|
HC CLOSED RX NAVICULAR FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
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 NAVICULAR FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
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 PATELLA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
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 PATELLA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
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 POST HIP ARTHRPLAS DISLOC
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$379.76 |
| Max. Negotiated Rate |
$560.39 |
| Rate for Payer: Aetna Commercial |
$529.26
|
| Rate for Payer: BCBS Trust/PPO |
$481.19
|
| Rate for Payer: BCN Commercial |
$481.19
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cofinity Commercial |
$535.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.13
|
| Rate for Payer: Healthscope Commercial |
$560.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
| Rate for Payer: PHP Commercial |
$529.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.94
|
| Rate for Payer: UHC Core |
$519.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.88 |
| Max. Negotiated Rate |
$560.39 |
| Rate for Payer: Aetna Commercial |
$529.26
|
| Rate for Payer: Aetna Medicare |
$161.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$194.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$194.58
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$155.66
|
| Rate for Payer: BCBS Trust/PPO |
$484.12
|
| Rate for Payer: BCN Commercial |
$484.12
|
| Rate for Payer: BCN Medicare Advantage |
$155.66
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cofinity Commercial |
$535.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.66
|
| Rate for Payer: Healthscope Commercial |
$560.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$163.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
| Rate for Payer: PACE Senior Care Partners |
$147.88
|
| Rate for Payer: PACE SWMI |
$155.66
|
| Rate for Payer: PHP Commercial |
$529.26
|
| Rate for Payer: PHP Medicare Advantage |
$155.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.71
|
| Rate for Payer: Priority Health Medicare |
$155.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.76
|
| Rate for Payer: Railroad Medicare Medicare |
$155.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.94
|
| Rate for Payer: UHC Core |
$519.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.66
|
| Rate for Payer: UHC Medicare Advantage |
$160.33
|
| Rate for Payer: VA VA |
$155.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
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 PROX HUMERUS FRACTURE
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
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 PROX THIGH FX
|
Facility
|
IP
|
$609.96
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.01 |
| Max. Negotiated Rate |
$548.96 |
| Rate for Payer: Aetna Commercial |
$518.47
|
| Rate for Payer: BCBS Trust/PPO |
$471.38
|
| Rate for Payer: BCN Commercial |
$471.38
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cofinity Commercial |
$524.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.97
|
| Rate for Payer: Healthscope Commercial |
$548.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
| Rate for Payer: PHP Commercial |
$518.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.76
|
| Rate for Payer: UHC Core |
$509.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.47
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
OP
|
$609.96
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.87 |
| Max. Negotiated Rate |
$548.96 |
| Rate for Payer: Aetna Commercial |
$518.47
|
| Rate for Payer: Aetna Medicare |
$158.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.61
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$152.49
|
| Rate for Payer: BCBS Trust/PPO |
$474.24
|
| Rate for Payer: BCN Commercial |
$474.24
|
| Rate for Payer: BCN Medicare Advantage |
$152.49
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cofinity Commercial |
$524.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.49
|
| Rate for Payer: Healthscope Commercial |
$548.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.47
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
| Rate for Payer: PACE Senior Care Partners |
$144.87
|
| Rate for Payer: PACE SWMI |
$152.49
|
| Rate for Payer: PHP Commercial |
$518.47
|
| Rate for Payer: PHP Medicare Advantage |
$152.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.67
|
| Rate for Payer: Priority Health Medicare |
$152.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.01
|
| Rate for Payer: Railroad Medicare Medicare |
$152.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.76
|
| Rate for Payer: UHC Core |
$509.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.49
|
| Rate for Payer: UHC Medicare Advantage |
$157.06
|
| Rate for Payer: VA VA |
$152.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.47
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
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 RADIAL HEAD/NECK FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
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 RAD/ULNA SHAFT FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
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 RAD/ULNA SHAFT FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
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 TIBIAL PLATEAU FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
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 TIBIAL PLATEAU FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
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 TIBIA SHAFT FX
|
Facility
|
OP
|
$378.83
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.97 |
| Max. Negotiated Rate |
$340.95 |
| Rate for Payer: Aetna Commercial |
$322.01
|
| Rate for Payer: Aetna Medicare |
$98.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.38
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$294.54
|
| Rate for Payer: BCN Commercial |
$294.54
|
| Rate for Payer: BCN Medicare Advantage |
$94.71
|
| Rate for Payer: Cash Price |
$303.06
|
| Rate for Payer: Cash Price |
$303.06
|
| Rate for Payer: Cofinity Commercial |
$325.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.71
|
| Rate for Payer: Healthscope Commercial |
$340.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.12
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$322.01
|
| Rate for Payer: PACE Senior Care Partners |
$89.97
|
| Rate for Payer: PACE SWMI |
$94.71
|
| Rate for Payer: PHP Commercial |
$322.01
|
| Rate for Payer: PHP Medicare Advantage |
$94.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.58
|
| Rate for Payer: Priority Health Medicare |
$94.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.05
|
| Rate for Payer: Railroad Medicare Medicare |
$94.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.37
|
| Rate for Payer: UHC Core |
$316.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.71
|
| Rate for Payer: UHC Medicare Advantage |
$97.55
|
| Rate for Payer: VA VA |
$94.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.12
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
IP
|
$378.83
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$231.05 |
| Max. Negotiated Rate |
$340.95 |
| Rate for Payer: Aetna Commercial |
$322.01
|
| Rate for Payer: BCBS Trust/PPO |
$292.76
|
| Rate for Payer: BCN Commercial |
$292.76
|
| Rate for Payer: Cash Price |
$303.06
|
| Rate for Payer: Cofinity Commercial |
$325.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.06
|
| Rate for Payer: Healthscope Commercial |
$340.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$322.01
|
| Rate for Payer: PHP Commercial |
$322.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.37
|
| Rate for Payer: UHC Core |
$316.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.12
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
OP
|
$622.20
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.77 |
| Max. Negotiated Rate |
$559.98 |
| Rate for Payer: Aetna Commercial |
$528.87
|
| Rate for Payer: Aetna Medicare |
$161.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$194.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$194.44
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$155.55
|
| Rate for Payer: BCBS Trust/PPO |
$483.76
|
| Rate for Payer: BCN Commercial |
$483.76
|
| Rate for Payer: BCN Medicare Advantage |
$155.55
|
| Rate for Payer: Cash Price |
$497.76
|
| Rate for Payer: Cash Price |
$497.76
|
| Rate for Payer: Cofinity Commercial |
$535.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.55
|
| Rate for Payer: Healthscope Commercial |
$559.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$466.65
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$163.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$528.87
|
| Rate for Payer: PACE Senior Care Partners |
$147.77
|
| Rate for Payer: PACE SWMI |
$155.55
|
| Rate for Payer: PHP Commercial |
$528.87
|
| Rate for Payer: PHP Medicare Advantage |
$155.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.31
|
| Rate for Payer: Priority Health Medicare |
$155.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.48
|
| Rate for Payer: Railroad Medicare Medicare |
$155.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.54
|
| Rate for Payer: UHC Core |
$519.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.55
|
| Rate for Payer: UHC Medicare Advantage |
$160.22
|
| Rate for Payer: VA VA |
$155.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$466.65
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
IP
|
$622.20
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$379.48 |
| Max. Negotiated Rate |
$559.98 |
| Rate for Payer: Aetna Commercial |
$528.87
|
| Rate for Payer: BCBS Trust/PPO |
$480.84
|
| Rate for Payer: BCN Commercial |
$480.84
|
| Rate for Payer: Cash Price |
$497.76
|
| Rate for Payer: Cofinity Commercial |
$535.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.76
|
| Rate for Payer: Healthscope Commercial |
$559.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$466.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$528.87
|
| Rate for Payer: PHP Commercial |
$528.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.54
|
| Rate for Payer: UHC Core |
$519.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$466.65
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
OP
|
$374.34
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.91 |
| Max. Negotiated Rate |
$336.91 |
| Rate for Payer: Aetna Commercial |
$318.19
|
| Rate for Payer: Aetna Medicare |
$97.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.98
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$93.58
|
| Rate for Payer: BCBS Trust/PPO |
$291.05
|
| Rate for Payer: BCN Commercial |
$291.05
|
| Rate for Payer: BCN Medicare Advantage |
$93.58
|
| Rate for Payer: Cash Price |
$299.47
|
| Rate for Payer: Cash Price |
$299.47
|
| Rate for Payer: Cofinity Commercial |
$321.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.58
|
| Rate for Payer: Healthscope Commercial |
$336.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.76
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.19
|
| Rate for Payer: PACE Senior Care Partners |
$88.91
|
| Rate for Payer: PACE SWMI |
$93.58
|
| Rate for Payer: PHP Commercial |
$318.19
|
| Rate for Payer: PHP Medicare Advantage |
$93.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.68
|
| Rate for Payer: Priority Health Medicare |
$93.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.31
|
| Rate for Payer: Railroad Medicare Medicare |
$93.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.42
|
| Rate for Payer: UHC Core |
$312.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.58
|
| Rate for Payer: UHC Medicare Advantage |
$96.39
|
| Rate for Payer: VA VA |
$93.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.76
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
IP
|
$374.34
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.31 |
| Max. Negotiated Rate |
$336.91 |
| Rate for Payer: Aetna Commercial |
$318.19
|
| Rate for Payer: BCBS Trust/PPO |
$289.29
|
| Rate for Payer: BCN Commercial |
$289.29
|
| Rate for Payer: Cash Price |
$299.47
|
| Rate for Payer: Cofinity Commercial |
$321.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.47
|
| Rate for Payer: Healthscope Commercial |
$336.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.19
|
| Rate for Payer: PHP Commercial |
$318.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.42
|
| Rate for Payer: UHC Core |
$312.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.76
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
OP
|
$613.92
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.81 |
| Max. Negotiated Rate |
$552.53 |
| Rate for Payer: Aetna Commercial |
$521.83
|
| Rate for Payer: Aetna Medicare |
$159.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.85
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$153.48
|
| Rate for Payer: BCBS Trust/PPO |
$477.32
|
| Rate for Payer: BCN Commercial |
$477.32
|
| Rate for Payer: BCN Medicare Advantage |
$153.48
|
| Rate for Payer: Cash Price |
$491.14
|
| Rate for Payer: Cash Price |
$491.14
|
| Rate for Payer: Cofinity Commercial |
$527.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.48
|
| Rate for Payer: Healthscope Commercial |
$552.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.44
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.83
|
| Rate for Payer: PACE Senior Care Partners |
$145.81
|
| Rate for Payer: PACE SWMI |
$153.48
|
| Rate for Payer: PHP Commercial |
$521.83
|
| Rate for Payer: PHP Medicare Advantage |
$153.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.11
|
| Rate for Payer: Priority Health Medicare |
$153.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.43
|
| Rate for Payer: Railroad Medicare Medicare |
$153.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.25
|
| Rate for Payer: UHC Core |
$512.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.48
|
| Rate for Payer: UHC Medicare Advantage |
$158.08
|
| Rate for Payer: VA VA |
$153.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.44
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
IP
|
$613.92
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$374.43 |
| Max. Negotiated Rate |
$552.53 |
| Rate for Payer: Aetna Commercial |
$521.83
|
| Rate for Payer: BCBS Trust/PPO |
$474.44
|
| Rate for Payer: BCN Commercial |
$474.44
|
| Rate for Payer: Cash Price |
$491.14
|
| Rate for Payer: Cofinity Commercial |
$527.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.14
|
| Rate for Payer: Healthscope Commercial |
$552.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.83
|
| Rate for Payer: PHP Commercial |
$521.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.25
|
| Rate for Payer: UHC Core |
$512.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.44
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
OP
|
$1,774.80
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$421.52 |
| Max. Negotiated Rate |
$1,597.32 |
| Rate for Payer: Aetna Commercial |
$1,508.58
|
| Rate for Payer: Aetna Medicare |
$461.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$554.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$554.62
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$443.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.91
|
| Rate for Payer: BCN Commercial |
$1,379.91
|
| Rate for Payer: BCN Medicare Advantage |
$443.70
|
| Rate for Payer: Cash Price |
$1,419.84
|
| Rate for Payer: Cash Price |
$1,419.84
|
| Rate for Payer: Cofinity Commercial |
$1,526.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,419.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.70
|
| Rate for Payer: Healthscope Commercial |
$1,597.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,331.10
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$465.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$510.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,508.58
|
| Rate for Payer: PACE Senior Care Partners |
$421.52
|
| Rate for Payer: PACE SWMI |
$443.70
|
| Rate for Payer: PHP Commercial |
$1,508.58
|
| Rate for Payer: PHP Medicare Advantage |
$443.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.08
|
| Rate for Payer: Priority Health Medicare |
$443.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,082.45
|
| Rate for Payer: Railroad Medicare Medicare |
$443.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,561.82
|
| Rate for Payer: UHC Core |
$1,481.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.70
|
| Rate for Payer: UHC Medicare Advantage |
$457.01
|
| Rate for Payer: VA VA |
$443.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,331.10
|
|
