|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$632.18 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: Aetna Medicare |
$692.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$831.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$831.82
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$665.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,069.57
|
| Rate for Payer: BCN Commercial |
$2,069.57
|
| Rate for Payer: BCN Medicare Advantage |
$665.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,289.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.46
|
| Rate for Payer: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$698.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$765.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PACE Senior Care Partners |
$632.18
|
| Rate for Payer: PACE SWMI |
$665.46
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| Rate for Payer: PHP Medicare Advantage |
$665.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,315.78
|
| Rate for Payer: Priority Health Medicare |
$665.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,623.44
|
| Rate for Payer: Railroad Medicare Medicare |
$665.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.40
|
| Rate for Payer: UHC Core |
$2,222.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.46
|
| Rate for Payer: UHC Medicare Advantage |
$685.42
|
| Rate for Payer: VA VA |
$665.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,653.12 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.66
|
| Rate for Payer: BCN Commercial |
$2,094.66
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,358.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,653.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,385.22
|
| Rate for Payer: UHC Core |
$2,263.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$643.74 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna Medicare |
$704.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$847.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$847.02
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$677.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,107.40
|
| Rate for Payer: BCN Commercial |
$2,107.40
|
| Rate for Payer: BCN Medicare Advantage |
$677.62
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.62
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$711.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$779.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PACE Senior Care Partners |
$643.74
|
| Rate for Payer: PACE SWMI |
$677.62
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: PHP Medicare Advantage |
$677.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,358.12
|
| Rate for Payer: Priority Health Medicare |
$677.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,653.12
|
| Rate for Payer: Railroad Medicare Medicare |
$677.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,385.22
|
| Rate for Payer: UHC Core |
$2,263.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$677.62
|
| Rate for Payer: UHC Medicare Advantage |
$697.95
|
| Rate for Payer: VA VA |
$677.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CITRIC ACID URINE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$40.45
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.40
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CITRIC ACID URINE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.73 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CK-MB FRACTION
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$25.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.24
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$24.99
|
| Rate for Payer: BCBS Trust/PPO |
$77.72
|
| Rate for Payer: BCN Commercial |
$77.72
|
| Rate for Payer: BCN Medicare Advantage |
$24.99
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PACE Senior Care Partners |
$23.74
|
| Rate for Payer: PACE SWMI |
$24.99
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$24.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.97
|
| Rate for Payer: Priority Health Medicare |
$24.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.97
|
| Rate for Payer: Railroad Medicare Medicare |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.99
|
| Rate for Payer: UHC Medicare Advantage |
$25.74
|
| Rate for Payer: VA VA |
$24.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC CK-MB FRACTION
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.97 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: BCBS Trust/PPO |
$77.25
|
| Rate for Payer: BCN Commercial |
$77.25
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC CLADOSPORIUM IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
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 CLADOSPORIUM IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
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 CLAM IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
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 CLAM IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
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 CLIP FIX DEVICE ROTATABLE
|
Facility
|
IP
|
$775.77
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$473.14 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: BCBS Trust/PPO |
$599.52
|
| Rate for Payer: BCN Commercial |
$599.52
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$659.40
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.68
|
| Rate for Payer: UHC Core |
$647.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
OP
|
$775.77
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.25 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: Aetna Medicare |
$201.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.43
|
| Rate for Payer: BCBS Complete |
$310.31
|
| Rate for Payer: BCBS MAPPO |
$193.94
|
| Rate for Payer: BCBS Trust/PPO |
$603.16
|
| Rate for Payer: BCN Commercial |
$603.16
|
| Rate for Payer: BCN Medicare Advantage |
$193.94
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.94
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$203.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$659.40
|
| Rate for Payer: PACE Senior Care Partners |
$184.25
|
| Rate for Payer: PACE SWMI |
$193.94
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: PHP Medicare Advantage |
$193.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.92
|
| Rate for Payer: Priority Health Medicare |
$193.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.14
|
| Rate for Payer: Railroad Medicare Medicare |
$193.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.68
|
| Rate for Payer: UHC Core |
$647.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.94
|
| Rate for Payer: UHC Medicare Advantage |
$199.76
|
| Rate for Payer: VA VA |
$193.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC CLOSED RX CARPAL FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$89.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.62
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$86.10
|
| Rate for Payer: BCBS Trust/PPO |
$267.76
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$86.10
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Senior Care Partners |
$81.79
|
| Rate for Payer: PACE SWMI |
$86.10
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$86.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Medicare |
$86.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: Railroad Medicare Medicare |
$86.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.10
|
| Rate for Payer: UHC Medicare Advantage |
$88.68
|
| Rate for Payer: VA VA |
$86.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX CARPAL FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.04 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: BCBS Trust/PPO |
$266.14
|
| Rate for Payer: BCN Commercial |
$266.14
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
76100174
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$89.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.62
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$86.10
|
| Rate for Payer: BCBS Trust/PPO |
$267.76
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$86.10
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Senior Care Partners |
$81.79
|
| Rate for Payer: PACE SWMI |
$86.10
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$86.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Medicare |
$86.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: Railroad Medicare Medicare |
$86.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.10
|
| Rate for Payer: UHC Medicare Advantage |
$88.68
|
| Rate for Payer: VA VA |
$86.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
76100174
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.04 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: BCBS Trust/PPO |
$266.14
|
| Rate for Payer: BCN Commercial |
$266.14
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
76100163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$89.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.62
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$86.10
|
| Rate for Payer: BCBS Trust/PPO |
$267.76
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$86.10
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Senior Care Partners |
$81.79
|
| Rate for Payer: PACE SWMI |
$86.10
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$86.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Medicare |
$86.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: Railroad Medicare Medicare |
$86.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.10
|
| Rate for Payer: UHC Medicare Advantage |
$88.68
|
| Rate for Payer: VA VA |
$86.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
76100163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.04 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: BCBS Trust/PPO |
$266.14
|
| Rate for Payer: BCN Commercial |
$266.14
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
76100166
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$89.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.62
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$86.10
|
| Rate for Payer: BCBS Trust/PPO |
$267.76
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$86.10
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Senior Care Partners |
$81.79
|
| Rate for Payer: PACE SWMI |
$86.10
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$86.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Medicare |
$86.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: Railroad Medicare Medicare |
$86.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.10
|
| Rate for Payer: UHC Medicare Advantage |
$88.68
|
| Rate for Payer: VA VA |
$86.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
76100166
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.04 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: BCBS Trust/PPO |
$266.14
|
| Rate for Payer: BCN Commercial |
$266.14
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
IP
|
$413.27
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
76100167
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$252.05 |
| Max. Negotiated Rate |
$371.94 |
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: BCBS Trust/PPO |
$319.38
|
| Rate for Payer: BCN Commercial |
$319.38
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$355.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.62
|
| Rate for Payer: Healthscope Commercial |
$371.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
| Rate for Payer: PHP Commercial |
$351.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.68
|
| Rate for Payer: UHC Core |
$345.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.95
|
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
OP
|
$413.27
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
76100167
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.15 |
| Max. Negotiated Rate |
$371.94 |
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: Aetna Medicare |
$107.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.15
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$103.32
|
| Rate for Payer: BCBS Trust/PPO |
$321.32
|
| Rate for Payer: BCN Commercial |
$321.32
|
| Rate for Payer: BCN Medicare Advantage |
$103.32
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$355.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.32
|
| Rate for Payer: Healthscope Commercial |
$371.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
| Rate for Payer: PACE Senior Care Partners |
$98.15
|
| Rate for Payer: PACE SWMI |
$103.32
|
| Rate for Payer: PHP Commercial |
$351.28
|
| Rate for Payer: PHP Medicare Advantage |
$103.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.54
|
| Rate for Payer: Priority Health Medicare |
$103.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.05
|
| Rate for Payer: Railroad Medicare Medicare |
$103.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.68
|
| Rate for Payer: UHC Core |
$345.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.32
|
| Rate for Payer: UHC Medicare Advantage |
$106.42
|
| Rate for Payer: VA VA |
$103.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.95
|
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
76100175
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$89.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.62
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$86.10
|
| Rate for Payer: BCBS Trust/PPO |
$267.76
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$86.10
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Senior Care Partners |
$81.79
|
| Rate for Payer: PACE SWMI |
$86.10
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$86.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Medicare |
$86.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: Railroad Medicare Medicare |
$86.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.10
|
| Rate for Payer: UHC Medicare Advantage |
$88.68
|
| Rate for Payer: VA VA |
$86.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
76100175
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.04 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: BCBS Trust/PPO |
$266.14
|
| Rate for Payer: BCN Commercial |
$266.14
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.06
|
| Rate for Payer: UHC Core |
$287.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
