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Arizona rates for HCPCS 27197

Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $2,640.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.79 / $120.84 / $281.64
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.93 / $123.93 / $123.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.71 / $337.73 / $552.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.54 / $158.33 / $197.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.99 / $156.93 / $245.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.47 / $173.08 / $1,689.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.20 / $137.35 / $987.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.00 / $1,535.00 / $2,175.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.25 / $130.65 / $257.60