HC CLOSED RX CARPAL FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 25630
|
Hospital Charge Code |
76100165
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$113.07 |
Max. Negotiated Rate |
$320.92 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$113.07
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$320.92
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$291.75
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 27786
|
Hospital Charge Code |
76100174
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$114.78 |
Max. Negotiated Rate |
$641.75 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$145.57
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.75
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health Narrow Network |
$513.40
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$323.09
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$293.72
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 27786
|
Hospital Charge Code |
76100174
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 25600
|
Hospital Charge Code |
76100163
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 25600
|
Hospital Charge Code |
76100163
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$109.14 |
Max. Negotiated Rate |
$366.67 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$109.14
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$366.67
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$333.34
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 26600
|
Hospital Charge Code |
76100166
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$109.99 |
Max. Negotiated Rate |
$324.88 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$109.99
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$324.88
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$295.35
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 26600
|
Hospital Charge Code |
76100166
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
IP
|
$413.27
|
|
Service Code
|
CPT 26605
|
Hospital Charge Code |
76100167
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$260.36 |
Max. Negotiated Rate |
$371.94 |
Rate for Payer: Aetna Commercial |
$351.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$268.63
|
Rate for Payer: Cash Price |
$330.62
|
Rate for Payer: Cofinity Commercial |
$289.29
|
Rate for Payer: Cofinity Commercial |
$355.41
|
Rate for Payer: Healthscope Commercial |
$371.94
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
Rate for Payer: PHP Commercial |
$351.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
Rate for Payer: Priority Health SBD |
$260.36
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
OP
|
$413.27
|
|
Service Code
|
CPT 26605
|
Hospital Charge Code |
76100167
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$114.78 |
Max. Negotiated Rate |
$371.94 |
Rate for Payer: Aetna Commercial |
$351.28
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$268.63
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$197.02
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$330.62
|
Rate for Payer: Cash Price |
$330.62
|
Rate for Payer: Cofinity Commercial |
$355.41
|
Rate for Payer: Cofinity Commercial |
$289.29
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$371.94
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$351.28
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$260.36
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$335.34
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$304.85
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 28470
|
Hospital Charge Code |
76100175
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$88.90 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$88.90
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$229.80
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$208.91
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 28470
|
Hospital Charge Code |
76100175
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX NAVICULAR FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 25622
|
Hospital Charge Code |
76100164
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$79.68 |
Max. Negotiated Rate |
$321.29 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$79.68
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$321.29
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$292.08
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX NAVICULAR FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 25622
|
Hospital Charge Code |
76100164
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 27520
|
Hospital Charge Code |
76100171
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$93.74 |
Max. Negotiated Rate |
$620.74 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$93.74
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.74
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health Narrow Network |
$496.59
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$339.30
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$308.45
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 27520
|
Hospital Charge Code |
76100171
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
OP
|
$622.66
|
|
Service Code
|
CPT 27265
|
Hospital Charge Code |
76100363
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$114.78 |
Max. Negotiated Rate |
$641.75 |
Rate for Payer: Aetna Commercial |
$529.26
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$404.73
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$242.49
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$498.13
|
Rate for Payer: Cash Price |
$498.13
|
Rate for Payer: Cofinity Commercial |
$535.49
|
Rate for Payer: Cofinity Commercial |
$435.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$560.39
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$529.26
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.75
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health Narrow Network |
$513.40
|
Rate for Payer: Priority Health SBD |
$392.28
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$464.64
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$422.40
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
IP
|
$622.66
|
|
Service Code
|
CPT 27265
|
Hospital Charge Code |
76100363
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$392.28 |
Max. Negotiated Rate |
$560.39 |
Rate for Payer: Aetna Commercial |
$529.26
|
Rate for Payer: Aetna New Business (MI Preferred) |
$404.73
|
Rate for Payer: Cash Price |
$498.13
|
Rate for Payer: Cofinity Commercial |
$435.86
|
Rate for Payer: Cofinity Commercial |
$535.49
|
Rate for Payer: Healthscope Commercial |
$560.39
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
Rate for Payer: PHP Commercial |
$529.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
Rate for Payer: Priority Health SBD |
$392.28
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 23600
|
Hospital Charge Code |
76100160
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 23600
|
Hospital Charge Code |
76100160
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$83.24 |
Max. Negotiated Rate |
$356.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$83.24
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$356.95
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$324.50
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
OP
|
$609.96
|
|
Service Code
|
CPT 27230
|
Hospital Charge Code |
76100317
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$109.36 |
Max. Negotiated Rate |
$641.75 |
Rate for Payer: Aetna Commercial |
$518.47
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$396.47
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$109.36
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$487.97
|
Rate for Payer: Cash Price |
$487.97
|
Rate for Payer: Cofinity Commercial |
$426.97
|
Rate for Payer: Cofinity Commercial |
$524.57
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$548.96
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$518.47
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.75
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health Narrow Network |
$513.40
|
Rate for Payer: Priority Health SBD |
$384.27
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$530.55
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$482.32
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
IP
|
$609.96
|
|
Service Code
|
CPT 27230
|
Hospital Charge Code |
76100317
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$384.27 |
Max. Negotiated Rate |
$548.96 |
Rate for Payer: Aetna Commercial |
$518.47
|
Rate for Payer: Aetna New Business (MI Preferred) |
$396.47
|
Rate for Payer: Cash Price |
$487.97
|
Rate for Payer: Cofinity Commercial |
$524.57
|
Rate for Payer: Cofinity Commercial |
$426.97
|
Rate for Payer: Healthscope Commercial |
$548.96
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
Rate for Payer: PHP Commercial |
$518.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
Rate for Payer: Priority Health SBD |
$384.27
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 24650
|
Hospital Charge Code |
76100161
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 24650
|
Hospital Charge Code |
76100161
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$103.72 |
Max. Negotiated Rate |
$620.74 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$103.72
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.74
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health Narrow Network |
$496.59
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$278.78
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$253.44
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
IP
|
$344.39
|
|
Service Code
|
CPT 25560
|
Hospital Charge Code |
76100162
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$216.97 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health SBD |
$216.97
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
OP
|
$344.39
|
|
Service Code
|
CPT 25560
|
Hospital Charge Code |
76100162
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$114.78 |
Max. Negotiated Rate |
$309.95 |
Rate for Payer: Aetna Commercial |
$292.73
|
Rate for Payer: Aetna Medicare |
$218.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
Rate for Payer: BCBS Complete |
$120.53
|
Rate for Payer: BCBS MAPPO |
$209.83
|
Rate for Payer: BCBS Trust/PPO |
$136.42
|
Rate for Payer: BCN Medicare Advantage |
$209.83
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cash Price |
$275.51
|
Rate for Payer: Cofinity Commercial |
$296.18
|
Rate for Payer: Cofinity Commercial |
$241.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
Rate for Payer: Healthscope Commercial |
$309.95
|
Rate for Payer: Mclaren Medicaid |
$114.78
|
Rate for Payer: Mclaren Medicare |
$209.83
|
Rate for Payer: Meridian Medicaid |
$120.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
Rate for Payer: PACE Medicare |
$199.34
|
Rate for Payer: PACE SWMI |
$209.83
|
Rate for Payer: PHP Commercial |
$292.73
|
Rate for Payer: PHP Medicare Advantage |
$209.83
|
Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
Rate for Payer: Priority Health Medicare |
$209.83
|
Rate for Payer: Priority Health SBD |
$216.97
|
Rate for Payer: Railroad Medicare Medicare |
$209.83
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$293.56
|
Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
Rate for Payer: UHC Exchange |
$266.87
|
Rate for Payer: UHC Medicare Advantage |
$216.12
|
Rate for Payer: VA VA |
$209.83
|
|