|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
IP
|
$1,774.80
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,082.45 |
| Max. Negotiated Rate |
$1,597.32 |
| Rate for Payer: Aetna Commercial |
$1,508.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,371.57
|
| Rate for Payer: BCN Commercial |
$1,371.57
|
| 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: Healthscope Commercial |
$1,597.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,331.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,508.58
|
| Rate for Payer: PHP Commercial |
$1,508.58
|
| 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 Narrow/Tiered Network |
$1,082.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,561.82
|
| Rate for Payer: UHC Core |
$1,481.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,331.10
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.36 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.10
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.52
|
| Rate for Payer: BCN Commercial |
$256.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$78.36
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.96
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.22 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.97
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
OP
|
$329.90
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.35 |
| Max. Negotiated Rate |
$296.91 |
| Rate for Payer: Aetna Commercial |
$280.42
|
| Rate for Payer: Aetna Medicare |
$85.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.09
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.50
|
| Rate for Payer: BCN Commercial |
$256.50
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.92
|
| Rate for Payer: Cash Price |
$263.92
|
| Rate for Payer: Cofinity Commercial |
$283.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.42
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.42
|
| Rate for Payer: PACE Senior Care Partners |
$78.35
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.42
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.01
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.21
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.31
|
| Rate for Payer: UHC Core |
$275.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.95
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.42
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
IP
|
$329.90
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.21 |
| Max. Negotiated Rate |
$296.91 |
| Rate for Payer: Aetna Commercial |
$280.42
|
| Rate for Payer: BCBS Trust/PPO |
$254.95
|
| Rate for Payer: BCN Commercial |
$254.95
|
| Rate for Payer: Cash Price |
$263.92
|
| Rate for Payer: Cofinity Commercial |
$283.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.92
|
| Rate for Payer: Healthscope Commercial |
$296.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.42
|
| Rate for Payer: PHP Commercial |
$280.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.31
|
| Rate for Payer: UHC Core |
$275.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.42
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
IP
|
$2,073.75
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,264.78 |
| Max. Negotiated Rate |
$1,866.38 |
| Rate for Payer: Aetna Commercial |
$1,762.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,602.59
|
| Rate for Payer: BCN Commercial |
$1,602.59
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cofinity Commercial |
$1,783.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.00
|
| Rate for Payer: Healthscope Commercial |
$1,866.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,762.69
|
| Rate for Payer: PHP Commercial |
$1,762.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,451.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,804.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,264.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.90
|
| Rate for Payer: UHC Core |
$1,731.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.31
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
OP
|
$2,073.75
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$492.52 |
| Max. Negotiated Rate |
$1,866.38 |
| Rate for Payer: Aetna Commercial |
$1,762.69
|
| Rate for Payer: Aetna Medicare |
$539.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.05
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$518.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.34
|
| Rate for Payer: BCN Commercial |
$1,612.34
|
| Rate for Payer: BCN Medicare Advantage |
$518.44
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cofinity Commercial |
$1,783.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.44
|
| Rate for Payer: Healthscope Commercial |
$1,866.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.31
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$544.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,762.69
|
| Rate for Payer: PACE Senior Care Partners |
$492.52
|
| Rate for Payer: PACE SWMI |
$518.44
|
| Rate for Payer: PHP Commercial |
$1,762.69
|
| Rate for Payer: PHP Medicare Advantage |
$518.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,451.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,804.16
|
| Rate for Payer: Priority Health Medicare |
$518.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,264.78
|
| Rate for Payer: Railroad Medicare Medicare |
$518.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.90
|
| Rate for Payer: UHC Core |
$1,731.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.44
|
| Rate for Payer: UHC Medicare Advantage |
$533.99
|
| Rate for Payer: VA VA |
$518.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.31
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
OP
|
$358.02
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.03 |
| Max. Negotiated Rate |
$322.22 |
| Rate for Payer: Aetna Commercial |
$304.32
|
| Rate for Payer: Aetna Medicare |
$93.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.88
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$89.50
|
| Rate for Payer: BCBS Trust/PPO |
$278.36
|
| Rate for Payer: BCN Commercial |
$278.36
|
| Rate for Payer: BCN Medicare Advantage |
$89.50
|
| Rate for Payer: Cash Price |
$286.42
|
| Rate for Payer: Cash Price |
$286.42
|
| Rate for Payer: Cofinity Commercial |
$307.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.50
|
| Rate for Payer: Healthscope Commercial |
$322.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.52
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.32
|
| Rate for Payer: PACE Senior Care Partners |
$85.03
|
| Rate for Payer: PACE SWMI |
$89.50
|
| Rate for Payer: PHP Commercial |
$304.32
|
| Rate for Payer: PHP Medicare Advantage |
$89.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.48
|
| Rate for Payer: Priority Health Medicare |
$89.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.36
|
| Rate for Payer: Railroad Medicare Medicare |
$89.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.06
|
| Rate for Payer: UHC Core |
$298.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.50
|
| Rate for Payer: UHC Medicare Advantage |
$92.19
|
| Rate for Payer: VA VA |
$89.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.52
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
IP
|
$358.02
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.36 |
| Max. Negotiated Rate |
$322.22 |
| Rate for Payer: Aetna Commercial |
$304.32
|
| Rate for Payer: BCBS Trust/PPO |
$276.68
|
| Rate for Payer: BCN Commercial |
$276.68
|
| Rate for Payer: Cash Price |
$286.42
|
| Rate for Payer: Cofinity Commercial |
$307.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.42
|
| Rate for Payer: Healthscope Commercial |
$322.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.32
|
| Rate for Payer: PHP Commercial |
$304.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.06
|
| Rate for Payer: UHC Core |
$298.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.52
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.22 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.97
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.36 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.10
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.52
|
| Rate for Payer: BCN Commercial |
$256.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$78.36
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.96
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.22 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.97
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.36 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.10
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.52
|
| Rate for Payer: BCN Commercial |
$256.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$78.36
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.96
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.22 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.97
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.36 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.10
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.52
|
| Rate for Payer: BCN Commercial |
$256.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$78.36
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.96
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.22 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.97
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.36 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.10
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.52
|
| Rate for Payer: BCN Commercial |
$256.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$78.36
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.96
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.22 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.97
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.36 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$85.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.10
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.48
|
| Rate for Payer: BCBS Trust/PPO |
$256.52
|
| Rate for Payer: BCN Commercial |
$256.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.48
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.48
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$78.36
|
| Rate for Payer: PACE SWMI |
$82.48
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$82.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.04
|
| Rate for Payer: Priority Health Medicare |
$82.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.22
|
| Rate for Payer: Railroad Medicare Medicare |
$82.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.34
|
| Rate for Payer: UHC Core |
$275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.48
|
| Rate for Payer: UHC Medicare Advantage |
$84.96
|
| Rate for Payer: VA VA |
$82.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
IP
|
$2,950.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,799.20 |
| Max. Negotiated Rate |
$2,655.00 |
| Rate for Payer: Aetna Commercial |
$2,507.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,279.76
|
| Rate for Payer: BCN Commercial |
$2,279.76
|
| Rate for Payer: Cash Price |
$2,360.00
|
| Rate for Payer: Cofinity Commercial |
$2,537.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.00
|
| Rate for Payer: Healthscope Commercial |
$2,655.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,212.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,507.50
|
| Rate for Payer: PHP Commercial |
$2,507.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,566.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,799.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,596.00
|
| Rate for Payer: UHC Core |
$2,463.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,212.50
|
|
|
HC CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
OP
|
$2,950.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.62 |
| Max. Negotiated Rate |
$2,655.00 |
| Rate for Payer: Aetna Commercial |
$2,507.50
|
| Rate for Payer: Aetna Medicare |
$767.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$921.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$921.88
|
| Rate for Payer: BCBS Complete |
$1,050.44
|
| Rate for Payer: BCBS MAPPO |
$737.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,293.62
|
| Rate for Payer: BCN Commercial |
$2,293.62
|
| Rate for Payer: BCN Medicare Advantage |
$737.50
|
| Rate for Payer: Cash Price |
$2,360.00
|
| Rate for Payer: Cash Price |
$2,360.00
|
| Rate for Payer: Cofinity Commercial |
$2,537.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.50
|
| Rate for Payer: Healthscope Commercial |
$2,655.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,212.50
|
| Rate for Payer: Mclaren Medicaid |
$1,000.42
|
| Rate for Payer: Meridian Medicaid |
$1,050.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$774.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$848.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,507.50
|
| Rate for Payer: PACE Senior Care Partners |
$700.62
|
| Rate for Payer: PACE SWMI |
$737.50
|
| Rate for Payer: PHP Commercial |
$2,507.50
|
| Rate for Payer: PHP Medicare Advantage |
$737.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,566.50
|
| Rate for Payer: Priority Health Medicare |
$737.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,799.20
|
| Rate for Payer: Railroad Medicare Medicare |
$737.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,596.00
|
| Rate for Payer: UHC Core |
$2,463.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$737.50
|
| Rate for Payer: UHC Medicare Advantage |
$759.62
|
| Rate for Payer: VA VA |
$737.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,212.50
|
|
|
HC CLOSED TX POST MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$315.48
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
76100302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.93 |
| Max. Negotiated Rate |
$283.93 |
| Rate for Payer: Aetna Commercial |
$268.16
|
| Rate for Payer: Aetna Medicare |
$82.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.59
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$78.87
|
| Rate for Payer: BCBS Trust/PPO |
$245.29
|
| Rate for Payer: BCN Commercial |
$245.29
|
| Rate for Payer: BCN Medicare Advantage |
$78.87
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$271.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.87
|
| Rate for Payer: Healthscope Commercial |
$283.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.61
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: PACE Senior Care Partners |
$74.93
|
| Rate for Payer: PACE SWMI |
$78.87
|
| Rate for Payer: PHP Commercial |
$268.16
|
| Rate for Payer: PHP Medicare Advantage |
$78.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.47
|
| Rate for Payer: Priority Health Medicare |
$78.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.41
|
| Rate for Payer: Railroad Medicare Medicare |
$78.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.62
|
| Rate for Payer: UHC Core |
$263.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.87
|
| Rate for Payer: UHC Medicare Advantage |
$81.24
|
| Rate for Payer: VA VA |
$78.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.61
|
|
|
HC CLOSED TX POST MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$315.48
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
76100302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$283.93 |
| Rate for Payer: Aetna Commercial |
$268.16
|
| Rate for Payer: BCBS Trust/PPO |
$243.80
|
| Rate for Payer: BCN Commercial |
$243.80
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$271.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Healthscope Commercial |
$283.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: PHP Commercial |
$268.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.62
|
| Rate for Payer: UHC Core |
$263.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.61
|
|
|
HC CLOSED TX PROX FIBULA/SHFT FX W/O MANJ
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
76100351
|
|
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 TX PROX FIBULA/SHFT FX W/O MANJ
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
76100351
|
|
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
|
|
