|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$653.88 |
| Rate for Payer: Aetna Commercial |
$617.55
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$448.90
|
| Rate for Payer: BCN Commercial |
$448.90
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Cofinity Commercial |
$508.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$508.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$653.88
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$617.55
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$457.71
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$537.63
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$58.66
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$870.72 |
| Max. Negotiated Rate |
$1,243.88 |
| Rate for Payer: Aetna Commercial |
$1,174.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.36
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,188.60
|
| Rate for Payer: Cofinity Commercial |
$967.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$967.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Healthscope Commercial |
$1,243.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: PHP Commercial |
$1,174.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health SBD |
$870.72
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,243.88 |
| Rate for Payer: Aetna Commercial |
$1,174.78
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$676.30
|
| Rate for Payer: BCN Commercial |
$676.30
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$967.46
|
| Rate for Payer: Cofinity Commercial |
$1,188.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$967.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,243.88
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,174.78
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$870.72
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,022.75
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.63
|
| Rate for Payer: BCN Commercial |
$4.63
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health SBD |
$48.20
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health SBD |
$48.20
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$266.19 |
| Max. Negotiated Rate |
$380.27 |
| Rate for Payer: Aetna Commercial |
$359.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.64
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$295.76
|
| Rate for Payer: Cofinity Commercial |
$363.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Healthscope Commercial |
$380.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: PHP Commercial |
$359.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: Priority Health SBD |
$266.19
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$359.14
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$98.29
|
| Rate for Payer: BCN Commercial |
$98.29
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$363.37
|
| Rate for Payer: Cofinity Commercial |
$295.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$380.27
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$359.14
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$266.19
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.42
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$87.04
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.78 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: Priority Health SBD |
$38.78
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna Medicare |
$30.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: BCBS Complete |
$24.62
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: Priority Health SBD |
$38.78
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$257.08 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.25
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$285.65
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health SBD |
$257.08
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$57.50 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$57.50
|
| Rate for Payer: BCN Commercial |
$57.50
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Cofinity Commercial |
$285.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$257.08
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.00
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$146.50
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$40.06 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$178.58
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$40.06
|
| Rate for Payer: BCN Commercial |
$40.06
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$180.68
|
| Rate for Payer: Cofinity Commercial |
$147.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$189.08
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$178.58
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$132.36
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.54
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$155.47
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$87.04
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$132.36 |
| Max. Negotiated Rate |
$189.08 |
| Rate for Payer: Aetna Commercial |
$178.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.56
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$147.06
|
| Rate for Payer: Cofinity Commercial |
$180.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Healthscope Commercial |
$189.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: PHP Commercial |
$178.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: Priority Health SBD |
$132.36
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$71.24 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$202.42
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$91.36
|
| Rate for Payer: BCN Commercial |
$91.36
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$166.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$166.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$214.33
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$202.42
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$150.03
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.24
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$176.22
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$87.04
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$150.03 |
| Max. Negotiated Rate |
$214.33 |
| Rate for Payer: Aetna Commercial |
$202.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.79
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$166.70
|
| Rate for Payer: Cofinity Commercial |
$204.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$166.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Healthscope Commercial |
$214.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: PHP Commercial |
$202.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: Priority Health SBD |
$150.03
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$969.55
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$90.63 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$824.12
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$90.63
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cofinity Commercial |
$833.81
|
| Rate for Payer: Cofinity Commercial |
$678.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$872.60
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$824.12
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$610.82
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.42
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$146.50
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$969.55
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$610.82 |
| Max. Negotiated Rate |
$872.60 |
| Rate for Payer: Aetna Commercial |
$824.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.21
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cofinity Commercial |
$678.68
|
| Rate for Payer: Cofinity Commercial |
$833.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.64
|
| Rate for Payer: Healthscope Commercial |
$872.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: PHP Commercial |
$824.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.21
|
| Rate for Payer: Priority Health SBD |
$610.82
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$71.98 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$290.43
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$106.43
|
| Rate for Payer: BCN Commercial |
$106.43
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cofinity Commercial |
$293.84
|
| Rate for Payer: Cofinity Commercial |
$239.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$239.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$307.51
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$290.43
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$215.26
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.98
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$146.50
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$215.26 |
| Max. Negotiated Rate |
$307.51 |
| Rate for Payer: Aetna Commercial |
$290.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.09
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cofinity Commercial |
$239.18
|
| Rate for Payer: Cofinity Commercial |
$293.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$239.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.34
|
| Rate for Payer: Healthscope Commercial |
$307.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: PHP Commercial |
$290.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.09
|
| Rate for Payer: Priority Health SBD |
$215.26
|
|
|
HC CAST LONG LEG
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$259.36 |
| Max. Negotiated Rate |
$370.51 |
| Rate for Payer: Aetna Commercial |
$349.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.59
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$288.18
|
| Rate for Payer: Cofinity Commercial |
$354.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$370.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: PHP Commercial |
$349.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health SBD |
$259.36
|
|
|
HC CAST LONG LEG
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$104.72 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$349.93
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$128.03
|
| Rate for Payer: BCN Commercial |
$128.03
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$354.04
|
| Rate for Payer: Cofinity Commercial |
$288.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$370.51
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$349.93
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$259.36
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.72
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$146.50
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST PANTALOON
|
Facility
|
IP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$578.70 |
| Max. Negotiated Rate |
$826.71 |
| Rate for Payer: Aetna Commercial |
$780.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.07
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$643.00
|
| Rate for Payer: Cofinity Commercial |
$789.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.86
|
| Rate for Payer: Healthscope Commercial |
$826.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: PHP Commercial |
$780.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.07
|
| Rate for Payer: Priority Health SBD |
$578.70
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$90.63 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$780.78
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$90.63
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$789.97
|
| Rate for Payer: Cofinity Commercial |
$643.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$826.71
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$780.78
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$578.70
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.22
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$146.50
|
| Rate for Payer: VA VA |
$260.21
|
|
