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New York rates for HCPCS G0415

Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.00 / $5,845.00 / $12,051.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,283.00 / $5,434.00 / $12,228.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,933.81 / $1,933.81 / $37,499.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,551.82 / $1,551.82 / $1,551.82
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $1,566.00 / $3,662.66
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,281.75 / $1,281.75 / $1,281.75
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $1,551.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,341.00 / $6,700.00 / $16,782.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,463.60 / $1,463.60 / $1,463.60