|
HC CLOSED TX PROX/MID PHALANX FX W/MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
76100232
|
|
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 PROX/MID PHALANX FX W/MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
76100232
|
|
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 RADIAL SHAFT FRACTURE W/O MANIP
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
76100352
|
|
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 RADIAL SHAFT FRACTURE W/O MANIP
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
76100352
|
|
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 TX SCAPULAR FX, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
76100273
|
|
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 SCAPULAR FX, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
76100273
|
|
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 SESAMOID FX
|
Facility
|
IP
|
$315.48
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
76100322
|
|
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 SESAMOID FX
|
Facility
|
OP
|
$315.48
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
76100322
|
|
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 SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MANIP
|
Facility
|
IP
|
$358.02
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
76100301
|
|
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 SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MANIP
|
Facility
|
OP
|
$358.02
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
76100301
|
|
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 SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
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 SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
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 TALUS FX; W/O MANIP
|
Facility
|
IP
|
$285.94
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$174.39 |
| Max. Negotiated Rate |
$257.35 |
| Rate for Payer: Aetna Commercial |
$243.05
|
| Rate for Payer: BCBS Trust/PPO |
$220.97
|
| Rate for Payer: BCN Commercial |
$220.97
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cofinity Commercial |
$245.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.75
|
| Rate for Payer: Healthscope Commercial |
$257.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.05
|
| Rate for Payer: PHP Commercial |
$243.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.63
|
| Rate for Payer: UHC Core |
$238.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.46
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
OP
|
$285.94
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$257.35 |
| Rate for Payer: Aetna Commercial |
$243.05
|
| Rate for Payer: Aetna Medicare |
$74.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.36
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$71.48
|
| Rate for Payer: BCBS Trust/PPO |
$222.32
|
| Rate for Payer: BCN Commercial |
$222.32
|
| Rate for Payer: BCN Medicare Advantage |
$71.48
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cofinity Commercial |
$245.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.48
|
| Rate for Payer: Healthscope Commercial |
$257.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.46
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.05
|
| Rate for Payer: PACE Senior Care Partners |
$67.91
|
| Rate for Payer: PACE SWMI |
$71.48
|
| Rate for Payer: PHP Commercial |
$243.05
|
| Rate for Payer: PHP Medicare Advantage |
$71.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.77
|
| Rate for Payer: Priority Health Medicare |
$71.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.39
|
| Rate for Payer: Railroad Medicare Medicare |
$71.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.63
|
| Rate for Payer: UHC Core |
$238.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.48
|
| Rate for Payer: UHC Medicare Advantage |
$73.63
|
| Rate for Payer: VA VA |
$71.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.46
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
IP
|
$610.45
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.31 |
| Max. Negotiated Rate |
$549.40 |
| Rate for Payer: Aetna Commercial |
$518.88
|
| Rate for Payer: BCBS Trust/PPO |
$471.76
|
| Rate for Payer: BCN Commercial |
$471.76
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cofinity Commercial |
$524.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.36
|
| Rate for Payer: Healthscope Commercial |
$549.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.88
|
| Rate for Payer: PHP Commercial |
$518.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.20
|
| Rate for Payer: UHC Core |
$509.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
OP
|
$610.45
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.98 |
| Max. Negotiated Rate |
$549.40 |
| Rate for Payer: Aetna Commercial |
$518.88
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.77
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$152.61
|
| Rate for Payer: BCBS Trust/PPO |
$474.62
|
| Rate for Payer: BCN Commercial |
$474.62
|
| Rate for Payer: BCN Medicare Advantage |
$152.61
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cofinity Commercial |
$524.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.61
|
| Rate for Payer: Healthscope Commercial |
$549.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.88
|
| Rate for Payer: PACE Senior Care Partners |
$144.98
|
| Rate for Payer: PACE SWMI |
$152.61
|
| Rate for Payer: PHP Commercial |
$518.88
|
| Rate for Payer: PHP Medicare Advantage |
$152.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.09
|
| Rate for Payer: Priority Health Medicare |
$152.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.31
|
| Rate for Payer: Railroad Medicare Medicare |
$152.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.20
|
| Rate for Payer: UHC Core |
$509.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.61
|
| Rate for Payer: UHC Medicare Advantage |
$157.19
|
| Rate for Payer: VA VA |
$152.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC CLOSED TX TOE FX WO MANIPULATION
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
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 TX TOE FX WO MANIPULATION
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
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 TX ULNAR FX PROX END
|
Facility
|
OP
|
$2,073.75
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
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 ULNAR FX PROX END
|
Facility
|
IP
|
$2,073.75
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
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 ULNAR FX, PROX END W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
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 ULNAR FX, PROX END W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
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 ULNAR SHAFT FX, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
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 ULNAR SHAFT FX, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
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 ULNAR STYLOID FX
|
Facility
|
IP
|
$315.48
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
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
|
|
