|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC CAROTENE
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$90.27 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: BCBS Trust/PPO |
$114.37
|
| Rate for Payer: BCN Commercial |
$114.37
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.24
|
| Rate for Payer: UHC Core |
$123.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.00
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: Aetna Medicare |
$38.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.25
|
| Rate for Payer: BCBS Complete |
$7.14
|
| Rate for Payer: BCBS MAPPO |
$37.00
|
| Rate for Payer: BCBS Trust/PPO |
$115.07
|
| Rate for Payer: BCN Commercial |
$115.07
|
| Rate for Payer: BCN Medicare Advantage |
$37.00
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.00
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.00
|
| Rate for Payer: Mclaren Medicaid |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$7.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PACE Senior Care Partners |
$35.15
|
| Rate for Payer: PACE SWMI |
$37.00
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: PHP Medicare Advantage |
$37.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.76
|
| Rate for Payer: Priority Health Medicare |
$37.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.24
|
| Rate for Payer: UHC Core |
$123.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$38.11
|
| Rate for Payer: VA VA |
$37.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.00
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$712.28
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$434.42 |
| Max. Negotiated Rate |
$641.05 |
| Rate for Payer: Aetna Commercial |
$605.44
|
| Rate for Payer: BCBS Trust/PPO |
$550.45
|
| Rate for Payer: BCN Commercial |
$550.45
|
| Rate for Payer: Cash Price |
$569.82
|
| Rate for Payer: Cofinity Commercial |
$612.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.82
|
| Rate for Payer: Healthscope Commercial |
$641.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$534.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.44
|
| Rate for Payer: PHP Commercial |
$605.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.81
|
| Rate for Payer: UHC Core |
$594.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$534.21
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$712.28
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$641.05 |
| Rate for Payer: Aetna Commercial |
$605.44
|
| Rate for Payer: Aetna Medicare |
$185.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.59
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$178.07
|
| Rate for Payer: BCBS Trust/PPO |
$553.80
|
| Rate for Payer: BCN Commercial |
$553.80
|
| Rate for Payer: BCN Medicare Advantage |
$178.07
|
| Rate for Payer: Cash Price |
$569.82
|
| Rate for Payer: Cash Price |
$569.82
|
| Rate for Payer: Cofinity Commercial |
$612.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.07
|
| Rate for Payer: Healthscope Commercial |
$641.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$534.21
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.44
|
| Rate for Payer: PACE Senior Care Partners |
$169.17
|
| Rate for Payer: PACE SWMI |
$178.07
|
| Rate for Payer: PHP Commercial |
$605.44
|
| Rate for Payer: PHP Medicare Advantage |
$178.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.68
|
| Rate for Payer: Priority Health Medicare |
$178.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.42
|
| Rate for Payer: Railroad Medicare Medicare |
$178.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.81
|
| Rate for Payer: UHC Core |
$594.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.07
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
| Rate for Payer: VA VA |
$178.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$534.21
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,354.99
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,219.49 |
| Rate for Payer: Aetna Commercial |
$1,151.74
|
| Rate for Payer: Aetna Medicare |
$352.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$423.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$423.43
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$338.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,053.50
|
| Rate for Payer: BCN Commercial |
$1,053.50
|
| Rate for Payer: BCN Medicare Advantage |
$338.75
|
| Rate for Payer: Cash Price |
$1,083.99
|
| Rate for Payer: Cash Price |
$1,083.99
|
| Rate for Payer: Cofinity Commercial |
$1,165.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,083.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.75
|
| Rate for Payer: Healthscope Commercial |
$1,219.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,016.24
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$355.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$389.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,151.74
|
| Rate for Payer: PACE Senior Care Partners |
$321.81
|
| Rate for Payer: PACE SWMI |
$338.75
|
| Rate for Payer: PHP Commercial |
$1,151.74
|
| Rate for Payer: PHP Medicare Advantage |
$338.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$948.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.84
|
| Rate for Payer: Priority Health Medicare |
$338.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.41
|
| Rate for Payer: Railroad Medicare Medicare |
$338.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,192.39
|
| Rate for Payer: UHC Core |
$1,131.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.75
|
| Rate for Payer: UHC Medicare Advantage |
$348.91
|
| Rate for Payer: VA VA |
$338.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,016.24
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,354.99
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$826.41 |
| Max. Negotiated Rate |
$1,219.49 |
| Rate for Payer: Aetna Commercial |
$1,151.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,047.14
|
| Rate for Payer: BCN Commercial |
$1,047.14
|
| Rate for Payer: Cash Price |
$1,083.99
|
| Rate for Payer: Cofinity Commercial |
$1,165.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,083.99
|
| Rate for Payer: Healthscope Commercial |
$1,219.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,016.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,151.74
|
| Rate for Payer: PHP Commercial |
$1,151.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$948.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,192.39
|
| Rate for Payer: UHC Core |
$1,131.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,016.24
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$414.24
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$252.64 |
| Max. Negotiated Rate |
$372.82 |
| Rate for Payer: Aetna Commercial |
$352.10
|
| Rate for Payer: BCBS Trust/PPO |
$320.12
|
| Rate for Payer: BCN Commercial |
$320.12
|
| Rate for Payer: Cash Price |
$331.39
|
| Rate for Payer: Cofinity Commercial |
$356.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.39
|
| Rate for Payer: Healthscope Commercial |
$372.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.10
|
| Rate for Payer: PHP Commercial |
$352.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.53
|
| Rate for Payer: UHC Core |
$345.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.68
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$414.24
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$98.38 |
| Max. Negotiated Rate |
$372.82 |
| Rate for Payer: Aetna Commercial |
$352.10
|
| Rate for Payer: Aetna Medicare |
$107.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.45
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$103.56
|
| Rate for Payer: BCBS Trust/PPO |
$322.07
|
| Rate for Payer: BCN Commercial |
$322.07
|
| Rate for Payer: BCN Medicare Advantage |
$103.56
|
| Rate for Payer: Cash Price |
$331.39
|
| Rate for Payer: Cash Price |
$331.39
|
| Rate for Payer: Cofinity Commercial |
$356.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.56
|
| Rate for Payer: Healthscope Commercial |
$372.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.68
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.10
|
| Rate for Payer: PACE Senior Care Partners |
$98.38
|
| Rate for Payer: PACE SWMI |
$103.56
|
| Rate for Payer: PHP Commercial |
$352.10
|
| Rate for Payer: PHP Medicare Advantage |
$103.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.39
|
| Rate for Payer: Priority Health Medicare |
$103.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.64
|
| Rate for Payer: Railroad Medicare Medicare |
$103.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.53
|
| Rate for Payer: UHC Core |
$345.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.56
|
| Rate for Payer: UHC Medicare Advantage |
$106.67
|
| Rate for Payer: VA VA |
$103.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.68
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$60.34
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.33 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.86
|
| Rate for Payer: BCBS Complete |
$24.14
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$46.91
|
| Rate for Payer: BCN Commercial |
$46.91
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.29
|
| Rate for Payer: PACE Senior Care Partners |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.50
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.54
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$60.34
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: BCBS Trust/PPO |
$46.63
|
| Rate for Payer: BCN Commercial |
$46.63
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.29
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$400.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$244.00 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: BCBS Trust/PPO |
$309.17
|
| Rate for Payer: BCN Commercial |
$309.17
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.06
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.06
|
| Rate for Payer: UHC Core |
$334.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$400.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$95.02 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna Medicare |
$104.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.02
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$100.02
|
| Rate for Payer: BCBS Trust/PPO |
$311.05
|
| Rate for Payer: BCN Commercial |
$311.05
|
| Rate for Payer: BCN Medicare Advantage |
$100.02
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.02
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.06
|
| Rate for Payer: PACE Senior Care Partners |
$95.02
|
| Rate for Payer: PACE SWMI |
$100.02
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: PHP Medicare Advantage |
$100.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.06
|
| Rate for Payer: Priority Health Medicare |
$100.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.00
|
| Rate for Payer: Railroad Medicare Medicare |
$100.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.06
|
| Rate for Payer: UHC Core |
$334.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.02
|
| Rate for Payer: UHC Medicare Advantage |
$103.02
|
| Rate for Payer: VA VA |
$100.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$205.97
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$125.62 |
| Max. Negotiated Rate |
$185.37 |
| Rate for Payer: Aetna Commercial |
$175.07
|
| Rate for Payer: BCBS Trust/PPO |
$159.17
|
| Rate for Payer: BCN Commercial |
$159.17
|
| Rate for Payer: Cash Price |
$164.78
|
| Rate for Payer: Cofinity Commercial |
$177.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.78
|
| Rate for Payer: Healthscope Commercial |
$185.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.07
|
| Rate for Payer: PHP Commercial |
$175.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.25
|
| Rate for Payer: UHC Core |
$171.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.48
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$205.97
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.92 |
| Max. Negotiated Rate |
$185.37 |
| Rate for Payer: Aetna Commercial |
$175.07
|
| Rate for Payer: Aetna Medicare |
$53.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.37
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$51.49
|
| Rate for Payer: BCBS Trust/PPO |
$160.14
|
| Rate for Payer: BCN Commercial |
$160.14
|
| Rate for Payer: BCN Medicare Advantage |
$51.49
|
| Rate for Payer: Cash Price |
$164.78
|
| Rate for Payer: Cash Price |
$164.78
|
| Rate for Payer: Cofinity Commercial |
$177.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.49
|
| Rate for Payer: Healthscope Commercial |
$185.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.48
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.07
|
| Rate for Payer: PACE Senior Care Partners |
$48.92
|
| Rate for Payer: PACE SWMI |
$51.49
|
| Rate for Payer: PHP Commercial |
$175.07
|
| Rate for Payer: PHP Medicare Advantage |
$51.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.19
|
| Rate for Payer: Priority Health Medicare |
$51.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.62
|
| Rate for Payer: Railroad Medicare Medicare |
$51.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.25
|
| Rate for Payer: UHC Core |
$171.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.49
|
| Rate for Payer: UHC Medicare Advantage |
$53.04
|
| Rate for Payer: VA VA |
$51.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.48
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$233.47
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$142.39 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$198.45
|
| Rate for Payer: BCBS Trust/PPO |
$180.43
|
| Rate for Payer: BCN Commercial |
$180.43
|
| Rate for Payer: Cash Price |
$186.78
|
| Rate for Payer: Cofinity Commercial |
$200.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.78
|
| Rate for Payer: Healthscope Commercial |
$210.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$198.45
|
| Rate for Payer: PHP Commercial |
$198.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.45
|
| Rate for Payer: UHC Core |
$194.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.10
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$233.47
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$55.45 |
| Max. Negotiated Rate |
$210.12 |
| Rate for Payer: Aetna Commercial |
$198.45
|
| Rate for Payer: Aetna Medicare |
$60.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.96
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$181.52
|
| Rate for Payer: BCN Commercial |
$181.52
|
| Rate for Payer: BCN Medicare Advantage |
$58.37
|
| Rate for Payer: Cash Price |
$186.78
|
| Rate for Payer: Cash Price |
$186.78
|
| Rate for Payer: Cofinity Commercial |
$200.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.37
|
| Rate for Payer: Healthscope Commercial |
$210.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.10
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$198.45
|
| Rate for Payer: PACE Senior Care Partners |
$55.45
|
| Rate for Payer: PACE SWMI |
$58.37
|
| Rate for Payer: PHP Commercial |
$198.45
|
| Rate for Payer: PHP Medicare Advantage |
$58.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.12
|
| Rate for Payer: Priority Health Medicare |
$58.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.39
|
| Rate for Payer: Railroad Medicare Medicare |
$58.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.45
|
| Rate for Payer: UHC Core |
$194.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.37
|
| Rate for Payer: UHC Medicare Advantage |
$60.12
|
| Rate for Payer: VA VA |
$58.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.10
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$950.54
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$176.18 |
| Max. Negotiated Rate |
$855.49 |
| Rate for Payer: Aetna Commercial |
$807.96
|
| Rate for Payer: Aetna Medicare |
$247.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.04
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$237.64
|
| Rate for Payer: BCBS Trust/PPO |
$739.04
|
| Rate for Payer: BCN Commercial |
$739.04
|
| Rate for Payer: BCN Medicare Advantage |
$237.64
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Commercial |
$817.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.64
|
| Rate for Payer: Healthscope Commercial |
$855.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.90
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$807.96
|
| Rate for Payer: PACE Senior Care Partners |
$225.75
|
| Rate for Payer: PACE SWMI |
$237.64
|
| Rate for Payer: PHP Commercial |
$807.96
|
| Rate for Payer: PHP Medicare Advantage |
$237.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$826.97
|
| Rate for Payer: Priority Health Medicare |
$237.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.73
|
| Rate for Payer: Railroad Medicare Medicare |
$237.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.48
|
| Rate for Payer: UHC Core |
$793.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.64
|
| Rate for Payer: UHC Medicare Advantage |
$244.76
|
| Rate for Payer: VA VA |
$237.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.90
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$950.54
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$579.73 |
| Max. Negotiated Rate |
$855.49 |
| Rate for Payer: Aetna Commercial |
$807.96
|
| Rate for Payer: BCBS Trust/PPO |
$734.58
|
| Rate for Payer: BCN Commercial |
$734.58
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Commercial |
$817.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Healthscope Commercial |
$855.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$807.96
|
| Rate for Payer: PHP Commercial |
$807.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$826.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.48
|
| Rate for Payer: UHC Core |
$793.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.90
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$302.65
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$184.59 |
| Max. Negotiated Rate |
$272.38 |
| Rate for Payer: Aetna Commercial |
$257.25
|
| Rate for Payer: BCBS Trust/PPO |
$233.89
|
| Rate for Payer: BCN Commercial |
$233.89
|
| Rate for Payer: Cash Price |
$242.12
|
| Rate for Payer: Cofinity Commercial |
$260.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.12
|
| Rate for Payer: Healthscope Commercial |
$272.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.25
|
| Rate for Payer: PHP Commercial |
$257.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.33
|
| Rate for Payer: UHC Core |
$252.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.99
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$302.65
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$71.88 |
| Max. Negotiated Rate |
$272.38 |
| Rate for Payer: Aetna Commercial |
$257.25
|
| Rate for Payer: Aetna Medicare |
$78.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.58
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$75.66
|
| Rate for Payer: BCBS Trust/PPO |
$235.31
|
| Rate for Payer: BCN Commercial |
$235.31
|
| Rate for Payer: BCN Medicare Advantage |
$75.66
|
| Rate for Payer: Cash Price |
$242.12
|
| Rate for Payer: Cash Price |
$242.12
|
| Rate for Payer: Cofinity Commercial |
$260.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.66
|
| Rate for Payer: Healthscope Commercial |
$272.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.99
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.25
|
| Rate for Payer: PACE Senior Care Partners |
$71.88
|
| Rate for Payer: PACE SWMI |
$75.66
|
| Rate for Payer: PHP Commercial |
$257.25
|
| Rate for Payer: PHP Medicare Advantage |
$75.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.31
|
| Rate for Payer: Priority Health Medicare |
$75.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.59
|
| Rate for Payer: Railroad Medicare Medicare |
$75.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.33
|
| Rate for Payer: UHC Core |
$252.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.66
|
| Rate for Payer: UHC Medicare Advantage |
$77.93
|
| Rate for Payer: VA VA |
$75.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.99
|
|
