|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
IP
|
$626.20
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$394.51 |
| Max. Negotiated Rate |
$563.58 |
| Rate for Payer: Aetna Commercial |
$532.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.03
|
| Rate for Payer: Cash Price |
$500.96
|
| Rate for Payer: Cofinity Commercial |
$438.34
|
| Rate for Payer: Cofinity Commercial |
$538.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$438.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.96
|
| Rate for Payer: Healthscope Commercial |
$563.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.27
|
| Rate for Payer: PHP Commercial |
$532.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.03
|
| Rate for Payer: Priority Health SBD |
$394.51
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
IP
|
$1,810.30
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,140.49 |
| Max. Negotiated Rate |
$1,629.27 |
| Rate for Payer: Aetna Commercial |
$1,538.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.70
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cofinity Commercial |
$1,267.21
|
| Rate for Payer: Cofinity Commercial |
$1,556.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,267.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.24
|
| Rate for Payer: Healthscope Commercial |
$1,629.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,538.76
|
| Rate for Payer: PHP Commercial |
$1,538.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,176.70
|
| Rate for Payer: Priority Health SBD |
$1,140.49
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
OP
|
$1,810.30
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$427.11 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna Commercial |
$1,538.76
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$427.11
|
| Rate for Payer: BCN Commercial |
$427.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cofinity Commercial |
$1,556.86
|
| Rate for Payer: Cofinity Commercial |
$1,267.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,267.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,629.27
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,538.76
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,538.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,176.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$1,140.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.86
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$882.81
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.01 |
| Max. Negotiated Rate |
$302.88 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health SBD |
$212.01
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.62 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$112.62
|
| Rate for Payer: BCN Commercial |
$112.62
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.41
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
IP
|
$336.50
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$302.85 |
| Rate for Payer: Aetna Commercial |
$286.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.72
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cofinity Commercial |
$235.55
|
| Rate for Payer: Cofinity Commercial |
$289.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.20
|
| Rate for Payer: Healthscope Commercial |
$302.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.02
|
| Rate for Payer: PHP Commercial |
$286.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.72
|
| Rate for Payer: Priority Health SBD |
$212.00
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
OP
|
$336.50
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.08 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.02
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$111.08
|
| Rate for Payer: BCN Commercial |
$111.08
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cofinity Commercial |
$289.39
|
| Rate for Payer: Cofinity Commercial |
$235.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.85
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.02
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.02
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.00
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.83
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
OP
|
$2,115.23
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$413.26 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna Commercial |
$1,797.95
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$413.26
|
| Rate for Payer: BCN Commercial |
$413.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cofinity Commercial |
$1,819.10
|
| Rate for Payer: Cofinity Commercial |
$1,480.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,480.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,903.71
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.95
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,797.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$1,332.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$551.22
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$882.81
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
IP
|
$2,115.23
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,332.59 |
| Max. Negotiated Rate |
$1,903.71 |
| Rate for Payer: Aetna Commercial |
$1,797.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.90
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cofinity Commercial |
$1,480.66
|
| Rate for Payer: Cofinity Commercial |
$1,819.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,480.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.18
|
| Rate for Payer: Healthscope Commercial |
$1,903.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.95
|
| Rate for Payer: PHP Commercial |
$1,797.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.90
|
| Rate for Payer: Priority Health SBD |
$1,332.59
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
IP
|
$365.18
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.06 |
| Max. Negotiated Rate |
$328.66 |
| Rate for Payer: Aetna Commercial |
$310.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.37
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cofinity Commercial |
$255.63
|
| Rate for Payer: Cofinity Commercial |
$314.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.14
|
| Rate for Payer: Healthscope Commercial |
$328.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.40
|
| Rate for Payer: PHP Commercial |
$310.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.37
|
| Rate for Payer: Priority Health SBD |
$230.06
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
OP
|
$365.18
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.62 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$310.40
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$112.62
|
| Rate for Payer: BCN Commercial |
$112.62
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cofinity Commercial |
$314.05
|
| Rate for Payer: Cofinity Commercial |
$255.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$328.66
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.40
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$310.40
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$230.06
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.70
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$418.95 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna Commercial |
$565.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.25
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$465.50
|
| Rate for Payer: Cofinity Commercial |
$571.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$465.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Healthscope Commercial |
$598.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: PHP Commercial |
$565.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health SBD |
$418.95
|
|
|
HC CLOSED TX FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.62 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$565.25
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$112.62
|
| Rate for Payer: BCN Commercial |
$112.62
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$571.90
|
| Rate for Payer: Cofinity Commercial |
$465.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$465.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$598.50
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$565.25
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$418.95
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.42
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.01 |
| Max. Negotiated Rate |
$302.88 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health SBD |
$212.01
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.40 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$69.40
|
| Rate for Payer: BCN Commercial |
$69.40
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.24
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$232.45
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.95
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.01 |
| Max. Negotiated Rate |
$302.88 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health SBD |
$212.01
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.62 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$112.62
|
| Rate for Payer: BCN Commercial |
$112.62
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.78
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.01 |
| Max. Negotiated Rate |
$302.88 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health SBD |
$212.01
|
|
|
HC CLOSED TX HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.01 |
| Max. Negotiated Rate |
$302.88 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health SBD |
$212.01
|
|
|
HC CLOSED TX HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.53 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$96.53
|
| Rate for Payer: BCN Commercial |
$96.53
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.31
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.63 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$646.00
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.00
|
| 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 |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$532.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$532.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$684.00
|
| 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 |
$646.00
|
| 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 |
$646.00
|
| 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 |
$494.00
|
| 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 |
$478.80
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$383.38
|
| 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 CLOSED TX INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
IP
|
$760.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$684.00 |
| Rate for Payer: Aetna Commercial |
$646.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$653.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$532.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.00
|
| Rate for Payer: Healthscope Commercial |
$684.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.00
|
| Rate for Payer: PHP Commercial |
$646.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health SBD |
$478.80
|
|
|
HC CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.53 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$96.53
|
| Rate for Payer: BCN Commercial |
$96.53
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$212.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.33
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$132.32
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$212.01 |
| Max. Negotiated Rate |
$302.88 |
| Rate for Payer: Aetna Commercial |
$286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.74
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$235.57
|
| Rate for Payer: Cofinity Commercial |
$289.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: PHP Commercial |
$286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health SBD |
$212.01
|
|
