 268 percent of total billed charges 268 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Alignment Medicare HMO 39 39% of all negotiated rates 402 percent of total billed charges 402 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 618 percent of total billed charges 618 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 515 percent of total billed charges 515 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 402 percent of total billed charges 402 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Cigna PPO 68 68% of all negotiated rates 700 percent of total billed charges 700 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Coalition PPO 59 59% of all negotiated rates 700 percent of total billed charges 700 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Coventry PPO 75 75% of all negotiated rates 773 percent of total billed charges 773 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 824 percent of total billed charges 824 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Humana-Commerical PPO 70 70% of all negotiated rates 721 percent of total billed charges 721 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 402 percent of total billed charges 402 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Multiplan PPO 80 80% of all negotiated rates 824 percent of total billed charges 824 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 One Health PPO 55 55% of all negotiated rates 700 percent of total billed charges 700 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Optum Medicare HMO 39 39% of all negotiated rates 402 percent of total billed charges 402 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 P3 HMO 39 39% of all negotiated rates 402 percent of total billed charges 402 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 721 percent of total billed charges 721 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Select Health HMO 41 41% of all negotiated rates 422 percent of total billed charges 422 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 345 percent of total billed charges 345 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Sierra/HPN HMO 60 60% of all negotiated rates 618 percent of total billed charges 618 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Silversummit Medicare HMO 39 39% of all negotiated rates 402 percent of total billed charges 402 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 361 percent of total billed charges 361 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 Teachers Trust PPO 68 68% of all negotiated rates 700 percent of total billed charges 700 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 TriWest PPO 30 30% of all negotiated rates 309 percent of total billed charges 309 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 UHN-Universal Health Network PPO 70 70% of all negotiated rates 721 percent of total billed charges 721 1030 23650 CLO TX SHLDR DISLC W/MANI 23650 CPT 3230509 LOCAL 450 RC outpatient 1030 876 United Healthcare PPO 60 60% of all negotiated rates 618 percent of total billed charges 618 1030 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Aetna Medicare HMO 26 26% of all negotiated rates 337 percent of total billed charges 337 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Alignment Medicare HMO 39 39% of all negotiated rates 505 percent of total billed charges 505 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 778 percent of total billed charges 778 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 648 percent of total billed charges 648 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 474 fee schedule 474 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 505 percent of total billed charges 505 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Cigna PPO 68 68% of all negotiated rates 881 percent of total billed charges 881 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Coalition PPO 59 59% of all negotiated rates 881 percent of total billed charges 881 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Coventry PPO 75 75% of all negotiated rates 972 percent of total billed charges 972 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1037 percent of total billed charges 1037 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 474 fee schedule 474 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Humana-Commerical PPO 70 70% of all negotiated rates 907 percent of total billed charges 907 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 505 percent of total billed charges 505 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 474 fee schedule 474 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Multiplan PPO 80 80% of all negotiated rates 1037 percent of total billed charges 1037 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 One Health PPO 55 55% of all negotiated rates 881 percent of total billed charges 881 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Optum Medicare HMO 39 39% of all negotiated rates 505 percent of total billed charges 505 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 P3 HMO 39 39% of all negotiated rates 505 percent of total billed charges 505 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 907 percent of total billed charges 907 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Select Health HMO 41 41% of all negotiated rates 531 percent of total billed charges 531 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 434 percent of total billed charges 434 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Sierra/HPN HMO 60 60% of all negotiated rates 778 percent of total billed charges 778 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Silversummit Medicare HMO 39 39% of all negotiated rates 505 percent of total billed charges 505 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 454 percent of total billed charges 454 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 Teachers Trust PPO 68 68% of all negotiated rates 881 percent of total billed charges 881 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 TriWest PPO 30 30% of all negotiated rates 389 percent of total billed charges 389 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 UHN-Universal Health Network PPO 70 70% of all negotiated rates 907 percent of total billed charges 907 1296 23675 CLSD TRMT SHLDR DISLOC W/MANIP ED CHARGE 23675 CPT 3230495 LOCAL 450 RC outpatient 1296 1102 United Healthcare PPO 60 60% of all negotiated rates 778 percent of total billed charges 778 1296 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 308 fee schedule 308 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 308 fee schedule 308 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 308 fee schedule 308 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 24500 ED CLOSED TRTMT OF HUMERAL SHAFT FX W/O MANIP CHARGE 24500 CPT 3230508 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Aetna Medicare HMO 26 26% of all negotiated rates 243 percent of total billed charges 243 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Alignment Medicare HMO 39 39% of all negotiated rates 365 percent of total billed charges 365 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 562 percent of total billed charges 562 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 468 percent of total billed charges 468 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 325 fee schedule 325 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 365 percent of total billed charges 365 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Cigna PPO 68 68% of all negotiated rates 636 percent of total billed charges 636 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Coalition PPO 59 59% of all negotiated rates 636 percent of total billed charges 636 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Coventry PPO 75 75% of all negotiated rates 702 percent of total billed charges 702 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 749 percent of total billed charges 749 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 325 fee schedule 325 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Humana-Commerical PPO 70 70% of all negotiated rates 655 percent of total billed charges 655 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 365 percent of total billed charges 365 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 325 fee schedule 325 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Multiplan PPO 80 80% of all negotiated rates 749 percent of total billed charges 749 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 One Health PPO 55 55% of all negotiated rates 636 percent of total billed charges 636 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Optum Medicare HMO 39 39% of all negotiated rates 365 percent of total billed charges 365 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 P3 HMO 39 39% of all negotiated rates 365 percent of total billed charges 365 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 655 percent of total billed charges 655 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Select Health HMO 41 41% of all negotiated rates 384 percent of total billed charges 384 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 314 percent of total billed charges 314 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Sierra/HPN HMO 60 60% of all negotiated rates 562 percent of total billed charges 562 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Silversummit Medicare HMO 39 39% of all negotiated rates 365 percent of total billed charges 365 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 328 percent of total billed charges 328 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 Teachers Trust PPO 68 68% of all negotiated rates 636 percent of total billed charges 636 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 TriWest PPO 30 30% of all negotiated rates 281 percent of total billed charges 281 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 UHN-Universal Health Network PPO 70 70% of all negotiated rates 655 percent of total billed charges 655 936 24530 TREAT HUMERUS FX W/O MANI 24530 CPT 3230580 LOCAL 450 RC outpatient 936 796 United Healthcare PPO 60 60% of all negotiated rates 562 percent of total billed charges 562 936 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Aetna Medicare HMO 26 26% of all negotiated rates 297 percent of total billed charges 297 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Alignment Medicare HMO 39 39% of all negotiated rates 445 percent of total billed charges 445 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 685 percent of total billed charges 685 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 571 percent of total billed charges 571 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 273 fee schedule 273 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 445 percent of total billed charges 445 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Cigna PPO 68 68% of all negotiated rates 777 percent of total billed charges 777 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Coalition PPO 59 59% of all negotiated rates 777 percent of total billed charges 777 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Coventry PPO 75 75% of all negotiated rates 857 percent of total billed charges 857 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 914 percent of total billed charges 914 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 273 fee schedule 273 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Humana-Commerical PPO 70 70% of all negotiated rates 799 percent of total billed charges 799 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 445 percent of total billed charges 445 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 273 fee schedule 273 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Multiplan PPO 80 80% of all negotiated rates 914 percent of total billed charges 914 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 One Health PPO 55 55% of all negotiated rates 777 percent of total billed charges 777 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Optum Medicare HMO 39 39% of all negotiated rates 445 percent of total billed charges 445 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 P3 HMO 39 39% of all negotiated rates 445 percent of total billed charges 445 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 799 percent of total billed charges 799 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Select Health HMO 41 41% of all negotiated rates 468 percent of total billed charges 468 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 383 percent of total billed charges 383 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Sierra/HPN HMO 60 60% of all negotiated rates 685 percent of total billed charges 685 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Silversummit Medicare HMO 39 39% of all negotiated rates 445 percent of total billed charges 445 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 400 percent of total billed charges 400 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 Teachers Trust PPO 68 68% of all negotiated rates 777 percent of total billed charges 777 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 TriWest PPO 30 30% of all negotiated rates 343 percent of total billed charges 343 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 UHN-Universal Health Network PPO 70 70% of all negotiated rates 799 percent of total billed charges 799 1142 24560 ED CLOSED TRTMT OF HUMERAL EPICONDYLAR FX W/O MANIP CHARGE 24560 CPT 3230537 LOCAL 450 RC outpatient 1142 971 United Healthcare PPO 60 60% of all negotiated rates 685 percent of total billed charges 685 1142 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Aetna Medicare HMO 26 26% of all negotiated rates 349 percent of total billed charges 349 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Alignment Medicare HMO 39 39% of all negotiated rates 523 percent of total billed charges 523 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 805 percent of total billed charges 805 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 671 percent of total billed charges 671 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 463 fee schedule 463 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 523 percent of total billed charges 523 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Cigna PPO 68 68% of all negotiated rates 912 percent of total billed charges 912 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Coalition PPO 59 59% of all negotiated rates 912 percent of total billed charges 912 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Coventry PPO 75 75% of all negotiated rates 1006 percent of total billed charges 1006 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1073 percent of total billed charges 1073 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 463 fee schedule 463 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Humana-Commerical PPO 70 70% of all negotiated rates 939 percent of total billed charges 939 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 523 percent of total billed charges 523 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 463 fee schedule 463 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Multiplan PPO 80 80% of all negotiated rates 1073 percent of total billed charges 1073 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 One Health PPO 55 55% of all negotiated rates 912 percent of total billed charges 912 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Optum Medicare HMO 39 39% of all negotiated rates 523 percent of total billed charges 523 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 P3 HMO 39 39% of all negotiated rates 523 percent of total billed charges 523 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 939 percent of total billed charges 939 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Select Health HMO 41 41% of all negotiated rates 550 percent of total billed charges 550 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 449 percent of total billed charges 449 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Sierra/HPN HMO 60 60% of all negotiated rates 805 percent of total billed charges 805 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Silversummit Medicare HMO 39 39% of all negotiated rates 523 percent of total billed charges 523 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 469 percent of total billed charges 469 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 Teachers Trust PPO 68 68% of all negotiated rates 912 percent of total billed charges 912 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 TriWest PPO 30 30% of all negotiated rates 402 percent of total billed charges 402 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 UHN-Universal Health Network PPO 70 70% of all negotiated rates 939 percent of total billed charges 939 1341 24565 CLOSED TX HUMERAL EPICONDYLAR FX W/MANIP 24565 CPT 3230534 LOCAL 450 RC outpatient 1341 1140 United Healthcare PPO 60 60% of all negotiated rates 805 percent of total billed charges 805 1341 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Aetna Medicare HMO 26 26% of all negotiated rates 189 percent of total billed charges 189 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Alignment Medicare HMO 39 39% of all negotiated rates 284 percent of total billed charges 284 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 437 percent of total billed charges 437 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 364 percent of total billed charges 364 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 317 fee schedule 317 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 284 percent of total billed charges 284 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Cigna PPO 68 68% of all negotiated rates 495 percent of total billed charges 495 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Coalition PPO 59 59% of all negotiated rates 495 percent of total billed charges 495 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Coventry PPO 75 75% of all negotiated rates 546 percent of total billed charges 546 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 582 percent of total billed charges 582 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 317 fee schedule 317 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Humana-Commerical PPO 70 70% of all negotiated rates 510 percent of total billed charges 510 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 284 percent of total billed charges 284 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 317 fee schedule 317 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Multiplan PPO 80 80% of all negotiated rates 582 percent of total billed charges 582 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 One Health PPO 55 55% of all negotiated rates 495 percent of total billed charges 495 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Optum Medicare HMO 39 39% of all negotiated rates 284 percent of total billed charges 284 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 P3 HMO 39 39% of all negotiated rates 284 percent of total billed charges 284 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 510 percent of total billed charges 510 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Select Health HMO 41 41% of all negotiated rates 298 percent of total billed charges 298 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 244 percent of total billed charges 244 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Sierra/HPN HMO 60 60% of all negotiated rates 437 percent of total billed charges 437 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Silversummit Medicare HMO 39 39% of all negotiated rates 284 percent of total billed charges 284 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 255 percent of total billed charges 255 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 Teachers Trust PPO 68 68% of all negotiated rates 495 percent of total billed charges 495 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 TriWest PPO 30 30% of all negotiated rates 218 percent of total billed charges 218 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 UHN-Universal Health Network PPO 70 70% of all negotiated rates 510 percent of total billed charges 510 728 24600 ELBOW DISLOCATION 24600 CPT 3230310 LOCAL 450 RC outpatient 728 619 United Healthcare PPO 60 60% of all negotiated rates 437 percent of total billed charges 437 728 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Aetna Medicare HMO 26 26% of all negotiated rates 1568 percent of total billed charges 1568 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Alignment Medicare HMO 39 39% of all negotiated rates 2352 percent of total billed charges 2352 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3619 percent of total billed charges 3619 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 3016 percent of total billed charges 3016 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 445 fee schedule 445 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2352 percent of total billed charges 2352 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Cigna PPO 68 68% of all negotiated rates 4102 percent of total billed charges 4102 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Coalition PPO 59 59% of all negotiated rates 4102 percent of total billed charges 4102 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Coventry PPO 75 75% of all negotiated rates 4524 percent of total billed charges 4524 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 4826 percent of total billed charges 4826 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 445 fee schedule 445 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Humana-Commerical PPO 70 70% of all negotiated rates 4222 percent of total billed charges 4222 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2352 percent of total billed charges 2352 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 445 fee schedule 445 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Multiplan PPO 80 80% of all negotiated rates 4826 percent of total billed charges 4826 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 One Health PPO 55 55% of all negotiated rates 4102 percent of total billed charges 4102 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Optum Medicare HMO 39 39% of all negotiated rates 2352 percent of total billed charges 2352 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 P3 HMO 39 39% of all negotiated rates 2352 percent of total billed charges 2352 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 4222 percent of total billed charges 4222 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Select Health HMO 41 41% of all negotiated rates 2473 percent of total billed charges 2473 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 2021 percent of total billed charges 2021 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Sierra/HPN HMO 60 60% of all negotiated rates 3619 percent of total billed charges 3619 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Silversummit Medicare HMO 39 39% of all negotiated rates 2352 percent of total billed charges 2352 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 2111 percent of total billed charges 2111 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 Teachers Trust PPO 68 68% of all negotiated rates 4102 percent of total billed charges 4102 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 TriWest PPO 30 30% of all negotiated rates 1810 percent of total billed charges 1810 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 UHN-Universal Health Network PPO 70 70% of all negotiated rates 4222 percent of total billed charges 4222 6032 24605 Clsd Elbw Dslctn w/Anes 24605 CPT 3236405 LOCAL 450 RC outpatient 6032 5127 United Healthcare PPO 60 60% of all negotiated rates 3619 percent of total billed charges 3619 6032 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Aetna Medicare HMO 26 26% of all negotiated rates 180 percent of total billed charges 180 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Alignment Medicare HMO 39 39% of all negotiated rates 271 percent of total billed charges 271 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 416 percent of total billed charges 416 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 347 percent of total billed charges 347 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 90 fee schedule 90 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 271 percent of total billed charges 271 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Cigna PPO 68 68% of all negotiated rates 472 percent of total billed charges 472 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Coalition PPO 59 59% of all negotiated rates 472 percent of total billed charges 472 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Coventry PPO 75 75% of all negotiated rates 521 percent of total billed charges 521 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 555 percent of total billed charges 555 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 90 fee schedule 90 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Humana-Commerical PPO 70 70% of all negotiated rates 486 percent of total billed charges 486 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 271 percent of total billed charges 271 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 90 fee schedule 90 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Multiplan PPO 80 80% of all negotiated rates 555 percent of total billed charges 555 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 One Health PPO 55 55% of all negotiated rates 472 percent of total billed charges 472 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Optum Medicare HMO 39 39% of all negotiated rates 271 percent of total billed charges 271 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 P3 HMO 39 39% of all negotiated rates 271 percent of total billed charges 271 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 486 percent of total billed charges 486 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Select Health HMO 41 41% of all negotiated rates 285 percent of total billed charges 285 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 232 percent of total billed charges 232 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Sierra/HPN HMO 60 60% of all negotiated rates 416 percent of total billed charges 416 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Silversummit Medicare HMO 39 39% of all negotiated rates 271 percent of total billed charges 271 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 243 percent of total billed charges 243 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 Teachers Trust PPO 68 68% of all negotiated rates 472 percent of total billed charges 472 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 TriWest PPO 30 30% of all negotiated rates 208 percent of total billed charges 208 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 UHN-Universal Health Network PPO 70 70% of all negotiated rates 486 percent of total billed charges 486 694 24640 CLO TX ELBOW- CHILD 24640 CPT 3233428 LOCAL 450 RC outpatient 694 590 United Healthcare PPO 60 60% of all negotiated rates 416 percent of total billed charges 416 694 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Aetna Medicare HMO 26 26% of all negotiated rates 202 percent of total billed charges 202 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Alignment Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 467 percent of total billed charges 467 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 389 percent of total billed charges 389 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 228 fee schedule 228 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Cigna PPO 68 68% of all negotiated rates 529 percent of total billed charges 529 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Coalition PPO 59 59% of all negotiated rates 529 percent of total billed charges 529 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Coventry PPO 75 75% of all negotiated rates 584 percent of total billed charges 584 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 622 percent of total billed charges 622 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 228 fee schedule 228 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Humana-Commerical PPO 70 70% of all negotiated rates 545 percent of total billed charges 545 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 228 fee schedule 228 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Multiplan PPO 80 80% of all negotiated rates 622 percent of total billed charges 622 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 One Health PPO 55 55% of all negotiated rates 529 percent of total billed charges 529 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Optum Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 P3 HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 545 percent of total billed charges 545 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Select Health HMO 41 41% of all negotiated rates 319 percent of total billed charges 319 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 261 percent of total billed charges 261 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Sierra/HPN HMO 60 60% of all negotiated rates 467 percent of total billed charges 467 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Silversummit Medicare HMO 39 39% of all negotiated rates 303 percent of total billed charges 303 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 272 percent of total billed charges 272 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 Teachers Trust PPO 68 68% of all negotiated rates 529 percent of total billed charges 529 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 TriWest PPO 30 30% of all negotiated rates 233 percent of total billed charges 233 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 UHN-Universal Health Network PPO 70 70% of all negotiated rates 545 percent of total billed charges 545 778 24650 - CD TX RADIALHEAD/NK FX WO 24650 CPT 3230102 LOCAL 450 RC outpatient 778 661 United Healthcare PPO 60 60% of all negotiated rates 467 percent of total billed charges 467 778 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Aetna Medicare HMO 26 26% of all negotiated rates 809 percent of total billed charges 809 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Alignment Medicare HMO 39 39% of all negotiated rates 1214 percent of total billed charges 1214 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1868 percent of total billed charges 1868 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1557 percent of total billed charges 1557 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 378 fee schedule 378 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1214 percent of total billed charges 1214 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Cigna PPO 68 68% of all negotiated rates 2117 percent of total billed charges 2117 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Coalition PPO 59 59% of all negotiated rates 2117 percent of total billed charges 2117 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Coventry PPO 75 75% of all negotiated rates 2335 percent of total billed charges 2335 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2490 percent of total billed charges 2490 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 378 fee schedule 378 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Humana-Commerical PPO 70 70% of all negotiated rates 2179 percent of total billed charges 2179 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1214 percent of total billed charges 1214 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 378 fee schedule 378 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Multiplan PPO 80 80% of all negotiated rates 2490 percent of total billed charges 2490 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 One Health PPO 55 55% of all negotiated rates 2117 percent of total billed charges 2117 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Optum Medicare HMO 39 39% of all negotiated rates 1214 percent of total billed charges 1214 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 P3 HMO 39 39% of all negotiated rates 1214 percent of total billed charges 1214 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2179 percent of total billed charges 2179 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Select Health HMO 41 41% of all negotiated rates 1276 percent of total billed charges 1276 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1043 percent of total billed charges 1043 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Sierra/HPN HMO 60 60% of all negotiated rates 1868 percent of total billed charges 1868 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Silversummit Medicare HMO 39 39% of all negotiated rates 1214 percent of total billed charges 1214 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1090 percent of total billed charges 1090 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 Teachers Trust PPO 68 68% of all negotiated rates 2117 percent of total billed charges 2117 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 TriWest PPO 30 30% of all negotiated rates 934 percent of total billed charges 934 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2179 percent of total billed charges 2179 3113 24655 CLSD TRTMT RADIAL HEAD W/MANIP ED CHARGE 24655 CPT 3230570 LOCAL 450 RC outpatient 3113 2646 United Healthcare PPO 60 60% of all negotiated rates 1868 percent of total billed charges 1868 3113 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Aetna Medicare HMO 26 26% of all negotiated rates 222 percent of total billed charges 222 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Alignment Medicare HMO 39 39% of all negotiated rates 333 percent of total billed charges 333 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 512 percent of total billed charges 512 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 427 percent of total billed charges 427 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 249 fee schedule 249 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 333 percent of total billed charges 333 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Cigna PPO 68 68% of all negotiated rates 581 percent of total billed charges 581 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Coalition PPO 59 59% of all negotiated rates 581 percent of total billed charges 581 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Coventry PPO 75 75% of all negotiated rates 641 percent of total billed charges 641 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 683 percent of total billed charges 683 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 249 fee schedule 249 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Humana-Commerical PPO 70 70% of all negotiated rates 598 percent of total billed charges 598 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 333 percent of total billed charges 333 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 249 fee schedule 249 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Multiplan PPO 80 80% of all negotiated rates 683 percent of total billed charges 683 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 One Health PPO 55 55% of all negotiated rates 581 percent of total billed charges 581 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Optum Medicare HMO 39 39% of all negotiated rates 333 percent of total billed charges 333 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 P3 HMO 39 39% of all negotiated rates 333 percent of total billed charges 333 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 598 percent of total billed charges 598 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Select Health HMO 41 41% of all negotiated rates 350 percent of total billed charges 350 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 286 percent of total billed charges 286 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Sierra/HPN HMO 60 60% of all negotiated rates 512 percent of total billed charges 512 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Silversummit Medicare HMO 39 39% of all negotiated rates 333 percent of total billed charges 333 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 299 percent of total billed charges 299 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 Teachers Trust PPO 68 68% of all negotiated rates 581 percent of total billed charges 581 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 TriWest PPO 30 30% of all negotiated rates 256 percent of total billed charges 256 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 UHN-Universal Health Network PPO 70 70% of all negotiated rates 598 percent of total billed charges 598 854 24670 Clsd Tx Ulnar Fx W/O Mani 24670 CPT 3230585 LOCAL 450 RC outpatient 854 726 United Healthcare PPO 60 60% of all negotiated rates 512 percent of total billed charges 512 854 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Aetna Medicare HMO 26 26% of all negotiated rates 449 percent of total billed charges 449 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Alignment Medicare HMO 39 39% of all negotiated rates 674 percent of total billed charges 674 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1036 percent of total billed charges 1036 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 864 percent of total billed charges 864 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 237 fee schedule 237 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 674 percent of total billed charges 674 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Cigna PPO 68 68% of all negotiated rates 1174 percent of total billed charges 1174 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Coalition PPO 59 59% of all negotiated rates 1174 percent of total billed charges 1174 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Coventry PPO 75 75% of all negotiated rates 1295 percent of total billed charges 1295 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1382 percent of total billed charges 1382 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 237 fee schedule 237 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Humana-Commerical PPO 70 70% of all negotiated rates 1209 percent of total billed charges 1209 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 674 percent of total billed charges 674 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 237 fee schedule 237 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Multiplan PPO 80 80% of all negotiated rates 1382 percent of total billed charges 1382 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 One Health PPO 55 55% of all negotiated rates 1174 percent of total billed charges 1174 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Optum Medicare HMO 39 39% of all negotiated rates 674 percent of total billed charges 674 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 P3 HMO 39 39% of all negotiated rates 674 percent of total billed charges 674 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1209 percent of total billed charges 1209 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Select Health HMO 41 41% of all negotiated rates 708 percent of total billed charges 708 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 579 percent of total billed charges 579 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Sierra/HPN HMO 60 60% of all negotiated rates 1036 percent of total billed charges 1036 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Silversummit Medicare HMO 39 39% of all negotiated rates 674 percent of total billed charges 674 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 604 percent of total billed charges 604 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 Teachers Trust PPO 68 68% of all negotiated rates 1174 percent of total billed charges 1174 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 TriWest PPO 30 30% of all negotiated rates 518 percent of total billed charges 518 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1209 percent of total billed charges 1209 1727 25500 CLO TRMT RADIAL SHFT W/O 25500 CPT 3230325 LOCAL 450 RC outpatient 1727 1468 United Healthcare PPO 60 60% of all negotiated rates 1036 percent of total billed charges 1036 1727 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Aetna Medicare HMO 26 26% of all negotiated rates 763 percent of total billed charges 763 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Alignment Medicare HMO 39 39% of all negotiated rates 1144 percent of total billed charges 1144 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1760 percent of total billed charges 1760 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1467 percent of total billed charges 1467 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 435 fee schedule 435 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1144 percent of total billed charges 1144 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Cigna PPO 68 68% of all negotiated rates 1994 percent of total billed charges 1994 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Coalition PPO 59 59% of all negotiated rates 1994 percent of total billed charges 1994 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Coventry PPO 75 75% of all negotiated rates 2200 percent of total billed charges 2200 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2346 percent of total billed charges 2346 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 435 fee schedule 435 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Humana-Commerical PPO 70 70% of all negotiated rates 2053 percent of total billed charges 2053 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1144 percent of total billed charges 1144 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 435 fee schedule 435 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Multiplan PPO 80 80% of all negotiated rates 2346 percent of total billed charges 2346 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 One Health PPO 55 55% of all negotiated rates 1994 percent of total billed charges 1994 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Optum Medicare HMO 39 39% of all negotiated rates 1144 percent of total billed charges 1144 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 P3 HMO 39 39% of all negotiated rates 1144 percent of total billed charges 1144 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2053 percent of total billed charges 2053 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Select Health HMO 41 41% of all negotiated rates 1203 percent of total billed charges 1203 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 983 percent of total billed charges 983 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Sierra/HPN HMO 60 60% of all negotiated rates 1760 percent of total billed charges 1760 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Silversummit Medicare HMO 39 39% of all negotiated rates 1144 percent of total billed charges 1144 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1027 percent of total billed charges 1027 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 Teachers Trust PPO 68 68% of all negotiated rates 1994 percent of total billed charges 1994 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 TriWest PPO 30 30% of all negotiated rates 880 percent of total billed charges 880 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2053 percent of total billed charges 2053 2933 25505 CLOSED TX OF RADIAL SHAFT FX W/MANIP CHARGE 25505 CPT 45025505 LOCAL 450 RC outpatient 2933 2493 United Healthcare PPO 60 60% of all negotiated rates 1760 percent of total billed charges 1760 2933 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 238 fee schedule 238 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 238 fee schedule 238 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 238 fee schedule 238 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 25560 CLSD TX RAD/ULNA W/O MANI 25560 CPT 3230540 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Aetna Medicare HMO 26 26% of all negotiated rates 629 percent of total billed charges 629 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Alignment Medicare HMO 39 39% of all negotiated rates 943 percent of total billed charges 943 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1451 percent of total billed charges 1451 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1209 percent of total billed charges 1209 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 445 fee schedule 445 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 943 percent of total billed charges 943 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Cigna PPO 68 68% of all negotiated rates 1644 percent of total billed charges 1644 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Coalition PPO 59 59% of all negotiated rates 1644 percent of total billed charges 1644 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Coventry PPO 75 75% of all negotiated rates 1814 percent of total billed charges 1814 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1934 percent of total billed charges 1934 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 445 fee schedule 445 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Humana-Commerical PPO 70 70% of all negotiated rates 1693 percent of total billed charges 1693 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 943 percent of total billed charges 943 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 445 fee schedule 445 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Multiplan PPO 80 80% of all negotiated rates 1934 percent of total billed charges 1934 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 One Health PPO 55 55% of all negotiated rates 1644 percent of total billed charges 1644 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Optum Medicare HMO 39 39% of all negotiated rates 943 percent of total billed charges 943 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 P3 HMO 39 39% of all negotiated rates 943 percent of total billed charges 943 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1693 percent of total billed charges 1693 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Select Health HMO 41 41% of all negotiated rates 991 percent of total billed charges 991 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 810 percent of total billed charges 810 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Sierra/HPN HMO 60 60% of all negotiated rates 1451 percent of total billed charges 1451 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Silversummit Medicare HMO 39 39% of all negotiated rates 943 percent of total billed charges 943 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 846 percent of total billed charges 846 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 Teachers Trust PPO 68 68% of all negotiated rates 1644 percent of total billed charges 1644 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 TriWest PPO 30 30% of all negotiated rates 725 percent of total billed charges 725 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1693 percent of total billed charges 1693 2418 25565 CLD RED ULNA/RAD W/MANIP 25565 CPT 3230032 LOCAL 450 RC outpatient 2418 2055 United Healthcare PPO 60 60% of all negotiated rates 1451 percent of total billed charges 1451 2418 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 294 fee schedule 294 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 294 fee schedule 294 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 294 fee schedule 294 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 25600 CLO TX DIST RADIAL FX W/O 25600 CPT 3230507 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Aetna Medicare HMO 26 26% of all negotiated rates 670 percent of total billed charges 670 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Alignment Medicare HMO 39 39% of all negotiated rates 1004 percent of total billed charges 1004 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1545 percent of total billed charges 1545 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1288 percent of total billed charges 1288 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 489 fee schedule 489 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1004 percent of total billed charges 1004 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Cigna PPO 68 68% of all negotiated rates 1751 percent of total billed charges 1751 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Coalition PPO 59 59% of all negotiated rates 1751 percent of total billed charges 1751 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Coventry PPO 75 75% of all negotiated rates 1931 percent of total billed charges 1931 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2060 percent of total billed charges 2060 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 489 fee schedule 489 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Humana-Commerical PPO 70 70% of all negotiated rates 1803 percent of total billed charges 1803 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1004 percent of total billed charges 1004 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 489 fee schedule 489 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Multiplan PPO 80 80% of all negotiated rates 2060 percent of total billed charges 2060 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 One Health PPO 55 55% of all negotiated rates 1751 percent of total billed charges 1751 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Optum Medicare HMO 39 39% of all negotiated rates 1004 percent of total billed charges 1004 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 P3 HMO 39 39% of all negotiated rates 1004 percent of total billed charges 1004 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1803 percent of total billed charges 1803 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Select Health HMO 41 41% of all negotiated rates 1056 percent of total billed charges 1056 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 863 percent of total billed charges 863 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Sierra/HPN HMO 60 60% of all negotiated rates 1545 percent of total billed charges 1545 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Silversummit Medicare HMO 39 39% of all negotiated rates 1004 percent of total billed charges 1004 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 901 percent of total billed charges 901 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 Teachers Trust PPO 68 68% of all negotiated rates 1751 percent of total billed charges 1751 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 TriWest PPO 30 30% of all negotiated rates 773 percent of total billed charges 773 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1803 percent of total billed charges 1803 2575 25605 CLO TRMT DISTAL FX W MANI 25605 CPT 3230116 LOCAL 450 RC outpatient 2575 2189 United Healthcare PPO 60 60% of all negotiated rates 1545 percent of total billed charges 1545 2575 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Aetna Medicare HMO 26 26% of all negotiated rates 508 percent of total billed charges 508 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Alignment Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 977 percent of total billed charges 977 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 263 fee schedule 263 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Cigna PPO 68 68% of all negotiated rates 1328 percent of total billed charges 1328 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Coalition PPO 59 59% of all negotiated rates 1328 percent of total billed charges 1328 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Coventry PPO 75 75% of all negotiated rates 1465 percent of total billed charges 1465 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1562 percent of total billed charges 1562 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 263 fee schedule 263 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Humana-Commerical PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 263 fee schedule 263 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Multiplan PPO 80 80% of all negotiated rates 1562 percent of total billed charges 1562 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 One Health PPO 55 55% of all negotiated rates 1328 percent of total billed charges 1328 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Optum Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 P3 HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Select Health HMO 41 41% of all negotiated rates 801 percent of total billed charges 801 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 654 percent of total billed charges 654 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Sierra/HPN HMO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Silversummit Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 684 percent of total billed charges 684 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 Teachers Trust PPO 68 68% of all negotiated rates 1328 percent of total billed charges 1328 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 TriWest PPO 30 30% of all negotiated rates 586 percent of total billed charges 586 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 25622 CLO TX WRIST W/O MANIP 25622 CPT 3230590 LOCAL 450 RC outpatient 1953 1660 United Healthcare PPO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Aetna Medicare HMO 26 26% of all negotiated rates 630 percent of total billed charges 630 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Alignment Medicare HMO 39 39% of all negotiated rates 945 percent of total billed charges 945 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1454 percent of total billed charges 1454 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1212 percent of total billed charges 1212 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 265 fee schedule 265 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 945 percent of total billed charges 945 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Cigna PPO 68 68% of all negotiated rates 1648 percent of total billed charges 1648 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Coalition PPO 59 59% of all negotiated rates 1648 percent of total billed charges 1648 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Coventry PPO 75 75% of all negotiated rates 1818 percent of total billed charges 1818 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1939 percent of total billed charges 1939 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 265 fee schedule 265 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Humana-Commerical PPO 70 70% of all negotiated rates 1697 percent of total billed charges 1697 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 945 percent of total billed charges 945 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 265 fee schedule 265 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Multiplan PPO 80 80% of all negotiated rates 1939 percent of total billed charges 1939 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 One Health PPO 55 55% of all negotiated rates 1648 percent of total billed charges 1648 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Optum Medicare HMO 39 39% of all negotiated rates 945 percent of total billed charges 945 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 P3 HMO 39 39% of all negotiated rates 945 percent of total billed charges 945 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1697 percent of total billed charges 1697 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Select Health HMO 41 41% of all negotiated rates 994 percent of total billed charges 994 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 812 percent of total billed charges 812 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Sierra/HPN HMO 60 60% of all negotiated rates 1454 percent of total billed charges 1454 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Silversummit Medicare HMO 39 39% of all negotiated rates 945 percent of total billed charges 945 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 848 percent of total billed charges 848 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 Teachers Trust PPO 68 68% of all negotiated rates 1648 percent of total billed charges 1648 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 TriWest PPO 30 30% of all negotiated rates 727 percent of total billed charges 727 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1697 percent of total billed charges 1697 2424 25630 CO TX CARPAL W/O MANIP 25630 CPT 3230288 LOCAL 450 RC outpatient 2424 2060 United Healthcare PPO 60 60% of all negotiated rates 1454 percent of total billed charges 1454 2424 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Aetna Medicare HMO 26 26% of all negotiated rates 231 percent of total billed charges 231 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Alignment Medicare HMO 39 39% of all negotiated rates 347 percent of total billed charges 347 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 533 percent of total billed charges 533 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 445 percent of total billed charges 445 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 285 fee schedule 285 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 347 percent of total billed charges 347 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Cigna PPO 68 68% of all negotiated rates 605 percent of total billed charges 605 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Coalition PPO 59 59% of all negotiated rates 605 percent of total billed charges 605 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Coventry PPO 75 75% of all negotiated rates 667 percent of total billed charges 667 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 711 percent of total billed charges 711 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 285 fee schedule 285 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Humana-Commerical PPO 70 70% of all negotiated rates 622 percent of total billed charges 622 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 347 percent of total billed charges 347 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 285 fee schedule 285 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Multiplan PPO 80 80% of all negotiated rates 711 percent of total billed charges 711 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 One Health PPO 55 55% of all negotiated rates 605 percent of total billed charges 605 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Optum Medicare HMO 39 39% of all negotiated rates 347 percent of total billed charges 347 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 P3 HMO 39 39% of all negotiated rates 347 percent of total billed charges 347 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 622 percent of total billed charges 622 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Select Health HMO 41 41% of all negotiated rates 364 percent of total billed charges 364 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 298 percent of total billed charges 298 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Sierra/HPN HMO 60 60% of all negotiated rates 533 percent of total billed charges 533 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Silversummit Medicare HMO 39 39% of all negotiated rates 347 percent of total billed charges 347 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 311 percent of total billed charges 311 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 Teachers Trust PPO 68 68% of all negotiated rates 605 percent of total billed charges 605 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 TriWest PPO 30 30% of all negotiated rates 267 percent of total billed charges 267 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 UHN-Universal Health Network PPO 70 70% of all negotiated rates 622 percent of total billed charges 622 889 25650 CD FX TX ULNAR STYLOID Charge 25650 CPT 3230125 LOCAL 450 RC outpatient 889 756 United Healthcare PPO 60 60% of all negotiated rates 533 percent of total billed charges 533 889 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Aetna Medicare HMO 26 26% of all negotiated rates 481 percent of total billed charges 481 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Alignment Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1110 percent of total billed charges 1110 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 925 percent of total billed charges 925 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 131 fee schedule 131 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Cigna PPO 68 68% of all negotiated rates 1258 percent of total billed charges 1258 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Coalition PPO 59 59% of all negotiated rates 1258 percent of total billed charges 1258 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Coventry PPO 75 75% of all negotiated rates 1388 percent of total billed charges 1388 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1480 percent of total billed charges 1480 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 131 fee schedule 131 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Humana-Commerical PPO 70 70% of all negotiated rates 1295 percent of total billed charges 1295 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 131 fee schedule 131 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Multiplan PPO 80 80% of all negotiated rates 1480 percent of total billed charges 1480 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 One Health PPO 55 55% of all negotiated rates 1258 percent of total billed charges 1258 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Optum Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 P3 HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1295 percent of total billed charges 1295 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Select Health HMO 41 41% of all negotiated rates 759 percent of total billed charges 759 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 620 percent of total billed charges 620 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Sierra/HPN HMO 60 60% of all negotiated rates 1110 percent of total billed charges 1110 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Silversummit Medicare HMO 39 39% of all negotiated rates 722 percent of total billed charges 722 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 648 percent of total billed charges 648 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 Teachers Trust PPO 68 68% of all negotiated rates 1258 percent of total billed charges 1258 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 TriWest PPO 30 30% of all negotiated rates 555 percent of total billed charges 555 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1295 percent of total billed charges 1295 1850 "26010 DRAIN FINGER ABSCESS, SIMPLE ED CHARGE" 26010 CPT 3231120 LOCAL 450 RC outpatient 1850 1573 United Healthcare PPO 60 60% of all negotiated rates 1110 percent of total billed charges 1110 1850 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Aetna Medicare HMO 26 26% of all negotiated rates 192 percent of total billed charges 192 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Alignment Medicare HMO 39 39% of all negotiated rates 287 percent of total billed charges 287 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 442 percent of total billed charges 442 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 369 percent of total billed charges 369 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 287 percent of total billed charges 287 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Cigna PPO 68 68% of all negotiated rates 501 percent of total billed charges 501 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Coalition PPO 59 59% of all negotiated rates 501 percent of total billed charges 501 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Coventry PPO 75 75% of all negotiated rates 553 percent of total billed charges 553 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 590 percent of total billed charges 590 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Humana-Commerical PPO 70 70% of all negotiated rates 516 percent of total billed charges 516 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 287 percent of total billed charges 287 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Multiplan PPO 80 80% of all negotiated rates 590 percent of total billed charges 590 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 One Health PPO 55 55% of all negotiated rates 501 percent of total billed charges 501 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Optum Medicare HMO 39 39% of all negotiated rates 287 percent of total billed charges 287 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 P3 HMO 39 39% of all negotiated rates 287 percent of total billed charges 287 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 516 percent of total billed charges 516 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Select Health HMO 41 41% of all negotiated rates 302 percent of total billed charges 302 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 247 percent of total billed charges 247 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Sierra/HPN HMO 60 60% of all negotiated rates 442 percent of total billed charges 442 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Silversummit Medicare HMO 39 39% of all negotiated rates 287 percent of total billed charges 287 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 258 percent of total billed charges 258 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 Teachers Trust PPO 68 68% of all negotiated rates 501 percent of total billed charges 501 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 TriWest PPO 30 30% of all negotiated rates 221 percent of total billed charges 221 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 UHN-Universal Health Network PPO 70 70% of all negotiated rates 516 percent of total billed charges 516 737 26011 DRNG FINGER ABSCESS COMPL 26011 CPT 3230382 LOCAL 450 RC outpatient 737 626 United Healthcare PPO 60 60% of all negotiated rates 442 percent of total billed charges 442 737 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Aetna Medicare HMO 26 26% of all negotiated rates 212 percent of total billed charges 212 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Alignment Medicare HMO 39 39% of all negotiated rates 318 percent of total billed charges 318 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 490 percent of total billed charges 490 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 408 percent of total billed charges 408 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 263 fee schedule 263 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 318 percent of total billed charges 318 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Cigna PPO 68 68% of all negotiated rates 555 percent of total billed charges 555 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Coalition PPO 59 59% of all negotiated rates 555 percent of total billed charges 555 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Coventry PPO 75 75% of all negotiated rates 612 percent of total billed charges 612 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 653 percent of total billed charges 653 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 263 fee schedule 263 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Humana-Commerical PPO 70 70% of all negotiated rates 571 percent of total billed charges 571 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 318 percent of total billed charges 318 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 263 fee schedule 263 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Multiplan PPO 80 80% of all negotiated rates 653 percent of total billed charges 653 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 One Health PPO 55 55% of all negotiated rates 555 percent of total billed charges 555 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Optum Medicare HMO 39 39% of all negotiated rates 318 percent of total billed charges 318 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 P3 HMO 39 39% of all negotiated rates 318 percent of total billed charges 318 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 571 percent of total billed charges 571 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Select Health HMO 41 41% of all negotiated rates 335 percent of total billed charges 335 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 273 percent of total billed charges 273 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Sierra/HPN HMO 60 60% of all negotiated rates 490 percent of total billed charges 490 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Silversummit Medicare HMO 39 39% of all negotiated rates 318 percent of total billed charges 318 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 286 percent of total billed charges 286 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 Teachers Trust PPO 68 68% of all negotiated rates 555 percent of total billed charges 555 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 TriWest PPO 30 30% of all negotiated rates 245 percent of total billed charges 245 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 UHN-Universal Health Network PPO 70 70% of all negotiated rates 571 percent of total billed charges 571 816 26600 CLD TX MTCPL FX W/O MANIP 26600 CPT 3230510 LOCAL 450 RC outpatient 816 694 United Healthcare PPO 60 60% of all negotiated rates 490 percent of total billed charges 490 816 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Aetna Medicare HMO 26 26% of all negotiated rates 274 percent of total billed charges 274 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Alignment Medicare HMO 39 39% of all negotiated rates 411 percent of total billed charges 411 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 632 percent of total billed charges 632 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 527 percent of total billed charges 527 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 277 fee schedule 277 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 411 percent of total billed charges 411 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Cigna PPO 68 68% of all negotiated rates 716 percent of total billed charges 716 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Coalition PPO 59 59% of all negotiated rates 716 percent of total billed charges 716 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Coventry PPO 75 75% of all negotiated rates 790 percent of total billed charges 790 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 842 percent of total billed charges 842 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 277 fee schedule 277 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Humana-Commerical PPO 70 70% of all negotiated rates 737 percent of total billed charges 737 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 411 percent of total billed charges 411 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 277 fee schedule 277 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Multiplan PPO 80 80% of all negotiated rates 842 percent of total billed charges 842 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 One Health PPO 55 55% of all negotiated rates 716 percent of total billed charges 716 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Optum Medicare HMO 39 39% of all negotiated rates 411 percent of total billed charges 411 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 P3 HMO 39 39% of all negotiated rates 411 percent of total billed charges 411 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 737 percent of total billed charges 737 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Select Health HMO 41 41% of all negotiated rates 432 percent of total billed charges 432 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 353 percent of total billed charges 353 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Sierra/HPN HMO 60 60% of all negotiated rates 632 percent of total billed charges 632 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Silversummit Medicare HMO 39 39% of all negotiated rates 411 percent of total billed charges 411 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 369 percent of total billed charges 369 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 Teachers Trust PPO 68 68% of all negotiated rates 716 percent of total billed charges 716 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 TriWest PPO 30 30% of all negotiated rates 316 percent of total billed charges 316 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 UHN-Universal Health Network PPO 70 70% of all negotiated rates 737 percent of total billed charges 737 1053 26605 ED TRTMT CLOSED METACARPAL FX SINGLE W/ MANIP CHARGE 26605 CPT 3230625 LOCAL 450 RC outpatient 1053 895 United Healthcare PPO 60 60% of all negotiated rates 632 percent of total billed charges 632 1053 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Aetna Medicare HMO 26 26% of all negotiated rates 209 percent of total billed charges 209 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Alignment Medicare HMO 39 39% of all negotiated rates 313 percent of total billed charges 313 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 481 percent of total billed charges 481 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 401 percent of total billed charges 401 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 313 percent of total billed charges 313 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Cigna PPO 68 68% of all negotiated rates 545 percent of total billed charges 545 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Coalition PPO 59 59% of all negotiated rates 545 percent of total billed charges 545 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Coventry PPO 75 75% of all negotiated rates 602 percent of total billed charges 602 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 642 percent of total billed charges 642 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Humana-Commerical PPO 70 70% of all negotiated rates 561 percent of total billed charges 561 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 313 percent of total billed charges 313 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Multiplan PPO 80 80% of all negotiated rates 642 percent of total billed charges 642 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 One Health PPO 55 55% of all negotiated rates 545 percent of total billed charges 545 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Optum Medicare HMO 39 39% of all negotiated rates 313 percent of total billed charges 313 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 P3 HMO 39 39% of all negotiated rates 313 percent of total billed charges 313 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 561 percent of total billed charges 561 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Select Health HMO 41 41% of all negotiated rates 329 percent of total billed charges 329 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 269 percent of total billed charges 269 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Sierra/HPN HMO 60 60% of all negotiated rates 481 percent of total billed charges 481 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Silversummit Medicare HMO 39 39% of all negotiated rates 313 percent of total billed charges 313 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 281 percent of total billed charges 281 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 Teachers Trust PPO 68 68% of all negotiated rates 545 percent of total billed charges 545 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 TriWest PPO 30 30% of all negotiated rates 241 percent of total billed charges 241 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 UHN-Universal Health Network PPO 70 70% of all negotiated rates 561 percent of total billed charges 561 802 26720 CLO TX FINGER FX PROX/MID 26720 CPT 3230530 LOCAL 450 RC outpatient 802 682 United Healthcare PPO 60 60% of all negotiated rates 481 percent of total billed charges 481 802 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Aetna Medicare HMO 26 26% of all negotiated rates 242 percent of total billed charges 242 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Alignment Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 557 percent of total billed charges 557 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 465 percent of total billed charges 465 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Cigna PPO 68 68% of all negotiated rates 632 percent of total billed charges 632 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Coalition PPO 59 59% of all negotiated rates 632 percent of total billed charges 632 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Coventry PPO 75 75% of all negotiated rates 697 percent of total billed charges 697 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 743 percent of total billed charges 743 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Humana-Commerical PPO 70 70% of all negotiated rates 650 percent of total billed charges 650 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 288 fee schedule 288 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Multiplan PPO 80 80% of all negotiated rates 743 percent of total billed charges 743 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 One Health PPO 55 55% of all negotiated rates 632 percent of total billed charges 632 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Optum Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 P3 HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 650 percent of total billed charges 650 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Select Health HMO 41 41% of all negotiated rates 381 percent of total billed charges 381 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 311 percent of total billed charges 311 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Sierra/HPN HMO 60 60% of all negotiated rates 557 percent of total billed charges 557 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Silversummit Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 325 percent of total billed charges 325 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 Teachers Trust PPO 68 68% of all negotiated rates 632 percent of total billed charges 632 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 TriWest PPO 30 30% of all negotiated rates 279 percent of total billed charges 279 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 UHN-Universal Health Network PPO 70 70% of all negotiated rates 650 percent of total billed charges 650 929 26725 CLO TX FING FX W/MANIP 26725 CPT 3230575 LOCAL 450 RC outpatient 929 790 United Healthcare PPO 60 60% of all negotiated rates 557 percent of total billed charges 557 929 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Aetna Medicare HMO 26 26% of all negotiated rates 184 percent of total billed charges 184 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Alignment Medicare HMO 39 39% of all negotiated rates 277 percent of total billed charges 277 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 425 percent of total billed charges 425 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 355 percent of total billed charges 355 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 277 percent of total billed charges 277 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Cigna PPO 68 68% of all negotiated rates 482 percent of total billed charges 482 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Coalition PPO 59 59% of all negotiated rates 482 percent of total billed charges 482 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Coventry PPO 75 75% of all negotiated rates 532 percent of total billed charges 532 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 567 percent of total billed charges 567 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Humana-Commerical PPO 70 70% of all negotiated rates 496 percent of total billed charges 496 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 277 percent of total billed charges 277 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 175 fee schedule 175 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Multiplan PPO 80 80% of all negotiated rates 567 percent of total billed charges 567 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 One Health PPO 55 55% of all negotiated rates 482 percent of total billed charges 482 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Optum Medicare HMO 39 39% of all negotiated rates 277 percent of total billed charges 277 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 P3 HMO 39 39% of all negotiated rates 277 percent of total billed charges 277 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 496 percent of total billed charges 496 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Select Health HMO 41 41% of all negotiated rates 291 percent of total billed charges 291 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 238 percent of total billed charges 238 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Sierra/HPN HMO 60 60% of all negotiated rates 425 percent of total billed charges 425 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Silversummit Medicare HMO 39 39% of all negotiated rates 277 percent of total billed charges 277 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 248 percent of total billed charges 248 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 Teachers Trust PPO 68 68% of all negotiated rates 482 percent of total billed charges 482 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 TriWest PPO 30 30% of all negotiated rates 213 percent of total billed charges 213 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 UHN-Universal Health Network PPO 70 70% of all negotiated rates 496 percent of total billed charges 496 709 26750 CLO TX DIST PHAL FX FINGE 26750 CPT 3230515 LOCAL 450 RC outpatient 709 603 United Healthcare PPO 60 60% of all negotiated rates 425 percent of total billed charges 425 709 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Aetna Medicare HMO 26 26% of all negotiated rates 241 percent of total billed charges 241 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Alignment Medicare HMO 39 39% of all negotiated rates 361 percent of total billed charges 361 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 555 percent of total billed charges 555 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 463 percent of total billed charges 463 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 259 fee schedule 259 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 361 percent of total billed charges 361 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Cigna PPO 68 68% of all negotiated rates 629 percent of total billed charges 629 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Coalition PPO 59 59% of all negotiated rates 629 percent of total billed charges 629 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Coventry PPO 75 75% of all negotiated rates 694 percent of total billed charges 694 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 740 percent of total billed charges 740 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 259 fee schedule 259 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Humana-Commerical PPO 70 70% of all negotiated rates 648 percent of total billed charges 648 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 361 percent of total billed charges 361 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 259 fee schedule 259 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Multiplan PPO 80 80% of all negotiated rates 740 percent of total billed charges 740 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 One Health PPO 55 55% of all negotiated rates 629 percent of total billed charges 629 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Optum Medicare HMO 39 39% of all negotiated rates 361 percent of total billed charges 361 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 P3 HMO 39 39% of all negotiated rates 361 percent of total billed charges 361 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 648 percent of total billed charges 648 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Select Health HMO 41 41% of all negotiated rates 379 percent of total billed charges 379 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 310 percent of total billed charges 310 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Sierra/HPN HMO 60 60% of all negotiated rates 555 percent of total billed charges 555 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Silversummit Medicare HMO 39 39% of all negotiated rates 361 percent of total billed charges 361 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 324 percent of total billed charges 324 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 Teachers Trust PPO 68 68% of all negotiated rates 629 percent of total billed charges 629 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 TriWest PPO 30 30% of all negotiated rates 278 percent of total billed charges 278 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 UHN-Universal Health Network PPO 70 70% of all negotiated rates 648 percent of total billed charges 648 925 26755 CLOTX DIST PH FX FING MAN 26755 CPT 3230506 LOCAL 450 RC outpatient 925 786 United Healthcare PPO 60 60% of all negotiated rates 555 percent of total billed charges 555 925 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Aetna Medicare HMO 26 26% of all negotiated rates 169 percent of total billed charges 169 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Alignment Medicare HMO 39 39% of all negotiated rates 254 percent of total billed charges 254 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 391 percent of total billed charges 391 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 326 percent of total billed charges 326 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 242 fee schedule 242 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 254 percent of total billed charges 254 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Cigna PPO 68 68% of all negotiated rates 443 percent of total billed charges 443 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Coalition PPO 59 59% of all negotiated rates 443 percent of total billed charges 443 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Coventry PPO 75 75% of all negotiated rates 488 percent of total billed charges 488 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 521 percent of total billed charges 521 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 242 fee schedule 242 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Humana-Commerical PPO 70 70% of all negotiated rates 456 percent of total billed charges 456 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 254 percent of total billed charges 254 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 242 fee schedule 242 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Multiplan PPO 80 80% of all negotiated rates 521 percent of total billed charges 521 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 One Health PPO 55 55% of all negotiated rates 443 percent of total billed charges 443 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Optum Medicare HMO 39 39% of all negotiated rates 254 percent of total billed charges 254 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 P3 HMO 39 39% of all negotiated rates 254 percent of total billed charges 254 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 456 percent of total billed charges 456 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Select Health HMO 41 41% of all negotiated rates 267 percent of total billed charges 267 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 218 percent of total billed charges 218 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Sierra/HPN HMO 60 60% of all negotiated rates 391 percent of total billed charges 391 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Silversummit Medicare HMO 39 39% of all negotiated rates 254 percent of total billed charges 254 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 228 percent of total billed charges 228 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 Teachers Trust PPO 68 68% of all negotiated rates 443 percent of total billed charges 443 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 TriWest PPO 30 30% of all negotiated rates 195 percent of total billed charges 195 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 UHN-Universal Health Network PPO 70 70% of all negotiated rates 456 percent of total billed charges 456 651 26770 CLSD REDUCTN DSLCTED FING 26770 CPT 3236406 LOCAL 450 RC outpatient 651 553 United Healthcare PPO 60 60% of all negotiated rates 391 percent of total billed charges 391 651 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Aetna Medicare HMO 26 26% of all negotiated rates 409 percent of total billed charges 409 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Alignment Medicare HMO 39 39% of all negotiated rates 613 percent of total billed charges 613 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 944 percent of total billed charges 944 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 787 percent of total billed charges 787 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 173 fee schedule 173 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 613 percent of total billed charges 613 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Cigna PPO 68 68% of all negotiated rates 1070 percent of total billed charges 1070 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Coalition PPO 59 59% of all negotiated rates 1070 percent of total billed charges 1070 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Coventry PPO 75 75% of all negotiated rates 1180 percent of total billed charges 1180 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1258 percent of total billed charges 1258 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 173 fee schedule 173 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Humana-Commerical PPO 70 70% of all negotiated rates 1101 percent of total billed charges 1101 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 613 percent of total billed charges 613 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 173 fee schedule 173 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Multiplan PPO 80 80% of all negotiated rates 1258 percent of total billed charges 1258 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 One Health PPO 55 55% of all negotiated rates 1070 percent of total billed charges 1070 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Optum Medicare HMO 39 39% of all negotiated rates 613 percent of total billed charges 613 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 P3 HMO 39 39% of all negotiated rates 613 percent of total billed charges 613 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1101 percent of total billed charges 1101 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Select Health HMO 41 41% of all negotiated rates 645 percent of total billed charges 645 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 527 percent of total billed charges 527 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Sierra/HPN HMO 60 60% of all negotiated rates 944 percent of total billed charges 944 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Silversummit Medicare HMO 39 39% of all negotiated rates 613 percent of total billed charges 613 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 551 percent of total billed charges 551 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 Teachers Trust PPO 68 68% of all negotiated rates 1070 percent of total billed charges 1070 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 TriWest PPO 30 30% of all negotiated rates 472 percent of total billed charges 472 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1101 percent of total billed charges 1101 1573 27250 CLO TX HIP DISLOC TRAUMAT 27250 CPT 3230003 LOCAL 450 RC outpatient 1573 1337 United Healthcare PPO 60 60% of all negotiated rates 944 percent of total billed charges 944 1573 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Aetna Medicare HMO 26 26% of all negotiated rates 1773 percent of total billed charges 1773 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Alignment Medicare HMO 39 39% of all negotiated rates 2660 percent of total billed charges 2660 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 4093 percent of total billed charges 4093 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 3411 percent of total billed charges 3411 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 721 fee schedule 721 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2660 percent of total billed charges 2660 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Cigna PPO 68 68% of all negotiated rates 4638 percent of total billed charges 4638 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Coalition PPO 59 59% of all negotiated rates 4638 percent of total billed charges 4638 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Coventry PPO 75 75% of all negotiated rates 5116 percent of total billed charges 5116 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 5457 percent of total billed charges 5457 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 721 fee schedule 721 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Humana-Commerical PPO 70 70% of all negotiated rates 4775 percent of total billed charges 4775 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2660 percent of total billed charges 2660 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 721 fee schedule 721 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Multiplan PPO 80 80% of all negotiated rates 5457 percent of total billed charges 5457 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 One Health PPO 55 55% of all negotiated rates 4638 percent of total billed charges 4638 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Optum Medicare HMO 39 39% of all negotiated rates 2660 percent of total billed charges 2660 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 P3 HMO 39 39% of all negotiated rates 2660 percent of total billed charges 2660 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 4775 percent of total billed charges 4775 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Select Health HMO 41 41% of all negotiated rates 2797 percent of total billed charges 2797 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 2285 percent of total billed charges 2285 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Sierra/HPN HMO 60 60% of all negotiated rates 4093 percent of total billed charges 4093 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Silversummit Medicare HMO 39 39% of all negotiated rates 2660 percent of total billed charges 2660 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 2387 percent of total billed charges 2387 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 Teachers Trust PPO 68 68% of all negotiated rates 4638 percent of total billed charges 4638 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 TriWest PPO 30 30% of all negotiated rates 2046 percent of total billed charges 2046 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 UHN-Universal Health Network PPO 70 70% of all negotiated rates 4775 percent of total billed charges 4775 6821 27252 ED TRTMT HIP DISLOCATION REQ ANES CHARGE 27252 CPT 3230558 LOCAL 450 RC outpatient 6821 5798 United Healthcare PPO 60 60% of all negotiated rates 4093 percent of total billed charges 4093 6821 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Aetna Medicare HMO 26 26% of all negotiated rates 197 percent of total billed charges 197 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Alignment Medicare HMO 39 39% of all negotiated rates 295 percent of total billed charges 295 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 454 percent of total billed charges 454 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 379 percent of total billed charges 379 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 470 fee schedule 470 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 295 percent of total billed charges 295 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Cigna PPO 68 68% of all negotiated rates 515 percent of total billed charges 515 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Coalition PPO 59 59% of all negotiated rates 515 percent of total billed charges 515 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Coventry PPO 75 75% of all negotiated rates 568 percent of total billed charges 568 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 606 percent of total billed charges 606 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 470 fee schedule 470 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Humana-Commerical PPO 70 70% of all negotiated rates 530 percent of total billed charges 530 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 295 percent of total billed charges 295 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 470 fee schedule 470 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Multiplan PPO 80 80% of all negotiated rates 606 percent of total billed charges 606 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 One Health PPO 55 55% of all negotiated rates 515 percent of total billed charges 515 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Optum Medicare HMO 39 39% of all negotiated rates 295 percent of total billed charges 295 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 P3 HMO 39 39% of all negotiated rates 295 percent of total billed charges 295 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 530 percent of total billed charges 530 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Select Health HMO 41 41% of all negotiated rates 310 percent of total billed charges 310 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 254 percent of total billed charges 254 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Sierra/HPN HMO 60 60% of all negotiated rates 454 percent of total billed charges 454 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Silversummit Medicare HMO 39 39% of all negotiated rates 295 percent of total billed charges 295 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 265 percent of total billed charges 265 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 Teachers Trust PPO 68 68% of all negotiated rates 515 percent of total billed charges 515 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 TriWest PPO 30 30% of all negotiated rates 227 percent of total billed charges 227 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 UHN-Universal Health Network PPO 70 70% of all negotiated rates 530 percent of total billed charges 530 757 27508 CLSD TX FEMRAL FX W/O MNP 27508 CPT 3230516 LOCAL 450 RC outpatient 757 643 United Healthcare PPO 60 60% of all negotiated rates 454 percent of total billed charges 454 757 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Aetna Medicare HMO 26 26% of all negotiated rates 210 percent of total billed charges 210 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Alignment Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 485 percent of total billed charges 485 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 405 percent of total billed charges 405 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 280 fee schedule 280 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Cigna PPO 68 68% of all negotiated rates 550 percent of total billed charges 550 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Coalition PPO 59 59% of all negotiated rates 550 percent of total billed charges 550 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Coventry PPO 75 75% of all negotiated rates 607 percent of total billed charges 607 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 647 percent of total billed charges 647 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 280 fee schedule 280 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Humana-Commerical PPO 70 70% of all negotiated rates 566 percent of total billed charges 566 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 280 fee schedule 280 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Multiplan PPO 80 80% of all negotiated rates 647 percent of total billed charges 647 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 One Health PPO 55 55% of all negotiated rates 550 percent of total billed charges 550 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Optum Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 P3 HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 566 percent of total billed charges 566 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Select Health HMO 41 41% of all negotiated rates 332 percent of total billed charges 332 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 271 percent of total billed charges 271 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Sierra/HPN HMO 60 60% of all negotiated rates 485 percent of total billed charges 485 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Silversummit Medicare HMO 39 39% of all negotiated rates 316 percent of total billed charges 316 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 283 percent of total billed charges 283 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 Teachers Trust PPO 68 68% of all negotiated rates 550 percent of total billed charges 550 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 TriWest PPO 30 30% of all negotiated rates 243 percent of total billed charges 243 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 UHN-Universal Health Network PPO 70 70% of all negotiated rates 566 percent of total billed charges 566 809 27520 CLSD TX PATELA FX W/O MNP 27520 CPT 3230104 LOCAL 450 RC outpatient 809 688 United Healthcare PPO 60 60% of all negotiated rates 485 percent of total billed charges 485 809 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Aetna Medicare HMO 26 26% of all negotiated rates 236 percent of total billed charges 236 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Alignment Medicare HMO 39 39% of all negotiated rates 355 percent of total billed charges 355 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 545 percent of total billed charges 545 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 455 percent of total billed charges 455 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 266 fee schedule 266 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 355 percent of total billed charges 355 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Cigna PPO 68 68% of all negotiated rates 618 percent of total billed charges 618 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Coalition PPO 59 59% of all negotiated rates 618 percent of total billed charges 618 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Coventry PPO 75 75% of all negotiated rates 682 percent of total billed charges 682 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 727 percent of total billed charges 727 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 266 fee schedule 266 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Humana-Commerical PPO 70 70% of all negotiated rates 636 percent of total billed charges 636 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 355 percent of total billed charges 355 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 266 fee schedule 266 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Multiplan PPO 80 80% of all negotiated rates 727 percent of total billed charges 727 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 One Health PPO 55 55% of all negotiated rates 618 percent of total billed charges 618 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Optum Medicare HMO 39 39% of all negotiated rates 355 percent of total billed charges 355 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 P3 HMO 39 39% of all negotiated rates 355 percent of total billed charges 355 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 636 percent of total billed charges 636 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Select Health HMO 41 41% of all negotiated rates 373 percent of total billed charges 373 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 305 percent of total billed charges 305 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Sierra/HPN HMO 60 60% of all negotiated rates 545 percent of total billed charges 545 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Silversummit Medicare HMO 39 39% of all negotiated rates 355 percent of total billed charges 355 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 318 percent of total billed charges 318 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 Teachers Trust PPO 68 68% of all negotiated rates 618 percent of total billed charges 618 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 TriWest PPO 30 30% of all negotiated rates 273 percent of total billed charges 273 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 UHN-Universal Health Network PPO 70 70% of all negotiated rates 636 percent of total billed charges 636 909 27530 CLO TX TIBFX PROX W/O MAN 27530 CPT 3230135 LOCAL 450 RC outpatient 909 773 United Healthcare PPO 60 60% of all negotiated rates 545 percent of total billed charges 545 909 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Aetna Medicare HMO 26 26% of all negotiated rates 227 percent of total billed charges 227 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Alignment Medicare HMO 39 39% of all negotiated rates 340 percent of total billed charges 340 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 523 percent of total billed charges 523 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 436 percent of total billed charges 436 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 446 fee schedule 446 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 340 percent of total billed charges 340 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Cigna PPO 68 68% of all negotiated rates 593 percent of total billed charges 593 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Coalition PPO 59 59% of all negotiated rates 593 percent of total billed charges 593 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Coventry PPO 75 75% of all negotiated rates 654 percent of total billed charges 654 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 698 percent of total billed charges 698 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 446 fee schedule 446 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Humana-Commerical PPO 70 70% of all negotiated rates 610 percent of total billed charges 610 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 340 percent of total billed charges 340 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 446 fee schedule 446 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Multiplan PPO 80 80% of all negotiated rates 698 percent of total billed charges 698 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 One Health PPO 55 55% of all negotiated rates 593 percent of total billed charges 593 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Optum Medicare HMO 39 39% of all negotiated rates 340 percent of total billed charges 340 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 P3 HMO 39 39% of all negotiated rates 340 percent of total billed charges 340 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 610 percent of total billed charges 610 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Select Health HMO 41 41% of all negotiated rates 358 percent of total billed charges 358 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 292 percent of total billed charges 292 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Sierra/HPN HMO 60 60% of all negotiated rates 523 percent of total billed charges 523 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Silversummit Medicare HMO 39 39% of all negotiated rates 340 percent of total billed charges 340 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 305 percent of total billed charges 305 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 Teachers Trust PPO 68 68% of all negotiated rates 593 percent of total billed charges 593 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 TriWest PPO 30 30% of all negotiated rates 262 percent of total billed charges 262 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 UHN-Universal Health Network PPO 70 70% of all negotiated rates 610 percent of total billed charges 610 872 27550 CLO TX KNEE DISLOC WO ANE 27550 CPT 3235503 LOCAL 450 RC outpatient 872 741 United Healthcare PPO 60 60% of all negotiated rates 523 percent of total billed charges 523 872 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Aetna Medicare HMO 26 26% of all negotiated rates 586 percent of total billed charges 586 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Alignment Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1351 percent of total billed charges 1351 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1126 percent of total billed charges 1126 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 317 fee schedule 317 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Cigna PPO 68 68% of all negotiated rates 1531 percent of total billed charges 1531 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Coalition PPO 59 59% of all negotiated rates 1531 percent of total billed charges 1531 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Coventry PPO 75 75% of all negotiated rates 1689 percent of total billed charges 1689 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1802 percent of total billed charges 1802 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 317 fee schedule 317 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Humana-Commerical PPO 70 70% of all negotiated rates 1576 percent of total billed charges 1576 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 317 fee schedule 317 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Multiplan PPO 80 80% of all negotiated rates 1802 percent of total billed charges 1802 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 One Health PPO 55 55% of all negotiated rates 1531 percent of total billed charges 1531 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Optum Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 P3 HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1576 percent of total billed charges 1576 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Select Health HMO 41 41% of all negotiated rates 923 percent of total billed charges 923 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 754 percent of total billed charges 754 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Sierra/HPN HMO 60 60% of all negotiated rates 1351 percent of total billed charges 1351 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Silversummit Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 788 percent of total billed charges 788 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 Teachers Trust PPO 68 68% of all negotiated rates 1531 percent of total billed charges 1531 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 TriWest PPO 30 30% of all negotiated rates 676 percent of total billed charges 676 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1576 percent of total billed charges 1576 2252 27560 CLSD TX PATELLAR DISLOCATION W/O ANESTHESIA 27560 CPT 45027560 LOCAL 450 RC outpatient 2252 1914 United Healthcare PPO 60 60% of all negotiated rates 1351 percent of total billed charges 1351 2252 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Aetna Medicare HMO 26 26% of all negotiated rates 508 percent of total billed charges 508 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Alignment Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 977 percent of total billed charges 977 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 302 fee schedule 302 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Cigna PPO 68 68% of all negotiated rates 1328 percent of total billed charges 1328 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Coalition PPO 59 59% of all negotiated rates 1328 percent of total billed charges 1328 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Coventry PPO 75 75% of all negotiated rates 1465 percent of total billed charges 1465 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1562 percent of total billed charges 1562 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 302 fee schedule 302 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Humana-Commerical PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 302 fee schedule 302 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Multiplan PPO 80 80% of all negotiated rates 1562 percent of total billed charges 1562 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 One Health PPO 55 55% of all negotiated rates 1328 percent of total billed charges 1328 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Optum Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 P3 HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Select Health HMO 41 41% of all negotiated rates 801 percent of total billed charges 801 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 654 percent of total billed charges 654 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Sierra/HPN HMO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Silversummit Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 684 percent of total billed charges 684 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 Teachers Trust PPO 68 68% of all negotiated rates 1328 percent of total billed charges 1328 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 TriWest PPO 30 30% of all negotiated rates 586 percent of total billed charges 586 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 27750 - CLOTX TIBIAL SHAFT FX W/O 27750 CPT 3230596 LOCAL 450 RC outpatient 1953 1660 United Healthcare PPO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Aetna Medicare HMO 26 26% of all negotiated rates 198 percent of total billed charges 198 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Alignment Medicare HMO 39 39% of all negotiated rates 298 percent of total billed charges 298 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 458 percent of total billed charges 458 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 382 percent of total billed charges 382 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 290 fee schedule 290 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 298 percent of total billed charges 298 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Cigna PPO 68 68% of all negotiated rates 519 percent of total billed charges 519 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Coalition PPO 59 59% of all negotiated rates 519 percent of total billed charges 519 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Coventry PPO 75 75% of all negotiated rates 572 percent of total billed charges 572 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 610 percent of total billed charges 610 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 290 fee schedule 290 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Humana-Commerical PPO 70 70% of all negotiated rates 534 percent of total billed charges 534 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 298 percent of total billed charges 298 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 290 fee schedule 290 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Multiplan PPO 80 80% of all negotiated rates 610 percent of total billed charges 610 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 One Health PPO 55 55% of all negotiated rates 519 percent of total billed charges 519 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Optum Medicare HMO 39 39% of all negotiated rates 298 percent of total billed charges 298 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 P3 HMO 39 39% of all negotiated rates 298 percent of total billed charges 298 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 534 percent of total billed charges 534 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Select Health HMO 41 41% of all negotiated rates 313 percent of total billed charges 313 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 256 percent of total billed charges 256 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Sierra/HPN HMO 60 60% of all negotiated rates 458 percent of total billed charges 458 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Silversummit Medicare HMO 39 39% of all negotiated rates 298 percent of total billed charges 298 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 267 percent of total billed charges 267 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 Teachers Trust PPO 68 68% of all negotiated rates 519 percent of total billed charges 519 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 TriWest PPO 30 30% of all negotiated rates 229 percent of total billed charges 229 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 UHN-Universal Health Network PPO 70 70% of all negotiated rates 534 percent of total billed charges 534 763 27760 TREATMENT OF ANKLE FRACTURE 27760 CPT 3230553 LOCAL 450 RC outpatient 763 649 United Healthcare PPO 60 60% of all negotiated rates 458 percent of total billed charges 458 763 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Aetna Medicare HMO 26 26% of all negotiated rates 607 percent of total billed charges 607 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Alignment Medicare HMO 39 39% of all negotiated rates 911 percent of total billed charges 911 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1402 percent of total billed charges 1402 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1168 percent of total billed charges 1168 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 265 fee schedule 265 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 911 percent of total billed charges 911 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Cigna PPO 68 68% of all negotiated rates 1588 percent of total billed charges 1588 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Coalition PPO 59 59% of all negotiated rates 1588 percent of total billed charges 1588 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Coventry PPO 75 75% of all negotiated rates 1752 percent of total billed charges 1752 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1869 percent of total billed charges 1869 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 265 fee schedule 265 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Humana-Commerical PPO 70 70% of all negotiated rates 1635 percent of total billed charges 1635 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 911 percent of total billed charges 911 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 265 fee schedule 265 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Multiplan PPO 80 80% of all negotiated rates 1869 percent of total billed charges 1869 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 One Health PPO 55 55% of all negotiated rates 1588 percent of total billed charges 1588 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Optum Medicare HMO 39 39% of all negotiated rates 911 percent of total billed charges 911 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 P3 HMO 39 39% of all negotiated rates 911 percent of total billed charges 911 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1635 percent of total billed charges 1635 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Select Health HMO 41 41% of all negotiated rates 958 percent of total billed charges 958 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 783 percent of total billed charges 783 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Sierra/HPN HMO 60 60% of all negotiated rates 1402 percent of total billed charges 1402 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Silversummit Medicare HMO 39 39% of all negotiated rates 911 percent of total billed charges 911 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 818 percent of total billed charges 818 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 Teachers Trust PPO 68 68% of all negotiated rates 1588 percent of total billed charges 1588 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 TriWest PPO 30 30% of all negotiated rates 701 percent of total billed charges 701 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1635 percent of total billed charges 1635 2336 27780 ED TRTMT CLOSED PROX FIBULA FX W/O MANIP CHARGE 27780 CPT 3230320 LOCAL 450 RC outpatient 2336 1986 United Healthcare PPO 60 60% of all negotiated rates 1402 percent of total billed charges 1402 2336 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Aetna Medicare HMO 26 26% of all negotiated rates 228 percent of total billed charges 228 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Alignment Medicare HMO 39 39% of all negotiated rates 342 percent of total billed charges 342 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 527 percent of total billed charges 527 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 439 percent of total billed charges 439 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 342 percent of total billed charges 342 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Cigna PPO 68 68% of all negotiated rates 597 percent of total billed charges 597 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Coalition PPO 59 59% of all negotiated rates 597 percent of total billed charges 597 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Coventry PPO 75 75% of all negotiated rates 659 percent of total billed charges 659 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 702 percent of total billed charges 702 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Humana-Commerical PPO 70 70% of all negotiated rates 615 percent of total billed charges 615 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 342 percent of total billed charges 342 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 272 fee schedule 272 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Multiplan PPO 80 80% of all negotiated rates 702 percent of total billed charges 702 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 One Health PPO 55 55% of all negotiated rates 597 percent of total billed charges 597 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Optum Medicare HMO 39 39% of all negotiated rates 342 percent of total billed charges 342 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 P3 HMO 39 39% of all negotiated rates 342 percent of total billed charges 342 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 615 percent of total billed charges 615 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Select Health HMO 41 41% of all negotiated rates 360 percent of total billed charges 360 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 294 percent of total billed charges 294 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Sierra/HPN HMO 60 60% of all negotiated rates 527 percent of total billed charges 527 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Silversummit Medicare HMO 39 39% of all negotiated rates 342 percent of total billed charges 342 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 307 percent of total billed charges 307 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 Teachers Trust PPO 68 68% of all negotiated rates 597 percent of total billed charges 597 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 TriWest PPO 30 30% of all negotiated rates 263 percent of total billed charges 263 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 UHN-Universal Health Network PPO 70 70% of all negotiated rates 615 percent of total billed charges 615 878 27786 CLO TX DIST FIBFX W/O MAN 27786 CPT 3230549 LOCAL 450 RC outpatient 878 746 United Healthcare PPO 60 60% of all negotiated rates 527 percent of total billed charges 527 878 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Aetna Medicare HMO 26 26% of all negotiated rates 275 percent of total billed charges 275 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Alignment Medicare HMO 39 39% of all negotiated rates 413 percent of total billed charges 413 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 635 percent of total billed charges 635 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 529 percent of total billed charges 529 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 365 fee schedule 365 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 413 percent of total billed charges 413 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Cigna PPO 68 68% of all negotiated rates 719 percent of total billed charges 719 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Coalition PPO 59 59% of all negotiated rates 719 percent of total billed charges 719 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Coventry PPO 75 75% of all negotiated rates 794 percent of total billed charges 794 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 846 percent of total billed charges 846 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 365 fee schedule 365 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Humana-Commerical PPO 70 70% of all negotiated rates 741 percent of total billed charges 741 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 413 percent of total billed charges 413 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 365 fee schedule 365 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Multiplan PPO 80 80% of all negotiated rates 846 percent of total billed charges 846 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 One Health PPO 55 55% of all negotiated rates 719 percent of total billed charges 719 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Optum Medicare HMO 39 39% of all negotiated rates 413 percent of total billed charges 413 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 P3 HMO 39 39% of all negotiated rates 413 percent of total billed charges 413 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 741 percent of total billed charges 741 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Select Health HMO 41 41% of all negotiated rates 434 percent of total billed charges 434 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 354 percent of total billed charges 354 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Sierra/HPN HMO 60 60% of all negotiated rates 635 percent of total billed charges 635 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Silversummit Medicare HMO 39 39% of all negotiated rates 413 percent of total billed charges 413 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 370 percent of total billed charges 370 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 Teachers Trust PPO 68 68% of all negotiated rates 719 percent of total billed charges 719 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 TriWest PPO 30 30% of all negotiated rates 317 percent of total billed charges 317 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 UHN-Universal Health Network PPO 70 70% of all negotiated rates 741 percent of total billed charges 741 1058 27788 CLO TX DIST FIBFX W MAN 27788 CPT 3230098 LOCAL 450 RC outpatient 1058 899 United Healthcare PPO 60 60% of all negotiated rates 635 percent of total billed charges 635 1058 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Aetna Medicare HMO 26 26% of all negotiated rates 203 percent of total billed charges 203 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Alignment Medicare HMO 39 39% of all negotiated rates 305 percent of total billed charges 305 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 469 percent of total billed charges 469 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 391 percent of total billed charges 391 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 286 fee schedule 286 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 305 percent of total billed charges 305 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Cigna PPO 68 68% of all negotiated rates 532 percent of total billed charges 532 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Coalition PPO 59 59% of all negotiated rates 532 percent of total billed charges 532 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Coventry PPO 75 75% of all negotiated rates 587 percent of total billed charges 587 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 626 percent of total billed charges 626 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 286 fee schedule 286 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Humana-Commerical PPO 70 70% of all negotiated rates 547 percent of total billed charges 547 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 305 percent of total billed charges 305 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 286 fee schedule 286 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Multiplan PPO 80 80% of all negotiated rates 626 percent of total billed charges 626 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 One Health PPO 55 55% of all negotiated rates 532 percent of total billed charges 532 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Optum Medicare HMO 39 39% of all negotiated rates 305 percent of total billed charges 305 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 P3 HMO 39 39% of all negotiated rates 305 percent of total billed charges 305 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 547 percent of total billed charges 547 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Select Health HMO 41 41% of all negotiated rates 321 percent of total billed charges 321 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 262 percent of total billed charges 262 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Sierra/HPN HMO 60 60% of all negotiated rates 469 percent of total billed charges 469 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Silversummit Medicare HMO 39 39% of all negotiated rates 305 percent of total billed charges 305 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 274 percent of total billed charges 274 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 Teachers Trust PPO 68 68% of all negotiated rates 532 percent of total billed charges 532 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 TriWest PPO 30 30% of all negotiated rates 235 percent of total billed charges 235 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 UHN-Universal Health Network PPO 70 70% of all negotiated rates 547 percent of total billed charges 547 782 27808 CLD TX BIMALL FX W/O MANI 27808 CPT 3230381 LOCAL 450 RC outpatient 782 665 United Healthcare PPO 60 60% of all negotiated rates 469 percent of total billed charges 469 782 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Aetna Medicare HMO 26 26% of all negotiated rates 1630 percent of total billed charges 1630 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Alignment Medicare HMO 39 39% of all negotiated rates 2445 percent of total billed charges 2445 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3762 percent of total billed charges 3762 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 3135 percent of total billed charges 3135 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 404 fee schedule 404 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2445 percent of total billed charges 2445 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Cigna PPO 68 68% of all negotiated rates 4264 percent of total billed charges 4264 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Coalition PPO 59 59% of all negotiated rates 4264 percent of total billed charges 4264 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Coventry PPO 75 75% of all negotiated rates 4703 percent of total billed charges 4703 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 5016 percent of total billed charges 5016 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 404 fee schedule 404 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Humana-Commerical PPO 70 70% of all negotiated rates 4389 percent of total billed charges 4389 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2445 percent of total billed charges 2445 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 404 fee schedule 404 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Multiplan PPO 80 80% of all negotiated rates 5016 percent of total billed charges 5016 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 One Health PPO 55 55% of all negotiated rates 4264 percent of total billed charges 4264 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Optum Medicare HMO 39 39% of all negotiated rates 2445 percent of total billed charges 2445 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 P3 HMO 39 39% of all negotiated rates 2445 percent of total billed charges 2445 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 4389 percent of total billed charges 4389 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Select Health HMO 41 41% of all negotiated rates 2571 percent of total billed charges 2571 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 2100 percent of total billed charges 2100 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Sierra/HPN HMO 60 60% of all negotiated rates 3762 percent of total billed charges 3762 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Silversummit Medicare HMO 39 39% of all negotiated rates 2445 percent of total billed charges 2445 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 2195 percent of total billed charges 2195 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 Teachers Trust PPO 68 68% of all negotiated rates 4264 percent of total billed charges 4264 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 TriWest PPO 30 30% of all negotiated rates 1881 percent of total billed charges 1881 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 UHN-Universal Health Network PPO 70 70% of all negotiated rates 4389 percent of total billed charges 4389 6270 27810 CDTX BIMALANKLE FX W/MANI 27810 CPT 3231129 LOCAL 450 RC outpatient 6270 5330 United Healthcare PPO 60 60% of all negotiated rates 3762 percent of total billed charges 3762 6270 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Aetna Medicare HMO 26 26% of all negotiated rates 443 percent of total billed charges 443 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Alignment Medicare HMO 39 39% of all negotiated rates 665 percent of total billed charges 665 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1023 percent of total billed charges 1023 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 853 percent of total billed charges 853 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 414 fee schedule 414 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 665 percent of total billed charges 665 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Cigna PPO 68 68% of all negotiated rates 1159 percent of total billed charges 1159 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Coalition PPO 59 59% of all negotiated rates 1159 percent of total billed charges 1159 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Coventry PPO 75 75% of all negotiated rates 1279 percent of total billed charges 1279 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1364 percent of total billed charges 1364 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 414 fee schedule 414 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Humana-Commerical PPO 70 70% of all negotiated rates 1194 percent of total billed charges 1194 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 665 percent of total billed charges 665 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 414 fee schedule 414 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Multiplan PPO 80 80% of all negotiated rates 1364 percent of total billed charges 1364 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 One Health PPO 55 55% of all negotiated rates 1159 percent of total billed charges 1159 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Optum Medicare HMO 39 39% of all negotiated rates 665 percent of total billed charges 665 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 P3 HMO 39 39% of all negotiated rates 665 percent of total billed charges 665 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1194 percent of total billed charges 1194 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Select Health HMO 41 41% of all negotiated rates 699 percent of total billed charges 699 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 571 percent of total billed charges 571 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Sierra/HPN HMO 60 60% of all negotiated rates 1023 percent of total billed charges 1023 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Silversummit Medicare HMO 39 39% of all negotiated rates 665 percent of total billed charges 665 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 597 percent of total billed charges 597 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 Teachers Trust PPO 68 68% of all negotiated rates 1159 percent of total billed charges 1159 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 TriWest PPO 30 30% of all negotiated rates 512 percent of total billed charges 512 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1194 percent of total billed charges 1194 1705 27818 CLD TX TRIMAL W/MANI 27818 CPT 3230110 LOCAL 450 RC outpatient 1705 1449 United Healthcare PPO 60 60% of all negotiated rates 1023 percent of total billed charges 1023 1705 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Aetna Medicare HMO 26 26% of all negotiated rates 251 percent of total billed charges 251 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Alignment Medicare HMO 39 39% of all negotiated rates 376 percent of total billed charges 376 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 579 percent of total billed charges 579 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 483 percent of total billed charges 483 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 352 fee schedule 352 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 376 percent of total billed charges 376 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Cigna PPO 68 68% of all negotiated rates 656 percent of total billed charges 656 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Coalition PPO 59 59% of all negotiated rates 656 percent of total billed charges 656 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Coventry PPO 75 75% of all negotiated rates 724 percent of total billed charges 724 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 772 percent of total billed charges 772 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 352 fee schedule 352 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Humana-Commerical PPO 70 70% of all negotiated rates 676 percent of total billed charges 676 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 376 percent of total billed charges 376 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 352 fee schedule 352 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Multiplan PPO 80 80% of all negotiated rates 772 percent of total billed charges 772 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 One Health PPO 55 55% of all negotiated rates 656 percent of total billed charges 656 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Optum Medicare HMO 39 39% of all negotiated rates 376 percent of total billed charges 376 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 P3 HMO 39 39% of all negotiated rates 376 percent of total billed charges 376 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 676 percent of total billed charges 676 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Select Health HMO 41 41% of all negotiated rates 396 percent of total billed charges 396 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 323 percent of total billed charges 323 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Sierra/HPN HMO 60 60% of all negotiated rates 579 percent of total billed charges 579 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Silversummit Medicare HMO 39 39% of all negotiated rates 376 percent of total billed charges 376 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 338 percent of total billed charges 338 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 Teachers Trust PPO 68 68% of all negotiated rates 656 percent of total billed charges 656 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 TriWest PPO 30 30% of all negotiated rates 290 percent of total billed charges 290 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 UHN-Universal Health Network PPO 70 70% of all negotiated rates 676 percent of total billed charges 676 965 27840 CLO TX ANK DISLOC WO ANEX 27840 CPT 3238408 LOCAL 450 RC outpatient 965 820 United Healthcare PPO 60 60% of all negotiated rates 579 percent of total billed charges 579 965 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Aetna Medicare HMO 26 26% of all negotiated rates 367 percent of total billed charges 367 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Alignment Medicare HMO 39 39% of all negotiated rates 551 percent of total billed charges 551 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 848 percent of total billed charges 848 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 707 percent of total billed charges 707 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 127 fee schedule 127 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 551 percent of total billed charges 551 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Cigna PPO 68 68% of all negotiated rates 961 percent of total billed charges 961 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Coalition PPO 59 59% of all negotiated rates 961 percent of total billed charges 961 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Coventry PPO 75 75% of all negotiated rates 1060 percent of total billed charges 1060 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1130 percent of total billed charges 1130 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 127 fee schedule 127 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Humana-Commerical PPO 70 70% of all negotiated rates 989 percent of total billed charges 989 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 551 percent of total billed charges 551 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 127 fee schedule 127 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Multiplan PPO 80 80% of all negotiated rates 1130 percent of total billed charges 1130 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 One Health PPO 55 55% of all negotiated rates 961 percent of total billed charges 961 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Optum Medicare HMO 39 39% of all negotiated rates 551 percent of total billed charges 551 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 P3 HMO 39 39% of all negotiated rates 551 percent of total billed charges 551 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 989 percent of total billed charges 989 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Select Health HMO 41 41% of all negotiated rates 579 percent of total billed charges 579 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 473 percent of total billed charges 473 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Sierra/HPN HMO 60 60% of all negotiated rates 848 percent of total billed charges 848 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Silversummit Medicare HMO 39 39% of all negotiated rates 551 percent of total billed charges 551 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 495 percent of total billed charges 495 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 Teachers Trust PPO 68 68% of all negotiated rates 961 percent of total billed charges 961 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 TriWest PPO 30 30% of all negotiated rates 424 percent of total billed charges 424 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 UHN-Universal Health Network PPO 70 70% of all negotiated rates 989 percent of total billed charges 989 1413 28190 ED REMOVE FOREIGN BODY SUB CHARGE 28190 CPT 3232108 LOCAL 450 RC outpatient 1413 1201 United Healthcare PPO 60 60% of all negotiated rates 848 percent of total billed charges 848 1413 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Aetna Medicare HMO 26 26% of all negotiated rates 262 percent of total billed charges 262 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Alignment Medicare HMO 39 39% of all negotiated rates 392 percent of total billed charges 392 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 604 percent of total billed charges 604 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 503 percent of total billed charges 503 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 217 fee schedule 217 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 392 percent of total billed charges 392 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Cigna PPO 68 68% of all negotiated rates 684 percent of total billed charges 684 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Coalition PPO 59 59% of all negotiated rates 684 percent of total billed charges 684 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Coventry PPO 75 75% of all negotiated rates 755 percent of total billed charges 755 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 805 percent of total billed charges 805 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 217 fee schedule 217 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Humana-Commerical PPO 70 70% of all negotiated rates 704 percent of total billed charges 704 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 392 percent of total billed charges 392 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 217 fee schedule 217 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Multiplan PPO 80 80% of all negotiated rates 805 percent of total billed charges 805 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 One Health PPO 55 55% of all negotiated rates 684 percent of total billed charges 684 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Optum Medicare HMO 39 39% of all negotiated rates 392 percent of total billed charges 392 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 P3 HMO 39 39% of all negotiated rates 392 percent of total billed charges 392 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 704 percent of total billed charges 704 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Select Health HMO 41 41% of all negotiated rates 412 percent of total billed charges 412 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 337 percent of total billed charges 337 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Sierra/HPN HMO 60 60% of all negotiated rates 604 percent of total billed charges 604 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Silversummit Medicare HMO 39 39% of all negotiated rates 392 percent of total billed charges 392 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 352 percent of total billed charges 352 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 Teachers Trust PPO 68 68% of all negotiated rates 684 percent of total billed charges 684 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 TriWest PPO 30 30% of all negotiated rates 302 percent of total billed charges 302 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 UHN-Universal Health Network PPO 70 70% of all negotiated rates 704 percent of total billed charges 704 1006 28400 ED TRTMT CLOSED CALCANEAL FX W/O MANIP CHARGE 28400 CPT 3230000 LOCAL 450 RC outpatient 1006 855 United Healthcare PPO 60 60% of all negotiated rates 604 percent of total billed charges 604 1006 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Aetna Medicare HMO 26 26% of all negotiated rates 586 percent of total billed charges 586 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Alignment Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1351 percent of total billed charges 1351 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1126 percent of total billed charges 1126 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 199 fee schedule 199 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Cigna PPO 68 68% of all negotiated rates 1531 percent of total billed charges 1531 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Coalition PPO 59 59% of all negotiated rates 1531 percent of total billed charges 1531 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Coventry PPO 75 75% of all negotiated rates 1689 percent of total billed charges 1689 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1802 percent of total billed charges 1802 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 199 fee schedule 199 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Humana-Commerical PPO 70 70% of all negotiated rates 1576 percent of total billed charges 1576 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 199 fee schedule 199 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Multiplan PPO 80 80% of all negotiated rates 1802 percent of total billed charges 1802 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 One Health PPO 55 55% of all negotiated rates 1531 percent of total billed charges 1531 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Optum Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 P3 HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1576 percent of total billed charges 1576 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Select Health HMO 41 41% of all negotiated rates 923 percent of total billed charges 923 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 754 percent of total billed charges 754 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Sierra/HPN HMO 60 60% of all negotiated rates 1351 percent of total billed charges 1351 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Silversummit Medicare HMO 39 39% of all negotiated rates 878 percent of total billed charges 878 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 788 percent of total billed charges 788 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 Teachers Trust PPO 68 68% of all negotiated rates 1531 percent of total billed charges 1531 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 TriWest PPO 30 30% of all negotiated rates 676 percent of total billed charges 676 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1576 percent of total billed charges 1576 2252 28430 CLOSED TX OF TALUS FX W/O MANIPULATION 28430 CPT 45028430 LOCAL 450 RC outpatient 2252 1914 United Healthcare PPO 60 60% of all negotiated rates 1351 percent of total billed charges 1351 2252 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Aetna Medicare HMO 26 26% of all negotiated rates 242 percent of total billed charges 242 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Alignment Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 557 percent of total billed charges 557 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 465 percent of total billed charges 465 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 278 fee schedule 278 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Cigna PPO 68 68% of all negotiated rates 632 percent of total billed charges 632 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Coalition PPO 59 59% of all negotiated rates 632 percent of total billed charges 632 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Coventry PPO 75 75% of all negotiated rates 697 percent of total billed charges 697 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 743 percent of total billed charges 743 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 278 fee schedule 278 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Humana-Commerical PPO 70 70% of all negotiated rates 650 percent of total billed charges 650 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 278 fee schedule 278 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Multiplan PPO 80 80% of all negotiated rates 743 percent of total billed charges 743 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 One Health PPO 55 55% of all negotiated rates 632 percent of total billed charges 632 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Optum Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 P3 HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 650 percent of total billed charges 650 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Select Health HMO 41 41% of all negotiated rates 381 percent of total billed charges 381 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 311 percent of total billed charges 311 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Sierra/HPN HMO 60 60% of all negotiated rates 557 percent of total billed charges 557 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Silversummit Medicare HMO 39 39% of all negotiated rates 362 percent of total billed charges 362 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 325 percent of total billed charges 325 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 Teachers Trust PPO 68 68% of all negotiated rates 632 percent of total billed charges 632 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 TriWest PPO 30 30% of all negotiated rates 279 percent of total billed charges 279 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 UHN-Universal Health Network PPO 70 70% of all negotiated rates 650 percent of total billed charges 650 929 28435 ED Closed treatment of talus fracture with manipulation 28435 CPT 3230545 LOCAL 450 RC outpatient 929 790 United Healthcare PPO 60 60% of all negotiated rates 557 percent of total billed charges 557 929 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Aetna Medicare HMO 26 26% of all negotiated rates 394 percent of total billed charges 394 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Alignment Medicare HMO 39 39% of all negotiated rates 590 percent of total billed charges 590 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 908 percent of total billed charges 908 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 757 percent of total billed charges 757 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 184 fee schedule 184 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 590 percent of total billed charges 590 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Cigna PPO 68 68% of all negotiated rates 1030 percent of total billed charges 1030 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Coalition PPO 59 59% of all negotiated rates 1030 percent of total billed charges 1030 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Coventry PPO 75 75% of all negotiated rates 1136 percent of total billed charges 1136 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1211 percent of total billed charges 1211 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 184 fee schedule 184 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Humana-Commerical PPO 70 70% of all negotiated rates 1060 percent of total billed charges 1060 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 590 percent of total billed charges 590 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 184 fee schedule 184 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Multiplan PPO 80 80% of all negotiated rates 1211 percent of total billed charges 1211 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 One Health PPO 55 55% of all negotiated rates 1030 percent of total billed charges 1030 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Optum Medicare HMO 39 39% of all negotiated rates 590 percent of total billed charges 590 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 P3 HMO 39 39% of all negotiated rates 590 percent of total billed charges 590 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1060 percent of total billed charges 1060 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Select Health HMO 41 41% of all negotiated rates 621 percent of total billed charges 621 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 507 percent of total billed charges 507 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Sierra/HPN HMO 60 60% of all negotiated rates 908 percent of total billed charges 908 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Silversummit Medicare HMO 39 39% of all negotiated rates 590 percent of total billed charges 590 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 530 percent of total billed charges 530 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 Teachers Trust PPO 68 68% of all negotiated rates 1030 percent of total billed charges 1030 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 TriWest PPO 30 30% of all negotiated rates 454 percent of total billed charges 454 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1060 percent of total billed charges 1060 1514 28450 ED TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT 28450 CPT 3230940 LOCAL 450 RC outpatient 1514 1287 United Healthcare PPO 60 60% of all negotiated rates 908 percent of total billed charges 908 1514 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 197 fee schedule 197 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 197 fee schedule 197 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 197 fee schedule 197 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 28470 ED TRTMT CLOSED METATARSAL FX W/O MANIP CHARGE 28470 CPT 3230512 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Aetna Medicare HMO 26 26% of all negotiated rates 508 percent of total billed charges 508 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Alignment Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 977 percent of total billed charges 977 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 119 fee schedule 119 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Cigna PPO 68 68% of all negotiated rates 1328 percent of total billed charges 1328 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Coalition PPO 59 59% of all negotiated rates 1328 percent of total billed charges 1328 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Coventry PPO 75 75% of all negotiated rates 1465 percent of total billed charges 1465 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1562 percent of total billed charges 1562 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 119 fee schedule 119 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Humana-Commerical PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 119 fee schedule 119 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Multiplan PPO 80 80% of all negotiated rates 1562 percent of total billed charges 1562 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 One Health PPO 55 55% of all negotiated rates 1328 percent of total billed charges 1328 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Optum Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 P3 HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Select Health HMO 41 41% of all negotiated rates 801 percent of total billed charges 801 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 654 percent of total billed charges 654 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Sierra/HPN HMO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Silversummit Medicare HMO 39 39% of all negotiated rates 762 percent of total billed charges 762 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 684 percent of total billed charges 684 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 Teachers Trust PPO 68 68% of all negotiated rates 1328 percent of total billed charges 1328 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 TriWest PPO 30 30% of all negotiated rates 586 percent of total billed charges 586 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1367 percent of total billed charges 1367 1953 28490 CLOTX FX BIGTOE PHAX/PHAL 28490 CPT 3230597 LOCAL 450 RC outpatient 1953 1660 United Healthcare PPO 60 60% of all negotiated rates 1172 percent of total billed charges 1172 1953 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 328 percent of total billed charges 328 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 114 fee schedule 114 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 114 fee schedule 114 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Humana-Commerical PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 114 fee schedule 114 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Multiplan PPO 80 80% of all negotiated rates 524 percent of total billed charges 524 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Select Health HMO 41 41% of all negotiated rates 269 percent of total billed charges 269 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Sierra/HPN HMO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 TriWest PPO 30 30% of all negotiated rates 197 percent of total billed charges 197 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 UHN-Universal Health Network PPO 70 70% of all negotiated rates 459 percent of total billed charges 459 655 28510 CLO TX FX PHALANX 28510 CPT 3238510 LOCAL 450 RC outpatient 655 557 United Healthcare PPO 60 60% of all negotiated rates 393 percent of total billed charges 393 655 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Aetna Medicare HMO 26 26% of all negotiated rates 739 percent of total billed charges 739 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Alignment Medicare HMO 39 39% of all negotiated rates 1109 percent of total billed charges 1109 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1706 percent of total billed charges 1706 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1422 percent of total billed charges 1422 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 135 fee schedule 135 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1109 percent of total billed charges 1109 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Cigna PPO 68 68% of all negotiated rates 1934 percent of total billed charges 1934 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Coalition PPO 59 59% of all negotiated rates 1934 percent of total billed charges 1934 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Coventry PPO 75 75% of all negotiated rates 2133 percent of total billed charges 2133 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2275 percent of total billed charges 2275 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 135 fee schedule 135 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Humana-Commerical PPO 70 70% of all negotiated rates 1991 percent of total billed charges 1991 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1109 percent of total billed charges 1109 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 135 fee schedule 135 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Multiplan PPO 80 80% of all negotiated rates 2275 percent of total billed charges 2275 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 One Health PPO 55 55% of all negotiated rates 1934 percent of total billed charges 1934 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Optum Medicare HMO 39 39% of all negotiated rates 1109 percent of total billed charges 1109 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 P3 HMO 39 39% of all negotiated rates 1109 percent of total billed charges 1109 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1991 percent of total billed charges 1991 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Select Health HMO 41 41% of all negotiated rates 1166 percent of total billed charges 1166 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 953 percent of total billed charges 953 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Sierra/HPN HMO 60 60% of all negotiated rates 1706 percent of total billed charges 1706 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Silversummit Medicare HMO 39 39% of all negotiated rates 1109 percent of total billed charges 1109 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 995 percent of total billed charges 995 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 Teachers Trust PPO 68 68% of all negotiated rates 1934 percent of total billed charges 1934 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 TriWest PPO 30 30% of all negotiated rates 853 percent of total billed charges 853 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1991 percent of total billed charges 1991 2844 28515 CLSD TX FX TOE W/MANIP 28515 CPT 45028515 LOCAL 450 RC outpatient 2844 2417 United Healthcare PPO 60 60% of all negotiated rates 1706 percent of total billed charges 1706 2844 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Aetna Medicare HMO 26 26% of all negotiated rates 153 percent of total billed charges 153 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Alignment Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 353 percent of total billed charges 353 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 294 percent of total billed charges 294 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 57 fee schedule 57 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Cigna PPO 68 68% of all negotiated rates 400 percent of total billed charges 400 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Coalition PPO 59 59% of all negotiated rates 400 percent of total billed charges 400 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Coventry PPO 75 75% of all negotiated rates 441 percent of total billed charges 441 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 57 fee schedule 57 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Humana-Commerical PPO 70 70% of all negotiated rates 412 percent of total billed charges 412 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 57 fee schedule 57 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Multiplan PPO 80 80% of all negotiated rates 470 percent of total billed charges 470 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 One Health PPO 55 55% of all negotiated rates 400 percent of total billed charges 400 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Optum Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 P3 HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 412 percent of total billed charges 412 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Select Health HMO 41 41% of all negotiated rates 241 percent of total billed charges 241 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 197 percent of total billed charges 197 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Sierra/HPN HMO 60 60% of all negotiated rates 353 percent of total billed charges 353 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Silversummit Medicare HMO 39 39% of all negotiated rates 229 percent of total billed charges 229 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 206 percent of total billed charges 206 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 Teachers Trust PPO 68 68% of all negotiated rates 400 percent of total billed charges 400 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 TriWest PPO 30 30% of all negotiated rates 176 percent of total billed charges 176 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 UHN-Universal Health Network PPO 70 70% of all negotiated rates 412 percent of total billed charges 412 588 29105 ED APPLICATION LONG ARM SPLINT CHARGE 29105 CPT 3231054 LOCAL 450 RC outpatient 588 500 United Healthcare PPO 60 60% of all negotiated rates 353 percent of total billed charges 353 588 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Aetna Medicare HMO 26 26% of all negotiated rates 129 percent of total billed charges 129 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Alignment Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 249 percent of total billed charges 249 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 38 fee schedule 38 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Cigna PPO 68 68% of all negotiated rates 338 percent of total billed charges 338 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Coalition PPO 59 59% of all negotiated rates 338 percent of total billed charges 338 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Coventry PPO 75 75% of all negotiated rates 373 percent of total billed charges 373 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 398 percent of total billed charges 398 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 38 fee schedule 38 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Humana-Commerical PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 38 fee schedule 38 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Multiplan PPO 80 80% of all negotiated rates 398 percent of total billed charges 398 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 One Health PPO 55 55% of all negotiated rates 338 percent of total billed charges 338 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Optum Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 P3 HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Select Health HMO 41 41% of all negotiated rates 204 percent of total billed charges 204 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 166 percent of total billed charges 166 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Sierra/HPN HMO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Silversummit Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 174 percent of total billed charges 174 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 Teachers Trust PPO 68 68% of all negotiated rates 338 percent of total billed charges 338 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 TriWest PPO 30 30% of all negotiated rates 149 percent of total billed charges 149 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 UHN-Universal Health Network PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29125 ED APPLICATION SHORT ARM SPLINT CHARGE 29125 CPT 3231252 LOCAL 450 RC outpatient 497 422 United Healthcare PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Aetna Medicare HMO 26 26% of all negotiated rates 138 percent of total billed charges 138 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Alignment Medicare HMO 39 39% of all negotiated rates 207 percent of total billed charges 207 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 319 percent of total billed charges 319 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 266 percent of total billed charges 266 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 27 fee schedule 27 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 207 percent of total billed charges 207 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Cigna PPO 68 68% of all negotiated rates 361 percent of total billed charges 361 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Coalition PPO 59 59% of all negotiated rates 361 percent of total billed charges 361 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Coventry PPO 75 75% of all negotiated rates 398 percent of total billed charges 398 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 425 percent of total billed charges 425 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 27 fee schedule 27 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Humana-Commerical PPO 70 70% of all negotiated rates 372 percent of total billed charges 372 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 207 percent of total billed charges 207 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 27 fee schedule 27 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Multiplan PPO 80 80% of all negotiated rates 425 percent of total billed charges 425 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 One Health PPO 55 55% of all negotiated rates 361 percent of total billed charges 361 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Optum Medicare HMO 39 39% of all negotiated rates 207 percent of total billed charges 207 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 P3 HMO 39 39% of all negotiated rates 207 percent of total billed charges 207 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 372 percent of total billed charges 372 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Select Health HMO 41 41% of all negotiated rates 218 percent of total billed charges 218 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 178 percent of total billed charges 178 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Sierra/HPN HMO 60 60% of all negotiated rates 319 percent of total billed charges 319 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Silversummit Medicare HMO 39 39% of all negotiated rates 207 percent of total billed charges 207 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 186 percent of total billed charges 186 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 Teachers Trust PPO 68 68% of all negotiated rates 361 percent of total billed charges 361 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 TriWest PPO 30 30% of all negotiated rates 159 percent of total billed charges 159 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 UHN-Universal Health Network PPO 70 70% of all negotiated rates 372 percent of total billed charges 372 531 29130 ED APPLICATION FINGER SPLINT CHARGE 29130 CPT 3231302 LOCAL 450 RC outpatient 531 451 United Healthcare PPO 60 60% of all negotiated rates 319 percent of total billed charges 319 531 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Aetna Medicare HMO 26 26% of all negotiated rates 129 percent of total billed charges 129 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Alignment Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 249 percent of total billed charges 249 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 41 fee schedule 41 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Cigna PPO 68 68% of all negotiated rates 338 percent of total billed charges 338 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Coalition PPO 59 59% of all negotiated rates 338 percent of total billed charges 338 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Coventry PPO 75 75% of all negotiated rates 373 percent of total billed charges 373 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 398 percent of total billed charges 398 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 41 fee schedule 41 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Humana-Commerical PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 41 fee schedule 41 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Multiplan PPO 80 80% of all negotiated rates 398 percent of total billed charges 398 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 One Health PPO 55 55% of all negotiated rates 338 percent of total billed charges 338 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Optum Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 P3 HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Select Health HMO 41 41% of all negotiated rates 204 percent of total billed charges 204 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 166 percent of total billed charges 166 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Sierra/HPN HMO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Silversummit Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 174 percent of total billed charges 174 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 Teachers Trust PPO 68 68% of all negotiated rates 338 percent of total billed charges 338 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 TriWest PPO 30 30% of all negotiated rates 149 percent of total billed charges 149 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 UHN-Universal Health Network PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29240 ED STRAPPING SHOULDER CHARGE 29240 CPT 3230045 LOCAL 450 RC outpatient 497 422 United Healthcare PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Aetna Medicare HMO 26 26% of all negotiated rates 127 percent of total billed charges 127 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Alignment Medicare HMO 39 39% of all negotiated rates 191 percent of total billed charges 191 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 293 percent of total billed charges 293 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 245 percent of total billed charges 245 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 191 percent of total billed charges 191 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Cigna PPO 68 68% of all negotiated rates 333 percent of total billed charges 333 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Coalition PPO 59 59% of all negotiated rates 333 percent of total billed charges 333 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Coventry PPO 75 75% of all negotiated rates 367 percent of total billed charges 367 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 391 percent of total billed charges 391 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Humana-Commerical PPO 70 70% of all negotiated rates 342 percent of total billed charges 342 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 191 percent of total billed charges 191 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Multiplan PPO 80 80% of all negotiated rates 391 percent of total billed charges 391 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 One Health PPO 55 55% of all negotiated rates 333 percent of total billed charges 333 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Optum Medicare HMO 39 39% of all negotiated rates 191 percent of total billed charges 191 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 P3 HMO 39 39% of all negotiated rates 191 percent of total billed charges 191 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 342 percent of total billed charges 342 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Select Health HMO 41 41% of all negotiated rates 200 percent of total billed charges 200 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 164 percent of total billed charges 164 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Sierra/HPN HMO 60 60% of all negotiated rates 293 percent of total billed charges 293 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Silversummit Medicare HMO 39 39% of all negotiated rates 191 percent of total billed charges 191 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 171 percent of total billed charges 171 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 Teachers Trust PPO 68 68% of all negotiated rates 333 percent of total billed charges 333 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 TriWest PPO 30 30% of all negotiated rates 147 percent of total billed charges 147 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 UHN-Universal Health Network PPO 70 70% of all negotiated rates 342 percent of total billed charges 342 489 29260 STRAPPING ELBOW OR WRIST 29260 CPT 3236420 LOCAL 450 RC outpatient 489 416 United Healthcare PPO 60 60% of all negotiated rates 293 percent of total billed charges 293 489 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Aetna Medicare HMO 26 26% of all negotiated rates 129 percent of total billed charges 129 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Alignment Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 249 percent of total billed charges 249 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 34 fee schedule 34 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Cigna PPO 68 68% of all negotiated rates 338 percent of total billed charges 338 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Coalition PPO 59 59% of all negotiated rates 338 percent of total billed charges 338 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Coventry PPO 75 75% of all negotiated rates 373 percent of total billed charges 373 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 398 percent of total billed charges 398 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 34 fee schedule 34 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Humana-Commerical PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 34 fee schedule 34 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Multiplan PPO 80 80% of all negotiated rates 398 percent of total billed charges 398 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 One Health PPO 55 55% of all negotiated rates 338 percent of total billed charges 338 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Optum Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 P3 HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Select Health HMO 41 41% of all negotiated rates 204 percent of total billed charges 204 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 166 percent of total billed charges 166 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Sierra/HPN HMO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Silversummit Medicare HMO 39 39% of all negotiated rates 194 percent of total billed charges 194 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 174 percent of total billed charges 174 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 Teachers Trust PPO 68 68% of all negotiated rates 338 percent of total billed charges 338 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 TriWest PPO 30 30% of all negotiated rates 149 percent of total billed charges 149 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 UHN-Universal Health Network PPO 70 70% of all negotiated rates 348 percent of total billed charges 348 497 29280 STRAPPING HAND/FINGER 29280 CPT 3230033 LOCAL 450 RC outpatient 497 422 United Healthcare PPO 60 60% of all negotiated rates 298 percent of total billed charges 298 497 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Aetna Medicare HMO 26 26% of all negotiated rates 150 percent of total billed charges 150 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Alignment Medicare HMO 39 39% of all negotiated rates 224 percent of total billed charges 224 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 345 percent of total billed charges 345 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 288 percent of total billed charges 288 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 224 percent of total billed charges 224 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Cigna PPO 68 68% of all negotiated rates 391 percent of total billed charges 391 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Coalition PPO 59 59% of all negotiated rates 391 percent of total billed charges 391 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Coventry PPO 75 75% of all negotiated rates 431 percent of total billed charges 431 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 460 percent of total billed charges 460 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Humana-Commerical PPO 70 70% of all negotiated rates 403 percent of total billed charges 403 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 224 percent of total billed charges 224 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Multiplan PPO 80 80% of all negotiated rates 460 percent of total billed charges 460 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 One Health PPO 55 55% of all negotiated rates 391 percent of total billed charges 391 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Optum Medicare HMO 39 39% of all negotiated rates 224 percent of total billed charges 224 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 P3 HMO 39 39% of all negotiated rates 224 percent of total billed charges 224 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 403 percent of total billed charges 403 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Select Health HMO 41 41% of all negotiated rates 236 percent of total billed charges 236 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 193 percent of total billed charges 193 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Sierra/HPN HMO 60 60% of all negotiated rates 345 percent of total billed charges 345 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Silversummit Medicare HMO 39 39% of all negotiated rates 224 percent of total billed charges 224 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 201 percent of total billed charges 201 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 Teachers Trust PPO 68 68% of all negotiated rates 391 percent of total billed charges 391 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 TriWest PPO 30 30% of all negotiated rates 173 percent of total billed charges 173 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 UHN-Universal Health Network PPO 70 70% of all negotiated rates 403 percent of total billed charges 403 575 "29505 APPLICATION, LONG LEG SPLINT ED CHARGE" 29505 CPT 3235055 LOCAL 450 RC outpatient 575 489 United Healthcare PPO 60 60% of all negotiated rates 345 percent of total billed charges 345 575 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Aetna Medicare HMO 26 26% of all negotiated rates 144 percent of total billed charges 144 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Alignment Medicare HMO 39 39% of all negotiated rates 216 percent of total billed charges 216 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 332 percent of total billed charges 332 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 277 percent of total billed charges 277 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 216 percent of total billed charges 216 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Cigna PPO 68 68% of all negotiated rates 376 percent of total billed charges 376 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Coalition PPO 59 59% of all negotiated rates 376 percent of total billed charges 376 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Coventry PPO 75 75% of all negotiated rates 415 percent of total billed charges 415 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 442 percent of total billed charges 442 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Humana-Commerical PPO 70 70% of all negotiated rates 387 percent of total billed charges 387 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 216 percent of total billed charges 216 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 48 fee schedule 48 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Multiplan PPO 80 80% of all negotiated rates 442 percent of total billed charges 442 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 One Health PPO 55 55% of all negotiated rates 376 percent of total billed charges 376 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Optum Medicare HMO 39 39% of all negotiated rates 216 percent of total billed charges 216 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 P3 HMO 39 39% of all negotiated rates 216 percent of total billed charges 216 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 387 percent of total billed charges 387 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Select Health HMO 41 41% of all negotiated rates 227 percent of total billed charges 227 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 185 percent of total billed charges 185 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Sierra/HPN HMO 60 60% of all negotiated rates 332 percent of total billed charges 332 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Silversummit Medicare HMO 39 39% of all negotiated rates 216 percent of total billed charges 216 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 194 percent of total billed charges 194 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 Teachers Trust PPO 68 68% of all negotiated rates 376 percent of total billed charges 376 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 TriWest PPO 30 30% of all negotiated rates 166 percent of total billed charges 166 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 UHN-Universal Health Network PPO 70 70% of all negotiated rates 387 percent of total billed charges 387 553 29515 ED APPLICATION SHORT LEG SPLINT CHARGE 29515 CPT 3235154 LOCAL 450 RC outpatient 553 470 United Healthcare PPO 60 60% of all negotiated rates 332 percent of total billed charges 332 553 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Aetna Medicare HMO 26 26% of all negotiated rates 128 percent of total billed charges 128 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Alignment Medicare HMO 39 39% of all negotiated rates 192 percent of total billed charges 192 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 295 percent of total billed charges 295 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 246 percent of total billed charges 246 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 192 percent of total billed charges 192 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Cigna PPO 68 68% of all negotiated rates 335 percent of total billed charges 335 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Coalition PPO 59 59% of all negotiated rates 335 percent of total billed charges 335 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Coventry PPO 75 75% of all negotiated rates 369 percent of total billed charges 369 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 394 percent of total billed charges 394 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Humana-Commerical PPO 70 70% of all negotiated rates 344 percent of total billed charges 344 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 192 percent of total billed charges 192 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 35 fee schedule 35 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Multiplan PPO 80 80% of all negotiated rates 394 percent of total billed charges 394 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 One Health PPO 55 55% of all negotiated rates 335 percent of total billed charges 335 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Optum Medicare HMO 39 39% of all negotiated rates 192 percent of total billed charges 192 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 P3 HMO 39 39% of all negotiated rates 192 percent of total billed charges 192 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 344 percent of total billed charges 344 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Select Health HMO 41 41% of all negotiated rates 202 percent of total billed charges 202 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 165 percent of total billed charges 165 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Sierra/HPN HMO 60 60% of all negotiated rates 295 percent of total billed charges 295 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Silversummit Medicare HMO 39 39% of all negotiated rates 192 percent of total billed charges 192 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 172 percent of total billed charges 172 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 Teachers Trust PPO 68 68% of all negotiated rates 335 percent of total billed charges 335 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 TriWest PPO 30 30% of all negotiated rates 148 percent of total billed charges 148 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 UHN-Universal Health Network PPO 70 70% of all negotiated rates 344 percent of total billed charges 344 492 29530 STRAPPING KNEE 29530 CPT 3233031 LOCAL 450 RC outpatient 492 418 United Healthcare PPO 60 60% of all negotiated rates 295 percent of total billed charges 295 492 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Aetna Medicare HMO 26 26% of all negotiated rates 87 percent of total billed charges 87 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Alignment Medicare HMO 39 39% of all negotiated rates 130 percent of total billed charges 130 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 200 percent of total billed charges 200 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 167 percent of total billed charges 167 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 25 fee schedule 25 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 130 percent of total billed charges 130 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Cigna PPO 68 68% of all negotiated rates 227 percent of total billed charges 227 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Coalition PPO 59 59% of all negotiated rates 227 percent of total billed charges 227 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Coventry PPO 75 75% of all negotiated rates 251 percent of total billed charges 251 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 267 percent of total billed charges 267 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 25 fee schedule 25 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Humana-Commerical PPO 70 70% of all negotiated rates 234 percent of total billed charges 234 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 130 percent of total billed charges 130 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 25 fee schedule 25 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Multiplan PPO 80 80% of all negotiated rates 267 percent of total billed charges 267 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 One Health PPO 55 55% of all negotiated rates 227 percent of total billed charges 227 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Optum Medicare HMO 39 39% of all negotiated rates 130 percent of total billed charges 130 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 P3 HMO 39 39% of all negotiated rates 130 percent of total billed charges 130 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 234 percent of total billed charges 234 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Select Health HMO 41 41% of all negotiated rates 137 percent of total billed charges 137 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 112 percent of total billed charges 112 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Sierra/HPN HMO 60 60% of all negotiated rates 200 percent of total billed charges 200 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Silversummit Medicare HMO 39 39% of all negotiated rates 130 percent of total billed charges 130 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 117 percent of total billed charges 117 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 Teachers Trust PPO 68 68% of all negotiated rates 227 percent of total billed charges 227 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 TriWest PPO 30 30% of all negotiated rates 100 percent of total billed charges 100 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 UHN-Universal Health Network PPO 70 70% of all negotiated rates 234 percent of total billed charges 234 334 29540 STRAPPING ANKLE 29540 CPT 3233030 LOCAL 450 RC outpatient 334 284 United Healthcare PPO 60 60% of all negotiated rates 200 percent of total billed charges 200 334 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Aetna Medicare HMO 26 26% of all negotiated rates 114 percent of total billed charges 114 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Alignment Medicare HMO 39 39% of all negotiated rates 171 percent of total billed charges 171 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 263 percent of total billed charges 263 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 220 percent of total billed charges 220 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 18 fee schedule 18 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 171 percent of total billed charges 171 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Cigna PPO 68 68% of all negotiated rates 299 percent of total billed charges 299 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Coalition PPO 59 59% of all negotiated rates 299 percent of total billed charges 299 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Coventry PPO 75 75% of all negotiated rates 329 percent of total billed charges 329 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 351 percent of total billed charges 351 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 18 fee schedule 18 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Humana-Commerical PPO 70 70% of all negotiated rates 307 percent of total billed charges 307 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 171 percent of total billed charges 171 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 18 fee schedule 18 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Multiplan PPO 80 80% of all negotiated rates 351 percent of total billed charges 351 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 One Health PPO 55 55% of all negotiated rates 299 percent of total billed charges 299 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Optum Medicare HMO 39 39% of all negotiated rates 171 percent of total billed charges 171 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 P3 HMO 39 39% of all negotiated rates 171 percent of total billed charges 171 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 307 percent of total billed charges 307 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Select Health HMO 41 41% of all negotiated rates 180 percent of total billed charges 180 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 147 percent of total billed charges 147 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Sierra/HPN HMO 60 60% of all negotiated rates 263 percent of total billed charges 263 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Silversummit Medicare HMO 39 39% of all negotiated rates 171 percent of total billed charges 171 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 154 percent of total billed charges 154 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 Teachers Trust PPO 68 68% of all negotiated rates 299 percent of total billed charges 299 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 TriWest PPO 30 30% of all negotiated rates 132 percent of total billed charges 132 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 UHN-Universal Health Network PPO 70 70% of all negotiated rates 307 percent of total billed charges 307 439 29550 STRAPPING TOES ED CHARGE 29550 CPT 3233035 LOCAL 450 RC outpatient 439 373 United Healthcare PPO 60 60% of all negotiated rates 263 percent of total billed charges 263 439 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Aetna Medicare HMO 26 26% of all negotiated rates 111 percent of total billed charges 111 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Alignment Medicare HMO 39 39% of all negotiated rates 167 percent of total billed charges 167 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 256 percent of total billed charges 256 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 214 percent of total billed charges 214 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 121 fee schedule 121 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 167 percent of total billed charges 167 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Cigna PPO 68 68% of all negotiated rates 290 percent of total billed charges 290 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Coalition PPO 59 59% of all negotiated rates 290 percent of total billed charges 290 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Coventry PPO 75 75% of all negotiated rates 320 percent of total billed charges 320 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 342 percent of total billed charges 342 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 121 fee schedule 121 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Humana-Commerical PPO 70 70% of all negotiated rates 299 percent of total billed charges 299 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 167 percent of total billed charges 167 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 121 fee schedule 121 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Multiplan PPO 80 80% of all negotiated rates 342 percent of total billed charges 342 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 One Health PPO 55 55% of all negotiated rates 290 percent of total billed charges 290 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Optum Medicare HMO 39 39% of all negotiated rates 167 percent of total billed charges 167 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 P3 HMO 39 39% of all negotiated rates 167 percent of total billed charges 167 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 299 percent of total billed charges 299 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Select Health HMO 41 41% of all negotiated rates 175 percent of total billed charges 175 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 143 percent of total billed charges 143 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Sierra/HPN HMO 60 60% of all negotiated rates 256 percent of total billed charges 256 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Silversummit Medicare HMO 39 39% of all negotiated rates 167 percent of total billed charges 167 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 149 percent of total billed charges 149 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 Teachers Trust PPO 68 68% of all negotiated rates 290 percent of total billed charges 290 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 TriWest PPO 30 30% of all negotiated rates 128 percent of total billed charges 128 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 UHN-Universal Health Network PPO 70 70% of all negotiated rates 299 percent of total billed charges 299 427 30300 ED REMOVE FOREIGN BODY INTRANASAL CHARGE 30300 CPT 3232110 LOCAL 450 RC outpatient 427 363 United Healthcare PPO 60 60% of all negotiated rates 256 percent of total billed charges 256 427 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Aetna Medicare HMO 26 26% of all negotiated rates 124 percent of total billed charges 124 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Alignment Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 238 percent of total billed charges 238 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 54 fee schedule 54 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Cigna PPO 68 68% of all negotiated rates 324 percent of total billed charges 324 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Coalition PPO 59 59% of all negotiated rates 324 percent of total billed charges 324 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Coventry PPO 75 75% of all negotiated rates 357 percent of total billed charges 357 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 381 percent of total billed charges 381 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 54 fee schedule 54 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Humana-Commerical PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 54 fee schedule 54 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Multiplan PPO 80 80% of all negotiated rates 381 percent of total billed charges 381 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 One Health PPO 55 55% of all negotiated rates 324 percent of total billed charges 324 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Optum Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 P3 HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Select Health HMO 41 41% of all negotiated rates 195 percent of total billed charges 195 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 159 percent of total billed charges 159 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Sierra/HPN HMO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Silversummit Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 167 percent of total billed charges 167 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 Teachers Trust PPO 68 68% of all negotiated rates 324 percent of total billed charges 324 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 TriWest PPO 30 30% of all negotiated rates 143 percent of total billed charges 143 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 UHN-Universal Health Network PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30901 CNTRL NSAL HMRR-ANT-SIMP 30901 CPT 3239013 LOCAL 450 RC outpatient 476 405 United Healthcare PPO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Aetna Medicare HMO 26 26% of all negotiated rates 124 percent of total billed charges 124 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Alignment Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 238 percent of total billed charges 238 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 76 fee schedule 76 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Cigna PPO 68 68% of all negotiated rates 324 percent of total billed charges 324 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Coalition PPO 59 59% of all negotiated rates 324 percent of total billed charges 324 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Coventry PPO 75 75% of all negotiated rates 357 percent of total billed charges 357 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 381 percent of total billed charges 381 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 76 fee schedule 76 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Humana-Commerical PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 76 fee schedule 76 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Multiplan PPO 80 80% of all negotiated rates 381 percent of total billed charges 381 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 One Health PPO 55 55% of all negotiated rates 324 percent of total billed charges 324 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Optum Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 P3 HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Select Health HMO 41 41% of all negotiated rates 195 percent of total billed charges 195 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 159 percent of total billed charges 159 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Sierra/HPN HMO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Silversummit Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 167 percent of total billed charges 167 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 Teachers Trust PPO 68 68% of all negotiated rates 324 percent of total billed charges 324 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 TriWest PPO 30 30% of all negotiated rates 143 percent of total billed charges 143 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 UHN-Universal Health Network PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30903 CNTRL NSAL HMRR COMPLEX 30903 CPT 3239039 LOCAL 450 RC outpatient 476 405 United Healthcare PPO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Aetna Medicare HMO 26 26% of all negotiated rates 124 percent of total billed charges 124 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Alignment Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 238 percent of total billed charges 238 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 96 fee schedule 96 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Cigna PPO 68 68% of all negotiated rates 324 percent of total billed charges 324 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Coalition PPO 59 59% of all negotiated rates 324 percent of total billed charges 324 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Coventry PPO 75 75% of all negotiated rates 357 percent of total billed charges 357 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 381 percent of total billed charges 381 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 96 fee schedule 96 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Humana-Commerical PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 96 fee schedule 96 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Multiplan PPO 80 80% of all negotiated rates 381 percent of total billed charges 381 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 One Health PPO 55 55% of all negotiated rates 324 percent of total billed charges 324 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Optum Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 P3 HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Select Health HMO 41 41% of all negotiated rates 195 percent of total billed charges 195 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 159 percent of total billed charges 159 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Sierra/HPN HMO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Silversummit Medicare HMO 39 39% of all negotiated rates 186 percent of total billed charges 186 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 167 percent of total billed charges 167 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 Teachers Trust PPO 68 68% of all negotiated rates 324 percent of total billed charges 324 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 TriWest PPO 30 30% of all negotiated rates 143 percent of total billed charges 143 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 UHN-Universal Health Network PPO 70 70% of all negotiated rates 333 percent of total billed charges 333 476 30905 CNTRL NSAL HMRR-POSTER 30905 CPT 3239054 LOCAL 450 RC outpatient 476 405 United Healthcare PPO 60 60% of all negotiated rates 286 percent of total billed charges 286 476 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Aetna Medicare HMO 26 26% of all negotiated rates 390 percent of total billed charges 390 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Alignment Medicare HMO 39 39% of all negotiated rates 585 percent of total billed charges 585 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 899 percent of total billed charges 899 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 750 percent of total billed charges 750 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 105 fee schedule 105 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 585 percent of total billed charges 585 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Cigna PPO 68 68% of all negotiated rates 1019 percent of total billed charges 1019 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Coalition PPO 59 59% of all negotiated rates 1019 percent of total billed charges 1019 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Coventry PPO 75 75% of all negotiated rates 1124 percent of total billed charges 1124 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1199 percent of total billed charges 1199 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 105 fee schedule 105 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Humana-Commerical PPO 70 70% of all negotiated rates 1049 percent of total billed charges 1049 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 585 percent of total billed charges 585 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 105 fee schedule 105 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Multiplan PPO 80 80% of all negotiated rates 1199 percent of total billed charges 1199 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 One Health PPO 55 55% of all negotiated rates 1019 percent of total billed charges 1019 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Optum Medicare HMO 39 39% of all negotiated rates 585 percent of total billed charges 585 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 P3 HMO 39 39% of all negotiated rates 585 percent of total billed charges 585 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1049 percent of total billed charges 1049 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Select Health HMO 41 41% of all negotiated rates 615 percent of total billed charges 615 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 502 percent of total billed charges 502 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Sierra/HPN HMO 60 60% of all negotiated rates 899 percent of total billed charges 899 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Silversummit Medicare HMO 39 39% of all negotiated rates 585 percent of total billed charges 585 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 525 percent of total billed charges 525 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 Teachers Trust PPO 68 68% of all negotiated rates 1019 percent of total billed charges 1019 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 TriWest PPO 30 30% of all negotiated rates 450 percent of total billed charges 450 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1049 percent of total billed charges 1049 1499 31500 ED INTUBATION EMERGENCY PROCEDURE CHARGE 31500 CPT 3235002 LOCAL 450 RC outpatient 1499 1274 United Healthcare PPO 60 60% of all negotiated rates 899 percent of total billed charges 899 1499 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Aetna Medicare HMO 26 26% of all negotiated rates 135 percent of total billed charges 135 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Alignment Medicare HMO 39 39% of all negotiated rates 202 percent of total billed charges 202 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 311 percent of total billed charges 311 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 259 percent of total billed charges 259 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 47 fee schedule 47 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 202 percent of total billed charges 202 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Cigna PPO 68 68% of all negotiated rates 352 percent of total billed charges 352 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Coalition PPO 59 59% of all negotiated rates 352 percent of total billed charges 352 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Coventry PPO 75 75% of all negotiated rates 389 percent of total billed charges 389 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 414 percent of total billed charges 414 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 47 fee schedule 47 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Humana-Commerical PPO 70 70% of all negotiated rates 363 percent of total billed charges 363 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 202 percent of total billed charges 202 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 47 fee schedule 47 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Multiplan PPO 80 80% of all negotiated rates 414 percent of total billed charges 414 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 One Health PPO 55 55% of all negotiated rates 352 percent of total billed charges 352 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Optum Medicare HMO 39 39% of all negotiated rates 202 percent of total billed charges 202 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 P3 HMO 39 39% of all negotiated rates 202 percent of total billed charges 202 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 363 percent of total billed charges 363 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Select Health HMO 41 41% of all negotiated rates 212 percent of total billed charges 212 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 174 percent of total billed charges 174 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Sierra/HPN HMO 60 60% of all negotiated rates 311 percent of total billed charges 311 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Silversummit Medicare HMO 39 39% of all negotiated rates 202 percent of total billed charges 202 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 181 percent of total billed charges 181 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 Teachers Trust PPO 68 68% of all negotiated rates 352 percent of total billed charges 352 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 TriWest PPO 30 30% of all negotiated rates 155 percent of total billed charges 155 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 UHN-Universal Health Network PPO 70 70% of all negotiated rates 363 percent of total billed charges 363 518 "31505 LARYNGOSCOPY, INDIRECT, DIAG ED CHARGE" 31505 CPT 3235051 LOCAL 450 RC outpatient 518 440 United Healthcare PPO 60 60% of all negotiated rates 311 percent of total billed charges 311 518 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Aetna Medicare HMO 26 26% of all negotiated rates 983 percent of total billed charges 983 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Alignment Medicare HMO 39 39% of all negotiated rates 1474 percent of total billed charges 1474 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 2267 percent of total billed charges 2267 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1890 percent of total billed charges 1890 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 153 fee schedule 153 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1474 percent of total billed charges 1474 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Cigna PPO 68 68% of all negotiated rates 2570 percent of total billed charges 2570 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Coalition PPO 59 59% of all negotiated rates 2570 percent of total billed charges 2570 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Coventry PPO 75 75% of all negotiated rates 2834 percent of total billed charges 2834 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 3023 percent of total billed charges 3023 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 153 fee schedule 153 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Humana-Commerical PPO 70 70% of all negotiated rates 2645 percent of total billed charges 2645 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1474 percent of total billed charges 1474 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 153 fee schedule 153 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Multiplan PPO 80 80% of all negotiated rates 3023 percent of total billed charges 3023 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 One Health PPO 55 55% of all negotiated rates 2570 percent of total billed charges 2570 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Optum Medicare HMO 39 39% of all negotiated rates 1474 percent of total billed charges 1474 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 P3 HMO 39 39% of all negotiated rates 1474 percent of total billed charges 1474 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2645 percent of total billed charges 2645 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Select Health HMO 41 41% of all negotiated rates 1549 percent of total billed charges 1549 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1266 percent of total billed charges 1266 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Sierra/HPN HMO 60 60% of all negotiated rates 2267 percent of total billed charges 2267 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Silversummit Medicare HMO 39 39% of all negotiated rates 1474 percent of total billed charges 1474 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1323 percent of total billed charges 1323 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 Teachers Trust PPO 68 68% of all negotiated rates 2570 percent of total billed charges 2570 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 TriWest PPO 30 30% of all negotiated rates 1134 percent of total billed charges 1134 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2645 percent of total billed charges 2645 3779 "31525 LARYNGOSCOPY DIR DIAG, NOT NB ED CHARGE" 31525 CPT 3233010 LOCAL 450 RC outpatient 3779 3212 United Healthcare PPO 60 60% of all negotiated rates 2267 percent of total billed charges 2267 3779 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Aetna Medicare HMO 26 26% of all negotiated rates 653 percent of total billed charges 653 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Alignment Medicare HMO 39 39% of all negotiated rates 979 percent of total billed charges 979 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1507 percent of total billed charges 1507 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1256 percent of total billed charges 1256 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 979 percent of total billed charges 979 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Cigna PPO 68 68% of all negotiated rates 1707 percent of total billed charges 1707 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Coalition PPO 59 59% of all negotiated rates 1707 percent of total billed charges 1707 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Coventry PPO 75 75% of all negotiated rates 1883 percent of total billed charges 1883 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2009 percent of total billed charges 2009 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Humana-Commerical PPO 70 70% of all negotiated rates 1758 percent of total billed charges 1758 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 979 percent of total billed charges 979 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Multiplan PPO 80 80% of all negotiated rates 2009 percent of total billed charges 2009 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 One Health PPO 55 55% of all negotiated rates 1707 percent of total billed charges 1707 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Optum Medicare HMO 39 39% of all negotiated rates 979 percent of total billed charges 979 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 P3 HMO 39 39% of all negotiated rates 979 percent of total billed charges 979 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1758 percent of total billed charges 1758 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Select Health HMO 41 41% of all negotiated rates 1030 percent of total billed charges 1030 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 841 percent of total billed charges 841 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Sierra/HPN HMO 60 60% of all negotiated rates 1507 percent of total billed charges 1507 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Silversummit Medicare HMO 39 39% of all negotiated rates 979 percent of total billed charges 979 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 879 percent of total billed charges 879 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 Teachers Trust PPO 68 68% of all negotiated rates 1707 percent of total billed charges 1707 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 TriWest PPO 30 30% of all negotiated rates 753 percent of total billed charges 753 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1758 percent of total billed charges 1758 2511 32422 CHEST TUBE INSERTION ED Charge 32422 CPT 3230117 LOCAL 450 RC outpatient 2511 2134 United Healthcare PPO 60 60% of all negotiated rates 1507 percent of total billed charges 1507 2511 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Aetna Medicare HMO 26 26% of all negotiated rates 1572 percent of total billed charges 1572 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Alignment Medicare HMO 39 39% of all negotiated rates 2359 percent of total billed charges 2359 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3629 percent of total billed charges 3629 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 3024 percent of total billed charges 3024 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 170 fee schedule 170 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2359 percent of total billed charges 2359 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Cigna PPO 68 68% of all negotiated rates 4113 percent of total billed charges 4113 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Coalition PPO 59 59% of all negotiated rates 4113 percent of total billed charges 4113 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Coventry PPO 75 75% of all negotiated rates 4536 percent of total billed charges 4536 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 4838 percent of total billed charges 4838 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 170 fee schedule 170 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Humana-Commerical PPO 70 70% of all negotiated rates 4234 percent of total billed charges 4234 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2359 percent of total billed charges 2359 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 170 fee schedule 170 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Multiplan PPO 80 80% of all negotiated rates 4838 percent of total billed charges 4838 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 One Health PPO 55 55% of all negotiated rates 4113 percent of total billed charges 4113 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Optum Medicare HMO 39 39% of all negotiated rates 2359 percent of total billed charges 2359 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 P3 HMO 39 39% of all negotiated rates 2359 percent of total billed charges 2359 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 4234 percent of total billed charges 4234 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Select Health HMO 41 41% of all negotiated rates 2480 percent of total billed charges 2480 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 2026 percent of total billed charges 2026 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Sierra/HPN HMO 60 60% of all negotiated rates 3629 percent of total billed charges 3629 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Silversummit Medicare HMO 39 39% of all negotiated rates 2359 percent of total billed charges 2359 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 2117 percent of total billed charges 2117 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 Teachers Trust PPO 68 68% of all negotiated rates 4113 percent of total billed charges 4113 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 TriWest PPO 30 30% of all negotiated rates 1814 percent of total billed charges 1814 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 UHN-Universal Health Network PPO 70 70% of all negotiated rates 4234 percent of total billed charges 4234 6048 32551 CHEST TUBE INSERT 32551 CPT 3233540 LOCAL 450 RC outpatient 6048 5141 United Healthcare PPO 60 60% of all negotiated rates 3629 percent of total billed charges 3629 6048 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Aetna Medicare HMO 26 26% of all negotiated rates 525 percent of total billed charges 525 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Alignment Medicare HMO 39 39% of all negotiated rates 787 percent of total billed charges 787 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1211 percent of total billed charges 1211 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1009 percent of total billed charges 1009 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 86 fee schedule 86 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 787 percent of total billed charges 787 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Cigna PPO 68 68% of all negotiated rates 1372 percent of total billed charges 1372 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Coalition PPO 59 59% of all negotiated rates 1372 percent of total billed charges 1372 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Coventry PPO 75 75% of all negotiated rates 1514 percent of total billed charges 1514 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1614 percent of total billed charges 1614 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 86 fee schedule 86 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Humana-Commerical PPO 70 70% of all negotiated rates 1413 percent of total billed charges 1413 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 787 percent of total billed charges 787 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 86 fee schedule 86 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Multiplan PPO 80 80% of all negotiated rates 1614 percent of total billed charges 1614 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 One Health PPO 55 55% of all negotiated rates 1372 percent of total billed charges 1372 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Optum Medicare HMO 39 39% of all negotiated rates 787 percent of total billed charges 787 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 P3 HMO 39 39% of all negotiated rates 787 percent of total billed charges 787 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1413 percent of total billed charges 1413 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Select Health HMO 41 41% of all negotiated rates 827 percent of total billed charges 827 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 676 percent of total billed charges 676 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Sierra/HPN HMO 60 60% of all negotiated rates 1211 percent of total billed charges 1211 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Silversummit Medicare HMO 39 39% of all negotiated rates 787 percent of total billed charges 787 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 706 percent of total billed charges 706 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 Teachers Trust PPO 68 68% of all negotiated rates 1372 percent of total billed charges 1372 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 TriWest PPO 30 30% of all negotiated rates 605 percent of total billed charges 605 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1413 percent of total billed charges 1413 2018 32554 THORACENTESIS W/O IMAGING 32554 CPT 3230109 LOCAL 450 RC outpatient 2018 1715 United Healthcare PPO 60 60% of all negotiated rates 1211 percent of total billed charges 1211 2018 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Aetna PPO 1950 case rate 1950 case rate 1950 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Aetna Medicare HMO 26 26% of all negotiated rates 32 percent of total billed charges 32 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Alignment Medicare HMO 39 39% of all negotiated rates 48 percent of total billed charges 48 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 73 percent of total billed charges 73 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 61 percent of total billed charges 61 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 438 fee schedule 438 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 48 percent of total billed charges 48 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Cigna PPO 68 68% of all negotiated rates 83 percent of total billed charges 83 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Coventry PPO 75 75% of all negotiated rates 92 percent of total billed charges 92 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 98 percent of total billed charges 98 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 438 fee schedule 438 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Humana-Commerical PPO 70 70% of all negotiated rates 85 percent of total billed charges 85 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 48 percent of total billed charges 48 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 438 fee schedule 438 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Multiplan PPO 80 80% of all negotiated rates 98 percent of total billed charges 98 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Multiplan HMO 80 80% of all negotiated rates 98 percent of total billed charges 98 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Optum Medicare HMO 39 39% of all negotiated rates 48 percent of total billed charges 48 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 P3 HMO 39 39% of all negotiated rates 48 percent of total billed charges 48 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 85 percent of total billed charges 85 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Saint Mary's Health Plan HMO 70 70% of all negotiated rates 85 percent of total billed charges 85 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Select Health HMO 41 41% of all negotiated rates 50 percent of total billed charges 50 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 41 percent of total billed charges 41 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Sierra/HPN HMO 60 60% of all negotiated rates 73 percent of total billed charges 73 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Silversummit Medicare HMO 39 39% of all negotiated rates 48 percent of total billed charges 48 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 43 percent of total billed charges 43 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 43 percent of total billed charges 43 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 TriWest PPO 30 30% of all negotiated rates 37 percent of total billed charges 37 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 TriWest PPO 30 30% of all negotiated rates 37 percent of total billed charges 37 122 33206 PACEMAKER INSERT - T CHARGE 33206 CPT 3033217 LOCAL 360 RC outpatient 122 104 UHN-Universal Health Network PPO 70 70% of all negotiated rates 85 percent of total billed charges 85 122 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Aetna Medicare HMO 26 26% of all negotiated rates 92 percent of total billed charges 92 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Alignment Medicare HMO 39 39% of all negotiated rates 137 percent of total billed charges 137 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 211 percent of total billed charges 211 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 176 percent of total billed charges 176 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 9 fee schedule 9 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 137 percent of total billed charges 137 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Cigna PPO 68 68% of all negotiated rates 239 percent of total billed charges 239 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Coalition PPO 59 59% of all negotiated rates 239 percent of total billed charges 239 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Coventry PPO 75 75% of all negotiated rates 264 percent of total billed charges 264 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 282 percent of total billed charges 282 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 9 fee schedule 9 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Humana-Commerical PPO 70 70% of all negotiated rates 246 percent of total billed charges 246 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 137 percent of total billed charges 137 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 9 fee schedule 9 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Multiplan PPO 80 80% of all negotiated rates 282 percent of total billed charges 282 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 One Health PPO 55 55% of all negotiated rates 239 percent of total billed charges 239 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Optum Medicare HMO 39 39% of all negotiated rates 137 percent of total billed charges 137 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 P3 HMO 39 39% of all negotiated rates 137 percent of total billed charges 137 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 246 percent of total billed charges 246 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Select Health HMO 41 41% of all negotiated rates 144 percent of total billed charges 144 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 118 percent of total billed charges 118 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Sierra/HPN HMO 60 60% of all negotiated rates 211 percent of total billed charges 211 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Silversummit Medicare HMO 39 39% of all negotiated rates 137 percent of total billed charges 137 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 123 percent of total billed charges 123 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 Teachers Trust PPO 68 68% of all negotiated rates 239 percent of total billed charges 239 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 TriWest PPO 30 30% of all negotiated rates 106 percent of total billed charges 106 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 UHN-Universal Health Network PPO 70 70% of all negotiated rates 246 percent of total billed charges 246 352 36000 ED INTRO OF NEEDLE OR INTRACATHETER VEIN CHARGE 36000 CPT 3230034 LOCAL 450 RC outpatient 352 299 United Healthcare PPO 60 60% of all negotiated rates 211 percent of total billed charges 211 352 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Aetna Medicare HMO 26 26% of all negotiated rates 31 percent of total billed charges 31 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Alignment Medicare HMO 39 39% of all negotiated rates 47 percent of total billed charges 47 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 72 percent of total billed charges 72 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 60 percent of total billed charges 60 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 9 fee schedule 9 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 47 percent of total billed charges 47 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Cigna PPO 68 68% of all negotiated rates 82 percent of total billed charges 82 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Coalition PPO 59 59% of all negotiated rates 82 percent of total billed charges 82 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Coventry PPO 75 75% of all negotiated rates 90 percent of total billed charges 90 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 96 percent of total billed charges 96 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 9 fee schedule 9 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Humana-Commerical PPO 70 70% of all negotiated rates 84 percent of total billed charges 84 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 47 percent of total billed charges 47 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 9 fee schedule 9 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Multiplan PPO 80 80% of all negotiated rates 96 percent of total billed charges 96 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 One Health PPO 55 55% of all negotiated rates 82 percent of total billed charges 82 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Optum Medicare HMO 39 39% of all negotiated rates 47 percent of total billed charges 47 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 P3 HMO 39 39% of all negotiated rates 47 percent of total billed charges 47 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 84 percent of total billed charges 84 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Select Health HMO 41 41% of all negotiated rates 49 percent of total billed charges 49 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 40 percent of total billed charges 40 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Sierra/HPN HMO 60 60% of all negotiated rates 72 percent of total billed charges 72 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Silversummit Medicare HMO 39 39% of all negotiated rates 47 percent of total billed charges 47 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 42 percent of total billed charges 42 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 Teachers Trust PPO 68 68% of all negotiated rates 82 percent of total billed charges 82 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 TriWest PPO 30 30% of all negotiated rates 36 percent of total billed charges 36 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 UHN-Universal Health Network PPO 70 70% of all negotiated rates 84 percent of total billed charges 84 120 36410 CENTRAL LINE COLL 36410 CPT 3234108 LOCAL 450 RC outpatient 120 102 United Healthcare PPO 60 60% of all negotiated rates 72 percent of total billed charges 72 120 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Aetna PPO 38 38% of all negotiated rates 366 percent of total billed charges 366 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Aetna Medicare HMO 26 26% of all negotiated rates 250 percent of total billed charges 250 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Alignment Medicare HMO 39 39% of all negotiated rates 375 percent of total billed charges 375 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 577 percent of total billed charges 577 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 481 percent of total billed charges 481 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 32 fee schedule 32 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 375 percent of total billed charges 375 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Cigna PPO 68 68% of all negotiated rates 654 percent of total billed charges 654 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Coalition PPO 49 49% of all negotiated rates 471 percent of total billed charges 471 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Coventry PPO 75 75% of all negotiated rates 722 percent of total billed charges 722 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 770 percent of total billed charges 770 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 32 fee schedule 32 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Humana-Commerical PPO 70 70% of all negotiated rates 673 percent of total billed charges 673 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 375 percent of total billed charges 375 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 32 fee schedule 32 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Multiplan PPO 80 80% of all negotiated rates 770 percent of total billed charges 770 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Multiplan HMO 80 80% of all negotiated rates 770 percent of total billed charges 770 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 One Health PPO 55 55% of all negotiated rates 471 percent of total billed charges 471 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Optum Medicare HMO 39 39% of all negotiated rates 375 percent of total billed charges 375 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 P3 HMO 39 39% of all negotiated rates 375 percent of total billed charges 375 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 673 percent of total billed charges 673 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Saint Mary's Health Plan HMO 70 70% of all negotiated rates 673 percent of total billed charges 673 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Select Health HMO 41 41% of all negotiated rates 394 percent of total billed charges 394 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 322 percent of total billed charges 322 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Sierra/HPN HMO 60 60% of all negotiated rates 577 percent of total billed charges 577 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Silversummit Medicare HMO 39 39% of all negotiated rates 375 percent of total billed charges 375 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 337 percent of total billed charges 337 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 337 percent of total billed charges 337 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 Teachers Trust PPO 65 65% of all negotiated rates 625 percent of total billed charges 625 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 TriWest PPO 30 30% of all negotiated rates 289 percent of total billed charges 289 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 TriWest PPO 30 30% of all negotiated rates 289 percent of total billed charges 289 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 UHN-Universal Health Network PPO 70 70% of all negotiated rates 673 percent of total billed charges 673 962 36430 TRANSFUSION BLOOD PRODUCT CHARGE 36430 CPT 3026430 LOCAL 391 RC outpatient 962 818 United Healthcare PPO 60 60% of all negotiated rates 577 percent of total billed charges 577 962 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Aetna Medicare HMO 26 26% of all negotiated rates 970 percent of total billed charges 970 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Alignment Medicare HMO 39 39% of all negotiated rates 1455 percent of total billed charges 1455 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 2239 percent of total billed charges 2239 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1866 percent of total billed charges 1866 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 116 fee schedule 116 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1455 percent of total billed charges 1455 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Cigna PPO 68 68% of all negotiated rates 2537 percent of total billed charges 2537 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Coalition PPO 59 59% of all negotiated rates 2537 percent of total billed charges 2537 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Coventry PPO 75 75% of all negotiated rates 2798 percent of total billed charges 2798 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2985 percent of total billed charges 2985 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 116 fee schedule 116 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Humana-Commerical PPO 70 70% of all negotiated rates 2612 percent of total billed charges 2612 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1455 percent of total billed charges 1455 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 116 fee schedule 116 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Multiplan PPO 80 80% of all negotiated rates 2985 percent of total billed charges 2985 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 One Health PPO 55 55% of all negotiated rates 2537 percent of total billed charges 2537 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Optum Medicare HMO 39 39% of all negotiated rates 1455 percent of total billed charges 1455 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 P3 HMO 39 39% of all negotiated rates 1455 percent of total billed charges 1455 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2612 percent of total billed charges 2612 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Select Health HMO 41 41% of all negotiated rates 1530 percent of total billed charges 1530 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1250 percent of total billed charges 1250 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Sierra/HPN HMO 60 60% of all negotiated rates 2239 percent of total billed charges 2239 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Silversummit Medicare HMO 39 39% of all negotiated rates 1455 percent of total billed charges 1455 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1306 percent of total billed charges 1306 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 Teachers Trust PPO 68 68% of all negotiated rates 2537 percent of total billed charges 2537 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 TriWest PPO 30 30% of all negotiated rates 1119 percent of total billed charges 1119 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2612 percent of total billed charges 2612 3731 36556 INSERT CENTRAL VENOUS CATH 5 YRS 36556 CPT 3230440 LOCAL 450 RC outpatient 3731 3171 United Healthcare PPO 60 60% of all negotiated rates 2239 percent of total billed charges 2239 3731 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Aetna PPO 750 case rate 750 case rate 750 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Aetna Medicare HMO 26 26% of all negotiated rates 1375 percent of total billed charges 1375 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Alignment Medicare HMO 39 39% of all negotiated rates 2063 percent of total billed charges 2063 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3174 percent of total billed charges 3174 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 2645 percent of total billed charges 2645 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2063 percent of total billed charges 2063 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Cigna PPO 68 68% of all negotiated rates 3597 percent of total billed charges 3597 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Coventry PPO 75 75% of all negotiated rates 3968 percent of total billed charges 3968 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 4232 percent of total billed charges 4232 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Humana-Commerical PPO 70 70% of all negotiated rates 3703 percent of total billed charges 3703 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2063 percent of total billed charges 2063 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Multiplan PPO 80 80% of all negotiated rates 4232 percent of total billed charges 4232 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Multiplan HMO 80 80% of all negotiated rates 4232 percent of total billed charges 4232 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Optum Medicare HMO 39 39% of all negotiated rates 2063 percent of total billed charges 2063 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 P3 HMO 39 39% of all negotiated rates 2063 percent of total billed charges 2063 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 3703 percent of total billed charges 3703 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Saint Mary's Health Plan HMO 70 70% of all negotiated rates 3703 percent of total billed charges 3703 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Select Health HMO 41 41% of all negotiated rates 2169 percent of total billed charges 2169 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1772 percent of total billed charges 1772 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Sierra/HPN HMO 60 60% of all negotiated rates 3174 percent of total billed charges 3174 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Silversummit Medicare HMO 39 39% of all negotiated rates 2063 percent of total billed charges 2063 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1852 percent of total billed charges 1852 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1852 percent of total billed charges 1852 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 Teachers Trust PPO 700 case rate 700 case rate 700 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 TriWest PPO 30 30% of all negotiated rates 1587 percent of total billed charges 1587 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 TriWest PPO 30 30% of all negotiated rates 1587 percent of total billed charges 1587 5290 36569 INSERT PICC CATH CHARGE 36569 CPT 3026568 LOCAL 360 RC outpatient 5290 4497 UHN-Universal Health Network PPO 70 70% of all negotiated rates 3703 percent of total billed charges 3703 5290 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Aetna PPO 750 case rate 750 case rate 750 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Aetna Medicare HMO 26 26% of all negotiated rates 752 percent of total billed charges 752 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Alignment Medicare HMO 39 39% of all negotiated rates 1129 percent of total billed charges 1129 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1736 percent of total billed charges 1736 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1447 percent of total billed charges 1447 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Anthem Medicaid HMO 381 NV Medicaid SDS Rate 381 fee schedule 381 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1129 percent of total billed charges 1129 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Cigna PPO 756 case rate 756 case rate 756 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Coalition PPO 700 Coalition grouper rate 700 case rate 700 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Coventry PPO 75 75% of all negotiated rates 2171 percent of total billed charges 2171 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2315 percent of total billed charges 2315 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 HPN Medicaid HMO 381 NV Medicaid SDS Rate 381 fee schedule 381 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Humana-Commerical PPO 46 46% of all negotiated rates 1331 percent of total billed charges 1331 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1129 percent of total billed charges 1129 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Molina Medicaid HMO 381 NV Medicaid SDS Rate 381 case rate 381 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Multiplan PPO 80 80% of all negotiated rates 2315 percent of total billed charges 2315 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Multiplan PPO 80 80% of all negotiated rates 2315 percent of total billed charges 2315 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 One Health PPO 686 case rate 686 case rate 686 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Optum Medicare HMO 39 39% of all negotiated rates 1129 percent of total billed charges 1129 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 P3 HMO 39 39% of all negotiated rates 1129 percent of total billed charges 1129 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Saint Mary's Health Plan PPO 65 65% of all negotiated rates 1881 percent of total billed charges 1881 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Saint Mary's Health Plan HMO 65 65% of all negotiated rates 1881 percent of total billed charges 1881 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Select Health HMO 41 41% of all negotiated rates 1187 percent of total billed charges 1187 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Sierra Healthcare Options PPO 756 case rate 756 case rate 756 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Sierra/HPN HMO 756 case rate 756 case rate 756 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Silversummit Medicare HMO 39 39% of all negotiated rates 1129 percent of total billed charges 1129 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1013 percent of total billed charges 1013 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Southpoint (Gaghan South) HMO 35 35% of all negotiated rates 1013 percent of total billed charges 1013 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 Teachers Trust PPO 700 Teachers grouper rate 700 case rate 700 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 TriWest PPO 30 30% of all negotiated rates 868 percent of total billed charges 868 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 TriWest HMO 30 30% of all negotiated rates 868 percent of total billed charges 868 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 UHN-Universal Health Network PPO 65 65% of all negotiated rates 1881 percent of total billed charges 1881 2894 36569 INSERT PICC W/O SUBCUT PO CHARGE 36569 CPT 3026570 LOCAL 490 RC outpatient 2894 2460 United Healthcare PPO 686 case rate 686 case rate 686 2894 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Aetna Medicare HMO 26 26% of all negotiated rates 1142 percent of total billed charges 1142 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Alignment Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 2635 percent of total billed charges 2635 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 2196 percent of total billed charges 2196 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Cigna PPO 68 68% of all negotiated rates 2986 percent of total billed charges 2986 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Coalition PPO 59 59% of all negotiated rates 2986 percent of total billed charges 2986 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Coventry PPO 75 75% of all negotiated rates 3293 percent of total billed charges 3293 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 3513 percent of total billed charges 3513 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Humana-Commerical PPO 70 70% of all negotiated rates 1223 percent of total billed charges 3074 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 88 fee schedule 88 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Multiplan PPO 80 80% of all negotiated rates 3513 percent of total billed charges 3513 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 One Health PPO 55 55% of all negotiated rates 2986 percent of total billed charges 2986 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Optum Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 P3 HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 3074 percent of total billed charges 3074 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Select Health HMO 41 41% of all negotiated rates 1800 percent of total billed charges 1800 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1471 percent of total billed charges 1471 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Sierra/HPN HMO 60 60% of all negotiated rates 2635 percent of total billed charges 2635 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Silversummit Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1537 percent of total billed charges 1537 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 Teachers Trust PPO 68 68% of all negotiated rates 2986 percent of total billed charges 2986 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 TriWest PPO 30 30% of all negotiated rates 1317 percent of total billed charges 1317 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 UHN-Universal Health Network PPO 70 70% of all negotiated rates 3074 percent of total billed charges 3074 4391 36569 PICC LINE AGE 5 YRS OR OLDER ED CHARGE 36569 CPT 3230095 LOCAL 450 RC outpatient 4391 3732 United Healthcare PPO 60 60% of all negotiated rates 2635 percent of total billed charges 2635 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Aetna Medicare HMO 26 26% of all negotiated rates 1142 percent of total billed charges 1142 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Alignment Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 2635 percent of total billed charges 2635 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 2196 percent of total billed charges 2196 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 310 fee schedule 310 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Cigna PPO 68 68% of all negotiated rates 2986 percent of total billed charges 2986 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Coalition PPO 59 59% of all negotiated rates 2986 percent of total billed charges 2986 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Coventry PPO 75 75% of all negotiated rates 3293 percent of total billed charges 3293 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 3513 percent of total billed charges 3513 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 310 fee schedule 310 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Humana-Commerical PPO 70 70% of all negotiated rates 316 percent of total billed charges 3074 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 310 fee schedule 310 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Multiplan PPO 80 80% of all negotiated rates 3513 percent of total billed charges 3513 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 One Health PPO 55 55% of all negotiated rates 2986 percent of total billed charges 2986 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Optum Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 P3 HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 3074 percent of total billed charges 3074 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Select Health HMO 41 41% of all negotiated rates 1800 percent of total billed charges 1800 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1471 percent of total billed charges 1471 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Sierra/HPN HMO 60 60% of all negotiated rates 2635 percent of total billed charges 2635 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Silversummit Medicare HMO 39 39% of all negotiated rates 1712 percent of total billed charges 1712 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1537 percent of total billed charges 1537 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 Teachers Trust PPO 68 68% of all negotiated rates 2986 percent of total billed charges 2986 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 TriWest PPO 30 30% of all negotiated rates 1317 percent of total billed charges 1317 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 UHN-Universal Health Network PPO 70 70% of all negotiated rates 3074 percent of total billed charges 3074 4391 36571 INSERT PIC CENTRAL ACCESS DEVICE W/SUBCUTE PORT OVER 5 36571 CPT 45036571 LOCAL 450 RC outpatient 4391 3732 United Healthcare PPO 60 60% of all negotiated rates 2635 percent of total billed charges 2635 4391 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Aetna PPO 750 case rate 750 case rate 750 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Aetna Medicare HMO 26 26% of all negotiated rates 691 percent of total billed charges 691 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Alignment Medicare HMO 39 39% of all negotiated rates 1037 percent of total billed charges 1037 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1595 percent of total billed charges 1595 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1329 percent of total billed charges 1329 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Anthem Medicaid HMO 213 NV Medicaid SDS Rate 213 fee schedule 213 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1037 percent of total billed charges 1037 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Cigna PPO 756 case rate 756 case rate 756 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Coalition PPO 700 Coalition grouper rate 700 case rate 700 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Coventry PPO 75 75% of all negotiated rates 1994 percent of total billed charges 1994 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2126 percent of total billed charges 2126 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 HPN Medicaid HMO 213 NV Medicaid SDS Rate 213 fee schedule 213 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Humana-Commerical PPO 46 46% of all negotiated rates 1223 percent of total billed charges 1223 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1037 percent of total billed charges 1037 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Molina Medicaid HMO 213 NV Medicaid SDS Rate 213 case rate 213 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Multiplan PPO 80 80% of all negotiated rates 2126 percent of total billed charges 2126 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Multiplan PPO 80 80% of all negotiated rates 2126 percent of total billed charges 2126 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 One Health PPO 686 case rate 686 case rate 686 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Optum Medicare HMO 39 39% of all negotiated rates 1037 percent of total billed charges 1037 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 P3 HMO 39 39% of all negotiated rates 1037 percent of total billed charges 1037 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Saint Mary's Health Plan PPO 65 65% of all negotiated rates 1728 percent of total billed charges 1728 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Saint Mary's Health Plan HMO 65 65% of all negotiated rates 1728 percent of total billed charges 1728 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Select Health HMO 41 41% of all negotiated rates 1090 percent of total billed charges 1090 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Sierra Healthcare Options PPO 756 case rate 756 case rate 756 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Sierra/HPN HMO 756 case rate 756 case rate 756 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Silversummit Medicare HMO 39 39% of all negotiated rates 1037 percent of total billed charges 1037 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 930 percent of total billed charges 930 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Southpoint (Gaghan South) HMO 35 35% of all negotiated rates 930 percent of total billed charges 930 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 Teachers Trust PPO 700 Teachers grouper rate 700 case rate 700 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 TriWest PPO 30 30% of all negotiated rates 797 percent of total billed charges 797 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 TriWest HMO 30 30% of all negotiated rates 797 percent of total billed charges 797 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 UHN-Universal Health Network PPO 65 65% of all negotiated rates 1728 percent of total billed charges 1728 2658 36589 REM VEN CATH W/O PORT/PMP CHARGE 36589 CPT 3275515 LOCAL 490 RC outpatient 2658 2259 United Healthcare PPO 686 case rate 686 case rate 686 2658 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Aetna PPO 38 38% of all negotiated rates 83 percent of total billed charges 83 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Aetna Medicare HMO 26 26% of all negotiated rates 57 percent of total billed charges 57 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Alignment Medicare HMO 39 39% of all negotiated rates 85 percent of total billed charges 85 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 131 percent of total billed charges 131 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 109 percent of total billed charges 109 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 25 fee schedule 25 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 85 percent of total billed charges 85 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Cigna PPO 68 68% of all negotiated rates 148 percent of total billed charges 148 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Coalition PPO 49 49% of all negotiated rates 107 percent of total billed charges 107 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Coventry PPO 75 75% of all negotiated rates 164 percent of total billed charges 164 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 174 percent of total billed charges 174 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 25 fee schedule 25 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Humana-Commerical PPO 70 70% of all negotiated rates 3480 percent of total billed charges 153 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 85 percent of total billed charges 85 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 25 fee schedule 25 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Multiplan PPO 80 80% of all negotiated rates 174 percent of total billed charges 174 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Multiplan HMO 80 80% of all negotiated rates 174 percent of total billed charges 174 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 One Health PPO 55 55% of all negotiated rates 107 percent of total billed charges 107 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Optum Medicare HMO 39 39% of all negotiated rates 85 percent of total billed charges 85 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 P3 HMO 39 39% of all negotiated rates 85 percent of total billed charges 85 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 153 percent of total billed charges 153 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Saint Mary's Health Plan HMO 70 70% of all negotiated rates 153 percent of total billed charges 153 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Select Health HMO 41 41% of all negotiated rates 89 percent of total billed charges 89 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 73 percent of total billed charges 73 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Sierra/HPN HMO 60 60% of all negotiated rates 131 percent of total billed charges 131 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Silversummit Medicare HMO 39 39% of all negotiated rates 85 percent of total billed charges 85 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 76 percent of total billed charges 76 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 76 percent of total billed charges 76 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 Teachers Trust PPO 65 65% of all negotiated rates 142 percent of total billed charges 142 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 TriWest PPO 30 30% of all negotiated rates 65 percent of total billed charges 65 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 TriWest PPO 30 30% of all negotiated rates 65 percent of total billed charges 65 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 UHN-Universal Health Network PPO 70 70% of all negotiated rates 153 percent of total billed charges 153 218 36592 LAB COLLECTION VIA PICC CHARGE 36592 CPT 3275520 LOCAL 300 RC outpatient 218 185 United Healthcare PPO 60 60% of all negotiated rates 131 percent of total billed charges 131 218 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Aetna Medicare HMO 26 26% of all negotiated rates 207 percent of total billed charges 207 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Alignment Medicare HMO 39 39% of all negotiated rates 311 percent of total billed charges 311 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 479 percent of total billed charges 479 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 399 percent of total billed charges 399 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 57 fee schedule 57 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 311 percent of total billed charges 311 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Cigna PPO 68 68% of all negotiated rates 543 percent of total billed charges 543 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Coalition PPO 59 59% of all negotiated rates 543 percent of total billed charges 543 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Coventry PPO 75 75% of all negotiated rates 599 percent of total billed charges 599 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 638 percent of total billed charges 638 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 57 fee schedule 57 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Humana-Commerical PPO 70 70% of all negotiated rates 1570 percent of total billed charges 559 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 311 percent of total billed charges 311 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 57 fee schedule 57 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Multiplan PPO 80 80% of all negotiated rates 638 percent of total billed charges 638 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 One Health PPO 55 55% of all negotiated rates 543 percent of total billed charges 543 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Optum Medicare HMO 39 39% of all negotiated rates 311 percent of total billed charges 311 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 P3 HMO 39 39% of all negotiated rates 311 percent of total billed charges 311 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 559 percent of total billed charges 559 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Select Health HMO 41 41% of all negotiated rates 327 percent of total billed charges 327 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 267 percent of total billed charges 267 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Sierra/HPN HMO 60 60% of all negotiated rates 479 percent of total billed charges 479 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Silversummit Medicare HMO 39 39% of all negotiated rates 311 percent of total billed charges 311 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 279 percent of total billed charges 279 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 Teachers Trust PPO 68 68% of all negotiated rates 543 percent of total billed charges 543 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 TriWest PPO 30 30% of all negotiated rates 239 percent of total billed charges 239 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 UHN-Universal Health Network PPO 70 70% of all negotiated rates 559 percent of total billed charges 559 798 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION 36680 CPT 45036680 LOCAL 450 RC outpatient 798 678 United Healthcare PPO 60 60% of all negotiated rates 479 percent of total billed charges 479 798 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Aetna Medicare HMO 26 26% of all negotiated rates 297 percent of total billed charges 297 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Alignment Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 686 percent of total billed charges 686 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 572 percent of total billed charges 572 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 162 fee schedule 162 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Cigna PPO 68 68% of all negotiated rates 777 percent of total billed charges 777 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Coalition PPO 59 59% of all negotiated rates 777 percent of total billed charges 777 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Coventry PPO 75 75% of all negotiated rates 857 percent of total billed charges 857 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 914 percent of total billed charges 914 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 162 fee schedule 162 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Humana-Commerical PPO 70 70% of all negotiated rates 7736 percent of total billed charges 800 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 162 fee schedule 162 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Multiplan PPO 80 80% of all negotiated rates 914 percent of total billed charges 914 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 One Health PPO 55 55% of all negotiated rates 777 percent of total billed charges 777 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Optum Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 P3 HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 800 percent of total billed charges 800 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Select Health HMO 41 41% of all negotiated rates 469 percent of total billed charges 469 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 383 percent of total billed charges 383 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Sierra/HPN HMO 60 60% of all negotiated rates 686 percent of total billed charges 686 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Silversummit Medicare HMO 39 39% of all negotiated rates 446 percent of total billed charges 446 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 400 percent of total billed charges 400 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 Teachers Trust PPO 68 68% of all negotiated rates 777 percent of total billed charges 777 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 TriWest PPO 30 30% of all negotiated rates 343 percent of total billed charges 343 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 UHN-Universal Health Network PPO 70 70% of all negotiated rates 800 percent of total billed charges 800 1143 40830 REPAIR MOUTH LACERATION 40830 CPT 3236410 LOCAL 450 RC outpatient 1143 972 United Healthcare PPO 60 60% of all negotiated rates 686 percent of total billed charges 686 1143 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Aetna Medicare HMO 26 26% of all negotiated rates 154 percent of total billed charges 154 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Alignment Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 355 percent of total billed charges 355 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 296 percent of total billed charges 296 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 150 fee schedule 150 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Cigna PPO 68 68% of all negotiated rates 402 percent of total billed charges 402 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Coalition PPO 59 59% of all negotiated rates 402 percent of total billed charges 402 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Coventry PPO 75 75% of all negotiated rates 443 percent of total billed charges 443 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 473 percent of total billed charges 473 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 150 fee schedule 150 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Humana-Commerical PPO 70 70% of all negotiated rates 1926 percent of total billed charges 414 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 150 fee schedule 150 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Multiplan PPO 80 80% of all negotiated rates 473 percent of total billed charges 473 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 One Health PPO 55 55% of all negotiated rates 402 percent of total billed charges 402 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Optum Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 P3 HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 414 percent of total billed charges 414 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Select Health HMO 41 41% of all negotiated rates 242 percent of total billed charges 242 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 198 percent of total billed charges 198 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Sierra/HPN HMO 60 60% of all negotiated rates 355 percent of total billed charges 355 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Silversummit Medicare HMO 39 39% of all negotiated rates 230 percent of total billed charges 230 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 207 percent of total billed charges 207 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 Teachers Trust PPO 68 68% of all negotiated rates 402 percent of total billed charges 402 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 TriWest PPO 30 30% of all negotiated rates 177 percent of total billed charges 177 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 UHN-Universal Health Network PPO 70 70% of all negotiated rates 414 percent of total billed charges 414 591 41250 ED REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO 41250 CPT 3236415 LOCAL 450 RC outpatient 591 502 United Healthcare PPO 60 60% of all negotiated rates 355 percent of total billed charges 355 591 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Aetna Medicare HMO 26 26% of all negotiated rates 481 percent of total billed charges 481 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Alignment Medicare HMO 39 39% of all negotiated rates 721 percent of total billed charges 721 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1109 percent of total billed charges 1109 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 925 percent of total billed charges 925 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 204 fee schedule 204 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 721 percent of total billed charges 721 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Cigna PPO 68 68% of all negotiated rates 1257 percent of total billed charges 1257 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Coalition PPO 59 59% of all negotiated rates 1257 percent of total billed charges 1257 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Coventry PPO 75 75% of all negotiated rates 1387 percent of total billed charges 1387 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1479 percent of total billed charges 1479 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 204 fee schedule 204 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Humana-Commerical PPO 70 70% of all negotiated rates 6166 percent of total billed charges 1294 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 721 percent of total billed charges 721 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 204 fee schedule 204 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Multiplan PPO 80 80% of all negotiated rates 1479 percent of total billed charges 1479 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 One Health PPO 55 55% of all negotiated rates 1257 percent of total billed charges 1257 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Optum Medicare HMO 39 39% of all negotiated rates 721 percent of total billed charges 721 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 P3 HMO 39 39% of all negotiated rates 721 percent of total billed charges 721 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 1294 percent of total billed charges 1294 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Select Health HMO 41 41% of all negotiated rates 758 percent of total billed charges 758 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 619 percent of total billed charges 619 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Sierra/HPN HMO 60 60% of all negotiated rates 1109 percent of total billed charges 1109 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Silversummit Medicare HMO 39 39% of all negotiated rates 721 percent of total billed charges 721 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 647 percent of total billed charges 647 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 Teachers Trust PPO 68 68% of all negotiated rates 1257 percent of total billed charges 1257 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 TriWest PPO 30 30% of all negotiated rates 555 percent of total billed charges 555 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 UHN-Universal Health Network PPO 70 70% of all negotiated rates 1294 percent of total billed charges 1294 1849 "41252 ED REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX" 41252 CPT 3230175 LOCAL 450 RC outpatient 1849 1572 United Healthcare PPO 60 60% of all negotiated rates 1109 percent of total billed charges 1109 1849 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Aetna Medicare HMO 26 26% of all negotiated rates 182 percent of total billed charges 182 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Alignment Medicare HMO 39 39% of all negotiated rates 273 percent of total billed charges 273 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 419 percent of total billed charges 419 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 350 percent of total billed charges 350 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 100 fee schedule 100 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 273 percent of total billed charges 273 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Cigna PPO 68 68% of all negotiated rates 475 percent of total billed charges 475 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Coalition PPO 59 59% of all negotiated rates 475 percent of total billed charges 475 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Coventry PPO 75 75% of all negotiated rates 524 percent of total billed charges 524 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 559 percent of total billed charges 559 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 100 fee schedule 100 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Humana-Commerical PPO 70 70% of all negotiated rates 5235 percent of total billed charges 489 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 273 percent of total billed charges 273 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 100 fee schedule 100 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Multiplan PPO 80 80% of all negotiated rates 559 percent of total billed charges 559 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 One Health PPO 55 55% of all negotiated rates 475 percent of total billed charges 475 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Optum Medicare HMO 39 39% of all negotiated rates 273 percent of total billed charges 273 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 P3 HMO 39 39% of all negotiated rates 273 percent of total billed charges 273 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 489 percent of total billed charges 489 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Select Health HMO 41 41% of all negotiated rates 287 percent of total billed charges 287 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 234 percent of total billed charges 234 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Sierra/HPN HMO 60 60% of all negotiated rates 419 percent of total billed charges 419 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Silversummit Medicare HMO 39 39% of all negotiated rates 273 percent of total billed charges 273 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 245 percent of total billed charges 245 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 Teachers Trust PPO 68 68% of all negotiated rates 475 percent of total billed charges 475 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 TriWest PPO 30 30% of all negotiated rates 210 percent of total billed charges 210 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 UHN-Universal Health Network PPO 70 70% of all negotiated rates 489 percent of total billed charges 489 699 "42000 DRAINAGE ABSCESS PALATE, UVULA ED CHARGE" 42000 CPT 3230610 LOCAL 450 RC outpatient 699 594 United Healthcare PPO 60 60% of all negotiated rates 419 percent of total billed charges 419 699 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Aetna Medicare HMO 26 26% of all negotiated rates 170 percent of total billed charges 170 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Alignment Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 392 percent of total billed charges 392 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 327 percent of total billed charges 327 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 128 fee schedule 128 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Cigna PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Coalition PPO 59 59% of all negotiated rates 445 percent of total billed charges 445 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Coventry PPO 75 75% of all negotiated rates 491 percent of total billed charges 491 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 523 percent of total billed charges 523 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 128 fee schedule 128 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Humana-Commerical PPO 70 70% of all negotiated rates 4605 percent of total billed charges 458 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 128 fee schedule 128 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Multiplan PPO 80 80% of all negotiated rates 523 percent of total billed charges 523 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 One Health PPO 55 55% of all negotiated rates 445 percent of total billed charges 445 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Optum Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 P3 HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 458 percent of total billed charges 458 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Select Health HMO 41 41% of all negotiated rates 268 percent of total billed charges 268 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 219 percent of total billed charges 219 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Sierra/HPN HMO 60 60% of all negotiated rates 392 percent of total billed charges 392 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Silversummit Medicare HMO 39 39% of all negotiated rates 255 percent of total billed charges 255 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 229 percent of total billed charges 229 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 Teachers Trust PPO 68 68% of all negotiated rates 445 percent of total billed charges 445 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 TriWest PPO 30 30% of all negotiated rates 196 percent of total billed charges 196 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 UHN-Universal Health Network PPO 70 70% of all negotiated rates 458 percent of total billed charges 458 654 42809 ED REMOVAL FOREIGN BODY PHARYNX CHARGE 42809 CPT 3232150 LOCAL 450 RC outpatient 654 556 United Healthcare PPO 60 60% of all negotiated rates 392 percent of total billed charges 392 654 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Aetna Medicare HMO 26 26% of all negotiated rates 132 percent of total billed charges 132 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Alignment Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 304 percent of total billed charges 304 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 254 percent of total billed charges 254 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 39 fee schedule 39 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Cigna PPO 68 68% of all negotiated rates 345 percent of total billed charges 345 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Coalition PPO 59 59% of all negotiated rates 345 percent of total billed charges 345 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Coventry PPO 75 75% of all negotiated rates 380 percent of total billed charges 380 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 406 percent of total billed charges 406 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 39 fee schedule 39 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Humana-Commerical PPO 70 70% of all negotiated rates 4610 percent of total billed charges 355 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 39 fee schedule 39 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Multiplan PPO 80 80% of all negotiated rates 406 percent of total billed charges 406 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 One Health PPO 55 55% of all negotiated rates 345 percent of total billed charges 345 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Optum Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 P3 HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 355 percent of total billed charges 355 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Select Health HMO 41 41% of all negotiated rates 208 percent of total billed charges 208 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 170 percent of total billed charges 170 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Sierra/HPN HMO 60 60% of all negotiated rates 304 percent of total billed charges 304 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Silversummit Medicare HMO 39 39% of all negotiated rates 198 percent of total billed charges 198 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 177 percent of total billed charges 177 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 Teachers Trust PPO 68 68% of all negotiated rates 345 percent of total billed charges 345 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 TriWest PPO 30 30% of all negotiated rates 152 percent of total billed charges 152 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 UHN-Universal Health Network PPO 70 70% of all negotiated rates 355 percent of total billed charges 355 507 43752 NG TUBE PLACEMENT 43752 CPT 3230035 LOCAL 450 RC outpatient 507 431 United Healthcare PPO 60 60% of all negotiated rates 304 percent of total billed charges 304 507 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Aetna Medicare HMO 26 26% of all negotiated rates 157 percent of total billed charges 157 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Alignment Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 362 percent of total billed charges 362 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 302 percent of total billed charges 302 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 20 fee schedule 20 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Cigna PPO 68 68% of all negotiated rates 410 percent of total billed charges 410 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Coalition PPO 59 59% of all negotiated rates 410 percent of total billed charges 410 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Coventry PPO 75 75% of all negotiated rates 452 percent of total billed charges 452 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 482 percent of total billed charges 482 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 20 fee schedule 20 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Humana-Commerical PPO 70 70% of all negotiated rates 1960 percent of total billed charges 422 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 20 fee schedule 20 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Multiplan PPO 80 80% of all negotiated rates 482 percent of total billed charges 482 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 One Health PPO 55 55% of all negotiated rates 410 percent of total billed charges 410 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Optum Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 P3 HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 422 percent of total billed charges 422 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Select Health HMO 41 41% of all negotiated rates 247 percent of total billed charges 247 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 202 percent of total billed charges 202 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Sierra/HPN HMO 60 60% of all negotiated rates 362 percent of total billed charges 362 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Silversummit Medicare HMO 39 39% of all negotiated rates 235 percent of total billed charges 235 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 211 percent of total billed charges 211 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 Teachers Trust PPO 68 68% of all negotiated rates 410 percent of total billed charges 410 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 TriWest PPO 30 30% of all negotiated rates 181 percent of total billed charges 181 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 UHN-Universal Health Network PPO 70 70% of all negotiated rates 422 percent of total billed charges 422 603 43753 GASTRIC INTUB AND ASP/LAVAGE ED CHARGE 43753 CPT 3230043 LOCAL 450 RC outpatient 603 513 United Healthcare PPO 60 60% of all negotiated rates 362 percent of total billed charges 362 603 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Aetna Medicare HMO 26 26% of all negotiated rates 338 percent of total billed charges 338 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Alignment Medicare HMO 39 39% of all negotiated rates 507 percent of total billed charges 507 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 779 percent of total billed charges 779 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 650 percent of total billed charges 650 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 507 percent of total billed charges 507 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Cigna PPO 68 68% of all negotiated rates 883 percent of total billed charges 883 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Coalition PPO 59 59% of all negotiated rates 883 percent of total billed charges 883 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Coventry PPO 75 75% of all negotiated rates 974 percent of total billed charges 974 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 1039 percent of total billed charges 1039 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Humana-Commerical PPO 70 70% of all negotiated rates 2705 percent of total billed charges 909 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 507 percent of total billed charges 507 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Multiplan PPO 80 80% of all negotiated rates 1039 percent of total billed charges 1039 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 One Health PPO 55 55% of all negotiated rates 883 percent of total billed charges 883 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Optum Medicare HMO 39 39% of all negotiated rates 507 percent of total billed charges 507 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 P3 HMO 39 39% of all negotiated rates 507 percent of total billed charges 507 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 909 percent of total billed charges 909 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Select Health HMO 41 41% of all negotiated rates 533 percent of total billed charges 533 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 435 percent of total billed charges 435 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Sierra/HPN HMO 60 60% of all negotiated rates 779 percent of total billed charges 779 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Silversummit Medicare HMO 39 39% of all negotiated rates 507 percent of total billed charges 507 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 455 percent of total billed charges 455 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 Teachers Trust PPO 68 68% of all negotiated rates 883 percent of total billed charges 883 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 TriWest PPO 30 30% of all negotiated rates 390 percent of total billed charges 390 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 UHN-Universal Health Network PPO 70 70% of all negotiated rates 909 percent of total billed charges 909 1299 43760 CHANGE GASTROSTOMY TUBE 43760 CPT 3230430 LOCAL 450 RC outpatient 1299 1104 United Healthcare PPO 60 60% of all negotiated rates 779 percent of total billed charges 779 1299 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Aetna Medicare HMO 26 26% of all negotiated rates 208 percent of total billed charges 208 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Alignment Medicare HMO 39 39% of all negotiated rates 312 percent of total billed charges 312 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 481 percent of total billed charges 481 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 401 percent of total billed charges 401 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 312 percent of total billed charges 312 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Cigna PPO 68 68% of all negotiated rates 545 percent of total billed charges 545 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Coventry PPO 75 75% of all negotiated rates 601 percent of total billed charges 601 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 641 percent of total billed charges 641 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Humana-Commerical PPO 70 70% of all negotiated rates 2679 percent of total billed charges 561 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 312 percent of total billed charges 312 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Multiplan HMO 80 80% of all negotiated rates 641 percent of total billed charges 641 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Optum Medicare HMO 39 39% of all negotiated rates 312 percent of total billed charges 312 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 P3 HMO 39 39% of all negotiated rates 312 percent of total billed charges 312 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Saint Mary's Health Plan HMO 70 70% of all negotiated rates 561 percent of total billed charges 561 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Select Health HMO 41 41% of all negotiated rates 328 percent of total billed charges 328 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 268 percent of total billed charges 268 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Sierra/HPN HMO 60 60% of all negotiated rates 481 percent of total billed charges 481 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Silversummit Medicare HMO 39 39% of all negotiated rates 312 percent of total billed charges 312 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 280 percent of total billed charges 280 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 TriWest PPO 30 30% of all negotiated rates 240 percent of total billed charges 240 801 43760 CHANGE G-TUBE CHARGE 43760 CPT 3020570 LOCAL 361 RC outpatient 801 681 UHN-Universal Health Network PPO 70 70% of all negotiated rates 561 percent of total billed charges 561 801 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Aetna Medicare HMO 26 26% of all negotiated rates 1446 percent of total billed charges 1446 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Alignment Medicare HMO 39 39% of all negotiated rates 2170 percent of total billed charges 2170 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3338 percent of total billed charges 3338 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 2782 percent of total billed charges 2782 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 215 fee schedule 215 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2170 percent of total billed charges 2170 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Cigna PPO 68 68% of all negotiated rates 3783 percent of total billed charges 3783 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Coalition PPO 59 59% of all negotiated rates 3783 percent of total billed charges 3783 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Coventry PPO 75 75% of all negotiated rates 4172 percent of total billed charges 4172 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 4450 percent of total billed charges 4450 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 215 fee schedule 215 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Humana-Commerical PPO 70 70% of all negotiated rates 3802 percent of total billed charges 3894 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2170 percent of total billed charges 2170 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 215 fee schedule 215 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Multiplan PPO 80 80% of all negotiated rates 4450 percent of total billed charges 4450 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 One Health PPO 55 55% of all negotiated rates 3783 percent of total billed charges 3783 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Optum Medicare HMO 39 39% of all negotiated rates 2170 percent of total billed charges 2170 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 P3 HMO 39 39% of all negotiated rates 2170 percent of total billed charges 2170 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 3894 percent of total billed charges 3894 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Select Health HMO 41 41% of all negotiated rates 2281 percent of total billed charges 2281 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1864 percent of total billed charges 1864 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Sierra/HPN HMO 60 60% of all negotiated rates 3338 percent of total billed charges 3338 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Silversummit Medicare HMO 39 39% of all negotiated rates 2170 percent of total billed charges 2170 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1947 percent of total billed charges 1947 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 Teachers Trust PPO 68 68% of all negotiated rates 3783 percent of total billed charges 3783 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 TriWest PPO 30 30% of all negotiated rates 1669 percent of total billed charges 1669 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 UHN-Universal Health Network PPO 70 70% of all negotiated rates 3894 percent of total billed charges 3894 5563 45915 REM FECAL IMPACT/FB ED Charge 45915 CPT 3230036 LOCAL 450 RC outpatient 5563 4729 United Healthcare PPO 60 60% of all negotiated rates 3338 percent of total billed charges 3338 5563 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Aetna Medicare HMO 26 26% of all negotiated rates 1778 percent of total billed charges 1778 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Alignment Medicare HMO 39 39% of all negotiated rates 2667 percent of total billed charges 2667 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 4103 percent of total billed charges 4103 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 3420 percent of total billed charges 3420 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 392 fee schedule 392 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2667 percent of total billed charges 2667 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Cigna PPO 68 68% of all negotiated rates 4651 percent of total billed charges 4651 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Coalition PPO 59 59% of all negotiated rates 4651 percent of total billed charges 4651 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Coventry PPO 75 75% of all negotiated rates 5129 percent of total billed charges 5129 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 5471 percent of total billed charges 5471 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 392 fee schedule 392 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Humana-Commerical PPO 70 70% of all negotiated rates 3542 percent of total billed charges 4787 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2667 percent of total billed charges 2667 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 392 fee schedule 392 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Multiplan PPO 80 80% of all negotiated rates 5471 percent of total billed charges 5471 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 One Health PPO 55 55% of all negotiated rates 4651 percent of total billed charges 4651 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Optum Medicare HMO 39 39% of all negotiated rates 2667 percent of total billed charges 2667 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 P3 HMO 39 39% of all negotiated rates 2667 percent of total billed charges 2667 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 4787 percent of total billed charges 4787 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Select Health HMO 41 41% of all negotiated rates 2804 percent of total billed charges 2804 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 2291 percent of total billed charges 2291 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Sierra/HPN HMO 60 60% of all negotiated rates 4103 percent of total billed charges 4103 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Silversummit Medicare HMO 39 39% of all negotiated rates 2667 percent of total billed charges 2667 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 2394 percent of total billed charges 2394 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 Teachers Trust PPO 68 68% of all negotiated rates 4651 percent of total billed charges 4651 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 TriWest PPO 30 30% of all negotiated rates 2052 percent of total billed charges 2052 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 UHN-Universal Health Network PPO 70 70% of all negotiated rates 4787 percent of total billed charges 4787 6839 46040 ED ID RECTAL ABSCESS CHARGE 46040 CPT 3234210 LOCAL 450 RC outpatient 6839 5813 United Healthcare PPO 60 60% of all negotiated rates 4103 percent of total billed charges 4103 6839 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Aetna Medicare HMO 26 26% of all negotiated rates 781 percent of total billed charges 781 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Alignment Medicare HMO 39 39% of all negotiated rates 1172 percent of total billed charges 1172 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 1802 percent of total billed charges 1802 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 1502 percent of total billed charges 1502 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 93 fee schedule 93 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 1172 percent of total billed charges 1172 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Cigna PPO 68 68% of all negotiated rates 2043 percent of total billed charges 2043 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Coalition PPO 59 59% of all negotiated rates 2043 percent of total billed charges 2043 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Coventry PPO 75 75% of all negotiated rates 2253 percent of total billed charges 2253 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 2403 percent of total billed charges 2403 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 93 fee schedule 93 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Humana-Commerical PPO 70 70% of all negotiated rates 4269 percent of total billed charges 2103 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 1172 percent of total billed charges 1172 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 93 fee schedule 93 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Multiplan PPO 80 80% of all negotiated rates 2403 percent of total billed charges 2403 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 One Health PPO 55 55% of all negotiated rates 2043 percent of total billed charges 2043 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Optum Medicare HMO 39 39% of all negotiated rates 1172 percent of total billed charges 1172 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 P3 HMO 39 39% of all negotiated rates 1172 percent of total billed charges 1172 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 2103 percent of total billed charges 2103 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Select Health HMO 41 41% of all negotiated rates 1232 percent of total billed charges 1232 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1006 percent of total billed charges 1006 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Sierra/HPN HMO 60 60% of all negotiated rates 1802 percent of total billed charges 1802 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Silversummit Medicare HMO 39 39% of all negotiated rates 1172 percent of total billed charges 1172 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1051 percent of total billed charges 1051 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 Teachers Trust PPO 68 68% of all negotiated rates 2043 percent of total billed charges 2043 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 TriWest PPO 30 30% of all negotiated rates 901 percent of total billed charges 901 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 UHN-Universal Health Network PPO 70 70% of all negotiated rates 2103 percent of total billed charges 2103 3004 46050 ID PERIANAL ABSCESS ED CHARGE 46050 CPT 3230605 LOCAL 450 RC outpatient 3004 2553 United Healthcare PPO 60 60% of all negotiated rates 1802 percent of total billed charges 1802 3004 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Aetna Medicare HMO 26 26% of all negotiated rates 288 percent of total billed charges 288 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Alignment Medicare HMO 39 39% of all negotiated rates 433 percent of total billed charges 433 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 665 percent of total billed charges 665 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 555 percent of total billed charges 555 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 101 fee schedule 101 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 433 percent of total billed charges 433 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Cigna PPO 68 68% of all negotiated rates 754 percent of total billed charges 754 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Coalition PPO 59 59% of all negotiated rates 754 percent of total billed charges 754 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Coventry PPO 75 75% of all negotiated rates 832 percent of total billed charges 832 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 887 percent of total billed charges 887 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 101 fee schedule 101 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Humana-Commerical PPO 70 70% of all negotiated rates 6628 percent of total billed charges 776 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 433 percent of total billed charges 433 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 101 fee schedule 101 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Multiplan PPO 80 80% of all negotiated rates 887 percent of total billed charges 887 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 One Health PPO 55 55% of all negotiated rates 754 percent of total billed charges 754 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Optum Medicare HMO 39 39% of all negotiated rates 433 percent of total billed charges 433 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 P3 HMO 39 39% of all negotiated rates 433 percent of total billed charges 433 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 776 percent of total billed charges 776 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Select Health HMO 41 41% of all negotiated rates 455 percent of total billed charges 455 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 372 percent of total billed charges 372 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Sierra/HPN HMO 60 60% of all negotiated rates 665 percent of total billed charges 665 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Silversummit Medicare HMO 39 39% of all negotiated rates 433 percent of total billed charges 433 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 388 percent of total billed charges 388 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 Teachers Trust PPO 68 68% of all negotiated rates 754 percent of total billed charges 754 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 TriWest PPO 30 30% of all negotiated rates 333 percent of total billed charges 333 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 UHN-Universal Health Network PPO 70 70% of all negotiated rates 776 percent of total billed charges 776 1109 46083 INCIS OF EXT THROMBOSED HEMORR ED CHARGE 46083 CPT 3234207 LOCAL 450 RC outpatient 1109 943 United Healthcare PPO 60 60% of all negotiated rates 665 percent of total billed charges 665 1109 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Aetna Medicare HMO 26 26% of all negotiated rates 1424 percent of total billed charges 1424 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Alignment Medicare HMO 39 39% of all negotiated rates 2136 percent of total billed charges 2136 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 3286 percent of total billed charges 3286 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 2738 percent of total billed charges 2738 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Anthem Medicaid HMO 100 100% of NV Medicaid Fee Schedule 106 fee schedule 106 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Blue Cross Blue Shield Medicare HMO 39 39% of all negotiated rates 2136 percent of total billed charges 2136 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Cigna PPO 68 68% of all negotiated rates 3724 percent of total billed charges 3724 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Coalition PPO 59 59% of all negotiated rates 3724 percent of total billed charges 3724 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Coventry PPO 75 75% of all negotiated rates 4107 percent of total billed charges 4107 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Great West Healthcare (Mediversal) PPO 80 80% of all negotiated rates 4381 percent of total billed charges 4381 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 HPN Medicaid HMO 100 100% of NV Medicaid Fee Schedule 106 fee schedule 106 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Humana-Commerical PPO 70 70% of all negotiated rates 4414 percent of total billed charges 3833 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Humana-Medicare Advantage HMO 39 39% of all negotiated rates 2136 percent of total billed charges 2136 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Molina Medicaid HMO 100 100% of NV Medicaid Fee Schedule 106 fee schedule 106 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Multiplan PPO 80 80% of all negotiated rates 4381 percent of total billed charges 4381 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 One Health PPO 55 55% of all negotiated rates 3724 percent of total billed charges 3724 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Optum Medicare HMO 39 39% of all negotiated rates 2136 percent of total billed charges 2136 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 P3 HMO 39 39% of all negotiated rates 2136 percent of total billed charges 2136 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Saint Mary's Health Plan PPO 70 70% of all negotiated rates 3833 percent of total billed charges 3833 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Select Health HMO 41 41% of all negotiated rates 2245 percent of total billed charges 2245 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Sierra Healthcare Options PPO 33.5 33.5% of all negotiated rates 1834 percent of total billed charges 1834 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Sierra/HPN HMO 60 60% of all negotiated rates 3286 percent of total billed charges 3286 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Silversummit Medicare HMO 39 39% of all negotiated rates 2136 percent of total billed charges 2136 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Southpoint (Gaghan South) PPO 35 35% of all negotiated rates 1917 percent of total billed charges 1917 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 Teachers Trust PPO 68 68% of all negotiated rates 3724 percent of total billed charges 3724 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 TriWest PPO 30 30% of all negotiated rates 1643 percent of total billed charges 1643 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 UHN-Universal Health Network PPO 70 70% of all negotiated rates 3833 percent of total billed charges 3833 5476 46320 ENUC/EXC EXT THROMBOTIC HEMORR ED CHARGE 46320 CPT 3233349 LOCAL 450 RC outpatient 5476 4655 United Healthcare PPO 60 60% of all negotiated rates 3286 percent of total billed charges 3286 5476 "46600 Anoscopy, Diag W/W/O Spec" 46600 CPT 3230037 LOCAL 450 RC outpatient 295 251 Aetna Medicare HMO 26 26% of all negotiated rates 77 percent of total billed charges 77 295 "46600 Anoscopy, Diag W/W/O Spec" 46600 CPT 3230037 LOCAL 450 RC outpatient 295 251 Alignment Medicare HMO 39 39% of all negotiated rates 115 percent of total billed charges 115 295 "46600 Anoscopy, Diag W/W/O Spec" 46600 CPT 3230037 LOCAL 450 RC outpatient 295 251 Anthem Blue Cross Blue Shield Indeminity PPO 60 60% of all negotiated rates 177 percent of total billed charges 177 295 "46600 Anoscopy, Diag W/W/O Spec" 46600 CPT 3230037 LOCAL 450 RC outpatient 295 251 Anthem Blue Cross Blue Shield Pathway X HMO 50 50% of all negotiated rates 148 percent of total billed charges 148 295 "46600 Anosc