|
HC CASSETTES QUEST
|
Facility
|
IP
|
$78.03
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.16 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$430.97
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$271.51 |
| Max. Negotiated Rate |
$387.87 |
| Rate for Payer: Aetna Commercial |
$366.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.13
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cofinity Advantage |
$301.68
|
| Rate for Payer: Cofinity Commercial |
$370.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.78
|
| Rate for Payer: Healthscope Commercial |
$387.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.23
|
| Rate for Payer: PHP Commercial |
$366.32
|
| Rate for Payer: Priority Health SBD |
$271.51
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$430.97
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna Commercial |
$366.32
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$125.89
|
| Rate for Payer: BCN Commercial |
$125.89
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cofinity Advantage |
$301.68
|
| Rate for Payer: Cofinity Commercial |
$370.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$387.87
|
| Rate for Payer: Mclaren Medicaid |
$84.68
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.32
|
| Rate for Payer: Nomi Health Commercial |
$485.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.23
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$366.32
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$271.51
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.13
|
| Rate for Payer: UHC Core |
$224.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$169.37
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$62.78
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.55 |
| Max. Negotiated Rate |
$56.50 |
| Rate for Payer: Aetna Commercial |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.81
|
| Rate for Payer: Cash Price |
$50.22
|
| Rate for Payer: Cofinity Advantage |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$53.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.22
|
| Rate for Payer: Healthscope Commercial |
$56.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.09
|
| Rate for Payer: PHP Commercial |
$53.36
|
| Rate for Payer: Priority Health SBD |
$39.55
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$62.78
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.67 |
| Max. Negotiated Rate |
$56.50 |
| Rate for Payer: Aetna Commercial |
$53.36
|
| Rate for Payer: Aetna Medicare |
$31.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.81
|
| Rate for Payer: BCBS Complete |
$25.11
|
| Rate for Payer: Cash Price |
$50.22
|
| Rate for Payer: Cofinity Advantage |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$53.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.22
|
| Rate for Payer: Healthscope Commercial |
$56.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.09
|
| Rate for Payer: PHP Commercial |
$53.36
|
| Rate for Payer: Priority Health SBD |
$39.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.81
|
| Rate for Payer: UHC Core |
$32.71
|
| Rate for Payer: UHC Exchange |
$24.67
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$416.23
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$262.22 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.55
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Advantage |
$291.36
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: Priority Health SBD |
$262.22
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$416.23
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$73.65 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$73.65
|
| Rate for Payer: BCN Commercial |
$73.65
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Advantage |
$291.36
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$262.22
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.55
|
| Rate for Payer: UHC Core |
$216.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$163.58
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$214.29
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$51.32 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna Commercial |
$182.15
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$51.32
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cofinity Advantage |
$150.00
|
| Rate for Payer: Cofinity Commercial |
$184.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$192.86
|
| Rate for Payer: Mclaren Medicaid |
$84.68
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.15
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.72
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$182.15
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$135.00
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.29
|
| Rate for Payer: UHC Core |
$111.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$84.22
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$214.29
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$192.86 |
| Rate for Payer: Aetna Commercial |
$182.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.29
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cofinity Advantage |
$150.00
|
| Rate for Payer: Cofinity Commercial |
$184.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.43
|
| Rate for Payer: Healthscope Commercial |
$192.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.72
|
| Rate for Payer: PHP Commercial |
$182.15
|
| Rate for Payer: Priority Health SBD |
$135.00
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$242.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna Commercial |
$206.47
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$117.02
|
| Rate for Payer: BCN Commercial |
$117.02
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cofinity Advantage |
$170.03
|
| Rate for Payer: Cofinity Commercial |
$208.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$218.61
|
| Rate for Payer: Mclaren Medicaid |
$84.68
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.47
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.18
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$206.47
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$153.03
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.88
|
| Rate for Payer: UHC Core |
$126.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$95.46
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$242.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$153.03 |
| Max. Negotiated Rate |
$218.61 |
| Rate for Payer: Aetna Commercial |
$206.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.88
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cofinity Advantage |
$170.03
|
| Rate for Payer: Cofinity Commercial |
$208.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.32
|
| Rate for Payer: Healthscope Commercial |
$218.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.18
|
| Rate for Payer: PHP Commercial |
$206.47
|
| Rate for Payer: Priority Health SBD |
$153.03
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$988.94
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$840.60
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$116.09
|
| Rate for Payer: BCN Commercial |
$116.09
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cofinity Advantage |
$692.26
|
| Rate for Payer: Cofinity Commercial |
$850.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$791.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$890.05
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.60
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.71
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$840.60
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$623.03
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.81
|
| Rate for Payer: UHC Core |
$515.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$388.65
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$988.94
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$623.03 |
| Max. Negotiated Rate |
$890.05 |
| Rate for Payer: Aetna Commercial |
$840.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.81
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cofinity Advantage |
$692.26
|
| Rate for Payer: Cofinity Commercial |
$850.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$791.15
|
| Rate for Payer: Healthscope Commercial |
$890.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.71
|
| Rate for Payer: PHP Commercial |
$840.60
|
| Rate for Payer: Priority Health SBD |
$623.03
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$348.51
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$219.56 |
| Max. Negotiated Rate |
$313.66 |
| Rate for Payer: Aetna Commercial |
$296.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.53
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cofinity Advantage |
$243.96
|
| Rate for Payer: Cofinity Commercial |
$299.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.81
|
| Rate for Payer: Healthscope Commercial |
$313.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.38
|
| Rate for Payer: PHP Commercial |
$296.23
|
| Rate for Payer: Priority Health SBD |
$219.56
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$348.51
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$136.32 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$296.23
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$136.32
|
| Rate for Payer: BCN Commercial |
$136.32
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cofinity Advantage |
$243.96
|
| Rate for Payer: Cofinity Commercial |
$299.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$313.66
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.23
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.38
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$296.23
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$219.56
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.53
|
| Rate for Payer: UHC Core |
$181.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$136.96
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST LONG LEG
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$163.99
|
| Rate for Payer: BCN Commercial |
$163.99
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Advantage |
$293.94
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$264.54
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.94
|
| Rate for Payer: UHC Core |
$218.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$165.02
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST LONG LEG
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$264.54 |
| Max. Negotiated Rate |
$377.92 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.94
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Advantage |
$293.94
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: Priority Health SBD |
$264.54
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$936.94
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$796.40
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$116.09
|
| Rate for Payer: BCN Commercial |
$116.09
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cofinity Advantage |
$655.86
|
| Rate for Payer: Cofinity Commercial |
$805.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$843.25
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.40
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.71
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$796.40
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$590.27
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.01
|
| Rate for Payer: UHC Core |
$488.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$368.22
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST PANTALOON
|
Facility
|
IP
|
$936.94
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$590.27 |
| Max. Negotiated Rate |
$843.25 |
| Rate for Payer: Aetna Commercial |
$796.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.01
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cofinity Advantage |
$655.86
|
| Rate for Payer: Cofinity Commercial |
$805.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.55
|
| Rate for Payer: Healthscope Commercial |
$843.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.71
|
| Rate for Payer: PHP Commercial |
$796.40
|
| Rate for Payer: Priority Health SBD |
$590.27
|
|
|
HC CAST PTB WALKING
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$69.11 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$69.11
|
| Rate for Payer: BCN Commercial |
$69.11
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Advantage |
$293.94
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$264.54
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.94
|
| Rate for Payer: UHC Core |
$218.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$165.02
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST PTB WALKING
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$264.54 |
| Max. Negotiated Rate |
$377.92 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.94
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Advantage |
$293.94
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: Priority Health SBD |
$264.54
|
|
|
HC CAST REPAIR
|
Facility
|
OP
|
$182.39
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.68 |
| Max. Negotiated Rate |
$164.15 |
| Rate for Payer: Aetna Commercial |
$155.03
|
| Rate for Payer: Aetna Medicare |
$91.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.55
|
| Rate for Payer: BCBS Complete |
$72.96
|
| Rate for Payer: Cash Price |
$145.91
|
| Rate for Payer: Cofinity Advantage |
$127.67
|
| Rate for Payer: Cofinity Commercial |
$156.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.91
|
| Rate for Payer: Healthscope Commercial |
$164.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.79
|
| Rate for Payer: PHP Commercial |
$155.03
|
| Rate for Payer: Priority Health SBD |
$114.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.55
|
| Rate for Payer: UHC Core |
$95.03
|
| Rate for Payer: UHC Exchange |
$71.68
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$182.39
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.91 |
| Max. Negotiated Rate |
$164.15 |
| Rate for Payer: Aetna Commercial |
$155.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.55
|
| Rate for Payer: Cash Price |
$145.91
|
| Rate for Payer: Cofinity Advantage |
$127.67
|
| Rate for Payer: Cofinity Commercial |
$156.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.91
|
| Rate for Payer: Healthscope Commercial |
$164.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.79
|
| Rate for Payer: PHP Commercial |
$155.03
|
| Rate for Payer: Priority Health SBD |
$114.91
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
IP
|
$315.57
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$198.81 |
| Max. Negotiated Rate |
$284.01 |
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.12
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Advantage |
$220.90
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: Priority Health SBD |
$198.81
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$315.57
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$116.09
|
| Rate for Payer: BCN Commercial |
$116.09
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Advantage |
$220.90
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Mclaren Medicaid |
$145.75
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$198.81
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.12
|
| Rate for Payer: UHC Core |
$164.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$124.02
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
